Sunday, January 20, 2013

Fibromyalgia / Depression / Anxiety

Breaking the Cycle

As a physical therapist with some forty years experience, I have treated thousands of patients with fibromyalgia. I am a certified specialist in arthritis through the American Physical Therapy Association. I am a former Tai Chi instructor through the Arthritis Foundation. I meditate regularly, and am considered an authority on diseases affecting the muscles, joints, and bones. This system is called the musculoskeletal system. My sub-specialty has been treating pain. Many years ago, I wrote the book called Stress Management: Does Anyone in Chicago Know About It?  I traveled America teaching the public stress management techniques.

Fibromyalgia is a medical condition where painful sensations are amplified by the way your brain and spinal cord process pain signals. The pain is real. The pain is magnified. The pain can be debilitating for many. One major problem with fibromyalgia is that you look perfectly healthy. Outsiders, or even family members may think you are 'faking' the problem. Symptoms may include issues with sleep, fatigue, memory, and mood. Other symptoms may include an increase in depression and anxiety, irritable bowel syndrome, tension headaches, and TMJ dysfunction. The common denominator is pain.  Healthcare practitioners can struggle to find the best modality for your treatment. This may include medications, physical therapy, psychological counseling, and/or alternative therapies such as yoga, meditation, massage therapy, or acupuncture.

The exact cause is uncertain. Cases have been reported following surgery, a physical trauma, infection, and/or psychological stress.  There is no cure for the disease! There are some 109 different types of arthritis. The Arthritis Foundation classifies fibromyalgia as a type of arthritis because of the painful joints involved. The pain can change in intensity and in location. Pain is universally classified between 'one' and 'ten'. The rating of a 'one' is no pain. The rating of a 'ten' is that you have to go to the hospital. Any number over a 'six' is considered serious pain. People with this disease typically have pain over a 'six' on almost any given day. One day the pain might be in the neck, the next day in the lower back, and so forth. It is a troubling disease for those of us trying to help people with the problems, because of the widespread symptoms.

I would imagine that each of you reading this Blog have had pain at one time or another. If you would look back at that time, I ask what did you look like physically? How did you feel mentally? I would guess that nearly all of you would describe changes in posture and a sense of being depressed. When someone is in pain their posture changes dramatically. They slouch forward with the head pulled forward and down. Their shoulders are rounded, they bend forward at the low back, and appear as if they are trying to roll up into a ball. Let's say for a moment that you have an awful toothache. How would you feel emotionally? Do you feel like having a party, want to go dancing, or laugh? No, of course not. You may feel depressed. You may feel sad. You want to be left alone.

Depression with pain is a common syndrome. Why? I believe because we have no control over the pain. Pain then affects our ability to function. Physicians have found long ago that if pain can be reduced after surgery there is quicker healing. Now, imagine someone with fibromyalgia who is in this state every day! It's no wonder they would benefit from counseling. It's no wonder they have muscle problems from poor posture placing a strain on the muscles. It's no wonder tension headaches and TMJ Dysfunction occur because of the pain and the depression combined. As depression increases so does the anxiety level.

I believe the treatment should include visits with a physical therapist. He/She can evaluate your posture, determine areas of muscle tightness, teach you proper body mechanics (lifting, pushing, pulling, carrying, etc.). If you are having tension headaches or TMJ Dysfunction, the physical therapist can assist you. As with any medical treatment, ask what kind of experience the therapist has regarding your main problems. There are many excellent therapists - then there are the 'others'. The therapist may be able to direct you to classes on arthritis or even where you will find yoga instructors. All this must be combined with medications controlled by your physician. Also psychological counseling can be a great tool.

There is no proven research that avoiding certain foods helps eliminate fibromyalgia. We do know that managing your lifestyle can be beneficial. Remember, there is no cure. Here are some ways to evaluate your lifestyle:

  • Find quiet time for yourself where you may even meditate
  • If you are overweight, lose the weight
  • Work on Stress Management techniques
  • Learn deep breathing exercises
  • Massage Therapy may give temporary relief
  • Attend classes in your community involving neck and/or low back pain prevention
  • Use your prescribed medications as directed
  • Do all exercises given to you by your physical therapist
  • Address your depression. Do you abuse drugs or alcohol? Are you a victim of abuse?
If you would like my personal opinion on your individual problem, I will be happy to help. Leave a comment here on my Blog. Feel free to always ask about anything I have written and I will explain further. 

Be sure to watch my book trailer about child abuse from alcoholic parents. The book is called "The Shade Tree Choir". The trailer is located at the top of this Blog with the book cover.

Thursday, January 10, 2013

Insomnia and Depression

Insomnia and Depression

Everyone has times in their lives where they feel depressed.  This is different from the clinical definition of depression.  Those who suffer clinical depression also can have great difficulty with sleep.  A lack of sleep then complicates the depression even further.  People who are bi-polar also have symptoms aggravated with a lack of sleep.  Come to think of it, all of us need proper deep sleep.  Without the deep sleep that our brains demand, physical and mental ailments are increased.

Our brains need three components to function properly.  These include increased blood flow, proper nutrition, and deep sleep where the brain is allowed to dream.  The expected result of deep sleep is to allow the body to heal - both physically and mentally. If we do not reach REM (rapid eye movement) sleep, then we suffer.  Daily stressors will be magnified.  Our poor mental states will slip backwards like sliding on ice.  Without REM sleep, there is reduced healing physically and mentally.

  Increased blood flow is attained in part from exercise.  Nutrition is attained with proper diet. You can locate all types of articles about 'brain foods' on the internet.  Deep sleep is a problem for many with depression.  I was one of those.  Notice, I used the word 'was'.  Until six months ago, I never slept all the way through a night for some twenty five years!  It was common for me to wake from a sleep and be up for hours.  There were times when I would drive to the car wash and then return home to wax my car, clean the engine, vacuum the interior - all in the middle of the night.  Other times I would drive for a couple hours and then return home.  I woke tired, I worked tired, and I had difficulty functioning.

What was my secret?  First I had a thorough physical exam.  I was referred for a sleep study and the results showed I suffered from sleep apnea. If you snore - you NEED a sleep study! I was prescribed a C-PAP breathing machine.  I also suffer from Restless Leg Syndrome and was given medication to control that.  Lastly, because of clinical depression and anxiety syndrome due to PTSD I was given medication to help me sleep.  All of it worked!  I finally wake up rested and no longer feel like I am in a 'fog'!

In the Community I started on Google Plus, called "Mental Health Issues", I see reports from many members having difficulty sleeping.  I tell them what worked for me.  I avoid caffeine after noon.  Alcohol can reduce sleep patterns. I use my C-PAP all night long.  If I am having an 'event' that creates stress for me, I will write about it or talk about it.  My goal is to purge that stress from me the best I can.  I may use deep breathing techniques.  I may also perform positive visualization in my mind.

In the past I tried many homeopathic remedies.  I tried listening to sounds of a rain forest. On one occasion, all was well until that Howler Monkey started screaming!  That didn't work so well.  I then tried sounds of the ocean (monotonous), rain on a tin roof (irritating), classical music (great until the drums and cannons were fired in Tchaikovsky's piece).  I soaked in a hot bath only to be even more awake!  I tried hot chocolate and warm milk only to gain weight.  I rolled to different positions and changed sides of the bed (then, even the cat left the room).

My advice is try to purge negative thoughts, get a physical exam to rule out medical problems, and get plenty of exercise.  Now if it's the middle of the night and you feel you need to exercise, drive to a high-crime area, park your car, and see how long before you have to run like a zebra!  You will return home and sleep just fine. 

 I mentioned deep breathing.  As a physical therapist, I taught the following technique many times in my forty year career. First off, avoid what are called 'burp foods' after the noon meal.  These are foods that create increased abdominal gasses and push against your diaphragm.  Eating these can make it difficulty for some to breathe.  Anyone who has any form of COPD should avoid these at all costs.  The include: broccoli, cauliflower, beets, and some beans.  Again, I refer you to the internet.  The two best sources I have found are the Mayo Clinic and the Cleveland Clinic.  Now back to proper breathing.  Inhale deeply through your nose, hold your breath for six seconds and then blow out like you are blowing through a straw - not a tailpipe on a 1957 Chevy!  Do this six times and you may indeed find a tremendous calming result. This pursed lip breathing will help lower blood pressure, reduce heart rate, and develop a sense of calm.

Positive Visualization is also helpful in stressful times.  This was best reported by Rebecca Anhalt in her Blog at or you may find her at She has many excellent articles.  There are two that relate to my Blog here. "Change your Thoughts, Change your World" and "Top 10 Negative Thought Patterns and How They Affect You!"  In a nutshell, what you put into your mind is what will come out.  Positive will be positive.  Negative will be negative. I would recommend everyone follow her Blog.

Lastly, I mentioned writing or purging by venting.  I find writing more useful.  If I am having an issue with a person (dead or alive), I will write a letter to that person and I write until all negative feelings are gone.  I will say anything I want and in any way I want.  When I feel better, I tear the material up and throw it away.  This is a great technique if you are having trouble with a spouse or significant other.  Just be certain to throw it deep into the trash.  If it is discovered, you will have a whole new set of problems.

In my novel, "The Shade Tree Choir" the main character, Krame has great difficulty sleeping due to the physical abuse he suffers from his alcoholic father.  At this age of eight, he develops what is called a neural pathway in the brain.  That pathway becomes what his body feels is 'normal'.  As Krame ages, sleep loss is a normal routine for him.  How would I know what Krame experiences?  I am that character!

If you want to help others, join my Community, "Mental Health Issues", on Google Plus and share what works for you.  If you want to help me, BUY my novel!  Thanks

Thursday, January 3, 2013

"The Day The Laughter Ended"

I was abandoned by a mentally ill mother at about age six months.  I was eventually reunited with her a few weeks later.  I was physically abused by an alcoholic step-father until age seventeen.  I received little, or no maternal support from my mother as she too was an alcoholic and mentally ill.  I was beaten with the buckle ends of belts, kicked with steel-toed boots, and forced to stand at attention for hours on end leaning into a corner. I was starved, deprived of water, and locked away in a darkened stairwell for some eighteen hours with only insects and heat to keep me company. All of this is told in my novel, "The Shade Tree Choir".

But... I survived

I graduated from college and received a post-graduate degree.  I am a retired physical therapist, author, public speaker, and the Cowboy Poet Laureate of Tennessee.  I am also an ergonomist, a comedian, and was honored to carry the Olympic Flame for the 1996, Atlanta Games. I suffer from PTSD, depression and anxiety.  The brief glimpse into me and my illness may hopefully give you readers some insight into your own situations or may help you to help others.

Our Two Brains

According to one school of thought we each have two brains.  There is the 'Old Brain' which is comprised of the brain stem and cerebellum. It is often referred to as the reptile or lizard brain. This brain was the basic mechanism for our primitive ancestors even before the dinosaurs.  It is here that reflex responses arise, repetitive routines are stored (spelling, basic arithmetic, grammar), and animalistic attributes are remembered.  Fear, anxiety, drives for water, food, and sex are found in this part of the brain.  Experiences gained through trauma from we were small children are also stored here.  All of these experiences never go away.  Experiences we had as small children set up in what is called a neural pathway.  The neural pathway is a learned response to a situation - either positive or negative.  The neural pathway is also always there and never goes away.  Another trauma later in life can re-activate that pathway. Reaction times are some ten times faster in this part of the brain compared to the 'New Brain'.

The new brain is the cerebrum. It is about 2/3 of our total brain size and is divided into right and left hemispheres.  It is here that we learn language and motor skills, intelligence is created, personality is developed, and thinking skills are created as well.  An example of how the old and new brains correlate with one another is driving and talking on the phone.  Driving and talking on a phone forces us to use the cerebrum and reduces the activity of the cerebellum. The reaction times stored in the cerebellum are reduced by ten fold.  The reduced reaction time is why it is dangerous to talk on a phone while driving.

Ages 1-3 Set the Stage for Life

Literature review shows studies done by Professor Allan Schore from UCLA on postmortem brains of children.   He reports the brain size of children with little or no interaction with their mothers have a significantly reduced brain size.  In living subjects, these people have reduced intelligence, less able to empathize with others, may be addicted to drugs, may be involved with violent crime, and have high pre-disposal to violent crime.  He further reports that 80% of our brain cells will be manufactured in the first two years of life.  Any deficits will be permanent. The growth of brain cells is a consequence of an infant's interaction with its mother.  It is his opinion that during these formative years nurture and nature cannot be disentangled.

The neural pathways developed as children from abuse are powerful and deep in the brain.  They are ever-present but with treatment they can be kept quiet.  Traumatic events later in life can ignite them back to life, and a diagnosis of PTSD may be given. Therapy is needed at that point.  Therapy may come in the form of medication, talk-therapy, or a combination of both.  Other supplemental forms of treatments may include yoga, meditation, and exercise (among others). Overcoming PTSD requires your brain to replace old learning experiences gained through trauma.  The new experiences will be associated with a sense of calm and peacefulness. The brain requires blood through physical exercise.  It requires sleep and needs to dream.  The brain requires nourishment with foods such as leafy green vegetables, blueberries, walnuts, etc.  I would recommend you read further on 'brain foods' as there is quite a bit of literature available.

The downside for people with chronic stress or chronic depression, and PTSD is a lack of desire to exercise and they certainly do not sleep well.  I have been diagnosed with PTSD because of a civil law suit involving real estate. After nearly six years they dropped the case. During those six years they increased their demands to over $300,000. Our attorney fees cost us some $40,000.  This event created in me, a return to the abusive years as a child. I re-activated my neural pathway. During this same time frame, I took a new position as a clinic director.  The stress of meeting corporate demands, long hours, employee problems, etc. combined with my law suit had my neural pathways fully charged.  I felt like I had no control in my life and was locked away in the trunk of a car being driven around awaiting an execution.  If you take any abused child - now an adult, and take away all control over his/her destiny they will implode or explode.  Something will happen. I tried to hang myself!  Thank, God it did not happen! I was unable to pull myself up to the attached rope in the attic because of a painful shoulder.  This selfish act of mine changed my life.

I quit my job earning six figures.  I sought medical help.  I now have a mission to help strangers who suffer from PTSD, depression, and anxiety disorders.  I write about it, I tell others my story, and I make myself available to any and all.  The stigma of being mentally ill must be changed worldwide. Child abuse must be addressed. Insurance coverage for mentally ill people must be addressed. Parenting skills for teenage mothers must be addressed.

If you chose to read my novel, "The Shade Tree Choir" you will learn my real life story as a child.  While I was a prankster and drew people to me because of my laughter and humor, inside the laughter died at a very young age. 

My next Blog will cover how our thoughts help determine our behavior.  I would refer you to an excellent source on the internet.  Rebecca Anhalt has valuable information on this very subject.  I will be quoting from her Blog.  Her site is

The Shade Tree Choir Book Trailer