10 Things to Know If You're Recently Diagnosed with IBD

Newly diagnosed with IBD? I wish you knew these first.   

Growing up as a teenager, I was a perfectly healthy child. I ate regularly; I was active and a bright kid who never had any particular routine or lifestyle that I used to follow. But everything started turning upside down once I started seeing symptoms. An bigger tragedy was when I almost felt like the game had ended after being diagnosed. No! Not at all. The actual game starts only after the diagnosis. Our bodies are always changing with IBD. From one day to the next, we don’t know how we are going to feel or what is going to happen. So it is of the upmost importance to know yourself and your body first. Ignorance certainly isn’t bliss here. If you feel like IBD is ruling your life, it’s time to take back the control. Here are the 10 things which I would like to share with all those who are newly diagnosed with IBD:

1. Educate yourself: Knowledge is power. Understanding IBD leaves you better equipped and empowered to manage it. There are many patients out there without enough knowledge about their IBD. It’s our responsibility to know everything we can about our disease and also our bodies. Take the time to learn everything you can. Read and discuss as much as possible with your doctors. 

2. Track your symptoms and triggers: Learn about your own symptoms and triggers. Many doctors suggest maintaining a food diary so that your doctor may be able to use the data you gathered to help guide your treatment plan. We can understand our daily life and limit what happens to us by doing this. 

3. Never miss your regular follow ups: After reaching my first remission, I assumed I was completely cured and had stopped my regular check-ups and follow ups with my doctor. The penalty for being so ignorant came with a cost of having the next severe flare up within the next few months which completely drained me and pulled me back to square one. IBD is a disease which needs to be managed and if you feel symptom free, you are not cured, it’s just that your medicines are working and controlling your symptoms. So it is important to have regular consultations with your doctor and monitor the functioning of your systems. 

4. Make every appointment count: Be well prepared as to what you need to discuss with your doctor before hand as most of the appointments will be limited to 10-15 minutes and you tend to lose out on discussing important stuff. You can even jot down pointers on paper before entering the doctor's cabin. 

5. Don't be afraid to ask for more information: The time slot allotted for each appointment may be limited. That doesn't mean you need to limit your queries and clarifications. Make the best of that limited time. For instance, if you’re being treated with steroids, ask for detailed information about how this medication could influence how you feel, the side effects, mood swings, weight gain, and such.

6. Know your treatment: First, know what kind of treatment the doctor has put you on. Whether it is the traditional treatment or biologics or allopathy or any other alternative therapies. Understanding your treatment can help you know what is happening to your body and analyse your recovery rate to attain symptom free life by choosing the best that suits your body as what suits others may not you and vice versa.  

7. Emotional health is equally important as your physical health: There could be days when your entire body hurts and there is nothing you can do. There could even be days when you don’t even want to move because you are so exhausted. During those days it’s not easy to control your emotions as you tend to feel more low and helpless. But you can still fight back by choosing to feel “it's OK”. Don’t let your IBD control you.

8. Coping with Stress: Stress doesn’t cause IBD, but it can sometimes make symptoms worse. Stress relief is crucial if stress provokes your flare-ups. Learning how to cope with stress and anxiety isn’t always easy. But it’s really important for us to keep stress under control. Yoga, meditation and music could be a few tools that may be helpful in this. 

9. Reach out for help when needed: IBD can be an embarrassing disease. It’s normal to feel alone sometimes. At a young age, we are taught not to discuss what happens behind a bathroom door. This can leave those of us with IBD, feeling extremely isolated and even hopeless. This can impact our self-esteem and quality of life. It's utmost important to have some go to people who understand these challenges and support us in every step of our journey. 

10. Nutrition matters: Understand how your system works and choose what goes into it rightly. When the intestine is under attack, it has a hard time absorbing nutrients. Therefore it's important for us to be aware of what we eat. Follow a low residue diet to relieve abdominal pain and diarrhea. If you have strictures, it is especially important to avoid nuts, seeds, beans and kernels. 

These are few of the things which I feel we need to keep in mind and plan our lifestyle when newly diagnosed. Knowing these pointers at the initial stages makes our lives much easier.  

Journaling with IBD: A Focus on Mental Health

During 2020’s intermittent quarantine, what has brought me more solace than anything is the act of journaling. As someone who was diagnosed with Crohn’s disease during the pandemic, much of my hospital experience was drastically different than others. Increasingly isolated from my loved ones, I could feel the weight of my diagnosis crushing me, the four walls of my hospital single closing in. 

For IBD patients specifically, mental health is tied so closely to our physical health. I’ve had days where my physical flare-ups make me double over; it’s no coincidence that those same days, my mood swings and sensitivity levels are out of control. In fact, this phenomenon is so common that there’s an actual term for it: the gut-brain connection. 

The gut-brain connection refers to how changes in our gut can have drastic impacts on how we feel and behave. Many tend to dichotomize our bodily systems, finding it hard to believe that our behaviors and moods can be swayed by what we eat and how our gut reacts. This is explained  by what’s called ‘bi-directional’ communication, in which our gut and brain talk to each other using different pathways. 

Re-focusing energy is powerful. With enough time, journaling can become a way to channel your energies into finding peace and introspection. What’s best about all this is that journaling can take any form you want it to. It’s simply a way to get your thoughts out on the page. Humans absorb so much information and stimuli during their waking hours; life, as it turns out, can be overwhelming at any point in time, regardless of an IBD diagnosis or not. 

Journaling should be a way to relieve stress, a way to declutter your mind. I’ve found it especially helpful to process my physical and mental pain; even doodling can help distract your mind for a few minutes. Especially for patients with IBD, a journal can be a place to record symptoms, reflect on treatments, or even track what foods you’re eating (Check out this article on how to start a food diary by David, a 2021 CCYAN Fellow!)

All you need is a notebook, even just a piece of paper, and a pen or pencil. Some people find it helpful to pair a journaling session with a few minutes of meditation: this is your choice! Whatever makes you feel the most grounded and relaxed. 

Here are a few journaling prompts to get you started:

How are you feeling right now? 

What does your body need? 

What is giving you energy? What is taking your energy?

What are you grateful for, at this moment?

What are some themes in your life right now? (rest, peace, healing, etc.)

Things that feel heavy today; things you can try and release today.

What do you need to let go of in order to move forward and grow?

What beliefs and assumptions are holding you back?

What do you have to be proud of? 

Where are you feeling stuck? Where are you feeling growth?

Challenges as a Crohn's Warrior in Malaysia

In Malaysia, Crohn’s disease is also known as “Western Disease” or “Rich People Disease.” The reason behind this is mainly because Crohn’s is a rare disease in Asia,  particularly in Malaysia, as compared to Western countries. Many in Malaysia have never heard of this disease. Therefore, they are not aware of the Crohn’s and colitis patients’ struggles with their pain, medical procedures and psychological issues. 

At the beginning stage, I had no one to guide me. I had no idea on how to handle my newly diagnosed disease. With no medical background, no one in the family or friends with similar conditions, I struggled to cope with this disease and my normal life. Can you imagine the struggles I faced as a first year university student with my condition? I was  alone and I didn’t even understand what was going on and my normal was no longer a  normal. The internet was my only resource for information other than my doctor. By reading  everything I could find in the internet, I slowly started to understand this disease. Back then,  there wasn’t even a support group for Crohn’s in Malaysia as the disease is relatively unknown to Malaysians. In fact, I didn’t even known about any other Crohn’s patients until I  met one almost a year later after my diagnosis. My gastro doctors encouraged me and other patients to start a group so we could create a support system to each other. Now,  newly diagnosed Crohn’s patients or caregivers in Malaysia have access to few channels  that they could use to discuss, ask, guide and support each other going through this painful disease. 

Living with chronic disease, I had to adjust and adopt to new diet and lifestyle.  Changes in diet were mostly trial and error in the beginning. I had to monitor my  consumption and take note of any changes. Why did I have to monitor those changes? It is simply because I wanted to avoid flare ups that were caused by certain food that I consume.  For me, I found that my Crohn’s is mostly under control when I avoid foods that contain eggs. So I have to ensure my daily food consumption is egg free. If I didn’t, I’d have to visit toilet frequently the whole day. Precaution is needed for Crohn’s patients because flare ups can happen in any situations, therefore any heads up is a good one to have. 

Apart from my diet, I had made some massive changes to my daily activities too. Since I’m an Ostomate, I have to ensure that I don’t partake often in hardcore sports in order to avoid stoma prolapse. 

The understanding and acceptance of IBD in society is still a challenge for me. Most of them, as  I mentioned above, do not know about Crohn’s disease. I remember one of my friends asking me “Sara, is your disease infectious?”. At that time, I just laughed and say “No, it  doesn’t”. The lack of awareness, although understandable, is a huge disappointment when  someone I confided in is not taking any initiative to understand it.

Stress is another thing that I started to consciously manage. What is the connection  between Crohn’s and stress? Well, stress generally affects a person emotionally and mentally as it damages a person’s emotional equilibrium. But it also affects the person’s health. Even a person without chronic disease can feel their health being affected by high stress levels. So, anyone with chronic health issues, such as IBD patients, have higher  chances of having a relapse and flare when they are stressed. It is imperative that I  recognize my stress inducers, my stress level, my tolerance level and ways to reduce stress  so that I do not have chronic flare ups. Although it is impossible to live stress free all the time, I  believe that I should try to manage stressful situations to the best of my abilities.

Navigating relationship with Crohn’s is complicated and challenging. Crohn’s has created ups and downs in my relationships with my family, friends and loved ones. In the beginning it was really hard to explain to them my condition. They did not understand the condition or why and how I got this disease in the first place at all. It took a while for my  family to accept my condition and now they are slowly getting used to it. They are a great  support for me at the moment, and my heartfelt thanks. 

Dealing with Crohn’s is tough enough and unfortunately, Crohn’s is not something  that we can ignore or that it will disappear one day. Every single day is a challenge for me because I go through physical and psychological pain. I have to survive, improve my quality of life and live my life as normal as possible; I hope more people will become aware of  Crohn’s disease, of patients’ struggles, and accept their conditions. Be kind even if you don’t see someone’s struggle, their pain or their decreasing health.

How Toxic Productivity Can Affect Chronic Illness

“The grind never stops” is a quote I’m sure all older gen-z and younger millennials have heard. Hustle culture is like the monster hiding under our beds just waiting to attack us the moment we dangle our foot off the bed. It’s the scary email we try to avoid, but eventually have to acknowledge is there. Our society places a great amount of pressure, on our generation specifically, to work hard and constantly strive for a lifestyle in which we are operating at an “optimal level”. This is deemed as success and this version of success should always be at the forefront of our minds and influence all decision making. Participating in this hyper productive hustle culture is difficult enough for the average person to achieve, but what does it look like for people that live with chronic illness? 

To put it simply, living with chronic illness(es) is hard. Personally, it is the most difficult thing I have ever experienced. With symptoms like chronic fatigue, anemia, and anxiety etc., paired with frequent doctor's appointments and stigma, one could imagine that it is virtually impossible for chronically ill people to participate in hustle culture. Unfortunately, being in this generation makes escaping from the plague of toxic productivity quite difficult. Growing up we have all heard the stories of the business person working 60+ hours a week to bring his dreams to fruition. This mentality has influenced our entire generation. Working hard should always produce tangible results, right? Well, not exactly. As someone that lives with IBD, overworking myself can have dire consequences. Stress and anxiety are common triggers for people living with IBD, so it can be exhausting to focus on extracurriculars, staying social, maintaining good grades, and overall performing “optimally” while you’re inches away from a flare up. Our culture’s ingrained toxic productivity can be seen as the genesis of this behavior. I regularly catch myself being filled with disappointment that my illness prevents me from working at the capacity that I deem as optimal. Blaming myself for the pressures that our society puts on this generation only adds fuel to the fire, but never addresses the true issue, which is our ingrained idea of hustle culture. 

As young chronically ill people, we must stay aware about never pushing our boundaries and our illnesses in the name of productivity. Productivity is a wolf in sheep’s clothing; it seems innocent enough until it comes and bites us, and that bite for many of us is a flare. It is never a moral failing if you aren't able to operate at the same capacity as your pre-diagnosed self or other able bodied individuals. As chronically ill people, we have so many unique challenges that we must acknowledge and honor. Here is a metaphor that I often remind myself of: 

“We are all running a race, and some people are completing laps in 7 minutes, and others are completing laps in 20 minutes. Some may have to stop to breathe, sit and take a brief rest, or even leave to grab water, but the timing doesn't matter, the effort and intention does. All effort is valid.”

In the metaphor above, the race represents toxic productivity and the one’s completing the laps in 20 minutes who have to frequently stop represents chronically ill people. Giving into the pressures of hustle culture and toxic productivity will only reinforce the cycle. So, for the college student that lives with IBD or other chronic illnesses, such as myself, who is putting excess amounts of pressure on themselves to excel in every facet of life, try to be conscious of allowing yourself the space to rest and recharge. “Rise and grind'' is hard to do when the rising part is the issue. Glamorizing and internalizing the generational curse that is hustle culture and toxic productivity can cause irreparable harm to ourselves. Remember, work does not equal self worth. 

So, when you’re in bed trying to get rest and all of your responsibilities and the ghosts of toxic productivity are whispering in your ear, try your hardest to ignore those voices, turn the other direction, and get that well deserved rest. 

Planning with Crohn's

Stay with me for this one – I promise it won’t be as boring as it sounds! If you immediately switch off when you hear the world ‘plan’, or indeed ‘regime’ or ‘strategy’, you’re not the only one! There are, however, benefits to planning when you live with a chronic condition like Crohn’s Disease – and more importantly, if your plans become routines, then they’re more likely to become second nature, and you’ll find yourself doing those tasks subconsciously. Here, I will share some of my planning tips, which you may just find helpful. It’s all about finding what works for you so that you can manage to fit in all of the things you want to do, despite your health condition(s).

Smartphone apps

There are tons of smartphone apps available to help you keep lists, plan activities and so on! I keep it fairly simple, making use of macOS/iOS Calendar, Reminders and Notes (or the same apps on other operating devices). The calendar function is ideal for noting down all of your appointments. This helps for looking to the future, but also looking back at when and where different events occurred. The reminders app is an absolute lifeline for me. I have separate folders for different activities (e.g. university, health, work, voluntary commitments and so on). I add in activities, and a date/time (or location) reminder. This definitely helps me to keep track of everything that I need to do. If I didn’t, I would definitely forget! From a health tracking perspective, this is ideal as a reminder for booking in my next vitamin B12 injection which takes place every three months, as well as for when I need to ring up my doctor to arrange routine blood tests, when I need to self-inject my treatment, and when I need to order my repeat prescription. You may think that you’ll remember everything, but when you are busy with ‘life’, on top of ‘brain fog’ which many of us can relate to, it’s easy to forget. I know I have done that in the past, particularly when it came to self-injecting my treatment. I would remember that I need it on Tuesday for example, which would be the two-week dose period. However, I would have a busy day at college, would forget when I came home, and then in bed at night, I would suddenly remember, and think ‘I’ll have it tomorrow’. But then tomorrow became the weekend, and before I knew it, it may be a whole week later and I still hadn’t given myself my injection. I knew that was no good, but I just needed to do something about it – which I did!

Finally, Notes are brilliant! Again, I have different folders for a whole variety of different items. ‘Health’ is one of those. I use notes for keeping track of how I have been feeling, as well as for noting down points to discuss with my healthcare teams. I also use notes to keep track of discussions held with healthcare professionals, either face-to-face or over the phone. It’s just another good way to have information at your fingertips to help with your care, while the discussions are still ‘fresh’ in your head. 

Scheduling in rest days

We all know what it’s like to live with a condition like Crohn’s – we have so much robbed away from us. As a result, when you are feeling on the better side, you will naturally try to fit in everything that you can. I know that I have been there! Though sometimes, it really doesn’t pay off. That’s why I try to give myself time and space to just ‘do nothing’ – because I know that’s what my body needs. In pre-pandemic times, I would avoid booking in too many back-to-back travels, so that I always had some time to recover. In the current climate, I do my best to block off certain days where I’ll have meetings, keeping overs ‘free’ to do work at my own pace, and also take it easy. It’s all about being in control, as much as possible, so that you give your body (and importantly, your mind) the time and space to breathe.

Leaving the house with everything that you need

Phone. Wallet/purse. Keys. Mask! The list goes on – but it’s really important to have everything that you need to hand. As well as the usual items that most of us require these days, I also have supplies in my backpack and car for every eventuality. This includes painkilling tablets and gel, anti-spasmodic tablets to help with cramps, laxative tablets if I notice a blockage, anti-diarrhoeal tablets if the opposite happens, lactase enzyme to help me digest products containing lactose and the RADAR key to access locked accessible toilets. This list can go on and will depend on personal circumstances. I always find it best to have everything stored in one bag, so you can ‘grab and go’. It may feel excessive, but you will thank yourself later on when you’re not caught short.

Knowing your triggers and avoiding them

Although everyone is different, we all have some kind of trigger which can worsen how we feel. For me, I know that stress is a key trigger for worsening symptoms. That’s why I try to minimise stress as much as is practically possible – although that is much easier said than done! That’s why you’ll generally see me planning to do work well in advance of deadlines, for example, and seemingly ‘being on top’ of everything. In reality, it’s much harder to do, and I do find myself rushing for deadlines still – but at least I have minimised that as much as is practically possible. I am also my own worst enemy. As a perfectionist, I place huge amounts of pressure on myself to succeed and to do everything to the very best of my abilities. While it’s a good quality to have, it isn’t when it impacts on your health. So, it’s really important to be kind to yourself, and to re-evaluate your workload if you find yourself totally swamped and feeling ill. Nothing is worth more than your health.

Do you have any other planning tips which help you to live with your condition whilst getting through life? Let us know in the comments and on social media! 

IBD and Anxiety

When you are first diagnosed with Inflammatory Bowel Disease you learn quickly that the brain and gut function as one. They are deeply connected. Even if you don’t have IBD, you can look to feelings like butterflies in your stomach when you are nervous, excited, or in love. IBD has given me the superpower of identifying an instinctual trust of my gut. One thing you commonly hear when talking about how to manage your IBD is that you have to manage your stress levels. Since the brain and gut are so connected, the chances that a flare up will occur when you’re stressed are high. Truthfully, being able to manage your stress is a very privileged thing to be able to do and that’s a conversation that needs to be had. Outside forces and systems of oppression exist heavily in our world today. We are not functioning in a world that allows you to thrive and prioritize both your mental and physical health. For most people, there is always a tremendous amount of stressors that you cannot escape. Things like finances, unstable households, going to school, and working all cause a great deal of stress. 

Today, I want to specifically talk about how managing stress levels and IBD feels increasingly impossible when you have clinical anxiety and/or PTSD, as these are so often linked with IBD. 

I was diagnosed with IBD at a young age. My physical health was always prioritized over my mental health. This was more pronounced, I think, because mental health is not a thing that is necessarily often invested in for young children. As a child, it was very difficult for me to identify what I was feeling and what triggered these feelings. Specifically, with my anxiety, I did not know what a neutral state of mind meant. I didn’t know what my anxiety looked or felt like till around my sophomore year of college. After going on anxiety medication for a bit, I was able to understand what intrusive thoughts were and how they occupied my life. 

The baseline for my anxiety is intrusive thoughts, but it can also manifest itself in different ways just based on the things I am doing in my life at the time. For example, my anxiety can manifest itself in ways such as crying in social settings, having an obsession with time (i.e. constantly looking at the clock or leaving hours early for events), and, when things are more extreme, staying in my room for days on end. For me, it is so important to specifically state how my anxiety manifests because for so long I did not know what it meant. I think it is important that we normalize talking about everything that anxiety can bring with it, not just generalizing or downplaying it. So often, I think anxiety is talked about in very loose terms and given very simple fixes for how to “handle it.” This, in return, can oftentimes belittle the situation. 

When these more intense and intrusive moments occur, my IBD flares up. So, I often question how I am to manage my stress when I often cannot control my anxieties. In the past, I would become stressed when I experienced my anxieties because I did not know what was wrong. Now, they still stress me out, even though I know that it is anxiety. 

For me, and I think many others, anxiety is something that I have to constantly cope with on the daily. If I am not ten steps ahead of it, it will simply swallow me whole. 

IBD and anxiety can feel overwhelming and scary, but what has helped me is knowing that I am not alone. Having these two conditions together is not uncommon, and what feels very isolating and full of despair is not the case. Medication has helped me in the past and therapy is a forever process for me. I also keep a bullet journal of coping skills I have used in the past - identifying coping mechanisms that worked and ones that did not. This list gives me a place to turn to when I feel as though nothing could help and it's easily accessible. I have also found solace in being in a community of people who understand. Explaining anxiety or IBD to someone who has not gone through it can be very exhausting and this goes for many other varying identities as well! When I do find the energy, making art is another space for me to process my anxiety, whether that be through a conceptual piece or just painting a canvas with one color over and over again.

What are ways you cope with your anxiety?

A Five Step Plan to Prepare for the Stress of School

By Erin Ard

August has always been my favorite month of the year. The word itself feels warm and seems so full of light. Summer is winding down, many of us have been able to do things we never have time for during the school year. We've been able to spend loads of time with friends or family, gone on vacation to somewhere new and exciting, explored some new DIY projects, or tackled a task from our ever stagnant To-Do list. We might even be exhausted from all the fun and relaxing times we've had that the thought of summer ending, is naturally bittersweet. August is our last month to ourselves. When August 31st comes around, classes are just around the corner. Now, I don’t mean to scare or worry you that you are running out of time. You still have plenty of time to relax and prepare. (But tick tock..)

This September will mark my own re-entrance to school after taking a year off. In May of last year, I graduated with my Bachelors and will be going back as a re-entry student to study DIETETICS! I am so excited you guys, you don't even know! Even though it's only been 15 months since I was in college, I feel like the mom who rediscovers herself and goes back to school after x number of years devoted to others. But this is MY time to shine! My heart is so full of excitement and intrigue for the new topics I'll be learning about and the career path I am headed towards. I have had 15 months to decompress from all those days spent studying, non-stop, on end and will be reattending with renewed energy and outlook. Because I know how stressful college life can be and the added stress of taking care of a chronic illness, I want to share some of my own insight on how to prepare for another school year.

After having a few rough semesters and thinking about this new year, I decided to do some research on how to prepare yourself mentally, emotionally, and physically. Many of the tips I found were in reference to another stressful life event, but they still hold potential for alleviating the stress experienced in school. Stress is stress, right? And when you have an inflammatory disease, a part of keeping your disease in check is taking the right precautions around stress management. So whether you are ready to get a move on or still trying to deny the fact that summer is ending, here is a five step plan to get you started.

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Step 1

Use this last month of summer to really get to know yourself, on every level.

Try to understand how you deal with stress by thinking about your past. Think back to a time when you were dealing with a lot of stress, maybe even in the midst of a flare-up, and ask yourself: How do I tend to perceive about the situation? Do I react to the stress or work through it? Are my thought tendencies self-deprecating or more self-righteous and determined? How did I feel physically, emotionally, and mentally? What was I missing? What could I have done differently?

Try this writing exercise! Like you would write a story, write down what was happening during a time you were being pushed to your limits. Bullet-point every obstacle and bold everything you tried to overcome the situation, even the failed attempts. Then, like how a writer outlines a story-line, write out how you would resolve the story. Include who and what from your life you would need and when you would use them. Keep this as a guide or for inspiration!

Step 2

Plan ahead, for EVERYTHING and keep yourself accountable.

It can be helpful to set up a plan for yourself ahead of time. Whatever makes yourself more productive, make a promise to DO THOSE THINGS! Get tasks done early when you are feeling well and full of energy, so you can rest when you are not. Prioritize what is most important in your life. Stick to a routine or try new things. Think about how much you need to do to be successful and what kind of effort that will take. Then start to build up your plan around these thoughts. Being accountable for yourself and the work you must accomplish ahead of time will save you in the long run.

Try this writing exercise! Make a promise to yourself for the new school year. Write down a few things you want to strive for, big or small. Then display it somewhere you will see every now and then as a nice reminder. This will keep you centered and focused on what you want to achieve and how you will do it. Here are some examples: "I promise to make good decisions for my health and well-being. I promise to make my bed each morning. I promise to do what I can, when I can, and not judge myself when I cannot."

Step 3

Be the responsible person you and your body deserve!

Make responsible decisions when it comes to food choices, workload, and managing stress. A part of developing a successful plan is sticking to it! If you know about your own unhealthy habits that can impact your ability to manage stress, then take steps to reroute them. Start with replacing bad habits with positive ones.

Step 4

Have a de-stress plan when life starts to get tough.

By having something set in motion ahead of time, you can comfort yourself knowing you've prepared for this! So whip out your de-stress kit and get to it! Here are some ideas to get you started:

• If you feel yourself getting anxious, stop for a moment. Practice deep breathing and positive inward thoughts or commit some time to a guided meditation. You may feel more calm and refreshed afterwards.

• Set up a routine to decompress after a long week (take a warm bath with a glass of wine, settle in with your favorite book with a cup of delicious tea, or just take a nap - but use this last one sparingly)

• If you struggle with eating healthy, staying away from trigger foods, or staying on a grocery budget then try your hand at food prep. Taking your Sunday afternoon just for this task can be relaxing in itself and can yield some great benefits. Say goodbye to wondering what your next meal will be and ordering too much take-out!

• Write a letter to yourself to read when the going gets tough. I did this in the depths of a my lowest moment and it allowed me to pull myself out of an emotional rut to refocus on happiness and success.

Step 5

Pick yourself up when you fall.

If you fail, a normal part of life, then you will need to brush yourself off and try again. Don't blame yourself, don't blame your shortcomings on your Crohn's or Colitis, and don't project your failures onto the universe. These tendencies will only allow you to harbor negative feelings about yourself or your past. Practice accepting things as they are and moving on with a more determined attitude. Find out where you might have went wrong and correct any bad behaviors that may have caused you to fail. Are your Netflix binge habits infringing on your study time? I know mine have before. Learning is all about finding what works for you and readjusting. This includes finding what works well in your own study habits. Try out some new ones if the old ones get stale.

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Whatever your plan ends up being, make sure that it is true to YOU! Incorporate everything you know can work and don't waste your time on what doesn't. I promise to

What strategies help YOU manage stress?

Stress, Its Effects on IBD, and How to Handle It

By Erin Dunne

We all have had moments where it feels like everything is happening all at once. Whether that be good or bad, it can be extremely overwhelming. With school and work, it may be projects piling up, exams, or a packed schedule. In our social lives, we may have weddings, plans with friends, and family events that happen within a short time frame. We may think of stress as a superficial, short term feeling that goes away once the chaos has subsided, but that is not always the case. The effects of stress can stay within the body for hours and sometimes days after the stressor has vanished. The intensity of the body's response depends on the individual and how they handle the stressor- either focusing on their emotions, avoiding the situation, or nourishing themselves and acknowledging the issue. It is essential to understand the different types of stress, how each variety can affect the body, and how to handle yourself when faced with such situations. Knowing what to do is not only beneficial for your overall health, but it makes you feel powerful and amazed at the control you can have over the situation!

What is stress and what does it do to the body?

Stress is the body's response to any situation that poses demands, constraints, or opportunity (Riehl, 2019). There are two main types of stress that people face: Acute and Chronic. Acute is short-term and is most common. An example would be daily occurrences such as a project deadline, or being stuck in traffic. Chronic stress is prolonged and can contribute more harm to the body if experienced too often. An example would be involvement in a toxic relationship. When the body detects a threat, the brain activates the sympathetic nervous system which stimulates a response typically known as the "fight or flight response." The sudden release of hormones, primarily adrenaline and cortisol, prepares the body to take action. When the rush of hormones is constant, this can cause a lot of wear and tear on your body. Once the alert phase is activated, the goal of the body is to return to its natural, parasympathetic state with regulated hormone levels.

When in "fight or flight" mode, the body focuses all of its energy into systems that are necessary and shuts off others that are not being used. One that becomes restrained is the digestive system. While there is no direct correlation between stress and IBD, more research has been conducted to investigate the influence of stress triggering symptoms. Ongoing stress can often go unnoticed, but it continues to impact the function of certain systems of the body. Stress is hard on the digestive system, as it affects which nutrients your intestines absorb, and how quickly food is moved. A recent study has found that IBD symptoms may increase because the sympathetic nervous system acts on the lining of the colon and may worsen current inflammation. Evidence has also led scientists to believe that stress hormones may help harmful bacteria reside in the intestines (Norton, 2010).

What causes stress?

This reaction is initiated by the presence of stressors, anything that triggers a physical response. The causes of stress differ for each individual- we all have our unique threshold and perceive situations differently. For example, if there is a presentation that requires the student to talk in front of their class, one person may not mind public speaking and are not worried about presenting, while another student may dread public speaking and feels exceptionally anxious. Of course, not all stress is bad- an example of good stress would be the feelings you may experience before an athletic event. Some common stressors include school, work, busy schedule, traveling, finances, lack of sleep, and poor diet.

How to handle stress:

Generally, there are two types of coping styles; Problem-Focused and Emotion-Focused. People who are Problem-Focused approach the issue head-on, whereas people who are Emotion-Focused tend to lean into distractions and avoid the issue. It is critical to recognize what coping style you tend to resort to naturally so you are more prepared when faced with a future problem. You are also able to understand yourself better! Regardless of your natural response to a stressful situation, it is also essential to know how to take a break amid chaos. Taking a break allows yourself to calm down and assist your body back to its normal state.

Stress reduction techniques can help you find peace and maintain perspective when consumed by pressure. It is vital to find something that appeals most to you- what works for one person may not work for another. Trying out a few different techniques can help you see what works best for you and can quickly become your go-to reaction to stressful situations. Some great things to incorporate into your stress managing tool-kit include: incorporating physical activity, talking and spending time with friends, reading, and baking. Even taking the time to focus on your breathing when you find yourself becoming overwhelmed can help manage the intensity of the stress response. Finding an activity that stimulates rest, clears your head, and makes you happy is one of the most beneficial things you can do for your overall well-being!

How I learned to calm my mind with movement:

Through the years, as I have become more aware of listening to my body and provide for its needs, I have learned the importance of handling stress better. I recognize now that when I experience significant amounts of pressure in a short amount of time, not only do I feel exhausted but I also suffer from an increase in symptoms. If I am under stress for a more extended amount of time, I have prolonged symptoms and discomfort. I have developed habits of practicing yoga, going on walks, and meditation- all things that allow me to slow down my mind and put life on pause. However, I do not only do these things when I'm stressed. They bring me such joy and contentment; I make time each day to do at least one (sometimes all) of these activities!

One of the best things about yoga is that it can be done almost anywhere. I love taking advantage of the beautiful weather and fresh air!

Typically, I start my morning with at least a ten minute meditation which helps me set my intentions for the day. While I have tried to sit in silence and meditate, my attention span is not that disciplined yet, so I use guided meditations from Headspace. If you're interested in practicing meditation, I would recommend downloading an app or finding videos on YouTube- both great resources! Another thing I do quite often is take what I like to call "Mindful Walks." I put on a podcast or playlist and take a long walk, making sure to be present and aware of my surroundings.

My favorite way to relieve stress is through my yoga practice. When I was younger, my older sister and I used to take classes together, and I have been intrigued ever since. Through the years I have leaned into my yoga practice to help quiet my mind and work on connecting my body and brain. At first, I was intimidated by the idea of flowing on my own. I thought it had to be in complete silence or to mellow music, and surrounded by aromatherapy. I soon realized that the purpose of yoga practice was to embrace my own intentions and make the most out of my time. I don't put pressure on myself to have a perfect session because I'm learning and am allowing my body to move the way it wants. Most of my sessions include aromatherapy, the twinkle lights in my dorm, and one of my favorite playlists. Even if it is only taking five minutes to flow, I notice an extreme shift in my mood after a session- I feel renewed.

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In the past, I would isolate myself and push through the pressure until I would eventually crack and break down. In the moment, I may not feel like moving or pausing but I have to remind myself of how I feel afterwards and the temporary rest I am giving to my body. After I am active, I not only feel more relaxed but I feel happier and come out with a better mindset- more motivated, present focused and ready to take on the next challenge.

Stay Lovely,

Erin