The Holiday season can be a difficult time for everyone, especially those who are suffering from chronic pain. There are many reasons for this: lack of sunshine, decreased physical activity, poor diet and a sense of inadequacy. These natural tendencies can be counteracted by making appropriate lifestyle modifications.
During the winter months the days get shorter and we see less sunshine. A lack of full spectrum light from the sun naturally leads to a depressed mood often referred to as seasonal affective disorder[i]. Personally, I would like to join the bears and hibernate through this time, but since I can’t do that, I find it helpful to use a broad-spectrum desk light and I also enjoy soaking up warmth and rays in an infrared sauna, occasionally. Another problem with decreasing sun exposure is a deficiency of Vitamin D. If you haven’t had your Vitamin D level checked recently please do and consider taking a supplement if needed.
Winter weather makes exercise difficult, but exercise has a multitude of beneficial effects on chronic pain including: increasing muscle strength and joint stability, reducing weight, improving sleep, releasing natural pain reducing substances known as endorphins and finally exercise has been shown to cause an increased expression of brain derived neurotrophic factor[ii], which in turn alleviates depression and anxiety. Luckily, we live in a time and place that allows many different indoor activities. If you have a membership to a health club or fitness center, you just need to show up consistently and try to get in 30 minutes of exercise at least 3 times a week. If you can’t afford a gym membership, try walking at the mall with a friend. If you don’t live near a mall then consider home exercises such as yoga or tai chi, but even better join or form an exercise group at a local church. Exercising in a group is more enjoyable and fosters accountability.
During the Holidays we tend to consume a high calorie, high fat diet. A poor diet tends to increase pain and inflammation[iii], conversely, eating a healthy diet is associated with a reduction in our pain scores[iv]. Understand that you will face temptation wherever you are this holiday season, at home, at work, at church or out shopping. Cookies and treats are everywhere. Be prepared and be judicious. Just because there is a cookie social after your child’s Christmas program doesn’t mean you have to eat a dozen cookies. It is okay to eat a cookie occasionally, but it is better to limit yourself to one. Cookies, cake, candy and pie, I love them all. I often turn to sweets for energy when I am tired, but this is counter-productive. A quick jolt of sugar tends to cause a rebound to even greater fatigue, which in turn makes me want to eat more sugar. This downward spiral causes weight gain, fatigue and depression. Be aware of the trap and limit your intake. Find healthy snack alternatives and allow yourself to indulge in these healthy options. In addition to what you eat, when you eat is an important consideration. Studies have shown that our cells have an active phase and a resting phase timed to our circadian rhythm[v]. When we consume calories after 6 pm, our cells don’t process them, and they are turned into fat and toxic metabolites. Limit the number of hours per day that you consume food, if possible, try not to eat after 4 pm. This is known as intermittent fasting. Try to consume most of your calories in the morning, you will feel better and you will tend to lose weight.
The holidays are portrayed as a happy time of year in Hallmark movies and in TV commercials, but for patient’s with pain the holidays can be a bitter reminder of how far from perfect their lives are. In general, there appears to be a peak in the incidence of severe depression right after Christmas[vi]. Holiday depression is common and usually it is temporary, but it can be a serious problem as well. If depression descends into hopelessness, please seek help. If possible, talk with friends or family about your feelings. Seek out counseling. If you can’t afford counseling there are free services through most churches, don’t be afraid to ask. In some cases, medical management of depression is necessary.
The Holiday Season is full of stress and unhealthy traditions. As a Christian, I see this as incredibly unfortunate. We celebrate the birth of our Savior during this time. Our Lord, Jesus, left a perfect world to come down into our world, marred by sin, so that he could show us the way to God. One of my favorite bible verses is 1 Peter 3:18: “For Christ also suffered once for sin, the righteous for the unrighteous, to bring us to God. He was put to death in the body but made alive in the Spirit.” Remember this about the Holiday: we are celebrating a man, who was born in a barn not a palace. He came into a messy world. The world is still a mess, but He overcame it for us and we have hope for everlasting life in his perfect world as a result. God Bless you all this Christmas.
[i] Lam RW, Levitan RD. Pathophysiology of seasonal affective disorder: a review. J Psychiatry Neurosci. 2000;25(5):469-80.
[ii] Sleiman SF, Henry J, Al-Haddad R, et al. Exercise promotes the expression of brain derived neurotrophic factor (BDNF) through the action of the ketone body β-hydroxybutyrate. Elife. 2016;5:e15092. Published 2016 Jun 2. doi:10.7554/eLife.15092
[iii] Minihane AM, Vinoy S, Russell WR, et al. Low-grade inflammation, diet composition and health: current research evidence and its translation. Br J Nutr. 2015;114(7):999-1012.
[iv] Clinton CM, O'Brien S, Law J, Renier CM, Wendt MR. Whole-foods, plant-based diet alleviates the symptoms of osteoarthritis. Arthritis. 2015;2015:708152.
[v] Kalsbeek A, la Fleur S, Fliers E. Circadian control of glucose metabolism. Mol Metab. 2014;3(4):372-83. Published 2014 Mar 19. doi:10.1016/j.molmet.2014.03.002
[vi] Sansone RA, Sansone LA. The christmas effect on psychopathology. Innov Clin Neurosci. 2011;8(12):10-3.