Chapter 1
As Above, So Below
The Bidirectional Relationship Between Your Physical and Emotional World
If you raised an eyebrow (or two) when you read the introduction to this book, I’m not surprised. You might even doubt that there is an emotional side to health. To that I would say: One, keep reading, and two, keep an open mind. After years of working with people all around the world in my functional medicine telehealth clinic, I’ve seen the emotional side of health affect so many people. As a functional medicine doctor, I’m trained to look at the person as a whole instead of seeing the body as separate unrelated parts like in the conventional medicine world. I often collaborate with conventional physicians, therapists, and holistic practitioners to organize the best protocols healthcare has to offer for my patients (there’s a reason why functional medicine is also known as integrative medicine), serving as a proverbial “wellness quarterback” for my patients. A person’s mental, emotional, and spiritual world is not just part of that overall holistic picture, it’s the critical piece.
Later on, we’ll dive into the nitty-gritty, granular reasons why our physical and emotional lives are intertwined. For example, we’ll talk about how gut bacteria can influence our mood and how stress can cause physiological changes that sabotage our health. But we’re not there just yet! Right now, I want to zoom out and talk about the practical everyday ways this gut-feeling connection reveals itself in our lives.
How the Physical Impacts the EmotionalFrom years of clinical experience in nutrition and lifestyle medicine, I know that physical health factors are more than capable of impacting your emotional world. You might be shaking your head, thinking, Well, of course, Dr. Cole—nobody likes to be sick, in pain, or have a disease! While it’s true that having a chronic health condition or being sick can be a difficult emotional experience, I’m not necessarily talking about the emotional hardship of a diagnosed disease or the trauma of an acute illness, even though this certainly adds to the cycle of stress and health problems. Instead, I’m talking about the less obvious physical health imbalances—like chronic inflammation or gut-health microbiome imbalances—that can more subtly sabotage our emotional health day after day, year after year. This physical-emotional connection is insidious because it’s often ignored by the conventional healthcare world, which treats mental health and emotional health as if the brain exists completely unconnected to the rest of the body. And yet it seems like every single day, mental health issues like anxiety, depression, or PTSD are connected to physical health factors, like diet, inflammation levels, or the status of the gut microbiome, further proving that the physical and emotional world has always been and always will be intertwined.
Just to give you a few examples:
◆ More and more studies are asserting that depression may be caused by chronic systemic inflammation in the body and showing that anti-inflammatory foods reduce symptoms of depression.
◆ Problems with the gut, such as yeast or bacterial overgrowth, often present themselves in the form of mood swings, anxiety, and persistent food cravings. When a patient comes in with any of these brain issues, the gut is the first thing I look at.
◆ Studies have suggested that inadequate immune system control and inflammation may raise the risk of developing PTSD after a trauma.
◆ Studies show that even mild dehydration can be linked to anxiety, tension, and mood disturbance, demonstrating that something as simple as drinking more water could improve mental health.
◆ Here’s one you probably already know: A more sedentary lifestyle has been linked to an increased risk of anxiety and depression. But did you also know that exercise has been shown to be as effective if not more effective at reducing depression than prescription antidepressants? It’s true.
If you’ve ever been told that mental health issues have nothing to do with your physical health, you’re not alone. But I’m here to tell you that the connection between the two is all too real and couldn’t be more relevant to your health and healing.
How the Emotional Influences the PhysicalNow that we’ve established how physical health influences emotional health, let me ask you a question: Have you ever eaten a perfectly “healthy” meal and ended up bloated and with stomach pains? Often that’s because you sat down stressed and anxious, ate while you were distracted or still in fight-or-flight mode, and then went back to your hectic day without a moment of peace or stillness. Just like food, our thoughts and emotions have the power to make us feel terrible or fuel our bodies with vibrant health. In my years practicing functional medicine, I’ve seen any number of the following:
◆ I’ve seen patients with chronic digestive issues cut virtually every “trigger” food out of their diet but see their digestive health continue to decline because of chronic stress.
◆ I’ve seen patients try every exercise and diet that exists but continue to hold on to weight because their body is in fight or flight from an abusive relationship or past trauma.
◆ I’ve seen patients try every conventional and natural treatment to quell their autoimmune condition, trying to force it into submission instead of taking a break from their hyperintense job or exercise routine.
◆ I have many patients who don’t know which came first—the digestive problem or the depression, the autoimmunity or the anxiety, the migraines or the mood disorder.
On the other end . . .
◆ I’ve seen patients quit a toxic job and completely reverse health conditions that had been getting worse for years.
◆ I’ve seen patients start meditating and investing in stress reduction and end up healing from chronic fatigue, hormone imbalances, inflammatory disorders, and so much more.
◆ I’ve seen patients start therapy and end up healing not just from anxiety and depression but also from migraines, allergies, IBS, psoriasis, acne—the list goes on ad infinitum.
◆ I’ve seen patient after patient break down in our consultations online, admitting that they feel sad, desperate, ignored, neglected, angry, or frustrated, and then report that they feel physical relief almost immediately just from being heard and letting their pent-up, suppressed emotions out.
When I see any of these patients going through experiences like the ones I mentioned above, the deeply mysterious, emotional nature of these situations always strikes me. Despite our best efforts to control certain aspects of our health by taking our supplements and medications and eating all the “right” things, if we don’t address the emotional component of our health, we can never truly heal. These are just a few of the many, many moments over the years that have made me a true believer in the bidirectional relationship between physical and emotional health.
ShameflammationIn my book
The Inflammation Spectrum, I describe chronic inflammation as a smoldering fire within, a fire that goes largely unnoticed until it turns into any number of health problems. Well, throughout my years of treating patients and helping them get their bodies and minds back to vibrant health, I’ve seen the way that negative thoughts and emotions can subtly and systematically sabotage health, in much the same way as inflammation can. In fact, I see this phenomenon of emotional suffering causing physical suffering so often that I decided to give it its own name: Shameflammation.
Shameflammation is present in every single one of us to some degree, and it can make us feel overwhelmed, anxious, hopeless, aimless, and totally disconnected from our intuition. It can be both the underlying cause and result of chronic health conditions—it’s often the one thing standing between us and optimal health. Shameflammation can make us feel like we’re constantly swimming upstream and at war with our bodies. Thoughts and emotions are like nutrients for your head, heart, and soul; and unfortunately, many of us have been feeding ourselves junk food for a long, long time.
So, now let’s answer the question I know a lot of you are asking yourselves: Why shame? Out of all the negative emotions in this world, why do we use shame for the term that represents the negative impact of our emotional world on the physical? Over the years, I’ve learned that shame is perhaps the strongest, most damaging negative emotion of all. Brené Brown, a renowned shame and vulnerability researcher, says that “shame is lethal” and explains that shame affects all of us and profoundly shapes the way we interact in the world.
Copyright © 2023 by Dr. Will Cole. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
