In this episode, I cover six things that I do or have done to help combat depression partially related to Ankylosing Spondylitis. 

First I do a Question of the Week. A question listed online asked if stress could trigger a flair. I came across this article that discusses this very item. I also include some personal insight into this topic.

I also discuss ways that I have tried to cope with depression. It never fails for me, that as the weather transitions from summer to fall here in Michigan, I get depression setting in. I HATE winter and with AS find everything I need to get done takes much longer. I found this article that outlined some things I do to help combat depression. They are: 

1. Exercise - My exercise is limited, but I know that when I do my stretches and pushups I feels better.
2. Sleep Well – I have sleep apnea and have started using my CPAP more to help correct this.
3. Get Educated – I started getting more information on depression, AS, and other topics that I knew would help to combat the “winter blahs”.
4. Get Support – I’ve made a bigger attempt at reaching out to fellow AS Warriors to build up my support network.
5. Manage Stress – You can pick any number of ways to manage stress. I like to use meditation and yoga. I put links below to YouTube videos on both topics.
6. Seek mental health counseling – Please consult a professional if you find that you are not having luck with getting to a better spot mentally.

Thank you very much for reading this and listening to the show.

Yoga for people with arthritis - https://youtu.be/RJ8kQPSug0U

Meditation for Beginners -  https://youtu.be/F0jedwTzIJg

See below for transcript:

Welcome to this episode of The Ankylosing Spondylitis podcast. In today's episode I want to talk about or cover dealing with some ways of dealing with depression. It's beginning to be that time of year again, in the Northern Hemisphere where we roll into fall and then winter's coming. For me personally, that generally means the onset of depression, the days get shorter, the weather gets crappier and it's just an overall time that I don't particularly care for. I know I'm going to be cooped up more inside where I live. So for me, it's a time of year when I have to really make sure to consciously fight depression and not succumb to it. 

I'll go over some of the things on fighting depression, but first on this episode I wanted to touch base with and do what I call the Question of the Week. I was going through the different forums on Facebook and I saw this question,does stress cause flares and make your AS worse? Well, I did a little bit of looking around. You know, with stress, we all have stress, you know, if you're working, you've got the stress of work and getting yourself there and just daily life and everything else. But if you have Ankylosing Spondylitis or any other type ofchronic condition on top of daily life, that can just be that extra push to cause many more or increased days of inflammation. One of the things looked at is, you know, AS which affects your spine can affect how you move, walk, feel anything because you use your spine all day long.

There have been some that looked at the links between stress and inflammation, and there was a study in 2017, and I'll have all this in the show notes. So there was a study in the 2017 issue of Frontiers in Human Neuroscience, stress can activate inflammatory responses in the brain, which can lead to excessive inflammation. Well, that's bad. If we get excessive ventilation, then it can push or create a flare where maybe there wasn't a flare, stressful events or situations can trigger the body to activate the sympathetic nervous system. In turn, your body produces epinephrine and cortisol called stress hormones. Due to the nature of Ankylosing Spondylitis, it can be difficult to untangle the origin of stress and inflammation. Says John Davis, a doctor at Mayo Clinic in Rochester. "Having an inflammatory disease and having pain ultimately creates psychological distress" he says. So, basically, as you boil this down as you read it, and I'm going to get Have the links encourage you all to read it. There's ways that you can help to mitigate some of this stress.

It really comes down to you. You have to stop and really try to think yourself through it and plan for any type of given situation. If there are unplanned events, car breaks down, whatever it might be, you know, it might be something as simple as you just have to take a deep breath, calm yourself, not go into a panic or anything and just know that it'll work out. That might help to mitigate some of the effects of those of the stress that you're doing and thereby reduce the inflammation and reduce or make sure that you don't have any type of flare up. 

So those are kind of interesting. Remember, even with all this, you're not alone. Go on to the end of the forums. Talk with folks. It's always good that Well, our loved ones might be able to empathize. Well, our loved ones might be able to empathize with us and feel bad, they're never going to understand exactly what all we go through with AS so make sure to go and talk to somebody who has as online and hopefully that can help you deal with any type of flare ups you're dealing with, as well as medication if you have it, and want to go that route. So that was just an interesting question I saw and now back on to the dealing with depression. 

So I was going through as I normally do looking online and came across this article about Six Ways to Cope with Depression is from Everyday Health. And again, I'll have a link in the show notes. I thought it was kind of interesting. Because some of this I do already practice, so I just have to be sometimes a little more mindful of it a little more, making sure that I do it on a regular basis. So one of the things we all know that having AS can present its own set of challenges, we can be in pain at different times, we can, you know, there can be times where you really, really want to do something with family or friends. You feel great in the morning. And by the time it rolls around to that three, four or five o'clock in the afternoon, when it's time to actually do whatever it was you've been planning on all day. You just don't feel like it anymore. That can create depression because you feel like you're missing out on a social life. You miss missing out on family life. There's any number of ways that it can come back at you. So there are some things that you can do to help with some of this. It's not going to cure it. Your going to definitely want to, you know, this is not medical advice as far as if your situation is not improve, seek medical help, whether it be from a doctor or a therapist, whoever reach out to a medical professional if your depression continues to seem to get worse. One thing is exercise. 

Now, I'm not great at this with having, as I've said multiple times before, many hip replacements, I can't walk long distances. I certainly can't jog or run. So my exercise is limited. I found that you know, exercise can help me. I do push ups in between, like when I'm watching TV, I do push ups when commercials Come on. might not get a lot my get 10 done before the commercials end. But then I get back up and watch TV. commercial break comes and get back down and do 10 more push ups. If you can do those great Do whatever your body allows you to do. That's the key is it's all about what your body can allow you to do.

The other thing that I've added in and been trying to do is yoga. Yoga is low impact for me, and I can't consistently do all the things that they show. But I, I did try out this what's called DDP yoga. And it's been fairly helpful. As far as stretching for me goes. If you are not sure where to begin with yoga, go to YouTube. I did a search for yoga for beginners. And there's, there's thousands of videos, I don't even know if I could go through them all, even to just look at them, let alone complete them all. So that is certainly something that you can do. There's a lot of them. They're all free. They'll show you different positions that you can do stretching and just do what you can do. You know, if somebody is bent like a pretzel and one of them and you can't do it, so be it just fast forward through that portion till you get to a to a way that you can do so, but don't feel bad. Don't Don't think that you're, you're not completing the yoga because you couldn't do two or three of the poses. Do what's what you can do. 

The other thing is sleep well. This has been a major issue for me. I have started using my sleep apnea machine on a more regular basis and I've noticed a big difference. I did not use it last night, and I ended up being exhausted today. So I'm going to set it up. I've been traveling and just hadn't unpacked it. I will be unpacking it and setting it up tonight to us. And it makes a big difference. I think one night I slept with it for six and a half hours on and it's probably the most six best sleep I've had in God knows how long with with snoring and tossing and turning. I just never get a good night's sleep. 

The third thing you can look at doing is getting educated on Ankylosing Spondylitis. There's so much information out there. I surprised and amazed that every time I do searches on this, the information I come across and the knowledge I'm learning as I take away for many years, I was diagnosed back in 1984, before internet or anything like that. And so for me, you went just off of what the doctors told you. And I never really looked much beyond that. If the doctor Toby, here's a pamphlet, read it. I read it that was as far as it went. It really wasn't until these last couple years that I really started digging in. Not necessarily with becoming the i thought i becoming an expert. But just to get better educated on what was going on to me how I switched to a new medication called Cosentyx and it was such a different result for me versus the others. The Enbrel and the Humira that I had been on, that I was really interested in how it worked and why it was so different than the others. So I did some reading and as much as I could on that, and it was, it's been interesting, this show has really allowed me to do some more digging and talk to people as well that have AS and what they're doing with it. And I've learned a lot from people I've talked to that have been on the shows, and people have talked to that have not been on the shows but I hope to have them on at some point. 

The other thing is and this was talked about the question today is for number four get support. If you feel yourself Not getting into a not getting the type of feedback and conversations you need from a family or spouse. Go ahead and and talk with the folks that are online and through the different forums on Facebook or wherever you're you're at. You know, I've spoken with folks on both Instagram and Facebook and learned so much and been inspired by the folks that I've talked to. It's really been interesting, it's been good for me. I hope it's been good for them as well. And I'm telling you, there's just great people out there that will will make sure that you're in a good spot. If you're having a rough day. And, you know, it's well worth your time and well worth the investment of your time.

Number five, manage stress. This is a big one. The more you let stress and we all have stress again, we stress comes up just from daily living. But the more you manage your stress, whether it be just taking a deep breath if something happens, or doing your yoga, or meditation, any of that can help to control is it longer you control the symptoms of stress in your body, it reduces that inflammation response of your body and thereby doesn't trigger the inflammation from your AS to kick it into high gear. So that's really the key is you, you want to try and maintain as little stress as possible. One of the ways that I helped to mitigate stress for myself is I started meditation.

I took a transcendental meditation class, I found it to be fantastic. It's not saying you need to do Transcendental Meditation. like yoga, I did a search on YouTube for meditation. And there is just thousands and thousands of beginners meditation videos there. I'll put a link in the show notes to a couple. I'm not in doors in these by any means it's just meditation for beginners, they're 10 to 12 minutes long. And it might be a starting place for you to go out and find something that works for you. I do 20 minutes in the morning, 20 minutes in the afternoon, evening. And I think it makes a big difference. I think it clears my mind and allows me to, to kind of reset myself to move forward with the rest of the day, whether it be in the evening and tackle what needs to get done, or whether it be through the rest of the day after the morning meditation. So I was very much a skeptic of things like meditation and yoga. For years. I viewed him as a False, fake. But the longer I've been kind of playing around with a doing them, the more I think that there really is something to it and, and I'd encourage folks to really take the time to look into both of those on a very basic beginner level, and, you know, incorporate those into your life again. 

Finally, the sixth thing is, seek mental health counseling. And that's what I said before. If the first five are not working for you, you feel yourself having really bad bouts of depression. I can certainly understand that I've been there. Go get professional help. Go talk to a therapist, go talk to your doctor. Go talk to both. It might be something very short term, where there's some type of additional medication that can help you it might be some type of long term issue that needs to be dealt with through therapy. And that medication is not going to help you. So, you know, as you move forward, don't let depression when you know, this ankylosing spondylitis has such a detrimental effect on people that it can strip you of what you were and what you wanted to be. But it doesn't have to strip you of everything. Don't let it Don't let it completely take you over and lose the person you were. Try to hold on to that as much as you think you can. Go out and Fight. Fight the AS make sure that your depression doesn't overpower you. And make sure if you have questions, concerns, you know anything.

 Don't hesitate to reach out to any of us on the angle of spondylitis sports. I see a lot of people talking about you know whether it be depression or just support Education, all of that on the boards. And it's great to see. So I encourage you to take advantage of that. I hope you all have a great day. And again, it's my pleasure to be able to bring this to you and I can't wait to keep and I hope you all have a great day. And as always, it's my pleasure to bring these episodes to you. Thank you and take care