Jan Nicholson, EdD is an integrative clinical psychologist in Virginia who brings innovative mind-body approaches to her therapeutic work. I had an opportunity to interview her regarding her insightful mind-body recommendations on fatigue, stress and adrenal burnout that some thyroid patients experience, even after treatment.
MARY SHOMON: Q: Fatigue seems to be a very common problem for thyroid patients -- even those of us who are receiving what doctors consider effective treatment. Do you have any mind-body suggestions for patients who struggle with daily fatigue that is not resolved by thyroid treatment?
JAN NICHOLSON, EdD: There are actually ways to build up one's energy reserves. If you have seen on television people in China doing movements together in a park, they are practicing qi gong, an effective way of building energy. It is getting quite easy for people in most locations to find a qi gong or a tai chi class. If you are too tired to go out to a class, then look for a DVD about these approaches and do it at home. It is possible for acupuncture to enhance one's energy wherever it is weak; it also is beneficial to have acupuncture at the start of each season, to help adjust to the ways in which seasonal changes affect one's functioning. There are hands-on and hands-off energy therapy approaches that can help energize people, such as Reiki, Healing Touch, and Reconnective HealingTM. Exercise helps to build energy for most people and it is usually possible for everyone to find some form of exercise they can handle, even if it is just to walk partway around the block initially. Laughter and having fun is energizing, so read humorous authors like Bill Bryson or watch a comedy. Music can be invigorating. If you are feeling down, you can make yourself a CD of four or five pieces of music starting with a slow quiet piece, and gradually building up to a fast joyful piece; this can give you energy.
Of course, it is not recommended we do what so many of us do when we are tired -- relying on caffeine for false energy, or overeating trying to get energy. If you find yourself doing this, try to catch yourself in that moment just before you do it and see what healthier alternative you might try instead.
MARY SHOMON: Q: One aspect of an endocrine imbalance that some thyroid patients face is adrenal fatigue, or what we sometimes call "adrenal burnout." This is not the same as the medical condition Addison's disease, where the adrenal glands are unable to produce cortisol. Instead, in adrenal burnout, depending on how burned out we are, we sometimes see overly high adrenal levels, or inconsistent spikes throughout the day, or chronically lower levels, plus an inability of the adrenals to ramp up needed hormone production when we are under stress. Of course, at the same time, many of us with chronic illness are under constant physical and emotional stress -- stress from low-level infection or inflammation, toxins, allergies, fatigue, and in some cases, anxiety or depression, plus the impact of stressful events in our lives. This ends up compounding the problem further. While there are medical and nutritional treatments to help support the adrenals, what other approaches do you think are especially helpful for patients as part of an overall effort to calm the adrenals and cope with stress more effectively?
JAN NICHOLSON, EdD: It is important to identify your stressors, especially ongoing ones, and to think in terms of what you can change and what you might be better off to accept, and how you might go about creating change or acceptance. Fighting things that will not change or it is not time to change becomes self-destructive. A great quote from Dr. Schulz is: "You have to know when to hold and when to fold, when to be powerful, when to be vulnerable." In a mindful way, do what it takes to shift self-destructive habits and to resolve problems. Learn and practice stress management techniques on a daily basis, being sure to get enough rest for your body to heal. Think of yourself as being on a healing path. To shift your approach to life and toward yourself to a kinder, gentler approach is essential when you have gotten to this point in terms of burn out.
MARY SHOMON: Q: Some experts say that autoimmune diseases seem to strike Type A personalities more often, as compared to people who are more laid back and less "stressed out." Do you have any thoughts about that finding, and perhaps any practical advice for hard-charging Type A folks?
JAN NICHOLSON, EdD: There has been a lot of research bearing out health issues associated with being a Type A personality; the hard-charging behavior tends to happen at home as well as at work, in all relationships, with a tendency to have more hostility/competitiveness and less joy. That is not beneficial for mental or physical health. In my practice, it is always an interesting process to find a way that works for Type A folks to be able to relax more and be gentler with themselves and others partly because hard-charging people often do not have much patience for learning and practicing mind-body approaches.
I would urge you, if that is your tendency, to try to suspend the belief that such things are a waste of time and to give it a try. Massage can feel so good that you might be able to let go and relax (start with a 15-minute seated massage if you are uncomfortable allowing more time); a hot tub, steam room, or sauna can have a similar effect. A great avenue to reduce stress is exercise; forms of meditation that involve movement (e.g., yoga, tai chi, qi gong) are usually preferred to sitting meditation. Acupuncture can help to balance the energy to be more calm. Short, focused relaxation techniques that can be completed in five minutes and get quick results can help to open the door to trying more in-depth approaches.