Chronic Pain Affects COVID-19 Symptoms

Those experiencing chronic pain, may not only be more susceptible to the COVID-19 virus, but if infected, may face additional consequences and higher morbidity risks than others.

That’s because there is a complicated relationship between the brain, the immune system, and chronic pain, explains Leanne O’Neil, owner of INDY Neurofeedback. This relationship is heightened, we are just now seeing, when a COVID client has been taking long-term pain therapies.

Generally speaking, chronic pain clients can be considered immune-compromised. Many are elderly and have multiple and inter-related health issues. Some are also on long-term opioid therapies and steroids, which are known to interact with the immune system, often times, suppressing it. That makes pain management during COVID-19 treatment, especially with seniors, particularly tricky.

The COVID team at the Western Reserve Hospital in Cuyahoga Falls, Ohio, has discovered a complicated relationship between opioids and COVID-19:

“Patients who use opioids to manage pain need to be especially careful during COVID-19,” Dr. Rhayed Narouze, MD, PhD, of Western Reserve Hospital noted. “As doctors, we should be mindful that the more and longer opioids have been taken, the more patients lose respiratory reserves, and may not be able to fight this particular infection.”

“As with many virus-related diseases, COVID-19 can present with extensive muscle aches and pains,” weighs in Jeffrey Fudin, PharmD, of the Stratton VA Medical Center in Albany, New York. “This can aggravate various pain syndromes, particularly those involving muscle and bone, such as chronic back or neck pain.”

Since COVID-19 affects respiration, excessive coughing will likely worsen experienced pain. As the person becomes sicker – especially if they are elderly – there will be at an elevated risk of requiring sedation, leading to opioid-induced respiratory depression, which increases mortality.

For persons on one or more sedating drugs or opioids, the risk seems to be even higher. These drugs included in this initial observational study include:

  • antidepressants
  • skeletal muscle relaxants — especially cyclobenzaprine (Flexeril and others)
  • carisoprodol (Soma), and

Chronic pain clients may be on oral steroids or may have received a recent steroid intervention, and thus may have an altered immune response. Steroids, for example, have been associated with a higher risk of influenza (and COVID).

So what can those with chronic pain do during the COVID pandemic to maintain health and wellness?

“We need to encourage continued movement and adaptive exercise options,” said Beth Darnall, PhD, of Stanford University in Palo Alto, California. Although they may not be able to attend regular physical therapy sessions (due to pandemic restrictions) to help manage pain, the good news is that there are a number of online tools available to demonstrate how to perform physical therapy exercises at home.

Here is a resource link from The American Chronic Pain Association to help patients stay active during the pandemic.

Clinical video can also promote client health and wellness, says Leanne O’Neil. This holds for medical, psychology, neurofeedback, and social work consultations, too. “Ideally,” O’Neil says, “clients need access to all three. This support can help those with chronic pain remain connected at a time when they may be feeling more isolated.”

Importantly, our clients with pain need to know how to get help if they need it. Let us know if you or a loved one need help managing chronic pain over and above prescription pain relief. That’s why we’re here.

Are You an Introvert?

woman happily reading aloneThere’s been some recent buzz on the Internet about introverts. According to self-reporting, introverts seem to cope with quarantine conditions better than their more extroverted friends. If you’ve shared in similar discussions, you might wonder if you tend toward introversion or extroversion. Because, well — is anyone exclusively just one type of personality?

Leanne O’Neil, owner of INDY Neurofeedback, weighs in. “Being 100% extroverted or introverted is pretty rare. Most people are a combination of both personality types. The labels “introvert” and “extrovert” have become a short-hand way to express how people react to the world around them. Scientifically, though, being more one way or the other has more to do with how your brain processes information, which shows up in your behavior.”

Famous psychologist Carl Jung began using the terms introvert and extrovert in the 1920s. Jung categorized individuals into these two basic personality types by noting energy expenditure. Introverts, Jung said, turned inward to recharge, while extroverts sought out other people for their energy needs. Those that fell right in the middle of the scale were referred to as ambiverts.

You might be an introvert if…

According to Psychology Today, approximately one-third to one-half of all people in the U.S. tend toward introversion. Of course, having the qualities of an introvert looks different depending on your gender, age, and cultural upbringing. That said, introverts in general share many of the same patterns of behavior, such as:

  • Feeling comfortable being alone
  • Needing quiet to concentrate
  • Being more reflective
  • Taking more time to make decisions
  • Disliking group work
  • Feeling stressed or uncomfortable in a crowd
  • Retreating into their own minds to rejuvenate or rest.

One way to determine where you fall on the introvert scale is to take a test, such as the Myers-Briggs Type Indicator or the SAPA project

Are we born an introvert or extrovert?

Behavioral psychologists aren’t sure about this yet. What they do know is the brains of the two personality types work very differently. Researchers know that introverts tend to have a higher blood flow to their frontal lobes than extroverts do. The frontal lobe of your brain is responsible for remembering things, solving problems, and planning ahead, among other things.

Introvert brains also react differently to dopamine. Dopamine is a chemical that turns on the reward and pleasure-seeking part of your brain. Introverts and extroverts have the same amount of the chemical, but extrovert brains get an excited buzz from their reward center. Introverts tend to feel overwhelmed by it.

What type of introvert are you?

Behavioral psychologists group introverts into four subtypes:

  • Social introverts – “Classic,” preferring small groups and quiet settings over crowds.
  • Thinking introverts – “Daydreamers,” spending a lot of time in thought and creative imaginations.
  • Anxious introverts – “Loners,” seeking out privacy, because they prefer it or feel awkward or shy.
  • Restrained/inhibited introverts –“Indecisives,” taking longer before committing and making decisions.

Interestingly, your introverted or extroverted ways will very likely change over time, and in different settings.

You’re not likely to swing from introvert to extrovert, but you may become more or less introverted, depending on what’s going on in your life.

At INDY Neurofeedback, we are fascinated with anything having to do with brains, thinking, challenges, changes, and behavior.

We welcome your questions…

Breathing, Your Brain, and the Coronavirus

Over the past 20 years, we’ve begun to understand how intensely breathing patters affect brain health and contribute to illness. Researchers working together with biofeedback techniques have

developed coaching strategies to optimize breathing patterns, improve health and wellbeing, and mental performance.

A prime example of how learning to self-optimize breathing patterns to help control health has to do with asthma. In a 2003 study, people with asthma were taught to reduce their reactivity to cigarette smoke and other airborne irritants.

  • Participants were first taught how to slow diaphragmatic breathing.
  • Next, they were taught to hold their breath but relax their bodies the moment they became aware of an airborne irritant such as cigarette smoke.
  • They then moved away from the polluted air while exhaling very slowly through their nose, waiting until the air was clearer to inhale and continue diaphragmatic breathing.

Using this research, people may well be able to reduce their exposure to the coronavirus by changing their breathing patterns.

Naturally, the first step to preventing catching the illness is by prevention by following the recommended public health guidelines, including social distancing, frequent thorough hand washing, surface disinfecting, and keeping hands away from one’s face. Recently, wearing a mask to protect one’s face has been added to this list.

So, how can one reduce their exposure to the virus when near other people by changing their breathing pattern? 

Normally when startled or surprised, we tend to gasp and inhale air rapidly. We also do this when someone sneezes, coughs or exhales near you – which causes a potential intake of germs from the contaminated person. Instead, change your breathing pattern.

Here’s how:

When a person is getting too close

  • Hold your breath with your mouth closed and relax your shoulders (just pause your breathing) as you move away.
  • Gently exhale through your nose (without inhaling), no matter how little air you have in your lungs.
  • When far enough away, gently inhale through your nose.
  • Remember to relax and feel your shoulders drop when holding your breath – which should last for only a few seconds as you move away from the person.
  • Exhale before inhaling through your nose.

When a person coughs or sneezes

  • Hold your breath and rotate you head away from the person while moving away from them and exhaling though your nose.
  • If you think the droplets of the sneeze or cough have landed on you or your clothing, go home, disrobe outside your house, and put your clothing into the washing machine. Take a shower and wash yourself with soap.

When passing a person who is approaching you

  • Inhale before they are six feet from you, and exhale through your nose as you pass them.
  • When you are more than six feet away, gently inhale through your nose.

When talking to people outside

  • Stand so that the breeze or wind hits both people from the same side. This way, any exhaled droplets are blown down wind from both of you.

“Although these breathing skills are simple,” suggests Leanne O’Neil of INDY Neurofeedback, “they will take practice and mindfulness to before they become habitual – and genuinely helpful – especially if you or someone in your family has asthma. Remember, this breathing pattern should not be forced. In fact with practice, it will occur effortlessly.”

There are so many, many interesting ways INDY Neurofeedback can help you and your family members use techniques to retrain your brain. If you have a physical, emotional or health issue holding you back, we welcome your call. Your first consultation is always free.

Your Brain… on Yoga

Yoga in all its forms has proven its benefits across multiple generations and continents. Interestingly, modern science is now confirming its usefulness for improved mental and physical health and even brain fitness.

Indeed, yoga has been shown to support healthy brain function and stave off neurological decline. That’s particularly good news for those with limited mobility or early onset dementia, as some form of yoga (such as chair yoga, water yoga, yoga for the blind, and gentle yoga) is accessible for a wide majority of people, regardless of age or fitness.

Here are yoga’s effects on the human brain:

  • Recent studies demonstrate a positive effect on the structure and/or function of the hippocampus, amygdala, prefrontal cortex, and cingulate cortex.
  • Psychologically, regular practice has also been shown to lower stress, reduce body image dissatisfaction and anxiety.
  • Brain scans of regular yoga practitioners show they have thicker cortexes and greater gray matter volume and density in several brain regions, including the frontal, limbic, temporal, occipital and cerebellar regions. This research seems to confirm that yoga appears to negate the otherwise normal decline in total gray matter volume that occurs with age.

Interestingly, these beneficial brain changes appear to occur fairly rapidly when yoga is done at least once (one hour session) per week.

Other ways yoga has proven benefits for your brain

  • Twenty minutes of yoga weekly improves speed and accuracy of mental processing to a greater degree than 20 minutes of aerobic exercise (jogging).
  • Yoga helps improve a variety of mental health problems, including psychiatric disorders like anxiety, ADHD, depression, post-traumatic stress disorder (PTSD), and schizophrenia, in part by increasing brain chemicals like gamma amino-butyric acid (GABA). Without GABA, nerve cells fire frequently and easily, triggering anxiety disorders, seizures and conditions such as addiction.
  • Yoga also boosts serotonin, and some studies suggest yoga can have a similar effect to antidepressants.
  • Yoga can help improve teenagers’ emotional resilience and ability to manage anger. This is especially helpful as teen frontal brain lobes (the seat of language and reason) are still being formed, leaving them to overly rely on their amygdala (the seat of emotions).

“It appears that the unique combination of physical movement and deep breath work of yoga offers these healthy brain benefits,” sums up Leanne O’Neil, owner of INDY Neurofeedback.

The evidence is clear. Regardless of your age or physical agility, consider finding a yoga class that you can do on a regular basis.

Too Much Screen Time Slows Brain Development in Preschoolers

The number of tablets, videos, television shows, and smart phone tools marketed toward toddlers and preschoolers has exploded over the last several years, prompting parents to ask, “How safe is screen time for very young children?”

A new study by a clinical researcher at Cincinnati Children’s Hospital (published in JAMA Pediatrics) decided to find a definitive answer. Pediatricians and clinical researchers scanned the brains of children 3 to 5 years old and found that those who watched more than the American Association of Pediatrics (AAP) recommended one hour a day (without parental involvement) had lower levels of brain development in key areas related to the development of language, literacy and cognitive skills.

This is important to note because the brain is developing the most rapidly in the first five years of life. That’s when brains are actively engaged in soaking up knowledge and forming strong connections in language, literacy and cognition. Even before screens became portable and ubiquitous, we have long known that parent-baby face to face or heart to heart engagement form the core of the social engagement system from which the child (and later adult) will function in all future relationships.

Specifically, these new studies show that excessive screen viewing is linked to the inability of children to pay attention and think clearly. There is a definite link between excessive screen time and language delay as well as a decrease in parent-child engagement. This is especially important to consider because today’s portable screens follow kids and parents everywhere – to the dinner table, in the car, during playtime with other kids, even to bed.

More troubling, very young kids are now routinely exposed to screen time. About 90% are using screens by age one, according to one study that used MRIs to research the impact of reading to children versus screen use by kids alone. In this testing, MRI results showed that children who used more than the AAP’s recommended one hour per day of screen time without parental interaction, had more disorganized, underdeveloped white matter throughout the brain.

“We know that early experiences shape brain growth, and media is one of these experiences,” says Leanne O’Neil of INDY Neurofeedback. “Heavy media use does not lead directly to brain damage, but rather, it is too passive for brain development and gets in the way of other experiences that could help children reinforce their rapidly growing brain networks.”

Here are AAP screen time guidelines for young children:

  • Babies under 18 months should not be exposed to screen media other than brief video chatting with friends and family. Babies need to interact with caregivers and their environment, so don’t use media as a babysitter.
  • By the time a youngster turns two, they can use some interactive touchscreens, as long as parents watch with them and reteach the content.
  • Children 3 to 5 years old can benefit from well-designed educational TV shows, which can improve a child’s cognitive abilities, help teach words, and positively impact social development. But just like toddlers, preschoolers learn much better from any educational materials when they are co-viewed with their caregiver, interacting about the material.

“The first years of life need to be focused on human interactions that encourage speaking, interacting socially and playing with loving caregivers,” says O’Neil. “This helps young brains develop thinking, problem-solving and other high functioning cognitive and lifelong learning skills.”

High blood pressure and brain health

Yes, high blood pressure and brain health are closely related, especially as we age. Here’s why:

Lesions in the white matter of our brains, often called hyper-intensity lesions, are damaged areas of the brain responsible for transmitting information from one part of the brain to another. Interestingly, these  brain lesions are more common with age.

In fact, ten to twenty percent of 60-year-olds have them, and they’re more present in 70, 80 and 90-year olds, according to the American Heart Association (AHA).

As hyper-intensity lesions accumulate in the brain, they can lead to functional changes such as depression, problems with balance, bladder control, and dementia.  Recently, a professor at the University of Connecticut School of Medicine’s Calhoun Cardiology Center found that lowering blood pressure may be the key to preventing these lesions. Subjects in the school’s study found that those with lower blood pressure developed 40 percent fewer white matter hyper-intensity lesions than those with higher blood pressure.

In a related study (Circulation journal), adults age 75 and older with hypertension (high blood pressure) who were able to lower their systolic blood pressure to 130 (with or without medication) developed fewer brain lesions than those who lowered their blood pressure to 145.

In addition to brain benefits, the study also found that the group with lower blood pressure had fewer cardiovascular events, including arrhythmias, heart failure and heart attacks.

Some physicians use age as “an excuse” to let higher blood pressure numbers slide. However, in 2017 the American Heart Association (AHA) revised their guidelines and set the generally approved threshold for high systolic blood pressure at 130 for all adults, regardless of age.

Even so, as much as 46 percent of American adults have high blood pressure under the new AHA guidelines.

“That’s a huge percentage,” cautions Leanne O’Neil, owner of INDY Neurofeedback. “My recommendation for brain health is to regularly have your blood pressure checked. Monitor your numbers, and do what you can to keep those numbers moving down, especially if you are overweight or over age 60. Not only will getting more exercise help, but you can also keep your blood pressure trending lower by eating fewer sugars, starches, fatty meats, and sodas, and adding more fruits and vegetables to your diet.” 

Diet soda + 10 years = increased risk of dementia & stroke 

diet soda popDiet soda + 10 years = increased risk of dementia & stroke 

Recently, a large study tracking stroke and dementia risk in diet soda drinkers caught our attention at INDY Neurofeedback.

The health hazards of sugary beverages like regular soda have been known since 2015. But a more recent study shows that the sugar-free soda version is not any healthier. 

Artificially flavored drinks like diet soda seem to be linked to a higher risk of stroke and dementia, according to a new study published in an American Heart Association journal.

This ten year study included one group of 2,888 adults age 45 and older, and a second group with 1,484 adults over age 60. Researchers studied the over-45 group for stroke risk (rare before age 45) and the over-60 group for dementia (rare before age 60).  

Researchers analyzed the number of artificially flavored drinks each person consumed. They then checked the group’s health over the next 10 years and found:

  • Those who drank at least one diet soda per day were about three-times more likely to experience an ischemic stroke (blockage of blood vessels to brain tissue), compared with those who avoided the beverages. 
  • Just one daily diet soda was linked to higher rates of dementia as well, although other risk factors like obesity or diabetes also could be to blame.
  • Researchers note that it isn’t proven that diet sodas caused these conditions. But it is true that those who developed stroke or dementia had consumed more soda than those who had not. (Other factors, such as obesity – also tied to diet soda drinking – could also be a factor).

More research is needed to determine exactly how—or how much—artificially sweetened beverages affect your vascular system, the network of vessels that carries blood to your brain. 

“What we do know,” says Leanne O’Neil of INDY Neurofeedback, “is that when vessels harden or develop sticky plaque build-up, it raises your risk of chronic conditions like heart disease and diabetes, as well as dementia and stroke.”

“So the best thing you can do for your brain health is to maintain a healthy lifestyle to help protect against these illnesses. What’s good for your health and heart is generally also good for your brain.” 

Learn to Quiet Your Brain — and Live Longer

Those of us at INDY Neurofeedback were fascinated with a new study recently published in the medical journal Nature, which linked quieter brains with longevity. We were fascinated because it confirmed what we have been seeing in our neurofeedback clinic for years.

It makes sense that a less active or calmer brain would use less body energy. That’s the theory behind activities such as mindfulness and meditation – which have been around for thousands of years. It also supports the HeartMath HRV (heart rate variability) program all clients are taught in conjunction with our neurofeedback training. 

In the Nature study, researchers from Harvard Medical School reported that a calm brain with less neural activity could lead to a longer life. 

Here’s what the Harvard study showed:

  • The study analyzed donated brain tissue from people who died (aged from 60 to over 100). 
  • A protein that suppresses neural activity — called REST — was found to be associated with neural activity and mortality.
  • Researchers noticed that the longest-lived people had lower levels of REST as well as genes related to neural activity.
  • The study showed that daily periods of slowed activity spent in meditation, uni-tasking, being in quiet environments, or sleeping, were just as important for life-long brain health and longevity as more well-known maxims such as staying active, maintaining a healthy weight, and exercise. 

“Even though our brains weigh only about one-seventieth of our total weight, brains consume nearly one third of all the energy in our body,” explains Leanne O’Neil, owner of INDY Neurofeedback. “So it is incredibly important that we learn how to quiet our brains to give them a chance to rest – especially when all around us, we’re encouraged to multi-task and stay engaged.”

“Learning how to quiet our overly-busy, multi-tasking brains is vital for our mental health. And now, we know it is also connected to longevity.”

Here is what INDY Neurofeedback tells our clients:

  • Begin to tune into and listen to your body. Find out where you are holding in tension, and acknowledge those areas. When you acknowledge your body, you are more open to what is really going on for you.
  • Learn to recognize when you are feeling overwhelmed.
  • Practice mindfulness and deep breathing.
  • Try regular meditating. It’s a good way to stay tuned to your internal mental state.
  • Learn to stop reacting and talking, and be present. Really listen to what others are communicating.
  • Be brutally honest with yourself about having clear boundaries. Know when you need to take a break from work, children, problem-solving, or being with others. 
  • Spend time alone, doing what you enjoy.

Those of us here at INDY Neurofeedback have noticed that by incorporating both HRV and neurofeedback techniques, individuals can learn to gain control over various over or under active parts of our brains, providing the tools for healthier more optimal brain function.

Slow Walking, Slow Mind?

What is the pace of your usual walk? Brisk and peppy, or slow-paced? Turns out that the gait of your walk provides reams of information to onlookers and health practitioners about your age – and brain health.

Physicians have long used walking speed as a marker for cognitive capacity in older people, since gait is linked to the central nervous system. But perhaps more interestingly, you don’t have to be a senior for walking pace to play a significant part in your overall health. 

New research suggests that even people in their 40s who walk slowly are more likely to have slower functioning brains. 

A new Duke University study is the first to suggest that the gait health analysis might work for younger people as well as seniors, reports The data comes from a long-term study that followed approximately 900 New Zealanders from their birth in the 1970s to their 45th birthdays. The study tested participant walking speed and examined their physical health in addition to brain function.

Significantly, the slower walkers tended to display signs of accelerated aging – specifically in their lungs, teeth, and immune systems, as the researchers had expected. But surprisingly, MRI scans of the slow walkers’ brains looked notably older than the brains of the regular paced walkers. 

Adding insult in injury, strangers who were asked to assess the age of the participants from photos of their faces said the slow walkers even looked older.

Researchers from Duke University conclude that these results suggest that, “A slow walk is a warning sign of brain decline decades before old age sets in.”

What does your brain convey about your overall health? From patterns of forgetfulness to repetitive thoughts, anxiety to inability to sleep, your brain’s optimum functioning is the key to your health – no matter what your age.

If there is something about your brain health you’d like to discuss with us, come talk with us. Our consultations are free and always confidential.