EP.273/ How to manage your endo and take action during a humanitarian crisis
Today’s episode is one I’ve been mulling over for a while. The situation between Israel and Palestine has divided the world, and I didn’t want to add my voice to just basically add another voice into the chaos. I wanted to do something that felt useful and relevant - and so today’s episode, is part of that.
Today I want to talk about ways to manage a humanitarian crisis when you’re already suffering so much with endo and your own health.
I know from personal experience, how challenging and overwhelming it is, to be dealing with very real health problems in your own life, whilst the world feels like it’s burning around you. You want to take action; you feel pressure to speak up and yet you can barely think straight due to your symptoms. It’s a really hard place to be in, and it can cause a lot of inner conflict and negative feelings about ourselves, because we can get frustrated that we’re not doing more, not being more vocal, etc. etc.
So, in this episode, I am trying to share ways that may help you hold space for both, and care for your health whilst also doing what you can (if you want to and you’re able to) for those affected by the Palestine and Israel conflict. My hope is that this small contribution, may give you the tools and resources to take your own action, if that’s what you choose to do, and so whilst I can’t directly help those in need (other than the obvious things like donating), by helping even just a handful of you, I am hoping that there will be a little bit of a butterfly effect and that this pretty unknown podcast, can make a small difference.
Before I begin, I also want to acknowledge my limitations here. I am not an expert on war or this particular conflict, by any stretch of the imagination. I am not a reliable source on the war, or a person who holds any weight or authority in terms of my views on the war or my perspective. There are far, far more educated, experienced and skilled people who you should be getting your information from. What I can do today, is offer some insights about how to look after your health during a time of crisis, based on my education as a health coach, as someone who has worked with vulnerable people and as someone who has gone through my own experiences with these kind of issues. If there is anything you don’t agree with in this episode, that offends you or that you think is incorrect, I apologise and I encourage you not to take my word as gospel, because I do not think it is – I am just one person, doing what I can, with the skills that I have.
Alright, now that’s clear, let’s get started.
Okay, so the first strategy I want to address is to prioritise your basic needs – so sleep, some degree of rest, food, water. These are all obvious things, but they are some of the first things to go when we’re anxious or stressed or fearful. We lose sleep to insomnia and being hooked on the news or social media; we skip meals because our stomachs are in knots, or we’re so consumed by the thing that is causing us distress that we forget to eat, or we make unhealthier choices around food because we’re seeking comfort. We stop making an effort to stay hydrated and go back to our old ways of getting by on way too much caffeine.
Does this sound familiar? For some of you, this might not be an issue, but I know many of you can relate to this.
In fact, I had a friend just last week who messaged me because she was stuck in a spiral about Gaza, and she has a lot going on mentally and physically, and she got entirely consumed for a week and was just skipping meals, forgetting her medication, drinking lots of stimulants, etc. and by the end of it, her health and her mental health were really deteriorating, and she’d been working hard to get to a good place with both of them.
And there’s definitely that temptation there I think, when something bad is happening in the world, to deprioritise ourselves, because there’s almost that feeling of “who am I to get good sleep or stay hydrated, when other people are barely able to get clean water and sleep hasn’t been an option”. I know I’ve had that thought many times over.
But here’s the thing. These foundational health habits are just that – they are foundational, they are essential. Sleep is not a self-care add on, it’s not like skincare or dry brushing. We need it to survive and to function, in fact, the physiological and psychological changes kick in after just one night of poor sleep or no sleep at all, and they get progressively worse as the days go by. The significant impact on our bodies and minds are of the reason why historically, sleep deprivation has been used as a form of torture in war and interrogations.
And when it comes to how it affects endometriosis, it’s pretty profound. Lack of sleep increases inflammation, which further fuels pain with endometriosis (potentially even progression if we consider how inflammatory chemicals are at the centre of endometriosis growth, but I don’t have evidence for that) and if that wasn’t enough, lack of sleep increases our sensitivity to pain and lowers our brain’s natural pain-relieving chemicals. Sleep deprivation also worsens negative thought patterns and feelings of depression and anxiety but can also trigger the onset of these conditions. And additionally, a bad night’s sleep causes insulin resistance, which sets the stage for blood sugar imbalances and hormonal dysfunction as a result.
When you’re trying to keep endo at bay, you need all these things on your side. Blood sugar and hormones have a profound effect on the development and symptoms of the disease. People with endo are at a higher risk of developing depression and anxiety or already suffer from it, and of course, many of us are battling pain and fatigue on a daily basis, so we certainly don’t want something to worsen that.
Now, if this is freaking you out because you can’t sleep much generally or have painsomnia, I’ve been there and I’m so sorry for you, but there are methods to improve our sleep with endo. That’s not what this episode is for, but I’ve linked to some of my articles and podcast episodes on the subject, and I actually have a whole module dedicated to it in my Live and Thrive with Endo courses (they’re not currently running right now though).
But, back to my point – it’s going to be much harder to think clearly about the Israel and Palestine situation and to take proactive steps when you’re being affected by the negative impact of sleep deprivation, or your blood sugar is dipping because you’ve skipped meals or you’re comforting yourself with a load of refined carbs. The situation is awful, awful – there’s no getting away from that, but if your physical health starts to worsen, you’re going to feel even worse about the situation than you already do and your mental health is really going to suffer, because you literally do not have the physical or mental resilience to allow your body to cope with the stress of it. I’m not being hypothetical here, the changes in your body that will occur from driving yourself into the ground with worry, will literally leave you with a weakened stress response and immune system and a lack of the right neurotransmitters, nutrients and resources to think clearly and in a way that is helpful to the situation.
I know some of you listening are thinking “But that’s what people are going through right now. People are in horrific conditions, existing in a state of trauma, and they don’t have access to these basic needs, so why should I prioritise myself here?”.
Because the healthier you are, both mentally and physically, the better able you are to serve others. Listen, I have been in this kind of situation many times, I often am, with my work. Every week I hear stories from clients that break my heart, and I want to stay up all night dedicated to their case and trying to resolve everything as soon as I possibly can – and trust me, I’ve done close to that on occasions and it’s a constant, daily battle, to factor in my own health and self-care and basic needs in my line of work, because it would be so easy to just go-go-go. I am sharing this topic, because I know this challenge and I know it very, very well, and as someone who has spent years working in services that support vulnerable people like people with endometriosis, homelessness or domestic violence, I know the impact of not looking after myself because I am trying to rescue everyone. It doesn’t work out. You become worse at your job, you become negative, you can’t see solutions or a way out, you lose hope, you spiral and eventually – you shut down. It’s actually known as compassion fatigue and it’s a very real thing. Compassion fatigue causes physical symptoms including sleep problems, anxiety, exhaustion and many others, and mentally, people can experience apathy, relationship problems and an inability to cope anymore with other people’s trauma, pain and suffering.
So, to wrap up this section, I’m pretty sure, in times of personal stress or world stress – so for example, the witnessing of war or covid, there will be some endo management strategies that go out the window. Perhaps you forget your supplements or get out of a routine with your physio stretches, whatever – but if you can, to the best of your ability (without beating yourself up about it for not doing it all perfectly), keep some degree of your basic needs in place, you’ll be helping yourself and others in the long run. And in terms of those extra add-on tools, you may use on a daily basis, if you can, try to hold onto the ones that you find the most effective and that without them, your endo symptoms tend to return. So, for example, for me, I really need certain daily supplements to keep on top of my MCAS symptoms, but there are other things like lymph drainage massages, that are helpful, but they are an extra add on that won’t cause me a huge problem if stop doing them. Does that make sense?
Okay, so now let’s move onto my next strategy and that’s to create boundaries.
I’m just going to be honest – I hate boundaries. I have a really hard time with them. When I worked with homeless young people, I was ready to adopt them all. Now obviously, look, I know there’s a million reasons why that would not be okay, and we had staff-young people relationship boundaries, and ethics and all of that, which I adhered to, but I struggled with it. I understand why boundaries are needed, why they’re healthy and why they’re important, but I find them challenging.
And yet, in scenarios like this, we need to have them to maintain our health and wellbeing. It’s all too easy to just leave the news on all day, or to just keep refreshing Twitter or news outlets to stay informed and updated. We can tell ourselves it’s so we stay educated, but to what end? What will staying up to date with every single change as it happens and occurs, achieve?
The stress response. That’s what it will achieve. Heightened cortisol and adrenaline, resources driven away from non-essential functions like ovulation and digestion and so on. If levels stay continuously elevated, inflammation rises and immunity weakens, and of course, we end up with the compassion fatigue scenario I explained earlier, or worsening endo symptoms.
I’m not saying don’t stay informed, I’m just saying choose your exposure and when you consume, choose wisely and put limits on it. You’ll still get all of the updates and information whether you tune in real-time as something in Gaza happens, or whether you tune in during the evening news later today. If there’s something you want to understand or research further, you could then maybe dedicate some time to that, but give yourself a limit, again, so you don’t spiral and so you can make room for your human needs of getting to bed, eating dinner, etc.
So, for example, if you’re someone who deals with anxiety and depression and you know your pain is particularly triggered by stress, then waking up, picking up your phone and checking Twitter for news updates, is probably not the best move. That repeated exposure will eventually lead to excessively elevated cortisol and adrenaline in the mornings, and eventually, your body will have to adapt to protect you from the effects of this, and the opposite will happen – your cortisol will become blunted, and you will feel exhausted all the time. But the process to that stage varies from person to person, in some, it can take years for that to happen, in others, weeks, and in the interim, when those levels are high, you’re going to feel scattered, jittery, wired, unable to think clearly and on high alert. It’s not a nice place to operate from.
So, perhaps instead, you wait until lunch to check Twitter or the news, and then you follow that up with a walk to help you destress and process the latest updates.
Or perhaps, you keep a day precious, where you don’t check in on the news and you just focus on trying to take some space to allow yourself to come down from the anxiety and trauma of the week’s new tragedies. You give yourself that time to restock and recharge and look after yourself, so you can move into the next week with some new energy.
Now, of course, if you work in humanitarian services or you’re a war correspondent, I totally understand that this is probably a very frustrating podcast and you’re yelling at me that it’s your job to stay informed with every update in real time, and I accept that a lot of this won’t be relevant to you (though I hope there are some boundary practices instilled in your workplace or you can at the least, make even a small amount of room for some basic needs), but for many of us, that’s not the reality. For many of us, consuming the news every hour, is not going to allow us to make change. Yes, we’ll be informed, but for the most part, it'll be passive – we won’t be taking immediate action on the new information we have.
And that leads me to my next point…
Take action in what way you can, but also understand and acknowledge your limits.
I think there is enormous pressure right now to post on social media and let people know your political views and where you stand with the Israel Palestine war, and I’m personally (and remember, I am not an expert on any of this) but I’m personally, not sure that’s very helpful. What we’re getting is a lot of polarising opinions, that are sometimes uninformed and in the worst case, Islamophobic or antisemitic, and the action of posting on social, is not always that proactive or helpful. I feel like this pressure to post and respond to the new updates and changes that are occurring, has the potential do three things – burn us out, cause more divide and confusion and hate, and finally, make us feel like we’re taking action and doing something, when in actual fact, we’re not really making much traction, but we are wearing ourselves out.
Of course, there are some people, who it is genuinely helpful when they post. Perhaps they have a background in politics or something particularly relevant, so they can offer insight or a perspective that helps us to understand or see the situation in a new or better light or ways we can help, but for others, it may just be exhausting to keep trying to post every time a new thing happens and let the world know where we stand on it. I’m not saying you’re wrong if you’ve posted, absolutely not! I’m just saying I think there are times, when it’s perhaps hurting yourself further or maybe adding to some of the confusion – I’m not saying your post did that, I’m just saying generally, I think it’s worth considering where we are putting our energy.
And so, one of the things I’ve been sitting with, is thinking about what I can do to make a difference, even if it is a tiny one, that actually relates to what I know, my skills and my capabilities. I am not a politician, or a war correspondent or a humanitarian or an activist. I am not the right person to be shouting my mouth off on Instagram about my opinion. I do am well aware that there are other people who can do that and do it well and actually do some good through that.
So, what can I do?
Well, I can donate of course. But sometimes, that feels meaningless, so I started looking into charities who have specifically mentioned that they are providing menstrual products and pain relief. To me, whenever something like this happens in the world, I think about the thousands of menstruators, many of whom will have endometriosis (when you consider the stats) who are dealing with intense trauma, the loss of their homes, their family, access to health care – and it may all be happening on their period, or in the midst of an endo flare. Now, I care about everyone, not just people who menstruate BUT, I know endo, I know periods and so I am the right type of person to think “Okay, there are going to be many people who need pain killers and period pads” – what can I do to help get those things to them? I’m sure there will be people who never even had that thought, it hadn’t even occurred to them because they don’t have periods, or their periods are easy. Maybe they’re parents and their concern is the children being affected, and they think of things I wouldn’t think of. And that’s perhaps what they can do – find a children’s charity they trust and support them or get involved with them somehow.
Now, unfortunately, I actually couldn’t find a heap of charities who were directly acting on this. There are many period poverty type charities donating to refugees, which is fantastic, but of course, aid isn’t getting to the people who need it right now, so perhaps that’s why I struggled to find too many. But what I have done, is put the links to any charities who focus on period poverty or who have mentioned that donations will be in part, going to menstrual products for those who need it right now.
Another way I have taken action in the past, is to use my free resources as a way of raising funds, so I added an optional donation to one of my free downloads.
Now, I have no idea what your skill set is, or what your experience is, or what position you are in right now health wise or financially. You may have just enough to survive and so donating is not an option for you, and I really do not want you beating yourself up over that. Additionally, if you’re just too sick right now to even contemplate taking some sort of action, please give yourself grace – sadly, I am sure there will be some other humanitarian crisis or war in the future, and perhaps then, you will have the energy and the resources to do more. Maybe right now, all you can do, is to be kind and compassionate and to not spread further antisemitic or anti-muslim messaging on the internet. I think when there are hashtags surfacing like HitlerWasRight and DeathtoMuslims and these hashtags are literally being used thousands of times, even just the small acts of kindness to others being affected by these hate messages, can make a significant difference.
But consider your limits – both physically and mentally, yes, but also, within what your skillset is and expertise, because when we recognise that, we can recognise our strengths and what we actually can do to make a difference, in a way that doesn’t exhaust, stress us thin or cause more harm.
Okay, I deeply hope this episode with helpful in some capacity. If you are someone affected by the Israel and Palestine conflict, whether directly or indirectly, my heart goes out to you.
Show Notes
Sleep and HPA axis
https://endometriosisnews.com/2020/09/17/5-ways-sleep-deprivaton-affects-endometriosis/
https://www.theendobellycoach.com/podcast/night-waking-endo
https://www.theendobellycoach.com/podcast/tired-all-the-time-hpa-axis-dysfunction-and-endo\
https://www.theendobellycoach.com/podcast/hpa-axis-dysfunction-healing-tips-endometriosis
Compassion fatigue
https://www.psychologytoday.com/us/basics/compassion-fatigue
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7560777/
Charities
https://www.actionaid.org.uk/supportchange/gaza-crisis-2021
https://www.oxfam.org.uk/oxfam-in-action/current-emergencies/gaza-crisis-appeal/
https://periodpoverty.uk
https://www.bloodygoodperiod.com
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The vets have given us a very stark picture of the reality. If Jelly goes back on the streets, his condition will deteriorate and he will suffer until he eventually passes away. We have been told to find him a home where he can continue getting care or put him to sleep.
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This episode is sponsored by Semaine. Semaine is a plant-based supplement for reducing period pain and inflammation, that you take for 7 days of your cycle, during your period. Semaine is made up of 9 super-powered plant extracts and minerals that are all vegan and sourced for maximum quality and bioavailability and selected based on the latest clinical research. If you want to try Semaine, they are currently offering 20% off your first order with code: THEENDOBELLYCOACH and they deliver worldwide! Head to: www.semainehealth.com
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Produced by Chris Robson