The Five Pillars of Mental and Physical Health
Sometimes the most important treatment is the simplest, most obvious one. Although, of course, medication, physical therapy (PT), hypnotherapy, acupuncture, psychotherapy, and other treatments can be invaluable to your child’s recovery, it is vital to make sure that your child has the “Five Pillars” of mental and physical health covered as best as possible. Often, just making sure these are attended to can make the most significant difference in recovery, and they don’t require long car rides or spending money!
In my latest parent group, we reviewed the Five Pillars. The parents said it was a great reminder to remember the basics, so I thought I would remind you all about them here.
Pillar No. 1 – Sleep
It is difficult enough to make sure teens and young adults get enough sleep, but adding pain into the mix makes it even harder. Most people with chronic pain have difficulty initiating or maintaining sleep throughout the night. Also, they tend to have difficulty in the morning and feel better later in the evening, leading to staying up late and then sleeping in late.
Adding easy access to devices makes it even harder for young people to get adequate sleep. I feel this is something worthy of being strict about.
Keep a Chart: First, try to have your child chart what time they go to sleep (tell them you will not be angry with them if they are honest with you, because it is an experiment for them) and how they feel each morning. Then see whether they notice that they feel better when they get to sleep earlier.
Suggestions for Falling Asleep Earlier:
- Have a phone cut-off time.
- Dim the lights and do a quiet activity that is not on a screen for a while before going to sleep, such as reading or drawing.
- Take a bath or shower before bedtime to unwind.
- Use a white noise machine and/or eye mask.
- Listen to a meditation app such as Calm, Insight Timer, or Headspace to fall asleep or get back to sleep if they wake up during the night.
Limit Screen Time: If they continue to stay on screens too late, consider shutting off wi-fi after a certain time (that will eliminate some activities) or having them charge their devices in your bedroom. As much as my clients hate it, they often secretly tell me that these measures really do allow them to feel more well-rested. I had one client who actually deleted all social media apps from her phone every night before she got into bed and then downloaded them in the morning. It worked for her!
Pillar No. 2 – Nutrition
Eating a well-rounded diet is tough for many teens, who tend to subsist on lots of pizza and highly processed foods. When they don’t feel well, getting them to eat at all, let alone a nutritious diet, is tough.
Many studies have shown a connection between diet and mental health. For example, eating a diet high in processed foods and sugar can increase inflammation, affecting mood, sleep, and energy levels. We want to be careful, though, not to label foods as “good” or “bad” because kids with chronic pain disorders tend to share similar personality traits as those who develop eating disorders.
In addition, we know that eating a well-balanced diet leads to feeling physically better. For example, eating enough protein is important for building muscle. Eating complex carbohydrates helps energy levels, which helps your child’s PT/physical rehabilitation.
Serve Healthy Meals: As best you can, try to serve healthy meals at home and send your kids to school with healthy lunches. People tend to eat more nutritious foods if they are easily accessible. So, instead of your child having to wash and cut veggies and fruit, it’s helpful if you have some already washed and cut up in the refrigerator. That way, they can just grab them easily.
To get a full array of nutrients, try to have foods in as many natural colors as possible. Avoid packaged foods that have ingredients that would not be found in a kitchen (such as ingredients that are difficult to pronounce).
Supplement with Protein Drinks: If your child is having difficulty eating because of abdominal issues and you need to supplement with protein drinks, some are healthier than others (meaning they have fewer chemicals and sugar). Orgain and OWYN are two healthier brands that I recommend.
Check for Vitamin and/or Iron Deficiencies: It is also wise to have your child get bloodwork done to test for micronutrients to see if they are deficient in any vitamins or iron because deficiencies can cause mental and physical health issues. These tests are done more comprehensively by a functional medicine practitioner.
Pillar No. 3 – Sun
One pillar of health that is often forgotten about is getting sun. It is good source of Vitamin D and good for the soul. Vitamin D is very important for both mental and physical health. Vitamin D deficiency can lead to mood changes, such as depression. It can also cause muscle weakness, fatigue, and joint pain.
If your child is too unwell to go outside, have them sit or lie down near a window where sunlight is streaming through, so that they can soak up some sun from inside. Or, if you can, put a lawn chair in a sunny place outside that they can lie on.
Pillar No. 4 – Movement
Part of recovery from chronic pain is getting one’s body moving again. If the body is stagnant, it becomes more fatigued and weaker. It needs to move for circulation, lymph node drainage, heart health, and muscles and joints. Bodies that don’t move get tighter and weaker, reinforcing the pain.
Encourage Daily Movement: Many parents cater to their kids all day and night so their children do not have to move. This help is given lovingly, but can hinder recovery. Build a little movement into your child’s day by finding small ways for them to have to do things independently. It might be as small as making them lift their cup to their own lips (a straw helps) or as large as coming down the stairs to get their own plate of food that you have prepared. You have to meet your child where he is, and then expect a little more over time, but in baby steps—slowly, but surely.
If your child usually lies down all day, encourage five minutes per hour of sitting propped up. If they sit propped up all day, encourage a minute each hour of sitting on the edge of the bed with their legs dangling down. If they are carried to the bathroom, have them walk, holding on to you. If they can move around independently but do not do any exercise, discuss ways to build more movement into their days in fun ways, such as walking the family dog with you.
Physical Therapy: If you can, it may also help to either take your child to PT if they can travel, or have someone come to your home for PT, or meet them over Zoom. Be sure to have your child pace their progress. Going too fast can backfire. Slow and steady wins the race!
Pillar No. 5 – Social/Something that Feels Meaningful
Most important is social contact. We are all social beings. No matter how introverted your child is, social connection is vital to living a healthy life. Social anxiety, being neurodivergent, and other stressors can make pain worse. Being in chronic pain can lead to isolation. Then, the pain gets even worse from the isolation. It becomes a vicious cycle.
Once kids are out of school because of pain, they become even more isolated and may fear returning to school because they are out of the loop socially.
Reaching Out to Friends for Visits: As with the movement pillar, baby steps are key. Encourage your child to text or DM an old friend. Invite a friend to come over to do something that doesn’t take a lot of energy, like watching a movie. Plan the visit to be short so that your child doesn’t have to worry about getting too tired.
Connecting at School: If your child has friends at school but can’t make it through a school day or even half of one, work with the school to allow your child to come just for lunch period to see friends, or lunch period and the one period after lunch. If your child does not have friends, have them attend clubs at lunch (or after school if that is when they get together) to meet students with the same interests. For kids who are anxious about meeting others, clubs are a great way to meet other students because of the built-in structure.
If your child is in a home hospital or an online school, try to have them attend an extracurricular activity to meet others. If they are not well enough for that, have your child attend the teen CHYPchats and the CHYP online summer camp to meet other youth.
Volunteering: If it is impossible right now to get your child to engage in anything social, encourage an activity that has meaning for them, such as volunteering at an animal shelter (it can be as simple as just sitting and holding a rabbit while an adult cleans the cage) or even volunteering for a cause online. Doing an activity that has personal meaning can be very helpful emotionally and physically for your child.
While it is important to engage in treatments, attending to these five pillars can go a very long way in your child’s journey toward regaining health and functioning.
