The Many Links Between Mental State and Fall Risk
Would you be surprised to be asked about your mental state as part of a fall risk screening? Whilst you may be accustomed to thinking about your mental balance, did you know that the way you feel, and the state of your mental health can have both direct and indirect influence on your risk of falling? Let’s dig into how.
Stress, anxiety, grief, depression, fear. All are natural human emotions that we feel from time to time. They can also have an impact on your balance today.
Short term effects
Stress and anxiety can affect your balance in the short term because your brain is focused on whatever it is that caused your emotional state. It is using up energy and attention in relation to that event or problem, which means there’s less attention for hazards in your environment, or that your brain is slower to process signals coming in from your sensory system and doesn’t react as fast to challenges.
Imagine a loved one is having a health crisis; it is natural that you will be focused on their needs more than on your own. And during that time, whether it lasts a day or several months, your balance ability will be negatively affected by the extra cognitive and emotional load.
Longer term effects
Some emotions can last a long time, and with depression and fear especially, they can lead to significant changes in daily activity levels, which can start to impact not only your capacity for attention, but also other factors which themselves affect your balance.
You may find you’re not sleeping so well. If your emotional state affects your sleep over the longer term, it is possible to fall into a vicious cycle of poor sleep feeding fear and anxiety which in turn further impact your sleep.
Just 1 bad night’s sleep can lower your balance ability the next day by up to 40%.
Medical literature shows that a fear of falling is correlated with increased risk of falling, likely because when people are afraid of falling, they start to limit their activity, especially physical activity.
In some ways this is a logical step to take – like many safety lessons we learn all through life (not playing outside alone after dark as a child for example) – but fear of falling also stops people from moving their bodies in good ways, depriving them of new experiences, or practice moving in different environments. This impacts every part of the balance system, from sensory inputs, cognitive interpretation, muscle strength and speed. They are unwittingly weakening their balance system in response to fear, when they need to be strengthening it.
Part of the issue may be a belief that once lost, your ability to balance is lost forever. This is simply not true. Multiple studies have shown that the right intervention(s) can make meaningful differences to people’s balance and risk of falling. Some interventions are short term, like perhaps changes in medications, or intensive physical therapy to improve motion so that you can move on your own again. Others are lifestyle tweaks, like better sleep or more regular activity. Ultimately, to keep your body mobile you need to move it.
How to improve your mood
There’s no magic wand to improve mood, the right solution for you will depend on what is causing you stress or worry. Talking to your doctor is an important first step if you feel very low. (if you are in crisis, call 988 in the US or find your country here: suicide.org)
Self-Help
There are a number of self-help strategies you may like to try, from meditation to group classes, talk therapy, journalling, starting a new hobby, trying different ways of movement like dance or Tai Chi.
Be kind to yourself and recognize it’s harder to get up and exercise or communicate with others when your emotional state is low. Even though these activities can have a positive effect on other key pillars of balance – from better sleep, improved mood, to better mobility, strength and balance directly.
That’s why the 6 Pillars of Balance* help you to identify not only which pillars might be hurting your balance today, but to encourage you to think about which is the easiest one to make a small change on. Maybe dealing with anxiety or sleep is too complex for you right now, as there are many factors getting in the way of your being able to sleep better. But perhaps doing some slow balance exercises or taking a walk outside, where you think carefully about the movements as you do them, can not only boost your sensorimotor system, but also give you 5-10 minutes of calm where you’re focusing only on the movement, and giving your brain a rest from any worry or fear.
While it may be tempting to ask a doctor for antidepressants or sleep aids to give yourself a quick fix, these categories of medications are known to increase fall risk. The CDC has compiled a list of medications to look out for and discuss with your doctor if you are concerned about your fall risk. As you age, the way your body processes medications can change, which means that you can start to experience negative side effects even if you haven’t before. Always check with your doctor or pharmacist before changing, stopping or starting medications.
*The Six Pillars of Balance can be found within the free ZIBRIO BalanceCoach app. Simply answer the questions about your life over the last week to get a personalized snapshot of how your habits are helping or hurting your balance. Then pick on the easiest one to improve today.