Illness can impact our mind but can our mind impact our illness?

Watching the Olympics these past two weeks got me thinking. Due to ongoing Covid restrictions, this year’s athletes were competing under very odd circumstances. With limited crowds and fans, how is this affecting their performance? Are they less motivated? Are they under less pressure? What is going through their mind? Then of course I realised that, while we as mere mortals would find this atmosphere so alien to our previous events, athletes perhaps are better mentally prepared for such circumstances. What I mean is, some athletes are mentally so strong they rarely wane under any situation. We as ordinary people, have become unwell and now find ourselves in our own very odd circumstances.

So how do we adapt to this new life and how do we ensure we perform to the best of our abilities? Well actually we have similar tools provided to us as athletes do. You see to us an athlete appears to be superhuman in not only strength, speed, agility and tact but also in mind. But are they really that superhuman? This is where Psychology comes in with its set of techniques to help keep the athlete focused on the right thing at the right time. But like us they get injured, suffer pain, illness, stress and depression. So, it is not just for performance in sports but psychology has its place in recovery from injury and illness too. We all are away from our much-loved sport and hobbies, we all feel in pain, we all have an unsure future. Life as we know it has changed and it’s a lot to cope with.

Relaxation techniques in the form of controlled breathing, mindfulness and meditation are all used by athletes and they are also recommended to ourselves. There are different guides to suit the situation but generally they all help us stay calm which keeps our muscles relaxed and loose, instead of tense and rigid causing more discomfort. They also keep our focus and stop our mind wandering to dwelling on the past and worrying about the future. They are very effective for lowering stress, anxiety and depression but they are also showing to be effective in managing pain related to conditions such as Fibromyalgia, Headache Disorders, Irritable Bowel Syndrome and the most widespread disorder Chronic Lower back pain*.

When we’re diagnosed with an illness, naturally our mind can go in a spin. What does it mean for me? Can I ever get back to my hobbies? How unwell will I become? What’s the treatment? Will I die earlier? What does the future hold? Medics can hopefully answer some these questions or at least give us some re-assurance of managing our symptoms but it won’t keep us from the worry, pain and our fears. Some Mindfulness can help focus our mind on the present. Not only what is happening today but what is happening right now, this very moment to the tiny detail of what can we hear, feel, smell, taste? Scanning our body to recognise each sensation. I’m not saying to retreat to your nearest meditation room immediately upon diagnosis in order to gain a hit of zen and all your worries will vanish. Of course not, we all need time to digest what we’ve been told, but you’ll learn to allow yourself to be upset and frustrated and then, in time, you can try and regain some calm. With practice we can learn to quickly steer our minds back to the present whenever needed, to move away from negative thoughts and calm our mood.

It is the same with chronic pain. How an athlete learns to deal with pain is taught by working through their reactions and emotions so they don’t fear pain as much **. Naturally when we feel pain we panic and cry out for help. That’s our brain in survival mode, it’s a natural reaction to get what we need to make it stop. It’s all about self-preservation and our strong instincts to stay alive and protect ourselves. Of course, if our doctors have told us our pain is not causing us actual harm and it’s part of a condition then calming this panicked mindset can only help us stay relaxed and in turn reduce any further pain.

This is exactly how it was when I had a bad back. Sciatica hurts and it can stop you dead. In bed I could hardly move from being scared it would hurt, I went into body protection mode, I stiffened up and it made moving more awkward and the pain even worse. The consultant in the hospital told me I couldn’t hurt my back and to get moving. Once I was told that moving is a good thing, I used controlled breathing to relax and mindfulness to recognise my physical feelings. I was determined to help myself as I got up and went about my day. Don’t get me wrong I wasn’t cured, far from it. But I managed to very slowly hobble my way through the streets of Lancashire and the more I moved in a day the more the pain eased. I still have back ache and when it hits hard, I have to take some time to get up and think my way out of bed to get moving which can ease it again.

Mindfulness based meditation teaches us how to cope with and how to lower constant pain as it detaches us from negative thoughts associated with pain and teaching us acceptance. It is all part of adapting to our new life. I won’t lie it does take practice, sometimes up to 8 weeks to feel any benefit and practice must be regular **. My Occupational Therapist recommended meditation to me and when a healthcare worker recommends a strategy, I am generally aware there’s some evidence behind it so here comes the science bit…

Well, what is actually happening in our brain then? There appears to be more and more research being done especially involving fMRI brain scans. One study done in 2009 explains the deeper a person goes into meditation or mindful state, scans show a wider spreading and greater strength of high frequency gamma-rays relating to a state of growing spaciousness and greater stability of awareness. In other words, we are in a content state doing something skilful and with ease ***. Another 2019 study shows us that mindfulness-based pain relief results in lower levels of pain. Here, scans display increased activity in the Thalamus, Primary Somatosensory regions and deactivation in the Posterior Cingulate Cortex *. Ok so I don’t know what these areas of our brain do (I’m not a Neurologist) but the point is these studies are trying to determine the areas which are related to pain to develop therapies which can better target pain. Once we know where these areas are, then perhaps we can manipulate it, right? Hopefully. They also go on to say and I quote… “long-term mindfulness practice can lead to significant increases in pain threshold values and lower pain sensitivity”. This is the bit we all need to know and if evidence suggests we can improve our symptoms, then it has to be worth a try.

So, there is method to the madness but please remember all of us are different and what works for some does not always work for another and we must find the right therapy for ourselves. I do hope you find some comfort in this week’s blog and I wish you all a much calmer weekend.

Namaste day!

Side note: I was that slow walking when sciatica hit, I was once over taken by a geriatric in a Zimmer frame, I was equally both embarrassed, I was half their age, and impressed at the skill and speed they were moving.

References

* Zeidan, F., Baumgartner, J. N., & Coghill, R. C. (2019). The neural mechanisms of mindfulness-based pain relief: a functional magnetic resonance imaging-based review and primer. Pain reports4(4).

** Price, I. (2018). Head Start: Build A Resilient Mindset So You Can Achieve Your Goals. Pearson Education Limited.

*** Hanson, R., & Mendius, R. (2009). Buddha’s Brain: The Practical Neuroscience of Happiness, Love and Wisdom. New Harbinger.

It all started when..

Every night I had the best sleep yet I woke up like it was 3am. Drowsy. I was ready for bed again. It was always 3am, every minute of every day. So spaced out and having to dodge the feeling of needing my bed. At best I was able to hold a conversation and maybe complete at least one taxing thing in the day. At worst I was clumsy, forgetful, couldn’t function, slow reactions and slowly crashed out into a deep sleep as soon as I hit my pillow. Every move took my energy away. I love the great outdoors yet the last ‘normal’ walk I did was just 6 miles and I felt very weak on the way home. After that, the last bike ride I did was 14 miles and a ride I would normally class as easy. I had to stop, every pedal stroke was heavy, my body ached. I called my partner but he was at work. I just couldn’t face the big hill I still had to climb to get back home. There was no alternative route. I got off and walked, grovelling. I never walk, it was against every fibre of my whole being!! Something was very wrong!

Fast forward and I was referred to an Occupational Therapist (OT) who told me I had this thing called fatigue and I must stop my level of exercise or I could make myself very much worse. I was stumped. I couldn’t get my head around this…

Me: “But I’m fit enough, I’m used to doing 10-mile hikes up big hills and this walk is flat” I argued.

OT: “No, don’t attempt it” she shrieked. “You struggled on your last walk and you’ve been struggling on your bike rides, that was your body telling you there’s a problem”.

Me: “Oh!” The very big penny dropped and landed smack in my forehead.

I’ve never had fatigue before so it was a shock to suddenly have to not do the things I love. Apparently when you get fatigue unless you stay within your limits, any form of exercise, regardless of your fitness, can harm you. Many end up in bed for days at a time. What will I do instead? Where will I go? Who will I see? Gosh, I was totally out of my comfort zone now. I was taught how to use Pacing to manage my condition. I like to grab Bulls by the horn, and this was one big Bull, so I grabbed it and made Pacing my new life mission.

Apparently, Pacing is currently the only technique used to help people with chronic fatigue. Getting used to this new way of life has taken determination, oh and for the country to be put in lockdown, for me to grasp it. You see for me I was in the best position. Can’t see anyone, can’t go anywhere. It was the perfect time to get my head around pacing and work my way out of this nightmare. I worked out what I did in my day and how long I could do each thing, then I tried to stay in these limits. Ha! As if it’s that easy. It wasn’t and still isn’t, but bear with me…you see every time we use energy, we spend imaginary money. My high energy tasks cost the most at £10 and my low energy tasks are £2 a time. A healthy person may have £1000 in their daily pot. I’m fatigued so I have £100 per day. I must spend it wisely or I will crash into bed and the more I do before that crash the longer I will be asleep for. It is also good for me to have money left over at the end of the day. This sets me up better for the next day. So, I worked out what my activities cost and then lived my life. Simple? Wrong! It’s soooo hard. I mean it’s just not living a life. Who times themselves watching TV? Who works out how long I went outside for, how far I got to and how I’m feeling? Who times how long I stood and made dinner for before I had to give up and sit back down? And who counts how many trips upstairs or to the kitchen I’ve had? Yet, there I was noting it all down (which also takes my money) and it’s the only way to get through this illness. It took weeks to work out my limits and some stuff fluctuates, making it even harder to figure out. Still keep on keeping on…

The next step is to make up a daily timetable. I’m allowed up to 3 high energy activities per day (£10), a few more medium level ones (£5), the most should be low energy stuff (£2) with some added relaxation time (free).

Relaxation, I mean real actual relaxation, was new to me. It’s things like meditation, sitting listening to the birds, mindfulness, listening to café music. I find relaxing the hardest thing to do. My brain kicks in, like someone put a coin in a Postman Pat ride-on, and it suddenly wants to be at its most active. I lie there trying to switch off to find calm. Every time I reach for my phone in a bid to occupy my mind, and before I know it an hour has past and there goes another fiver! The times I’ve purposely left my phone upstairs or in a random bag as an ‘out of sight, out of mind’ tactic. It never works. I end up using more energy getting to it again. It does get easier though and now I’ve found my own way to relax, I can fill some time enjoying peace and quiet. I personally like sitting outside daydreaming while drinking a coffee. Unless there’s a neighbour chatting, then I can eavesdrop (I can’t help it, they talk loudly!) Otherwise, I’m a serial daydreamer, have been since childhood and all school life. It comes easy to me. I let my thoughts just come and go.

It’s taken time not to feel guilty, but allowing time to relax in my day, is not doing nothing it is complete rest for my body to heal. Peace of mind that doing nothing is my doing something to help myself and Pacing, after all, is the only way to manage fatigue.

See Pacing Menu to find out more about the Pacing technique.