Out walking anxiety and panic are a given now but a couple of years ago at least that was the only problem. Bigger than those problems now is the exhaustion I get hit with when I go too far and it is this that I have to contend with for hours after. It is the reason I cannot stay and ride out panic. It is also the reason why I have a safe zone which is hard to expand. Everyone's agoraphobia, if you want to call it that, differs. In this I have found my own differs from a lot of people but still I know people who experience the same thing.
In fact looking back this problem existed before the panic attacks started. It was this problem which had me back and forth to the doctors believing I had something physically wrong with me before anxiety increased to the level of an attack. And there I found no answer. All the tests were fine and no reason was ever given. We all know doctors can misdiagnose so that has always left doubt in my mind and after all this time it is hard to shake that doubt. But then I ask myself why do I feel the same way in the car where I am not physically exerting myself? Well to be perfectly honest it is so long since I have driven regularly that I am unsure if that is true so will have to soon test that out.
The only explanation I have ever read for this which makes any sense I found in a book by Dr Claire Weekes written over four decades ago. It is according to her nervous fatigue. And this fatigue manifests itself in 4 stages though not always in order and all 4 may not always manifest. So why would I believe what she has written? I understand it and more importantly I can relate to it. Reading about this regression sequence I can actually see it happening in my time line and it makes perfect sense. My only concern would be as to why it doesn't appear to be so common among people with anxiety disorders. But then everyone is different. A racing heart is one of the most common symptoms experienced yet that is something I thankfully am not troubled with- or at least not aware of it. That leads me to another theory. It could be that some people do experience this but don't see it as a problem so don't mention it much as a result. There is every possibility that as with many anxiety related symptoms it is my reaction to it that is the problem rather than it being a problem in its own right. So what I want to do here is discuss nervous fatigue as detailed by Dr Weekes.
Nervous Fatigue
It was Dr Weekes' belief that the prelude to anxiety and panic disorders is nervous fatigue. This fatigue does not happen over night but over a period of time- sometimes years. Invariably there is a problem or problems to begin with such as stress, sorrow, bereavement, guilt, etc. Over time this has a prolonged and lasting effect on the nerves. Through this period the nerves become sensitised and anxieties are intensified as a result. The anxieties are the same for everyone else but it is the sensitised nerves that makes them feel worse for the fatigued individual.
The anxiety disorder that this leads to can be one of two types. It can be that the original problem is still there and needs to be dealt with as well as the nervous fatigue. Or it can be that the original problem has gone but it is the fear of the developed symptoms which is the disorder. From this it is clear to see that the former is the hardest of the two to deal with. But both start as a problem which produces nervous fatigue over time which becomes the ideal setting for an anxiety disorder. This disorder develops in up to 4 stages.
1. Muscular Fatigue
The first stage in the process is muscular fatigue. Persistent problems that plague the mind inevitably bring tension in the body. The tension becomes constant and this is not good for the muscles as they need rest as well as use. Tiredness then is inevitable and over a period of time this turns to exhaustion. It is a subtle spiral. It happens over such a long period that it creeps up unseen and while the body is tiring with tension yet more tension is still being added to the point where the body is spent. This can lead to a stage where even standing up is an effort and the most menial of tasks is exhausting.
This tiredness is bewildering as there seems like no explanation for it but there are also other symptoms produced. The most obvious are muscle aches and stiffness in the limbs. Also though other muscles are effected. A person's vision can become blurred and visual disturbances occur as a result of eye muscles being overworked. Speech can be effected as the face muscles tire. The list of possibilities is endless and each one also brings with it a worry for the person being effected. Ironically this leads to more tension then more fatigue in the vicious circle.
Muscular fatigue is almost identical to the fatigue that would normally be experienced through constant physical exercise which is easy to see. But there is a difference. Because the muscles are in a prolonged tense state there are no periods of relaxation so this leads to agitation rather than relaxation. Mostly the person experiencing this has no idea why unlike someone who has just completed a fitness workout so fatigue it is a worry more than a satisfaction. Sleep doesn't come so easily either as tired nerves are not comfortable nerves and no amount of sleep will refresh overworked nerves which in itself leads to confusion.
2. Emotional Fatigue
Muscular fatigue saps the body of energy and the nerves become 'sensitised'. They are likened to the well oiled gun in that it takes very little to set off the trigger and they themselves become trigger happy shooting off at will. This is the state where emotional fatigue begins. What this means is that every emotion is intensified. The middle ground is lost and instead things are either extremely bad or extremely good- though almost always the former. The person in this state can laugh uncontrollably at the most moderately funny thing and likewise cry their eyes out over a little sadness. What also happens is that emotions are recorded easily and become burnt in quickly to create habit. This is where the fear-adrenalin-fear cycle is created which we know as panic.
This cycle starts with a single fear- a thought, a sensation, etc. When the nerves are sensitised the slightest thing can be a fear that in a non-fatigued person is not an issue. The nervous system reacts to this fear by releasing adrenalin which in turn produces the sensations we all know and hate. And it is these sensations that brings about more fear then more adrenalin release and so on. This is how the cycle works and this is the reason we become stuck. This is a panic attack. The more this happens the more tired our bodies become and the more set this routine becomes making it easier to occur next time. This is why panic attacks can seem to increase in length over time. It is not actually this cycle which is lasting longer because there is only so much adrenalin which cn be released and eventually the nervous system will realise there is no real fear. The nerves and body though get so exhausted that it feels like the attack has not subsided. It is the repetition of these episodes which makes it become a panic disorder. Some people can have the occasional panic attack but then none after because it needs to happen repeatedly to become habit.
This cycle is important to understand because it is at the root of any self help guide you will read or hear relating to eradicating panic. Dr Claire Weekes states that there are two fears and that the panic cycle (panic attack) is the fear of fear. First fear is that initial fear. There is nothing you can do to stop it happening but it is harmless. Second fear is the big problem but this can be stopped as second fear is fear of the first fear- ie the individual's fear reaction to that first fear which sets off the panic cycle of fear-adrenalin-fear. Whether you listen to the 'Panic Eliminator' contained in the Linden Method, 'One Move Live' contained in Joe Barry's Anxiety Release Method or any other self help solution it is this concept which is being reworked (or more accurately copied). The key is in stopping second fear and by that you learn not to react to first fear. In Mindful Acceptance this is also used by labelling first fear as simply a thought, sensation or whatever and thereby attaching no negative emotion to it (second fear). It disempowers the panic attack at source and prevents the panic cycle occurring.
A person in the stage of emotional fatigue becomes introspective as a result of these alarming episodes. Going out just brings more suffering so they stay in and they tend to shy away from doing things as any physical effort just leaves them exhausted. The state then goes from bad to worse as introspection heightens anxiety and yet another cycle is formed. This person is caught in a state of almost constant anxiety waiting with apprehension for the next attack to strike unaware that this tension is feeding the anxiety and tiring the body in the process.
3. Mental Fatigue
A person reading or listening to a presentation at length loses attention after a time. The brain becomes mentally fatigued. The student studying for exams discovers this too. As does the person with nervous fatigue as the mind tires in time with the body. This is where unwanted thoughts can occur and where obsessive compulsive behaviour can begin. In a clear mind thoughts can come and go but not so with a tired mind in which they tend to stick. And when thoughts stick they are impossible to repel. The more the thought is pushed away the more intense it becomes.
The thought process alters. Although positive thoughts take longer to pass through than in a clear mind they pass through regardless. Achievements for example rarely stay in the mind for long. Negative thoughts however demand more attention and stick more readily. A process of negative thinking therefore develops with mental fatigue. Unwanted thoughts come back time and time again.
4. Spirit Fatigue
The final stage is fatigue of the spirit and that is something everyone with an anxiety disorder understands all too well. It is brought about with the seeming hopelessness of the situation. Being constantly tired, full of worry and awaiting the next attack breeds hopelessness naturally. It is not a nice place to be and being introspective the person in this position becomes worn down. As the world keeps turning the individual becomes detached from it seeing everyone else going about their business problem free. They may become resentful, feel victimised and concede defeat to ever returning back to normality. Life becomes an empty pleasure free existence of dark discomfort every day.
Conclusion
I can understand what Dr Weekes is saying and in my own situation it offers a reason as to why I am in the position I am in. That comfort though is not something to be used to wallow in self pity as an excuse for not trying to get better. It is instead an understanding which is needed because without that there is no chance of recovery lost in bewilderment. Whether it is fact or theory is irrelevant to me. What is fact? Some cite their methods are based on scientific fact but scientific fact can be a couple of government funded students conducting a study to see if people with dimples are less prone to hay fever. That for me is science. More real to me is something that makes perfect sense and that I can believe in because if it is something you cannot truly believe in then it is useless. It has to feel right and this explanation is right for me. But over and above all that the important thing is that before reading this I was extremely worried as no-one offered an answer. This woman had a practise and dealt with people like this, like me. So that gives me strength. But I can see it not just applying to anxiety.
