Moving

I remember getting annoyed with my wife on more than one occasion. Mind over matter. Jeez, stop bloody moaning. Walking around the island of Karrera and she was struggling while I marched on- I could go all day. Walking around Amsterdam she wanted to go somewhere to sit down while I wanted to keep on walking. A couple of examples. Each time I would get pissed off. Walking not a problem. When it did get hard you just keep pushing until you break through that barrier until it eases. I told my wife. She couldn't see it. That frustrated the life out of me. Pandering. Get a grip! You put one foot in front of the other and keep doing it. Where the hell is the difficulty in that I ask you?

My life seems to be full of irony. I walk halfway to the school as the body starts to shutdown and turn then head back home. I watch her walk on with her knee problem making her hobble the rest of the way. I don't forget. I hear my own scorning tongue in my head. Karma maybe. Sometimes it makes me push on. Never far enough. Always leading to a point of regret. I can never go where she goes. In the back of my mind I fear I never will again. And it is in the mind that all these problems, and probably therefore the solutions, lie. If I could switch that old grey matter on I am sure I could physically go and keep going. But the reality is I can't turn it off and I therefore can't keep going.

I can't help things happen in life for a reason. I might not be better but I think I have become a better more understanding person. I remember scowling at the woman in my work who shuffled about claiming she had ME and was off work every other day. Maybe I needed to see for myself how limited and troublesome life can be with irrational and mostly unexplainable (concrete proof) difficulties. How pride can have its head repeatedly jumped upon and how guilt can be thrown on by the stone until you lie immovable under the weight. Lessons in compassion. I have read people who have come through my own situation say they have come out a stronger, happier and better person like it was all worth it in the end and the problems were an intervention at a time when they needed a life change- however much it is hard to convince myself on this side of the fence somewhere deep down I hold on to that. So maybe I was a pretty uncompassionate cold person, well no maybe actually. I still have my troubles at this time but I am a better more aware person for it I would say. A rite of mental passage if you will.

But there was a positive point to this post. As I said I have been reading more and more about recovered specimens and how they want to give back their story and tell the troubled ones not to give up, to their credit giving them hope. Me included and it has me in a more upbeat mood. Not only that but in this more positive frame of mind I have been getting what Dr Claire Weekes referred to as glimpses. Little pin pricks of normality in my day where there was was just the black shroud of doubt. Little seeds that can grow, be threaded together and weaved into a new life tapestry- a better one. And whether that transpires or not is of little consequence at the moment. The point is its a change of mood. More hopeful and a little more confident. Things can't change over night. Little victories here and there to build upon and when I get these little 'glimpses' I do feel like the power meter has just jumped up a notch. It brings a willingness to push on and push out and get better and not be weighed down by the bad habits I have learnt. Doing more at the moment. Understanding more. It all seems to be coming together. Fingers crossed. Must better at the moment anyway regardless. Feel like I am starting to move as opposed to standing still.

Panic and fatigue

It's like this: I know the external threat is internal but that doesn't make it any easier to deal with or understand but instead I grab at my neck which is only an initial response to a longer thought process which would have me tearing off every layer of skin and bone to delve beneath the bloody mess and grasp this anxious jumping bean which has been a-bounce bouncy bouncying about and grab it, crush it, smash it and kick it all the way to Timbuktu in a fit of fury until I am sure it has gone forever. And that begins and concludes my Kerouacesque analogy of agitation, deep breath. Restlessness is swinging me and shaking me at a time I would much rather just flop on a comfy surface. That is anxiety and again I am back in that dark place where the demons dance, prod, slap, scratch, bite and with shrill high pitched screams refuse to leave me alone. I'm sick to the back teeth off it to the point I want to vent my fury on something but the demons are inside. It will pass and I don't know why but I feel it is about to pass soon. This prolonged bout of illness frequenting the family home is no doubt the source of this current angst, agitation, tiredness and depression.

It has been so long since my last long stay in the confnes of madness that I struggle to remember the old ways of coping. Incidents occur and pass but when they are again becoming the norm its difficult to keep hold of the few strands of sanity in my grasp. Its like the climb and continually losing your footing to the point where you realise you have been sliding to a quick descent and it is time to grip something and hold on before you descend any further down until the storm passes. I had to find distraction and I finally managed to find that in reading a Dr Weekes book. Immediately she knew why, even all those years ago, I couldn't find some solace anywhere else:

It will not be difficult for you to read this book: it is about you and your nerves, and for this reason you will read it with interest, whereas to read an ordinary book or newspaper may seem an impossibility...

Too true. The previous day I read a wonderful short novel named 'The Alchemist' by Paolo Coelho. It was no problem at all but as it resonated so much with possible aspirations I've had and was such a joy to read it might have helped. During this period of peak anxiety though I had to turn the laptop off because I could not concentrate and every magazine and book I picked up I dropped just as quickly because I found trying to read agitating. Not with Dr Weekes though. It was a subject I needed to read because I always used to read about the simplicity of anxiety when I was anxious as it seemed to bring clarity. Dr Weekes' books are old and certain terms need to be swapped in the mind, for example scary references to nervous breakdown or nervous illness are more likely today to be referred to as an anxiety disorder- I guess. But something always speaks to me in those simplistic words of her type no matter how archaic they are in comparison to today's language.

Synchronicity brought the book and my blogging reading together as I read for the thousandth time the process of how someone develops an anxiety disorder. You know the tale so there is no need for me to give anything other than a brief outline. Palpitations or some other some other natural sensation occurs out of the blue giving a person a fright. They wait for another and if it doesn't come they are fine. If it returns though then there is the basis for a disorder to develop because here starts the cycle. The person tenses up fearing the next attack which makes it more likely to happen and when it does happen the tension and adrenalin release make the experience more intense and the likelihood of another happening soon pretty much certain. This is the cycle. And at some point the sufferer goes to see his GP. For me a quick diagnosis is what everyone needs to have a chance of not developing a disorder because I do see why a lack of a diagnosis can lead people into a disorder and in my own case I am convinced of the fact.

At this stage the sufferer consults a doctor, who usually succeeds in reassuring him and banishing his fear...On the other hand, should the doctor, in an effort to reassure, make too light of the palpitations, the patient may stay in bed of his own volition...

According to the wise doctor this is a crucial point where the sufferer's future depends on the diagnosis and approach to relating that of the doctor. A bit of a lottery if you talk to a variety of people about their GP. But in my experience these two possible outcomes are rare. The usual outcome of this meeting is a misdiagnosis and far from reassuring they are sometimes more frightened. In my own case I can count at least five times that I visited the medical centre seeing a different doctor every time, my current GP was not there at the time. Not once did anyone even mention panic or anxiety. I got an ECG, nasal sprays, pills for balance, blood tests, swabs and probably other things forgotten by time. One thing I can remember though was the looks of disinterest in what I was saying, the lack of belief in what I was relating and the frustration I felt afterwards. In fact I remember the last time I went the doctor looked at me as if I was telling a tall story, sighed and then wrote me out an appointment for the blood tests which I'd had only a few weeks previously. I put it in the bin outside and never went back. At that time I had a steady job and could travel the country, 2 years later I was housebound.

Oh my I sound bitter and if I am honest I am. What is the point though? Its not going to change anything. I really should stop mulling that over. But it does make me laugh and angry too when I read how much mental problems are causing the NHS when there are, I know, a lot of people who wouldn't be in this position were they properly diagnosed in the first place. One doctor I had took my pulse and noted it was very fast. Of course it is, I told her, look how nervous I am. I was so nervous I could hardly stop fidgeting but she obviously didn't think that was of importance and I had no idea that my problems could have been mental rather than physical. Even now I am still trying to understand it.

Some years ago, when recuperating from an operation, I stayed with some friends who were planning a bush walk. 
They asked a young man to join us. It was not a long walk, they assured me, (but long enough for me I thought as I looked at his long legs). To my astonishment this big fellow soon fell behind and we frequently had to wait for him to catch up. At lunch he lay exhausted on the grass. Later he told me his story. For years, since his student days, he had had recurring spasms of intense panic, so that his life had become a nightmare. He was not afraid of anything in particular, only the feeling of fear itself, and this had become so intensified and exhausting that even that short walk had been too much. This man was eventually cured and able to lead a scientific expedition. I mention him because he was no weakling but a clever scientist in a responsible position. With help he recovered quickly, after having suffered for ten years.


For me this one paragraph was gold dust and I would have paid anything just for that confirmation. No medical person has told me this could happen and may be what was happening in my case. I've not seen it explained anywhere in the anxiety literature I have read. Even when I started frequenting forums and asked other agoraphobics if they had experienced this problem it took me months to find some one else as most have never experienced this or don't talk about it. This was a much needed path out of bewilderment for me to help me accept that my problem was probably not physical. I just needed that confirmation and I had found it- written 4 decades ago. When I read this the other day I had actually forgotten about it which is probably because my brain these days doesn't retain much. And again it gave me a comforting feeling as I was having the same doubts again. If I had known this 5 years ago then...more regrets.

All this reflection has taught me one thing. Happiness and peace are not to be found in the past but the lure of possibility lies ahead. Hope is a much better companion in the now than regret. It is time to let go of those feelings and look ahead. After reading some of the book yesterday I decided against my better judgement to go to the school with my wife which I did, for only the second time ever, and then we went to the shops after. This morning I took my son right into creche which I have never done before. None of these things were easy and I'm still feeling this heavy cloud of agitation over me but I know it will pass, and when possible I am not going to wait. On Sunday for the first time in about 4 months I didn't go out and around about that walks, and getting out in general, have been sparse. I'm determined to break that cycle as its just giving me more time to think- which is not a good thing.

Nervous Fatigue

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.

A little thought

We have five senses and they all give us constant sensations which pass in thoughts to our brain. Here the functionality is the same as it always was. But in a state of anxiety or nervous exhaustion something has changed. The difference between now and before is that we fear some of those thoughts. And this usually leads us to a conclusion. If only we could stop these thoughts then we would not get anxious and panic. For most, including myself not long ago, this is the conundrum we face. Just how do we stop those horrid thoughts?

For three months in 2006 that was my question to the visiting CPN. She brought me presents. I had a new relaxation CD, a new visualisation CD and questionnaires by the bucket load. Nothing of use. Every time she came I would say: How do I stop these bad thoughts? She had no answer. This infuriated me. I had only one question and required only one answer but never got it. She was supposed to have all the answers and could not even provide one. Now I know the answer to the question and that is that there is no way to stop the thoughts. If only someone could have told me that then it would have saved over a year of ripping my brain to shreds in search of an answer. More than that if someone had only just told me why I could not stop the thoughts and that I was wrong in my theory then it would at least have put my mind at rest.

If we look at the process again in the first paragraph we see the answer to that question is clear. So clear that it was always staring me straight in the face and I never saw it because I was already convinced otherwise. The process of thought has never changed. Our senses still work the same though maybe a little more heightened but the thoughts to our brain are still the same. The difference is that we now fear them and there is the real question: why do we fear them? Well actually that is not the question. It really doesn't matter why we fear them. I could spend another couple of paragraphs explaining that but it doesn't really matter. What is important to know is that it is not the thoughts themselves that are the problem but our reaction to the thought.

An example of before and now may illustrate the difference. We are walking along and notice that we are a little out of breath. Previously we may take an intake of breath to compensate or we may just note it but keep walking on. We may even stop for a moment to let it right itself and go on. Regardless of what we did before it is not enough to trouble us. We receive the thought, look at it, realise it is not a problem and continue. The thought comes, is viewed and the is let go with no emotional attachment to it so never returns.

Now it is different. We are walking along and suddenly notice we are a little out of breath. The same thought is sent from our senses. Now though we look at it and add fear to it. What the hell is wrong? What is wrong with my breathing? I'm going to stop breathing! Am I going to suffocate? Right away fear is attached and if we try to ignore it then the thought keeps coming back because it has an emotional attachment. Not only that but trying not to think of it brings it to mind every time prolonging it and giving it more importance. We have not dealt with it and the more we try to ignore the more the emotional attachment intensifies. As we realise we cannot rid ourself of this thought and cannot face it either anxiety grows and sooner rather than later the flight or fight mechanism kicks in with the release of adrenalin. We must escape to the safe place and though we may get relief there that thought has still not been dealt with. It will be waiting for us bigger and badder the next time the next time we are in the same situation. And because of that a simple association is enough to link to the thought and then relive the experience again.

So it is simple to see where the problem lies. It is also simple to see the solution: we just have to change the way we react to our thoughts. The application though is not so easy. Its the reason why I know how to recover but can't seem to put it into practice. Although the theory is simple in that we must unlearn the way we have programmed ourselves to react it is not as straight forward as that. The longer you have reacted that way the more the reaction is set in stone and very hard to change- it almost bypasses concious thinking. But to change you have to keep trying to react differently. It is finding the way to react differently and go against what has become your natural reaction which is the biggest challenge of all.

If you read any self help materialon anxiety then at the root is this theory that this is key to recovery. It is just dressed up differently with their own slant on things though in the case of Claire Weekes I would say that is not the case as she was a pioneer in the field. But for the others there is no real difference from what she wrote 40 years ago to what they are writing now and charging for at a higher cost. There are alot of people out there taking advantage of people's desperate state.

What does concern me though is that the people we look to in a time of need like GPs and mental health workers do not seem to know this. I have found through bitter experience that they are very ill informed and I have yet to find one of any help at all who knows what they are talking about. So it is good that there is material out there to help us because however much it costs that is the only place we will find true understanding. The trouble is though that we may have to put up with years of ignorance relying on people we thought new the answers before we find out our trust has been misplaced.

Anyway that is just a little thought of mine to sit in among the other little thoughts we are being bombarded with each second of every day. I hope though it is a positive one.