panic and physical health
Feb. 8th, 2005 06:31 am![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
baratronOne of the reasons I swear psychiatry is in its infancy is the general lack of connectedness that researchers make between mental and physical health. Psych research seems to get stuck at the "you appear to be depressed because your brain doesn't have enough serotonin - now how can we fix that?" stage. But physical health has a huge influence on mental health, and I'm not just talking about the obvious fact that people with poor physical health tend to get depressed by it.
When I was at my worst mentally I had a lot of weird physical symptoms as well. The fact my depression wasn't being managed even by a sledgehammer attack of 3 different drugs all on top of each other implied there was probably some sort of physical cause. So I went off and had blood tests for just about every medical condition that can cause depression along with fatigue and body pain. Everything came back negative - to the surprise of my GP. It was all quite confusing. It was only when I got really really physically sick, and became too tired and weak even to be able to walk, and finally dragged myself into the doctor with a complete list of every single symptom I had that the answer turned up. And it was surprisingly simple. "Hyperventilation occulta", my doctor said. WHAT?!
It turned out that almost everything I was experiencing was being caused by one thing: bad breathing. In this modern day & age, where asthma gets treated by shoving a couple of inhalers at a kid, very few doctors or nurses take the time to actually check how the patient is breathing. On reading up about it and going to see a specialist physiotherapist, the problem became even clearer. It transpired that I had probably never used my diaphragm properly to breathe, and had only ever breathed using the accessory muscles in the chest and (during asthma attacks) the neck and shoulders. It also transpired that I breathed with my nose and mouth together, at a rate roughly 4 times faster than normal. Um.
Apparently the carbon dioxide level of the blood is very important in a number of regulatory processes. It controls how much oxygen you breathe in, for starters. It is also involved in such diverse things as temperature regulation and the production of adrenaline. And the brain, or hypothalmus, works assuming that the baseline carbon dioxide level of your blood is normal. If, over a long period of time, you breathe out too much carbon dioxide, the baseline gradually drifts lower and lower, and your body forgets where "normal" really is. The upshot of this includes such delights as exhaustion, muscle weakness, depression and panic attacks. Really.
Anyone who's had an anxiety disorder knows that panic attacks breed panic attacks. You have one, and you're likely to have a bunch more in quick succession. Quite apart from the underlying stresses which feed the anxiety (and then the fear of breaking down again which makes you all the more likely to), there are the physical symptoms of panic attacks which lower your blood carbon dioxide level, boosting your adrenaline level and making you into a giant timebomb. Panicky people tend to breathe quickly, and may even hyperventilate enough to notice. Their heartbeat speeds up. They sigh, or gasp. All things that mess up how much CO2 is in the blood.
I have had a cold for a week, and my nose has been blocked for much of this time. I have been forced to breathe through my mouth a lot, with much sneezing and coughing. It is not, perhaps, surprising that I woke up today in that waking up from a nightmare panicky can't cope shit gonna die what? exhausted need more sleep rinse repeat cycle that I know and love from my past.
What is surprising is that I didn't recognise it, until I had a complete meltdown just now.
When I was at my worst mentally I had a lot of weird physical symptoms as well. The fact my depression wasn't being managed even by a sledgehammer attack of 3 different drugs all on top of each other implied there was probably some sort of physical cause. So I went off and had blood tests for just about every medical condition that can cause depression along with fatigue and body pain. Everything came back negative - to the surprise of my GP. It was all quite confusing. It was only when I got really really physically sick, and became too tired and weak even to be able to walk, and finally dragged myself into the doctor with a complete list of every single symptom I had that the answer turned up. And it was surprisingly simple. "Hyperventilation occulta", my doctor said. WHAT?!
It turned out that almost everything I was experiencing was being caused by one thing: bad breathing. In this modern day & age, where asthma gets treated by shoving a couple of inhalers at a kid, very few doctors or nurses take the time to actually check how the patient is breathing. On reading up about it and going to see a specialist physiotherapist, the problem became even clearer. It transpired that I had probably never used my diaphragm properly to breathe, and had only ever breathed using the accessory muscles in the chest and (during asthma attacks) the neck and shoulders. It also transpired that I breathed with my nose and mouth together, at a rate roughly 4 times faster than normal. Um.
Apparently the carbon dioxide level of the blood is very important in a number of regulatory processes. It controls how much oxygen you breathe in, for starters. It is also involved in such diverse things as temperature regulation and the production of adrenaline. And the brain, or hypothalmus, works assuming that the baseline carbon dioxide level of your blood is normal. If, over a long period of time, you breathe out too much carbon dioxide, the baseline gradually drifts lower and lower, and your body forgets where "normal" really is. The upshot of this includes such delights as exhaustion, muscle weakness, depression and panic attacks. Really.
Anyone who's had an anxiety disorder knows that panic attacks breed panic attacks. You have one, and you're likely to have a bunch more in quick succession. Quite apart from the underlying stresses which feed the anxiety (and then the fear of breaking down again which makes you all the more likely to), there are the physical symptoms of panic attacks which lower your blood carbon dioxide level, boosting your adrenaline level and making you into a giant timebomb. Panicky people tend to breathe quickly, and may even hyperventilate enough to notice. Their heartbeat speeds up. They sigh, or gasp. All things that mess up how much CO2 is in the blood.
I have had a cold for a week, and my nose has been blocked for much of this time. I have been forced to breathe through my mouth a lot, with much sneezing and coughing. It is not, perhaps, surprising that I woke up today in that waking up from a nightmare panicky can't cope shit gonna die what? exhausted need more sleep rinse repeat cycle that I know and love from my past.
What is surprising is that I didn't recognise it, until I had a complete meltdown just now.
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no subject
Date: 2005-02-08 07:28 am (UTC)How are you doing, these days? Are you more able to breathe fully?
no subject
Date: 2005-02-11 10:46 pm (UTC)Every so often I forget how important it is, which is why that cold was useful... I suppose :) The difference in my mental health when my breathing is better is just unbelievable. Generally so much better able to deal with things. Amazing how much difference it makes.
I try not to be too evangelistical, though, because I know how resistant I was to the idea that my breathing was screwed up, and how utterly crackpot I considered it as a possible cure. I see people posting about mystery chronic fatigue ailments and I'm soo tempted to ask if they've had their breathing checked, but after the first 10 or 20 people ignored me or were rude in reply I gave up... :/
no subject
Date: 2005-02-08 09:06 am (UTC)The worst thing is panicking ABOUT panicking. It's insane. But it happens, every single time. You feel slightly anxious - no biggie, and then BOOM! The thought "oh dear, I odn't want to have a panic attack". 5 minutes later you're panicking. >_<
I *hate* that.
I had constant panic attacks all last week because of the constant snorking, sneezing, coughing and having to breathe through my mouth.
I have a very regulated breathing cycle from so much respiratory physio for panic. I don't even notice it, but I always breathe moderately deeply, through my nose and very evenly.
Having a blocked nose screws that all up, I feel horrid and next thing I know I'm yearning for valium whilst trying to keep it together.
The breathing I do is to maintain CO2 levels, btw. Sometimes it helps to hold your breath (although it's excruciating when you feel like you can't breathe), and that's also where the 'breathe in the bag' thing comes from. I learned all about panic when I started physio for it, but it's still a bitch to control.
Don't breathe too deeply. Count to ten (slowly inhaling), pause (2 seconds), Count to ten (slowly exhaling, pause, start over again.
Do this when you're having a panic attack, focus on it. The slow breathing is the key, it stops you from gulping oxygen and making it worse. And I mean *FOCUS* on the breathing, to stop the horrid downward spiral of Panic Thought (you know, the "I'm gonna puke/pass out/die, etc etc). Lie down on your back and make sure you're breathing so that you're stomach rises and falls, not your chest.
THis has helped me SO much.
no subject
Date: 2005-02-08 09:20 am (UTC)no subject
Date: 2005-02-08 11:24 am (UTC)since clarly I show some of what you talk about
my one question is: when I get stressed my corisol level seems to go up as opposed to adrenaline what symptoms would i get in this case
I seem to have a para sympathetic response to stress (cortisol) as opposed to a sympathetic response (adrenaline)
no subject
Date: 2005-02-08 02:56 pm (UTC)In terms of the connectedness between physical and mental illness, what surprises me more is how we treat them as two totally different things, rather than just considering them both illness. This is not to say that there might not be nonphysical causes for mental illness that play a role as well. However, building a more inclusive picture of illness would not only help us solve crossover issues like this, but also would help reduce the negative stigma associated with those with mental health issues and possibly encourage more people to come forth and report their problems.
On a "humourous only because it's so irritating and crass," level, one quote in that "What the %*(#$@ Do We Know?" movie (which I strongly disliked) was: "Most issues dealt with by the psychiatric profession are just examples of people making lousy choices. Someone just has to instruct them to make better ones."
They coupled this with a strong go-off-your-medicine-and-use-positive-thinking message at the end. Whee!
no subject
Date: 2005-02-08 09:55 pm (UTC)