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Resisting the temptation to overdo it

Posted May 12 2012 9:50am

Sometimes you just gotta chill

My left knee is bothering me this morning. My arms and shoulders are also sore. I pushed myself harder than usual over the past few days, and I’m feeling it. So, rather than doing a full workout, I’m letting myself recover. I have plans to do a bunch of stuff later today, so for now I’m taking it easy and just starting my day at an easy pace.

I’ve been reading up on Mind Body Skills for Regulating the Autonomic Nervous System , and I”m really liking what I see. Unlike the ONF guidelines for persistent mTBI symptoms which rely on the DSM-IV far too much (in my opinion) and hit on a lot of points at a very high level from what seems like a more academic point of view, the DCoE material reads like it’s based in actual empirical results — tested and proven (or not proven) with real-live people in real-life situations (e.g., combat and post-deployment life). And where things haven’t been tested and haven’t been proven, they say so. Which is good. The emphasis in the DCoE paper is clearly on actual concrete implementation of the techniques, which is refreshing, in the midst of so much information that backs away from application with the standard-issue “__________________ can often be difficult as there is a paucity of research in the area and there are no evidence-based treatment guidelines available” disclaimer that not only absolves the writer of responsibility for inaccuracies or incompleteness, but also relieves readers of any sort of obligation to try something in good faith.

Personally, I believe that long-standing post-concussion complications and mTBI issues warrant at least a good-faith try, using the best information we have available to us at the time. The condition can be so debilitating, why sit by when there are possible alternatives? Even if they aren’t perfect, at least they’re something.

And the “something” that the DCoE is doing, is providing really excellent information on the autonomic nervous system AND ways you can possibly work with it to improve sleep, mood, energy, and the other aspects of life that the ANS contributes to.

Here’s some info from pages 7-8 of the report (bold emphasis is mine)

EMOTIONS, AROUSAL AND THE ANS

The autonomic nervous system (ANS) is the branch of the nervous system that functions independent of conscious awareness. It involves the unconscious regulation of organs and system functions that maintain basic operations within the body – for example, heart rate, digestion, respiration rate, salivation, blood pressure, perspiration and diameter of the pupils. The ANS is a functional system within the central and peripheral nervous system that manages all of the body’s internal functions. It is the automatic nature of the ANS that enables the regulation of many systems without interfering with everything else the brain is responsible for on a daily basis involving conscious thoughts and emotions.

The autonomic nervous system has two components: sympathetic (SNS) and parasympathetic (PNS). The SNS prepares the body to fight, flee, or freeze in stressful situations (depending on the circumstances), while the PNS prepares the body to rest and digest in relaxing situations. These sub-branches both supply nerves to various central and peripheral nervous system regions, the endocrine system, and visceral organs. The SNS becomes dominant in states of stress and fear. Signs of SNS activation include increased heart rate and respiration, cold and pale skin, dilated pupils and raised blood pressure. In contrast, the PNS becomes dominant in states of rest and relaxation. Signs of PNS dominance include decreased heart rate and respiration, warm and flushed skin, normally reactive pupils and lowered blood pressure. Because PNS and SNS states are associated with distinct body activities, a variety of biofeedback instruments, such as those that measure heart rate, body temperature, blood flow, pupil dilation and breathing are often used to indicate the body’s ANS arousal state.

Stress and stress vulnerability can be broadly defined as either the absence of adequate balance between the ANS and the PNS during resting states or the improper predominance of one over the other in particular situations. For example, it would be dysfunctional to have PNS predominance during times requiring high energy and arousal, such as when under threat or attack. Equally, it would be dysfunctional to have SNS predominance during times of relaxation, such as when readying for sleep.

Research in affective neuroscience (the study of correlates between the brain and emotion) has identified central nervous system (CNS) regions involved in emotion. This research suggests that emotions involve a mix of cortical (e.g., frontal, temporal and parietal) and subcortical/limbic (e.g., basal ganglia, thalamus, amygdala and hippocampus) regions of the brain. Evolving alongside this research, emerging neurophysiological research has sought to identify the ANS correlates in emotion.

Mounting research over the past three decades suggests a relationship between emotions and changes in the ANS.  There is some evidence that different emotions may be distinguished based on a complex pattern of sympathetic and parasympathetic activation. However, this literature is evolving and there are relatively few studies that have simultaneously examined brain activity and ANS responses while experiencing emotions, making it difficult to determine specific pathways and conclusions about ways in which the brain, the ANS and emotional experiences relate to one another. Nonetheless, research exploring connections between the ANS and emotions via associated networks in the CNS continues to expand, and researchers continue to look for some of the specific ways that mood and emotions may be connected simultaneously to the brain (i.e., the mind) and to the ANS (i.e., the body), in addition to how interventions designed to directly manipulate the ANS and body may impact moods and cognitive abilities.

This to me is a key point — the ANS is directly connected to moods and emotions (in ways that we still don’t fully understand scientifically, but we can see in our everyday lives). Additionally, stress and stress vulnerability are directly related to imbalances in the ANS. It’s all tied together, closely connected, and we’re still learning how it all fits together.

But no matter how it’s all put together, the bottom line is that our autonomic nervous system (ANS) is hugely important in our lives. It’s central to it. We can’t live without it. AND Iooking to the work of the UB folks about how “concussion produces a temporary alteration of the central regulatory systems that control, for example, the autonomic nervous system and circadian rhythms, as well as the autoregulatory protection of the brain, which under normal conditions maintains a constant state of cerebral blood flow. [and] . . .  that PCS represents a condition whereby the regulatory and autoregulatory mechanisms of the brain do not naturally return to normal”  it just makes sense that if we have access to techniques and approaches we can use to actually regulate our mis-behaving ANS ourselves, then let’s do it.

Let’s not waste a lot of time trying to cover our collective asses with disclaimers and suppositions that “in TBI there is no recovery” and “every brain is different” and “we don’t have conclusive evidence to do/say/try such-and-such”. Sure, I’m all for being responsible and prudent and using best judgment and not wading in over your head at the drop of a hat.

But lives are at stake. Your life. My life. The lives of thousands and millions of individuals who sustain TBIs each year. And if there’s information out there that can help us and which might do some good, then I say, go for it. Some of it may seem to me like a bunch of hooey that’s not based at all in science or experience. But that may work for others. Still, I don’t want to see anyone taken advantage of, obviously, by hacks and people who write their own rules and come up with their own versions of “science” and “medicine”.  So that’s where my enthusiasm for the DCoE material comes from. It’s based on science,  and it admits that there may be issues with some of the techniques surveyed. But it doesn’t shy away from talking about them and encouraging further research.

So, all this being said, I am pretty encouraged by this offering from the DCoE. And I’m really encouraged by the materials coming out of University at Buffalo. These two taken together are giving me actual concrete information to work with, that is both intellectually motivating and emotionally encouraging. Probably the biggest plus of all of this, is that I feel like someone is actually paying attention to what is harming so many people, and they’re actually doing something about it. They’re putting themselves out there, setting examples, and blazing a trail that can actually be followed.

Now, I know TBI and concussion are complicated issues. And there are a lot of people who are trying to make a difference, for a number of different reasons. So in everything, I’ve got to take grains of salt here and there. Nobody’s perfect, obviously, and we’re all learning as we go. For me, in my own life and my own recovery, balancing out my ANS with breathing and practice and good living hygiene, is really key. Making sure I don’t overdo it to either one side or the other — either getting stuck in fight-flight or being bogged down in rest-digest. Both sides are important for life, and it’s vital that I be able to switch off between the two. That’s just common sense. And it’s good practice.

Speaking of practice, I just downloaded the Breathe2Relax app for my iPhone . I’ve set it up and may use it sometime. Not sure if/when I will, but I heard about it in the DCoE paper, and it’s not only free but also looks like it might be useful. I’m not a huge fan of depending on a smartphone for living my everyday life, but in a pinch at work, when I’m so wired I can’t think straight, it might come in handy. For the times when I don’t want to be hooked up to my iPhone, there’s always the simple and effective (and free) technique of counting my breaths… and imagining expanding the different parts of my body to “crack apart” the hard shell of stress that’s coating me. That helps a lot, too. It gets me to sleep, and it helps me relax in general.

Anyway, speaking of not overdoing it, it’s time I got on with my day. The weather is beautiful, and it looks like I can get to the beach. It’s a drive, but I’ve got time.

Onward.


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