Being chronically under stress disrupts recovery and repair functions
When we get chronically under stress, this curve shifts further in the direction of tension so that proper recovery is no longer possible and less pressure is created. This disproportion leads to the fact that the recovery and repair functions are chronically insufficiently available. In the long run, this undermines performance and resistance at the immunological level, which can, as often observed, suddenly lead to a complete collapse after an infection. I believe these infections are the straw that breaks the camel’s back.
Performance limit collapses to a low level.
The performance limit has then collapsed to an individually different individual level of 20-40% of the original functional capacity. These performance limits can no longer be raised to the senior level, even with maximum motivational effort. The amygdala has been switched entirely to be on alarm.
A vicious circle of tension and performance pressure
Therefore, any attempt at going beyond this reduced performance limit will result in significant stimulation of the sympathetic nervous system, which then drives the tension further and further upwards, with adverse effects on the ability of the autonomous nervous system to regulate itself. The only way to avoid this vicious circle is to respect the current performance limits and only carefully test them without going beyond them.
How hard do I have to work?
The Stress Staircase
To illustrate this, the “Model of the Stress Staircase” helps.
The primary hypothesis of the regulatory disorder of the autonomic nervous system teaches us that the sustained stress of recent years has pushed the tension curve more and more to the dangerous zone of imminent breakdown.
A procedure called pacing, namely a prolonged increase in the energy used while strictly observing the performance limits. Why this is so important can be derived from the diagram.
Observe your boundaries but foster parasympathetic/vagus activities to regain true relaxation.
In my office, I apply heart rate variability measures (HRV) to show my patients whether they are still on chronic sympathetic arousal or have already obtained some parasympathetic activity. This feedback is helping to stay on track. There are some HRV APPS on the market. You can try to determine whether this feedback is helpful for you.
First, please start with a few well-being activities.
1) It should be fun and thus becomes easier anyway.
2) It should help soften and loosen up the “blinkers” that concentrate more on the disease and its consequences.
3) You should be able to reflect on something positive in your “evening prayer”.. First, please select only one activity you regularly integrate into your everyday life. If this is successful, add more, but always with careful consideration of your endurance limits.
Granted, a complicated process.
That’s the point in my practice that I am most in demand to encourage my patients to keep going. We need strength for the therapeutic process, effort, and discipline. As seen from the energy barrel model, it is easiest to draw these positive forces from the “Social Integration – Joy of Life, Commitment, Hobbies” field. You can find activities or hobbies which you can start on your own at your pace.
List of Activities
My patients compiled a list of possible activities from their own experience, which did them well during the difficult time. The activities can either be stimulating and energizing or a good distraction from energy-consuming brooding. You are invited to pick a few and try to integrate them into your everyday life firmly. Create positive rituals for yourself. Download this list and start with just one activity. Adjust this to your current level of performance. Even 5 minutes is enough at first; it doesn’t have to be an hour. It can always be extended.
Using this Excel sheet, you can get a precise overview by evaluating each activity according to the criteria “pleasant and energizing” and “necessary effort.”
In the first column, please rate how pleasant this activity is for you or how well it can distract you (0 = not very pleasant, 10 = very pleasant). In the second column, please estimate how much effort you need to carry out this activity. (0 = little strength; 10 = a lot of strength). This can change in the course of the disease so that, e.g., the healthier you are, the less effort it takes.
In the last column, the EXCEL spreadsheet automatically calculates the difference between the effort and the strength-giving potential by subtracting the point value for pleasant activity and well-being and likewise from the point value for the effort. The result will be shown automatically in the last column, »Balance sheet. «
Thus, you can easily detect which activities provide the best energy for you.
If you still feel very weak, it may well be that a previously popular activity would currently require much effort and low energy gain. So the overall result of being able to feel better may not occur. But keep on going! The greater the value in the Balance sheet column, the more energy you can draw from an activity.
Repeating these assessments every month is advisable because your strength may have improved.
The Excel spreadsheet is structured to calculate the total values of your ratings automatically:
1. Between gain of strength and effort and
2. The total values, how many activities were pleasant, served well-being or were suitable as distractions.
You will notice that most of the activities at the beginning are only suitable for distraction but may trigger feelings of well-being later. Finally, you can see how, over time, the balance sheet’s total increases if you fill out the table regularly.
That is the goal! Find activities (again) that give you strength at an acceptable cost.
Take the activities listed as a suggestion to try this out. Pick those activities that match your situation. If you are bed-bound, pick those with minimum effort or start only with two to three minutes, but start!
The essential principle behind this is to open your blinders from focusing on the heaviness, the pain, the symptoms, the exhaustion, and the frustration. You may better focus on things that give you some reward rather than activities you feel obliged to do, like household chores. As I said before, try to delegate everything you can of these kind of tasks to save energy for doing nice things. You may initially only be forced to start because I suggest them, and you have trust and confidence in my words. But if you keep at it, these activities will unfold their beneficial, distracting, and benevolent power over time.