How everyday events can lead to functional symptoms
I mentioned in my last post that many people believe that their functional symptoms came out of the blue with no warning.
However, when I enquire into what they tell me is their normal life, I am amazed at the amount of stressors they have endured uncomplainingly. Not only is there often poor sleep, but also, disrupted meals, precious little rest and recreation and frequently a hostile internal environment, where they are relentlessly critical of themselves. Living like that is a recipe for calamity!
In my book, Maree gives an account of her life leading to the onset of her functional illness and it always amazes me how much she tolerated before her system collapsed. I have let Maree tell her story in her own words, but I have added highlights to illustrate what to me are warning signs, that she was at risk of developing a functional illness.
MAREE’S STORY
Six years ago after the birth of my second child, I had a retained placenta, lost quite a lot of blood, I needed to go under general anaesthetic to remove the placenta and stitch the rupture in my cervix. I was given a blood transfusion and iron tablets. After this point, I also started putting lots of pressure on myself to start my master’s degree and plan our wedding (scheduled for four months after my son was born). I was having periods of feeling generally unwell (fatigue, nausea, vertigo) that would come and go. I went to the doctors, but they said my bloods were all fine so no issue. After the wedding I had an episode of body tremors and generally very fatigued, feeling anxious and depressed. I went to a counsellor who helped, and I started to feel like I was getting my energy and motivation back when I fell pregnant again. (My copper coil had fallen out without me realising!) My third pregnancy was difficult with fatigue, nausea and catching every bug going. I was worried I was going to be sick for the birth, but my body cleverly bounced back to give birth, and all went fine. I felt a boost of energy after that and started doing four spin classes a week and booked a family holiday to Spain when my daughter was 12 weeks old. A week after getting back, I hit a very bad period of fatigue, aches and nausea … I actually became very paranoid and anxious that I was pregnant again, even though the pregnancy tests were negative, and I paid for a private scan to make sure. I went to the doctors again who diagnosed me with Gilbert syndrome, but said it was totally harmless so nothing to do with my symptoms. I kept trying to push through to get my energy back, and that’s when I also started the aerial silks. When my daughter was four months, I performed in an aerial Christmas show and even though I felt awful I kept pushing on. I then got a virus (pretty sure it was COVID because it was just spreading around that time) which really floored me. Fortunately, everything was locked down and I was forced to stop and recover. Even then, I was only getting four to six hours of sleep, trying to juggle everything. I was starting to feel better but once lockdown rules eased, I went back into pushing myself to finish my master’s degree and build my business more and take on more complex behaviour cases and earn more money. I had another bout of illness and COVID over the following Christmas and then decided to start working with a business coach to expand. Even at this point I was feeling very burnt out, but I kept pushing forward because it was ‘what should be done’. There was a voice inside telling me not to do it and that I wasn’t enjoying the work anymore, but I had just spent all that time and money doing my master’s to become a clinical animal behaviourist so I had to keep going – otherwise, I would be a total failure. My anxiety, fatigue, tremors, brain fog and body pains were getting worse, and I couldn’t keep up with all the demands from work and being a parent. I would then beat myself up about not being good enough and keep pushing on. Then one night I had a three-hour episode of full body tremors. I had to stay in bed for a few days, but I did slowly get back up and do more with help but now I had this awful constant sense of dread, fatigue and anxiety about things getting worse. In the past when I had experienced the periods of fatigue, I was always worried it would stay but they usually went away after a while. However, this time it wasn’t going away. The doctors prescribed me beta blockers so I would take one to help my nerves about work but after three days of taking them I was even worse. I went to a job and had to leave early. I felt totally disoriented, spaced out and panicky, and had bad stomach pains. It was then the Easter holidays, and both my parents and husband were going to be away so I would be looking after the kids myself. I didn’t want to ask for help or ruin anyone else’s plans and I was so desperate for things to just go back to normal that I told my parents and Damien to go and not worry about me. Over that week I could feel my mind and body starting to break but I kept going, and then on the Friday evening my body started to feel very weird, and I had a panic attack. I had another panic attack that night and took more beta blockers. I truly thought I was going to die, and my poor kids would find my body with no-one there to look after them. My mum came back from holiday the next day to help, and I kept taking the beta blockers, but things got much worse, and I had a week of almost constant panic attacks to the point where I couldn’t even spend a minute by myself in the house or with the kids. The furthest I could walk was to the bottom of the lane outside our house without my body going into overload and shutting down. After this point I was at my very worst and couldn’t do much without having to go and lie down again. It felt like my nervous system was a faulty car alarm and just setting off all the time over nothing. My sleep was very badly affected, I had pain in my joints and body, and I kept getting migraines and tension headaches. I was so scared that I wouldn’t be able to look after my kids again and be the mum that I had so enjoyed being. I was also angry with myself for pushing so much with work when that now seemed totally meaningless in my current situation. I got back in touch with the doctor but the only option but the only option they had for me was to take anti-anxiety medication, and after my experience with the beta blockers I had a huge fear about taking anything else.
Fortunately, Maree found her way back to health and the account of this is so inspiring, I hope you get to read this, but here I want to focus on all the highlighted elements that were predisposing factors towards Maree’s illness.
In many ways, Maree’s story is typical of how functional illness can develop in otherwise healthy, fit, high-achieving individuals. After years of listening to stories like Maree’s, the pattern is clear. The steady accumulation of otherwise normal life events, (work demands, worry, raising a family) can accumulate to you reach some tipping point and symptoms appear.
Maree is also typical of many of my patients who ignore the early warning signs and ‘push through’. This is a terrible idea.
Maree also had a lot of anxiety and fears which activated her defensive mode (see post on May 28th as a reminder).
This is a long post but before you go, you might like to write your own story, including all the possible stressors, whether they be life events, illnesses, surgery, psychological problems or simply a personality that demands too much from you. Writing can be very illuminating. You are not complaining here, but merely listing all the factors that may have affected your well-being.
In the next post, we will look at some of the psychological factors that can lead to functional health problems.
Until then, best wishes for your health.