My Covid Part 2

Dark and imposing Norfolk sky

9th June 2020

What I am sharing here is my own post-Covid experience, and my learning from this. I hope parts of it may be helpful to you too. Please ignore what doesn’t fit for you and take on what does.

I am now 9 weeks on from having had Covid-19. I have never had a test – I asked for one when I had the virus and they weren’t available even to NHS staff in my area (Norfolk) at that time. However, I had all the classic symptoms and on the two occasions I called 111 and spoke to two nurses and a duty GP, they all confirmed it was almost certain I had the virus. 

My experience is similar to many others: I was quite unwell but able to stay home with the reassurance of a prescribed inhaler in case I needed to be hospitalised (it’s a 30 minute drive away and ambulances were running on a 1-2 hour delay at that time). For more details of this phase of the virus see my previous blog here.

As I started to improve my symptoms abated and then seemed to return with force every few days. It was draining, and still a little bit scary. What would happen next? Would I get a ‘cytokine storm’ which I had read about, when your immune system seemingly goes haywire, or viral pneumonia, or something else (worse)? No-one really knew, data was being collected but we were all still learning. 

Intermittently I still had fatigue, muscle pain, tingling in my fingers and toes, headaches, over-salivating, sore throat, catarrh, and a tight chest with a strange feeling – someone else online compared it to glass shards in your lungs and I recognise that although the feeling was not as extreme as that. 

Unexpectedly I also had bouts of depression. I know this because I resumed daily walking locally when I could, and I know the point on this route when I normally feel the endorphins, the sense of wellbeing kick in. It didn’t happen. I felt anxious, uncertain, and powerless. Even though I could see logically that my trend line was going in the right direction, at the times when I relapsed it didn’t feel like it.

After around 5 weeks I went to my GP for another reason. He asked me how I was and I told him. The fatigue was uppermost at this time: I would do something in the morning, some office work from home for example, and would have to nap for 30 mins or an hour after lunch just to continue functioning. I don’t do napping, and it was infuriating. If I had clients (I divide my time between garden photography, writing and psychotherapy) I would need an hour to recover between zoom sessions.  My GP ordered a bunch of blood tests. 

Time passed, just under 3 weeks. I went for the blood tests, and the following day they all came back normal. I went back to see my GP and explained my theory, derived from monitoring my life since Covid, trying to be aware of what was going on both inside and outside my body, what activities seemed to trigger symptoms more than others. My speculation was that every time I put my body under any stress at all, it felt like my immune system went into overdrive and delivered all these unpleasant symptoms unnecessarily. He nodded in agreement. Then he said quietly: “You need to retrain your body”. This was my turning point. 

I realised that up until then I had been a victim. I had felt powerless and frightened (terrified at times) of this thing that was being done to my body (and mind) by this alien, unknown, potentially lethal virus. And even when my rational brain knew I no longer had the virus, it felt like I was still under attack. 

By this one comment, “You need to retrain your body”, my GP put me back in the driving seat. I could be active in my recovery, I had agency in how I could feel – even if it often didn’t feel that way. 

As a psychotherapist I have been very interested lately in the advances in neuroscience and how they relate to recovery from trauma. The link between mind and body, between mental wellbeing and physical health, has always seemed to me to be way stronger and more inextricably interwoven than western medicine (the ‘medical model’) had previously allowed. 

In particular, I have recently been interested in the role of the vagal nerve which runs from our brain stem to our gut, taking in most major organs along the way. Amongst other functions, it takes sensations from our gut, and transmits them to our heart and brain. Stimulating the vagus nerve has been shown to have a calming effect by slowing heart rate and lowering blood pressure. Crucially for post-Covid sufferers, it also inhibits inflammatory cytokine production, in other words it calms your over-active immune system. (A high level of cytokines, incidentally, has also been linked to symptoms of depression.)1

In trauma, this leads to the idea of two types of processing aiding recovery: top-down processing via the cortex – making meaning out of disregulated memory (eg flashbacks) by creating a narrative – and bottom-up processing, from body to mind, via breathing meditation, yoga, mindfulness and similar activities. Diaphragmatic (belly) breathing directly impacts the vagal nerve, sending calming messages to our heart and brain, which in turn calms down our internal feelings and responses. 

For me, when I get stressed I subconsciously tense my belly muscles. By turning my attention to noticing when this starts to happen and using belly breathing to pause the process and unlock the muscles, I have seemed to be able to calm my post-Covid symptoms. It doesn’t always work of course. But like any other muscle training, the more I use this technique, the easier and more natural it becomes, and hopefully as I continue, the more effective it will become. Is becoming. 

I am also attempting to do a five minute mindfulness meditation most days, and also to limit my intake of news and social media which is likely (highly likely at the moment) to press my anger buttons and raise my stress levels and bodily tension. We are lucky enough to live near the coast, so weekend walks on the beach are also part of my personal treatment plan. A small amount of Pilates and/or yoga. Daily local walking. Talking to friends and family on zoom and facetime. Feeling loved and nurtured, and loving and nurturing others.

Healing works from the body to the mind and also from the mind to the body. Decrease the anger, and I decrease the stress, which calms my body, which calms the symptoms. Increase the outgoing compassion and loving, and I increase the healing. It seems to be working.

So my learning from this experience is that taking some small control in my own recovery was a game-changer. Doing healing activities, and refusing to be defeated by my own disregulated immune system, but rather retraining it gently to understand that my body is actually ok now. I hope that yours soon will be too. 

Hopeful sunny beach and sky

5 things I have found helpful in coping with anxiety

A few friends have posted things to do with anxiety recently, so I thought I would share what I personally find really useful, and many of my clients seem to do too.

1 Concentrating on this moment (and the next, and the next) 

When I get anxious about something which may (or may not) happen in the future, (for example,  going walking up a mountain in Wales when I don’t think I’m fit enough) I say to myself, ‘right now you are ok. everything is ok. Concentrate on this, right now it’s all ok’. And repeat.

2 Do something to get some distance

A long day dancing like a crazy person at a local music festival helped me to start to come to terms with the possibility that we may never manage to sell our house on the terms we would like…

3 Breathe and count

This is great in those moments when you feel the agitation or panic rising, sometimes without you consciously knowing why. The counting is important: it takes your mind away from doing the worry temporarily and allows your body to calm itself.

So, belly breathing, expanding your stomach like a balloon as you breathe in, and letting it collapse gently as you breathe out: in for 2, out for 3; then in for 3, out for 4; then in for 4, out for 5, and so on, to the point that feels comfortable for you. Don’t push it. This is not a test. 

4 Tell someone

It doesn’t have to be a big deal, maybe as simple as ‘I am feeling a bit jittery right now’. Choose someone you trust to be supportive.

5 Learning to not mind

This one is longer term and needs work. In my case, a LOT of work. It is also potentially the most helpful. It’s about letting go of needing things to be a particular way. For example, ‘I must get a job’, ‘I should be better at keeping in touch with my family’, ‘I ought to do more about rejecting plastic in my local supermarket’, ‘I need us to be able to sell the house soon’ (you see a theme developing here?)

Trying to let go of the ‘should’, ‘must’, ought’, ‘want’, need’ words, trying to be ok with my flaws, and to accept what the world throws at me. Kind of close to ‘everything happens for a reason’ but not so glib perhaps; more, ‘let me be ok with what happens even if it’s not what I wanted to happen right now’.  When you find out how to do this seamlessly and easily, please let me know.

To be or not to be.. the greatest choice of all?

No, this isn’t a post about suicide, or even suicidal thoughts. Although in your case it might be. It’s a post inspired by the words of another blogger, , who wrote ‘I would rather bleed from the choices I make then be hurt by what someone choose for  me.’ It’s a post about making choices.

As a humanistic psychotherapist I often see people with anger issues. People  who tell me they can’t control what they say in arguments with loved ones, or lash out verbally at their children and are instantly remorseful. People who tell me about the ‘red mist’ coming down.

There are practical tips all over the webosphere for controlling anger, and these are (mostly) helpful. But my first suggestion to a client is that the next time they are in a situation where they find themselves getting angry, they might try to just notice what’s going on. How they are physically in their body, what’s going through their mind, how they are feeling.

Because by noticing how they are when their anger is triggered, the next time they might notice a bit sooner in the process. And that is key. If I don’t notice I’m angry until I’m exploding, then I’m on autopilot. I’m reacting. If I notice as the anger builds, then I can decide how to act. I am responding. I have a choice.

This is clearly only part of the process of the therapy; finding out together why it happens and what may be underlying the anger is the real work. But that’s another story. Choice is part of the taking back of control in our lives. When we allow others to make choices for us – as we do when we let someone wind us up to the point of explosion – then we are giving up our power. We can’t help feeling emotions like anger, sadness and fear. But we can choose what we do with them.

Have a great weekend.