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adrenaline & ME …

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I’ve wanted to write about adrenaline & ME for such a long time. Basically, because I know it’s what I use to do things. I need to trigger this adrenaline in order to accomplish even the smallest of tasks. However, I am also very aware that living like this is making me sicker, and I wondered what the scientific evidence behind this was. I knew it was not a simple case of ‘boom’ and ‘bust’, I can actually feel myself deep inside getting sicker each day. There is no BOOM, everything is done in bust, it’s just that I am triggering adrenaline to do the simplest of things, like, to go to the bathroom, to brush my teeth. And while I’m doing this I know I’m managing to do it on sheer determination, which for me is what triggers the adrenaline.

While researching for my own article, I came across the one below, which discusses everything I wanted to and says it probably far better and eloquently than I ever could. So because Jodi’s website asks visitors to share her articles as much as possible, I thought I would use this article instead of writing my own. Expect to see more of her work on fragmented.ME blog …; she’s an excellent communicator and her work is informative, often based on true understanding, as well as being well written and researched. That said, it wasn’t, by any means, easier than writing my own article as the code in the article made an absolutely mess of my website, which meant I had to restyle it all up. I’ve also changed a few typos, when I noticed them, but everything else is as it was originally written by,

Jodi Bassett, who died in 2016 from ME (see Jodi’s memorial)

 fragmented.ME xXx


Blog article to follow is Copyright © Jodi Bassett November 2010.
Updated March 2012. From www.hfme.org 

Assisting the M.E. patient in managing relapses and adrenaline surges

M.E. patients have strict limits on how active they can be. If these limits are breached, symptoms worsen immediately and there is also a further deterioration 24 – 48 hours later, as well as the very real potential for repeated or severe overexertion to prevent significant recovery, cause disease progression or even death.

It is very important that M.E. patients stay within their limits. Unfortunately, M.E. patients may find staying within these limits all of the time very difficult for a number of reasons.

This paper explains how carers, doctors, and also friends, family members and partners of M.E. patients, can help patients to avoid overexertion and so have their best possible long-term health outcome. It also describes the characteristics and signs of adrenaline surges and relapses in M.E. for the benefit of these individuals, as well as for newly ill M.E. patients themselves.

This paper is designed to be read together with the more detailed hospital or carer notes for M.E. paper.

What is an adrenaline surge and how does this affect M.E. patients?

People with M.E. can sometimes operate significantly above their actual illness level for certain periods of time thanks to surges of adrenaline – albeit at the cost of severe and prolonged worsening of the illness afterward.

Adrenaline is often referred to as the ‘fight or flight’ hormone as it kicks into action in situations of potential danger. However, adrenaline also kicks in when the body is in physiological difficulty, which is very often what is happening to severe M.E. sufferers. Adrenaline surges make the heart pump faster and raise the blood pressure, forcing blood around the body with greater force to supply the muscles with more oxygen, so that they can make a greater effort. Surges of adrenaline increase the metabolism. They also relax and dilate the airways so that more oxygen than usual can be taken in. Adrenaline surges can also decrease the amount of pain felt. As a result of all of these factors, adrenaline surges – while they last – have the ability to increase physical speed, strength and other physical abilities.

Unfortunately, when these bursts of adrenaline wear off – as they must – people with M.E. are left far more ill as a result for many days, weeks, months or even years of overexertion. People with M.E. are harmed by adrenaline surges, both by the physiological stress to the body of the changes caused by adrenaline, and by the extra activity which adrenaline enables, which may be far beyond the body’s normal limits so that such activity causes damage. For every short term ‘gain’ there is a far greater loss overall.

Surges of adrenaline can last hours, days, weeks or even months at a time.

These adrenaline surges are a bit like credit cards. They allow patients to do things that they could never otherwise do, or ‘afford.’ But the interest rate is extortionate, sky high, a killer. As Clytie, a very ill M.E. patient, explains:

I try to xplain this one in terms of money
ok, you could buy a ferrari, coulnd’t you?
no, i don’t have the money
oh, but you could borrow lots of money, sell your house, take up dealing drugs, gamble, and in the end you’d have your ferrari
… blank look …
maybe for a day or so, before the loan sharks shoot your kneecaps off, and the gangs blackmail you, and you have to find a way to rerpay all that money… could take you a lifetime
… rather frightened look …
yeah. you get the point

M.E. expert Dr Melvin Ramsay explains;

The degree of physical incapacity varies greatly, but is directly related to the length of time the patient persists in physical effort after its onset; put in another way, those patients who are given a period of enforced rest from the onset have the best prognosis. Since the limitations which the disease imposes vary considerably from case to case, the responsibility for determining these rests upon the patient. Once these are ascertained the patient is advised to fashion a pattern of living that comes well within them.

Why do M.E. patients sometimes overexert themselves, considering the severe consequences?

There are many reasons why this occurs, including the following:

  • Once a patient gets going, stopping can be very difficult. This is due to neurological problems with stopping and starting new tasks easily, and also because once an adrenaline surge has occurred, it takes a long time to wear off.
  • When a patient has become very ill from overexertion or is in the middle of an adrenaline surge, judgement can be affected, and the patient may be lost in the moment and not realize how important it is for them to stop what they are doing as soon as possible.
  • Resting after a relapse is often very difficult for the M.E. patient emotionally. It can be very difficult to lie in a dark quiet room in extreme pain and worse, with no distraction from it. It can be tempting to keep the adrenaline surge going in a small way, to put off the crash. (A bit like drinking more alcohol the day after a night of heavy drinking to delay the inevitable horrible hangover.)
  • Many patients with M.E. have been treated appallingly in the earlier stages of their illness. Medical abuse is very common. Patients have often been told or forced to keep pushing through their limits and that this is what they must do if they ever want to recover. This ignorant advice has forced many patients to develop a very high tolerance for pain and discomfort – and this can be a real obstacle when it comes to training oneself to rest appropriately when experiencing minor symptoms. Patients have often become very used to paying a high price afterwards for every little bit of fun they have or every task they do, and have had to accept this as a way of life for so long that change can be difficult.
  • Many patients, along with much of the general population, have a very strong work ethic and at times find not pushing themselves to do things very difficult. M.E. patients need a level of discipline at least as high as the average Olympic athlete to control and restrict all their activities so completely for years.
  • M.E. is an acute onset disease which means that patients go from healthy to very disabled from one day to the next. Being so disabled so suddenly is shocking and takes a long time to get used to. Particularly in the early years of M.E., patients often feel the need to constantly push at the boundaries to work out where their limits are. This is also often tied to denial of the realities of the disease, and a desire to keep ignoring physical limits in the madly optimistic hope that this will make them go away as quickly as they came.

Other reasons include:

  • Due to the brutal severity of M.E., some M.E. patients must overexert just to live or to have a little bit of basic human contact.
  • Many M.E. patients overexert themselves as they have no other choice, unfortunately, and do not have the appropriate financial or practical support they need due to the political situation facing M.E. patients. Patients with M.E. are also often forced to overexert themselves in order to get the welfare payments they are entitled to (and need to have to survive) and to try and get some basic medical care.
  • Many M.E. patients are told that ‘everyone recovers, it is just a matter of when, and at most you will be well in 5 years’ by ignorant doctors, websites and patients that do not understand the massive difference between the neurological disease M.E. and mere post viral fatigue syndromes. Thus they have no idea that there is a big long-term cost with every short-term relapse, and by the time they do get this information it is often far too late and they have become severely affected and greatly harmed their chances of future recovery.
  • Many M.E. patients are told that they are not ill, and that they cannot do things simply because they believe they can’t. This incredibly abusive brainwashing can lead many patients to again and again try and push past their limits in a brave but misguided effort to ‘mind over matter’ the disease. Unfortunately, many patients have so much faith and trust in their doctors that they ignore what they know to be true about their own bodies and their disease for many months or even years, often ending up severely affected and very disabled.

What signs may indicate a relapse or an adrenaline surge?

Signs that a M.E. patient is overexerting and/or running on adrenaline may include the following:

  • Very fast and continuous talking is a sure sign of an adrenaline burst. Speech may also become very loud as the patient becomes unable to modulate their volume level. This may also be accompanied by fast and jittery movements. Speech may make evident feelings of euphoria, over-excitability or wild optimism and will often be less well-considered than normal. The patient may also sit up or stand for longer than usual (without realising they are doing so) or get fired up to undertake tasks that they would usually be too ill to do. (Big cleaning or organisational tasks for example.)
  • After or during an adrenaline surge, sleeping and resting is very difficult as the patient feels ‘wired’ and very “unfatigued”. Sleep onset may be delayed for many hours, perhaps leaving the patient unable to sleep until mid-morning or unable to sleep that night at all. The patient may also only be able to sleep for one or two hours at a time, awaken for a few minutes many times during the night, and/or may experience very light sleep where the slightest noise wakes them up.
  • Particularly in the first few years of the disease, patients may sleep, or be unconscious, for much longer than usual after overexertion, perhaps 12 – 16 hours or more. In very severe cases, the patient may be unable to maintain consciousness for more than a few hours a day.
  • When suffering a severe neurological episode M.E. patients may be mistaken for being drunk or high on drugs. They may slur their words, talk very fast and ramble, seem euphoric and have very poor balance.
  • A lack of facial expression and ‘slack’ facial muscles and/or extreme facial pallor.
  • A burning sensation in the eyes and/or an inability to tolerate visual stimulus and to keep the eyes open.
  • Excessive water drinking (to try to boost blood volume).
  • Excessive hunger and a desire for sugar – or carbohydrate – rich foods. Even after eating, the patient may still feel as if they have very low blood sugar and may need to eat far more often than usual.
  • Sweating or shortness of breath after minor exertion.
  • Visible shaking of the arms or legs or twitching facial muscles.
  • Paralysis and weakness in the muscles or an inability to move, speak or understand speech.
  • Sudden loss of ability to walk.
  • Very sore throat and/or painful and tender glands in the neck (and possibly other flu-like symptoms).
  • Very distinctly pink, purple or blue feet or legs, with white blotches, after standing or sitting for too long.
  • Patients may complain of a severe headache or feeling of pain or pressure at the base of the skull. This may also be accompanied by pain behind one or both eyes or ears, or blackouts.
  • Sudden onset ringing in the ears or loss of hearing.
  • During and after overexertion, a patient’s pulse will very often become much faster (150 bpm or more), their blood pressure will become lower and their temperature may rise and they may feel very hot (or alternating very hot and very cold). Pulse and/or temperature measurements may be useful in determining when a patient is overexerting. As blood pressure readings tend to only be severely abnormal when the patient is standing or sitting upright – which in itself causes relapse – this test will often be counter-productive and inappropriate.

Other things to be aware of:

  • Sometimes when the patient is running on adrenaline, it is very obvious that this is what is happening. The patient is able to do more than usual but feels very unwell and wired; a bit like they haven’t slept in days but have had a LOT of coffee. At other times, particularly where the adrenaline surge is long-lasting, the adrenaline effects can be more subtle and can easily be mistaken for genuine wellbeing for a period of time.
  • When a patient declares that they are improving and suddenly able to do tasks again which they have not been able to do for many months or years – and this occurs right after a very big task has been completed such as a house move or a very taxing trip to the doctor, it is almost certainly an adrenaline surge and not a real improvement. The big task was well beyond their limits and so the body has releases a surge of adrenaline just to cope.
    Unfortunately, this type of lower-level but prolonged adrenaline surge will often be less easily recognized for what it is by the patient, especially where there are problems with memory and placing events which occurred weeks ago in the appropriate timescale. (Events which occurred more than a few days ago may be forgotten, or seem to have occurred much longer ago than they actually did.)
    This type of adrenaline surge can sometimes fool even the most experienced M.E. patients. Having hope of improvement replaced with the realities of a severe relapse can be very disheartening, to say the least.
  • When a patient regularly pays a big price for doing small tasks but then suddenly pays only a small price for a big task, suspect an adrenaline surge. There is just no such thing as a free lunch with M.E., unfortunately. (No expected relapse indicates use of the ‘credit card’ or that the patient’s body is ‘writing cheques it can’t cash!’)
  • Often a considerable rest period is needed before and after a task, which may be hours, days, weeks or months long. For example, someone may need 2 weeks rest before an outing, for example, and may then spend 3 weeks extremely ill afterwards recovering from it. The need for a long rest period before a task is a sign that this task is not within usual limits and will probably require an adrenaline surge to be completed and so be detrimental to the patient’s long-term health.
    Ideally, a patient will only complete tasks which can be done daily or every second or third day without causing relapse. The goal is to do only 80% of the activity that can be done sustainably each day.
  • Thanks to adrenaline surges, a patient may spend several hours one day a week studying or working and then 6 days extremely ill and disabled, or be able to struggle through study or work part-time and spend the other half of their week as well as all their weeks off and end of year holiday time extremely ill and disabled. This type of schedule can only be kept up for a few years at best, as the patient becomes sicker and sicker and less able to bounce back from relapses.
  • Some patients will manage their limits very carefully but still exhibit signs that they are running on a low level of adrenaline most or all of the time. This is likely an indication that more rest is needed and that more challenging tasks should, if possible, be scaled back or discontinued.
  • When the adrenaline surge starts to wane, the patient will often feel very irritable. Part of this is due to problems with blood sugar and so eating a substantial meal can help the patient feel better both physically and emotionally. Cravings for sugar and carbohydrate-rich foods are common at this time, but a meal containing some protein, fat and some low GI and GL carbohydrate foods is a better choice. Part of this is also an emotional response, as coming down form an adrenaline high is very difficult emotionally. A patient has just had a reminder of how it might be if they were not as ill and disabled, and also has a significant worsening of their symptoms and disability level.
    The patient may also feel very cold and shaky and even more sensitive than usual to light and noise as an adrenaline surge starts to wane.
  • When a person with M.E. starts to rest after an adrenaline surge, it takes a little while for the adrenaline to wear off. So the patient will start resting and slowly start to feel more and more unwell. Unfortunately the patient will have to go through a period of feeling much worse, in order to feel better. Starting to feel worse shows that the adrenaline is wearing off and that the patient is resting properly. The period of feeling very ill may last for hours, days or weeks or longer, depending on how ill the patient is and how severely they overexerted.
    In contrast, when a M.E. patient who has not overexerted rests they will feel better right away and this improvement may continue to build over time. Thus feeling much more ill after a period of resting is another sign that the patient has been running on adrenaline and overexerting.

What can you do to help?

  • When you notice fast talking, and other signs of an adrenaline burst or surge, encourage the patient to slow down. Perhaps remind them that the sooner they rest, the better off they will be.
  • When a patient is talking very fast and very loudly, subtle reminders to speak more quietly may be helpful. (Remember that slow slurred talking may in fact be a very good sign of health and of living within limits!)
  • When you notice a patient sitting or standing up when they do not need to, or for longer than they can usually cope with, a reminder to lie down may be helpful as the patient may not realise that they are standing up for too long.
  • When the patient has completed a big task that was far beyond their limits out of necessity, be aware from the outset that this will cause a surge of adrenaline to be released. This surge will affect the patient during the event but probably also for some days or weeks or months afterwards. The patient may feel somewhat less ill and be able to do some tasks which they haven’t managed for some time. But tasks done using adrenaline surges come at a very high cost long-term and so must be strongly discouraged and absolutely never encouraged.
    Making sure that the patient is aware of this characteristic of M.E. before a big task is completed and before they tragically misinterpret these signs of serious overexertion and illness as a desperately wanted improvement in their condition can only be helpful.
  • When a big adrenaline surge has occurred, the only way to stop it is to make sure that the body is no longer placed in physiological difficulty. For the severe M.E. patient, this will mean at least 3 days of complete rest. (The time period of rest needed will vary with how severe and prolonged the surge is and how ill the patient is.) Adrenaline will stop being released when the body is at rest and time has passed allowing the adrenaline in the system to wear off.
    Severely affected patients will need almost complete rest constantly, to avoid adrenaline surges and relapses in symptoms.
  • Do not instigate conversations with a patient when they are trying hard to come down off an adrenaline surge. You may ruin hours of solid resting by asking a question that forces the patient’s body to have to rely on adrenaline again in order to reply. If possible, write down any questions you have so that the patient can answer them in their own time and in the way easiest for them. When patients are severely affected and can’t speak often, you may want to devise a system whereby they can reply to yes and no questions or questions with 2 options using hand signals or printed cards.
  • If possible, if you are a carer who visits the patient’s home for a few hours a day, make a set time to talk to the patient so that they do not have to be in ‘on’ and ready to talk the whole time you are there. Staying ‘on’ may require an adrenaline burst and leave the patient very ill afterwards even of you only spoke to them very briefly. Having to be ‘on’ in case of interaction is almost as taxing as actually talking, for many patients.
  • When you speak to a M.E. patient who is very ill or relapsing, speak slowly, calmly and somewhat softly. Do not speak loudly or shout. Do not ask stressful or difficult questions when the patient is at their most ill or if it is not their ‘best’ time of day.
  • Don’t repeat things unless you are asked or indicated to do so. M.E. patients often have a significant time delay in understanding spoken words, and they may rely on a period of silence after each statement in order to understand what you have said.
  • For more information on how to appropriately treat M.E. patients and help them to avoid relapse please see the following two essential papers: hospital or carer notes for M.E. and also why patients with severe M.E. are housebound and bedbound.

How should you use this information?

This paper largely focuses on patients who are at the severe end of the moderate continuum to severely affected patients who are almost entirely bedbound. It will have to be adjusted somewhat for patients who are more moderately affected, or extremely severely affected.

How much assistance and guidance you give a M.E. patient to help them minimise relapses depends on several factors. These include how close you are to the patient, how receptive they are to input from you, how ill the patient is and how well they are managing their symptoms and relapses themselves.

M.E. patients understand their own limits very, very well almost all of the time. All they may need from you is the occasional verbal reminder to lie down or to rest.

Perhaps in most cases, just the fact that you have a desire to help and have read this paper and that you both have a solid understanding of the challenges they face and the nature of M.E. relapses will be enough. Knowledge is power.

Conclusion

It may seem obvious that M.E. patients would always do what is best for their long-term outcome, but this is not always the case. M.E. is a very difficult disease to manage. M.E. patients are very often sick to death of all the resting, carefulness and explaining required of them and so anything that you can do to help is very welcome.

Thank you for taking the time to read this paper.

Assisting the M.E. patient in managing relapses and adrenaline surges – Summary

It is very important that M.E. patients stay within their limits in order to prevent relapse and disease progression and so that chances for significant recovery are not destroyed. This paper explains how carers and loved ones of M.E. patients can help patients to avoid overexertion and so have their best possible long-term health outcome.

People with M.E. can sometimes operate significantly above their actual illness level for certain periods of time thanks to surges of adrenaline released when the body is put in physiological difficulty – albeit at the cost of severe and prolonged worsening of the illness afterward. These adrenaline surges are a bit like credit cards. They allow patients to do things that they could never otherwise do, or ‘afford.’ But the interest rate is extortionate.

Signs that a M.E. patient is overexerting or running on adrenaline, may include the following:

  • Very fast, loud and continuous talking is a sure sign of an adrenaline burst. The patient may also sit up or stand for longer than usual (without realising they are doing so) or get ‘hyper’ and fired up to undertake tasks that they would usually be too ill to do. Sleeping and resting is very difficult as the patient feels ‘wired’ and very ‘unfatigued.’
  • A lack of facial expression and ‘slack’ facial muscles and/or extreme facial pallor.
  • A burning sensation in the eyes and/or an inability to tolerate visual stimulus and to keep the eyes open.
  • Excessive water drinking (to try and boost blood volume) and excessive hunger and a desire for sugar- or carbohydrate –rich foods. Even after eating, the patient may still feel as if they have very low blood sugar and may need to eat far more often than usual.
  • Sweating or shortness of breath after minor exertion or a sudden loss of the ability to walk.
  • Visible shaking of the arms or legs or twitching facial muscles.
  • Paralysis and weakness in the muscles or an inability to move, speak or understand speech.
  • Very distinctly pink, purple or blue feet or legs, with white blotches, after standing or sitting for too long.
  • Patients may complain of a severe headache or feeling of pain or pressure at the base of the skull. This may also be accompanied by pain behind one or both eyes or ears, or blackouts.
  • Sudden onset ringing in the ears or loss of hearing or sore throat and painful glands in the neck.
  • During and after overexertion, a patient’s pulse will very often become much faster (150 bpm or more), their blood pressure will become lower and their temperature may rise and they may feel very hot.

When a patient declares that they are improving and suddenly able to do tasks again which they have not been able to do for many months or years – and this occurs right after a very big task has been completed such as a house move or a very taxing trip to the doctor, it is almost certainly an adrenaline surge and not a real improvement. Improvements just do not occur after overexertion in M.E. this way. The big task was well beyond their limits and so the body has released a surge of adrenaline just to cope. Unfortunately, this type of lower-level but prolonged adrenaline surge will often be less easily recognized for what it is by the patient.

Tasks done using adrenaline surges come at a very high cost long-term and so must be strongly discouraged and absolutely never encouraged. You might gently remind the patient to lie down and rest if they sit up for much longer than usual, or are talking very fast and far more than usual, and so on. Do not instigate conversations with a patient when they are trying hard to come down off an adrenaline surge as this can undo hours of resting. If possible, make a set time to talk to the patient so that they do not have to be in ‘on’ and potentially ready to talk for hours at a time as this is almost as taxing as actually talking for many patients.

The only way to stop an adrenaline surge is to make sure that the body is no longer placed in physiological difficulty. This often means 3 days or more of absolute rest. While some of the effects of overexertion are immediate there are also secondary relapses that are delayed by 24 – 72 hours. Ideally, a patient will live long-term only completing tasks which can be done daily or every second or third day without causing relapse.

In most cases, just the fact that you have a solid understanding of the challenges patients face, understand the nature of M.E. relapses, and know how to help to not make things harder, will be helpful enough. Thank you for taking the time to read this paper. Please see the full-length version [above] for more information.

 © Jodi Bassett

Last Updated on 05/05/2021 by Jodi Bassett

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Jodi Bassett was living with Myalgic Encephalomyelitis (ME) when she founded The Hummingbirds' Foundation for ME, an online educational and advocacy site. She was an Australian artist, graphic designer, writer and patient advocate. According to her website: "In 1995, at the age of 19, Jodi went from being healthy and happy one day, to very ill and disabled with the neurological disease Myalgic Encephalomyelitis (M.E.) the next. When first ill, Jodi was reduced to only being able to be 40% as active as pre-illness. Due to inappropriate medical advice leading to sustained overexertion (which causes serious and permanent bodily damage in M.E.) Jodi’s illness quickly went from moderate to extremely severe. By 1999 she was capable of less than even 5% of her pre-illness activity level." She did her advocacy work in bed with a laptop. Jodi died in June 11, 2016 at home from secondary Breast Cancer. Her ME at the time was doing quite well and she was no longer housebound.

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10 steps to practicing Radical Acceptance
according to DBT’s founder, Marsha Linehan:

 

1.  Observe that you are questioning or fighting reality (“it shouldn’t be this way”)

2.  Remind yourself that the unpleasant reality is just as it is and cannot be changed (“this is what happened”)

3.  Remind yourself that there are causes for the reality (“this is how things happened”)

4.  Practice accepting with your whole self (mind, body, spirit) - Use accepting self-talk, relaxation techniques, mindfulness and/or imagery

5.  List all of the behaviors you would engage in if you did accept the facts and then engage in those behaviors as if you have already accepted the facts

6.  Imagine, in your mind’s eye, believing what you do not want to accept and rehearse in your mind what you would do if you accepted what seems unacceptable

7.  Attend to body sensations as you think about what you need to accept

8.  Allow disappointment, sadness or grief to arise within you

9.  Acknowledge that life can be worth living even when there is pain

10.  Do pros and cons if you find yourself resisting practicing acceptance

Logo of ijpsych

2009 Oct-Dec; 51(4): 239–241.
doi: 10.4103/0019-5545.58285: 10.4103/0019-5545.58285
PMCID: PMC2802367
PMID: 20048445

The biochemistry of belief

Address for correspondence: Dr. TS Sathyanarayana Rao, Department of Psychiatry, JSS University, JSS Medical College Hospital, M.G. Road, Mysore - 570 004, India. E-mail: moc.oohay@91oarsst
This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

“Man is what he believes”

Anton Chekhov

Beliefs are basically the guiding principles in life that provide direction and meaning in life. Beliefs are the preset, organized filters to our perceptions of the world (external and internal). Beliefs are like ‘Internal commands’ to the brain as to how to represent what is happening, when we congruently believe something to be true. In the absence of beliefs or inability to tap into them, people feel disempowered.

Beliefs originate from what we hear - and keep on hearing from others, ever since we were children (and even before that!). The sources of beliefs include environment, events, knowledge, past experiences, visualization etc. One of the biggest misconceptions people often harbor is that belief is a static, intellectual concept. Nothing can be farther from truth! Beliefs are a choice. We have the power to choose our beliefs. Our beliefs become our reality.

Beliefs are not just cold mental premises, but are ‘hot stuff’ intertwined with emotions (conscious or unconscious). Perhaps, that is why we feel threatened or react with sometimes uncalled for aggression, when we believe our beliefs are being challenged! Research findings have repeatedly pointed out that the emotional brain is no longer confined to the classical locales of the hippocampus, amygdala and hypothalamus.[1] The sensory inputs we receive from the environment undergo a filtering process as they travel across one or more synapses, ultimately reaching the area of higher processing, like the frontal lobes. There, the sensory information enters our conscious awareness. What portion of this sensory information enters is determined by our beliefs. Fortunately for us, receptors on the cell membranes are flexible, which can alter in sensitivity and conformation. In other words, even when we feel stuck ‘emotionally’, there is always a biochemical potential for change and possible growth. When we choose to change our thoughts (bursts of neurochemicals!), we become open and receptive to other pieces of sensory information hitherto blocked by our beliefs! When we change our thinking, we change our beliefs. When we change our beliefs, we change our behavior.

A mention of the ‘Placebo’ is most appropriate at this juncture. Medical history is replete with numerous reported cases where placebos were found to have a profound effect on a variety of disorders. One such astounding case was that of a woman suffering from severe nausea and vomiting. Objective measurements of her gastric contractions indicated a disrupted pattern matching the condition she complained of. Then a ‘new, magical, extremely potent’ drug was offered to her, which would, the doctors proclaimed, undoubtedly cure her nausea. Within a few minutes, her nausea vanished! The very same gastric tests now revealed normal pattern, when, in actuality, she had been given syrup of ipecac, a substance usually used to induce nausea! When the syrup was presented to her, paired with the strong suggestion of relief of nausea, by an authority figure, it acted as a (command) message to the brain that triggered a cascade of self-regulatory biochemical responses within the body.[2] This instance dramatically demonstrates that the influence of placebo could be more potent than expected drug effect.

An important observation was that, part of the placebo response seemed to involve the meaning of the disorder or the illness to the individual. In other words, the person's belief or how she/he interprets (inter-presents or internally represents) directly governs the biological response or behavior. Another remarkable study involved a schizophrenic. This woman was observed to have split personality. Under normal conditions, her blood glucose levels were normal. However, the moment she believed she was diabetic, her entire physiology changed to become that of a diabetic, including elevated blood glucose levels.[3]

Suggestions or symbolic messages shape beliefs that in turn affect our physical well being. Several cases of ‘Disappearance of warts’ have been reported by Ornstein and Sobel wherein they ponder on how the brain translates the suggestions (sometimes using hypnosis) into systematic biochemical battle strategies such as chemical messengers sent to enlist the aid of immune cells in an assault on the microbe-induced miniature tumor or probably small arteries are selectively constricted, cutting off the vital nutrient supply to warts but not touching the neighboring healthy cells.[2]

Findings of carefully designed research indicate that our interpretation of what we are seeing (experiencing) can literally alter our physiology. In fact, all symptoms of medicine work through our beliefs. By subtly transforming the unknown (disease/disorder) into something known, named, tamed and explained, alarm reactions in the brain can be calmed down. All therapies have a hidden, symbolic value and influence on the psyche, besides the direct specific effect they may have on the body.

Just as amazingly life-affirming placebos are, the reverse, “Nocebo' has been observed to be playing its part too. It is associated with negative, life-threatening or disempowering beliefs. Arthur Barsky, a psychiatrist states that it is the patient's expectations – beliefs whether a drug or procedure works or will have side effects – that plays a crucial role in the outcome.[4]

The biochemistry of our body stems from our awareness.[5] Belief-reinforced awareness becomes our biochemistry. Each and every tiny cell in our body is perfectly and absolutely aware of our thoughts, feelings and of course, our beliefs. There is a beautiful saying ‘Nobody grows old. When people stop growing, they become old’. If you believe you are fragile, the biochemistry of your body unquestionably obeys and manifests it. If you believe you are tough (irrespective of your weight and bone density!), your body undeniably mirrors it. When you believe you are depressed (more precisely, when you become consciously aware of your ‘Being depressed’), you stamp the raw data received through your sense organs, with a judgment – that is your personal view – and physically become the ‘interpretation’ as you internalize it. A classic example is ‘Psychosocial dwarfism’, wherein children who feel and believethat they are unloved, translate the perceived lack of love into depleted levels of growth hormone, in contrast to the strongly held view that growth hormone is released according to a preprogrammed schedule coded into the individual's genes!

Providing scientific evidence to support a holistic approach to well being and healthcare, Bruce Lipton sheds light on mechanism underlying healing at cellular level. He emphasizes that ‘love’ is the most healing emotion and ‘placebo’ effect accounts for a substantial percentage of any drug's action, underscoring the significance of beliefs in health and sickness. According to him, as adults, we still believe in and act our lives out based on information we absorbed as children (pathetic indeed!). And the good news is, we can do something about the ‘tape’ our subconscious mind is playing (ol' silly beliefs) and change them NOW.[6] Further recent literature evidences provided knowledge based on scientific principles of biology of belief. There are limited studies on clinics of traditional beliefs and if we get more scientific data, we can use these traditional systems in clinical mental health management. Human belief system is formed by all the experiences learned and experimented filtered through personality.[7] The senses to capture inner and outer perceptions have higher brain potentials. Some questions that arise in this context are, does the integration and acceptance of these perceptions result in the establishment of beliefs? Does the establishment of these beliefs depend on proof demonstrations? The proofs might be the perceptions, which we can directly see or having scientific proof or custom or faith.[8,9] Beliefs are developed as stimuli received as trusted information and stored in the memory. These perceptions are generalized and established into belief. These beliefs are involved in the moral judgment of the person. Beliefs help in decision-making. Bogousslavsky and Inglin explained that, how some physicians were more successful by taking an account of patient beliefs. Beliefs influence factors involved in the development of psychopathology. They also influence the cognitive and emotional assessment, addictiveness, responses to false positives and persistent normal defensive reactions. Total brain function is required in stabilizing the belief and in responding to environmental system. Some of the brain regions and the neural circuits are very important in establishing beliefs and executing emotions. Frontal lobes play a major role in beliefs. Mental representations of the world are integrated with sub-cortical information by prefrontal cortex. Amygdala and Hippocampus are involved in the process of thinking and thus help in execution of beliefs. NMDA receptor is involved in thinking and in the development of beliefs. These beliefs are subjected to challenge. A belief that is subjected to more challenges becomes stronger. When a new stimulus comes, it creates distress in the brain with already existing patterns. The distress results in the release of dopamine (neurotransmitter) to transmit the signal.[10,11] Research findings of Young and Saxe (2008) revealed that medial prefrontal cortex is involved in processing the belief valence.[12] Right temporoparietal junction and precuneus are involved in the processing of beliefs to moral judgment. True beliefs are processed through right temporoparietal junction.[13,14] Saxe (2006) explained that beliefs judging starts at the age of five years citing example of judging of belief questions on short stories by the children.[15] Belief attribution involved activating regions of medial prefrontal cortex, superior temporal gyri and hippocampal regions. Studies by Krummenacher et al, have shown that dopamine levels are associated with paranormal thoughts suggesting the role of dopamine in belief development in the brain.[16] Flannelly et al, illustrated on how primitive brain mechanisms that evolved to assess environmental threats in related psychiatric disorders.[17] Also were highlighted the issues such as the way beliefs can affect psychiatric symptoms through these brain systems. The theories discussed widely are related to (a) link psychiatric disorders to threat assessment and (b) explain how the normal functioning of threat assessment systems can become pathological. It is proposed that three brain structures are implicated in brain disorders in response to threat assessment and self-defense: the regions are the prefrontal cortex, the basal ganglia and parts of limbic system. The functionality of these regions has great potential to understand mechanism of belief formation and its relevance in neurological functions/dysfunctions. Now it is clear that biology and physiology of belief is an open area for research both at basic and clinical level. The future directions are to develop validated experimental or sound theoretical interpretation to make ‘BELIEF’ as a potential clinical management tool.

Perceptual shifts are the prerequisites for changing the belief and hence changing the biochemistry of our body favorably. Our innate desire and willingness to learn and grow lead to newer perceptions. When we consciously allow newer perceptions to enter the brain by seeking new experiences, learning new skills and changed perspectives, our body can respond in newer ways –this is the true secret of youth. Beliefs (internal representations/interpretations) thus hold the magic wand of remarkable transformations in our biochemical profile. If you are chasing joy and peace all the time everywhere but exclaim exhausted, ‘Oh, it's to be found nowhere!’, why not change your interpretation of NOWHERE to ‘NOW HERE’; just by introducing a gap, you change your awareness – that changes your belief and that changes your biochemistry in an instant!

Everything exists as a ‘Matrix of pure possibilities’ akin to ‘formless’ molten wax or moldable soft clay. We shape them into anything we desire by choosing to do so, prompted, dictated (consciously or unconsciously) by our beliefs. The awareness that we are part of these ever-changing fields of energy that constantly interact with one another is what gives us the key hitherto elusive, to unlock the immense power within us. And it is our awareness of this awesome truth that changes everything. Then we transform ourselves from passive onlookers to powerful creators. Our beliefs provide the script to write or re-write the code of our reality.

Thoughts and beliefs are an integral part of the brain's operations. Neurotransmitters could be termed the ‘words’ brain uses to communicate with exchange of information occurring constantly, mediated by these molecular messengers. Unraveling the mystery of this molecular music induced by the magic of beliefs, dramatically influencing the biochemistry of brain could be an exciting adventure and a worth pursuing cerebral challenge.

REFERENCES

1. Candace Pert. Molecules of emotion: Why you feel the way you feel. New York, USA: Scribner Publications; 2003. ISBN-10: 0684846349.
2. Ornstein R, Sobel D. The healing brain: Breakthrough discoveries about how the brain keeps us healthy. USA: Malor Books; 1999. ISBN-10: 1883536170.
3. Robbins A. Unlimited power: The new science of personal excellence. UK: Simon and Schuster; 1986. ISBN 0-7434-0939-6.
4. Braden G. The spontaneous healing of belief. Hay House Publishers (India) Pvt. Ltd; 2008. ISBN 978-81-89988-39-5.
5. Chopra D. Ageless body, timeless mind: The quantum alternative to growing old. Hormony Publishers; 1994. ISBN -10: 0517882124.
6. Lipton B. The biology of belief: Unleashing the power of consciousness, matter and miracles. Mountain of Love Publishers; 2005. ISBN 978-0975991473.
7. Bogousslavsky J, Inglin M. Beliefs and the brain. Eur Neurol. 2007;58:129–32. [PubMed: 17622716]
8. Gundersen L. Faith and healing. Ann Intern Med. 2000;132:169–72. [PubMed: 10644287]
9. Mueller PS, Plevak DJ, Rummans TA. Religious involvement, spirituality, and medicine: Implications for clinical practice. Mayo Clin Proc. 2001;76:1225–35. [PubMed: 11761504]
10. Patel AD, Peretz I, Tramo M, Labreque R. Processing prosodic and musical patterns: A neuropsychological investigation. Brain Lang. 1998;61:123–44. [PubMed: 9448936]
11. Tramo MJ. Biology and music. Music of the hemispheres. Science. 2001;291:54–6. [PubMed: 11192009]
12. Young L, Saxe R. The neural basis of belief encoding and integration in moral judgment. Neuroimage. 2008;40:1912–20. [PubMed: 18342544]
13. Aichhorn M, Perner J, Weiss B, Kronbichler M, Staffen W, Ladurner G. Temporo-parietal junction activity in theory-of-mind tasks: Falseness, beliefs, or attention. J Cogn Neurosci. 2009;21:1179–92. [PubMed: 18702587]
14. Abraham A, Rakoczy H, Werning M, von Cramon DY, Schubotz RI. Matching mind to world and vice versa: Functional dissociations between belief and desire mental state processing. Soc Neurosci. 2009;1:18. [PubMed: 19670085]
15. Saxe R. Why and how to study Theory of Mind with fMRI. Brain Res. 2006;1079:57–65. [PubMed: 16480695]
16. Krummenacher P, Mohr C, Haker H, Brugger P. Dopamine, paranormal belief, and the detection of meaningful stimuli. J Cogn Neurosci. 2009 Jun 30; [Epub ahead of print] [PubMed: 19642883]
17. Flannelly KJ, Koenig HG, Galek K, Ellison CG. Beliefs, mental health, and evolutionary threat assessment systems in the brain. J Nerv Ment Dis. 2007;195:996–1003. [PubMed: 18091193]

Articles from Indian Journal of Psychiatry are provided here courtesy of Wolters Kluwer -- Medknow Publications

HRPacing ...

Description

Heart Rate Pacing is a technique used to stay within ones energy reserves. The anaerobic threshold (AT) is the heart rate at which aerobic energy surges. The threshold is often around about 60% of a ones maximum heart rate, though each person is different and an individual's threshold may vary from day to day or within a day.

(Note: Maximum heart rate is 220 minus ones age. For a 50 year old, 60% of maximum heart rate is (220 - 50) x 0.6 = 102 bpm.)

Features:

* Changes colour to indicate:

- Resting - (REST) Lavender

- Recovery (RECOVER) - Green (RHR + 10%)

- Exertion (EXERT) - Orange (RHR + 20%)

- Anaerobic Threshold (AT) - Red ((220-50)x0.6)

* Set an alert based on:

- reaching Anaerobic Threshold Zone, or

- custom set Maximum Heart Rate.

* Set the Anaerobic Threshold Tolerance from 0.6 (default) to 0.5 if desired.

* Set a custom interval between alerts (15 secs default).

* Displays 12/24 hour clock based on user settings in Fitbit profile.

ME Awareness Fundraising : Ten Books In Ten Months

 

I am fundraising for The ME Trust UK as part of ME Awareness 2021

I will be fundraising for ten months starting in May 2021 through to end of February 2022.

Please take the time to read what it is about and donate if you can.

I am going to read 10 books in 10 months and document them on my ‘ten books in ten months ...’ page.

Please click the link above or below to donate and help me raise as much money as we can
for The ME Trust UK

I have been sick since 1984. It took till 2001 for doctors to diagnose me with ME.
Initially, I was mildly sick then moderately but in recent years I’ve progressed to being severely affected.
I am housebound and often bedbound for months on end.

I really want to raise awareness and to raise money to help research #endME.

I am planning on reading ten books in ten months starting 12th May, which is international ME Awareness Day.
At one time in my life I could have read ten books in ten days. But this challenge will be hard for me to do.

So please please if you can support me and help raise money for the ME Trust UK

YOU CAN DONATE BY CLICKING THE LINK BELOW

ME Awareness Fundraising : Ten Books In Ten Months

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help me fund my ME treatment ...

... help me fund my ME treatment ...

you can choose to donate as much or as little by sliding the slider along

you can pay for the introductory workshop by donating £65

you can pay for an individual care plan by donating £71

you can pay for a monthly session by donating £71

you can pay for an individual progression plan by donating £71

you can pay for a medical review by donating £121

you can pay for a medical follow up by donating £121

you can pay for the individual assessment by donating £141

you can pay for a medical assessment by donating £187

Thank you very much !

help me fund my assessment treatments ...

... help me fund my ME treatment ...

you can choose to donate as much or as little by sliding the slider along

you can pay for a medical assessment by donating £187

you can pay for an initial assessment by donating £141

you can pay for a medical review by donating £121

Thank you very much !

help me fund my preparation for rehabilitation treatments ...

... help me fund my ME treatment ...

you can choose to donate as much or as little by sliding the slider along

you can pay for the introductory workshop by donating £65

you can pay for an individual care plan by donating £71

Thank you very much !

help me fund my rehabilitation treatments ...

... help me fund my ME treatment ...

you can choose to donate as much or as little by sliding the slider along

you can pay for a monthly session by donating £71

Thank you very much !

help me fund my follow up treatments ...

... help me fund my ME treatment ...

you can choose to donate as much or as little by sliding the slider along

you can pay for an individual progression plan by donating £71

you can pay for a medical follow up by donating £121

Thank you very much !

ME Awareness Fundraising : Ten Books In Ten Months

 

I am fundraising for The ME Trust UK as part of ME Awareness 2021

I will be fundraising for ten months starting in May 2021 through to end of February 2022.

You will see this pop once in each week that you visit my site during this ten month period.

Please take the time to read what it is about and donate if you can.

I am going to read 10 books in 10 months and document them on my ‘ten books in ten months ...’ page.

Please click the link above or below to donate and help me raise as much money as we can
for The ME Trust UK

I have been sick since 1984. It took till 2001 for doctors to diagnose me with ME.
Initially, I was mildly sick then moderately but in recent years I’ve progressed to being severely affected.
I am housebound and often bedbound for months on end.

I really want to raise awareness and to raise money to help research #endME.

I am planning on reading ten books in ten months starting 12th May, which is international ME Awareness Day.
At one time in my life I could have read ten books in ten days. But this challenge will be hard for me to do.

So please please if you can support me and help raise money for the ME Trust UK.

YOU CAN DONATE BY CLICKING THE LINK BELOW

ME Awareness Fundraising : Ten Books In Ten Months

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