Physical versus Psychological Anxiety

One symptom that I had, long before my official diagnosis of small fiber neuropathy (but coinciding with the beginning of the “parethesias” I felt), was the constant feeling of being “on edge”. It would feel like adrenaline was flowing from within my body, for no apparent reason.   This symptom came out of the blue, after my first panic attack (along with the symptoms of SFN) back in 2014, and would manifest regularly – without explanation.

This had been lumped in as part of having an anxiety disorder, with psychological underpinnings at its root.  Yet, it always mystified me why this was happening, as it was not something I had felt before. I can now see clearly that this particular symptom I was feeling was a physical process happening within me, and had little, if anything to do with psychology…but it had (has) everything to do with basic physiology.

My worst periods of SFN sensations come at night. I’ve noticed more recently, that sometimes when I am awaken by the pains at night, I can feel this adrenaline flow through my body at the same time.   It is as though my body has its own innate intelligence, and knows to release adrenaline when it’s being attacked, even if I am not consciously aware of what is occurring.   And so, whatever it is that is attacking my nerves (likely, the immune system gone amuk), my body has its way of conveying anxiousness – an alarm siren, well before I knew about SFN, and well before the symptoms progressed to its current point.   Today, I can often feel the physical sensations coincide with this adrenaline flow.

I feel it is very important to write about this, because too frequently misdiagnosis occur because the idea of a physical underpinning to what is happening in the body is discounted. Often, during the couple years prior to my diagnosis, I’d have Doctors discount a physical problem within a few minutes of speaking with me. Yet, it is critical for the well being of people who have such an issue to be aware of it.   Though the problem can’t easily be remedied in many situations, understanding the mechanics of what is occurring helps to better psychologically cope, and can help to prevent a negative feedback-loop of ever-escalating psychological anxiousness due to both an unknown and unacknowledged physiological problem.

The Illusion of Choice – Fate Versus Free Will

“If you believe, you can achieve!” proclaim the self-help gurus. I believe such a statement is true for a certain percentage of individuals, in a certain number of situations.   It can be a great motivator for people who have CHOICES, to make the best possible choices they can in their lives, aligned with their values and where they seek to go.

However, as with nearly all things in life, there are two sides to this coin.   This proclamation of belief, can also serve to lessen one’s empathy towards others.  After all, if one doesn’t achieve, it must be because one hasn’t believed and has set their expectations too low due to this. Under this mantra, altering one’s situation is always a matter under one’s control, starting in his/her mind.   I believe there are many real-world situations that prove this type of thinking to be very naïve, when applied to all situations.

Free will, in any situation, requires choice. When we find ourselves in situations where our choices are limited, our free will becomes limited. Let us take this to an extreme to illustrate. Take a homeless man or woman who has severe schizophrenia. Having been abandoned by both family and society, without the mental abilities to function in a job, what choices do he/she have in life? The answer simply is none.   He/She bears a fate that the ordinary person bears the fruits of, for genetic evolution requires a constant throw of the dice.   The idea of choice and “free will” for the individual in this set of circumstance is a mere illusion, and yet there are some who will look down on such people as being crazy, lazy, or a simple nuisance to society. These people live at the mercy of others, and if we abandon them as a society it is because of our free will, not theirs. Their material situation is a reflection of our collective beliefs and actions, not the other way around.

At the core of the “If you believe, you can achieve!” mantra, lays the age-old question of “Fate versus Free Will”.   It is has become popular to believe that we “make our own fate”.

Personally, I believe that in order for free will to exist for a given situation, there must be CHOICE of some sort.  This choice must be genuine, and not coerced. For instance, if a man steals food in order to feed his starving family, did he really have a complete choice in the matter?

As any casual player of chess will know, you often find yourself in positions where you are forced to make a move you did not wish to make, in order to keep the game going. No matter how much one may exercise the power of belief and perception in such a situation, the pieces and their positions on the board are what they are – and one must make the best of the situation for what it is.

One must also recognize that there are moments when matters of fate and free will are going to get blurred, and as a result, we must err towards a compassionate view of situations, including ourselves, regardless of the outcomes.  Perhaps we do something we wouldn’t ordinarily have done under a different set of conditions, but it was the best possible choice under the set of circumstances that existed. It is important to look at things from the vantage point of compassion, for both ourselves and others.

I decided to write about this topic, because I believe that dealing with a chronic pain issue has given me some deeper insights and perspective into this. I have always been about positive thinking, and the power of making the best choices.   Yet, I can now see some great limitations to this type of thinking, as well as the harm it can do, given certain sets of circumstances.

One of the humbling things about life, is that when something goes wrong with our bodies, we don’t always have control over the situation, regardless of our beliefs.   Therefore, we must adapt our thinking and our expectations to align it with our new reality. To do otherwise, would be to try to paddle upstream.   Working against the current of life is seldom the path to healing.   I know when I have tried to do this, I found myself feeling depressed and saddened.

When our bodies are in a healthy, pain-free state, we often can’t conceive the notion that matters of choice and free will hang by a tiny thread.   For when we are in a state of chronic pain, many of these choices evaporate.

Back when my problems first began, I noticed that periodically, I would have moments where I felt in complete emotional turmoil. These moments would last, usually 20 – 30 minutes, before subsiding. These waves would typically come in after dealing with bouts of pain and SFN-related sensations.   I still feel them today, though with less frequency now that I know and understand the mechanics of what is occurring.   Nonetheless, if I am having an intense moment of pain, this feeling can still arise.

I often find myself going into a deep state of prayer and surrender during such moments. I have no power over the situation.   It is a matter I give over to God.

I was reading that the part of the brain that processes pain is right next to the area of the brain that deals with emotion. And so, it is not surprising that the two affect one another. When we feel pain, our emotions are more likely to fluctuate – and we feel less happiness and joy.   To a great extent, this is something not under our control – and it is not a matter of “free will”, since no sane person wills chronic pain and it’s emotional ramifications on themselves.

To further analogize in the most simplest of ways, it is seldom that a child is happy that he/she cut his/her finger, or that a person would feel happy to be severely injured in a car accident. If a person felt happy in such a situation, they would be called a “masochist”, as the response would seem wholly unnatural.

In these analogies, the instinctual emotional responses to these underlying physical situations are not simply a matter of belief being guided by free will.  These responses are, in large part, the result of millions of years of evolution. Physical pain signals a threat to our survival, and so emotionally the body is going to respond in kind. We have no control over this, any more than we have control over the whole process of evolution from which our bodies emerged – this is a matter of fate.

I think it’s important, when we apply certain dogmas to our life, such as “If you believe, you can achieve!” or “we make our own fate”, that we must also be mindful that such philosophies will not work for everyone under all conditions. Therefore, we must always be careful to consider the other person’s set of circumstances, and to attempt to put ourselves in that person’s shoes, before prescribing solutions.

We also must always be humbled by the ever-changing circumstances that life can throw at us, and embrace things with an open and compassionate heart.

Don’t worry, its just anxiety…

Don't worry its just anxiety

I recently had this cartoon made, as it expresses the frustration I have felt many times prior to my Small Fiber Neuropathy diagnosis.

Too often, the pains that patients feel are either discounted or ignored, as tests for various diseases and conditions all come back being normal.   Many doctors seem to have little awareness of SFN, and so a proper diagnosis can take years.

I am sure that others who have gone through this can relate.  And if you are currently going through such an ordeal, please know that you are not alone.