Anxiety, pain, and that time I drove around with only one lens in my sunglasses

The past few weeks have been exceptionally stressful around our house. My husband has had work deadlines, I have been busy with work both in the clinic and at home, I was gone for four days to Boston for a continuing education class last weekend, the kids have had a cold, we had a random showing for our house pop up, and I have a marathon coming up this weekend. We thankfully have a lot of help from our parents and a great friend group for support, but still, it's felt like a lot this month. Anxiety is NOT new to me by any means, just check out my other blogs for a little insight here and here, but even so, it continues to be something that I struggle with during particularly stressful times. I have come a long way over the years and now I am rarely disabled from it, but it is something that I have learned can be a big contributor to physical pain.

This is anxiety y'all- being so worked up in your own brain that you DO NOT NOTICE that you are wearing sunglasses with ONLY ONE LENS. This was after twins but before I went back on my anxiety meds, and clearly I need them. Because I definitely walked through the grocery store parking lot wearing these, and back to my car.

Mental health, like pelvic health, is not discussed a whole lot. Like pelvic health, there is a shame that goes along with things like depression, addiction, anxiety. It's not talked about and when it is, there's a heaviness and an embarrassment that goes with it. It's the opposite of what you need when struggling with a mental health issue. Part of the reason I started a blog was to start normalizing pelvic pain, incontinence, prolapse, sexual dysfunction. All the things that make you uncomfortable to hear me talk about. Those are the things I want to throw out and rub in everyone's face until it becomes as normal as low back pain. Because seriously, who does not know someone with back pain? I'm willing to bet there is no one out there who doesn't. Well guess what, that means you most likely know someone with pelvic floor dysfunction or a mental health disorder like depression or anxiety. In fact, pelvic pain usually comes along with stress, anxiety, depression, so you may know someone with both.

Here's how it works: Pain is meant to be a built-in alarm system for our bodies to keep us safe. So, if you touch a hot stove or cut yourself cooking dinner, you want to feel pain to tell your hand to move away. It's an awesome evolutionary tool that has allowed us humans to survive all these years. Once you have this initial injury, you'll often feel the acute pain as the tissues heal over the next few days or weeks. The nerves at the site of the injury are stimulated which remind the brain that it hurts, and your brain sends chemicals and cells to the area to help things heal. This is all normal and good. 

The problem is that many of us end up with chronic and often seemingly unexplainable pain and often, there's a link with our mental state. For now let's talk about pelvic pain because that's my jam. Chronic, unexplained pain is usually happening even after the tissues have healed, so pain without any damage. It feels like something is damaged, but with chronic pain (3 months or more of pain) the tissues are usually no longer damaged. This kind of pain occurs because your nervous system is a little too excited. It wants to warn us of threats and dangers, but at this point those are gone. With chronic pain, our nervous system becomes overly sensitive, so the nerves in the body may turn on faster or stay on longer which tells the brain that your body is in danger. 

When you have anxiety, your brain can assume that your body is in danger, so it naturally sends chemicals throughout your body that tend to make things more sensitive. You become even more stressed from the pain and this makes your brain even more paranoid about everything that moves or gets touched. The mental stress over the pain you feel causes your brain to release even more stress chemicals that can cause inflammation, sensitivity and pain. It's a vicious cycle. It can be extremely debilitating. It is rough. It's hard on the person who hurts and it's hard on their caregivers and loved ones. It's kind of a nightmare. Many of the patients who walk through my door are at their wits end, they are depressed and they have lost hope. It's easy to see how you could get that way after not knowing how to break the cycle. Pain makes you exhausted, sad, sometimes angry. It takes over everything. 

But, the wonderful thing is that there is definitely hope and help. The first thing that PTs often do is some pain education. Sometimes I have patients watch this video and we talk about the brain, the nerves and the nervous system. I tell them that their anxiety and tension is causing part of their nervous system to be turned on practically all the time (the sympathetic nervous system). The thing is, unless a bear is chasing you down the street, you don't need your sympathetic nervous system quite so excited all day long. Back in the day if, I don't know, a wooly mammoth or something was chasing you down, you'd want that sympathetic nervous system to kick in so you can run like for your life, literally. However, sitting in your office on a normal ho-hum workday is not the time for it to be needed. In my case, the sympathetic nervous system was turned on practically all the time. My husband could tell me that we were out of milk and it would literally send me into a tailspin of anxiety and panic which would then make my neck hurt and of course my pelvic floor as well. It's not a fun way to live. 

The way to make it better is to use our "rest and digest" nervous system, the parasympathetic branch. It keeps us calm, it tells the brain not to be so sensitive, to stop letting out all of these crazy chemicals that circulate through our bodies and make us hurt. Learning how pain works, how to turn on the parasympathetic nervous system is often the beginning of the end of chronic pain. 

For me, I got into yoga, I started running, I learned to breath correctly (that's for another blog but you can check out this quick video for an intro), and I ended up going on an oral medication that helps keep my brain chemistry more regulated. Now, I don't have pain in my neck or my vagina. (I have pain everywhere else at the moment but that's thanks to my upcoming marathon and all the running. So. Much. Running.) I have seen first hand how my patients' stress increases their pain, which usually makes them anxious and perpetuates that pain cycle. When we work on breathing, calming down the brain and the nervous system, talking about things that make them laugh, their pain is often immediately reduced. It's awesome. Yes, there's a lot more that goes into the full healing process, but the brain is a huge part of it. Your body is NOT BROKEN. You are not broken. Your body does not have to be perfect to work well. Sometimes you just need to break the cycle. 

When your best friend is a yoga teacher you learn to be really good at using your breath to calm down. Also you have access to a free yoga teacher who is also an awesome physical therapist and just happens to be the BEST baker I know. Not a bad deal I've got going on here. This is her teaching a workshop, helping so many people to learn to manage their own anxiety through activating their parasympathetic nervous systems. 

Living with anxiety is hard and it can wreak havoc on your body, but it's not forever. We got through the crazy week. The house is super clean thanks to the house showing, my marathon is only a couple of days away and I get to celebrate with my family and one of my best friends from college, my husband's deadlines have been met and/or pushed back, and my kids aren't sick anymore. My pelvic pain is under control and I get to have amazing conversations with incredible men and women at work while getting to share my passion. Don't let your pain get the better of you. There's a PT who can help, and you don't even necessarily have to show them your vagina y'all. Let us help you heal. 

My de-stressors: peace and quiet, chocolate, a book (this one I am reading for book club just happens to be about being Present, not Perfect which was needed after this week), and a little red wine, you know, for my heart obviously. 

Dr. Lacy Kells PT, DPT
The Physio Down Low
Advanced Physical Therapy Solutions

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