I’ve been debating for a while whether or not I should post what follows, but if any of this helps even one person, then I’ll consider it having been worth the effort. The purpose of this post is to provide a few resources that people may not be aware of when it comes to dealing with anxiety, depression, or PTSD, while also sharing a little about my own experience. Please note: none of this is intended to be a substitute for seeking out professional medical advice. They are just resources and random thoughts.
Backstory: In July 2020, I had an “event.” It included four episodes of an extremely rapid heartbeat; close to, if not at, my maximum heart rate. As a distance runner who trains rigorously, it felt like a set of four all-out interval repeats lasting several minutes, with a couple minutes rest after each repetition. During the rest periods, my heart rate dropped to around 110-120 beats/minute, so not really resting. When the fourth episode began, I told my wife that it was time to call for help. I thought I might not be alive for much longer.
According to the first doctor I met with, blood work indicated the possibility of an N-STEMI heart attack, so I was admitted to a Critical Decision Unit and put under observation for 24 hours. During my stay, I went through a battery of tests, including an EKG and echocardiography stress test. At the end of the day, tests revealed that my heart is about as healthy as possible for someone my age, and that I did not have a heart attack. After being released, I wore a heart monitor for two weeks. Data extracted from the monitor revealed both Asymptomatic Nontransient Supra-Ventricular Tachycardia and a rare extra beat in my atrial chamber. However, my symptoms from these conditions are mild, and neither explains what actually happened to me. In a follow-up appointment, my cardiologist eluded to the fact that being an endurance athlete may have saved my life.
So: physically I’m healthy…so end of story, right? Not quite…
Since the episode in July, I have been dealing with PTSD and the anxiety that goes along with it. Along the way, I have discovered a few resources, mostly by luck. And I thought I would share a few of those here, and also toss out a few random thoughts…
Therapy in a Nutshell
“Therapy in a Nutshell” is a website created by Emma McAdam, a licensed therapist who has created a lot of online content. Her home page is here. One of her offerings is a free online course focusing on the basics of anxiety, depression, and PTSD. She also has an extensive series of videos, with new content being made available frequently. One video that I use quite regularly is…
Another of McAdam’s videos that I found particularly helpful for my own situation is…
I was previously aware of the fight, flight, or freeze response, but her video also includes a brief discussion about those situations where you don’t know if what you are encountering is actually dangerous. Why does this matter? For my own situation, I have not been given an explicit explanation for why the attack in July happened. Physical explanations have been ruled out, and what I am left with is the notion that my attack was caused by stress. Or maybe not…I just don’t know. So, when I start to feel my heart rate or blood pressure rise, my brain revisits that Saturday morning when I wondered if I would live to see the afternoon.
Because of this, I have had to figure out how to begin to rewire my brain, and if you’re not familiar with how all of that works, the above link is actually part three of her series on this topic. Part 1 is here…
Knowing your triggers
One of the things I have had to figure out is what triggers my anxiety, and then how to systematically go about reducing the impacts of those triggers. For me, most, if not all, of my triggers are associated with not being in a completely relaxed state physically, or not feeling mentally that I am in complete control of my situation. Before July 25, 2020, none of the items in this list bothered me in the slightest.
My triggers have included:
-running
-hunger
-being cold
-having to go to the bathroom
-going to the grocery store
-alcohol (not talking large amounts here…sometimes just a sip of wine, but not every time)
-caffeine (I haven’t started tackling this one yet, but let’s just say that I used to drink at least a few cups of coffee per day, and since July 25, 2020, I have had two cups of coffee in the past four months.)
-having to multi-task, or being pulled in more than one direction
-distractions when I am trying to focus on a specific task
-needing to “perform”
-having strict time constraints that put pressure on me to finish a task at a faster pace than I would like
-not getting enough sleep
-anything else that puts me in a situation where I might feel even the slightest bit out of control of my situation.
Once my triggers were identified, I decided to start working on them, one at a time. The first trigger I tackled was running, because it is such an important part of my daily routine, and ultimately, it also reduces my overall stress level. The first time I ran after the attack, my heart wouldn’t slow down to normal levels when I stopped running. It would drop to around 110-115 beats per minute, and then fluctuate, because my brain was telling me that I was going to have another attack.
I didn’t know if I would make it home that first day, and wound up sitting in the grass for a while, waiting for my heart rate to return to more normal levels. It took about 10 minutes for my heart rate to drop to around 80, and then I slowly made my way home. (Note: as an endurance athlete, my resting heart rate is around 36 beats/minute, so sitting with a heart rate of 80+ is not normal for me.)
The next day, I decided to try an experiment. The experiment consisted of running a short distance, until my heart rate went above roughly 130 beats/minute. At that point, I stopped and walked slowly, until it went below 100. Once it went below 100, I started running again, and allowed my heart rate to increase slightly with each repetition until on the last two repeats, it was in the upper 150s.
While it may look somewhat insignificant, a few of the downward ramps indicate that my heart didn’t smoothly drop below 110 beats/minute every time. Particularly in the second repetition, once my heart rate dropped to about 115 beats/minute, it fluctuated for a while before getting below 100, and I had to consciously tell myself to give it time, that it would eventually drop. After 12 repetitions, I called it quits for the day, and hoped this would begin to convince my brain that when I run, my heart rate will return to normal when I stop running. And for the most part, it worked. Sometimes it took a little longer than I would have liked, but a few months later, I am now running my normal training schedule again, mostly without incident. And this means that running is no longer a significant trigger for me. This doesn’t mean that my anxiety never happens when I am running, but that it is usually tied into something else, such as being cold, or getting hungry.
From a practical standpoint, the solution here was relatively straightforward. Go out and run, and let your brain experience stopping running repeatedly, until it has been rewired such that it no longer triggers a “you’re going to have an attack” response. Most of the other triggers I experience are more complex. As such, the rest of my list of triggers continue to exist in my world right now, but they occur less frequently than they used to, and the anxiety I experience is less severe. Clinical psychologist Nick Wignall, who Ms. McAdam interviews in this video…
…discusses how the approach to things matters, including the need for curiosity. “Why does my brain react as it does to certain situations, and what, if anything, can I do to change this?” I don’t think you necessarily need to find an answer; just remain curious.
Dr. Wignall’s website contains articles that may or may not prove to be helpful, including several on stress and anxiety. To be honest, I discovered his articles fairly recently, so they haven’t been a significant part of my own progress. However, they do contain some pertinent information that might be useful to others.
Engaging the Parasympathetic Response
One of Emma McAdam’s more recent videos discusses the importance of being able to activate the parasympathetic response. Rather than explain it, a link to her video is below. I will add a quick comment that this is something that I have been working on for my own situation. In the weeks/months since my attack, and as I have worked on my own anxiety, I have noticed that there are moments where my body seems to be starting to take over, initiating the parasympathetic response without me consciously working on it. For example, I sometimes find myself yawning excessively; perhaps one indication that my parasympathetic response is becoming more instinctively engaged.
Reaching out
Another important aspect of dealing with all of this is reaching out to people who exist in various capacities in your world; those you live with (parents, spouses, roommates), and those you don’t. I am fortunate to have support from a few different people, including, of course, my spouse, but others as well. Some of that support is direct support, while much of it is indirect.
One of those individuals is Jo Verdis. Jo’s story is as unique as she is, and she is in the late stages of publishing On Earth I Am Safe: Finding healing, comfort, self-expression and love through creativity. The book explores Jo’s experience with “creativity revelopment,” a term she uses to describe the acts of finding peace and healing trauma through the process of creativity. Her website is…
While she grew up with a focus on music (piano and composition), her creative energies now explore anything and everything: song-writing, drawing, painting, rug-making, sculpture, writing a book; you name it, she’s either done it or will likely be doing it soon. Probably one of the most important aspects of her approach is that creativity is primarily about the process of the creative act, not the result. It is an act where judgement is left behind in the spirit of freedom and playful expression. Having seen a draft of her book, I know it has the potential to impact the lives of many who struggle with PTSD, anxiety, and depression, regardless of the cause.
Forget About Stigmas, Know that You are not Alone, and Seek Out the Help You Need
As a faculty member at an institution of higher education with more than 20 years of experience, I used to believe that when I looked at my room full of students, there was a likelihood that a small percentage suffered from some sort of trauma. Over the past few years, that impression has changed to where I now believe that there is a good chance that 50% or more are struggling with depression, anxiety, or PTSD. I have no data to back this up; it is just my impression. But it goes without saying that believing that you are alone in your struggle, that you are the only person in the room who deals with anxiety, is likely not true. We all do a wonderful job of trying to hide our imperfections. Unfortunately, that doesn’t necessarily help overcome trauma.
Lastly, don’t hesitate to seek professional help. Ms. McAdam’s website is, in my opinion, a wonderful resource, but at the end of the day, it is just that — a resource. It is no substitute for personalized care from a mental health professional.
Mak Running... 