Do you suffer from depression and fatigue? Do you often feel you are ‘running on empty’? Do you wonder if there is something physically wrong with you?
You may even have been diagnosed with TATS (Tired all the time syndrome).
Depression and fatigue
When Agnes came to see me, at the age of 64, she had been experiencing symptoms of depression and fatigue for many years. In fact, as she explained, this has been going on since she was 21.
‘What happened when you were 21?’ I asked her.
‘It began when I got married.’ said Agnes. ‘I’d trained as a nurse and was happily working in a local hospital when I found I was pregnant. The pregnancy was quite unexpected and my fiancé and I got married in a hurry, but everything changed after that.
I had to leave the job I loved so much and, after the birth of the baby and, after the onset of my depression and fatigue, I never found the confidence to return. In fact, my health seemed to take a downward spiral after that as I was investigated for what could be causing my symptoms.’
‘What were you investigated for?’ I asked.
‘Everything over the years,’ Agnes replied with a wry smile.’ My heart was checked, I had a brain scan; at one point they hadn’t they thought I had a low-grade infection and I was put on long-term antibiotics. Another specialist thought I might have multiple sclerosis as I was experiencing some tingling and numbness in my legs.
What with all the tests and the tiredness, I found I was always struggling to keep up and, as the years went by, I just came to accept this as the norm.’
‘All those tests must have made you very anxious’ I said to Agnes.
She seemed surprised at my observation.
‘Well, I guess they did. In fact I was told not to have any more children in case I had an underlying problem. I just came to regard myself as ill in some way.’
‘What are the symptoms you get now?’ I asked her.
I get light headed and dizzy. I still get the tingling in my legs and sometimes my hands.’ said Agnes ‘but the biggest problems are the depression and fatigue.
I’d been observing Agnes for quite a while, sitting there quietly in my office. Something I had noticed was the pattern of her breathing which was very tight and shallow.
It occurred to me this anxious breathing pattern may have become established all those years ago when she had been traumatized by an unexpected pregnancy that had dramatically altered the course of her life.
Breathing: Getting it wrong
Breathing is something we do all of the time but many of us get it wrong without realising. Anxiety causes tension in the body and can make our breathing rate too fast and too shallow. This is our fight or flight mechanism which is useful if we are under threat and need to react immediately.
Most of the time, however, we are not under any threat but if our breathing has become shallow and fast by habit, then that in itself can cause tension in the body and in the mind.
Constant shallow breathing, or chronic hyperventilation as it is sometimes known, creates anxiety and can cause real physical symptoms like palpitations and dizziness. It can also cause headaches and muscle weakness because the oxygen and carbon dioxide in our bloodstream is not correctly balanced.
The effects of chronic hyperventilation
Chronic hyperventilation or hyperventilation syndrome is actually regarded as a breathing disorder and may affect up to 30% of an otherwise healthy population.
Poor breathers expel too much carbon dioxide (CO2) from the system, which alters blood chemistry and also disturbs the body’s pH balance which can then produce some very unpleasant symptoms. Just a small drop in CO2 levels will have a negative impact.
In an anxious person, the symptoms lead to further anxiety and so the over breathing cycle is perpetuated, as in my client Agnes, a lady with a lifetime of unexplained physical symptoms now behind her.
If hyperventilation becomes chronic and is the new ‘normal’ pattern of breathing, a range of problems can result: from tiredness to disturbed sleep, poor concentration, tingling, dizziness, palpitations and chest pains, coughing, sighing and yawning, unstable blood pressure, irritable bowel syndrome, aching muscles, cramps and pain, twitching and tension plus feelings of panic, anxiety and/or depression.
As ever, psycho-education is a major factor in starting to resolving the issue. Understanding the importance of our breathing mechanism provides a real motivation to embark on a long term programme of regular breathing exercises.
It’s not all about oxygen
So let’s take a close look at the physiology of breathing. You might be surprised to hear that breathing is not primarily about oxygen. It’s about carbon dioxide. (CO2)
When you hold your breath it is the increase in carbon dioxide which prompts you to want to breathe again.
CO2 is a para hormoneand has a very important function. It is not simply a waste product as previously believed. CO2 performs important tasks on its journey from mitochondria to lungs. The good news is that the level of CO2 in our bodies can be raised or lowered with breathing techniques.
We need CO2 to benefit from the oxygen we breathe in and the more CO2 we have in our bloodstream, the easier it is for the oxygen to get to where it is needed.
When we hyperventilate, CO2 goes down. Conversely, when we hold our breath, CO2 increases and blood vessels expand which means better blood circulation to all parts of the body, arms and legs, digestion and brain. When circulation to nerve fibres is affected and the capillaries contract, we are even more prone to experiencing pain and the body will take longer to repair itself.
CO2 improves blood circulation as it expands the blood vessels and also affects the levels of beneficial nitric oxide in the blood.
The 3 step tool: Slow and controlled breathing
So it’s a good idea to take time out each day to simply stop for five or ten minutes and quietly focus on your breathing, allowing it to settle and slow down.
You can relax into that slower breathing style right now, simply following the breath and silently counting as you breathe in and breathe out, noticing the count that feels right to you at this moment.
• Step 1: Breathe in and count your breath.
• Step 2: breathe out slowly and count your breath.
• Step 3: Pause the breathe and rest before repeating with a calm and controlled in breath.
You might breathe in to the count of 6, and out to 6 and then pause on the out breath for 6.
Or the right count for you might be 4, 4 and 4? Breathe in, breathe out and pause. Breathe in, out, pause.
Don’t force it. It will happen naturally after a while and you will become better with practise.
This is an important exercise in establishing better breathing as a very useful way to improve energy, emotional and physical wellbeing. After you have practised for several minutes, allow your breathing to return to an unobserved pattern.
Beneficial changes and shifts in your normal breathing rate will occur at a pace which is right for you. But you must continue this as a regular exercise.
What about Agnes?
Agnes started regular breathing exercises three times a day for 10 min sessions at a time. Slowly but surely she noticed changes. She noticed her sleep was better at first and she had more energy in the daytime.
She noticed an elevation in her mood and an ongoing improvement in the light-headedness and tingling which she now linked very firmly to a long term anxious breathing pattern.
Agnes does not regard herself as ill any longer. She has stopped looking for the source of her problem and come to realise that something as simple as breathing, something we do all of the time without thinking, can have an enormous impact on our physical and emotional well-being.
Agnes discovered this late in life, but is now making up for lost time by taking up a voluntary post at her local hospital and doing more of the things she loves to do.
