Calm, energised &  joyful

How often do you wake up feeling this way? I hope that you do, but if, like a large percentage of people in the Western world these days, you often don't then this section might resonate with you. For those of you who have pretty good energy and mood, but are interested in learning how to keep your resilience high then maybe just move on to the individual sections.


The silent slide into chronic fatigue

This is the My Story bit of this website. It's quite long. Not War and Peace, but longer than any web designer would advise. However, the 'story' and detail feels important. I know that poor energy and, even, exhaustion is a growing problem. Frequently, I have a patient book in with some issue or other and when we drill down into their case history fatigue is a problem. Not occasional fatigue, but chronic and increasing fatigue which they don't understand. This is why I decided to 'come out' as someone who has suffered from chronic fatigue. The title of Dr James Wilson's excellent book on the subject gives us a clue to the extent of the problem: Adrenal Fatigue: The 21st Century Stress Syndrome. This is my experience as a therapist, that this problem is becoming epidemic - I see it with endurance runners who stick rigidly to their training plan and are 'hitting walls' and experiencing episodes of exhaustion that they don't understand, I'm seeing it, currently, with what's described as Long Covid: any naturopath worth their salt knows that a nasty virus can cause post-viral fatigue - glandular fever and Guillaume Barre have always been culprits, but mainly over recent years I've been seeing it with people who have simply normalised around unrealistic expectations of themselves and their levels of activity and achievement and who believe they've been managing, but in reality have been sliding further and further into what Hans Seyle, in the 1930s, identified as adaptation syndrome ?? (more of that later).


So, primarily, that's what this section is about. I believe I fell into a big, black hole that took about eight years to learn how to get out and stay out of so that I could pass on what I've learnt in order to prevent others from falling into holes. It is intended to help you understand that if you feel stressed, knackered and deeply joyless and have felt this way for a while I know how that feels - it's torturous. But more important than knowing that I have experienced this and I empathise with you, I want to convey to you that you can heal - that you can, with knowledge, effort and faith in yourself, reclaim your calm, energy & joy.


Secondly, this section is also relevant to those who generally sleep well, who are reasonably energised and generally feel pretty buoyant but would like to increase their resilience and their experience of joy (because this can, to some degree, be 'learnt'). And, in the current Covid climate, I think that applies to most of us. The practices and knowledge that can help one individual with chronic fatigue reverse the condition will also improve bounce-back, energy and mood in the average bod.


Thirdly, and this is a comment on us socially, maybe even philosophically, increased resilience is about creating some 'latitude' so that when the shit hits the fan, which it undoubtedly will, we have some spare capacity; so that we don't, at that shit-splat-fan point, turn into a gibbering wreck, unable to handle things and start to suffer from insomnia, exhaustion etc... I would argue that our society encourages us to live in catastrophe mode, 'on the edge', with our finances, our energy, our sleep, our health - with every resource. Nowhere are we encouraged or educated to understand our internal rhythms or needs, to nourish, build and protect our resources (and let's not even begin on the planet). But I'm now in danger of getting into anti-capitalist rant mode and no-one wants that, do they? Don't you? Damn!

So, the short(ish) version of my story is that while studying for my acupuncture degree in 2005, I began to struggle dropping off to sleep and would often wake in the night with raging hypoglycaemia and then lie awake for hours. I was a single mum, negotiating a still-difficult relationship with the father of my two sons, doing a full-time degree and also squeezing in work to supplement my income. I once worked out that in one 12-month period I lost about 700 hours of sleep. I coped for about four years like this and then suddenly began to experience crushing exhaustion upon waking, could barely get myself out of bed for 8.30 am in order to throw a Weetabix down my 9-year old's throat before driving him the half-mile to school. I also felt depressed. I probably don't need to write that, do I?! I went to the GP who told me I was depressed. No s**t Sherlock. I mean, I was, but I also knew that something had gone wrong physiologically - I could just feel it. The GP ran a few blood tests who said everything was fine. I insisted on being given a copy and eventually she relented and printed a copy out. My ferritin was 14 and my TSH was 2.5. And, just like 99.9% of GPs practising in Britain today would she pronounced all my bloods well within normal range (that might seem like an unnecessary detail in an alleged short version, but those bloods are significant; don't forget them!)


I then spent the next four years feeling a mess - a disastrous failure. I couldn't sleep and yet was baffled at why I couldn't spring out of bed, could never get anywhere on time (to be fair, that's been a lifelong characteristic(!), but it was particularly bad during this time), I faced criticism for sometimes driving my son to school, not being able to socialise 'satisfactorily', to stay up late enough, decorate my house, and generally for not being able to do what everyone else seemed able to do. And I criticised myself too. I felt utterly inadequate for all sorts of reasons - for not being more organised, more proactive with my work, or more fun. I even berated myself for struggling to join in with my fell-running friends. That last one makes me feel quite sad when I remember just how cross I would get with myself when I couldn't run or cycle in the hills where I live. I was on my frigging knees and yet I couldn't step back, see why I was so exhausted and give myself a break. And this is, I think, one of the cardinal signs of many people with chronic fatigue. And one reason why it is such a tricky situation to heal from.


I started suffering from postural orthostatic tachycardia syndrome (POTS)

The Low Point

The low point (which is, of course, when the improvement starts because carrying on as I had been just wasn't possible) was about 4 am one morning in 2012 or 2013 when I'd been awake most of the night (after about 7 years of dire sleep) and I just sat at the kitchen table, crying and drinking whiskey because I was so desperate to be asleep, to be unconscious, so I swallowed a few ibuprofen to knock me out. Later that day I felt scared at what I'd done and terrified that in a moment of desperation I'd do something more terminal just because being that bone-tied was so unbearable. I did not want to die - far from it - I had a firm belief in the sacredness, preciousness and joy of life, but when I was that bone-tired I couldn't feel those things. And that, simply, was not an option - I had two teenage sons who depended upon me. I thought to myself: "What if this just keeps getting worse - I won't be able to work at all and then what? I'll lose the house, the boys will have to live with their dad and what will become of me then...?" That 4 am wake-up call made me realise how unwell I had become. In retrospect, I recognise this as the crisis point that I needed to galvanise me into action. 


So I feel I can now stop with the 'how dreadful it was' bit and get onto the important part - how it changed and how I got better. But it feels important to convey to anyone out there who is crippled with depression, insomnia or exhaustion and their GP is telling them that they're ok and they clearly aren't to take heart. 


There are lots of helpful things...

I had practised yoga on a weekly basis for years when the shitstorm began - when it just was a matter of insomnia, but the exhaustion hadn't yet kicked in. I came to recognise that on a Monday night, after my evening yoga class, I would generally sleep pretty well. I have always loved hillwalking and it was the same thing - after a day out walking I could pretty much guarantee a good sleep. So, do yoga every evening! I hear you cry. Well, I did practise yoga on other evenings and sometimes it definitely helped, but by now the fear of not sleeping was quite acute and so sometimes yoga didn't help - I figure that being at home with all the 'stress triggers' around me, my nervous system would have been switched into flight or fight rather than shifting into rest and digest as it seemed able to do during a yoga class where I was out of the house. 

I started to realise that the aspect of my nervous system that governs our flight or fight response, the autonomic nervous system, was part of the problem. It had, somehow, become almost permanently 'switched on' and unlike most people whose minds switch off when it's bedtime, mine seemed to crank up a gear, so that I had to do specific things to get it to switch off. Which was a ball-ache, but the knowledge that yoga or a long walk - that anything could have a positive impact was a lifeline - gave me hope and a starting point to my search for a cure.


I had meditated on and off for years but I had heard very interesting things about Mindfulness so I booked onto an 8-week Mindfulness-Based Stress Reduction course. It was a revelation and I use it to this day. Over the years I have pleaded with patients struggling with anxiety, depression, tiredness or insomnia to give it a whirl and used to hand out business cards from Mindfulness teachers I knew, saying that I would rather do myself out of business by them practising Mindfulness and, as a result, no longer needing my services! It was true, but I recommended it to so many patients that a few years ago I trained to teach Mindfulness. 

Then came the miracle of the Buteyko Breathing technique. This technique is a nuts-and-bolts approach to improving the relaxation response and, very directly, calming the autonomic nervous system. It is extremely practical and one's improvement is measured, which is a highly motivating factor. I practised it diligently, three times a day - such was my determination/desperation. What I also noticed was that my hands warmed up after practising the breathing techniques, my IBS and chilblains disappeared pretty much overnight. Anyone with even the most rudimentary of physiology can grasp that my cardiovascular and digestive systems were being, well - stimulated and soothed respectively - hmmm?! And, joy of joys, my sleep improved. It improved in terms of quantity and in terms of quality. And, subsequently, the quality of my energy improved. The relief was stratospheric. 

However, I was still prone to waking in the night with hypoglycaemia. This was less frequent than it had been, but I could still be woken, generally about four hours after I'd fallen asleep, and would race downstairs for a glass of milk and some cake or a few gingernuts, the worst possible thing, I now understand, but that's what I craved in the small hours. And what is more, if I didn't stick to my stringent breathing and yoga routines all the progress would seem to unravel. And this is, I think, a real head-f**k for people with chronic fatigue - often we can seem to improve, but don't understand why and, of course, the opposite occurs - which makes real progress virtually impossible. Also, when you're in a hole, it's so hard to see that you are actually making progress and, when you're in one of your rare, energised moments, it's so tempting to go ballistic and use up our tiny, fragile energy reserve because we've felt unable to do much for so long. This 'ricocheting off the walls' is a classic pattern and eventually, people can give up trying to heal and resign themselves to the received wisdom about chronic fatigue - that there is no real cure. Which is heartbreaking.


The next breakthrough was with the wonderful Barry Durrant-Peatfield. Dr P had worked as a GP since the 1960s but had become so disillusioned with the way mainstream medicine manages hypothyroidism and adrenal exhaustion (well, it doesn't actually accept that adrenal exhaustion exists) that he jumped ship, gave up his licence to practice mainstream medicine within the NHS and started to work with patients privately and naturopathically. I travelled to West Sussex to attend a consultation with him. He was delightfully old-school, drove a lovely old jag and referred to people as ladies or chaps. I walked into his office, he looked at me for a few seconds, felt my fingertips (cold as I hadn't been practising my breathing very regularly), I explained that my fingertips were actually warmer than they usually were. "Nonsense, they're warmer because I'm holding your hand, my dear," he said, winking at me. He was the most delicious flirt and, for a moment, I half-expected Hattie Jacques to come bustling rounded the corner! I briefly described my symptoms and he said: "Well, my dear, you know what's the matter with you, don't you?" I replied that since I'd driven all the way from Derbyshire, I was quite keen to hear his opinion. I did, however, have a strong suspicion, based on online research I had done.

He said, that he would check my blood pressure and that this would confirm or refute his suspicions. He took my blood pressure with a sphygmomanometer: nice touch, I thought. However, this wasn't just because he was just a technophobe (he totally was), but it provided him with the crucial piece of information that he needed to be confident in his suspicion and this is never done within the NHS when someone presents with chronic fatigue. I too use a sphyg with my patients - it provides much more useful information than a digital monitor, which doesn't measure this phenomenon very accurately at all. The thing he wanted to measure was the difference in blood pressure from me sitting to me standing and you need to do this as the patient stands up, quickly, as they're moving and it's very difficult to capture this change clearly with a digital monitor. He then felt my pulse, again sitting and immediately upon standing. "Your adrenals are a bit f****d, my dear," he pronounced.

And, boy, was he ever right! I drove home feeling a huge sense of relief and a hope that now I had a 'diagnosis'. As a naturopath, we cannot call this a diagnosis, but what mattered was that he gave me a name for what was at the root of my problems, that he validated that there was something, physically, wrong. However, while we're on the thorny subject of diagnoses... One of the problems with the name chronic fatigue is that is doesn't describe a pathophysiological process. This useless label just says 'tired' and 'for a long time'. Or ME - personally, I hate the label ME even more as very few chronic fatigue sufferers have encephalomyelitis (inflammation of the brain). So this vague, non-description gives doctors, the media, family and friends justification in denying that there is anything wrong. And it's invisible to the untrained eye. It's not invisible at all, of course, but most people, including most GPs and even endocrinologists, don't know the right tests to run and don't recognise the patterns within the signs and symptoms, so it stays undiagnosed. And when you read the list of signs and symptoms of chronic fatigue it is long and varied indeed, which certainly doesn't help a GP trained in a linear, reductionist way of interpreting illness.



Adrenal fatigue

However, adrenal fatigue is different - that name does point to a pathophysiological process.  





I have screamed at Jennie Murray in frustration when hearing a GP being interviewed on Woman's Hour wittering on about adrenal fatigue being a made-up illness that doesn't exist, her justification being that adrenaline has a short half-life! Totally missing the point, but sadly there was nobody present to explain what adrenal fatigue is and that it does exist. 



The next important breakthrough was in my diet.




Barry Peatfield


Sarah Myhill