Anhedonia, Isolation and Physiotherapy

I don’t know if you have heard of ‘anhedonia’. It is where you don’t feel pleasure doing something that it normally pleasurable. It’s something that I experience quite a lot, and I don’t know exactly why. I think it is probably because of anxiety and depression. But it does make socialising a little bit more difficult because it means that you are not smiling as much.

Socialising is very important for people experiencing anxiety and depression because of the humour that it can give rise to. I’ve had a couple of instances recently where I’ve experienced a sense of release through spontaneous laughter. Everybody needs to have a feeling of release from their frustrations. This is why many people turn to drink and drugs and of course end up creating a whole new layer of problems. Maybe my craving for chocolate is a response to anhedonia. Yesterday I succumbed to eating some chocolate, which I know is a migraine and reflux trigger for me. I managed to partially restrain myself by only eating about half of the bar, and then I realised that the only way to avoid eating the rest of it was by throwing the remnants in the bin.

I noticed that though the desire to eat chocolate was initially very strong, it passed. I wonder if this is true for all desires and whether it applies to anxiety. Us anxious souls, can we just learn to let the feeling pass, even though like the urge to eat chocolate it can seem overwhelming?

Another habit that I am trying to break is putting grass in my ear. I know this sounds weird but the sensation gives me a real sense of release. However, the downside is that it’s probably harmful to your ears. Last month I had an ear infection which may have been a result of this unusual habit.  I’ve managed to avoid the grass trick, though every few days, particularly if I am experiencing hyperventilation, I have succumbed to temptation.

Going back to the social contact theme, I’ve been spending more time by myself in the last few days and I’ve noticed that I’ve been getting more depressed. Yesterday, I went out and met up with a friend and had a few casual words with people and felt surprisingly better. A lot better than on Sunday when I just talked to people on the phone. Even though it was Skype it didn’t seem to have the same beneficial effect as face to face contact. I guess some people would put this down to oxytocin. The problem I find with socialising is that it takes up so much time that you don’t get anything else done, once you’ve done your chores.  I guess the trick is to have a balance and to learn to endure the feeling of isolation from time to time.

The reason I’ve been spending more time by myself is because I’ve resting my ankle, so I had to cancel going on a walk at the weekend. I think that an exercise that the physio gave me was too much for my ankle. The exercise involves resting your head on a balance ball, creating a bridge with your torso and legs and then lifting a leg off the ground.  It was the lifting my leg off the ground that seemed to be too much. I think the lesson is not to do any exercise that feels like it is a strain and to make your mind up about which physiotherapy exercises you are prescribed are safe for you to do. It is difficult to get the balance right between exercising enough so that your body is being challenged without causing strain. The right exercises involve stress without strain.

Going back to the topic of social isolation, what is the best way to deal with this. We live in a society where more and more people are feeling isolated due to demographic changes around people moving away from family because of work reasons, relationship breakups and a society where we are increasingly doing things by ourselves. We go to work in our separate cars, spend less time walking where we are more likely to meet people, watch films by ourselves at home. In fact an increasing number of people live by themselves. Any kind of illness or disability can add to feelings of isolation for a whole range of reasons.  Mental health issues make it harder for people to interact with others. Mobility issues can make it more difficult for people to participate in walks or sporting activities or use buses. My current thoughts about this are;

1) Do not feel bad about yourself if you are feeling isolated. As you can see from the list of reasons that I give above, there are many things within modern western society that cause isolation, and most of them are nothing to do with what you are like as a person

2) Organise your life so that you do things around people. For example, rather than work on your computer at home take your laptop to a cafe or work in the local library. Rather than have your own car, participate in a car share scheme. Buy food from a local co-operative that buys in bulk.

3) Try to have some regular activities each week that involve doing things with other people, these could include a religious or humanist or secular meeting, undertaking voluntary work, joining a choir.

(Sorry, I know that I’ve started doing what a lot of people do on these blogs, i.e. just churn out a load of tips, but I think I’m sticking to my original goal which is to focus on general ideas of how to approach things, rather than throw loads of ‘tips’ at people).

I saw the podiatrist yesterday.  She also, as it turns out, has problems with her knees. My problems relate to my feet and not resting properly after injury. She made me think though that maybe part of dealing with these physical limitations is to take an attitude of acceptance in some ways and to focus on what you can do. I do find this hard because I think that most of my injuries have been avoidable, but maybe many people could say this. I think that when we move from seeing ourselves as victims and feel more grateful for what we do have then our general mood improves as well.




Purple People Eater

After an RSI scare where my left elbow started hurting when I was playing the piano and typing, I have rested it and gone back to normal again. Well, virtually normal because I’ve hardly picked up my guitar. This was because I wasn’t sure how much of the problem was caused by the guitar. I also had quite a bad ear infection.  This was not only very painful but also impacted on my hearing. I was prescribed Otomise which had a dramatically positive effect. However whilst taking Otomise, I woke up one morning with a strange purple liquid coming out of my left elbow. I noticed that every time I used a joint I was getting purple bruises. For example simply using my bicycle brakes resulted in purple bruises around my knuckles. Fortunately this problem – a google search came up with Heinrich Schonlein Purpura, ? – cleared up when I stopped taking the medication just leaving me with a few purplish patches on my left leg and left pinkie knuckle. I think that my liver was struggling to metabolise the steroids or antibiotics that constitute Otomise.

I saw an ENT specialist regarding my difficulties with voice projection and he said that my vocal cords had atrophied, particularly on the right side and even though my reflux didn’t feel as bad now there was still evidence of redness around the cords that indicated that reflux was still there. This didn’t come up in my previous examinations, and I think it was different this time because the consultant had me trying to speak loudly whilst he had the endoscope down my throat. He prescribed proton pump inhibitors and Gaviscon, neither of which I have started on yet because I have been trying to give my body a break from chemicals after what happened with Otomise. The good news was that he said that my vocal cords were still fundamentally okay.

Mr Karagama (the specialist) said that I need to strengthen my vocal cords, which is also what the physio says about my knee injuries.  My challenge is to develop a daily routine of strengthening, stretching and relaxation.  Currently I am doing a mix of Pilates and swimming (once a week), cycling a couple of times and my physio exercises every two days and Mindfulness for the relaxation. I have one day a week off exercise each week.

My thought for this month is around one’s strengths and vulnerabilities and how to use these to one’s advantage. I have started making a list of mine and I realised that the lines between strengths and vulnerabilities are blurred because in different situations and times strengths can be weaknesses and weaknesses strengths. I realised also that I was very aware of my vulnerabilities, particularly physical ones. One of these is finding it difficult to metabolise certain chemicals whether in food or medicines without succumbing to reflux, migraines or side-effects. However, even here there may be some advantages (to keep this brief I won’t elabourate). The challenge is to a) be aware of what one’s strengths and weaknesses are and then b) to use one’s strengths to tackle the challenges that arise from one’s weaknesses. I also noticed that in general the things that we like doing are normally a strength because we tend to be good at what we like.  So another way to identify your strengths is to think about what you enjoy.