Is anxiety an overuse injury?

Overuse injuries are the culmination of repeated minor traumas, often with an exacerbating trigger event that precedes the onset of symptoms. It has taken a long time for physical overuse injuries to be recognised because they take a while to appear and the cause and effect are not as closely connected as in acute injuries.

I think that anxiety and depressive disorders may follow the same pattern. In my case I can see that for many years as a child I had experienced minor traumas related to feeling neglected and worry related to Catholicism, then as a teenager I experienced a combination of stresses following a road accident where I was hospitalised, school exams, and a piece about me in a national newspaper. I think this combination of stresses then led to an anxiety disorder. The symptoms of anxiety themselves generate stress and this perpetuates the disorder.

Following the model of seeing the same principles operating in both mental and physical disorders, I think that an alternative model of some mental health issues is to view them as mental overuse injuries. Experiencing a range of physical overuse injuries, taught me that the diagnosis and treatment of these problems is not joined up.  Books or web articles about Repetitive Strain Injury of the hands from typing never connect it to vocal overuse injuries or the other myriad of overuse injuries that can effect any part of the body.  It is therefore maybe no surprise that nobody has made the connection between these injuries as a whole and mental health issues that have been caused by mental trauma/overuse.

Having worked in the mental health field eventually I realised that roughly two thirds of people with mental health issues have experienced either physical or sexual abuse or neglect i.e. mental trauma/overuse.  There are people who haven’t experienced a significant level of mental trauma but who nevertheless still develop mental health issues which indicates that in these cases the cause may be purely biological in some way, so it is important not to overgeneralise the amount of ‘mental overuse injury’ but I think that is substantial.

The following illustrates an example of how anxiety can be an overuse injury.  In my previous job I had opportunities to just work by myself or have a change of environment by going to meetings outside of the building where I was based.  When I changed jobs I was suddenly around people all day long and I developed a problem with constant hyperventilation (previously I had just experienced hyperventilation intermittently). I think that in the previous jobs the time by myself and the opportunities to leave the building gave me some recovery time. Also in the new job on my very first day I was presented with a very stressful incident.  I think that this incident was the trigger but that the reduction in recovery time, and incidentally an increase in stress because of a house move, led to the hyperventilation problem.  This process of reducing recovery time and cumulative and sudden increases in stresses, plus a triggering stressful event that precede the onset of symptoms is exactly the same process that occurs in physical overuse injuries.

At the same time as developing the mental overuse injury I also developed a physical overuse injury with my knee.  I think this was connected to carrying my bicycle up three flights of steep stairs almost everyday and running up and down stairs at lunchtime. In both cases the mental and physical overuse injury were related to stresses associated with a change in environment and routine.