How We Cope With Anxiety When Our Bodies Need Rest

How can those of us dealing with fatigue from chronic illness find a healthy outlet?

In recent months, I’ve been trying to recall what my life was like before illness. Specifically, I’ve been trying to unravel whether I’ve always been an anxious person, or if Lyme disease and dysautonomia brought it on. One thing I know for certain is that chronic illness worsened any anxiety I may have already had.

As members of the Mighty community know all too well, illness brings a lot of baggage with it beyond the physical symptoms. In my case, chronic fatigue, dizziness, and brain fog limited my ability to work and socialize. Then there was the cost of the tests and doctors’ appointments, none of which seemed to provide answers or much help. Worse for me, was the feeling of not being believed by many of my friends and family during the years when I didn’t have a diagnosis. It’s no wonder there’s a well-documented correlation between chronic illness and mental health disorders.

On top of these new stressors, my illness limited many of the healthy ways I used to cope with anxiety. Before becoming sick, if I was feeling anxious, I could go to the gym or talk with a friend or co-worker. But the many adjustments I’ve made to accommodate my illness have taken those coping mechanisms away. Though I’m lucky that I can still enjoy taking walks, with the fatigue of dysautonomia and the joint pain of Lyme, oftentimes vigorous exercise is out of the question. There are still people I can talk to, but conversation is difficult. On a good day, it wears me out, and on a bad day, I can’t process what people are saying or pull coherent thoughts from the swirl of fog rolling around my brain.

Over the past year, as some of my symptoms have worsened, I’ve begun experiencing acute anxiety in the afternoons when I’m at my most exhausted. Around mid-afternoon, my head, neck, and facial pain becomes so severe that I simply cannot think clearly. As the afternoon wears on, I’m so exhausted from fighting pain and brain fog that I can’t even type on the computer or sit in a chair. At those points, I lie down on my couch. Sometimes I meditate. Sometimes I just try to rest.

Of course, this is when anxiety chooses to rear up. As tired as my body is, all my brain can think about is all the things I should be doing rather than resting. From there, my feelings of inadequacy spiral into how lazy I am for resting in the middle of the day with the sun shining in the windows and everyone else (in my imagination) still going strong after hours of work.

It was during one of these forced breaks that I happened upon an NPR interview with Dr. Tracy Dennis-Tiwary, a professor, anxiety researcher, and author of “Future Tense: Why Anxiety Is Good For You Even Though It Feels Bad.” As counterintuitive as it may sound, Dennis-Tiwary argues that when we pathologize anxiety, we miss out on the signals our body is sending us. For instance, if I’m experiencing anxiety about an upcoming project, my body is signaling that I care about my work and have concerns that I might have more to do. To speed me along, my body releases dopamine, a motivating chemical that spurs me to pursue rewards and take action.

But how does that work for those of us whose bodies are simply too exhausted or in too much pain to follow through? Dennis-Tiwari compares anxiety to a smoke alarm that alerts us that it’s time to act. Aptly enough, a friend of mine with dysautonomia and Lyme once described her fatigue as so severe that if her house was on fire, she wouldn’t be able to get off the couch to run. To those of us who feel that way, a smoke alarm doesn’t do much good.

At the same time, Dennis-Tiwari’s premise resonated with me in some ways. I wondered if there might be a way that it could be reframed to fit the circumstances of those of us dealing with chronic conditions that often make us too fatigued to act. At the core of Dennis-Tiwari’s message, the takeaway seemed to be that if my body was telling me that I care about a certain goal, then I needed to take steps to achieve it. For many, that might mean putting in an extra hour of work to finish a project. However, for those of us who need to pace ourselves, pushing ourselves beyond our limits would set us back further.

In my case, if there’s something I need to accomplish but I’m too fatigued to do it, that means I need to rest my body so that I can pick up the fight again. The next afternoon as I laid down to rest, I found this thought comforting as anxiety tried to rear up. I thought to myself, I care about my work, but to do it, I need to rest and take care of myself. This inaction is the action I need. This is still a hard lesson for me to accept, but viewing rest as a step toward a larger goal helps.

I should note that even though Dennis-Tiwary posits that anxiety can have hidden benefits, she does not argue that anxiety is not a real disease or that those struggling with it just need to “pull themselves up by their bootstraps.” She is clear that anxiety exists on a spectrum, from everyday butterflies before a speech, to the kind of anxiety that interferes with our daily activities. Rather, she makes the argument that anxiety can be viewed as a natural part of life, and when we pathologize all anxiety, we miss out on the messages it’s trying to give us. Anxiety about anxiety can be counterproductive because it overlooks how anxiety can energize us to address issues we care about

And for those of us not feeling so energized, well, maybe we can still heed that smoke alarm, but use it as a signal to stop and think about what it is our unique bodies in our unique situations are trying to say.