The Long Covid Collective

Covid Therapy pt 2 (for part 1 see the label Managing Symptoms)

Hi guys! So it's been a month in which I have tried various therapy exercises (which I will write out for you to try) and I learned about the wondermiddel SSRI's to which I will link research article!

Therapy exercises

*Window of tolerance

My covid therapist told me that once you have reached a base level with your symptoms (i.e. your tiredness does not go above a doable level (for me 3) and you have a little grip on relieving symptoms and calming your nervous system) then you can start with a safe activation activity. The goal is to find an activity that will raise your BPM but without causing a disruption. Through these activities you will re-train your nervous system that an activation does not mean disregulation and from that window of tolerance you can add things.

We first tried very gentle strength training

- 2x a week with resistand bands.

- do the exercises mindfully. So rather than focussing on i.e. my biceps and the amount of reps, I had to feel which other muscles were also working and breathing out.

- the goal is NOT that your BPM does not go up, the goal is that it will come down when you rest. The goal is also to find what works for you and to recognize triggers. I.e.: your BPM spiked, but it is because you worked out whilst your tiredness level was a 7 so next time you only work out when it is at a 3. Maybe you try sitting down, maybe you try working out outside where the oxygen is better?

Sadly it didnt work for me, either my BPM would spike for days or my temp would go up. I think that because this was such a different approach to how I normally did strength training, it caused me to be too much in my head which was too much of an activation. I was super down that the strenght training didnt work out. I felt that I again 'failed' but my covid therapist reframed that. This isnt about succeeding or failing, this is a proces about finding what works for my body. That can change throughout the week or menstrual cycle. So developing a toolbox.

Since walking has always been something I did to clear my head, we decided to give that a go.

- daily short walks (10 min)

- choose surroundings that don't put unnecessary strain. Either put in earplugs (no music!) Or go to a park.

- walk with accelerations. Start with your current pace and then after a few minutes accelerate to a faster pace for 1-2 minutes and then slow down again but walk mindfully. Feel your feet roll down, feel your muscles moving. The lower in your body your mind is (legs, feet) the lower your breathing will be. Your breath will follow your focus. If you have to go up hill then do not go faster, this already counts as an acceleration.

- The goal is that I can do these walks alongside my regular daily things, but it is also not uncommon to be a little more tired the first 2 weeks. And take proper rest after a walk (so no screentime but take a nap. This will help your body go into rest mode).

What I have noticed:

- before the walk my heart rate would be 85 BPM, during my slow paced walk it would be 110 BPM, first acceleration 135 BPM and later 120 BPM, after the walk my resting heart rate would stay around 65/70 BPM

- it seems like the body needs 1 or 2 rounds of slow/acceleration before it remembers how to work, then it gets into the normal pace.

- do not be worried about sweating or feeling a stronger pulse. For LC people we start to connect those symptoms to being Ill, but they are also natural responses to working out. We need to learn to trust our bodies again.

- the mindfull part of the walk realy is the dealbraker.

- It is a matter of being in touch with your body. If I am too tired then I don't force myself. However I also noticed that my tiredness and my symptoms go down after a walk so sometimes it is a matter of trying. When I am balanced, a walk will put me more into balance and I am calm throughout the day. If I am out of balance (i.e. the day before I spend to much time on my phone) a walk will push me further out of balance.

Other helpful things

* anti histamine: last time I wrote about getting your bloodwork checked, since several underlaying causes (such as a covid related flare up Epstein-Barr Virus) can either make your LC symptoms worse or can result in symptoms similar to LC. One thing my covid counselor brought up was getting your antibodies checked with blood work. When you have an ongoing infection your body will produce antibodies. Some people showed really high numbers of antibodies in their bloodwork weeks or even months after their infection due to a disregulation. The body did not get the signal that the infection was over and kept producing antibodies, causing fatigue and other LC symptoms. They then started taking antihistamines and their symptoms cleared up!

* SSRI (antidipressants) - a study in the Netherlands showed that LC sufferers who started taking SSRI (a type of antidepressants) saw significant improvements, especially with their cognitive function. Former neuropsychiatrist Carla Rus has been doing research on the effect of this drug. A short outtake of the article:

This study used an exploratory questionnaire and found that 63,4% of 95 post-Covid syndrome patients reported a reasonably good to strong response to an SSRI. ... Brainfog and sensory overload decreased the most. Patients experienced improved well-being. The response to SSRIs in post-Covid conditions was explained by seven possible neurobiological mechanisms as reported in the recent literature.

Multiple people on the Dutch Long-Covid platform wrote that due to Carla Rus they went to their GP for fluvoxamine (SSRI) and felf significantly better after a week or 2/3. They were advised to take the medicine for 1-2 years so that their brain could learn to reprogramm itself.

I have not requested this option myself yet, I am afraid that once I feel well again due to the SSRI, I will go back to my old ways without learning anything from this period. However, when I hit my 1 year mark and still am where I am, then I will speak to my GP.

I hope this helped and that the days are kind to you all! 🌻