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The Body and The Mind

I have a first-class degree in Psychology and Biology from a top UK university. You would therefore think I know all too well about the mind-body theory. Makes sense doesn’t it? The discipline of Biology, the body, and its relationship with Psychology, the mind and behaviour. But that would be far too obvious, wouldn’t it?

I spent three years at university and to my surprise I graduated with a not-so-joint joint-honours degree. The two courses I so excitedly signed up for as a package deal were kept far far apart from one another. In biology lectures, we would learn about the physiology of major systems within our body, whilst in psychology we learned about human behaviour and mental health. Surprisingly, even when we were looking at similar issues, the two paths never crossed during my entire time as a student. I was flummoxed. Why on earth were they ignoring each other? I went to university to explore these two courses together, not view them from worlds apart. When we learned about the brain in biology, it was a complex arrangement of neurones and chemicals that robotically influenced our behaviour. Discussing the mind and human emotion was taboo. Similarly, no one would talk about the inconceivable abundance of cells and tissues that generated our thoughts in psychology seminars. Perhaps a brief mention of serotonin or dopamine, but it was only surface deep. At times, it honestly felt as though I was cheating on each of the courses with each other. I recall a time during revision leading up to exams when I had to check with a course-mate: “Wait do you want biology’s version or psychology’s version of this?”. Don’t get me wrong, I enjoyed all of my modules at uni and loved getting my degree in both. I just felt quite disheartened that they were treated as independent systems when we can so clearly see that they are completely dependent of one another. Unfortunately, I have now since discovered after being unwell with long covid that my university course merely reflected the scientific community as a whole. According to mainstream science, the mind-body experience doesn’t exist and it’s only recently that people are starting to wake up to the idea of it.

Long covid is thought to be similar to disorders such as Myalgic encephalomyelitis (ME), which you may have heard of as chronic fatigue syndrome (CFS). Since the battle against Long Covid is still in its very early days, researchers aren’t able to determine fully the cause of it and it may be that they never will. The same can be said for ME/CFS. There has been years of research conducted to determine the reasons behind ME/CFS and doctors have filtered this into possible theories, but nothing has been conclusive. Since the symptoms of long covid and ME/CFS are extremely similar, it is thought that they have the same causative mechanisms. Perhaps this new post-covid problem will be the propeller that helps individuals living with ME/CFS when a pandemic was just another idea for a science-fiction movie.

I have carried out a lot of independent research into the causes of long covid. There appears to be roughly five principles that are being prioritised by the scientific community. Just a disclaimer, I am not a doctor or a scientist, this is what I have simply taken away from the research.

The five main potential causes are:

  • Microclots (tiny blood clots in the blood)

  • Residual organ damage (complications with organs as a result of exposure to the virus)

  • Persistent virus (covid stays in the system and causes further symptoms)

  • Exaggerated immune response (immune system is overly-sensitive and this can lead to autoimmunity against the body's own cells)

  • Dysfunctional nerve signalling

The final cause mentioned on that list is the one I want to discuss further. This one makes the most sense to me in terms of my own experience and it does have the potential to link with the brain-body theory that I am talking about. I can also see that many other sufferers feel the same way about this. It is essentially the idea that the nervous system is unable to reset itself after the initial covid infection. It is thought that the autonomic nervous system (responsible for involuntary actions such as breathing) is wired into overdrive.

The autonomic nervous system can be divided into two distinct parts. The parasympathetic nervous system (rest and digest) and the sympathetic nervous system (fight or flight). With this theory, long covid is caused when the sympathetic nervous system circuits into a state that it's unable to get out of. Sufferers are therefore now in constant ‘fight or flight’ mode. This alteration can impact the body in an abundance of ways and generate symptoms that the person has never experienced before. So if this is the case, why hasn’t everyone that’s had covid gone on to develop long-covid? (It is estimated that around 10% do).

Well according to research, it is thought that under the correct conditions, an individual’s system can be triggered, typically by a virus like long covid, that catapults the body into a full-scale cycle of neural abnormality. Like with most disorders, individuals can have certain vulnerabilities which cause them to be more likely to get it. I decided to draw a picture to help articulate this. I have done this using multiple sources of information but the dominant inspiration behind it is from The Gupta Programme (Ashok Gupta 2016).

In essence, the image shows that three contributing factors can generate the response. Genetics/upbringing, a physical trigger and psychological stress. It is thought that all three things need to be present to provoke the body enough to enter into this state. A ‘perfect storm’ so to speak. Once this has occurred the symptoms can begin. Insomnia, heart palpitations, breathlessness. brain fog, dizziness, anxiety, muscle aches, muscle weakness and joint pain, just to name a few! It is interesting to me that the majority of these symptoms can be directly traced back to not only the nervous system in general but the autonomic sympathetic branch. Fast breathing? Heart rate increases? Muscle tension? All a common physiological reaction to the typical fight or flight response.

In addition to the three precipitating factors, there are perpetuating factors that can govern these symptoms. An individual with a hyper-vigilant sensitive brain is more likely to tip over to the sympathetic ‘fight or flight’ response than an individual that has a less attentive nervous system. Moreover, a person that encounters stress from their environment will also be more susceptible to symptoms. It is thought that the presence of stress hormones, such as adrenaline and cortisol, plays a role in the frequency and intensity of symptoms. Which makes sense. In a normal body, the ‘fight or flight’ response is liable for the greatest release of ‘stress hormones' the body can experience. So add more to the mix from external stressors? Well, it’s going to be a repetitive and endless cycle of tension and symptoms! It is also evident that people that are perfectionists or over-achievers are more vulnerable to getting long covid which is something I talk about in my previous blog called ‘Picture-Perfect’.

I can vouch for this theory since I would consider the guilt I felt for not being at work as an external stressor. I believe this stressor definitely contributed to the intensity of my symptoms. For example, in the initial 6 weeks of being unwell, the first day when I felt a little brighter was the day that the easter holidays began. That can’t have been a coincidence. I remember saying to a family member “It feels like the fog has lifted a bit”. For next two weeks of the easter holidays, I was able to go on walks and I even went out for dinner twice. I felt less fatigued, I could engage in meaningful conversations, I experienced very little muscle pain and I was able to get so many tasks done that I had been putting off. I genuinely thought I was almost better and ready to get back to work. However, two days before school started back up again? A great big crash. It was one of the worst days I can recall since feeling unwell. I was unable to move, struggled to talk and I could not lift myself off the sofa. The only difference? I was expected to be back at work on the Monday. I honestly believe that the guilt that was completely alleviated for the two weeks came crashing back down. Please note that for some of you reading this you may be thinking: "well why don’t you just quit your job? No guilt means no stress means no symptoms, duh?". But I would still consider myself as unwell during those two guilt-less weeks. Although I was able to do more and felt better in myself, I was still very far away from where I normally would be. It is clear that there are other biological events contributing to it. But, my point is, surely the mind does play a role in this? However, through all of the hundreds and thousands of words written about long covid to date, I am yet to come across research that explains the role of the mind in getting and suffering from long covid.

That’s not to say that there are physiological mechanisms that have a role to play in long covid. I imagine that all of the causes aforementioned above, such as microclots and organ damage, still very much could be a cause for the condition and its symptoms. Who am I to question the years of extensive research and findings that many scientists from all over the world have carried out? However, I believe that the role the mind should not be discredited during this exploration. I guess you could argue that everything I have mentioned is biological. Stress, on a biological basis, is just the hormone cortisol and a hyper-vigilant brain is just a result of different ‘wiring’ of the nervous system. Therefore it could be easy to say that the mind is unimportant in all of this. However, what can’t be denied is the emotional role in these conditions. How the brain initially perceives stress and our feelings, such as guilt, are purely psychological. They are influenced by social and environmental factors that the body does not have a say in. These things can only really be changed using psychological approaches. For example, anti-depressants and anxiety medications reduce the symptoms on a biological level by altering the chemistry of the brain. Whereas, techniques such as Cognitive behavioural therapy (CBT) work to adjust thinking patterns and behaviours. Both come from different fields in science and both are just as important as one another when supporting a person suffering from the condition.

Another point to add is that there are instances of people suffering from long-term fatigued-based syndromes and have given up with the hope of a cure. Some have spent many years desperate for answers, in pain and unable to lead a normal life. However, there are miraculous stories where individuals have completed psychological approaches that have led them to make significant improvements in their health and well-being. There are even stories of people making a full recovery after years of suffering! The common denominator of their prosperity was that they had completed brain re-training courses. These work on the theory of neuroplasticity, whereby the brain is capable of reorganising its structure, for better or for worse! Although these programs endeavour to re-establish normal connections in the structure of the brain (biological), the way the courses are administered are entirely psychological. The first chapters of most brain re-training programmes start with explaining the theories behind these chronic conditions but more importantly, suggest to the client that it is possible for them to get better. To give a person hope that they can get better is a social approach, there’s nothing biological about it. Yet this is the key component that underpins the entirety of these types of programs.

To conclude this post, I will say that I believe we would be fools to minimise any territories of research within the area of chronic conditions. I believe this issue should be viewed holistically. Of course, investigating the biological causation of the syndrome should be a priority, but if we are looking for a cure here (which I hope we are), I am not sure whether it will come in a neatly packaged pill box. The best way to determine the cause and the cure is by looking at individuals that have suffered from the condition and come out the other end fully recovered. These are the people that need to be listened to. I am yet to come across a fully-recovered long-hauler that hasn’t incorporated both mind and body strategies for their recovery. I have seen people take vitamins and supplements, execute an anti-inflammatory diet and use pacing techniques for keeping active. But the majority of people who improved have also used mindfulness techniques, practised meditation, completed brain re-training programs, done CBT and been part of support groups. All of which have no biological foundation. I have been and will continue to implement all of these strategies in order to get myself 100% better. Most of all though I truly believe I can and I will restore myself to full health. I really look forward to seeing what the academic and medical world comes up with on this, because I know that all of us long-haulers are expecting and hoping for great things!

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