Waking Up Scared

Ever had a nightmare that left physical feelings of distress?  I once had such a realistic dream about Paul being unfaithful that I spent a full day being angry toward him and sad even though I knew it was not true.  Counselors consider these somatic experiences.  Our bodies feel the impacts of our experiences - even our dreams - and carry those experiences.  This somatic experiencing can exist even when we ignore the cognitive and emotional impacts of our experiences.  As people say, the body keeps score.

So imagine waking up every day experiencing fear.  Most of us can manage fear - to one degree or another - when we know what it is we fear.  For example, I fear being trapped in small spaces.  I have walked away from more than one closed MRI machine despite my medical need for the testing.  I learned to manage that fear or have taken medication to get me through the testing.  I found a way to deal because I knew why I had the fear and knew the reason for my fear would be time-limited.  I also knew I needed the testing.  I found a solution.  I took medication.  And, whereas the fear still existed and I had somatic responses, the long-term impact was minimal. 

What if you did not know the cause of your fear?  What if - every day - you woke up frightened and could not explain why?  What if the fear took hours to go away?  What if the fear paralyzed you - kept you from focusing on anything else?

If you know this type of fear - I am sorry.  I watch Paul go through this type of fear every day. It is one of the most exhausting symptoms of his Alzheimer's.  Why?  Here is what happens to the brain one one is fearful:

Fear starts in the amygdala even before we know we are afraid.  This fear center attends to potential threat and sends excitatory signals to other parts of the brain.  It's job is to keep the brain at full alert.

Then the sympathetic nervous system (SNS) kicks in and releases adrenaline.  This occurs so that if there is a real threat, the body is prepared to run or fight.  Some people freeze or faint.  All of these are protective mechanisms.  The body is really amazing.  When adrenaline is coursing through our veins, our pupils dilate (bringing in more light so we can see the threat) and blood flow goes where we need it most.  Even digestion stops - because, you know - who needs to digest anything when a serial killer is chasing you!  Here is my least favorite result of adrenaline - cortisol. Cortisol is a stress hormone.  It gets released into the bloodstream and increases glucose levels, which increases energy (remember fight or flight).  The body is amazing - especially when there is a real threat.

But, what happens to the body when there is a prolonged exposure to all of these chemicals from constant fear when there is not threat?  What happens to the body when these chemicals are just floating around most of the time?  Adrenaline and cortisol exposure over time weakens the body's immune system.  When the immune system is weakened, people become more susceptible to illness, infection, and injury.  These chemicals increase blood pressure and put the heart at risk.  Exposure to cortisol can cause weight gain.  As the chemical dissipate over time, exhaustion sets in and recovery time - the time to feel "normal" again takes longer and longer. 

Sounds torturous doesn't it? I am blaming my 40 pound weight gain over the past five years on cortisol.  Bad cortisol - how dare!

Seriously though.  Paul woke up again today in complete panic.  Since we moved in April of this year, this has been his constant battle.  I am certain waking up in a new home after nearly five years in a different home is what set this off.  Nothing we've tried has calmed this yet.  And, now I am wondering if this is Paul's new baseline.  Is fear his newest nemesis? 

Paul had one of his twice-yearly neurological visits last month.  When I mentioned Paul has been sleeping an average of 16 hours per day since the move, she explained how these chemicals actually cause injury to the brain and body over time.  She likened the impact on his brain to that of a person battling a non-stop flu or infection.  She said the brain needs time to recover from daily injury.  In this case, the daily injury and the treatment for the injury are darn near one in the same - sleep (rest).  

Going to sleep causes him to lose track of where he is or what he knew yesterday or whatever.  He wakes up panicked. Those stress chemicals float around in him keeping him agitated.  They exhaust him.  He goes to sleep.  It starts all over again.  

Can you even begin to imagine what this must be like as a lived experience.  I watch it every day and still do not know how he manages it.  My husband is weakened by this disease.  And, yet I still think he is amazing!