The Autonomic Nervous System Part 3: Maintaining Balance

Thus Far

In the first two parts of this series, you've looked at the Fight, Flight or Freeze and Rest and Digest responses in your body.

Both are important. Fight, Flight or Freeze keeps you alive in dangerous situations, and gives you energy when you exercise (the so-called "runner's high" comes from an adrenaline rush.) Rest and Digest allow you to do the work of thriving: growth and repair.

One or the Other

You can't use the sympathetic and parasympathetic nervous systems at the same time. Your body has to choose between the two. What this means is that if your body is in Fight, Flight or Freeze more often than necessary, you lose out on your ability to Rest and Digest. 

Stress in Present-Day America

Remember how in Part 1 you learned that many modern day stresses are interpreted by your body as threats, and it reacts by turning on Fight, Flight or Freeze? So...chances are you are in Fight, Flight, or Freeze more often than necessary, and losing out on your time to Rest and Digest. 

Not having time to Rest and Digest makes healing harder.

Oy vey. Chances are you can't get rid of traffic jams, your screaming kid, or your moody boss. So what CAN you do to turn on Rest and Digest? Plenty.

Rest and Digest's Secret Weapon

Fight, Flight or Freeze is mediated by your spinal cord (thoracic and lumbar regions, if you are curious) - the signal "THREAT!" only has to make it to your spine for your body to turn on Fight, Flight or Freeze. Your brain is not part of the equation. This allows for the quickest response during an emergency.

BUT

Rest and Digest is mediated by your sacral spinal cord AND your brain. That last detail is *super important.* It means that you can use your brain - your willpower - to turn on Rest and Digest when you want to.

Cool.

Training Time 

You can train your body to override Fight, Flight or Freeze if your brain realizes that the situation does not require it. For instance, you can teach yourself how to be calm during gridlock, while watching your kid meltdown, or dealing with another one of your boss's unreasonable demands. Are those situations stressful? Sure. But do they have to be? Not necessarily.

Do not pretend to be calm - while on the inside you are a mess - but  call on your training so you can really be calm, inside and out, when a difficult situation arises. You probably have heard of this before - it's stress management.

Switching between the Two

The key to finding balance - the unique balance that works for you at this stage in your life - is that

You want your body to be able to switch quickly and efficiently between Fight, Flight or Freeze and Rest and Digest.

Don't be discouraged if you go to a yoga class or get a massage and then walk out and almost get hit by a car. Yes, you are no longer in Rest and Digest - but the fact that you can react quickly to a threat is a sign that your nervous system is working properly. Once the threat has passed, you want to go back to Rest and Digest efficiently. That is why taking yoga, getting massages, or doing meditation are so helpful - they train our body in Rest and Digest, so that over time, we are able to switch into it more quickly.

The Take-away

Figure out what activities gets you to a state of Rest and Digest, and put them at the top of your priority list. Rest and Digest is not a luxury, it's a necessity.

To get there, you may use one of the techniques listed above, or something else, maybe a particularly enjoyable hobby: gardening, playing your favorite instrument, woodworking. 

How do you know you are in Rest and Digest? One simple sign is that your belly begins to gurgle. That is the "Digest" part in action.

By encouraging Rest and Digest, not only will you feel better in the moment, it will train your body to spend more time there, giving you additional resources to heal your pain.

And healing your pain is exactly what you want to do.

 

The Autonomic Nervous System Part 2: Rest & Digest

The Parasympathetic Nervous System

The Parasympathetic Nervous System, often referred to as the Rest and Digest response, takes over when there are no threats present. When you don't need to fight, run, or freeze, your body can go back to chillin' out and taking care of itself.

Your blood and energy return to your digestion, your heart rate maintains its normal (non-emergency) rate, your adrenal glands stop releasing adrenaline, your pupils stop dilating, and the muscles that contract to make your hair stand on end relax.

This is the place you want your body to be when you are not facing an immediate threat or emergency.

In this state you get to put your resources towards thriving instead of surviving: your body performs maintenance and upkeep, aka healing.

The Importance of "Rest and Digest"

You can see how essential the parasympathetic nervous system is to your overall health. Without it, you wouldn't be able to efficiently process nutrients, sleep, enjoy a day on the beach, read a book, give a hug - any activity that requires you to be calm.

If you were always in Fight, Flight or Freeze your heart would wear out, your digestive system wouldn't have enough energy to do its work, your eyes would constantly be on alert.

It would be very hard to fall asleep, do focused work in a sustainable manner, or go about your daily life. Which probably sounds an awful lot like you, since you are dealing with chronic pelvic pain.

So Now What?

In the next post you'll learn about how to keep your nervous system in balance, so you have your Fight, Flight or Freeze response primed to go when you need it, and can spend the rest of the time happily Restin' and Digestin'.

The Autonomic Nervous System Part 1: Fight, Flight or Freeze

This week we'll be looking at parts of our nervous system, the balance between them, and how that plays into pelvic pain.

The Autonomic Nervous System

The autonomic nervous system (ANS) controls our involuntary nervous responses, like our heartbeat and digestion. We don't have to think about these functions for them to happen.

Three main parts comprise the ANS: the sympathetic, parasympathetic, and enteric. They work together to maintain homeostasis, or balance, in the body.

The Sympathetic Nervous System: Fight, Flight or Freeze

Often called the "fight or flight" response, the sympathetic nervous system is more accurately a "fight, flight, or freeze" response. Simply put, this is our defense mechanism.

If you were attacked by a hungry animal or a hostile person, you would try to fight it off. This is the "fight" response.

On the other hand, if it was possible, you may instead run, rather than staying to fight. This is the "flight" response.

You know the phrase "like a deer caught in the headlights?" That is the "freeze" response. To freeze - originating from the instinct to remain immobile in the hopes of not being noticed by a predator - is a technique used by various prey animals as well as humans. The freeze response includes playing dead. (Many predators prefer to eat live animals rather than ones that have already kicked the bucket, so instead of attacking, they may sniff around, decide said the prey was dead, and move on. Once the threat has passed,  the prey can relax and go back to living.) 

In human terms, the "freeze response" would include hiding in fear, or submitting to an attack in the hopes the attacker would leave you alone or at least reduce the severity of the attack. 

Of course, these days modern Americans are not usually being attacked by predators. So instead our sympathetic nervous is activated by other threats: a car swerving in front of you, almost being hit while crossing the street, or...stress. A looming deadline for an impossibly huge project, financial worries, family drama, dreading an exam. Daily stresses are interpreted by our nervous system as threats, and without our conscious control, create a specific response in your body.

The Sympathetic Response

What happens when your body perceives a threat? It prepares for "fight, flight or freeze." Functions that are not essential to your survival in that moment are shut down: blood is shifted from your digestive system to your muscles, your heart races, you start pumping out adrenaline, your hairs stand on end, your pupils dilate. 

In the olden times, this response would help us elude a threat. Once the threat passed, we could relax and go back to other essential functions, like digestion, or a slower, more sustainable heart rate. 

But today we have perceived threats around us all the time - rushing to get to work, your two year old having a tantrum, trying to avoid the bully at school. So our sympathetic nervous system is "on" more frequently.

But the sympathetic nervous system is supposed to help with homeostasis, remember? That's balance in the body. If our sympathetic nervous system is being called upon more frequently, we are out of balance, what we commonly refer to today as being "stressed."

Next Up

In the next segment we will learn about the sympathetic nervous system's buddy, the parasympathetic nervous system. While the sympathetic nervous system is often maligned in our society - who likes being stressed? - both are needed to maintain balance.

Mind-Body Medicine

Today's post is about what mind-body medicine is and how it can reduce pelvic pain. Click above to watch it!

International Society for the Study of Vulvovaginal Disease

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This past weekend, Chicago was the site of the 22nd Biennial Conference on Diseases of the Vulva and Vagina, hosted by the International Society for the Study of Vulvovaginal Disorders (ISSVD.) The mission and founding document of the society shed light on why so many vulvar and vaginal patients may be frustrated with lack of quality care. (The bold text below is my own emphasis.)

The mission of the ISSVD is

To promote international communication among gynecologists, pathologists, dermatologists, and related disciplines, and to establish international agreement on terminology and definitions of vulvovaginal diseases.

To promote clinical investigation, basic research, and dissemination of knowledge in this field.

The organization was founded in 1970 at the Federation of International Gynecologists and Obstetricians, with the first meeting being held in 1971 in San Francisco. At this first meeting, the founding fellows signed a resolution as to the reason for their existence:

WHEREAS, diseases affecting the human vulva are not confined to the limitations of a single medical specialty, nor to the borders of a single nation, and

WHEREAS, there apparently exists no generally agreed upon terminology regarding classification of vulvar disease, and

WHEREAS, the free and efficient communication of facts and ideas is necessary, if we are to apply the ever-advancing wave of medical knowledge to the field of vulvar disease,

WE, the undersigned, do hereby resolve that there is justification for an international society devoted to the subject of vulvar disease and do hereby constitute THE INTERNATIONAL SOCIETY FOR THE STUDY OF VULVAR DISEASE.”

So...Western medicine dates back hundreds of years, yet a group dedicated to the study of the vulva - the avenue through which most of the world's population is born into the world - didn't start until 1970?! That's less than 50 years ago. Since part of the organization's mission is to agree on terminology, that means we are still finding the words to describe what is going on in women's bodies.

Is it any wonder that there is not sufficient knowledge to keep women's bodies healthy?

Today, the ISSVD only numbers about 300 people. That's 300 people, sprinkled in and amongst the 7 billion people on this planet. That's 300 vulvovaginal specialists for 3.5 BILLION women.

No wonder our lady parts don't get the care they deserve.

While I am saddened that attention to women's care is so behind, I am grateful to the pioneering doctors who are members and I am hopeful that their research will bring much-needed relief to so many women.

The ISSVD has kindly offered me a summary of this past weekend's proceedings, which I will excitedly report back to you when I get it!

PS Isn't the ISSVD's vulva-esque logo rockin' ? More on it's symbolism (besides the obvious) here.

PPS The founding members of the ISSVD were all men; not surprising, given how few women were doctors back in 1970. But still...cray-cray. Thank goodness that while in 1970 women made up 9% of medical school graduates, today that number is 48%. Hopefully this will translate into better care for women over time!