How I've Been Reframing My Thoughts During A Flare

I suspect my counselor has been quietly helping me to reframe things for years now, but I’ve only recently started to get good at it myself. Reframing is a mental exercise wherein you choose to assess a situation differently. To use a mundane example, say you have a lot of bananas nearing the end of their shelf life. You could think, “Oh no! I’ve wasted all those perfectly good bananas.” Or you could reframe the thought to, “Oh good, I’ll put those in the freezer and have plenty of bananas the next time I want to make banana bread.”

I struggled with reframing until TMS put my depression into remission. Before that I thought it all sounded very contrived, maybe even silly. I don’t think my depressed brain was able to see positive sides to difficult things. Then TMS helped my brain make a whole bunch of new neural pathways, and so now I have other options. The depressed pathways don’t go away, but they no longer have a monopoly on my thought patterns. Now anytime I catch myself going down those depression pathways I force myself to back up, metaphorically speaking, and go down a different route. I consider it a form of mental exercise to help me stay in good mental shape.

Recently my POTS and IBS have both flared up. My POTS is the worst it’s ever been, and my IBS is certainly in a bad place too, though maybe not at its worst. With these major health challenges I have needed to practice reframing a lot. In many ways I’ve had to reframe my whole life, at least in the short term, since my life is so much different right now than it has ever been. I wanted to share some examples of how this has played out during this flare.

I wrote in a recent blog post about how my POTS and anxiety play into one another and escalate. My first goal was to work on stopping that escalation. Before focusing on the mental side of that problem I spoke with several of my doctors to make sure there wasn’t anything new or alarming going on with my health. Anxiety can be a helpful way for your body to let you know that something is wrong, so I don’t like to dismiss it too quickly, in case it is telling me something important. In this case my doctors and I determined that my anxiety was most likely just telling me that my POTS was bad, albeit in a very loud voice. So then I felt comfortable putting my efforts towards calming my mental state.

One of the things causing heightened anxiety was that my heart rate would jump up by as much as 50 beats per minute anytime I stood up. This isn’t drastically out of the ordinary for a POTS patient but with my medications and lifestyle changes my heart rate typically only goes up about 20 beats per minute so it was a significant and noticeable worsening of symptoms. A sudden increase in heart rate feels a whole lot like an anxiety attack to me. It took a few days for me to realize that an elevated heart rate is also indicative of exercise. That might sound obvious but to me it was a bit of a revelation. So I reframed what was happening in my body when I stood up from ‘anxiety’ to ‘exercise.’ After all, exercise is not to be feared. In fact it is encouraged. Now when I stand up I’m working for my future rather than suffering from anxiety in my present. Those two things are worlds apart.

Another thing I noticed was that I was dreading getting out of bed in the morning. I found myself thinking, “It’s all downhill from here, this is the best I’m going to feel all day.” Unsurprisingly, that fatalistic mindset was not helpful. I was able to make some lifestyle modifications to make getting out of bed easier, like keeping a change of clothes (including my compression socks) next to my bed so I could change before standing up, and keeping my morning meds nearby so they could kick in before I got up. But I also needed to reframe my thought patterns. When I would experience the negative thoughts that I outlined above I would force myself to step back and try again. I reminded myself that I would feel differently once I got up, but it wouldn’t all be bad. I allowed that sometimes I might feel awful but that those minutes would pass and I’d be able to feel lots of other ways too. I’m not going for any toxic positivity here, just trying for a more balanced and realistic view. I will feel many things throughout the course of a day. Some of them will be positive and some negative. That’s just called being human.

The last example I want to talk about is a bit more overarching. Over the past few weeks of this flare I’ve found myself having good and bad days, and I thought of them as such. I recently realized that by calling them ‘good’ and ‘bad’ I was assigning them unnecessary and unhelpful value. Particularly the ‘bad’ days. I decided that ‘hard’ days was a much more appropriate name. You see, on hard days I am not doing anything badly. I didn’t screw anything up or make bad decisions. It’s just that progress is not linear. Some days are going to be more challenging than others and that is totally normal. No value statements needed.

I plan to continue to actively reframe my thought patterns as I move forward, especially on the hard days.