Tuesday, January 10, 2017

Depression from Neurological Disorders

Having a chronic neurological disorder (Cramp Fasciculation Syndrome - CFS) is not easy to contend with, even if it is benign and will not kill me. Every day I remind myself how lucky I am not to have something more sinister like ALS, MS, or Parkinson’s disease. Unfortunately, when I am confined to laying down over 14 hours a day; when a good day is one with diarrhea and not being constipated (IBS seems to one of symptoms); and the fact I cannot do activities I enjoy, it is hard not to get depressed from time to time.

Since I can no longer rock climb, hike, mountaineer, or wrestle anymore due to limitations and safety concerns over my hands and feet, I have turned to cycling. To my surprise I am very fast on a bike and do well at time trialing but struggle a bit at other types of cycling races (mass starts) like road races and criteriums. I fail to have the confidence in my bike handling abilities due to paresthesia in my hands when riding in close proximity to other riders. However, time trials are ideal for me since I am not riding in big crowds; races are shorter (less concern over cramping and spasms); bike handling skills are generally not as difficult; and riding on aero bars puts much less pressure on my hands and does not make my paresthesia symptoms worse.

I work out hard just about every day (I have some rest days) even though I do not feel like working out at all. Once I start exercising or competing, I can push myself to high levels of pain I have not felt before. In a few races my vision became blurred and my depth perception was compromised. What was happening is that my legs were so oxygen deprived that my body, as a defense mechanism, transferred blood from my brain to my legs. That is crazy. I can generate well over 300 watts while elevating my heart rate at over 95% of its maximum rate for an hour (Not too bad for anyone that is 52 years old). This type of intensity is an amazing amount of stress on the body (on top of the CFS). Needless to say this has led to more pain and the need for more rest after workouts. I figure if I need more rest because I am in a great deal of pain already from a neurological disorder then I may as well give my body a reason for being in pain. There is definitely a difference between good pain and bad pain. Despite a great deal of success on the bike that would make almost anyone giddy, it is hard to enjoy it when you are in constant pain. I should be happy, but I find myself more depressed than happy (but less depressed if I were not biking). Part of the problem is that I am never satisfied with my effort, I always feel I can do better. Hence, that leads to more difficult training and more pain – why do I create such a vicious cycle of events?

There is no easy answer to this question. First, like I said earlier, if I am going to be pain then I may as well work as hard as I can to try to mask the bad pain with good pain. Second, there is always a fear of having something more sinister – my workouts prove that I am free of deadly disorders. Third, you only live once so you got to make the most with the cards you have been dealt. Fourth, I live under the philosophy that people should work hard throughout their lives to improve themselves to not only be a better person, but to excel at what you choose to do. In five years from now I do not want to regret not finding out how good I can cycle. Fifth, I would be more depressed if I did not exercise.

I am not sure how I am accomplishing what I have to date. I am amazed and will like to see how good I can get as long as my conditions allows me to do it.

If anyone is interested, here are a few of my unique training tips for increased good pain and less depression and a fast time trial (TT):

Shorter more intense workouts. Less endurance and more power (less likely to have cramps and spasms).

Long hill repeats over shorter interval workouts. Less speed and more power.

Hypoglycemic workouts (short, but hard morning workouts on just water before eating). I believe this helps improve endurance and speed and gives me a better understanding of my body and its propensity to get spasms and cramps.

Lots of rest throughout the day after workouts (even though it is depressing).

Lots of stretching and flexibility exercises.

Ride by yourself (for TT focus). This makes your workout complete without having to draft off another rider.

Ride in a big gear going uphill with a slower cadence. This resistance builds strength and power.

Lots of strength training (including the upper body – I think this is overlooked by cyclists). I am not necessarily looking at trying to add muscle mass (more weight to cyclist is not a good thing), but maintaining both a strong lower and upper body.

Morning workouts over afternoon or evening workouts when the body is fresher (I feel more pain later in the day than in the beginning regardless if I have worked out or not).

The goal is to get the body accustomed to feeling lots of pain. Painful workouts leads to pushing through pain when racing.

Depression from a neurological disorder is difficult to deal with. And hard exercise may make pain increase and the amount of time spent laying down go up. But without a goal or something to drive you physically, I am sure I would be much more depressed without cycling. When and if cycling becomes too difficult to do due to CFS symptoms, maybe I will try my hand at swimming.

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