Relaxation pack. Hampshire and Isle of Wight CFS/ME Service. Lifestyle Management Programme. Relax. Chronic Fatigue Syndrome (CFS) ME

Transcription

1 Week 1 Week 2 Week 3 Week 4 Week 5 Sleep pack Relax Clinic pack Relax Hampshire and Isle of Wight CFS/ME Service Relaxation pack Hampshire and Isle of Wight Chronic Fatigue Syndrome/ME Service. The material contained in this and subsequent packs must not be copied or reproduced in any way.

2 In CFS/ME it is common for people to have problems with mental fatigue. Often you may have difficulty reading for long periods, tending to lose concentration after a while and no longer able to take in the information you are reading. If this applies to you the following technique could help you to read this booklet. Think about how much you can read before your fatigue level starts to increase. For some people it is 1 page (or just a paragraph), for others it is 20 pages or more. Stop reading when you have read the number of pages you can read without increasing your mental fatigue. Mark the point you have reached. Put the booklet down at this point and take a break from reading for a significant period of time. Come back to the booklet. Only read the number of pages or paragraphs you can read without increasing your mental fatigue. Ask someone else to read it and give you the information verbally. By using this technique you will be able to complete reading the booklet in stages and be able to concentrate and retain the information more easily. 87

3 Rest and relaxation Throughout daily life, activity needs to be balanced with rest. We cannot function without adequate rest. Rest can mean different things to different people. Some people may suggest that rest means sleeping or perhaps just sitting down and not doing anything. Others may suggest that rest means being able to relax. When we talk about rest within the field of Chronic Fatigue Syndrome we mean relaxation. What is relaxation? Prior to becoming ill you may have found reading, watching TV, or talking to friends on the telephone a good way to unwind. Now however, due to the overactive brain or sensory overload phenomena experienced in CFS/ME, the concept of relaxation needs to be redefined. Anything that stimulates or over stimulates the brain either in terms of physical or mental effort is termed activity. Thus talking, watching TV, reading and even eating are regarded as activities. Relaxation should focus not just on resting the body, but also on resting the mind. Relaxation aims to achieve a state of minimal neurological (brain) activity. On a continuum between wakefulness and sleep the dot indicates the point at which relaxation occurs. Asleep Awake It is important to try not to go to sleep during a relaxation session. The only exception is the use of relaxation to assist with sleep at the end of the day. As you begin to implement the techniques you may well find that your sleep pattern improves due to a more helpful balance of rest and activity throughout the day. 88

4 As part of our treatment programme we advise people to find some relaxation techniques/ music that works for you. List of relaxation resources This list is not exhaustive. There are so many things out there that can help you relax, a lot of it is personal choice and preference. Try things that feel comfortable, but remember to ring the changes; you don t want to get bored. Some places to try could include: Your local library, who can order things in for you. Friends and family s music collections. Local charity shops will sometimes have tapes/ CDs at reduced prices. Music shops will also have a variety of choices if you asked. Relaxation CDs can also be found in some garden centres. Downloads. Internet Searches Alternatively, just type in the word relaxation into any search engine or music sites and see what you get! There is a lot of relaxation information out there and lots of different techniques to try. You may want to build up a selection so you don t get bored with one album. Look for ones that you like and that you will use on a regular basis. 89

5 Stress Stress can be anything that disturbs your status quo. This can be mental or physical. When you are stressed, your body reacts in various ways in order to try to restore its balance and you may experience a variety of symptoms. What are stressful events? A stressful event can be anything that you perceive as threatening, change in your life or disturbing emotions. For example, divorces, moving house, difficult relationships, bringing up children alone, work pressure, overwork. The list is endless. The actual event triggering stress will depend on the individual, but the most important thing is to be able to identify it and recognise its effect on the body. What reaction does stress cause? The body s first reaction to stress is a surge of adrenaline and steroids. This prepares the body for a flight or fight reaction. For example, if you narrowly missed having an accident you may feel tense, sweaty, have a dry mouth and your heart rate increases. The feeling goes away once the stress is removed. If the stress does not go away, for example continuing arguments or a busy lifestyle or a chronic illness, the early reactions can become permanent. This is why learning to relax is beneficial as it supports the Automatic Nervous System. 90

6 Automatic Nervous System It is true of the body s system to respond to fight or flight situations using the Sympathetic Nervous System or the Parasympathetic Nervous System to calm us after a stressful event. If stress continues for a long time, the body becomes unable to maintain its balance and may break down. This may take the form of chronic conditions such as migraine, high blood pressure and stomach upsets. What role does stress play in CFS? Stress may be involved in two ways: It may help to cause or trigger the illness. For example people under stress are more vulnerable to infections. This is because stress alters your body s immune system Once you have CFS, stress may exacerbate and perpetuate some of the symptoms. For example, muscle tension, palpitations and sweating are all common in CFS. What can I do about stress? There are two things you can do: You can try to identify and remove sources of stress in your life You can help your body to maintain its balance and prevent symptoms of stress. These include learning the difference between recreation and relaxation and the importance of effective relaxation through the use of techniques such as breathing exercises and relaxation. This will help your Autonomic Nervous System be better balanced and help you towards recovery. 91

7 How to relax Creating a feeling of relaxation incorporates being able to switch off both physically and mentally. There are a number of strategies you can use to help you to achieve this. For example: Breathing exercises Listening to soft relaxation music Following a guided relaxation technique. Relaxation is a skill. It needs to be learnt. Initially the aim is to relax in a quiet environment where you feel comfortable and free from distraction. The techniques once learnt can then be used in alternative environments, for example at work or on the bus. What bodily changes occur during the relation response? Hormone production decreases Sweating decreases markedly Digestion is switched on, tummy may grumble Mind becomes more tranquil daydreamy Breathing rate decreases as less oxygen is needed Heart rate decreases and blood pressure drops Body may cool as blood is diverted from major organs Muscles relax 92

8 Autonomic Nervous System Sympathetic Nervous System Produces a stress reaction. An essential survival mechanism where large amounts of energy can be accessed for short-term use. In the wild it has enabled us to give our best in either fighting or running away. A fight or flight response. Parasympathetic Nervous System Produces a calm or peaceful effect. Essential for convalescence, healing and reorganising. Energy is directed and resourced in a long-term way to enable performance of selfnurturing activities. Parasympathetic Calm Sympathetic Stress The two systems behave like a see-saw, one side is in predominance whilst the other is quiet. In life we are aiming to have the appropriate system active at any time. 93

9 Some of the effects of stress and calm on the body are outlined below: Stress Body system Calm Breathing is rapid and from the upper part of the chest. The muscles become tense and ready for action. The blood is directed to the brain, muscles and special senses. The senses are highly alert, for example, the hearing is straining to pick up the slightest noise. Digestion is switched off as the body prepares for action. The brain is working over-time in a problem solving manner, to make sure that you are aware of everything around you and to help you cope with any problems that may occur. Breathing Muscles and Joints Blood Circulation Special Senses Digestion The Brain Breathing is slow and from the lower part of the chest, using the diaphragm. The muscles relax, taking pressure off the joints. The blood is directed to the skin and digestive system. This gives a feeling of warmth to the skin and improves digestion. The senses, such as sight and sound, reduce their attention. Sounds seem quieter and more distant. Digestion is switched on. You may hear the intestines gurgling and feel hungry during or after rest periods. Your thoughts become unfocused and creative with a day dream quality. 94

10 Breathing techniques Breathing is automatic and we are not normally aware of it. Although breathing is vital, it is often done improperly shallow and haphazardly. However breathing can be controlled by an act of will. Two main types of breathing 1 Chest breathing Inefficient Shallow Associated with tension and anxiety 1 2 Abdominal breathing Uses the diaphragm Provides with sufficient oxygen Expels carbon dioxide adequately Improves circulation to abdominal organs Relaxed body and mind. 2 95

11 Abdominal Breathing Exercise Sit or lie down Close eyes Put one hand on chest, other on abdomen Breathe in/ out smoothly, slowly and deeply As you breathe in, let your abdomen rise first then your chest Breathing out; pull your abdominal muscles in Put your hands by your side and concentrate on your breathing, being aware of your abdomen rising and falling Practise abdominal breathing several times a day until it becomes your natural pattern of breathing whether you are sitting, standing or lying down. Abdominal Breathing Technique Follow these steps Breathe out through your mouth and let your shoulders drop right down Concentrate on your stomach and let the muscles of your stomach relax Take as slow a breath as you can in through your nose and push your stomach muscles gently outwards Hold the breath for two seconds, with your stomach as relaxed as you can Now let the breath go making sure you breathe all the air out of your lungs and breathe out through your mouth Let your stomach fall gently down again with the out breath. How to test that you are doing the technique right It is very easy to take a deep breath in but this can often make your muscles more tense if you are not breathing in the correct way. Therefore the most important element of this breathing is concentrating on getting your stomach to relax, to allow the diaphragm to drop into the abdomen and therefore allowing the chest to expand. To test that you are doing the technique correctly, place a hand on your stomach just below your ribs, this hand should gently rise when you breathe in and fall down as you breath out. 96

12 Square breathing Square breathing only takes a few minutes to carry out and has almost immediate effect, reducing some of the symptoms of anxiety. This is a portable relaxation tool that can be applied in many situations/ environments, whether you are sitting, standing, lying down. The square breathing also is a beneficial method of distraction and can stop/ prevent anxious thoughts. Method In your mind visualise drawing a square in time and your breath: Hold Breathe in Breathe out Pause Each stage of the square should take approximately 3 5 seconds. 97

13 Positions for relaxation Try various positions in order to find out which one suits you best. Lying on a firm bed with arms by your side, make sure the head, neck and trunk are in a straight line. Any tight clothing, jewellery loosened. 1You may need a cushion under your head, or supporting your back. 2Lying on a bed with knees bent, or lying on the floor with legs up on a stool. 98

14 3Lying on your front: recovery position. 4Sitting down: the chair should have a high back so that you can rest your head. 5Sitting down: sit in a chair with your head resting on its side on a cushion. 99