I’m sitting at my desk, trying to think of ideas for articles, and great anecdotes to share, when I felt a dimness growing in my vision. I couldn’t even really describe what it felt like, other than a general dimming of my vision. I quickly pulled out my handy database of ophthalmic information, Google, and looked up my symptoms. “Dimming of vision”. Whoa. Don’t ever do that without having an Optometrist standing beside you. Or maybe a bottle of tequila. With a bit of additional anxiety (breath? exhale? who’s got time for that?), I calmly told my hypochondriac wife about it. She did the freaking out for me and called my friendly neighborhood Optometrist.
Before I move on in the story, let me tell you a little I haven’t told you, yet. About a year ago, I went Keto. I cut out sugar totally and it had an effect. I got some major floaters, some ocular migraines (if you’ve never had those, look it up before you do to save yourself a scare.), and general eye unease. I consulted my handy database of ophthalmic information, Google, and looked up my symptoms. Yes, I should’ve learned my lesson this time from that time! It told me about Posterior Vitreous Detachment, Retinal Detachment, and a bunch of other things that sounded like pretty terrifying physiological issues. When I went to see my Optometrist and told him about the disastrous state my eyes were in, and explained about the Keto, and going cold turkey on the sugars, and decided I needed to start learning braille, he just kinda looked at me and told me to relax. We went through the checkup and he told me everything was fine, I just had some new floaters and ocular migraines and new floaters were fairly common with big changes to the diet, or stress, or just living for more than a few minutes. He is also a big time nutrition and health guy, so we ended up talking about how amazing it felt being on Keto for close to an hour.
So when my wife relaxed enough to ask me which eye surgeon I wanted to see, I told her that if anyone knew what it was, or how to fix it, or where I could learn Braille, it was my Optometrist.
We got to the appointment, and my optometrist looked in my eyes for a while. He turned the blinding lights off and sat back.
“Stress,” he said.
Then he asked me why I was smiling like the cat with the canary, or the kid in the candy store, or the writer who just found a topic.
Hearing my eye doctor tell me that stress was the most likely cause of my eye issue really made me happy.
“Now I know what my next article is going to be about!”, I told him.
“What is it going to be about?”, he asked.
“This, I said.”
“What? This what?”
“This, this!”. And then I explained to him about Relazation. And you know how something surprises you without being particularly surprising? He did that to me by explaining to me about the prefrontal cortex and the amygdala and the impact it has on vision and vertigo. Which is what I was feeling, I just didn’t know I knew the word for it. And so I was like, “oh, so Sarge is responsible?” and he was like “who?” and then I told him about my articles and we had a laugh and…well, I get carried away.
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If you’ve been following along, you know the Sarge. He’s the amygdala (in my cartoon world), and is a part of the brain deep in your limbic system, ancient and fast and completely uninterested in nuance. His job is to fire the alarm. He doesn’t ask whether the threat is real. He doesn’t distinguish between a tiger and a passive-aggressive email from someone you work with. When the Sarge has been running the alarm for a long time, even at a low, just above background noise level, cortisol builds up. And cortisol effects you all over. It drives vasoconstriction. Blood vessels narrow. The optic nerve and the retina are sensitive to changes in blood flow. That is my dimming.
Cortisol also disrupts serotonin, which lowers the threshold for cortical spreading depression, the actual clinical name for what happens during an ocular migraine. A wave of electrical silence across the visual cortex. That is why the light does strange things.
And stress hormones hit the vestibular system directly. Cortisol receptors live in the inner ear. If the floor has ever tilted on you during a high-stress period, that’s why. The Sarge was on fire and vertigo was my result.
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My optometrist wasn’t telling me I was broken, he was telling me my body had been generating noise for a while, and the volume finally got high enough to see. Or not see, in this particular case. This is what living with anxiety actually looks like sometimes. Not a panic attack. Not a breakdown in the middle of a meeting. Just a Monday afternoon when you go to the Optometrist for a major medical emergency and find out your nervous system has been trying to get your attention for weeks.
The question isn’t how to stop the Sarge from doing this. He is going to do it. That’s his job. The question is whether you start reading the signs earlier. The ones that arrive before the ocular emergencies do.
The tight jaw you stopped noticing because it’s always there. The shallow chest breathing you’ve been doing since last week. The tension that has been living between your shoulder blades since that talk with your boss. The body has been sending smoke signals. The vertigo is just what happens when you stop checking the skies for long enough.
Living with anxiety means getting better at reading the early dispatches. Not eliminating the Sarge. Not forcing yourself into calm. Just catching it sooner, when the cost of not hearing it is still small. Lao Tzu, author of the Tao Te Ching, said it best when he said to take care of the big things when they’re little. It’s much easier to pull up an acorn than a giant oak.
> “Confront the difficult while it is still easy;\
> accomplish the great task by a series of small acts.”
Here’s the good news: the same mechanism that helps the vagus nerve helps with vasoconstriction. The slow exhale directly counters cortisol’s effects. Longer on the way out than on the way in. The parasympathetic system engages, cortisol eases, blood flow normalizes.
But the bigger practice is earlier than the exhale. Before the vertigo. Before the dimness. A body scan isn’t meditation for the seriously committed, it’s just asking: what do I sense right now? What has been on overload? Where am I holding something I didn’t even notice I was holding?
It just takes sixty seconds.
> Start at the top of your head and move down slowly. Notice sensation without trying to change anything.
> Scalp and forehead: any tightness? Jaw clenched?
> Shoulders: where are they? Usually higher than you think.
> Chest: shallow or full?
> Belly: held in or soft?
> Hands: gripping something?
> Feet: can you feel the floor?
The Taoists have been doing this for over 2,000 years. Be still, get quiet, listen to your body before it starts yelling. And they didn’t even need an optometrist to suggest it.
Unlike me, I guess. Still learning. Am I getting better? I don’t know. I hope so.
Slow down. Be quiet.
— R