#vagus nerve dysfunction

[oliveasaltylife]

I want to write a thoughtful and informative post about Chiari for Chiari Malformation Awareness Month, but I am so fucking exhausted from this condition (paired with tethered cord & co) that I can't even fully form my thoughts.

I am constantly trying to correct my posture throughout the day to hopefully ease the pulling sensation that comes from the base of my skull, but that only does so much. I try to find resting positions to help with the cramps and knots in my neck, but I have less than a handful to choose from. If I have my head down (looking at my phone for example) for too long, my face and eyelids start to feel droopy, my vision gets fuzzy, I become tachycardic, and often feel fuzzy and faint--I've been told this is likely because something is effecting my brainstem and/or compression of vasculature in my neck. I have constant tingles and less feeling in the right side of my face/head/mouth that intensifies without warning, but also after activities like sitting still for an hour while I get diagnostic imaging done. Sometimes the tingling turn to shooting pain that goes through my teeth and I can't close my mouth. I have had migraines since I was in elementary school, that have progressed to daily--possibly even one long migraine--since college.

Lifelong symptoms for conditions that have only progressed because medical "professionals," and even my own parents, never took me seriously. Ignorance and arrogance in the medical field allow conditions like Chiari to be systematically overlooked because it's considered to be "rare," along with a number of other disabilities and even comorbidities. Chiari is not rare, it's rarely diagnosed. And even when it is diagnosed, too many physicians put too much weight into the size of the herniation being the determining factor in the severity of symptoms and/or pain their patient is experiencing. SIZE DOES NOT MATTER.

There are also too many physicians who are unaware of the necessity of distinguishing if the Chiari is congenital or acquired due to other conditions like tethered cord, AAI/CCI, spinal cord injury, etc. Addressing what caused, or is contributing to, the herniation is the safest way to proceed in treatment, gives the best chances for a better outcome, and the best possibility for managing symptoms.

TLDR; living with Chiari and related conditions SUCKS SO MUCH

[helenwhiteart-blog]

Cervical instability at the core of fibromyalgia?

I just want to pick up the thread of cervical instability and its relationship with chronic pain again, as written about just the other day in the context of covid (having found numerous suggestions that covid can aggravate or even instigate cervical instability). In particular, I want to look at how this one, often unnoticed, structural issue might very well be lurking there right at the very…

[stephjacq]

2023.10.02 Baba Yaga’s hut

Spooktober Art journal prompts

[whereonceiwasfire]

If you're game to write a cheese melt (Vlad & Dani father-daughter dynamic) ficlet, I'd love to read one. If not, that's cool :)

*vibrating with excitement* My friend. Your cheese melt art has been living rent free in my head for WEEKS. It's my sincerest pleasure to write a ficlet for this. I hope it's okay that it's an outsider POV, I just had an idea and my brain went brrrrrrr LOL

May I offer you a dysfunctional parent-teacher interview?

Parent-teacher interviews are always a nightmare, but there's one in particular that’s making Amity Middle School’s beloved Ms. Burnell sweat through her shirt. As the time slot nears, her gaze keeps flickering to the clock, her classroom door, back to her nervously interlaced fingers on the desktop.

It’s going to be fine. Perfectly fine.

“This one! Over here! Dad! This is my class!” The excited words, shouted in the syrupy sweet voice of a little girl, sets every nerve on edge, Ms. Burnell’s heart plummeting straight into the pit of her stomach.

Oh lord. Maybe it’s not going to be fine. 

Her student comes bounding into the classroom, eyes bright and excited, oversized blue sweater sleeves slipping over her hands, even as she gestures emphatically for her father to follow. Black hair spills out of her ponytail, whipping across her face as she throws herself into a desk across from Ms. Burnell’s with a bright smile. 

Her father, on the other hand… 

The heel of his expensive Italian loafers strike against the linoleum as the man stops at the threshold of the classroom, cool gaze doing an assessing sweep of the space, expression crinkling in distaste as it does. He doesn’t say a single word, doesn’t make any move to actually step inside the classroom. 

Ms. Burnell is the one who clears her throat, pushing to an awkward stand as she extends a hand out to the man. 

“Hello, Mr. Masters. Thank you for making the time to come discuss your daughter’s education. I know you’re very busy.” 

The man’s eyes slip to her outstretched palm, and for a motifying second, she doesn’t think he’s going to take it. When he finally does, he just gives a brief, cursory shake before swiping his palm off on his suit jacket and striding past her toward his daughter. 

Ms. Burnell’s face is all kinds of warm, chest tight with embarassment as she fumbles back to her desk, trying to wrestle herself back into some kind of composure. Still, she barely looks up as she pulls out a folder with Danielle Masters scrawled across the tab.

“Dad! Dad! That one’s mine! Do you see it? Do you like it?” Danielle calls proudly, tugging on her father’s suit sleeve and pointing toward the paintings that are spread out beneath the windows to dry, paper wavy and crinkled.

“Oh, er. That’s actually a good place for us to start,” Ms. Burnell cuts in apologetically. 

Mr. Masters gaze snaps from where he’d been examining his daughter’s project, over to her, brows dropped low. 

“Why? Is there a problem with my daughter’s work?” The question is sharp, accusatory, and she’s pretty sure her soul shrivels up a little bit at the unguarded disdain in the man’s eyes.

Swallowing hard, sweat beading against the back of her neck, Ms. Burnell resists the urge to immediately take it back. Surely he can see the problem with the piece—isn’t going to make her say it? 

It's too scary.

When his challenging gaze doesn’t waver, she forces the words out. 

“Uhm. Well. It’s just. Not quite. Appropriate for a sixth grade class?” It pitches up into a question as she gestures vaguely toward Dani’s painting. 

It’s a bit sloppy, the layers of paint caked upon each other, the lines hasty and uneven, but the scene itself is clear enough—a little, smiling, white-haired girl in the shadow of some kind of hulking creature, its skin blue, eyes red, sharp fangs bared as its cape flares out to take up the rest of the page. 

Ms. Burnell almost set up an appointment for Danielle with the school counselor when she saw it, wondering if Dani felt like she was the little girl, trapped amongst nightmares and “monsters.” She decided against it for the time being, until she could speak with the girl’s father, but that’s proving rather unhelpful so far if the contemptuous way the man is looking at her is any indication.

“Did Danielle complete the assignment?” he asks finally. 

“Uhm. Yes.” 

“And adhere to the grading criteria?” 

“Sh-she did,” Ms. Burnell answers reluctantly.

“Then I don’t see the problem,” he answers, finality in the words as his gaze turns to his daughter. He takes a much softer tone with her, brushing the disorderly strands of hair off her face, an absent domesticity in the way he straightens the ponytail gone lopsided. “I think you did a lovely job, dear.” 

“Thank you! I used Alizarin Crimson,” she answers proudly, hair flopping right back into her eyes.

“Excellent choice.” 

“Uhm. Well, there’s also the matter of Danielle’s conduct,” Ms. Burnell cuts in.    

The man lets out an irritated sigh, arms crossing over his chest as he leans back against one of the desks, one ankle crossed over the other, unimpressed gaze finding Ms. Burnell once more. 

“What?” he says, like it’s an inconvenience.

She swallows hard. “She’s been…uhm. Not getting along with some of the other girls.” 

“That is so unfair, Mackenzie started it!” Danielle shouts abruptly, popping up to her knees on her chair, palms slapping down against the desktop. 

“Well that’s not what Mack—” 

The girl keeps going, cutting Ms. Burnell off. 

“She said the only reason Eli agreed to play with me at recess was because Joshua dared him too, and I said nuh unh and she said yuh hunh, and I asked how she knew that, and she couldn’t even prove it, it was so obvious she was making it up!” 

“Mackenzie told me that you said some pretty unkind words to her, Danielle.” 

“Barely! I just said it was a bad look for her to be so jealous of me and just because she looks like she fished her outfit from the same trash bin she got her personality from isn’t any reason to be a jerk.”

Her father’s expression twists into a sharp smirk, amusement lighting his blue eyes, and Ms. Burnell thinks she’s starting to get a better sense of why Danielle is proving to be one of the most challenging students in her class this year. 

“We treat people with kindness and respect in this classroom, Dani. Do you think what you said to Mackenzie was kind and respectful?” 

“Well…” Dani’s gaze drops, expression pinching in thought, and Ms. Burnell thinks she might actually be getting through to her.

“It doesn’t sound as though this other girl was treating Danielle with kindness and respect,” Mr. Masters answers, the words coming out with a mocking turn, like he finds the concepts incidental at best.

“That’s true. She did start it,” Dani reasserts, turning her gaze up to her dad.  

“I’ve spoken to Mackenzie about her part in everything,” Ms. Burnell answers tightly. “But we’re here to talk about Danielle’s conduct. That’s not the only incident of its kind that’s occurred this year and—” 

“You know, it sounds to me as though Danielle’s doing just fine,” Mr. Masters says, pushing up to a proper stand, tugging the bottom of his sleeves and smoothing the dark, wrinkleless fabric.

“But—” 

“Did she make this girl cry?” 

“Well. No, but—” 

“And how are my daughter’s academics?” he asks, gaze fixed on hers, sending a chill creeping down her spine. 

“Fine, but—” 

“Has she gotten into a physical altercation with anyone?” 

“Not exactly, but—” 

“Started any fires?” he asks, sarcasm and derision dripping from the words. 

“No, she hasn’t started any fires.” 

“Then I believe this meeting is finished. Thank you for your time, Ms…”

“Burnell,” she answers weakly.

“Thank you for your time, Ms. Burnell. Danielle, are you ready to go?”

“Yup!” She pops up to an enthusiastic stand, rushing over to the windows to snatch up her painting, twisting it toward Ms. Burnell. “Can I take this home?”

She gives a heavy sigh, massaging her temples with her fingertips. “Sure, Dani. That's fine.” 

“Thanks, Ms. B!” As the girl traipses after her dad, a bounce in her step, horrifying painting swinging at her side, Ms. Burnell can hear the girl still chattering away, even as they pass out of her classroom, voices growing distant. “Do you think I should have made Mackenzie cry?” she asks.

Ms. Burnell is glad she can’t hear the man’s response—she doesn’t even want to know his answer.

[on-a-lucky-tide]

i am here thinking again. what could be the moment that price catches nikolai off-guard for once? surely even the smoothest men can be caught lacking, eh?

Nik has an allergic reaction to viagra and gives Price a small fright.

cw: allergic reaction, erectile dysfunction

"Nik, ah, Nik, stop."

Price shoved Nik's shoulders and tried to shuffle up the bed from beneath him. Something wasn't bloody right. Nik was mute, none of the usual guttural moans, or slurred Russian filth, delirious with pleasure. Nik was vocal. It was part of the fun and it got Price goin' like little else.

Hell, this was the first time they had fucked in months due to a range of different reasons, from clashing missions to meetings to Nik's schedule, and Price was expecting Nik to be ravenous. Instead, he seemed to be struggling; his brow creased, his eyes foggy.

Nik slumped to the side, propped on his elbow, his big chest heaving. "John, is there... was something wrong?"

"Yeah, you, I'm worried... Nik, look at me, oi, look at me." Price grabbed Nik's chin and lifted his head from where it was tilted forward. "Bloody 'ell, you don't look right. Think it was the resta--? Nik? Nik!"

Nik stumbled from the bed, almost tripping over the tangle of blankets and pillows wrapped around his legs. He just about made it to the toilet before the expensive three course meal and the few glasses of Macallan they'd knocked back after became a wasted investment.

Price walked into the en suite after him, rubbing a warm palm over his back. "Ay, you're alrigh', deep breaths between." As Nik's body continued to seize and tense, Price looked the rest of him over. There were hives on the back of the hands grasping the toilet bowl and his skin was cold to the touch, clammy, not the flushed heat it should have been from sex. "Nik, 'm gonna call the infirmary."

"Nyet!" Nik near shouted into the toilet bowl, reaching out to grab Price just behind the knee before he could walk away. "Nyet, John... It will pass."

"Don't be a muppet. They'll give you a look over and make sure you don't need A&E." Price grabbed one of his travel mugs and filled it with water from the tap. Nik took it from him in a shaking hand and managed several gulps before slumping back against the wall, throwing the toilet seat down as he went. His chin fell to his chest, one forearm slanted across a raised knee.

"This... This is self-inflicted," Nik said. "I am already embarrassed enough."

Price squinted, sitting slowly on the toilet lid, nudging the flush down with his elbow. "Start talkin'. This ain't like you. And if I don't think you're bein' honest, I'm callin' Janie."

"She is the doctor who signed you off for your ACL surgery."

"The very same."

"I would be in trouble."

"Yeah, loads. Stop delaying."

Nik sighed, pressing his fingers into his eyes before his palm flattened to his chest. Price could see the flush of shame up his neck, the way his eyes stayed fixed on the floor rather than look up as he spoke. "I have an allergy to sildenafil."

Price wracked his brains and then huffed an incredulous laugh. "Viagra, Nik, I..."

When Nik turned his face away, swallowing, Price wanted to kick himself with steel toe-capped size twelves for being an arsehole of a partner.

"Ay, ay, don't... I'm sorry, that was... I was just... Why the fuck are you takin' viagra?"

Nik's jaw twitched from where his teeth were clenched, and he wiped one big hand down his face. The shame rolling off of him was palpable. "I am having... problems."

"Are they... Are we talkin' life-threatening problems?"

"Nyet. I simply cannot... it will not... you know," Nik waved his hand vaguely, "I... I was screened for some things. They said perhaps it is nerve damage from some shrapnel in my back, or perhaps it is all in my head, but I am... too ashamed to pursue more."

Price slipped from the toilet to sit at Nik's side against the wall, gently sliding his hand into the one dangling over his knee. Nik always spoke openly about sex, about their relationship, chuckling when Price squirmed and blushed like a prude. To watch him fumble and close up made Price's heart ache. "Why'd ya not tell me?"

Nik huffed dismissively, still looking away. "Da, how to say to your handsome, vigorous partner that you are unable to satisfy him in bed? That your body is... useless. That you are less than a man."

"Oh yeah, so the obvious solution is to take viagra, which you are violently allergic to. Absolute banger of a solution, Nik. Top marks," Price squeezed his hand, "and all this B.S. about bein' less than a man? Wind it in. It's bollocks."

"Zatknis, John..."

"Yer a smart man, Nik. But sometimes yer a..."

"...Muppet."

"Yeah, one of those," Price growled. "Yer seein' Janie in the mornin'. Not just for the allergy, for the lot."

"John, I cannot, it--"

"It could be a lot of things. Some of them more dangerous than others. Mine was stress."

Nik looked up quickly. "You have...?"

"Oh yeah. Mine stopped workin' fer about seven months five years ago. Coincided with a few large scale international fuck ups, a crammed schedule, an injury and some physio. Couldn't get it up fer the hottest piece of arse on Grindr, even if ya paid me."

"I did not know..."

"Course you didn't, we weren't exactly bumpin' uglies back then, were we?"

Nik smiled. "You have such a way with words..."

"Mhm." Price stroked his thumb over the back of Nik's hand, studying his face carefully. "You solid? No tight throat? You can breathe? There's an epipen in the first aid kit in the hallway."

"I am fine. This... It was similar when I tested it, but without the--" he gestured at the toilet, "my breathing is fine. I would... like to go to bed."

"Course." Price climbed to his feet, grunting at the clashing sensation of clicking knees and a numb arse, before helping Nik do the same. "Brush yer bloody teeth so I can kiss you."

Nik huffed softly. "Da."

When they climbed back into bed, Price kissed Nik gently, and then gathered him to his chest. Nik rested his ear over Price's heart and Price stroked his fingers through his hair. There was no fuckin' way he was sleeping that night. He'd stay awake and watch Nik sleep, listening to his slow breathing, checking the pulse at his neck. In the morning, he would let Janie eviscerate him for being so laissez faire with his health.

Then, and only then, they were gonna have a long chat about honesty, openness and trust. Cause knowing that Nik would rather poison himself than 'fail' Price in any way - regardless of how legitimate Nik felt that belief was - left Price with a sick feeling in the pit of his stomach.

[max1461]

does it feel any more caesarean now

It feels like there's (in addition to partial seizures) something wrong with my vagus nerve, because I also can't vomit, yawn, or orgasm, which all involved said nerve. Well see I can start to do those things, but they get half way through and then stop, they don't complete. Very unpleasant on its own, but worse is that evidently the vagus nerve is also responsible for activating calming the brain when activity gets too high i.e. helping to prevent seizures, so this is presumably making the seizures worse. The doctor said I've probably always had mild TLE and something about the dentist visit set it off and made the symptoms much worse. I lowkey hypothesize, granted with no medical knowledge, that what happened is that the anesthetic drizzled down and fucked with my vagus nerve (I have various circumstantial pieces of evidence in terms of the pain I felt in my neck and so on), and that this allowed my preexisting seizure disorder to run wild. Doctor thinks it's the other way around, vagus nerve fuckery is a product of the seizures. If vagus nerve dysfunction is the prime mover here I'm looking for a way to treat it so if anyone has thoughts about that I'd be open to hearing them (of course I will run them past my doctor first).

Yeah one of the nonstop symptoms of this has been that my GI tract has like stopped fucking moving I literally only want to eat liquid foods because I have no sense of hunger at all even after two weeks and no sense of a need to poop. So. That's rather "caesarean" isn't it, the caesarean section, where they cut the baby out, it's like that.

[ineffablelara]

Loki's dysfunctional family

"I don’t want to hear your riddles and your vague excuses for him, I want the truth. Answer me!"

This is from wml, I consider the book to be its own canon but still, I think this sums up Loki's relationship with Frigga very well, he loves her and she loves him but her priority is always defending Odin, even if she has to lie to Loki to achieve that, she also created this persona where she is the wise, all-knowing queen who always knows better than everyone else, I love how it's the one thing that all the movies that feature her got right, she's probably the most consistent character from all the Thor movies bc she always behaves and speaks in the same way: "You're a little foolish child but I love you and I also know better than you'll ever know so just listen to me for I am you mother and I'm wiser than you"

Like, even in a deleted scene from the first Thor she displays this slightly narcissistic behavior (I didn't want to use the word narcissistic bc that migt be a bit extreme but rn I can't think of another word, please don't think I'm calling her a monster or something, I just think she displays a little arrogance in ways that can be considered funny, playful or harmless sometimes)

"Thor, just remember, you have something even the great Allfather never had" "What is that?" "Me for a mother, now don't keep you father waiting"

"Always so perceptive about everyone but yourself"

"You're no idiot, you're here aren't you? Seeking counsel from the wisest person in Asgard"

This is just from the movies, in the official tdw novelization she has a conversation with Jane that happens after the "don't let him hear you say that" scene that goes:

“I can’t remember the last time Thor brought a friend home to meet us,” Frigga said to Jane. “When a young man brings a young woman home to meet his parents…” Frigga began, implying a possible marriage between Thor and Jane. “Technically, I think we have only known each other for three days,” Jane said, surprised to be having this conversation so soon. “And if it were three million, would that change how you feel?”

This last one always makes laugh bc... girl I really don't know if my feelings for a man I met three days ago would remain the same after three million years, was that really supposed to sound wise and reasonable? lmao okayy

And the "Always so perceptive about everyone but yourself" one kinda makes me uncomfortable bc it sounds patronizing, this might just be my own traumas speaking but telling someone that they don't know how they feel but you do always strikes a nerve , it makes me so angry bc who are you to tell me that I'm wrong about my own feelings?

And also, is Loki really not perceptive about himself? Really? Is she going going full Thor with the "imagined slights" thing?

This is what bothers me the most about Loki's family dynamic, they NEVER take him or his complaints seriously, they always downplay his grievances to make him sound ungratefull or overly dramatic and this is one of the most hurtful things you can do to a person imo, Loki voices a discomfort he has with something about their family and they instantly try to silence him or make him feel bad for complaining, that's why I'm glad he started to stand his ground with her in the prison scene

I think he then understood how alone he truly was, Frigga didn't exactly wanted to hear what he had to say nor did she try to understand him and his motives for doing what he did, she just wanted him to accept that Odin was indeed his father, a great King who did no wrong and they were a perfect family

And this doesn't happen just with Frigga, Thor participates in that too and their behavior almost reads to me as gaslighting sometimes, there's a scene in wml that always stuck with me:

Thor let out a heavy sigh. “I don’t know what it is that I have done,” he said, his voice softer than usual. Loki snorted. “Oh, please.” “I’m trying to apologize.” “And yet you can’t even work out what for, so I don’t think it counts.” Thor stared at him, his hands working in and out of fists at his side. Loki braced himself, ready for Thor to strike something, possibly him, but instead he said, his tone soft with hurt, “You are so determined to despise me, aren’t you?” It would have been better to be struck. Loki flinched as though he had been. “I don’t—” But Thor held up a hand. “Spare me, brother. Whatever you hold against me, whatever I have done to wound you, I hope you know that I am not your enemy. I want to fight by your side, not against you.”

For those of you who haven't read the book here goes some context: (ohh and obviously this contains spoilers so be aware)

Loki and Thor were sent to a diplomatic mission in Alfheim and things got out of hand, Loki then came up with a scheme to turn things to their favor wich Thor promptly agreed, things obviously didn't turn well for them and they got caught, they were sent to Odin who demanded an explanation for their behavior, Thor then tossed all the blame on Loki, saying that it was all his idea and he had no choice but going along with it, Odin then scolded Thor and let him go and proceeded to HUMILATE Loki for his behavior and even insinuated that his son had a dark and evil nature and there was no point in trying to change that bc people can't change their hearts and who they really are deep down, Loki was really hurt after Odin's harsh words and Thor went to "apologize" to him, Loki was furious and said they could have at least shared the blame, but Thor said that he couldn't risk angering their father, Thor then says the first line of the dialogue I put here and well, I'm assuming you read the rest.

Like, I can't believe Thor's audacity in that book, he threw his own brother under the bus bc he was scared of angering Odin and then left Loki there, completely alone to face their terrifying father (they're both scared of him in the book, it's very clear), then he goes to his rooms with a half assed apology and expects Loki to just forgive him and his cowardice as if nothing happened and goes even further by saying that Loki just keeps trying to find reasons to despise him???

The worst part is: It works, Loki wishes that Thor had just striked him bc his words hurt more than a punch, nevermind that he was the one who just got betrayed, Thor finds a way to paint him as the bad guy and Loki buys it, istg they're so toxic, it's painful to read but at the same time I feel it's so accurate

Also, I'm not hating on Thor for behaving like that btw, yes it was fucked up and he was a coward but that's only a symptom of Odin's bad parentage, his influence destroyed any chance Loki and Thor had of being normal, loving siblings, they were so terrified of him that they were willing to do anything to stay on his good graces, even if that meant betraying each other

Ans my point is, Loki's family is used to turn his words and actions against him, even if they're not aware of what they're doing, they manipulate him to invalidate his feelings and that only alienates him further from them, he gets more and more alone bc no one ever tries to show him genuine understanding and compassion, they only ever have accusing words for him and make him feel like he's a monster for criticizing them and their crappy behavior, he knows that he can't count on the two people he loves the most (Thor and Frigga) to share his pain and suffering so what does he do? He drowns in his own sorrow and heartbreak and lets those negative feelings fester inside him bc he has no one willing to listen to him, willing to be a friend

That's part of his tragedy, stuck in a toxic family that makes him feel awful for daring to complain about their behavior and spending his whole life without ever making a real friend (I mean, OG Loki at least), always isolated, always misunderstood, vilanized by the very people who claimed to love him, and I mean, if his own family thought he was a monster how could he allow himself to show vulnerability to others? They would hate him even more right?

And just like that Loki stayed stuck in his toxic family for nearly his whole life, bc he was unable to let himself be seen by others, the irony I think, is if he left them he would see how fucked up they were and would surely break free from their toxicity but his fear of being misunderstood kept him chained with them forever basically, and the longer he stayed the worse his self esteem got, and the worse his self esteem got the longer he stayed.

Thanks for reading all this, I don't think I ever yapped that much about Loki but I really could spend a whole day talking about his dysfunctional family lol

[covid-safer-hotties]

An interesting perspective article about Long Covid

Should we be fighting gene damage instead of individual symptoms?

The pathogenesis of long COVID (LC) still presents many areas of uncertainty. This leads to difficulties in finding an effective specific therapy. We hypothesize that the key to LC pathogenesis lies in the presence of chronic functional damage to the main anti-inflammatory mechanisms of our body: the three reflexes mediated by the vagus nerve, the hypothalamic-pituitary-adrenal (HPA) hormonal axis, and the mitochondrial redox status. We will illustrate that this neuro-endocrine-metabolic axis is closely interconnected and how the SARS-CoV-2 can damage it at all stages through direct, immune-inflammatory, epigenetic damage mechanisms, as well as through the reactivation of neurotropic viruses. According to our theory, the direct mitochondrial damage carried out by the virus, which replicates within these organelles, and the cellular oxidative imbalance, cannot be countered in patients who develop LC. This is because their anti-inflammatory mechanisms are inconsistent due to reduced vagal tone and direct damage to the endocrine glands of the HPA axis. We will illustrate how acetylcholine (ACh) and cortisol, with its cytoplasmatic and cellular receptors respectively, are fundamental players in the LC process. Both Ach and cortisol play multifaceted and synergistic roles in reducing inflammation. They achieve this by modulating the activity of innate and cell-mediated immunity, attenuating endothelial and platelet activation, and modulating mitochondrial function, which is crucial for cellular energy production and anti-inflammatory mechanisms. In our opinion, it is essential to study the sensitivity of the glucocorticoids receptor in people who develop LC and whether SARS-CoV-2 can cause long-term epigenetic variations in its expression and function.

[azulcrescent]

Hi Azul! :) I started following your silly scribbles about a year ago, and seeing Cheryl model how she came out to her friends and family in the comic helped me articulate my gender experience better with my wife and even come out to my friends and family. Thanks for sharing your art! I also wanted to say that I'm sorry that you're experiencing poor sleep and burnout lately. :( Those can make you feel awful. I've had a chronic illness for the past six years -- and I'm fully aware that's something separate, nor do I want to equate it with your experiences -- but, at risk of giving any unsolicited advice, I do wish someone had said something to me about this when I first felt those as well. Because I was pushing myself to work for 2 hours a day as a special education paraprofessional in a wheelchair due to fatigue and systemic dysfunctions throughout my body -- so I had to quit my job since I was making my health even worse. When I stopped working, I was fully bed bound for a time but even still kept pushing myself to attempt grad school online despite only being able to sit up for 5-10% of the day. My point is that, even when our bodies are burnt out, we still push ourselves because that's generally just our human nature to do. And I wish that during that time someone had gently said it's okay to slow everything down and listen to what my body was telling me it needed.

With slowing down, I also get that finances are a thing, and I wouldn't have been able to recover from severe to moderate ME/CFS without my wife working her butt off for us to cover medical expenses by switching jobs and upskilling. (She jokes that she has no more butt anymore because of those years :'(... )

So, although this is stepping into unsolicited advice, but as someone who was burnt out and constantly eepy for years, I feel like it would be remiss of me to not try to say something and just give a bullet point list of free things that helped my nervous system not be so overstimulated and tired but wired that I couldn't sleep and even when I did it was unrefreshing and yucky to wake up the next day:

•Search for "ally boothroyd yoga nidra" on YouTube and pick a 10 minute video •Do belly breathing to expand the diaphragm (one of the few ways we can give input to our parasympathetic nervous systems -- the rest, digest, and heal system) •When breathing, breathe in for 4, hold for 4, out for 4, hold for 4, repeat to tell your body it can be calm •Spinal flossing in bed: start from your lowest vertebrae you can, try to isolate it with your muscles, and shift it up down left and right, then go up to the next one •Listen to how your body responds to foods: maybe try cutting out gluten and refined sugars for a week to see if it helps in any way; a lot of our immune system is in the gut, and being in a stressed state can cause our immune systems to mistake food molecules for pathogens which then activates the immune system and turns off the parasympathetic nervous system •Drop your jaw fully open like you're going to yawn, then stretch your tongue upward outside your mouth as far as it can go and stretch it around. This is a stretch for the muscles near your vagus nerve near your ear/neck behind the jaw to help them relax •Plan a bedtime routine for the thirty minutes before you go to bed and be consistent •Brain retraining: When you feel stressed or anxious about sleep or being burnt out, compassionately tell yourself "Stop, stop, stop." Thank that part of you for bringing up its concern, then remind that part of yourself that it doesn't need to worry anymore because you are working on recovering and healing. And if the insomnia or fatigue do happen, you have plans for what to do and will be okay. •Remember the conclusion from the American TV show Mythbusters: https://www.tumblr.com/gretchensinister/678474387179077632/one-of-the-most-life-changing-things-i-ever You're still getting rest even if you just close your eyes. You've talked about having ADHD, and while I don't have it, I get that it messes up brain chemicals and can contribute to both insomnia and burn out. There might be a reddit discussion that speaks to you better about medications or deficiencies. I hope you get to rest. Cheering for you. It's always fun to see your art. Thanks for what you do! :) Sleepy cat tax:

Glad to hear you like my comics! And thank you for the very informative and helpful info on sleeping better! Ill try to put your advice to use!

[crippleprophet]

forgive me for the question, but do you know what counts as a subluxation? my SI joint frequently needs to be popped when it’s painful and feels weirdly “out of place” when it does so, but i always figured an actual subluxation would be way more painful than what i experience LOL

so what a subluxation looks like / “counts” as can to a certain extent vary depending on the joint, but pain with a feeling of something being out of place are imo the key signs of a subluxation. remember that this is a smaller movement out of place than a dislocation so you aren’t dealing with the same extent of damage (tendon & ligament tears, greater nerve damage, etc) that would cause the type of severe acute pain you’re thinking of.

not that subluxations can’t be very painful! but for me (obv this is just anecdotal) the vast majority of my si joint subluxations aren’t a sharp, acute pain but a dull, vague, intense ache or offness that i often don’t realize how bad it is until i do a lumbar extension stretch or something similar. for years the only recognizable symptoms of my si joint dysfunction were knee pain & migraines (both of which had other causal factors as well but improved/worsened in tandem with relocation/subluxation).

a surefire sign of si joint subluxation is if it feels like something in your lower back that’s “out of line” is physically blocking you from standing upright at the hips. i’ve only had this issue severely/significantly twice, with a handful of more minor times, so it’s definitely not a requirement though!

relatedly, si joint dysfunction is often worsened by sitting upright, so if you recognize worse pain, stiffness, out of place ness, etc after standing up from sitting in a chair that’s probably what’s happening

the si joint is not supposed to have much movement so imo it’s safe to assume you have some sort of si joint dysfunction going on! it’s super common in ankylosing spondylitis but also can occur with any kind of more generalized hypermobility.

i’ve been meaning to make a post about the stretches i do because i’ve modified some for accessibility but until i get that up feel free to dm me for the sources i use! there are a lot of good sets out there if you just look at si joint dysfunction articles, i’d just suggest really going gentle & staying within your limits because i once herniated a disc trying to get my si joint back in place & let me tell you that was Worse.

an si belt has been absolutely lifesaving for me. started typing up my other product recommendations but it got so long i’m gonna make it its own post 😂 anyway best of luck to you i hope that was helpful!!

[macgyvermedical]

Okay I'm a whump fan and nursing student, and this seems like a dumb question but I cannot find information fucking anywhere. How do spinal fractures/nerve damage only paralyze the skeletal muscles and not cause organs to stop working? Is there a specific type of injury or point in the spine that's the dividing line between death and paraplegia? Also, is there anything that works in reverse? Either a smaller injury or medication to the spine or nerves. The area being numb or not and skeletal muscle control don't matter as long as the organs and nervous system communication required for life are stopped

The short answer is that it is very common to have some level of organ dysfunction after a spinal injury. Some vital organs just don't need the brain to tell them what to do to be effective, or rely on other signals, such as hormones or the vagus nerve to transmit those signals instead of the spinal nerves.

For example:

The heart needs signals from the vagus nerve, but that exits the skull at a different place than the spinal column, so it is usually unaffected in a spinal injury.

The kidneys and liver are mostly controlled via hormones.

The stomach gets some nerve supply from the vagus nerve, but some from the T6-T9 area of the spine. The stomach may be weakened if a spinal cord injury is higher than T6.

The rest of the gastrointestinal tract and bladder is affected by just about any spinal injury, though whether this is an inability to pass stool or stooling without meaning to depends on where the injury is.

Lungs/diaphragm are controlled at the level of C8 and above, causing difficulty or weakness in breathing.

Spinal cord injuries come in 2 main types: Complete and incomplete.

Complete spinal cord injuries mean generally that the spinal cord has been severed and most or all signals have been stopped. This is usually a loss of sensation, muscle control, and possibly a problem with smooth muscle tissue like that in veins and arteries (causing low blood pressure).

Incomplete means the spinal cord has been torn or otherwise injured but some nerves can still send signals to areas below the site of injury. Incomplete is more of a choose your own adventure writing-wise, since it might mean there is movement but no sensation, sensation but no movement, some organ dysfunction, or a combination.

Having a vertebra break doesn't necessarily mean the spinal cord will be injured, but it does mean it is more likely.

The following are common consequences of complete or near-complete spinal cord injuries:

C1-C4: "neck down" paralysis, difficulty breathing on own, difficulty urinating or defecating on own, difficulty speaking. trouble with maintaining blood pressure.

C5-C6: "Shoulder down" paralysis. Weak breathing but able to breathe and speak on own, difficulty urinating and defecating. Trouble with maintaining blood pressure. Can raise arms and bend elbows, difficulty moving hands and wrists.

C7-C8: "Armpit down" paralysis. Potentially weak breathing, able to use arms and hands, sometimes able to drive an adapted vehicle, may be able to transfer from bed to wheelchair, trouble maintaining blood pressure, bowel or bladder must be managed with catheter, medications, etc..

T1-T5: "Belly down" paralysis. Breathing is intact, but may not be able to hold themselves up due to weakness of back and abdominal muscles. Trouble maintaining blood pressure. Bowel or bladder must be managed with catheter, medications, etc..

T6-T12: "Pelvis down" paralysis. Can probably hold themselves up in a wheelchair, may walk with braces or walking frame, bowel or bladder must be managed with catheter, medications, etc..

L1-L5: "Buttock down" paralysis. May have difficulties with bowel and bladder that can be managed with incontinence supplies, may be able to walk with braces or walking frame, may have some specific movements in legs.

S1-S4: "Buttock down" weakness. Difficulties with controlling bowel and bladder that can be managed with incontinence supplies, probably able to walk with braces. Depending on level of injury may have some leg movements but not others.

[this-is-me19]

Anxiety or Postural Orthostatic Tachycardia Syndrom (POTS)

I have no idea how to tell the difference right now.

Normally, my POTS has other symptoms, such as dizziness, lightheadedness, chest pain or tight chest, while my anxiety makes my brain go nuts with bad or intrusive thoughts and makes my chest just feel restricted as if I have all this pressure around and over my heart.

I’ve been stuck in a funk since yesterday evening that I didn’t realize until I took a cool shower today and had to do it twice within a few hours of each of them.

I didn’t notice the brain fog and general foggy grumpiness of my brain that makes thinking hard and rather negative until the second shower because I felt I could finally think.

I hate this.

Packing to move sucks.

I honestly can’t tell which is causing it since POTS is a dysfunction of the…vagus nerve…electrical aspect of the cardiovascular system…and I have general anxiety disorder. Ugh.

[protected-and-loved-by-castiel]

In basic introductions to polyvagal theory, we learn about 3 nervous system states - safe and social, fight/flight, and freeze/shutdown. The safe and social state involves the Ventral Vagus nerve, the fight/flight state involves high activation of the sympathetic nervous system, and the freeze/shutdown state involves high activation of the Dorsal Vagus nerve.

From this simplistic explanation, it is easy to assume that engagement of the Dorsal Vagus nerve is something to be avoided. I have received emails asking “Is Dorsal the bad one?” and “What can I do to get out of Dorsal activation?”

I realize that some of the ways I have presented polyvagal info in the past contributed to this misunderstanding, and many of the sources I have referred people to have further solidified this false idea that Dorsal is bad.

In this post, I want to honor the Dorsal Vagus for its fantastic ability to multi-task, and I hope that by the end, perhaps your view of this nerve will have shifted.

DORSAL REST is a state of dorsal vagus activation that is supported by ventral vagus activation. The activation of the ventral vagus moderates the activity of the dorsal, so that the body system does not go into a freeze/shutdown state.

In this mixed state, we feel low energy or immobilization that is tolerable and not distressing. This state allows the body to rest and rebuild after injury, to properly digest food and absorb nutrition, to access meditative or spiritual states, and to sleep. With the help of the ventral vagus, the dorsal vagus offers us restoration, rejuvenation, and healing.

This is possibly the most important vagal state to know about for long-term trauma recovery, for long-haul covid recovery, and for all of us who have just hit the “pandemic wall.” Our bodies require regular activation of the dorsal vagus to heal from normal wear and tear and more frequent activation of the dorsal vagus to heal from trauma.

When we run on high tone sympathetic energy for a long time (months to years), our adrenal resources become depleted. When we eventually crash, we flip from high energy anxiety and hypervigilence to exhaustion and loss of interest in high energy activities. If we cannot access safety at this point, we will become depressed, and the depression will last until we are able to access a sense of safety or refuge somewhere.

Sometimes the stories we tell ourselves or each other about being low energy are the biggest danger cues in our environment. Our society has labeled being low energy as lazy, incompetent, childish, and dysfunctional. When our self-talk is blaming or shaming us for being low energy, our bodies are less capable of using that low energy time for healing. Self-talk is of course not our only barrier to safety, but it is one of the few that is within our control.

Embracing Dorsal Rest has allowed me to better cope with PMDD, a cyclical type of depression that involves severe mood drops just before my period. Those 5-7 days each month still suck, but they suck a little less now that I understand low energy phases are a natural and normal part of my body’s self-healing process. I find that shifting my self-talk changes my experience of how distressing these low energy phases are for me. Thus I have been trying to reframe “sickness behaviors” as “healing behaviors.”

Here is my current list of 100% healthy “healing behaviors” which I find necessary when I am immobilized by my Dorsal Vagus…

Nesting & Naps

Comfort Food

Time and Space Alone - sometimes we need isolation to recharge

Low energy activities - listening to music, watching Netflix, reading, coloring, meditation, visualizations, breathwork, prayer, yin yoga, constructive rest, visiting with internalized others (inner mentor, inner child, etc)

Sensory Defenses - shades drawn, headphones on, humidifier, soft blankets, temp set to a comfy range, etc etc

Doing “nothing” - day dreaming, spacing out, losing time

If I shame myself for any of these, I quickly find myself out of DORSAL REST and into DORSAL FREEZE.

I hope that this post gives you some permission to be slow and restful and know that this is exactly what your body needs.

.

.

.

🧠 This is part 1 of 2 in an essay titled, Dorsal Rest: The Most Important Polyvagal State for Coping with On-Going Trauma, which is posted at my blog.

.

.

.

If you want to learn exercises that can help us move from dorsal freeze to dorsal rest, check out my 12 month mini course: 50 Vagus Exercises in a Year.

Details here: https://traumageek.thinkific.com/courses/50-vagus-exercises-in-a-year

[kamini-vidrawan-ras-tablet]

Gut Health: The Microbiome Connection

Gut health has become a hot topic in recent years, and for good reason. The health of our gut affects not only digestion but also our overall well-being, from immunity to mental health. At the center of this fascinating connection is the gut microbiome—a complex community of trillions of microorganisms, including bacteria, viruses, fungi, and other microbes, that live in our digestive system. This invisible ecosystem plays a pivotal role in our health, and understanding its impact can unlock new approaches to prevent and treat a wide range of conditions.

What is the Gut Microbiome?

The gut microbiome refers to the diverse population of microorganisms residing in the human digestive tract. In fact, these microbes outnumber human cells by a factor of 10, and together, they contribute significantly to the processes that keep our bodies healthy. While the majority of these microbes are beneficial, helping with digestion, nutrient absorption, and immune function, some can be harmful if they become imbalanced.

This microbial community is highly individualized—each person’s microbiome is as unique as a fingerprint, shaped by factors like genetics, diet, lifestyle, environment, and even the birth process (vaginal vs. C-section). Because of its complexity and individuality, the gut microbiome has been the focus of extensive research in recent years, revealing how crucial it is for maintaining overall health.

Gut Microbiome and Digestion

At the most basic level, the gut microbiome is instrumental in breaking down food and extracting nutrients that our body cannot process on its own. Certain bacteria in the gut break down complex carbohydrates and fiber into short-chain fatty acids, which provide energy to the cells lining the intestines and promote gut health. Additionally, these microbes aid in synthesizing essential vitamins, such as Vitamin K and certain B vitamins, which are crucial for metabolic processes and overall health.

When the balance of beneficial and harmful microbes in the gut is disrupted, known as dysbiosis, it can lead to a variety of digestive issues, including bloating, diarrhea, constipation, and even conditions like irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). Maintaining a healthy gut microbiome is, therefore, essential for optimal digestion and nutrient absorption.

The Microbiome’s Impact on Immunity

The gut is often referred to as the “second brain” or the "first line of defense" because it plays a central role in immune function. Approximately 70-80% of the immune system resides in the gut-associated lymphoid tissue (GALT), which includes the mucosal lining of the intestines. This means that the health of the microbiome directly influences the body’s ability to fight off infections and manage inflammation.

A healthy gut microbiome helps maintain the balance of immune cells, preventing overactive immune responses (which can lead to allergies and autoimmune diseases) and underactive responses (which leave the body susceptible to infections). Studies have shown that an imbalanced microbiome can contribute to immune dysfunction, making it easier for harmful pathogens to invade and trigger inflammatory responses.

Gut Health and Mental Well-being: The Gut-Brain Axis

One of the most exciting and emerging areas of microbiome research is the connection between gut health and mental health, often referred to as the gut-brain axis. The gut and brain are closely connected through the vagus nerve, a major communication pathway that allows signals to flow in both directions. This means that the state of the gut microbiome can influence brain function, mood, and behavior, and vice versa.

Research has found that an imbalanced microbiome can affect the production of neurotransmitters like serotonin (the “feel-good” hormone), which is primarily produced in the gut. A disrupted microbiome may contribute to mental health conditions like anxiety, depression, and even neurodevelopmental disorders like autism. Conversely, improving gut health with a balanced diet, prebiotics, and probiotics has been shown to improve mood and cognitive function in some individuals.

How to Support a Healthy Gut Microbiome

Maintaining a healthy gut microbiome requires a balanced approach, combining diet, lifestyle, and mindful practices that promote the growth of beneficial microbes while reducing harmful ones. Here are some tips to help support your gut health:

Eat a Diverse Diet: A varied diet rich in fruits, vegetables, whole grains, and legumes provides different types of fiber and nutrients that feed beneficial gut bacteria. The more diverse your diet, the more diverse your microbiome will be, which is a key factor in promoting gut health.

Include Fermented Foods: Fermented foods like yogurt, kefir, sauerkraut, kimchi, and kombucha contain probiotics—live beneficial bacteria that can help replenish and strengthen your gut microbiome.

Add Prebiotics: Prebiotics are plant-based fibers that feed good bacteria in your gut. Foods like garlic, onions, bananas, asparagus, and leeks are great sources of prebiotics that help promote the growth of beneficial microbes.

Limit Sugar and Processed Foods: A diet high in sugar and processed foods can disrupt the balance of your gut microbiome, promoting the growth of harmful bacteria. Reducing these foods can help maintain a healthier gut environment.

Stay Hydrated: Drinking plenty of water is essential for maintaining the mucosal lining of the intestines and promoting the growth of healthy bacteria.

Manage Stress: Chronic stress can have a negative impact on gut health by triggering inflammation and altering the microbiome. Practicing stress management techniques such as meditation, deep breathing, and yoga can help restore balance to your gut.

Exercise Regularly: Physical activity has been shown to promote the growth of beneficial gut bacteria and improve the diversity of the microbiome. A moderate exercise routine can positively impact gut health.

Consider Probiotics: If your gut health is compromised, taking a high-quality probiotic supplement can help restore balance. Consult a healthcare professional before starting any supplementation to ensure it’s the right fit for your needs.

The Future of Gut Health Research

The research into the gut microbiome is still in its early stages, but it holds tremendous promise for the future of medicine. Scientists are discovering new ways that the microbiome influences health, from reducing the risk of chronic diseases like heart disease and diabetes to potentially offering new treatments for conditions like autoimmune diseases and cancer.

As our understanding of the gut microbiome continues to evolve, we can expect to see more personalized approaches to healthcare, with treatments and diets tailored to an individual’s unique microbiome profile. Do You Know KVR?

Conclusion

The gut microbiome is a powerful force in determining our overall health. From digestion to immunity, and even mental well-being, the trillions of microorganisms living in our digestive system are critical to maintaining balance and wellness. By understanding the microbiome’s role and adopting habits that support its health, we can take significant steps toward improving our quality of life and preventing a range of chronic conditions.

With ongoing research and growing awareness, we are just beginning to uncover the full potential of gut health. So, the next time you think about your health, remember—your gut may just hold the key to your well-being.

[butts-bouncing-on-the-beltway]

Circling back around to this one in the wake of my anti-psych posts:

A significant part of my personal "unmasking" process, and as part of trying to heal my dysregulated nervous system, has been learning what regulation looks like for me specifically.

I am learning that if I get restless, the answer is usually to get up, do something different for a while, and THEN circle back to what I was doing before. But what does "restless" feel like in my body?

Well, restless doesn't feel to me like it feels to someone with a regulated nervous system! To someone with a regulated nervous system, it may feel like boredom or disinterest. For me, it starts with this gradual fragmenting of my thoughts. They become harder and harder to articulate, as if they are foggy and uncertain, or as if I am struggling to recall words or complex concepts. After that, if I continue to force myself to focus on my tasks, I become fidgety, restless, and like. Itchy on the inside of my brain. Like there's a specific type of experience I need to "scratch the itch" but I can't think of or identify what it is and trying to focus on what it might be often makes the notion swim farther away in the currents of my mind. Continued focus then leads to irritability, confusion, exhaustion, and eventually, a shutdown of my ability to function at a basic level. And I truly mean that. I can't get up to use the bathroom, I can't vocalize my needs, I can't prepare or even eat food, I can't bathe or brush my teeth and hair. Rapidly, ignoring restlessness becomes dysfunction for me, because my restlessness is not boredom or a momentary dysruption it is a dysregulated experience that will only worsen if left unmanaged.

So restlessness for my body is not a short lived experience, it is biofeedback from my body-mind that something about my physical-emotional environment needs to change. Sometimes getting up to change my task or environment at the first opportunity is enough. Sometimes it's not.

So what does RE-regulation look like if I miss the tipping point and start sliding into dysfunction? Well, for me, I have found my vagus nerve to be very helpful in lowering my current threshhold of restlessness just enough to pull me back from the edge if I'm just over the tipping point. But if I'm far past it, often I rely heavily on antihistimines, electrolyte hydration, and sleep. This is damage control time. I have autoimmune responses to my nervous system dysregulation, so being dysregulated past the tipping point usually means a flare. Anti-histimines can slow or decrease the severity of that flare, while hydration and rest can help me reduce the strain on my mind from functioning under those parameters. This is not medical advice to be clear, just my explanation of how and why I have to cope with this particular experience.

This is one example of how uniquely personalized nervous system regulation and unmasking can both be. Often the most important step one can take in either is learning how to interact with your personal experience of biofeedback. What does dysregulation feel like to you? What different types of dysregulation do you experience? How does your body signal the different stages of that dysregulation, and what level of functioning do you have at each stage? I've found mood trackers and journaling really helpful for this process, but everyone will find their own preferred way of learning their body-mind's biofeedback.

Once you know yours, you can ask yourself the most important question: what do I need at this stage of dysregulation to either cope with or reduce my level of distress and dysfunction?

I was talking to a client today about "how to identify masking" as part of the process of learning how to shift masking from a reflexive coping strategy to a voluntary and conscious one and I feel like it led to a really important shift in framework FOR ME about masking and social distress.

Paraphrasing, the ideas we came to are as follows:

One of the reasons masking can be so difficult to recognize is because, essentially, masking is the act of performing "yourself" as a mirror for the other person you are interacting with. It's this idea of "I will micro-manage my own mood, affect, behavior, mannerisms, and environment in order to reflect back to you whatever version of "self" you need from me because if I don't there will be consequences". So because masking is essentially performing "mirroring" as selfhood by amplifying or minimizing aspects of yourself based on what you think the other person wants to see in you, it varies significantly from one context to another. The major commonality is that it takes up an INCREDIBLE amount of energy, mental and emotional resources, cognitive processing power, etc. So you don't identify masking by specific behaviors so much as by the feeling of "having a significant amount of your mental/emotional resources be occupied by the act of social interaction" to the point that it doesn't leave enough left-over for other cognitive tasks, or leaves you feeling exhausted and worn out, or basically by the impact that masking has on you during and after.

In this framework, part of why we get so anxious about new or unfamiliar people or situations is because we don't know how to mask in that context yet, and so until we get there and figure it out, we're basically just terrified of what could go wrong since we don't know what we're walking into.*

*This is the underlying framework of anticipatory and obsessive anxiety as well. Anticipatory and obsessive anxiety functions as the mechanism by which we conduct both predictive reasoning-basd advance planning and review/self-correctionof our mental predictive model.

Autistic aversion to uncertainty has a lot to do with our need to be able to use predictive reasoning-based advance planning to cope with "social deficits" aka how much harder it is for us to interpret subtextual/nonverbal cues, learn/meet social expectations, and work through/around disordered sensory processing. That predictive reasoning requires us to be familiar, in advance, with the stable constant factors that influence decision making in social contexts. If we aren't familiar with the constant variables than we can't plan, if we can't plan than we are more likely to make noticeable social mis-steps, and if we take notable social mis-steps there are consequences. It becomes necessary for us to be hypervigilent to observable patterns in other people's behavior in order to try to reverse engineer the social interaction playbook on the fly. That ends up making us more likely to assume personal responsibility for predicting and managing the emotional regulatory needs of people around us at all costs, replicating the behavioral/cognitive impacts of chronic traumatic stress due to the activation of our sympathetic nervous system from chronic hypervigilence.

Essentially, masking is a cognitive defense mechanism to severe and/or persistant traumatic interpersonal stressors. As the neurological impacts of chronic traumatic stress heal, we mask less frequently. But in order to heal from chronic traumatic stress, the human brain requires a safe environment that does not trigger a retraumatization episode or replicate feelings of helplessness/fear for safety. In other words, reducing/terminating masking safely requires us as autistic people to have consistent access to social environments in which we are able to utilize autistic interpersonal boundaries without fear of consequence or chonically unmet need. This requires the people around us to be able to respect not only autistic interpersonal boundaries, but also autistic self-expression/advocacy modalities and mediums.

I feel like a lot of the pieces of this framework have been rattling around in my head for a while but the flavor of words hit just right today and all the connections snapped into place.

Anyway, I'm still sort of sorting through the clinical implications of this framework but I think it's a direction I want to keep exploring for sure.