How do you step off an ill-fated roller coaster when it’s still in motion?

I recently shared my suspicion that I am struggling with HPA axis dysfunction, on top of my recent small intestine bacterial overgrowth (SIBO) diagnosis, nutrient deficiencies, and potentially even hypothyroidism.

Perhaps that sounds like a lot of bad luck, or maybe it sounds like I’m a hypochondriac. To me, it makes perfect sense.

I was hospitalized with gastroenteritis, a leading cause of SIBO, as a baby. It was the result of food poisoning, another leading cause. I’ve had SIBO symptoms for as long as I can remember, so it’s fair to assume I’ve had SIBO for the majority of my life. SIBO causes damage to the gut, which leads to an inability to absorb nutrients. Because of its many negative effects, the body sees SIBO as a stressor, like any other underlying illness. This can lead or at least contribute to HPA axis dysregulation over time, which can in turn lead to a sluggish thyroid or full-blown hypothyroidism.

This isn’t even taking into account endometriosis and the strain that’s put on my body and brain over the years.

But there’s another sneaky condition that has helped propel me into my current state of poor health: anxiety.

Anxiety is often associated with endometriosis when you live with chronic pain and fear managing everyday life with a debilitating disease. Over time, I attributed my anxiety to life with endometriosis, but it didn’t fully add up — I’ve had anxiety since childhood.

Now the pieces of the puzzle are fitting together. Anxiety (that is often acute) is a symptom of SIBO, and this is based more on the physiological impact of the disease than the emotional, though that can be devastating as well.

Coupled with a stressful home environment, it became the perfect storm for developing some serious anxiety.

As a child, I feared getting into trouble, being “bad” at school, struggling to understand subjects — and so I worked intensely hard on my schoolwork in order to control these variables. If I worked hard enough, I would hopefully avoid much of what scared me.

As I grew up, I began to rely on my work ethic as a symbol of consistency in my life. My family home was only becoming harder to live in, so homework and revision were my escape. I learned that if I pushed myself to extreme levels, I was capable of controlling the outcome and my future. Good grades meant I would be able to go to university, get a good job, and live my own life under my own rules. This tendency became obsessive from an early age, but at some point it blurred into my only way of existence and the key to my happiness. If only I worked harder, I would be happy, I would have the life I desired. Anxiety dangles a carrot at the end of a tunnel of hard, grueling work and I fall for it every time.

Nowadays, this anxiety feels both mental and very, very physiological. Oftentimes I know it’s better to pace myself, remember my triggers, etc., but my physical symptoms hold me hostage, rooting me in my old ways in the hope that they’ll be alleviated once I overcome the next hurdle. But of course, there’s always another hurdle. Even a simple email can kick off a spiral of physical symptoms.

This has resulted in an inability to fully recover from my HPA axis dysfunction, which feels like it’s been going on for a very, very long time. Years ago I wrote about experiencing burnout as a result of living with endo. Though I am dedicated to managing endo through nutrition, lifestyle changes, etc., I forgot about the recovery from burnout, or what I now know is HPA axis dysfunction. How could I slow down or allow myself to rest when there was so much work to do?

In the past few years, my anxiety and workload have only increased. Wondering which came first is like the chicken-or-egg dilemma. The point is: The ever-increasing anxiety has pushed my health to limits I can’t ignore, and my recovery is going to be a process — a process of treating my SIBO, a process of relearning how I see my reality, and a process of exploring intentional rest and recovery.

How do I step off this ill-fated roller coaster? By realizing I’m the one controlling it.

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Note: Endometriosis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Endometriosis News or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to endometriosis.