What Is Dysautonomia (Or Autonomic Dysfunction)?

Generally speaking, dysautonomia is a disruption of your autonomic nervous system. Therefore, to understand what autonomic dysfunction is, it’s best to discuss the roles of the two sides of your autonomic nervous system and how they operate normally when everything is working as expected.

On the one side of it, you have what we call your sympathetic nervous system, which is your fight or flight response. It’s the one that allows you to feel that surge of adrenaline. For example, if you were about to get hit by a bus when you were crossing the street, it would be your sympathetic nervous system that would kick in and get you across without harm.

On the flip side, you have your parasympathetic nervous system, which we call your rest and digest response. It’s the part of your nervous system that helps you to relax, vasodilate, and feel settled.

To understand better, you can think of the autonomic nervous system being the car that keeps you moving and functioning day-to-day and the sympathetic nervous system would be the gas pedal, allowing you to quickly accelerate past an obstacle into safety. It’s revving the engine and making the car go faster.

Your parasympathetic nervous system in this example would be the brake pedal, which allows you to slow down at a traffic light or when you are pulling into your driveway. Or bringing you to a complete and safe stop, when you need it and for as long as you need to.

 

UNDERSTANDING AUTONOMIC NERVOUS SYSTEM DYSFUNCTION

Normally, your autonomic nervous system functions without you even thinking about it. When it’s balanced or in homeostasis, things run smoothly in the sense that your heart rate, blood pressure, and lungs all of that just ticks along quite nicely and automatically in the background. 

Dysautonomia then is when there’s a disruption in that communication. 

This means that in times where the fight or flight response would be useful, your body might not respond quickly to the situation at hand, or not at all. That can manifest as low energy, overwhelm, or feeling disproportionately burdened by a task.

Your ability to switch off, recover and rest is equally affected. Being able to bounce back from a workout, getting good sleep, and extracting the nutrients and energy from your food just to mention a few examples, can all be limited compared to your normal baseline.

What Are Some Dysautonomia And Autonomic Dysfunction Symptoms

Looking at how the body is responding to different positions can actually give us some real insight into, is it a dysautonomia, or is it something else? 

When you have a dysautonomia, some things that you might find you suddenly start to struggle with are quick positional changes (going from lying down to standing up quite quickly). 

You also might notice things that were otherwise quite easy for you, so perhaps going for a walk with the dog or taking the kids for a walk might be really challenging, and you find yourself short of breath. You might notice your pulse is racing much more than what would seem appropriate for your level of activity. You might notice a headache, fatigue, and just this inability to do day-to-day tasks, which are otherwise quite second nature for you. 

And sometimes it can be quite severe to the point where you might faint. Other times it can be just this level of discomfort that wasn’t there before you had that illness or injury.

How People Get Dysautonomia

Dysautonomia can happen from many causes, such as:

  • Head injury (concussion)
  • Mast cell disorder
  • Trauma
  • Illness (such as COVID)

Head injury such as concussion is a common mechanism. You can also have mast cell disorders, traumas. Illnesses, such as COVID, can certainly disrupt this, and these are just a few of the many things that can cause a dysautonomia. To create an effective treatment plan, it is imperative to identify the actual cause of your dysautonomia. To do that, it’s best to get this looked at by a clinical team.

DYSAUTONOMIA AFTER COVID

One of the common situations after which you might end up with a dysautonomia would be COVID. Most people have had COVID by now, but we know that an inflammatory illness can disrupt that communication between your brain, the vagus nerve, and the innervation between your heart and the lungs, which is so important. 

Those inflammatory changes are not localised, they happen throughout the entire body and negatively impact this process. 

How Can I Tell If I Have Dysautonomia

Sometimes people will come in and they’ll say, “Oh, I just can’t tolerate getting back to running,” or, “I can’t tolerate going to the supermarket and being on my feet for an hour. I feel really tired.” Some people have fainting episodes. 

Sometimes people come in thinking it is one thing, but after we do some clinical tests, we find that it’s actually a postural intolerance, or we find that the heart rate is spiking when the blood pressure is not when it should. 

There’s a few gold standard tests that can be done, such as heart rate variability, tilt table testing, but a really comprehensive review by a clinician is definitely needed to formally diagnose this. 

And while dysautonomia can be a challenge for patients, and it is a bit of a rehab journey for some, if you get the right team around you from a clinical perspective, it is very treatable and manageable, and most people do quite well in the end.

Next Steps

To assure that you receive the right advice for your unique situation, it would however be beneficial to have a consultation with a trained professional to discuss your treatment options with you. To know more about concussion and related topics, read our blogs: https://brainhub.com.au/blog/

At Brain Hub, we strive to provide effective concussion treatment in Sydney, tailoring our approach to each individual’s unique recovery needs. Contact the clinic on 1300 770 197, or click here to pick a time for your initial appointment:

DR JESSICA POVALL

Doctor of Physiotherapy
DPT, BSc (Hons), PGCertPhty