Hyperhidrosis #2 – ‘It’s a cruel cruel summer!’

For those who have Hyperhidrosis summer here in London can be a nightmare. Especially if you’re commuting to and from work. Whilst air conditioning is increasingly being installed in offices, buses, shops and on the underground trains such as the district line, sweat soaked clothes before 9 in the morning is an all too familiar experience.

For most of the population sweating in the heat is a normal occurrence which, whilst uncomfortable, soon passes. However, for someone with hyperhydrosis, where the sweat glands and sympathetic nervous system are over active, excessive sweating is often an ever present discomfort.

The other day I jumped on one of the new route master buses which are based on an older style of hop on hop off bus, which were replaced several years ago. A tragedy in my opinion as they were great fun to travel on, employed a conductor and were well ventilated. The new designs by Thomas Heatherwick are a futuristic version but have no windows that can open, the idea being that temperature can be controlled internally. This is a huge oversight in the design as even in the coldest winter fresh air is a must. The day I hopped on the air conditioning on all buses had failed. Whilst it was 25 degrees outside it was more like 40 inside. Needless to say I hopped off at the next stop.

Similarly, whilst shopping for suitable summer clothes I went into a big brand store on Oxford street. To my horror the air conditioning had failed and whilst the staff ran around frantically setting up huge cooling machines machines, which did little other than blow the hot air around, I lasted about 2 minutes before heading for another store where the air conditioning was guaranteed to be in full swing. These days, has air conditioning turned us all into hypersensitive creatures of comfort?

Recently I spent some time in Malaysia where the temperature is consistently between 30 and 40 degrees centigrade with the humidity at around 90%. There, being too hot and sweating is something everyone experiences throughout the year. Some love the heat and the humidity whilst others struggle and these days, throughout Malaysia, it’s unusual to find a cafe, restaurant, shop or taxi that doesn’t have air conditioning. That’s great news for comfort but not such good news for the environment. As offices, homes and shops etc pump the hot air back outside conversely the outside heats up creating a vicious cycle. On top of that there’s the growing need for more power and energy – as we cool our interiors the exterior gets hotter. This reminds me of the smoking ban which improved the experience for non-smokers in bars, clubs and restaurants but step outside for some fresh air and you’re likely to get a lung-full of smoke as smokers are relegated to the ‘fresh air’.

Whilst summer in London can be a challenge for those with hyperhidrosis winter can also present another series of problems. This can include going from the cold outside into hot and over-heated spaces which may encourage the body to sweat and then back out into the cold again.

I remember the first time I went skiing. For those who have had the experience you’ll know how much energy is used when learning to do it. Falling down and getting back up produces a lot of body heat and being outside for most of the day I’d sweat and then I’d stop for lunch where I’d soon become cold and wet. Eventually I learned to take a change of clothes but those initial days of getting hot then cold then hot then cold resulted in me flying home with a nasty dose of flu. Being cold and wet for long periods can deplete the body’s immune system however there is one person who has developed a system for dealing with such conditions.

Wim Hof is known as the ‘Ice man’ and has swum under icebergs, run a marathon north of the polar circle wearing nothing but shorts and publicly demonstrated how he can spend hours submersed in ice. He has learnt to control his hypothalamus which governs the body temperature and claims that learning how to do this can strengthen the immune system and fight disease. He runs workshops in holland and the US and believes that anyone can learn to do it. His website is http://www.innerfire.nl and I’ve found some of his techniques very useful particularly if you experience sweating during the night which may also disturb your sleep.

Sitting on public transport and hurtling or sometimes crawling across the city can be a stressful experience in itself. This is often amplified by excessive sweating. I’ve found it very useful at times like this to meditate on the feeling of coldness on the skin. This is a memory we can all recall from being out in the snow, handling ice cubes or getting into a cold swimming pool. This accessible memory is like turning on the internal air conditioning and is just another tool to help us live with hyperhidrosis.

(It’s a cruel cruel summer!) c/o Bananarama 1983

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Hyperhidrosis – ‘The body of water’

What is Hyperhidrosis?

Hyperhidrosis describes a condition when the sympathetic nervous system along with sweat glands throughout the body are over-active. As a result the hands, head, feet and sometimes entire body can sweat very easily and in some cases constantly.

Human beings sweat. When we’re hot, nervous or have been exercising it’s part of the body’s natural cooling system and when we’re stressed our bodies heat up as adrenalin pumps through our system preparing us for flight or fight mode. For most of the population this is something that just happens and whilst it may sometimes be unpleasant it passes and is soon forgotten.

Meanwhile for some, sweating is excessive and can be a constant and uncomfortable experience. At this level it is often diagnosed as hyperhidrosis. There are many products now on the market and whilst Botox has become quite widely used there are also a new generation of pharmaceuticals that apparently control how water in the body is released. Another more drastic action is a major operation known as a sympathectomy. This severs the nerves that are responsible for making the hands sweat and can be effective but may also have quite drastic and lasting side effects. These can include excessive sweating elsewhere throughout the body, eyelid drooping as well as going through the trauma of the operation and it simply not working. Whilst there is much more understanding about this condition compared to 20 years ago many people with hyperhidrosis are often desperate for a way out of their sweating experience and so may be at the mercy of some quite harmful interventions that could still be in their infancy and understanding around long-term use etc.

For those who sweat moderately it may be difficult to appreciate how difficult the experience of excessive sweating can be. For many individuals hyperhidrosis can be embarrassing and create a constant sense of self-consciousness resulting in anxiety, shame, depression and social withdrawal.

You may have a friend or family member who might have mentioned something about their sweating and perhaps you noticed what they were talking about but most of the time you probably wondered what all the fuss was about. However, for those who experience it there is often an ever present anxiety around – going into hot rooms, which clothes to wear, unease at being touched or having to shake someone’s hand etc. Hyperhidrosis can lead to social anxiety and isolation and because most people who suffer from it often feel misunderstood by those around them or feel they have to hide the condition it can be a very lonely experience.

There is much more awareness of hyperhidrosis today with support groups springing up as well more varied treatments available. Connecting to others with the condition is a good way to feel supported and understood. One such network group is http://www.hyperhidrosisuk.org run by a dedicated and hard working group of volunteers.

My story

Having experienced hyperhydrosis from a young age I later opted for a sympathectomy and underwent the trauma of this major operation. The good news is it worked but whilst my hands stopped sweating to the extent they used to the rest of my body went into overdrive. This is the side-effect I’ve learned to live with and through my re-training as a psychotherapist I’ve explored within myself what might have been the caused. I’ve concluded that there are no clear answers to this query but the exploration has lead me towards how the body deals with trauma as one possible explanation. Could it be that at some point in our early life something within the sympathetic nervous system was switched on through some impactfull experience and has not been switched off? This, though, may not explain hereditary influences. An example of this is a colleague of mine with hyperhidrosis who noticed that, after a couple of months of having a baby, her son’s hands were sweating suggesting he may have inherited it from her. The one thing I have come to learn is that at this point in time we just don’t know the definitive cause. For me, the attention has to be in the reality of the present moment and how I can maintain a constructive attitude to both my body and the condition.

How can counselling help?

Counselling can’t offer a way to stop the sweating but it can provide a space in which to discuss the shame, anxiety and stress that is experienced as a result. It can also help build a better relationship with our body where excessive sweating can lead to feeling disappointed with it and generally out of control. Counselling may also help us learn from our experience rather than remaining stuck in a cycle of avoidance and stress where we may feel at war with our bodies and as such with the condition.

Our bodies are approximately 70% water. With hyperhidrosis water leaks from the body through our skin. Our bodies can’t help it and learning to be kind to ourselves and our bodies regardless of the flaws is an important step towards coping with hyperhidrosis or any other uncomfortable condition for that matter.

Acceptance and tolerance is the key so that whatever decisions we make, whether its taking medication, having an operation or leaving the medical profession out of it. From a place of insight and love for ourselves we must make informed decisions and learn how to act with discomfort rather than react against it which only results in stress and anxiety. Mindfulness may be a helpful tool and I’ve found Jon Kabat Zinn’s book ‘Full catastrophe living’ very helpful.