More Than Meets the Eye

I have an autonomic disorder called Postural Orthostatic Tachycardia Syndrome – POTS for short. It’s a mouthful that means that I have issues with low blood pressure, a fast heart rate on standing, and chronic nausea, among other things.

Having a chronic health condition like this impacts my life, but with lifestyle changes such as keeping hydrated, avoiding standing for long periods of time, wearing support stockings, and eating a diet high in salt, I’m able to function quite well 95% of the time. Medications help too, and I’m grateful that my heart, blood pressure, and nausea meds help to manage symptoms.

What does this have to do with dog training? Well, quite a bit. You see, my dog Layla has a chronic health condition too. She was diagnosed with Generalized Anxiety Disorder – GAD for short – in 2008. This disorder causes her to be hypervigilant, hyperalert, and to have difficulty resting.

Having a chronic health condition like Layla’s impacts her life, but lifestyle changes such as keeping to a set routine, managing her auditory environment, providing plenty of physical and mental exercise, and avoiding anxiety-producing situations help her to function quite well 95% of the time. Medications help too, and I’m grateful that Layla’s daily sertraline and situational trazodone and alprazolam help to manage her symptoms.

My POTS was not easy to diagnose, but after extensive testing and a definitive tilt table test, it became very clear what my disorder was. Before diagnosis, I often fainted multiple times a day upon standing, and was too lightheaded to work or carry out daily life tasks. Now that I have a diagnosis, my condition can be managed with regular blood pressure and heart rate readings. I simply monitor these numbers from supine, sitting, and standing positions to get a better idea of what’s going on with my body at any point in time.

Layla’s condition was not easy to diagnose either, but after extensive training and behavioral modification it became clear that she needed further help. She simply wasn’t making the progress that a “normal” dog would be expected to make. I kept records on her behaviors and took representative video of her life, which were reviewed by a board-certified veterinary behaviorist. Based on her symptoms, the behaviorist diagnosed Layla with GAD.

Unlike POTS, GAD doesn’t have handy numbers we can look at. We can’t measure the level of available serotonin in Layla’s brain to see whether she’s lacking. We don’t know whether the early trauma she experienced caused her hippocampus to shrink or her amygdala to become larger than normal. We can’t even begin to test the levels of the complex stew of neurochemicals in her brain.

We can’t measure anxiety-related issues as easily as we can measure heart-related issues. That doesn’t mean that they’re not every bit as much of a physical problem, though. My POTS is not my fault, and I can’t just “get over it” with lifestyle changes and a positive attitude. Layla’s anxiety is not her fault either, and she can no more “get over it” on her own than I can suddenly have an autonomic system that functions normally. Her brain doesn’t function normally, but it works much more normally now that she’s on medications. In fact, that’s a big part of how she was diagnosed. When we tried anxiety medications for her, they made such a huge difference in her ability to function that it was clear that they were correcting a true chemical imbalance. The dog whom I’d never seen sleeping was suddenly able to take naps. She was less twitchy, less explosive, and suddenly all the training we’d done together started to show. Her personality didn’t change, but it was like the static of the anxiety was turned down enough for her to access the skills we’d been working so hard on for the past three years. Before her diagnosis, Layla was frantic the majority of her waking time, and awake much more than most dogs. With medication and a diagnosis, Layla’s condition can be monitored with regular attention paid to her sleep cycle and reactivity.

Invisible disabilities come in many forms. People don’t know that I have a chronic health condition from looking at or talking to me. They also can’t tell that Layla has a chronic health condition from watching her work or play. I look like any other person, and Layla looks like any other dog. However, the physical abnormalities in the way our systems work are very real.

One of my greatest hopes is that someday we’ll be able to measure anxiety, to point to a definitive test and say, “yes, your dog has a neurochemical imbalance that needs to be addressed with medication” in much the same way we currently address thyroid or heart issues. How many dogs like Layla are currently suffering without treatment for lack of a diagnosis or their owner’s misunderstanding of the very real chemical basis of anxiety?

One hundred years ago, my fainting issues would have been seen as “female hysterics” and dismissed out of hand. Today, we look back on that attitude with horror and sympathy for the people who lived with very real autonomic issues.

My hope is that one hundred years from now, we look back on the current treatment of mental health issues like Layla’s GAD with much the same horror and sympathy. When we know better, we do better. I’m so grateful that I was able to do better by Layla. Her life, and mine, are all the richer for it.