Protocol Minirico Mental Intervention and Nicotineamide Riboside Supplementation in Long Covid

Active Reprogramming
Most people with fatigue and other symptoms have specific situations that trigger their symptoms. This is because our brains learn associations. This happens to all of us and often there is no clear reason why the brain has developed the particular links you are experiencing. This exercise will teach you how to reprogram your brain and create new associations to what you currently experience as triggers.

  1. Close your eyes and sit in a comfortable position. Take three deep breaths. Visualize a trigger as vividly as you can – how does it feel?

  2. Tell yourself that you are healthy, strong, not in danger, safe and not afraid. Close your eyes and visualize your trigger again, but this time with joy and ease, without fear – imagine that you are happy, it is a great day, it is sunny outside and all good things are happening. Continue to visualize until you do not feel any symptoms but just feel a good feeling. How was this for you?

  3. Take the same attitude of fearlessness, joy, and ease and engage in the trigger situation in a very small way. Continue with this level of exposure until you have minimal/no symptoms.

  4. Increase the level of exposure, while continuing to remind your brain that everything is okay. Your brain will vary in how much symptoms it creates. Don't worry about it. You can expect it to happen. It's a normal part of the recovery process. But don't stop. Keep moving forward and you will gradually rewire the neural circuits to the symptoms.

  5. Then find a new trigger and repeat the same process. You will gradually unlearn these triggers and you will take big steps towards getting rid of your bothersome symptoms. You will get there. You will get better!
Throughout the process, you should know that the symptoms are not dangerous, as they are just coming from your brain and there is nothing wrong with you. You can even look forward to having some symptoms, as this is your time to practice and reprogram your brain.

For a broader introduction to graded activity that is not as cognitive, see the module on graded activity .
 
Graded activity adaptation: Increasing capacity

As mentioned, graded activity adaptation is about increasing your capacity within the arena of life you want. So it's good to know something about what happens in our bodies when we increase our capacity. Our bodies are supposed to react with discomfort when we move beyond our current capacity level. So discomfort during exercise represents the body trying to adapt and is not an aggravation. If you choose to do something that far exceeds your current capacity, this will involve a significantly greater discomfort. There's nothing dangerous about it, it's not like you're destroying anything in your body, but it won't be as tempting to repeat and it will take longer for your body to recover. The strategy we want you to choose is therefore that you move a little beyond your current capacity, then you will feel some discomfort, but it will not be difficult for you to repeat the activity.

There are people whose job it is to increase their capacity, and they follow exactly the same principles. An example is a cross-country skier who has between 10 and 14 training sessions a week. 90% of these sessions are just outside the athlete's current capacity, they feel like they're working, but they want to train the next day and their body is ready for it. The remaining 10% are significantly beyond their current capacity. In this case, they also feel extreme discomfort, but they know that this is not dangerous and that it represents increased capacity in the long term.

My comment: I’ve spoken to cross-country skiers about rehab after non-injury long-term absence. This is not how they do it.

They tell them to stay at a level that the body can absorb (i.e. no symptoms from activity) and wait for a stable improvement to occur (min. 3 weeks of being able to do more). Stay at this level for as long as you have to, you can’t force an improvement.

When you have an improved baseline, you increase the activity just one day by a very small amount, and rest more afterwards. If you absorb the improvement, you have a new baseline. If not, you go back to the old one.

As a reference: if your «exercise» is to walk 5 mins every second day, an increase would be to walk 7 mins one day and stay at 5 mins the other days.

You’re told to account for all types of exertion. So it’s basically pacing, and the improvement has to come before the increase.
 
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