When Chronic Rest Becomes Part of the Problem

Understanding physical deconditioning, symptom overlap, and gradual re-engagement

By Coach Powers, Ph.D.

Abstract

Many individuals navigating benzodiazepine withdrawal experience profound fatigue, weakness, and reduced tolerance for activity. While these symptoms are often attributed solely to withdrawal or underlying medical conditions, prolonged inactivity can contribute an additional and frequently overlooked factor: physical deconditioning. This article examines how deconditioning develops, how it can overlap with and amplify withdrawal-related symptoms, and why it is often misinterpreted in clinical settings. It also outlines a gradual, non-shaming approach to rebuilding physical capacity alongside nervous system recovery.

When Recovery Slows the Body Down

During withdrawal, it is common, and often necessary, for individuals to reduce activity. When the nervous system is so overwhelmed, symptoms can be intense, and rest becomes a way to cope. Over time, however, what begins as a protective response can gradually shift into prolonged inactivity.

As days turn into weeks or months (sometimes years), the body begins to adapt to that reduced level of use. And as the expression goes, we either "use it or we lose."

With enough time in bed, movement feels heavier, our energy drops, and basic activities can start to feel disproportionately difficult. At that point, the experience is no longer just about withdrawal or sensitization. It's also about how the body has adjusted to doing less.

This can have subtle but dynamic impacts.

What Deconditioning Actually Is

Deconditioning refers to the physical changes that occur when the body is not used in its normal capacity. This includes reductions in muscle strength, cardiovascular efficiency, and overall endurance, along with changes in metabolism and circulation. These shifts are well-documented and can begin within relatively short periods of inactivity.

As the body adapts, tolerance for movement decreases. Standing, walking, or exertion may feel more taxing than expected, not because something new is structurally wrong, but because the body has become less conditioned to handle those demands. In this sense, the symptoms are not random. They reflect a system that has adjusted to a lower level of activity. This can be particularly problematic because when this happens, the body can produce symptoms that look like other conditions. For people with health anxiety, this can be especially challenging and distressing.

Why This Gets Misinterpreted

One of the challenges is that the symptoms of deconditioning overlap closely with those of withdrawal and many other conditions. Fatigue, weakness, body aches, dizziness, pain, blood pressure and blood sugar spikes, and reduced exercise tolerance can all emerge in this context, making it difficult to distinguish what is driving the actual experience.

As a result, individuals often pursue additional explanations, and clinicians may focus on isolated systems, such as musculoskeletal, endocrine, and neurological, without fully considering the role of prolonged inactivity. While appropriate medical evaluation is important, deconditioning is frequently under-recognized as a contributing factor. Further, many people in withdrawal might feel shame and not openly discuss with their doctors their honest level of physical inactivity.

Others simply don't see it.

The Overlap: Sensitization and Deconditioning

In many cases, individuals are not dealing with a single process, but two interacting ones.

Benzodiazepine withdrawal can produce profound nervous system sensitization, characterized by heightened reactivity, discomfort, and reduced stress tolerance. When this is combined with physical deconditioning, the overall burden on the body increases. In other words, it actually becomes easier to become deconditioned, and much quicker than if the individual wasn't coming off the medication.

This overlap can make symptoms feel more intense, less predictable, and even scary.

Additionally, activity may trigger discomfort more easily or trigger waves. Exercise intolerance is a real phenomenon that many experience in withdrawal, and it can be a tricky challenge. When this happens, recovery can feel slower, and we lose confidence in our bodies.

Understanding that these processes can coexist helps clarify why the experience can feel so complex.

The Reinforcing Cycle

Another key element to this equation is the role of reinforced cycles, which are so very common in withdrawal. When movement becomes uncomfortable, painful, or triggers waves, avoidance often follows. This is a natural response, especially when symptoms increase with activity. However, over time, reduced movement leads to further deconditioning, which in turn lowers tolerance even more.

This is frustrating for us because we know we need to be more physically active, but how?

An inevitable pressure builds beneath the surface, and fears can really begin to manifest, sometimes leading to impulsive decisions. People either try to white-knuckle recovery, or they may try to race off their benzos in fear of creating more physical issues if they taper more slowly.

This creates a reinforcing cycle in which less activity leads to more symptoms, and more symptoms lead to less activity. Breaking this pattern does not require force, but it does require a gradual shift back toward movement.

Rebuilding Gradually

Reconditioning begins with reintroducing movement at a level the system can tolerate. That is very important to understand, so I'll say it again. Reconditioning needs to begin with reintroducing movement at a level the system can tolerate.

This is not about returning immediately to previous levels of activity, but about establishing a consistent baseline that can be sustained without overwhelming the nervous system. It's about discovering where our Bear (survival brain) is most stubborn and most guarded, figuring out our baselines and thresholds, and then gently working through them gradually over time.

Small, repeatable efforts, such as brief periods of walking, light movement, or increased upright time, allow the body to begin adapting again. It truly doesn't need to be much at first. We need not join a gym, go hiking, or buy a bunch of exercise equipment. Less is more.

It begins with just a little more time out of bed, a few extra steps daily, or some light resistance bands work.

It begins with a better diet, more sunlight, and adequate water.

Over time, these inputs signal that the system is safe to re-engage, and capacity begins to return.

Working With the Body, Not Against It

Now, this is important to remember…

As movement is reintroduced, some discomfort is to be expected. Mild fatigue, soreness, or temporary increases in symptoms can occur as the body adjusts. These responses do not necessarily indicate harm, but they do require pacing and awareness. The challenge is that when most people experience an uptick in symptoms or pushback from their bodies, they tend to abandon their plan.

We need not do this.

Simply find your baseline (what is tolerable without symptoms), and spend some time in that space. As your conditioning improves, you can gradually increase your steps, activity, nutrition, and other healthy exposures.

Pairing physical activity with regulation strategies, such as slow breathing or sensory grounding, can help the nervous system interpret movement as safe rather than threatening. This supports both physical and neurological adaptation over time. So, don't forget your other tools, such as mindfulness and the power of somatic sensory work.

For example, if you're going for short walks, listen to uplifting music, wear a lovely fragrance or lotion, chew gum, or eat fruit. Combine sensory pleasure with gradual movement, and above everything else, don't fight the Bear.

Simply allow him to be scared and be wary. Allow him to be with us while we rebuild our leadership. That's enough.

A More Complete View of Recovery

Recovery is often framed entirely in terms of calming the nervous system, which is greatly important, but physical capacity plays an equally important role. When deconditioning is part of the picture, progress may depend not only on reducing sensitization but also on gradually rebuilding strength and tolerance.

Our bodies were meant to move. That's how we evolved, and when we begin to get our bodies back into their natural rhythms, a unique thing often happens… our minds grow healthier, too!

This broader perspective helps reduce confusion and self-blame. It helps us see our path more clearly. Symptoms that once felt unexplained can be understood as part of a larger pattern of adaptation, rather than evidence of a new or worsening condition. We need not fall down rabbit holes chasing other health explanations.

Certainly, see your doctors. Get blood work. Keep healthy and rule out any other conditions that may be relevant. But aside from that, don't overlook the very real impact of deconditioning. Because often, what feels like some other serious health problem really is just a body that's been inactive too long.

Lying in bed for excessive periods of time can create muscle loss, physical pains in our joints, bones, and body. Blood pressure and blood sugar can spike or become dysregulated. Nerves can get aggravated, and chronic fatigue can set in.

But these are not signs of something more serious going on, no matter what our health anxiety and fear-driven Bears tell us!

References

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