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Managing Stress through Cushing’s

Modified and reprinted with permission from Brian Gordon,  FowlLanguageComics.com

Modified and reprinted with permission from Brian Gordon, FowlLanguageComics.com

Have you ever lost the “thing” and it nearly put you over the edge? It doesn’t matter what the thing was. It could be the car keys, (one always seems to be running late when the keys go missing, have you noticed?) the cat, a bill that needs paying, one’s glasses, one’s mind. It really doesn’t matter what it is. What happens to our body in that moment is stressful and makes us feel miserable.

In this article, I want to first normalize the challenge we all have, as human beings managing stress. Second, I want to review definitions and examples of stressors. Third, I want to discuss options to enhance your own stress management practice and leave you with some resources that I have found helpful, both personally and professionally.

The mental health community commonly breaks stress into two categories, positive and negative. A general definition of stress is: the body’s response to changes that create taxing demands, either positive or negative. The endocrinologist, Hans Selye, coined the term stress, and also eustress, to define perceived beneficial stress. He emphasized that eustress was perceived as positive by the individual experiencing it, even though it too, was taxing to the body. Examples may include the wedding day, first day on a job, attending a party, working out at the gym. With eustress, time flies and one feels energized, motivated and inspired (thank you cortisol?) In contrast, distress is perceived by the individual as negative. The body often feels anxious, irritable, angry and tired. Examples can range from bad traffic on a Monday to losses of loved ones, conflict with others and living with a chronic illness. Interestingly, the Chinese characters for stress or “crisis” roughly represent “danger” and “opportunity.”(The American Institute of Stress).

So, what do we do with all this? The mental health community today focuses on a mind/body approach in the management of stress. That is good news for us! If anyone was able to catch the Webinar on October 24th, with Dr. Susan Webb, she acknowledged many of the stressors that may impact our quality of life. I specifically noted the emotional lability, (think, emotional rollercoaster) depressed and anxious mood , irritability and memory problems along with residual joint pain and muscle weakness. I probably noticed these because they have been the ones with which I have struggled the most. Dr. Webb emphasized the need to adapt, take action and not blame ourselves or others. I want to discuss next, some options to assist us in further managing our stress and therefore progressing in our adaptation.

  1.  Adapt and delegate: I must constantly conserve my energy. I walk more slowly, I vacuum and dust less often, I sit while folding the laundry and I ask for help bringing in the groceries. I no longer drink coffee all day long and wine at night. I’ve cut out sugar. What have you found you now do that is adaptive, that paces your energy and delegates the work load? This is good for prevention of distress.
  2. Assert yourself: I respectfully and directly ask for what I need rather than doing it all myself. To not do so would breed resentment. I can’t afford that negative thought and subsequent feeling in my body. In what areas have you found yourself speaking up more assertively? In what areas, and with whom, would you benefit from doing more of this? This is good for prevention of distress.
  3. Exercise: I don’t care if it is bouncing on a rebounder (a mini-trampoline), stretching and breathing through yoga, or going for a walk, I have to have movement to ward off irritability and the general aches and pains with which I now live. As an aside, nothing was more maddening than all the articles I read telling me to walk to lose weight when I couldn’t. I couldn’t walk well or lose weight! Anyone relate? So I bought a rebounder and jumped on it. When I couldn’t do that, I sat and bounced. Adaptation… What have you found that you can do for physical exercise now? What do you enjoy? Any movement in which you are able to move your arms or legs back and forth is calming to the nervous system. We call it bilateral stimulation. This calming of the nervous system is great for stress management. Have you ever seen an upset person? They walk, they pace, they do not want to sit down. When upset and made to sit down, we feel worse. The body has its own wisdom and wants to manage its stress. It just needs our help. When really upset, the body often prefers walking or running or cycling or any fast bilateral stimulation. This, interestingly, isn’t just good for the body, but assists the mind in processing as well. This prevents negative thoughts from becoming repetitive and unproductive. Exercise is good for prevention of distress as well as intervention in a stressful moment.
  4. Challenge negative thinking: When I feel poorly, I am more apt to see the cup as half empty. When this happens I just notice it, refuse to make decisions in that moment and watch it pass. It ALWAYS passes. As the quote above notes, we get to decide when to let go and when to hold on. Noticing our negative thinking and not making any hasty decisions is good for prevention as well as intervention in a stressful moment.
  5. Write a gratitude list: I used to have this gigantic symptom list. As each symptom has abated, I write that on my gratitude list. My hair has finally returned and I have lost weight. Those two things had me in tears for years. No more! As Dr. Webb also stated in the recent Webinar, “This disease is not the end”. I loved hearing that. The Webinar made it onto my daily gratitude list. Much research has been done about the power of positive thinking on the mind and body. While this is not always easy, the discipline in identifying 5-10 things a day for which we are grateful and writing them down will help manage our stress. The gratitude list can, therefore, be considered an early intervention strategy.
  6. Create a calm place: I am trained in EMDR, a therapeutic model for treating anxiety and trauma. One of the first things we do with almost all patients, before processing traumatic events, is assist them in creating, in their mind, a calm place. To do this, you simply imagine a place or an activity that elicits a sense of calm or confidence. Once you identify such a place or activity, ask yourself what you see, hear, smell, and feel. For example, if your place was lying in the sand at the beach, perhaps you feel the sun, the warm sand against your body, the cool breeze, hear the seagulls and waves, smell the ocean and seaweed. Notice any sense of calm and where in your body you feel this calm. Give the feeling of calm a color if you can. (I know, I’m pushing it now). Imagine that color flowing through your body from your head to your toes. Give your place or activity a name. It can be as easy as “beach” or “surfing”. You can’t get this wrong. The idea is that if your mind goes there, your body will follow. It will not know you aren’t in Tahiti. Try to do this for 5 minutes a day. This may be a good one before sleep. This is both a prevention and intervention strategy.
  7. Tapping: Tap on the spot, centered below either eye with your index and middle fingers. You will know when you have found the spot as it is slightly tender. (this spot is considered an acupressure spot) Notice if any sense of stress or anxiety diminishes after a dozen or so taps. This works best in acutely stressful moments. I did this before MRI’s to prevent the panic attacks that began to find their way into my life.
  8. Alternate squeezing of fists or toes: This, when done slowly, can calm anxiety. I seem to sit next to anxious people on planes who feel like vomiting or are holding panic attacks at bay, so I invite them to try this. It always works. It also works with stress balls but that seems a bit more obvious than some would like. This, therefore, is better used as an intervention to calm the body in an acutely stressful situation.
  9. Alternate nostril breathing: With your finger over your left nostril, inhale with your right nostril. Then place your finger over your right nostril, exhaling through your left nostril. Do this slowly, 5 times as needed to calm the body. This works well as a prevention or intervention strategy in managing stress.
  10. Stimulate your senses with your favorite songs, smells and sights. Put your bare feet in the grass or dirt. Better yet, lay in the grass. Sing. Take a bath with Epsom salts and your favorite essential oil. Do whatever brings you joy. I have found coloring in coloring books to be marvelously calming. This works well as a prevention or intervention strategy.

In this issue we covered the definitions of stress and 10 strategies that may further our own stress management practice. The body of literature on stress management is significant and this article is only a brief overview. I chose many strategies that are evidence based in their effectiveness with pain management, as well. That being said, stress is normal and the management of it changes daily for all of us depending on our health, our hunger, the amount of restful sleep we’ve gotten and all those other ever-changing external variables. Please continue to connect with others as the connection itself is a significant protective factor in maintaining our health, both physically and emotionally. I would love to hear from you. Your feedback on the 10 things and their relevance to your own stress management is important. Please let us know.

Some of my favorite free resources for stress management:

Home


Youtube: Tripura Mandala yoga nidra for sleep
Youtube: Tripura Mandala yoga nidra for inner peace and tranquility
http://www.thrivingnow.com – EFT Tapping points
http://www.stress.org – The American Institute of Stress

Author: Dawn Herring, Licensed Marriage and Family Therapist (and Cushing’s patient)

Newsletter: Winter, 2015

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