Stress is a common, nearly inescapable part of our modern lives. And it’s not all bad.
The right amount of stress can motivate us to pursue important goals and help us meet the demands of a challenging situation. Encountering and coping with stress builds our resilience and can grow our confidence in our ability to handle a wide variety of situations.
But stress can also wreak havoc on our nervous system if we’re not able to recover from it, leading to health complications and serious mental health conditions like anxiety and depression.
Our threat defense system (the urge we get to fight, flee, freeze, or fawn) can be activated by small stressors throughout the day, like seeing disturbing media, running late, or having a tense encounter with a patient or co-worker.
Big events can also activate our stress response, such as, ahem, a major cyber security attack that changes the way we care for patients on a daily basis.
During COVID many of us were in a state of heightened stress from which our bodies may not have fully recovered. Add in personal life events since then (e.g. babies, marriages, divorces, layoffs), and some of us might be experiencing a low tolerance for dealing with extra stressors.
In Resiliency Training, we talk about the “Zone of Resilience,” a concept based on Ndefo, Siegal and Treleaven's descriptions of how stressors and trauma can affect our nervous system.
Being in the zone of resilience means we’re optimally energized to do what we need to do--whether we’re caring for patients at work, interacting with our friends and family, or pursuing our interests and hobbies. In other words, we’re not so activated that we’re anxious or overwhelmed, but not so under-activated that we’re lethargic or checked out.
When we’re in the “zone,” we tend to feel more capable of responding to stressors and challenges. Our thoughts are clear, we can think creatively and flexibly, and we can adjust our emotions and actions to the demands of a situation.
If we’re at work, for example, and a code occurs, we’re more likely to respond efficiently using the skills and techniques we’ve acquired and to work as a team to care for the patient. In this situation, it’s appropriate to experience a temporary spike in adrenaline and cortisol to respond to the situation. But after the code is over, our bodies level out.
Sometimes, though, we’ve experienced prolonged stress day after day or month after month,and haven’t had time to catch our breath or take a break from it. Chronic stress can move us into the hyper zone. In the hyper zone, we have difficulty concentrating, move quickly from one thing to the next, and we may experience anxiety.
Extra big stressors can move us into the hyper zone too, such as a pandemic or a cyber security attack. Minutes, hours, days, weeks, or months later, our bodies can crash from this state into the hypo zone. In the hypo zone we feel extra lethargic, potentially spacey, withdrawn, slow, and even numb. Some of us, like myself, move into the hypo zone pretty quickly.
When we move outside our zone of resilience, naming to ourselves what zone we’re in (e.g. hyper or hypo) can be helpful. Acknowledging that we’re not the only ones to experience fluctuations in energy levels can also alleviate the criticism we direct towards ourselves for being unable to concentrate or being extra tired. If prolonged symptoms of anxiety or depression are interfering with our ability to function in our lives, we may also benefit from seeking professional help.
To avoid the highs and lows of the hyper and hypo zones the Nagoski sisters explain how we can ‘complete the stress cycle’, or recover from stress, on a daily basis. While avoiding stress is impossible, particularly if we want to have a rich and meaningful life, we can regulate our nervous systems and restore ourselves to our zone of resilience with tools that remind our bodies we are safe, rather than threatened. The Nagoskis’ tips for completing the stress cycle are below:
Physical activity (to flush the adrenaline out of your body)
Deep, abdominal breathing (to signal to your body you are safe)
Positive social interaction (another signal you are not threatened)
Laughter (e.g. deep, belly laughter)
Physical affection (e.g. supportive gesture, hugs, holding hands)
Cry (to release stress hormones)
Creative expression (e.g. writing, dancing, painting, etc.)
Luckily, we can use these techniques in just a few minutes. For example, we can take the stairs rather than the elevator a few times a day, or deepen our breath into our belly as we walk from one meeting or patient to the next. We can seek out positive social interaction, and perhaps laughter, with close colleagues or friends. Receiving a hug from someone else or placing our hands on a part of our body to support ourselves (e.g. heart, belly, neck) can also signal to our bodies that we’re safe and bring us back to our zone of resilience.
To find more time to complete the stress cycle, consider replacing habitual activities that move us out of our zone of resilience, even for just a few minutes, with activities that restore us.
For example, rather than scrolling through social media for a few minutes on a break, we might reach out to a good friend, take a short walk, or do something creative for a few minutes like doodle, play with a fidget toy or write a short poem on our phone. We might look outside a window at a tree, ground our feet on the floor, or have a good cry in the PAR room.
As we become more aware of our stressors as they are happening, we can make conscious choices about how we respond and how we care for ourselves. These choices might be in contrast to the choices others around us are making or are encouraged to make.
Often in healthcare we are rewarded for being very productive and overly involved at work, or for staying in the hyper zone. What would happen if instead we encouraged each other and modeled behaviors that restore us to our zone of resilience?
