Stress Management

For the first decade of looking for answers to our undiagnosed conditions, my twin sister and I were regularly told that our symptoms were “in our head,” that we were “just depressed,” and that nothing was actually wrong. My mom was even blamed for making us think that we had these “not real” health problems. (Side note: it was her research and perseverance that finally led us to our diagnoses that explained our lifetime of struggles, which is why we refer to her as “Queen Zebra”).

We were told we were crazy and taunted by the medical world for so many years, and it made me want to be very clear that my physical complaints were not psychological. So much so that when a law school classmate inquired as to how stress impacted my health conditions, I replied “there’s no impact.” To be honest, I’d never allowed myself to give the question any thought. In my mind at the time, I couldn’t allow there to be any perception that stress or emotions could impact my physical symptoms because I needed people to believe that my symptoms were real and that they were serious - and that they weren’t my fault.

The question of “how does stress impact your conditions?” also didn’t seem relevant to me because my life was what it was, and the stressful aspects weren’t things that I felt I had any control over. Though we had a very loving and happy household, the stress in our lives started early. My twin sister and I had dealt with disabling physical symptoms since we were young children, my dad died from colon cancer when I was 17, we grew up with loss and pain around us, we learned at a young age that some people can’t be trusted and that boundaries - though painful - can be critical, and we were ambitious and hard-workers dreaming of changing the world while battling our bodies in environments that often didn’t show respect or equality to those of us with invisible illnesses and disabilities.

It’s only been over the last handful of years that I’ve recognized how important it is to manage my stress levels, and how much control I have over the stress in my life. It was a concussion that led to this lifechanging insight because it forced me to take some time off from work and life, and this space helped me to get my priorities straight. While the concussion experience really sucked and I don’t recommend it, it served as an incredibly valuable learning experience because it introduced me to stress management practices as part of my recovery and led me and my husband to change how we made decisions: we went from fitting happiness into our lives, to fitting our lives (including work) into happiness. When you make happiness your top priority, everything flows from there. This new approach to life has had a tremendously beneficial impact not only on my (and our) happiness, but also on my health.

How Stress Can Impact Health

  • Stress can worsen pain.

  • Stress can cause or exacerbate hypervigilence. When you're in a state of hypervigilance, you can become incredibly sensitive and/or reactive to your surroundings and cause you to remain in “high alert” mode.

  • A dysfunctional autonomic nervous system (as is the case in someone with Dysautonomia/POTS) can cause your body to think its in more danger than it actually is, which can further worsen pain.

  • Many of us have trauma from being told our symptoms are “in our heads,” or that we just have an anxiety disorder or depression (which, by the way, also diminishes the importance of and challenges associated with mental health conditions). Those of us with Dysautonomia/POTS have a physical disorder that impacts the mind-body connection; it’s not all in our heads, but what’s in our heads makes a big difference in how we get through the day.

  • Stress activates mast cells, causing them to release prestored and newly synthesized inflammatory mediators and induce increased blood-brain barrier permeability, recruit immune and inflammatory cells into the brain, and cause mast cell degranulation in several tissues. In other words, stress can worsen mast cell symptoms.

Stress Management Suggestions

Breathwork

Breathwork is an important stress management modality because it helps to tamper the body’s sympathetic tress response and raise the body’s parasympathetic (rest-digest-recover) nervous system response.

  • Work with a practitioner to ensure you are breathing properly and fully.

  • Use breathing exercises to train yourself to increase your CO2 tolerance. Stay tuned for more info about this.

    • Bag breathing is one way to increase CO2 tolerance. Turn a gallon Ziplock bag inside out or use a paper bag, enclose it around your mouth and nose, and inhale and exhale through your nose. This is excellent to do upon waking, before going to sleep, before/after eating before/during/after activity, when stressed or anxious.

  • Train yourself to be a nose-breather (instead of a mouth breather) by wearing paper medical tape on your lips while you sleep.

  • Use an abdominal binder and/or resistance bands tied around your abdomen and ribcage to add proprioceptive cues to help you understand if you are breathing fully.

  • Use a breathing trainer, such as the Relaxator.

  • Incorporate breathwork throughout your day, even if it’s just 1 minute at a time.

  • Stay tuned for a blog post on different types of breathing exercises and ways to improve your breathing.

  • Experts and their resources: Patrick McKeown’s Oxygen Advantage and James Nestor.

Meditation

Meditation can be an excellent form of stress management for many people, and there are various forms of meditation that appeal to different people and in different circumstances. Be aware, though, that meditation - or certain forms of meditation - may not be a good option for someone experiencing anxiety, depending on the severity and details of the anxiety.

  • Resources for exploring meditation include: Insight Timer, Calm, Headspace, YouTube, “Stress Less, Accomplish More” by Emily Fletcher.

Mindfulness

Mindfulness is the quality or act of being present in the moment, and involves a focus on (1) attention and (2) acceptance, as a means of managing stress.

  • Mindfulness training guides an individual to tune into their experience to focus on what is happening in the present moment. This may involve directly the individual’s attention to their breath, thoughts, physical sensations, emotions, etc. The individual is then guided to accept those feelings and experiences without judgment, instead of reacting or responding to them.

Grounding

Grounding techniques can help to switch off the sympathetic “fight-flight-freeze” response to perceived danger, and allow an individual to regroup and not be ruled by their emotions and body sensations.

  • Grounding techniques involve focusing on one or more of your five senses and can help you focus yourself in the present moment. For example:

    • Notice and count the physical objects in your surroundings (i.e., count the number of tiles, the number of trees, etc.)

    • Notice the things you are in physical contact with and how they feel (i.e., the soft socks on your feet, the hard chair you’re sitting on, the scratchy rug you’re standing on, etc.)

    • Notice the smells or sounds around you

Emotional Freedom Technique (EFT)/Tapping

EFT/Tapping, also known as psychological acupressure, can be helpful in reducing physical pain and stress and balancing energy.

  • This technique involves tapping different parts of the body in a particular sequence while identifying and considering an issue that they want to resolve. There are many online resources to learn tapping.

Nature

Nature - even images of nature - are known to reduce psychological stress.

  • Note: People with allergies and mast cell diseases may struggle with exposure to nature. For my entire life living on the East Coast, I didn’t tolerate being in nature - grass, trees, flowers, etc. wreaked havoc on my body. West Coast nature, however, does wonders for me body. Not only do I tolerate California’s nature, exposure to the mountains, ocean, trees, plants, and flowers here have been magical for me. I still don’t do great with grass, but that’s pretty easy to avoid.

Laughter

Laughter is one of the best ways to relieve an individual’s stress response.

  • Marry or partner up with someone funny, surround yourself with friends and family who make you laugh, make yourself laugh, watch silly videos, do whatever you have to do to never stop laughing.

Hypnosis

Hypnosis can help to create a feeling of safety within the body.

  • I recommend working with a medical professional trained in medical hypnosis (medical hypnosis is different from stage hypnosis). Medical hypnosis has been life-changing for me.

Community

Community helps us feel connected to and accepted and supported by other people, which helps us to feel less alone in our experiences. Living with chronic conditions can be isolating, given the different and sometimes unusual ways that we need to live our lives. It can be extra challenging for those of us living with chronic conditions to find the “right” communities and to maintain relationships the way we want to.

  • I recommend focusing on the quality of your community, rather than the quantity of members in your community.

Self advocacy

Learning to stand up and advocate for yourself is critical for managing stress. The more your needs are met, and the less you get pushed into doing things that aren’t good for you, the easier and less stressful your life will be - and the prouder of yourself you will be!

Music

Singing, playing an instrument, and listening to music are excellent ways to lower stress levels. Especially if you’re like me and music makes you wiggle and giggle.

Being intentional with your life decisions, rather than being a passive participant in your life.

It can be really easy to live on auto pilot and to suddenly wake up one day and wonder how you ended up doing life in a way that doesn’t make you happy, feel your best, or work for your lifestyle. I’ve seen this countless times in my industry, where attorneys keep their heads down and work so hard for years climbing all the ladders they can find, and then one they day realize that they don’t know why they became a specialist in X or why they’re still working for a company that doesn’t match their lifestyle needs.

My and my husband’s life got exponentially better when we went from fitting happiness into our busy career-focused lives to prioritizing happiness and fitting everything into that. We moved from the East Coast to the West Coast, living minutes from the beach, which is better for my physical health, both of our emotional and mental health and certainly better for our day-to-day happiness. When we changed how we made life decisions, things in our professional lives starting clicking into place in a way they hadn’t when we were hyper-focused on winning the career game and our overall stress levels went down because we were living life entirely on our own terms instead of trying to fit into other people’s molds or fit other people’s needs - and we feel like we’re living on vacation every day.

Boundaries. Saying “no.”

Saying “no” to one thing allows you to say “yes” to something else. Learn to listen to your body and make decisions whenever possible based on whether you’re getting a full body “yes” or “no.” When our to-do lists are filled with things we wished we had said “no” to, our stress levels go up and we don’t show up as well as we do when our list is more primarily filled with things that excite us and that we can truly manage.

Nutrition and Blood Sugar Regulation

Maintaining “healthy” eating habits regarding how, when, and what we eat is critical for managing stress. A diet filled with sugar and ultra processed foods sends the body on a rollercoaster ride, which can cause or exacerbate feelings of anxiety, depression, brain fog, general discomfort, and so much more. Eating nutritious, whole foods (vegetables, fruits, nuts, seeds, fish, meat, whole grains) makes an enormous difference in how we are able to respond to and manage stress and our ability to navigate our busy lives. Read more about my general food recommendations.

Sleep

Getting sufficient, quality sleep is critical for managing all aspects of health - physical, mental, and emotional - and can also allow people to recover more easily from, and respond more effectively to, stressful events. Read more about how to improve your sleep.