March 17, 2021
Cindy Lopez:
[00:00:00] Welcome to Voices of Compassion, CHC’s podcast series providing courage, connection and compassion, highlighting topics that matter to our community, our parents, families, educators and other professionals. I’m Cindy Lopez and today we’re talking about what else? Stress of course. None of us are exempt from experiencing some degree of stress these days. As we deal with COVID, social unrest, natural disasters and more, we’ve all developed some coping strategies, but sometimes if the stress is prolonged it can exceed our ability to cope. Listen in to this episode with Dr. Patrice Crisostomo, Clinical Program Manager and licensed psychologist at CHC as she shares her expertise and strategies about coping with stress. Welcome Dr. Crisostomo.
Dr. Patrice Crisostomo:
[00:00:57] Thanks so much for inviting me to talk about this really important topic.
Cindy Lopez:
[00:01:02] So Dr. Crisostomo, as we live with stress, I’m wondering, what really causes stress and is stress bad for us?
Dr. Patrice Crisostomo:
[00:01:13] So Cindy really great questions. So, stressful situations can trigger a cascade of hormones that are released in our body, really well orchestrated physiological changes. And our body’s responses have really been evolved as survival mechanisms to help humans and other mammals react really quickly to life-threatening situations for protection, and so these are referred to as the sympathetic and the parasympathetic nervous systems. So the sympathetic nervous system is what activates our body to prepare for an action against a threat. And then in contrast, we have the parasympathetic nervous system that helps to calm our systems down after a threat or a danger has passed and allows us to rest and recoup and recover. And these are really natural reactions to perceived dangers that are immediate, and they actually happen without us really fully processing what’s happening. So it makes it kind of difficult for us to control, and I also want to answer your question, is all stress bad for us, the answer is no, so not all stress is bad.
[00:02:34] So our body is really well equipped to respond to stress and there is an optimal level of stress that helps us to perform well. It’s an upside down kind of U shaped bell curve in terms of the relationship between stress and performance. So if you think about kind of on the left-hand side of this upside down curve, without stress we might not have any motivation to perform or to do anything, we might just be really sleepy to be honest. And then in the middle of that upside down U-shaped bell curve that would be more approaching the optimal amount of stress, so we are more alert, we’re more focused, having that middle range of stress allows us to learn effectively and to get tasks done. But then on the right hand side too much stress can lead to fatigue and exhaustion and breakdowns. So, in the field of study around stress we know that there are positive stressors, so things that we respond to because they are temporary challenges or stressors, and so our stress response will activate quickly and then kind of go back down to a default or baseline. And then there’s tolerable stress which is more prolonged, but can still be viewed by a person as manageable because they’re still buffered by existing supports, either internal or external that we have, and then there’s also a level of stress that we as mental health professionals would consider as toxic. So these are things like prolonged stressors like chronic trauma, where the system can be really overwhelmed, it’s essentially like revving your car engine for days or weeks at a time. And many medical and mental health professionals right now are coming to this consensus that the cumulative and prolonged effects of the current circumstances, this global pandemic really has a potential to be more serious and long lasting because COVID has really altered almost every aspect of our life, and there’s still a sense of uncertainty about how long we’ll be experiencing restrictions.
[00:05:01] And I would say on top of that our resources and the sources of support that would typically buffer or counterbalance the impact of stress are also impacted. People are experiencing grief and loss both in the typical sense, if we know people who’ve actually passed away from COVID but also there’s a grief and loss with regards to the sense of physical safety, normalcy, independence, being able to engage and acknowledge important milestones, and just the psychological and physiological fatigue of maintaining a routine where we’re responding to various stressors that kind of keep on popping up like an endless game of wack-o-mole.
Cindy Lopez:
[00:05:48] Yeah, it’s understandable that we’re all feeling more stress kind of leaning toward that toxic stress category you were talking about. So Dr. Crisostomo, I’m wondering how it impacts us. So what does it look like and how does it manifest itself?
Dr. Patrice Crisostomo:
[00:06:07] Yeah, so as I was mentioning, so when we are experiencing a stressor there are immediate physiological changes that happen. However it’s the chronic stress that I was referring to in terms of the more prolonged or toxic stress that can actually begin to change our brain, our brain size, structure and functioning. So there is a series of interactions between endocrine glands and our body and our kidneys referred to as the HPA access and we know from research with kind of basic animal science research that high levels of a particular chemical called cortisol can really wreak havoc on our brains. So this can impact our fear signals in the part of the brain called the amygdala, it can impact our hippocampus which impacts our ability to learn effectively as well as remember information, and we also know that chronic stress can impact the whole body from digestion to cognition to cardiac health as well as immune functioning which I think is really important for us to attend to given that this pandemic is potentially impacting our physical health.
[00:07:28] So specifically when thinking about cognition and mental health we know that toxic stress in children and youth can make it harder for kids to learn and can contribute to the risk of development of mental health difficulties, which is why we take this really seriously, as medical and mental health professionals who work with kids and teens and young adults. And for everyone we know that repeated stress or trauma can cause a brain to become even more vigilant and even what we would consider hypervigilant, so excessively vigilant to overreact to even non-threatening situations, so even more neutral situations. Someone who’s had previous stress exposure may be more prone to viewing that neutral situation as more dangerous or threatening or stressful. And you also asked, so how does stress manifest itself, so certainly there are physical symptoms as well as emotional and behavioral symptoms of stress. And adults can have some overlapping symptoms as kids and teens, and it really does depend on kind of the developmental stage of the youth or child. So in terms of physical symptoms, this can look like stomach aches, digestional problems, headaches, nightmares, changes in appetite and eating, which can result in weight loss or weight gain.
[00:09:04] And then in children, this might look like regression, so bed wetting may come up. And in terms of emotional or behavioral symptoms for everyone this can look like withdrawal. So pulling away in certain interpersonal situations, irritability or aggression, being more tearful or more easily prone to crying, being more fearful, acting out, for kids especially increased kind of clinginess towards attachment figures or caregivers, difficulties with paying attention, and then for everyone kind of changes in overall functioning. So for kids and teens this could look like, changes in how well they’re doing at school or their motivation to participate in school. For adults, this could look like increased concerns with regards to job performance, or even just efficiency in which you’re getting your tasks done. This could also look like moodiness, just some hopelessness for the future. It’s very individualized in terms of stress responses and how it actually gets manifested.
Cindy Lopez:
[00:10:12] Thank you for tuning in! Just a note, before we continue on with today’s episode, we hope you’re following us on social media, so you don’t need to wait a whole week between episodes to get engaging, inspiring and educational content from CHC. Our social handles are linked on our podcast webpage at podcasts.chconline.org.
[00:10:35] As we think about what is stress, we know it’s not all bad for us, but we know if it gets out of control so to speak, if we experienced that kind of toxic stress, we know it can impact us. Can you talk about some healthy ways to cope with stress?
Dr. Patrice Crisostomo:
[00:10:52] So I actually really like to think instead of the terms healthy versus unhealthy, I try to think more about effective versus ineffective, in terms of coping strategies. So for example, like what will help you both in the short term, as well as long-term, but to answer your question, so I actually think it’s important for us to kind of go back to basics, and making sure that you’re getting enough sleep, eating regularly and making good food choices, moving your body and exercising, and if you’re an adult or an older adolescent, being really careful to monitor how alcohol and consumption of other substances maybe working, or not working in your life. Excessive alcohol use and I should also state that alcohol consumption is up significantly during the pandemic. Alcohol use can impact our sleep, which can then impact our immune functioning. And we know that stress can also be buffered by our social environment, so as safely as we can surrounding ourselves with supportive peers and family members.
[00:12:03] We know that meditation can be helpful, certainly deep breathing is helpful, and there are a number of resources online and also talks and webinars that have been presented here at CHC around deep breathing. And I think also engaging in relaxing activities, however you define relaxation. So that could mean for someone taking a bath or going for a long walk and for others, it could be dancing by yourself in your bedroom, or journaling. I also think it’s really important for us to pay attention to our thinking, so focusing more on what we can versus what we cannot control. I think it’s pretty easy to kind of get hung up on things that we ultimately don’t have control over, and it can also get to be challenging to get out of that rabbit hole. I think too, spending time by ourselves, which can be a challenge if you have multiple people at home. It’s important to find effective alone time, and it’s okay to have that full range of emotions. And so remembering to tell yourself that’s okay. So I think that relates to my next point, which is, engaging in self-validation and just being kind to ourselves. This is a really hard point in time. And so with that, like trying as much as we can not to sweat the small stuff. So now might be a really good time to re-examine our priorities. So considering the goals and values for yourself and for your family. And there’s a, a writer and a mental health professional his name is Ross Greene, who talks about non-negotiable things, negotiable things, as well as things that people should just let go.
Cindy Lopez:
[00:13:58] As I hear you talking a couple things come to mind and one is this idea of resilience, right. I think all of us, I certainly don’t feel as resilient as I did, maybe, you know, before a year ago. So how can coping with stress help you to become more resilient?
Dr. Patrice Crisostomo:
[00:14:17] Yeah, great point and yes, I agree with you fully, Cindy. We’re all dealing with this, this level of stress that is uncertain in terms of when it will end and unrelenting. Resilience researchers think of the idea of resilience as the process of adapting well in the face of adversity or a trauma or tragedy or sources of stress. And I think when people consider what resilience means, they often times think about like it’s the bouncing back from difficult experiences, but it can also involve the personal growth that occurs as a result of undergoing painful or really challenging events.
[00:15:07] When we experience growth and when we make it through challenges, it’s a way for us to come away feeling more confident and empowered and aware of our strengths. When we know we’ve gone through something difficult in the past, it can help to provide just a sense of confidence that we can weather future storms, and know that we have a set of skills that can be generalized or used in the future and applied effectively.
Cindy Lopez:
[00:15:38] So Dr. Crisostomo thinking about all of this stress and resilience and all the things that you’ve talked about with us today, how do I know as a parent specifically, how do I know when it’s time to seek out help to deal with my child’s stress, for example, or my own stress? What signs might I be seeing or what should I be looking for?
Dr. Patrice Crisostomo:
[00:16:02] Yeah it’s not always clear when to ask for outside help, and we also know that there’s a stigma, against help seeking behaviors specifically for mental health. So I encourage parents to really pay attention to their gut instincts and to talk with teachers or trusted friends, or your child’s pediatrician if you have questions about how your child or teen is doing and feeling, it really does I think take a village and consult specifically with a mental health provider if you are noticing that either for yourself or for your child there are significant changes in behaviors or in their emotions that are interfering with their ability to function. So if you’re starting to notice like a functional impairment, like they’re no longer eating or sleeping well or they’re not completing schoolwork, or they just seem really unmotivated to see their friends and this is different than what you know about your loved one, and then if there are any concerns related to safety. So for example, if someone is experiencing a desire to harm themselves or others, or is experiencing suicidal thoughts, definitely those are times to consult and, and speak to a mental health professional.
Cindy Lopez:
[00:17:26] Thank you Dr. Crisostomo much for spending some time with us today. If there were one thing that you hope our listeners would take away from this episode what would that be?
Dr. Patrice Crisostomo:
[00:17:36] Yeah, I would say, I just I encourage people to do whatever they can to find opportunities to recoup and recover, whether or not that means taking a nap, or if there is downtime just finding an opportunity to engage in some relaxation activities. We know that the pandemic is not over, and even when it becomes safer to return to school or to work, we will be living with the Coronavirus, just kind of like we do with the flu. So we know that there is a long haul to this, and to not be afraid to ask for help if you need it because help really is available.
Cindy Lopez:
[00:18:20] Yeah, thank you so much and to our listeners thank you for joining us today and we hope you’ll listen in again next week to our next episode. If you’re interested in some of the resources or people that Dr. Crisostomo mentioned, please check out our podcast web pages, podcasts.chconline.org. If you’re worried about your child, you can also reach out to us at chconline.org; you can access a free 30 minute parent consultation if that makes sense, you can also get an appointment for teletherapy, so whatever you need, please know that we’re here for you. So thank you, Dr. Crisostomo for joining us today.
Dr. Patrice Crisostomo:
[00:19:06] Thanks so much for having me.
Cindy Lopez:
[00:19:08] Find us online at podcasts.chconline.org. Also, please follow us on our socials. Find us on Facebook at chc.paloalto and Twitter and Instagram at CHC_paloalto. You can also visit our YouTube channel at chconlinepaloalto. And we are on LinkedIn. Subscribe to Voices of Compassion on Apple podcasts, Spotify and other podcast apps, and sign up for a virtual village email list so you never miss an update or an episode. I always love to hear from you so send me an email or a voice memo at podcasts@chconline.org or leave us a rating and review. We look forward to you tuning in each week. After all we are in this together. See you next week.
