Serenity Under Stress

Welcome, its not the amount of stress but how you handle it

Hello. Thank you all for showing up to my talk today about holiday stress. I hope that you get something out of it. We’re going to start off here today with some slides that I prepared and we’re going to talk a little bit about…well first of all I should introduce myself. Today our talk is going to be about stress and particularly holiday stress. So I’ve titled it Serenity under stress because I think you know it’s not about whether or not you have stress it’s really about how you manage it. So I really want, if I can, to give you a road map to follow to help you manage the stress that you’re you’re undergoing during this holiday season.

Who am I?

So just a little bit about me my name is Dr Beth Walker Gram and I am an acupuncturist and a Chinese medical herbalist. The name of my practice is called Elemental Wellness and that exists in both California and here where I live in the village of Tangled in rural Scotland and I specialize in Family Medicine which basically just means moms, babies, aging, mental health and my special interests really are mental health and autoimmune diseases. I spent 13 years of my life at least at this point now studying diet and nutrition and Pediatric health and then I spent six years in medical school, Chinese medical school, getting my doctoral degree in acupuncture and Chinese medicine and again, a lot of my focus while I was in school was on things like autoimmune conditions and mental health so that’s my background. “Why should I listen to you?” You don’t have to but you can and I spent a lot of time learning about this stuff.

Physiology of Stress

I want to start today off to talk a little bit about what stress is and I hope that I’m not going to bore anybody with the physiology but I find the physiology to be really interesting actually. I think a lot of times we we blame ourselves for feeling stress and it’s a physiological reaction so there’s something about giving yourself that extra bit of information that kind of releases you from obligation to fight that stress a little bit. The Cleveland Clinic defines stress as “the body’s reaction to any change that requires an adjustment or response” The body reacts to these changes with physical mental and emotional responses. They go on to say that “stress is a normal part of life and you can experience stress from your environment, your body, and your thoughts”. So, we live in a world today where there’s a lot of pollution, temperature changes when when the shift of the seasons happens you go from a very warm day or a cold day or vice versa. The rest of your environment, your sensory input. Sights, sounds, smells, all of this can trigger a stress response in your body. Exercise is one of those interesting things that we don’t think about a lot. Not that it’s not good for you, it’s just that it can induce a stress response in your body. Sometimes that’s good, sometimes that’s not what we want. And then also stress can come from emotions or thoughts whether they’re true or not and memories as well can sometimes cause us stress.

Not always a negative

I do want to emphasize that stress is not always a negative thing. It’s a physiological response and some of the things that that physiological response produces are actually beneficial. It increases productivity, it improves coping ability during life expansion; the birth of a child, a promotion or when you’re when you’re trying to go through a mortgage process. You can cope better, you can focus better and so these are things that help us succeed in these times in our life where we need that kind of response. And it improves physical performance during competition so you know people who are athletes or who rely on physical performance for their livelihood and their joy: stress can can improve performance in those ways. That’s important to note and then also it’s important to remember that it keeps us safe. There is a reason why it exists and mostly it exists as a mechanism for safety

General Stress vs Holiday Stress

So this talk is going to be about stress and a lot of the stuff that we’re going to talk about today is just blanket “this is how you handle stress”, all kinds of stress. But specifically, because of the time of year I want to talk a little bit about holiday stress as well because I think you know when we come into this time of year there’s a lot of specific stressors that come with the holiday season. Things like additional scheduling commitments, budgeting concerns, expectations from both yourself and from the other people around you. We all have a lot of emotions wrapped up in this time of year and and we’ve got memories and thoughts and feelings about it and sometimes that causes us to expect a certain outcome. We put a lot of weight on a happy holiday season and then relationships, they’re not always easy. Sometimes they’re challenging and at this time when you find yourself [as] many of us [do] face to face with relatives often for the one time a year when we are face to face with them. That can cause tension and thereby stress. Also Lifestyle Changes because we all take holidays from work or we, you know, we’re having to go to a bunch of other parties. These effect our ability to maintain the healthy lifestyle practices that we sort of balance our health on and so a shift in a lifestyle change can also increase your stress. I kind of break this all down into time, money, expectation versus intention, love and self-care and it kind of hits you in all those good spots.

Physical manifestations and stimulus

We’ll talk a little bit more about that later how we’re going to balance that but before that I want to get into the physical manifestations of stress because as I said before it’s a physiological response so there are lots of things that cause it. As we talk about stimulus we’ll have emotional stimulus or physical stimulus either from your environment or from from memories things like that so you have a stimulus that engages your autonomic nervous system right and the autonomic nervous system is responsible for that fight flight or freeze or the rest and digest. So there’s two pieces of the autonomic nervous system the sympathetic nervous system is what we call the fight flight or freeze response. So that’s your sympathetic nervous system and when you’re under a stimulus that would induce stress your autonomic nervous system engages your sympathetic nervous system. This goes into your Adrenal medulla and creates stress hormones and there’s a hormonal response to this where your hormone or your Adrenal medulla produce cortisol, adrenaline and noradrenaline and the result of this is what we call fight flight or freeze. So I just want you to take a minute and go “oh okay, so when something happens my Nervous System picks up on that” it engages the sympathetic nervous system and the hypothalamus that says “oh by the way, go make these hormones” and then your body makes the hormones. And that’s what causes the symptoms that we know of that we call stress which are that fight flight or freeze response. It’s important to remember that whether your stimulus is emotional or physical the response to that stimulus is always physical. So, whether it starts off as emotional, it always ends in that physical place where your body is producing these results.

Fight, flight or freeze

So I’m just going to talk a minute about that fight flight or freeze response for those of you who don’t know, because it does some really interesting things. So these chemicals that your body is making, adrenaline, noradrenaline, cortisol; those have physiological effects. They dilate your pupils, they increase your blood glucose, your heart rate and your blood pressure. They increase blood flow to the muscles and they decrease your digestive function. The end result of this for you, means that in terms of a safety mechanism, dilating your pupils you can see what’s going on around you better, you can see farther. Increasing your blood glucose, you have energy to fight if you need to. Your heart rate and your blood pressure, that gets blood everywhere into your body and the increased blood flow to your muscles even though it can be good to help you run away in case there’s a tiger, it can also increase symptoms of tension and pain. So, if you suffer from chronic pain, being under stress can sometimes exacerbate that. And then, the other thing that it does is it decreases your digestive function. So it basically shunts your resources out to your limbs so you can fight or flee, but that means that there’s not enough blood flow or attention being given to your digestive system. So you’ll find things like sluggish bowels or lower appetites those are other side effects of this response.

Feedback Loop

The other thing that I want you to understand is that you can sometimes get into a feedback loop where perceived physical manifestations of stress can trigger actual manifestations of stress. And you can perpetuate that chemical cascade because the other thing that happens is the noradrenaline that your your adrenal cortex is pumping out increases your alertness, increases your memory function and increases your focus and attention again as we said before earlier. Those can be really positive things, but also they mean that you’re hypersensitive to perceived stressors in your environment, which can sometimes get you back into that feedback loop. So alertness can sometimes equal sensitivity and memory function can often be a problem when you’re talking about powerful holiday memories that have strong associations and that focus and attention sometimes translates into perfectionism so these are pieces of that feedback loop that can sometimes plague us during during the holidays.

Comic Relief

This is our comic relief, we have a couple of these in here right. Who among us hasn’t taken our our stress relieving things and just shoved them in a cabinet and so nervous that someone’s going to judge you for where you hide your your dirty laundry right? Or “what’s making you so stressed? stress right! Anyway, comic relief for the afternoon

Emotional Manifestations

So when we talk about stress, I’ve just talked a little about the physical response but there’s also emotional manifestations. So for us when we’re looking at Chinese medicine we talk about stress as being what we would call liver qi stagnation and part of that is, a lot because of the physical manifestations but this manifests for us as things like irritability. And that happens biologically because your blood sugar is on a roller coaster. Your liver is is working hard to keep your blood glucose level high so that you have access to energy in a very quick and easy way. It’s doing a process called gluconeogenesis where it takes its fat stores and it turns them into ready sugar. But also, this means that you’re using your blood sugar rapidly go it goes up and down and up and down and your liver is not as good at regulating your blood sugar as say a regular diet. The other thing that we call liver qi stagnation in Chinese medicine as symptoms of depression and anxiety and a lot of this has to do with neurotransmitter imbalances. We know that depression and anxiety are caused by serotonin imbalances and and also that part of that fight, flight, or freeze feedback loop can be because anxiety will sometimes trigger a fight, flight, or freeze and so then you get into that feedback loop, depression is a mixture of the the serotonin and the noradrenaline and the dopamine. And then, anxiety can sometimes trigger that. And then the other thing that happens, I put it as emotional because I think it mostly affects us emotionally, but it really is a physical thing and that is that the fight, flight, or freeze reduces the blood flow to your reproductive organs and can also cause low libido which can sometimes increase emotional stress in our relationships.

The liver is a princess

Heartfelt change commented “now I know why liverish means being disagreeable or peevish”. Absolutely and the other thing that I always tell people is that the liver is a princess. One of the best ways to calm your liver down is to give it sugar. Why? Well because when it’s cranky, it’s working really really hard at keeping your blood sugar regulated so all it wants is for you to feed it sweet things. So, we’ll get into that a little bit later as well.

Acupuncture and Stress: the parasympathetic

So acupuncture and stress because I’m an acupuncturist you know I’m going to talk about acupuncture. That’s one of the reasons I’m here today, but the thing that acupuncture is really really good at is that other side of the system that parasympathetic nervous system as opposed to the sympathetic that’s causing all of this stress. So you might recognize this diagram we just saw a few minutes ago but this time we’re going to talk about that parasympathetic nervous system so acupuncture works by being part of that stimulus. It’s a physical stimulus that triggers your autonomic nervous system to generate what’s called beta endorphins that initiate the parasympathetic nervous system to generate acetylcholine and put you into the parasympathetic response which we like to call rest and digest. So that is how that cascade works and really acupuncture isn’t the only thing that does this to you but this is one of the ways that acupuncture works when we talk about how it helps you relieve your stress. So again, when we’re looking at that parasympathetic response how we get to rest and digest is the acetylcholine and the beta endorphins work together to contract your pupils, to reduce your heart rate, to increase your glandular secretions (the feel good hormones) and to increase smooth muscle contractility which makes it easier for you to breathe and for your heart to beat. And it increases the vagal nerve impulses that produce the increase your sexual function and also decrease those sympathetic neurotransmitters the noradrenaline and things like that. So this is all what this is, the chemical cascade and the physiological aspects of what rest and digest actually means in your body. And the acupuncture does this right it regulates the autonomic nervous system through the hypothalamus as we saw before but it does that via the skin. So when when you’re piercing the skin with acupuncture this starts that cascade and it also activates the neurons to release acetylcholine which is you remember an important piece of this chemical cascade and it enhances vagal activity it increases beta endorphins and all this put together help to reduce the stress response.

Acupuncture and Immune function

It also helps your body clear out cortisol so it reduces your cortisol levels and it improves your immune function and then also helps to break that feedback loop cycle of chronic stress. Yhey did a study actually of immune functions and anxious women where they were looking at you know the cells and and the chemicals and the natural killer cell activity in the immune system and they said that were improved by acupuncture. That they augmented immune parameters. So they really, after having acupuncture, even if you’re immune compromised, the acupuncture does actually improve your immune function. Which, as we all know, when we start getting into a stressful state and when we’re in the holidays at cold and flu season, everybody loves that.

Herbal allies

The other thing that I do, not just acupuncture, I’m also an herbalist and I do love how Chinese medicine likes to support the liver. During this time I oftentimes use liver therapies to help manage blood sugar levels to relax muscle tension, we’ve got a couple of really great herbs that do that to support digestive function. Because again, when you’re in a state of stress, your digestive function is reduced and and your digestive system could use a bit of support during that time. And then also, to promote the healthy function of your nervous system.

Priorities

So, holiday stress I hinted at it earlier, but as I said before, holiday stress is its own special kind of stress. And so I’m just going to kind of come back here to this slide where we talk about all the different things that the holidays bring to you. Additional scheduling commitments, they tax your time. Your budgeting concerns tax your money. Expectations from yourself or other people, we’re going to talk a little bit about expectation versus intention. I wanted to work on that. Relationships: so much of how we feel about ourselves and our world is about love and that comes a lot from our relationships. And lifestyle changes. Your lifestyle is your self-care so when that’s compromised not only are you worried about the love you’re getting from your relationships but also from yourself and that’s important so I like to think of this time expectation money triangle. We like to balance it, too much to do, not enough money, nothing turns out the way I want, and so for me, I like to say “well, let’s identify where the constraint is coming from and if it’s your choice or something you have no control over” and then also to set clear boundaries or I’m sorry not boundaries set clear priorities based on your own values. Identify “is this coming from the outside? can I control it? can I not control it ?” And then, if it’s something you control or those things that are within your control, you can set your priorities. Priorities that resonate with you.

Intention vs expectation

And then, I find that when we talk about intention versus expectation, you get better results with intention. And the difference here is that it’s really about “what I bring to the situation” rather than “what I can get out of it” and so that’s a shift in mindset that has to come and it’s so much harder than it sounds but um I find that this works a lot to help break that cycle where you have an expectation and then you don’t get what you want and then you feel depressed about that so instead if you go hey I think I’m going to bring this to the situation oftentimes that keeps you from having an expectation about the outcome which can oftentimes improve the outcome ironically enough.

Then balancing that triangle, time, expectation, money. We used to have this joke in a theater: “You can have it good, you can have it fast, or you can have it cheap. Pick one.” Right? Or pick two even, but you’re never gonna get all three. So, is it something where, based on your priorities, can you balance that triangle? Can you trade time for money? Are your expectations a little high? Do you need the Pinterest life or is your life good enough for everyday consumption? So balancing that triangle: pick two and let the other one go. Because very likely you’re not going to get all three and that’s just, again, managing expectations and then also setting clear boundaries for yourself so that you don’t overextend yourself; particularly for something that’s not high on your priorities list.

Relationships

I know that these are all sort of things that we swim around in our soup that we think about and then we forget about when we get under the gun so this is just that gentle reminder of how we can manage those pieces of stress that are in our life that get really hectic around the holiday season. So in talking specifically about our relationships, the top three: time, money, expectations. Let’s dig into relationships because that’s the easy one right now. So preparation is key and I think you know in terms of that it’s about centering again. You’re dealing with your priorities, finding that centering place in yourself where you’re like “all right I’m gonna need to set boundaries.” And “how do I get clear with myself about what those boundaries are?” And then, when you get to that place where you’re ready to do that; to set boundaries, draw firm lines and remember your triangle and your priorities and then remember when we talk about intention and expectation. It let’s you know love versus obligation. Clearly define your intentions. Are you doing something because you feel you need to do it or are you doing something because you’re bringing love to the situation? And take the good, it’s family. Sometimes you have to pick your battles. So if you’re able to to take the good and let the bad go, that’s never bad advice.

Lonliness

I also know that sometimes, at this time of year, loneliness can be an issue. I think if loneliness is hard that sometimes balancing that triangle by giving the gift of your time, by either taking care of yourself or by helping others can sometimes combat those feelings. Also to remember, when you’re setting your boundaries, when you’re looking at these relationships, balance that introvert extrovert energy. You don’t have to go to all the functions. It’s just not necessary and avoid the crowds if you have to. That’s also just survival techniques, but the lifestyle changes, that’s something that I definitely can help with in what I do.

Lifestyle: Nutrition

This is the meat of what I spend my days teaching my patients about Liver qi stagnation or health in general but nutrition is top of the list here. As I said, in holiday time, what do we have? We have holiday treats right? And nobody says “Oh you shouldn’t have holiday treats.” You should have holiday treats! Your liver is a princess. It would like the sugar, but how much is too much? So for me, I like to say if you’re experiencing digestive changes like bloating and bowel changes, that’s too much. So enjoy your sweets, enjoy your treats and the holidays. But, pay attention to your digestive system and if you start noticing changes that’s when you know that you need to pull back.

Lifestyle: Sleep

The other thing that gets shorted a lot during the holidays is your sleep. And because insomnia is a risk factor for later development of depression, you need to make sure you’re giving yourself enough. I know sometimes the parties, the late nights, we burn the candle at both ends. But regularity is just as important to your sleep quality as the amount of time you spend in bed. So, make sure you’re paying attention to that and you’re kind of giving yourself the gift of that relationship with sleep. Because you do need to keep it regular.

Lifestyle: Exercise

Classic: exercise. Yeah we all know we need to exercise but really I kid you not it’s a really important piece of managing stress. They mean what they say. So, if you can get out and exercise even if it’s you turn your cocktail party into a dance party, get a little more movement into your life. Get outside. I know it’s cold and dark but even a brisk 15 minute walk is better than nothing for the day.

Lifestyle: Emotional Hygiene

Emotional hygiene is another huge one. Prioritize “me time”. At this time of year, everybody’s pulling you in a million different directions but now is the time to spend time with yourself. And on that note, I would just say that acupuncture can be a great way to do me time. But also my friend Emma at Heartfelt Change is doing this amazing lecture series or meditation series called Stress Busters and I’m going to put a link here in the comments for you so the Stress Busters is going to be…she’ll talk about this more, but if you go check out her website you can see. It’s a really affordable, really quick and easy way to just tuck a few extra tools into your pocket. They’re going to help you manage your stress but also give you that little bit of “me time” that you might need during the holiday season so check it out! Again, I love giving you tools. If I could give you a bunch of tools and you could take care of this yourself that’s great! I’m happy to do that, but I’m also always here with my needles if you need somebody to be like “please just put me in that state of relaxation”, come on over. I’m also going to say that Emma is really great at helping you find that for yourself as well. From experience I can say that’s good. If she’s on, she can maybe type in the comments more info about her Stress Busters and you’ll get to know more about that.

Comic Relief: Coloring Zebras

Anyway, so prioritizing me time leads us to…oh no where did my zebras [go]! Because you know we’ve all tried all of the things to relieve stress haven’t we? But not all of it works. But it’s okay, we can still try it. I just love that it’s supposed to relieve stress. Oh my gosh! I know the Crayons. It’s a colorful zebra, it relieves stress because he’s happy now.

Help: Herbal Allies, Acupuncture and Accountabili-buddy

Anyway, the last thing I’m just going to say to you; well I’ve got two more things I want to say to you before I let you all go. But the first one is, if you’re having a hard time managing these things on your own you should absolutely get help. Now is the time to use acupuncture to help break the stress cycle. Stop the physical manifestations of the stress response and provide space to sort of reset [the] mental emotional response. Use herbal formulas if you need to. I mean now is the time [for] herbal allies. I don’t always use herbs in my practice but you know if there was a time it would be the holidays. Have a little insurance policy in your back pocket. Grab some herbal support. Help your digestive function so you can keep that healthy and support your body as it’s going through this stress response. And then also enlist someone to help you stay honest. This is one of those funny things about my practice that some people have figured it out and other people are just like “I don’t even know”. But a lot of times, having a regular appointment with a healthcare practitioner helps you be a little bit more honest with yourself about how you’re taking care of yourself. If you have to come into someone’s office every week and outline just what you did or how you felt or how it went it gives us a bit more objectivity. And it doesn’t have to be me. It doesn’t have to be a healthcare practitioner. Maybe it’s just a friend, but to have regular check-in, visits with whatever your support system is for you can be really helpful in keeping you on track and reaching your goals. And that’s before, during, and after the holidays. Because there definitely is a cycle there and I I do agree that it’s important to set yourself up now. Now is the time you might not have hit stress yet but winter is coming and now is the time to get the support systems in place. So maybe it’s your friend on the block. Whoever it is, activate that and get them in line and you can do it for each other and that that can be helpful.

Warning Signs & Help

So the last thing I want to talk about just because stress is a real thing and emotional health and mental health is a real thing is that if you find yourself veering to things that maybe are beyond what we would call a normal stress response, it’s really important to call your primary care provider. Call your GP surgery. I’ve got a couple of help lines listed on here in the U.S. you can call NAMI in the UK you can call SAMH there’s links to the email addresses and hotlines that you can call. But I want to help you figure out how to identify that first. Things that are veering beyond stress. If it’s excessive worrying or fear, when I say excessive I mean is it keeping you from doing things in your life? Is your worrying or your fear keeping you from action? Are you having prolonged or strong feelings of anger or irritability? There’s help you can get for that. Feeling excessively sad or low? Again, is it keeping you from your life these feelings of sadness or a low mood? Are you avoiding friends and social activities? Are you feeling confused? Is your thinking just muddled and you’re not thinking clearly? Are you having extreme mood changes or swings? or Have you had a significant change in your sleeping habits or feeling tired and low energy all the time? When you wake up are you having difficulty perceiving reality? I know sometimes people think, they go “oh I’m not delusional or hallucinating but I have sense” and there’s nothing wrong with that. It’s part of your brain protecting yourself but if you are having a difficult time with that real/unreal place and or having delusions or hallucinations you can get help for that. Also, if we go into things like substance abuse, is your substance habit out of control? Are you veering into abuse or are you still well managed? And if you’re having suicidal thoughts, of course. You know we talk about this in healthcare all the time. Have you thought about it? Have you planned it? There’s levels to this, but if you’ve thought about it and you’re coming up on the holiday season, please get help. There are phone numbers there. There are people there who are willing to help you. Then also we have things like an inability to carry out your daily activities or handle daily problems and stress. As I said, all of these things, if it’s causing you a problem like on a daily basis, or a lot of times this manifests for us in the holidays, if you’re having an intense fear of weight gain or you have a concern with your appearance, these are some of those early warning signs that things could get serious as the season progresses. So, if you’re having any of these things, I encourage you to reach out to a health care provider and get help for that.

Questions and Resources

These are my resources and where I got all my info from and I’m just going to hang out here and answer any questions if anybody has any. So if you are watching this on repeat and you’re not here to to comment go ahead and put something in the comments I will get back to you I will respond to you. You can go ahead and like you know hashtag replay if you want to and always you can go to my website. I’ve got a link here in the comments it’s elementalwellness.net is where you can go. You can send me an email, you can sign up for an appointment. I offer free 20-minute consultations. I like to talk about these things so if you have a question and you’re like I don’t know if acupuncture is right for me so that I’m curious give me a call we’ll chat for 20 minutes I’ll be straight with you.

Community Acupuncture

Also I’ve just begun offering uh an ear Acupuncture Clinic a community style clinic in Oban I’ve partnered with the Argyll Wellbeing Hub and so on Fridays at lunchtime we are offering a drop-in Clinic where you can come. You can get a little ear acupuncture and sit for 20-30 minutes on your lunch hour have a little Zen time. Relax, enjoy the atmosphere with other people who are looking to relax and enjoy some acupuncture. It can be a really great way to get you through. You know they say that within 72 hours of having acupuncture you’ll you’ll sort of feel those results and they can last for up to a month. So you might not even have to come in every week or you might just be able to drop in and those appointments are completely free. So we just really want you to try acupuncture.

Questions and Closing

[Question] Can folk try you out anywhere in town? Yes I busk on the streets. I just run around and poke people with little needles. No. I don’t. Um yeah you can come see me at the Argyll Wellbeing Hub on Fridays from 12:30 to 2:30. I’ll be there then or you can come to my private Clinic here in Taynuilt. Give me a call before you show up. It’s my house, but this is where I treat patients and I’m here most days seeing people and putting needles in them. Beyond that I I tend to hang out on Facebook on Tuesdays with Emma from Heartfelt Change because we like talking about holistic medicine. So I hope this helped you today. I hope it might have brought a little bit more information to you. I just want you to really feel empowered to understand that whatever you’re feeling from a stress perspective. That it’s your body telling you something. It’s not in your head, it’s not even something that you have control over most times. But that doesn’t mean there aren’t tools that that you can use to help yourself or tools that you can use that others wield that can help you as well. So again, if you have any other questions, go ahead and reach out. And I will talk to you all again soon thank you so much!