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Tag: stress

The Impact of Adverse Childhood Experiences: Managing Emotions and Stress

Linda Chamberlain is the founder of the Alaska Family Violence Prevention Project and an internationally recognized advocate for understanding the effects of domestic violence and adverse childhood experiences on brain development and health. She focuses on creating tools that highlight trauma-informed practices for parents, service providers, and organizations that work with kids and families.

Children develop 85% of their core brain structure in their first five years of life and then continue to build on that core foundation the rest of their lives. The young brain is like a sponge—effortlessly, continuously, and indiscriminately soaking up information. From birth, our undeveloped brains are waiting for experiences to shape them. Our first experiences become the building blocks for our whole lives. Our brains are mirrors to our childhood developmental experiences.

Dr. Chamberlain recognizes the importance of social and emotional skills in academic and life success. The biological sponginess of our brains allows us to acquire so much information before age five, but it also makes youth more vulnerable to trauma than people who are older. Most people perceive youth to be more resilient than adults, but it’s actually the opposite; if anyone is impacted by trauma more severely, it’s the youngest child.

Trauma Tree

The roots represent the prenatal stage of growth and where the tree touches the ground is birth. The trunk is infancy, early childhood is the lower branches, and up to adulthood is the top branches. When trauma occurs, the rest of the tree’s (brain’s) growth beyond that point is negatively affected. As you age, you have more life experiences and knowledge to cope, but also more branches to compensate.

This concept becomes significant when we learn that 95% of kids have adverse childhood experiences. Kids who grow up in domestic violence end up with mental health issues more often than kids who are direct victims of physical abuse. Exposure to violence is a lifetime legacy. While domestic violence and abuse are often tangible and identifiable, there’s an endless range of situations and experiences that are adverse (or less tangible and identifiable).

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The brain of a child, Dr. Chamberlain asserts, will become exactly what the child is exposed to. Children exposed to fighting parents will experience a state a fear, and systems in their brains shut down. Parents who fight in front of their kids are literally changing their children’s brains. Moreover, a baby absorbs her parent’s internal state. A kind parent creates a kind child; a patient parent creates a patient child.

Symptoms of chronic stress or signs of exposure to trauma can range from night terrors to attachment issues. Kids who are labeled as ADHD or defiant may be operating in crisis or survival mode. Trauma and stress are stored in our bodies, reside in our nervous systems, and disconnect the person we are from the body we live in. Trauma also interferes with the development of self-regulatory skills.

The great news is that our brains have the capacity to change, heal, and rewire across our lifespans. A resilient individual isn’t someone who avoids stress but someone who learns how to manage it. Kids can develop competence under adverse circumstances because of strong parent-child relationships as well as the ability to self-regulate attention, emotions, and behaviors. Both resilience and mindfulness are learned skills. Kids can even learn resilience vicariously by watching others overcome adversity.

One simple strategy to teach kids to manage emotions and stress is the Fingerhold Practice. It combines breathing and holding each finger and can be helpful when difficult feelings arise or challenging experiences are anticipated. Holding each finger in turn, gently but firmly, with the other hand and breathing comfortably or slowly can be calming, reduce tension, and provide a sense of control. Many adults feel relief after 2-5 minutes per finger, while kids typically feel relief more quickly (30-60 seconds).

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Real Food: Gut Health

Hippocrates, the Father of Western Medicine, believed that all diseases begin in the gut. The digestive system is directly linked to the immune, nervous and endocrine systems. It’s the avenue through which nutrition is taken in, broken down, absorbed, assimilated and incorporated into our bodies. If your gut is healthy, chances are you’re healthy.

Our modern western lifestyle, however, is far different than Hippocrates’ was in 460 BC. We exist in a culture of stress (which exacerbates digestive issues). We’ve strayed from the daily organic farm to table tradition. And we cohabitate with countless manufactured toxins. From the way we live to the way we feel, our bodies suffer from pervasive threats to our digestive health.

Stress can cause and exacerbate digestive ailments.

Stress can cause and exacerbate digestive ailments.

In their presentation, “Real Food: Gut Health,” Laura Stout, R.D., and Phaedra Fegley, M.D. and Director of Integrated Health, discussed our most common gastrointestinal diseases, their symptoms and some dietary suggestions. Over and over, they extolled the virtues of a plant based diet for keeping the digestive fire strong and healthy. A plant based diet reduces inflammation, increases absorption of nutrients and excretion of toxins, and fuels our bodies for optimal health.

A plant based diet offers lots of fiber. Fiber is what gives plants their structure and is indigestible by humans. Fiber does not add calories to your diet, but it does play a critical role in maintaining gastrointestinal health. The fibrous portion of a vegetable is a prebiotic and can alter the composition of organisms within the gut. Prebiotic food sources include asparagus, garlic, onions, leeks and bananas.

Fibrous, fermented foods optimize gut health.

Fibrous, fermented foods optimize gut health.

The intestinal wall is made up of probiotics, or strains of naturally occurring bacteria which are fed by prebiotics. Probiotics aid digestion, provide nutrients, synthesize vitamins and boost immunity. They rely on prebiotics for nourishment, so buying supplemental probiotics without consuming prebiotics is ineffective. Probiotic food sources include yogurt, kefir, miso, tempeh, kombucha and fermented foods. The pasteurization process kills probiotics.

Understanding and balancing prebiotics and probiotics is essential to cultivating a healthy gut microbiome so that your body can break down your food. But even so, there are foods in our modern western diet that are universally difficult to digest. FODMAP is an acronym of these carbohydrates and their restriction (the FODMAP diet) has been beneficial for people who suffer from gastrointestinal disorders. The carbs are: fructose (fruits with more fructose than glucose, honey, agave nectar); lactose (dairy); fructans (wheat, barley, rye, onion, garlic); galactans (beans, lentils); and polyols (sweeteners such as sorbitol, xylitol).

gut flora

Another seemingly trivial part of our culture that affects our digestive health is drinking cold liquids. Restaurants set tables with plates, utensils, napkins and ice water; it’s how we dine. But, drinking cold water is akin to squelching a fire—you’re literally throwing ice water onto a fire (your digestive system). It’s best to consume liquids that are warm or room temperature, and it’s better to drink liquids between rather than with meals.

The fire of life.

Your gut: the fire of life.

Gastroesophageal Reflux Disease (GERD) is chronic damage caused by stomach acid coming up from the stomach into the esophagus. Symptoms include heartburn, regurgitation, chest pain, feeling like food is stuck in your throat and difficulty or pain when swallowing. Contributing factors can be pregnancy, obesity, alcohol, smoking and certain medications. Lifestyle changes to alleviate the symptoms of GERD include raising the head of your bed 6-8”, not lying down after eating, wearing loose clothing, and drinking liquids between meals rather than with meals. Problematic foods include coffee, tea, cola, citrus, mint flavoring, high fat processed foods, tomato based foods and spicy foods.

A Peptic Ulcer is a break in the lining of the stomach, first part of the small intestine, or lower esophagus. Symptoms include pain (usually worse at night), feelings of fullness, belching, vomiting, poor appetite and weight loss. Treatment options include: antibiotics to get rid of any existing H-pylori bacteria; acid blockers; and stopping the use of NSAIDS and tobacco. Dietary suggestions include limiting the use of alcohol and caffeine as well as fatty, acidic and spicy foods.

Small Intestine Bacterial Overgrowth (SIBO) is a chronic bacterial infection of the small intestine. It’s caused by bacteria that normally live in the gastrointestinal tract that have abnormally overgrown into the small intestine (and are similar to the bacteria found in the colon). The bacteria interfere with the normal digestion and absorption of food that occurs within the small intestine and cause damage to its lining. Common symptoms include abdominal gas, cramps and/or pain as well as constipation and/or diarrhea. Treatment includes antibiotics and probiotics.

Celiac Disease is an immune reaction to eating gluten, a protein found in wheat, barley and rye. Over time, this reaction produces inflammation that damages the small intestine’s lining and prevents absorption of some nutrients (malabsorption). The intestinal damage can cause weight loss, bloating and diarrhea. Eventually, your brain, nervous system, bones, liver and other organs can be deprived of nourishment.

Celiac_disease

The truncating of the villi lining of the small intestine is called villous atrophy.

Irritable Bowel Syndrome (IBS) is the umbrella term used for all of these digestive issues. Stress, diet, medications and hormonal imbalances can play a role.

Inflammatory Bowel Disease (IBD) is an autoimmune disease of the colon and small intestine. Crohn’s Disease and Ulcerative Colitis are the most common types. Currently, there is no medical cure for IBD but prebiotics and probiotics are becoming increasingly effective treatments.

Leaky Gut Syndrome is the condition of increased intestinal permeability which allows food and toxins to leave the intestines and enter the bloodstream. Because these particles aren’t supposed to be in the bloodstream, the immune system identifies them as dangerous and creates an immune response, attacking them along with other healthy cells. Leaky Gut can cause allergies, fatigue, skin conditions, depression, anxiety, insomnia, migraines, and more. It’s important to remember that intestinal impermeability is not fixed—we all have it to some degree and it can change over time.

leakyGut_largeIntegrated Health’s mission is to promote self-healing through interaction of mind, body and spirit and enhance traditional medicine practices.

Stop Stress!

Children and adults with intellectual or developmental disabilities often experience stressful events and interactions and then use maladaptive strategies to manage these situations. In addition, the presence of behavior challenges in children is linked to elevated stress in parents. Stress is an epidemic in our western world. It’s implicated in 7-10 of the leading causes of death (heart disease, cancer, stroke, suicide, homicide) and indirectly linked to cancer, liver disease and emphysema. 75-90% of visits to primary health care doctors are for stress related concerns. Stress negatively impacts our physical, emotional and psychological wellbeing.

jim-porter_smallHaving recently attended Dr. James Porter’s presentation, “Stop Stress This Minute,” at the Yampa Valley Medical Center, we learned about the causes and effects of stress as well as effective management strategies to reduce its powerful impact.

What causes stress? Is it your job, finances, relationships, responsibilities? No, Dr. Porter says; it’s you! Stress is the result of you, or more specifically, your thinking. Stress is a word that stands for problems. But stress is your problem to solve. Taking responsibility for solving your problems doesn’t mean that you are to blame. It means that you are the one to solve the problem.

Stress is related to feelings of control (a concept so important for people within the I/DD world). People who feel in control of their lives are invigorated and challenged by busy schedules. They believe there’s a solution to every problem. People who don’t feel in control of their lives are overwhelmed. They tend to see problems as unsolvable. In order to feel in control, we need to believe we’re in control. Control begins in our minds.

Stress is the body’s response to demands placed on it. It’s different for everyone; what stresses you out is different than what stresses your coworker or roommate out. Your signs and symptoms are specific to you. Stress is not what happens to you, but how you respond to it.

While today’s stressors have evolved from those of the caveman 25,000 years ago, the physiological reaction is the same. We inherited the Fight or Flight response from our ancestors. When we feel threatened and can’t escape (a predator attacking its prey), our bodies activate a supercharged, high octane response. The hypothalamus sends a message to the adrenal glands. The heart pumps 2-3 times faster, sending nutrient rich blood to major muscles. Capillaries close down and blood pressure rises. Eyes dilate and bodily functions associated with long term survival shut down (digestion and sexual function stop, the immune system shuts down, and excess waste is eliminated). Fight or Flight is short term for survival.

Physical signs of stress can include a pounding heart, upset stomach, dry mouth, rapid pulse, skin rash, perspiration, sleeplessness, diarrhea, recurrent colds, headache, fatigue, weight loss or gain, frequent urination, unexplained or frequent “allergy” attacks, gritting or grinding teeth, neck ache, back pain and muscle spasms. Emotional signs can include anger, frustration, worry, fear, panic, anxiety, feelings of loneliness or worthlessness, and overreaction to petty annoyances. Psychological signs can include crying spells or suicidal thoughts, depression, frequent or wild mood swings, obsessive or compulsive behavior, lies or excuses to cover up poor work, and difficulty in making decisions.

Today, most people manage stress by smoking, eating, drinking, spending money or using drugs. Stress is a ubiquitous and dominating lifestyle factor. So why don’t we manage it? Dr. Porter suggests that our culture promotes stress like a badge of honor—it’s synonymous with the American work ethic. We’ve cultivated a mindset against managing stress. Doctors receive little or no training about its impact on health. As a result, we don’t know how stressed out we are.

Stress is cumulative and our levels vary throughout the day. If something small bothers you, your stress levels have accumulated and you need to hit the reset button. It takes 1-2 hours for stress chemicals (adrenaline and cortisol) to come down to baseline. Dr. Porter encourages us to know our stress number: 0 = no stress and 10 = a panic attack. If we’re at 5 or above, we need to use a strategy to bring it down.

One strategy is Cognitive Restructuring. It’s based on the equation: A (activating event) + B (belief) = C (consequence). Cognitive Restructuring means changing your thinking and it requires a commitment to transformation. It challenges us to get rid of negative self-talk. For example, when we get a flat tire on the way to work (A), we tend to get stressed (C). Most people believe that A = C, when it’s actually our beliefs about the flat tire (B) that determine the consequence. Cognitive Restructuring implies that if we change our thinking (B), we can change the outcome of a stressful event. Instead of responding to A by thinking, “Why does this kind of stuff always happen to me?!”, choose to accept what can’t be changed and stop passing judgment. We can’t change events, but we can change the way we view them. The only thing standing between us and our new behavior is a single thought (B).

Another strategy is to Self-Regulate. This includes deep breathing, progressive muscle relaxation, mindfulness and meditation. Deep breathing opens the capillaries that close during fight or flight. Progressive muscle relaxation relaxes the muscles and lowers blood pressure, heart rate, and respiration. It’s simply the tensing and then relaxing of each muscle group of the body, one group at a time. Mindfulness is all about being in the present moment. In today’s society, we tend to do things mindlessly, or we let our minds wander into the future and feel anxiety or reflect into the past and feel anger. In meditation, we notice the in breath, the out breath and the gap in between. Meditation trains the mind to identify thoughts without judging them or becoming them. Meditation allows us to notice what goes on in the present (where life happens) and breathing is how we bring ourselves into the present.

We’re all somewhat addicted to stress. It’s a buzz; it makes us efficient! It can be the spice of life, but it can also be the kiss of death. So when you decide what it is you want to change—which events or situations cause toxic stress—start small. Make one change at a time and practice it for weeks, if not months, before adding in additional layers of change. First, become aware of the need to change, learn why you should change and consider how you want to change. Once you take action, focus on maintaining your healthy behaviors.

A Time Management Matrix can help you decide which behaviors you want to change.

A Time Management Matrix can help you decide which behaviors you want to change.

And for those of us who know, work or live with people with I/DD or children with behavioral challenges, Dr. Porter’s work reminds us to be curious about how stress presents itself and knowledgeable about strategies to manage it. While stress is a natural human state calling us to pay attention, it can also be identified and nurtured to work for us rather than against us.

There's a relationship between increasing levels of stress and optimal performance--but only to a certain point.

There’s a relationship between increasing levels of stress and optimal performance–but only to a certain point.

Dr. James Porter has presented seminars on stress management at West Point and for The FBI, The Navy, The Department of Homeland Security, The American Heart Association, The International Stress Management Association and at Time Life Headquarters in NYC. His work has been reported on in a wide variety of national media including Good Morning America, PM Magazine, Ladies Home Journal, The Daily News, The Dallas Morning News and in such medical Journals as The Journal of Bio-communication and the Journal of Cardiopulmonary Rehabilitation and The Journal of Family Practice. He is currently a fellow of The American Institute of Stress.

See more at: http://www.youtube.com/watch?v=qAqoKGy9zHM