Reduce Stress and Run Your Practice Better

Consider the level of stress you experience at this point in your life.  Where would you put yourself on a scale of 1 to 10, with 1 being at ease and fully capable of managing stresses in your life and 10 being, "HELP, I am on the brink of not coping."  If you score anywhere above a 5, you are not alone.  There are a myriad of pressures that are part and parcel of running and/or being part of a private practice.

Let's begin our discussion by looking at how the brain is affected by stress and, most importantly, identify what you can do to develop greater stress resiliency.  At low levels and for short periods of time, stress can actually improve our ability to think and make effective decisions.  There is an inverted-U relationship between stress (catecholamine release) and cognitive functioning (in the prefrontal cortex).  The greater the stress and the longer it lasts, the more detrimental it is for our ability to cope and rebound after the stress abates.  There are some basic guidelines that can help you enhance your ability to thrive during times of adversity.

Ready to make a difference in your life? Below is a brief list of key guidelines, followed by a more detailed explanation of what you can do to develop a more stress resilient brain

1. Identify where your stress is coming from

2. Determine what you can control and what you can't

3. Focus on lifestyle factors that you are willing to address

4. Minimize your negativity bias (we all have it)

In this article, we will focus on the first two. 

Begin by identifying those situations in your life that you experience as stressful. Because no two brains are alike, what might be stressful for one person is not necessarily perceived as such by another.  Awareness is key.  Pay attention to how you experience stress (e.g., headaches, abdominal/gastric discomfort, tight jaws, difficulty sleeping, changes in mood, irritability) so that you can learn to identify it as early as possible.  Stress comes from one of two places - external or internal.  External stresses can be further divided into those over which you can control or influence (e.g., lack of a work-life balance that increases your stress level) and those over which you cannot (e.g., the need to use EHRs). 

Internal stresses come from our own self-talk (and if you are saying to yourself, I don't know what she means, that's what I am talking about).  Examples of internal stresses are self-criticisms, setting unrealistic expectations, reacting to external stresses in ways that make them more distressing.  Use the table below to track and learn more about sources of stress in your life.  Keep track for about a week so that you can begin to identify trends and common themes. Notice if there are any patterns to when and where you experience the most stress.

Identifying Sources of Stress

Now that you are more aware of what, when, and in which category you experience the most stress, it is time to put into effect strategies for developing more stress resiliency.  Begin with the external stresses and look at the ones that you can control. Now decide where you can get the biggest bang for your effort. There are numerous lifestyle factors (listed below) that build the brain's resiliency, and some in particular, increase the levels of BDNF (brain derived neurotropic factor), a chemical that is implicated in enhancing neuroplasticity and neuron health. It's like fertilizer for the brain.

• Exercise – one of the most effective ways to increase BDNF (see reference below)

• Diet – particularly dark greens, blueberries, dark chocolate (or cacao), green tea

Of the stresses you can control, you decide what you are willing to change.  Of the stresses you cannot control, focus on how you respond - because that is something you can control.  In difficult situations, there are 3 different responses that have the effect of exacerbating our stress:

• Helpless – feeling powerless over your situation.

• Resentful – feeling angry and vengeful about what is happening

• Guilty – taking on too much responsibility for the situation

It is important to recognize that you have choices about how you respond.  Shift from helpless to confident by spending less time complaining about your predicament and more time looking for opportunities to learn, grow, improve, and/or adapt to the situation.  Shift from resentful to challenging by asking yourself how you will take some ownership over what is happening, looking for the personal challenge in the situation.  Shift from guilty to empowering by recognizing what you can own and what you can empower others to do. 

Read the second part of this blog here.