Show notes:

112. The Stress-Trauma Continuum

Vanessa 00:00
Welcome to the Empowered brain, the only podcast using science, psychology and coaching to help you rewire your brain and create a life you love with your host, Dr. Vanessa Calderon, a Harvard grad physician, master coach, and mother of two.

Hey, friends, welcome back to the podcast, I want to talk about the stress trauma continuing today. Now, before I go on, I want to mention something that's really important. So if you only listen to the first three minutes of this episode, I want to make sure you hear this. If you are experiencing signs of chronic stress, or burnout, I want you to know that you're not alone and that you can get help. How do you know if you're burned out, I'm going to explain to you the symptoms of burnout, because I want you to know and identify them and who you are maybe in a loved one.

One of the first signs is exhaustion, you're feeling completely exhausted. Now this can show up in different ways. One, you can feel physically exhausted, where you can sleep eight hours a night, and wake up the next day and still feel totally drained. Or you can feel emotionally exhausted. When someone asks you how are you and you just want to start crying you find yourself wanting to cry. And you might be surprised by this because maybe you generally have an optimistic swing to life. Maybe you are not someone that's ever dealt with emotions of anxiety or depression before. And now you're catching yourself feeling like you're gonna cry, sometimes. That is exhaustion. That's one of the signs of burnout.

The second one is something called depersonalization, also known in medicine as poor bedside manner. But this is whenever you find the need to consistently constantly just vent about your job. Or about for example, if you're a clinician about your patients how bad they are. So notice if you're experiencing physical emotional exhaustion, or depersonalization. And the last one is a lack of sense of personal accomplishment, where you start doubting the meaning and the quality of your work. Maybe you're saying things like, who cares? My work doesn't really serve a purpose. Anyway, anyone can do my job. This is so dumb, you're starting to feel those symptoms of apathy. So if this is you, if you're experiencing burnout, again, I want to tell you that you're not alone. And it's not like it's a light switch that goes off all of a sudden, and you're like, Oh, holy smokes, I'm burned out. No, it's something that happens really slowly and consistently, it's when you're experiencing stressors over and over and over again. And generally, you probably think that you can just work harder to solve the problem. So you're pushing against it, pushing against it, pushing against it. And all of a sudden, you don't have the resources to keep pushing against it, and you experience burnout.

So if this is you again, you're not alone, and I want to help you, you can get help. I want you to know that. And I want to help you reach out to me directly. You can email me [email protected], you can reach out to me on Instagram or Facebook, or just send me a direct message DM me, but reach out to me because I can help you. I want to share with you that I also clinically experienced burnout. I'm a clinician I experienced burnout twice.

The first time I had no idea what was happening in my life, I had never experienced that before. And my solution whenever something wasn't working right was always to work harder. And I'll tell you right now, that working harder does not solve the problem of burnout. It just makes it much, much, much worse. The second time I experienced burnout was when I was leading a department and hospital in the middle of COVID. And I just internalized all the stress and didn't do what I need to take care for myself. So again, if you are experiencing this, you can bounce back. I definitely bounce back. I have a career that's thriving. I am so happy with what I'm doing in my life. I feel like I have so much purpose. I don't doubt the quality of my life. I'm living a life where I feel very fulfilled and you can too. So if you're experiencing this, please reach out to me. Okay, again, you can reach out to me at Vanessa@vanessa Calderonmd.com go to my website and you can reach out to me there or you can just DM me on social media, the handles to my social media are in the show notes.

Okay, so I wanted to make sure to talk about that first because I've had so many students and I've had so many clients who come to me and in the very beginning, they're like, I don't know what's wrong. I just don't feel right. Something's just kind of missing some things wrong. And then the more and more we dive into it, the more signs and symptoms of burnout that they have. And when I named that for them, and I say, Hey, you're experiencing burnout, they're shocked, they had no idea. And that's not surprising, because it's not like we're told, you know, or no one's watching out for us, essentially, we have to watch out for ourselves. And you can also watch out for your colleagues. So if you have a friend or a colleague that has any of these symptoms, please encourage them to also get help. It doesn't have to be me, but I am here to help. But if they know somebody else that they trust, or they can go out and get help somewhere else, please encourage them to get help.

Okay, let's shift back to the topic of today's podcast episode, which is the trauma stress continuum or the stress trauma continuum. So essentially, what I want to talk to you all about today is how not all stress is bad stress. But bad stress, if it's not cared for appropriately, can become very, very bad. Stress can become toxic, and can lead to burnout and other really negative side effects of chronic stress. So here's what I want you to do right now, I want you to imagine, you know, those old school XY graphs, on the x axis of the line on the bottom, I want you to imagine stress on the bottom, okay, going from low to high. So the more you move out to the right of that x axis, the more stress you're experiencing. And on the y axis, I want you to imagine, it says physical and mental activity. Okay, so the x axis is on the bottom, it stressed the y axis is your physical and mental activity.

Now, when you are way over to the left of that graph, you are actually pretty bored. When you're not experiencing any stress at all or any stimulation, you're actually pretty bored. And your physical and your mental activity isn't at its peak, you're dissatisfied, and maybe you might be unhappy. So you might have experienced as if you were in a job where you stopped feeling challenged. Or if you are someone that really likes energy and activity, and you're showing up and there's not a lot going on, kind of bored. So that's what happens over to the left. Now, as you start moving over to the right of the curve of the stress curve, what you will notice is your physical and your mental activity actually goes up, when you move over just slightly to the right, and you're just stimulated a little bit. So you have stress. But that kind of stress is kind of like a stimulation, tap stress. It's like a healthy stress, you start to experience more creativity, the ability to be more innovative, you start to experience satisfaction, you're happier, you're being challenged in a way that's really good for you. That's healthy stress, okay, so that's also known as just stimulation, really healthy stress or stimulation.

Now, if you keep moving over to the right side of that curve, experiencing more and more stress, what starts to happen to your physical and mental activity is it starts to decrease again, where you will now start experiencing fatigue, or exhaustion, you might experience anxiety, you might start experiencing low self-esteem because you don't feel like you're very effective. And the further you go on the right and the longer you stay there with all of that stress, you no longer have the resources to deal with that level of stress. And that is where burnout happens.

So again, in the middle, where you have the right amount of stress, the healthy stress that stimulation, we call that you stress is your amount of stress. That's your healthy stress. That's the type of stress that really supports you, that keeps you in this mindset where you're innovative, where you're healthy, where you're being challenged in a really good way. Anything over to the right of that where you're chronically stressed out, that's distress, you will know how you feel when you're distressed, it isn't great. And anything over the left where you're bored. That's hypo stress, that's boredom. That's hyper-stress. When you are unintentionally over to the left, where you're experiencing hypo stress, you're bored, you're frustrated, you're dissatisfied in life. Now what I just described to you here, is the human response to the stress curve.

Okay. It was I think, published in 1979 by your gears and Dotson, and it's something that I used to teach a lot because I think it's such a great sort of visual of good stress versus bad stress. Versus really like hypo stress versus use stress, which is normal stress stimulation, which is bad stress, which is distress. Now, I want you to think of yourself in this sort of stress trauma continuum, because most of us are flush waiting between all of these levels of stress, there are times when we're bored. There are times when we're being challenged. And there are times when we're overly stressed or experiencing chronic stress, we're not always in our optimal level of activity, we're not always in that sort of comfort zone that you stress, we shift from one side to the other side.

Now, I want to share with you what you can do, depending on where you are on the curve, right? So when you catch yourself kind of in the middle, in that zone, where you're being challenged, that you stress zone, what I want you to do in that zone is I want you really to notice how you feel, you're probably calm, you're steady, you're feeling focused, you're really productive, you're taking things in stride, things feel really good to you, I want you to just notice that, in those moments, you're able to communicate more effectively, you're likely having patterns where you're sleeping more, or you're sleeping, a regular healthy amount of sleep, you're eating healthy, you're exercising healthy, and your performance is really consistent. And that area of your life is where you're thriving. That's thriving, when you are in that part. When you are thriving in life.

What I want you to do in those moments is to celebrate yourself, I want you to take a pause and notice and savor the good. Let the good in. In the world of neuroplasticity, you let in the good when the good is there. That's what helps you remodel your brain to start having a tilt towards instead of negativity towards positivity or neutral. So you let in the good. In those moments, it's a great opportunity to be in service and help others who are struggling. And in those moments, you can keep using your go-to coping strategies, whatever is keeping you in that moment of thriving, notice what that is, and celebrate those. If you're having any feelings of guilt, like this is too easy, or I shouldn't be suffering like my colleagues, I want you to notice those feelings and let them go. Because sometimes when we're feeling good when we're thriving, we start to feel guilty, like we don't deserve it.

Notice that and let it go because you absolutely deserve to be thriving all of the time. When you're over to the left side of that curve, this is like high blood stress, frustration, boredom, and dissatisfaction. I want you to notice that you're there. And I want you to ask yourself, What can I do at this moment to intentionally rest? How can I use this time to restore myself like a restorative restful time, instead of, you know, complaining and saying that this stinks, this is boring? Take a moment to be mindful of that moment and be grateful that you have downtime. Now, if you're consistently at that place at work, now something has to change. But if this is occasional once in a while you're in that moment, give yourself time to rest to restore.

Give yourself a moment of downtime and really celebrate that downtime. Now let's see you're moving over to the right of that stress curve, you're moving over from your stress from that normal level of activity where you're feeling stimulated, feeling good weather thriving, and you're slightly starting to move over to more levels of stress. You're probably what I want you to do in this moment, we call that surviving. So instead of thriving, you're now surviving. That's probably where you're feeling kind of exhausted and fatigued. When that's happening. Notice what's coming up for you. Are you feeling nervous? Are you feeling anxious? Are you sad? Are your moods fluctuating? Do you feel like you're short with the people that you love? Are you you know, not as patient with your kids or your significant other? But is your performance look like at work? Is it inconsistent? Are you more easily overwhelmed or irritated? Do you have an increased need to control things? And a difficulty to surrender to let things be a difficulty adjusting to change? What's happening to your sleep at this time? Are you sleeping in normal amounts? Or are you having trouble sleeping? What's happening to your diet? Are you choosing healthy whole foods? Or now? Are you choosing more carbs or sugars? Notice the activities and the relationships that used to bring you joy, what's happening to those? Are those still present in your life? Or are you avoiding them? Are they causing you stress? Are you isolating yourself? If you are in that space, you have Mark, you've moved from thriving over to now surviving. When you're in that space, here's what you do.

Here's how you cope with that. Number one, notice your to-do list. What on your to-do list can you just let go of can you just say not right now I'm not going to worry about this right now. And just cross it off. Number two, how can you add a coping style Adeje to your daily routine? Maybe for you. It's something simple like exercising, like, you know, when you move your body and you get those endorphins, you feel really good. How can you add that in? Maybe for you, it's just sitting down quietly and having a warm cup of tea, or reading a book for fun. How can you add one or two coping strategies to your day? Maybe it's as simple as committing to sleeping at night, then building your social media. What else can you do?

The other thing you can do is you can stop isolating yourself, and you can reconnect to the people around you with purpose. Now, this is really important because you have people around you that love you, and that want to support you. And when you're feeling, you know, stressed out or like you're just surviving, you start isolating yourself from those people around you. So what you want to do at this moment is you want to reconnect with purpose, who in your life are your like, you know, Ride or Die friends, those like kind of low-maintenance friends that no matter what will just always support you? Maybe it's a parent, maybe it's a sibling, how can you reach out to them to just get filled up so that they can really like to fill your cup?

The next thing you can do with just sort of simply just uses some deep breathing in those difficult moments to create mindfulness. And to help you cope with the stress. Now I created an entire self-regulation, kind of like a cheat sheet, a self-regulation cheat sheet that walks you through 10 different exercises that each take, like 10 seconds or less, that you can access anytime it's under in my website, Vanessa Calderon, md.com, go to free resources and download that self-regulation cheat sheet. And there's a podcast episode associated with that. It's probably about 10 to 15 podcast episodes back here. So you can go look for the self-regulation podcast episode, listen to that podcast episode, and download that cheat sheet. And you can use those techniques when you're experiencing this survival mentality.

Alright, so we talked about thriving, we talked about surviving. And when you keep moving over on that stress curve over to the right, so first, you were in your likes your stimulation, you're feeling really good, you're being challenged in a healthy way. And now you're experiencing a lot more stress, and you don't necessarily have the coping mechanisms. Now you're experiencing so much stress that you don't think you can keep up. And now you're struggling. So we've gone from thriving to surviving, and now we're talking about struggling. When you're experiencing that struggle, notice what you're experiencing. How do you know how your body lets you know that you're struggling? What are you feeling? Are you feeling chest pain? Are you feeling overwhelmed? or anxiety? Are you feeling this persistent fear or panic? Do you have a sense of hopelessness or like sadness?

That's pervasive in all areas of your life? What are you experiencing? What are you feeling? Are you feeling exhausted? Are you feeling you know, emotional exhaustion where you just want to cry when anyone talks to you? Or are you feeling physically exhausted? When no matter what you just can't get your energy levels back up? What's happening to your performance? Are you noticing that you're now poorly performing in many areas of your life? Are you having trouble focusing, or concentrating? What are you doing with the people around you? Are you avoiding all interactions now? Not just with the people that love you, but even the people you have to work with? Like your co-workers? What's happening to your body? Are you feeling fatigued? Do you have aches and pains, I know for me when I was chronically burned out, and I was in the stage of struggling, and I hadn't actually put my finger on it, because I had no idea that this is what I was experiencing.

I was starting to manifest physical symptoms of stress. So I started getting really bad shoulder pain, and sore necks and shoulders. And at first, I thought it wasn't a big deal, because I've been stressed before. But this was to another degree. You know, normally, I'm like, oh, I'll just get a massage. I'll be fine. But the message was not cutting it. And then I started to experience really bad job pain because I was grinding my teeth at night when I slept. And that was manifesting as really bad jaw pain. So what is happening to your body when you're in this state of struggling? What are you doing to try to get yourself out of it? Are you self-medicating with things like alcohol, or other substances? Are you eating more sugar than you normally would more dessert more ice cream? Are you buffering or numbing out with other activities like extra Netflix at night or just scrolling through social media to avoid the feelings? If this is you, and you're experiencing any of them and you find yourself struggling, here's what you can do.

The very first thing I want you to do, is I want you to just pause and focus on meeting your basic needs. What is it that you need as a human being You need to sleep, you need to eat healthy whole foods, and you need to drink water. So focus on meeting your basic needs. Sleep is the number one most important thing. I teach about the resiliency building blocks that I created, and at the very foundation of that asleep, because without sleep, you can't have any of the rest of it, it'll be hard for you to exercise when you're tired.

You make poor diet choices when you're tired. So you want to make sure you're focusing on sleep. The next thing that you want to do, and this can be a struggle is you want to establish boundaries wherever you can. Because one of the things that may have gotten you into this problem, to begin with, is your lack or your inability to set boundaries. So if this is you, you want to start to notice, wow, right? Can I start seeing no more? What's not serving me anymore? What would be possible if I set these boundaries? And again, if this is you, I created another step guide. It's a really simple, easy-step guide to help you set boundaries. It's in the same place VanessaCalderonmd.com, backslash resources. And I think it's called The Ultimate Guide to stop people pleasing and set boundaries.

So go there, and download that it's fantastic. And it'll walk you through exactly how to set those boundaries. The next thing you want to do is inform the people around you that you might need help that you might need support. This is not at all a weakness. This is not seen as a weakness. I was so afraid to be perceived as weak, I was so afraid to be vulnerable, that it took me forever to ask for help. It took me until I started manifesting physical symptoms of stress that I finally was like Holy smokes, hold on a second, I need help. So I want you to know that if this is you and you're struggling to stay afloat, you don't think you can keep up with us.

Go to the people that love you go to the people that support you, maybe it's your significant other, your spouse, maybe it's your boss at work, and inform them that you're going to have to give some things back for just a little bit of time. And identify your next steps for bouncing back at those moments. Like for for me with my husband, I was like, well, I need some time to just really reconnect with myself. So in the mornings, I'm going to be meditating a little longer, I'm gonna need your help with the kids. So just notice what it is that you need and ask for that support. You want to make sure that you're letting support the support system around you know that you need help because you do not have to carry this burden alone.

Again, you don't have to do this alone. If I leave you with anything, it's this. Number one, you're not alone. You're not the only person that's feeling this. And I know that as a fact because I've helped hundreds of other people with this. And I know that when you're feeling the stress when you're feeling like you're struggling, it can feel so isolating. And that is what the ego does. That's what shame does, it tries to keep you isolated, it tries to keep you from pulling out of what you're experiencing. But don't let that happen. Just remember, you're not alone. I can help you. And you probably have people in your life that love you and want to help you too. So reach out for help.

Alright, so what's the last step? So I mentioned that when you chronically move over to the right of that stress curve, you're chronically there, and you're not pulling yourself out. That's where burnout happens. And burnout happens after multiple exposures to stressful events. It's chronic stress at its worse, that's burnout. Burnout can feel like you're in crisis mode. Like you can't survive this like this is horrible. It can be very disabling, and distressing, you can feel completely hopeless. You can start having moments of nightmares, you know where you're going to sleep at night and you can stop dreaming about whatever work or something else. For me, I would dream about the hospital, I would dream about the schedule not being complete. I will dream about having to work more night shifts, I will dream about failing my patients because I was so exhausted.

So notice what it is that you're experiencing. Maybe you're having panic attacks, maybe you're experiencing more anxiety than you normally feel. Maybe you're unable to fall asleep at night and lie down and you're just lying there and you can't go to sleep. While you keep waking up throughout the night. You can't stay asleep. That was a big one for me. Sleep was hugely disturbed when I started experiencing symptoms of burnout. Maybe you're having intrusive thoughts, like you're not good enough like the stinks like what are you doing with your life, you're failing, if you might even be having thoughts of self-harm. And I really, truly hope that this is not you but you might be having thoughts of self-harm. If that's you again, I want you to go out and seek help and support. Please do not act upon those thoughts go out and seek help and support. Those aren't just thoughts. They're not reality and you can bounce back from this. You might notice that you're easily aggressive. You're easily enraged by the silliest things which is kind gonna set you off, you might start making these careless mistakes because you can't really focus.

You'll withdraw from relationships. And now you are even more dependent on substances on food on other activities because you think that they're going to help you cope. But really, that's super unhealthy mechanisms of coping, and they just make things worse. So if this is you, if you are in a crisis, if you are absolutely in a crisis, I want you to reach out to a mental health specialist. If you have an EAP Employee Assistance Program at your job or your work, please reach out to them directly. They can help you. Again, you can email me I'll try to connect you with support Vanessa at Vanessa Calderon, md.com, and arrange time for PTO, if you have paid time off, take time to do that this is a great time to use it. It's not at all a sign of weakness. It's a sign of intelligence of mindfulness, it's a sign that you know, you're ready to make a change because this is not how you want to live your life. Make sure that you're requesting support from the people that love you and you're letting people in again, the ego and shame will try to keep you isolated. But you want to let people in to help you. That's how you will bounce back, my friends.

Okay, we covered a lot today. Again, I want to remind you that not all stress is bad stress. There's that healthy stress, that stimulation that we all need to keep living our lives. And it's really helpful for us to be in a state of where we're being challenged where we're consistently growing, that makes us happy. versus what we call hypo stress where you're frustrated when you're bored or dissatisfied. If you're catching yourself in spurts of hypo stress and you're feeling bored or frustrated, use it as a moment to rest your body, and your mind as a moment of restoration. Don't look at it as off the stinks. Instead, look at it as a moment of gratitude. But if you're constantly in hypo stress, if you're constantly feeling like you're not challenged, then that's the moment that you know, it's a moment in life where you can reflect and say, Is this what I want to keep doing? Or do I need to find, for example, another career that is challenging me, I can help you with that too.

By the way, we do a lot of career changes during the journey. So reach out to me for help if you want [email protected] Now when you move over from restoration, rest to that healthy stress on the other side of that is toxic stress, toxic stress when you're finding like you're barely surviving, or you're starting to struggle, and that as you continue to move over, that's where you experienced trauma. And that is the stress trauma continuum, from restoration to rest, healthy levels of stress, toxic stress, like you're feeling like you're barely surviving or you're struggling all the way to trauma, which is through moments of crisis, where you feel like you can't deal with this anymore. Okay, sweet friends. I hope you found this helpful. Please, if you identify any of these symptoms in yourself, know that you're not alone. Please reach out for help. If you identify any of these symptoms and people that you love, or in a colleague, offer them support, let them know they're not alone. And I will see you next week sending you all so much love

Hey, sweet friends, if you love what you're learning, then you've got to join us on the journey. It's my all-inclusive program and the best community out there giving you the education you never knew you needed to help you create a life you love. Join us at VanessaCalderon md.com/join. I'll see you there.