October 13

How Do Chronic Stress and Trauma Impact Your Health?


There is a lot of talk these days about trauma and how traumatic this year – 2020 – has been.  It makes sense.  This year has been crazy.  But for those of us who have experienced individual traumas over the course of our life (is there anyone who hasn’t?) the experiences and effects of this year may be more significant than we have realized.

I had the opportunity this past weekend to hear Dr. Yvette Marie Miller speak on the effects of racism, trauma and chronic stress on health, including strategies for managing stress and improving health.  Sounds like my kind of talk, right?  It really was.  In so many ways.  Dr. Miller is the Executive Medical Officer of the American Red Cross (ARC), an agency that sees a lot of trauma across this country – everything from personal disasters like house fires to statewide impacts of natural disasters.  When I was working as a physician in South Florida’s public health system, the American Red Cross was a critical partner during hurricane response and recovery efforts.  Some of the most resilient and caring individuals I have ever met were with the ARC. 

Adverse Childhood Events or ACEs

In support of her discussion that racism is a chronic stressor that has direct impacts on the health of the individual, she also discussed the ACEs studies from the late 1990s.  ACEs are Adverse Childhood Events and the standardized questionnaire that’s out there includes events like emotional, physical and sexual abuse, neglect, and violence in the home (especially witnessing the abuse of your mother) but also included in these kinds of experiences are bullying, discrimination, racism and sexism.  The thing that has always stuck out to me over the years studying ACEs is that I believe we would be very hard-pressed to find an individual who has not experienced some of this over the course of their lifetime.  That being said, the questionnaire is scored based on the number of ACEs you experienced and, clinically, we’re looking for a score that indicates someone has had more than their fair share of these experiences. 

The Body Keeps Score

Why do we care?  Because studies tell us that when someone has a higher ACEs score, they are at higher risk for depression, heart disease, hypertension, smoking, memory loss, irritability, inability to focus mentally, and many other health-related issues.  These experiences create stress, both emotional and physical, that significantly impacts our physical, mental and emotional health as an adult.  There is a fascinating book, although it can be a challenging read, called The Body Keeps Score by Bessel Van Der Kolk, MD that helps us to understand that just because we can block an experience from our memory, our biochemistry and physical body don’t forget. 

Many of us tend to downplay the traumatic experiences we have survived.  I believe one reason for this is that we assume our lives and experiences are typical or normal somehow and that it’s no big deal that we saw what we saw or felt what we felt.  That could not be further from the truth.  Your story – your experience in this world – is unique and important. 

Add on the Stress of 2020…

The reason I bring all of this up right now in this bizarre world of 2020 is that these kinds of stressors – traumatic experiences – are cumulative.  Maybe you can easily say that some of the ACEs experiences were your experience growing up, but it really has never been an issue.  Life has just moved along and you’ve been able to keep up pretty easily.  But maybe now you’re having a hard time with the non-stop hits that have come this year, one after the other.  It’s harder to focus.  Your memory is not what it used to be.  It’s harder to sleep or to truly relax.  If that’s you…you are not alone.  To be honest, I’m there, too.

Great…so now what?

OK, back to Dr. Miller’s talk and likely your biggest question – how do we decrease the effects of ACEs and trauma in our lives and on our health?  Dr. Miller was talking to me when her next slide said – Self-Care.  Seriously!!  I jumped up and down in my chair (if that’s possible…although it could be why my back hurts today).  Pulling from her slides:

  • Self-care is paying attention to and supporting one’s own physical and mental health with or without the support of a healthcare provider.
  • Self-care develops the resilience to deal with stress in a healthy way.
  • Personal resilience promotes and supports community-based resilience.
  • The process of developing resilience provides an opportunity to model positive behavior for family, coworkers and community.

As usual, I have to put a quick disclaimer in here that self-care is obviously not the cure for every disease under the sun.  But for a Preventive Medicine physician like me, it becomes the way to prevent and decrease the risk for so many illnesses that are entirely too common in our country.

Needless to say, Friends, my passion for all of this just jumped 362%.  (That’s an estimate.)  And I’m so glad you’re here to share in this adventure with me.

This Week’s Self-Care Practice…for the next three weeks:

We’ve established that this year has been hard.  No other way to put it.  And one of the biggest stressors is coming up in three weeks – the Presidential Election.  Given that there are mostly only strong opinions on this one, I am going to make an assumption that most of you know how you are going to vote and no one is going to change your mind.

If that is the case, I strongly recommend you turn the TV and social media off.  Just for the next few weeks.  Limit the amount of election coverage to which you are exposed.  We’ve already said you know how you’re going to vote and nothing will change that – so why watch?  That may put a few folks off…but I’m trying to help you decrease your stress level and improve your health.  That’s it.  I can confidently say, this is not political. 

If you are still on the fence about how you want to vote, be very intentional about what you watch and the discussions in which you engage.  What information do you need to be able to decide on your candidate?  Seek out those answers and then walk away.  Again, my goal is to help you decrease your stress level during an already intense and overwhelming season.

And then, on November 3rd (or before) go and vote.  Please vote.  Know that your vote is between you and that screen/piece of paper you mark.  Share with friends and family if you want.  And if you don’t want to – don’t.  Again, self-care right now is about maintaining some peace for you in this situation. 

Give it a try – take care of you this week.

Is maximizing your health through self-care an interest of yours? Me, too! I put together a guide with my seven favorite easy and (mostly) free self-care activities that you can start today to get you feeling better tomorrow. Get your copy by hitting that button right down there. You can let me know what you think of it over on Facebook – just search @gracemedstudio.

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