Four Resilience Skills To Counter Depression and Unhealthy Stress

Stress Is Good

Stress can be bad but it can also be good. And even when it is bad, it can still be good. Let me explain.

While we typically think of stress as a negative, there is a type of stress called eustress that is considered positive and healthy. Eustress is the stress we experience when we are excited about something currently or soon to occur, like meeting your favorite singer, the last two minutes of a close football game, or perhaps riding a roller coaster. Eustress is experienced just like acute negative stress - your heart races, breathing deepens, pupils dilate. This is because both types of stress, positive and negative, trigger the autonomic nervous system.

The autonomic nervous system controls much of the automatic stuff your body does to keep us alive - like breathing, and making your heart beat, and regulating your temperature. It works through two competing forces - the sympathetic and the parasympathetic nervous systems. When you are relaxed, the body is more stable - blood pressure remains the same, heart rate is pretty steady, breathing is normal - but when a threat is present or anticipated, the sympathetic system turns everything up to be ready to engage the threat (fight) or run away from the threat (flee), or perhaps even freeze if the situation is outside of your ability to respond immediately. Often this system works very quickly - I think of it like a rocket blasting off.

The parasympathetic system kicks in when the threat is no longer present. I always remember this because I think of a parachute (parachute, parasympathetic), which is much slower than freefall. It allows the rocket to return safely to earth without crashing - or your autonomic system to return safely to baseline.

This process is often referred to as the Flight or Flight Phenomena (sometimes known as Fight or Flee or Freeze) and when it kicks in, the body doesn't know the difference between "I'm excited because I'm about to meet my hero" or "I'm scared because I'm about to get medical test results." You (your mind) knows what's going on and you interpret the bodily sensations with this context. Your mind is very powerful and if you direct your mind in certain ways, you can impact your fight or flight response. When we recognize the sensations as excitement, we respond differently than when we recognize the sensations as fear.

Even Bad Stress Can be Good

I also said that even when stress is bad, it can be good and this is because as we interpret the stress, we also decide how to respond to it. Much like guilt, a little bit of stress serves as a warning, like the check engine light on your car's dash. In this sense, a healthy level of stress helps us move closer to our goals. Stress is telling you that something is not functioning at its optimal level. To get the light to turn off - to reduce the stress - you need to do something - repair something, adjust something, or refill something. For example, if we are stressed about a test in our upcoming psychology class, we are likely to study more for it. This can reduce anticipatory stress. Reflecting on what depletes you and what nourishes you can help you make healthy adjustments to how you interact with your environment. Left unchecked though, those dash lights will start multiplying - stress expands exponentially if left unchecked.

Too Much Stress is Usually Bad

When we experience stress, we tend to work hard to reduce it - to turn off the dash light. But when the stress we experience becomes greater than our capacity to respond to it or when it continues for an extended period of time, it becomes unhealthy. Left unchecked, the single light on the dash can multiply. When our ability to counter stress is overwhelmed, the stress starts attacking the mind and the body.

There is a plethora of research demonstrating the impact of unhealthy stress on our physical and mental health. Healthline.com discusses the broad physical impact in their article, The Effects of Stress on Your Body. While the body is preprogrammed to react to the environment, when stress is constant, the response from the body builds up and creates unhealthy, dangerous, even deadly consequences. The physical results of ongoing stress include headaches, heartburn, fertility problems, erectile dysfunction, missed periods, stomach pain, high blood pressure, and increased risk of heart attack. Behaviorally speaking, ongoing stress can result in a low sex drive, tense muscles, insomnia, and depression.

According to the Canadian Red Cross (CRC), "Stress has a psychological impact that can manifest as irritability or aggression, a feeling of loss of control, insomnia, fatigue or exhaustion, sadness or tears, concentration or memory problems, or more. . .Continued stress can lead to other problems, such as depression, anxiety or burnout" (Racine, 2020).

Resilience vs Stress

The counter to unhealthy stress and decrease the negative impact of stressful life events (both acute and chronic), psychologists are looking more at the concept of resilience. According to the American Psychological Association (APA), resilience is "the process and outcome of successfully adapting to difficult or challenging life experiences, especially through mental, emotional, and behavioral flexibility and adjustment to external and internal demands" (APA Dictionary of Psychology, n.d.). In short, resilient people are more able to counter and recover from adversity than those with lower resilience. But while resilience has previously been studied as its own variable, more recent research is linking resilience with other positive physical and mental health outcomes.

A recent research in the Journal of Educational Psychology, a peer-reviewed journal of the APA, looked at studies that attempted to boost resilience in college students. They concluded that resilience can be learned (Ang et al., 2022) and that activities aimed at helping students learn resilience are generally successful. They also found that the skills used to become more resilient also had some interesting additional positive effects across the 29 randomized studies they analyzed.

Specifically, Ang et al. (2022) found that resilience interventions significantly improved resilience and reduced depression and unhealthy stress in their sample of college students. Although significant, the effect was small, meaning that research is still needed to determine what exactly within the training impacted the outcome and how we can increase the power of the interventions. For example, they found that when combined with skills to enhance social competency, the impact of the resilience interventions was even stronger. This tells us that resilience is strengthened when we engage with others in a healthy way.

Similarly, Janzarik et al. (2023) published a study in the International Journal of Environmental and Public Health that looked at a resilience intervention for nurses. They used pre- and post-testing as well as a control group to determine if the effects of the intervention were truly related to the intervention itself. Their eight week group intervention used cognitive-behavior techniques along with mindfulness, including work to enhance cognitive flexibility. They also trained their participants in progressive muscle relaxation, strength identification, and self-efficacy skills. They looked at six resiliency factors: cognitive flexibility, coping, self-efficacy, self-esteem, self-care, and mindfulness.

There is a lot going on in this study, but they found some really interesting results that help us understand the impact of their resilience training program. The control group received no treatment but took the same assessments in the same timeframe. The authors found that the treatment groups' overall mental health improved significantly while the control group remained relatively unchanged. The same was true for overall life satisfaction, emotional regulation, active coping, and resilience. Other variables were not significant and the effect size overall was small to moderate.

Along with the social component of the Ang et al. (2022) study, these results add components of mindfulness (awareness of the present moment and your position within your environment) and cognitive flexibility (effectively changing your thinking to best meet the current moment).

Resilience 2.0

Resilience is about countering adversity and enhancing recovery. More recently, research and clinical work is adding a third layer to the definition, arguing for a resilience 2.0, of sorts. This new view of resilience goes beyond countering and recovering and adds the concept of growth. While traditional resilience focuses on how we can regain functioning that equals our functioning pre-trauma, resilience 2.0 argues that with intervention we can be even healthier than we were pre-trauma, at least in certain areas of our lives.

This idea is called Posttraumatic Growth, and research has identified five areas where we can develop improved mental health after working through trauma, including (a) appreciation for life, (2) relationships with others, (3) new possibilities in life, (4) personal strength, and (5) spiritual change. I wrote an article about this last month - Posttraumatic Growth: An Introduction - if you want to learn a little more on this burgeoning addition to the concept of resilience and trauma recovery.

Learning to be Resilient: Four Skills

We know there is such a thing as good stress - eustress - and we know that low levels of bad stress, if responded to appropriately, can lead to positive outcomes and a reduction in future stress. We also know that intense stress and prolonged stress can easily overtake our ability to respond to it. And that there are things we can do to become more resilient, which can reduce the negative impact of stress and even help us avoid the stress in the first place. We talked about a few recent research studies that looked at resilience training, and although this list is not exhaustive by any means, interventions that involve a social component increase their effectiveness. We also know that mindfulness and cognitive flexibility can enhance the outcome of resilience interventions. Similarly studies that emphasize individual strengths add to the power of resilience training.

Here are four skills to help build resilience and counter unhealthy stress and depression:

1. Engage with People Who Nourish You

   A major key to happiness is finding people who nourish you - who bring out the best in you and who want the best for you. Think about who would celebrate your successes and help you get up when you fall. These are your VIPs.

2. Discover and Amplify Your Strengths

   Psychology is deficit-based by design - it helps to identify and reduce mental health problems. But strengths are also important. Strengths are those aspects of ourselves that we see as positive and can be developed. When we identify what is good about us, we can build on this to become better versions of ourselves. It's important to minimize what is not going well, but it is equally important to amplify what is.

3. Be Mindful and Present Focused

   Mindfulness requires both awareness and acceptance. Awareness means focusing on yourself and your experiences in the moment. Acceptance means processing each moment without judgment - and that includes no judgement about the self. Mindfulness a skill that can take some time to develop since we are more typically focused on the past or anxious about the future.

4. Be Flexible and Counter Faulty Thinking

Cognitive-behavior therapy (CBT) is a very effective treatment for a large number of mental health issues, including depression and anxiety. There is more research measuring the positive outcomes for CBT than any other approach.  It's no surprise that CBT techniques also work well to build resilience and counter stress. Two subareas have emerged as helpful:

• • Enhancing Flexible Thinking. For many of us, we develop very specific ways to interact with others and with the world that in most cases, or at least in our past, have worked well. When new stressors are added, when our environment changes or stress becomes more chronic, our old ways of responding no longer work. Flexible thinking involves adapting to your environment. If you can be mindful and in the moment, the next step is to determine how to respond for the best outcome. This often involves adjusting how you respond and in many cases it means developing new tools altogether. Having the right tool in the moment makes all the difference.
  • Countering Faulty Thinking. Even with our best intentions, we can easily slide into bad habits and negative patterns of thinking. In CBT we call them cognitive distortions because they aren't representative of the real world but rather a distorted interpretation of the real world. Some common distortions include catastrophizing - making things worse in your mind than they really are, mindreading - assuming you know what others are thinking without any real evidence beyond speculation, and fortune telling - living out the future in your mind, often to a negative or catastrophic end. Countering faulty thinking involves identifying them, recognizing them when they occur, and either ignoring them or replacing them with more rational thoughts. Practice is the key because old habits are hard to break but thankfully so are new habits.

References

American Psychological Association (n.d.). Resilience. In APA Dictionary of Psychology. Retrieved from https://www.apa.org/topics/resilience.

Ang, W. H. D., Lau, S. T., Cheng, L. J., Chew, H. S. J., Tan, J. H., Shorey, S., & Lau, Y. (2022). Effectiveness of resilience interventions for higher education students: A meta-analysis and metaregression. Journal of Educational Psychology. Advance online publication. https://doi-org.antioch.idm.oclc.org/10.1037/edu0000719

Healthline (n.d.). The effects of stress on your body. Retrieved from https://www.healthline.com/health/stress/effects-on-body.

Janzarik, G., Wollschläger, D., Wessa, M. & Lieb, K. (2022). A group intervention to promote resilience in nursing professionals: A randomised controlled trial. Int. J. Environ. Res. Public Health, 19(2), 649; https://doi.org/10.3390/ijerph19020649

Racine, V. (2020). The impact of stress on your mental health. Retrieved from https://www.redcross.ca/blog/2020/10/the-impact-of-stress-on-your-mental-health#:~:text=Stress%20has%20a%20psychological%20impact,as%20depression%2C%20anxiety%20or%20burnout.