We are fortunate enough to have a stress expert here with us today, Dr. Heidi Hanna. Thanks for being here, and what perfect timing!

It’s great during this time of social distancing that we have these discussions set up to support each other and talk about life as we know it. Life is always changing anyway, and we just kind of roll with it. Certainly people are more heightened right now to stress in general and how it affects us. 

I want to share some of your credentials first because they are impressive and it’s nice for people to know where you are coming from.

You are the Chief Energy Officer of Synergy Brain Fitness, a company providing brain-based

health and performance programs to individuals and organizations, a Senior Researcher with the Brain Health Initiative, a Fellow and Advisory Board Member for the American Institute of Stress, an instructor at Harvard University, and a regular lecturer at Canyon Ranch Resort and Spa. 

You are a NY Times bestselling author on stress and have written seven books, including The Sharp Solution, Stressaholic, Recharge and What’s So Funny About Stress. You work with premier companies such as Google, Starbucks, Microsoft, and you are a member of the Association for Applied and Therapeutic Humor.

How does humor affect our ability to deal with stress?

While I was becoming a certified humor professional I started learning about the impact of humor on the brain. I conduct research on the humor mindset, and I think that especially now I feel that being a certified humor professional is the biggest strength that I have. Humor allows us to see the world through a lens that lets us play with our pain. As long as we laugh at what we do and not who we are, we can minimize tension and improve our immune function. It’s great to surround yourself with funny friends, and even if it’s not in person you can still do it online and it’s very contagious. 

What is stress, how can we deal with it, and how can it bring out the best in us?

First, let’s talk about one of my favorite topics, which is allostasis and allostatic load. My friend and mentor, the late Bruce McEwen, came up with the model for allostasis and allostatic load. 

Most health professionals are trained under the concept of homeostasis as balance, and that the body is constantly trying to get back to a state of balance. People view resilience as the ability of the body to bounce back to the state it was in before, but that’s not really what our bodies want. We need to stop thinking so much about managing stress but rather mastering it to fuel positive change. 

I’ve seen many patients struggle because their nutrition was bad, or they weren’t working out, or they had these negative thought patterns. So often our negative thought patterns are triggered by what goes on in our bodies first. This experience is what led me down the path to Integrative Neuroscience and I started layering many facets such as nutrition, exercise physiology, and paired up with a research partner who has the world’s largest standardized database of research. We’ve pulled out evidence that:

• We are hard-wired for safety
• We operate 95-99% on nonconscious processing

After going  through a really challenging time I told someone that I was really stressed out. The person responded by saying, “Well, that’s not helping.” Can stress be helpful?

If I put on my psychology hat, my initial response would be that it can be helpful, if there is an emergency and you need more adrenaline. If you are really in an emergency and the demand on your energy is more than you have available, then the adrenaline boost from stress can be great. It will get more sugar to where you need it with your muscles, helps you to run out of the building, and so on. 

The problem is, in that situation that you described, was it helpful? Did the stress allow you to take action, or was the stress hijacking your brain and getting you stuck in a loop with your thinking, or feeling overwhelmed. Getting stuck in those types of repetitive thought patterns over time can be damaging.

I come at this, by the way, from the inside out because I’ve struggled with depression and anxiety since I was 10-12 years old, and at the age of 12 actually started fainting for reasons we couldn’t identify at the time. It wasn’t until I was in my 40’s that I finally identified it as vasovagal syndrome induced by anxiety.

When you think of fight or flight, and the adrenaline rush that we need in an emergency, that can be good and helpful. It will bridge the gap between demand and capacity as long as we take action within around 30 minutes. The problem is that we don’t take action within a short period of time. We are stuck inside, we are sitting still, the initial stress response is rushing through our bodies. If we don’t take action within 30 minutes, the stress becomes chronic. Unfortunately, over time that will hardwire new negative thoughts, habits, and behavior.

When you can’t do something about it or have control is when you really get into those cycles. That initial anxiety often turns into depression, burnout, and exhaustion. That’s where I believe that most of the damage happens. That’s when our immune function goes down, and that’s where we see the chronic wear and tear.

How can we find the blessings of adversity? What do we do when intensification of the threat goes up, such as with COVID -19?

This simple definition of stress is often helpful for people: Stress is the reaction that happens in the gap between demand and capacity. Stress can be:

• Physical
• Emotional
• Mental
• Spiritual
• Social
• Financial
• Operational

Stress can even be operational within a whole system, as we know from functional medicine. Anytime any of these systems are off,  the body needs to overcome the challenge. That’s what allostasis –it is the process of adaptation. 

We want to have allostasis and positively adapt so that we are in a better state than we were before, rather than return to homeostasis. Even trauma studies have shown that people can have post-traumatic stress growth if the circumstances are favorable. We need to look at what those circumstances are.

How can people deal with stressful things that come their way without getting swept up into a stressed state?

Most of the stress we deal with is not acute. It’s the day-to-day grind, the hustle, feeling like we aren’t enough or we don’t have enough. I have done a Stress 360 framework study looking at the stress load which is that allostatic load of demand versus capacity, but also looking at ‘stress lens’ which is the perspective that you have on all of that.

We have looked at over 38,000 responses and have examined the lifestyle patterns that people have that seems to be causing the most stress. What is stress exactly? I looked at finances, family relationships, nutrition, sleep, exercise, all those things that everyone assumes that causes stress. The number one factor by far was feeling like there’s not enough time to get it all done. 

What is a circuit breaker that can happen to break that cycle? Stress is a stimulus and response, but in that gap between the two we have the choice to respond. Rather than have a stress reaction it is better to have a stress response: I noticed the trigger, I felt bad, that is telling me something, and what is it telling me? What am I going to do differently?

What about the old adage to ‘take a deep breath’?

If you approach stress with curiosity and ask what the stress is trying to teach we can make adjustments. “Taking a deep breath” didn’t always work for me. When you breathe in, the sympathetic nervous system is being aroused. We are  consuming oxygen, increasing our heart rate, but it’s the exhale that activates the parasympathetic pathways. So when people take a deep breath they tend to gulp in air which almost over-activates the sympathetic or stress/ distress response. When people take a deep breath we want them to gently inhale to expand the chest and not ‘over inhale’ but rather ‘over exhale.’

I have people go through the whole brain recharge process of breathing, feeling, and focusing, which brings your brain back online. Then we breathe in and we expand love, gratitude, and kindness, then breathe out and extend those things to others.

Research shows that a slightly varied rate of breathing of 3-5 seconds in and about 5-6 seconds out is probably optimal for most people. 

It’s wonderful to have those specifics!

Yes, it’s real! Research out of Stanford University recently showed that there is a variance. Some people will be a little faster or a little slower. 

I’m involved in research study helping people evaluate or measure their optimal breathing rate. We are looking at what sound cues and tones are helpful. We are looking at whether we can take ocean wave sounds that have been shown to calm the nervous system then add on binaural beats, add on optimal rate breathing, and actually see our heart rate variability get into resonant frequency faster. That would allow us to provide specific formulas for people to shift into that calmer parasympathetic de-stressed state more quickly and feel calmer and more at ease. 

The advances that you are describing shows that people can make gains quickly–That’s good news!

Yes, we have to get quick wins without perfection so that patients see results to motivate them to keep working to learn to incorporate practices that will reduce stress. One of the great things about personalized and functional medicine and in integrated neuroscience is that we are not fragmented or siloed in the way that medicine typically is. There is a real shift now towards integration.

For example, I am collaborating on a longitudinal study with folks from Harvard University and Massachusetts General Hospital similar to the Framingham Heart Study but looking at brain health and performance instead. We are able to customize various interventions for people and track them over their lifespan so that we can see what really works for optimal brain health.

I see evidence of integrative approaches with this study and my work with the Global Stress Summit. That’s where I met Dr. Bruce McEwen and Dr. Stephen Porges who has been instrumental in helping us understand the vagus nerve, and his wife Dr. Carol Sue Carter’s work on oxytocin, vasopressin, and social bonding. These researchers may all be very specialized but we are all starting to incorporate our different knowledge and datasets into the same common framework that is practicable and applicable to help patients see quick results.

This shift towards integration seems to be working because patients are already coming in with some knowledge about certain things such as probiotics, mindfulness, and so on, and are looking to improve their practice.

I agree! People are educated enough to know that they want to feel better. They don’t want to be resilient, they want to be positively adaptable or even ‘pro-adaptable.’ People need to understand that they are their own experiment and to a large extent their bodies will tell them what works and what doesn’t. The more balanced you become it becomes easier to pick up on the signs of what works for you and what doesn’t.

I want to add that people do have some control and they don’t need to strive for perfection. The person that illuminated it for me best perhaps is Dr. Dale Bredesen’s work that highlights 36 factors that lead to dementia. Each person needs to flip a certain number of those factors in their favor, and the exact number of factors each person needs varies. I have seen patients with early cognitive impairment on the path to dementia who have followed Dr. Bredeson’s protocol and seen reversal in a year or two. The idea is not that they needed to be perfect or shift all 36 things their way. They let go of the stress/ distress of perfection and trust that their bodies know the way.

I’m glad that you brought up cognitive decline and the symptoms around brain health and performance because there has never been a better time to take care of your brain. We now know that we need brain strength, endurance, and flexibility. We can train ourselves, especially proactively when we are younger that we can circuit break our stress patterns. There is no time within our entire lifespan that we can’t have a better brain.  Many people who have full-blown Alzheimer’s disease never have a sign or symptom, and they end up dying from another cause. The number one risk factor for Alzheimer’s aside from age is chronic stress. All lifestyle domains are important: how you eat, how you move, how you sleep, how you connect with people. Too much or too little of any of those things can cause stress. The release of stress hormones can stimulate inflammation and plaque buildup in the arteries. I tell people don’t let all of that worry you. Take a step back, take a breath, pay attention to what’s going on. What’s the area that’s most realistic for you to change or improve right now. Once people get motivated by doing something well and seeing improvement they are more willing to hang in there and try the next thing. 

Could you reflect on a tactical toolkit that people can use day to day, especially right now in the midst of COVID-19? I have heard you state that self-compassion is perhaps the most important thing that people need right now?

Self-compassion has been a game-changer for me. I started focusing on it more last year when I was going through another bout of depression.  I was so exhausted from the hustle and working so hard. I stumbled across Kristin Neff’s research, and there’s so many people working on this. Self-esteem comes from us comparing ourselves to other people. Self-compassion is the idea that we are all in this together, we are all human, we all suffer, and there is a gentleness to that. People want to be heard and validated. 

That ties into training your brain to be different. We need to be proactive and reactive in the sense that we need to explore what’s out there and learn about practices that may work for you. What I suggest if you want to create a better rhythm for yourself is do three main things:

1. Morning plug-in: Within the first hour of waking up, Nudge your nervous system into a more optimal state with thing such as music, essential oils, and so on. You have to proactively put things in place so that you have them when you need them.
2. Recharge: Plan at least three time per day, maybe around meal times, of what, when and how you will recharge your brain. These daytime recharges should not be considered optional.
3. Unwind and prime your brain for sleep: At least an hour before bed do things that will calm your mind and prepare you for restorative rest.

Can you share with us how your foundations course to develop mastery in some of the domains that we have discussed today?

I have so many ways that people can hang out with me! My passion is teaching other practitioners learn how to teach others, leading workshops, teaching other thought leaders such as HR professionals. There are a lot of ways that listeners can find content. I have courses on LinkedIn and on my website. Because of what’s going on right now there’s been some last minute adjustments in some of my programming because I am really rallying around the first responder community. The best thing to do is go to my website at heidihanna.com, and also I am most active on FaceBook and LinkedIn. All of my free webinars and events are linked there. Anything else that people may want such as the recharge toolkit, ebooks, it is there for them. I love sharing with people and I want to make it practical and try to simplify it enough for people to apply this information to their practice.

Medical practitioners are burning out in the midst of this massive pandemic. We know of the sobering statistics of veterans taking their own lives when suffering from PTSD, and just recently the statistics are higher for those in the medical profession. That is due to burn out. We are healers and we want to take care of people but we are also very sensitive and we absorb the pain and the suffering. It is so important for practitioners to practice self-compassion, love, and kindness, and make your self-care mandatory. Remember that patients will model our behavior.

I found out the hard way that my cup has to be full, and it was pointed out to me by Dan Kalish of the Kalish Institute that I need to be living all of the things that I am expecting and asking of my patients. Living them fully, 100%!

I highly recommend that listeners watch Jill Bolte Taylor’s Ted Talk, read her book, or watch her on Oprah. She is a brain scientist and had a stroke. She lost her ability to problem solve, but what she felt very clearly was energy. We are responsible for the energy that we bring to the moment we have. Stress is highly contagious but so is positivity. The quality of our connections are based way more on energy than on time. We can control the amount of energy we bring to the moment even in the midst of chaotic circumstances.