Retrain Your Brain
One summer during high school, I set a dorm room on fire. I didn’t mean to. I was boarding at a college campus in rural Massachusetts for a week-long lacrosse camp. It turns out that when you stuff a plastic bag with rags soaked in linseed oil (which my roommate Karenna and I dutifully applied to our wooden lacrosse sticks at bedtime), it’s pretty flammable — particularly if situated near a hot naked lightbulb.
Lesson learned.
Speaking of hot and naked, retrograde apologies to the throng of adolescent girls who — in the middle of the night — were suddenly and miserably ushered from their beds into a humid gymnasium till sunrise. There was no amount of guitar strumming (thank you, counselors) to drown out the sound of fire trucks and teen whimpering. Nonetheless, “Blowing in the Wind” is always a pleasant tune no matter the hour.
What’s my point in telling this story? It’s a moment where fear saved my life. There’s nothing like waking up to a raging ball of fire in your bedroom to get your blood pumping. The surge of adrenaline and cortisol got me up, out of bed, and away from danger within seconds.
Indeed some level of fear is necessary for our survival. When faced with a threat, the emotion center of our brain (the limbic system) overrides the rational/analytical or “thinking” part of our brain (the prefrontal cortex). The limbic system sends a signal to our emergency regulatory system, and our bodies go into “fight-or-flight” mode: Our adrenal glands release stress hormones (adrenaline and cortisol) into our bloodstream to ready our bodies and minds to fight.
Here’s the kicker: Our bodies can’t very well tell the difference between a physical threat and an emotional one (like reading a worrisome headline about the Delta variant, vaccine risks, or the risk of COVID-19 itself to our unvaccinated kids). Our minds go on high alert and our bodies tense up similarly in each scenario.
It’s important to note that these hormone bursts are meant to be short-term (like 3-5 minutes), yet many of us have been pumping out stress hormones like an open garden hose for over 15 months. How does this affect our bodies and minds?
Our muscles tense, our breathing becomes more frequent and shallow, our heart rate increases, and myriad other physical symptoms can occur. Stress-induced changes to our cardiovascular system, for example, can promote anything from elevated blood pressure to a stress-induced heart attack. (Welcome to my day job in a pandemic!)
We can develop cognitive distortions where we become fearful of even small threats. Over the past year and a half, we’ve grown so accustomed to living in fear that for many people even the slightest hint of uncertainty kicks our stress hormone axis back into high gear. It’s not conscious; it’s that fear has become the default emotional state.
We’re more easily drawn to self-soothing behaviors — like binge eating, drinking, using recreational drugs, or simply avoiding uncomfortable situations — that often do more harm than good and can simply kick the can of emotional and physical distress down the road.
The problem is this: It takes time (i.e. more than a summer) to drain the proverbial bathtub of fear — to unlock tight muscles in our head, jaw, neck and low back and release ourselves from fear-based thinking and behavior — even when the immediate threat is gone.
And when fear continues to be embedded in so many COVID-related headlines, it can be even more difficult to unwind and to know when to worry.
Fear is kind of like food. We need it to survive, but it’s hard to have a healthy relationship with it. (Not surprisingly, we often use food to soothe anxiety and fear. Also not surprisingly, helping many of my patients lose pandemic pounds isn’t about dieting; it’s about recalibrating fear and reestablishing routines. More on that another time.)
As we emerge from collective trauma, we need time to rest. We need time to refuel. We also need time to take an honest look at ourselves — to assess our own anxiety (some of which is normal, expected, and appropriate), to acknowledge the triggers, and to recognize where anxiety may be doing more harm than good.
How can we rejigger our anxiety so that it’s in proportion to reality? How do we recalibrate fear so that it protects us from danger but doesn’t override our rational thoughts?
Step one: Accept that you’re human.
Acknowledging that your body’s innate wiring is there for a reason (it certainly comes in handy when running out of a fiery dorm room), but that it does get activated at non-optimal times is half the battle. You’re not crazy; you’re normal. And if you regularly attribute your overthinking, noisy brain or your tense neck, sweaty palms, pounding heart, and wide-awake-in-the-night sensations to something other than being a wired-for-survival human, you might want to re-read this whole ditty from the top. Or better yet: Talk to your doctor.
Step two: Practice a few tricks to de-escalate acute anxiety.
Deep breathing. It’s cheap, easy, and always available to you. Focusing on your breath is like a built-in parachute out of an anxious state. Breathing brings the body into a calm state and invites the rational brain back into the driver’s seat.
Exercise. Whether it’s a short brisk walk around the block or 30 minutes on a Peloton, exercise is an excellent way to discharge adrenaline, calm an overactive mind, and relax our bodies.
Meditation. To those of you thinking, “Hmmm…Dr. McBride has gone a little ‘woo woo’ on us,” remember that meditation (and other mindfulness practices) is a three THOUSAND year old trend for a reason. Try Headspace, Calm, or the 10% Happier apps. Pick up a copy of one of my favorite books, Wherever You Go, There You Are: Mindfulness Meditation in Everyday Life by Jon Kabat-Zinn. It’s a quick, high-yield read. I challenge you to find out it doesn’t apply to you!
Develop a mantra. When you feel your pot of adrenaline going from simmer to boil, try soothing self-talk. Examples: “This feeling will pass” or “You can do this,” or (my personal fave when my house, hair, or thoughts-right-before-going-on-live-TV feel awry) “Who Cares?” It really works! I actually have a sticky note on my computer screen that says: “WHO CARES?” (Don’t worry, patients, it doesn’t apply to medical decision-making.) Make a list of your own mantras. Try them out. Stick them to your computer.
Step three: Put data into context to maintain perspective.
An example. Yes, the Delta variant is here and will soon be the dominant form of coronavirus in the US. And yes, it is more transmissible. But the vaccines work marvelously well against it (BUT be sure to get two doses of Pfizer or Moderna and consider a single mRNA shot if you’ve had J&J. More about that here today.) It is unvaccinated adults who are at highest risk from COVID-19 from Delta or any variant of this virus. Kids remain at low (but of course not zero) risk for severe consequences from COVID-19. Nonetheless the headlines about Delta are naturally ginning up anxiety, particularly among parents of unvaccinated kids. Let’s put this in perspective. My brilliant friends, doctor Tracy Beth Hoeg and epidemiologist Allison Krug calculated that a child’s risk of dying from COVID-19 in the US per week as of last week is 0.00002% or 2 in a million. I won’t judge anyone who thinks this risk is high or who worries about lifting pandemic restrictions for their child. After all, we’re all entitled to our own risk tolerance. But with data in hand, we can better modulate our anxiety and put rational thought back in the driver’s seat.
Step four: Keep learning.
Treat yourself to nine minutes of calm about COVID, variants, and what lies ahead from Professor Sunetra Gupta at Oxford University here.
The University of Washington published a fantastic article about the “stickiness” of fear and how to retrain our brains after trauma.
Journal. Rest your brain. Talk to a therapist. In doing so, you’ll open up space to reflect on the past year and recharge your battery.
The vaccines are here, but no one is immune to the natural fear and trauma we’ve experienced. Your best plan is to name it, normalize it, and navigate it this summer.
Retraining your brain will help you run from the blaze, relax when it’s gone, and recline by the campfire with ease.
I will see you later this week. Until then, be well.