How to Thrive When All You Feel is Turmoil: Moving Beyond Crisis Fatigue

Even before the pandemic, we were facing a cultural epidemic: It’s got a lot of different names: – anxiety, depression, overwhelm, burnout.

I’m sure you've known the feelings – your heart races, your breathing gets shallow, you feel a lump in your throat, a hollow feeling in your chest, you feel like the world is crashing in. You may become hyperaware of everything that’s going on around you. It's commonly known as fight or flight mode. You may also find yourself in another version of this: freeze mode in which you just can't get mobilized – you feel stuck. And then there's another mode called fawn mode in which your people-pleasing self goes into overdrive – a survival mode because fitting into our ‘tribe’ or culture was necessary on an evolutionary basis for safety and accessing food and shelter.

These are all ancient mechanisms our brain has created for survival, and they emanate from our stress response system – more technically called our hypothalamic pituitary adrenal (HPA) axis. The responses that get triggered – which in addition to the ones I've just mentioned, also include increased heart and respiratory rates, enhancing blood flow to brain and muscles, increased release of glucose to the muscles and insulin to mop up glucose after the response is through, enhanced peripheral vision, reduced blood flood to the gut, and more – are all meant to help us survive in a threat – and are meant to be short-lived – like minutes to hours at most. But for the past couple of years, for most of us, it’s been activated at a low level nearly constantly, with stronger hits of activation occurring all too frequently. This response is often called survival mode – because that's what it's there for, but when we’re stuck in survival mode, the chemicals coursing through our blood, adrenaline, and cortisol, telling us to run, hide, freeze, fight, turn more to foe than friend. 

Survival Mode in Overdrive

While for a hot minute these reactions can serve us well. In the extreme of examples, we can run from enemies, escape charging lions, lift a car off of someone. We can also resist bacteria and viruses, think clearly under pressure, meet tough deadlines, and complete marathons. But when we’re in survival mode day in and day out, and especially when that mode is activated by things that don't bring us joy or satisfaction or even a good challenge, our well-being and our overall health pay the price. Long-term, chronic, or sudden significant stress, can lead to what's called allostatic load, in which survival mode goes into overdrive, can a very real take a toll on our health, affecting our hormones,  neurotransmitters, and inflammatory and immune responses. Allostatic load creates “wear and tear” on your body – in fact cortisol, the primary chemical behind the stress response, is nicknamed the wear and tear hormone. All of this can lead to us getting sick. Physically. Mentally. And on top of that, high allostatic load is associated with worse health outcomes. 

Too often we assume stress, anxiety, fear, and agitation are just how we’re “wired” or just “who we are.” But It's not just you. We forget that we live in a context that is creating these responses – because we live in a world where we feel that our survival is chronically threatened – and it's taking a toll so much so that there's a name for what we're collectively and individually experiencing – it's called crisis fatigue. It's a normal response to an insane moment in our world. 

So, what can we do? First let's understand crisis fatigue a bit more, then I'll share my personal resilience building practice – some tools that are known to be helpful for weathering the storm when it’s swirling around you – and it’s been swirling for most of us for at least the last two years.

Understanding Crisis Fatigue

Crisis fatigue is the response to the prolonged stress that develops due to unexpected or difficult events, such as war, economic depressions, or a pandemic. It triggers the HPA Axis to put you in survival mode, leading to the snowball effects I've just described, and which I lay out at length in my book, The Adrenal Thyroid Revolution. It's allostatic load due to traumatic social events.

These familiar issues that so many of us are facing are examples of factors that can lead to crisis fatigue:

• Climate change news
• Economic depressions
• Pandemics
• Political instability
• Natural disasters
• Racism

A person may experience stress due to a direct impact of the crisis itself, due to secondary consequences (i.e., losing one's possessions due to a natural disaster, having to relocate because of fires in one's community, or indirectly, also called vicarious trauma, from anxiety caused by reading or watching the news, or having incidents occur in one's local community (i.e., changing one’s personal behaviors like going to the movies or concerts because of fears of gun violence).

And remember – any one of these can cause crisis fatigue. Most of us are dealing with many or not all of these, simultaneously, and have been for a sustained time. It's a recipe for allostatic load and all kinds of fatigue – including crisis fatigue!

Crisis Fatigue Symptoms

Even prior to the pandemic, at least 1 in 4 women was already on an antidepressant, about that many were on anti-anxiety meds, and half of all women were having diagnosable levels of sleep problems. When we add in hormone, gut, and autoimmune problems, that moves the dial up to about 99% of women feeling the stress in one way or another.

On top of it, short- and long-term HPA Axis activation creates vicious cycles in which we eat more sugar, drink more alcohol, binge-watch TV until we've going to bed too late, then we don't sleep well and we're too tired to exercise, get together with friends, and do the other things we need to for our health – like take long walks in nature or do the basics, like eat well or floss our teeth regularly. 

While crisis fatigue not a recognized medical diagnosis, it is a recognized phenomenon, and those experiencing it may have very real mental or physical symptoms. Further, not everyone experiences crisis fatigue in the same way or to the same degree.

Here are some of the ways crisis fatigue may show up:

• Physical symptoms like fatigue, insomnia, physical tension, loss of appetite or increased appetite, especially for ‘comfort foods,' body aches, digestive problems, headaches. hormonal problems, and increased frequency of getting sick are common. So are exacerbations of existing problems like herpes or autoimmune disease flares, new onset or worsening high blood pressure, or blood sugar problems, and more.  

• Emotional exhaustion: You might feel emotionally fatigued, not feel like socializing, you may feel detached, helpless, anxious, irritable, angry, depressed, or cynical, you may have a sense of apathy or lack of motivation – it may be harder to get motivated to do those things that you previously enjoyed doing – like exercising or being creative, doing your job at your best level – or at all. Eating disorders and substance misuse/abuse are more common when we're feeling this way.

Certain individuals may also be more vulnerable to experiencing crisis fatigue. This includes those on the frontline of crisis, i.e., health care or other crisis workers, those with a history of trauma, past, current, or ongoing exposure to discrimination, a prior mental health condition, financial uncertainty, lack of safety or stability at home or work, grief or loss, or social isolation.

How to Heal from Crisis Fatigue

We aren’t meant to spend most of our time in overdrive or irritated, anxious, fearful, vulnerable, or fighting, or in the aftermath of feeling exhausted, depleted, spent, and down. Again, survival mode is meant to be a short-lived reaction, but we're in it chronically. Further, chronic fatigue reduces our empathy and ability to act – so it's not productive in the face of crisis. So how do we get out of it?

The antidote that allows us to get out of survival mode, allostatic load, and crisis fatigue, and back into thriving, is spending more time in what is called the parasympathetic nervous system response by engaging our vagus nerve response. This is the calm, peaceful mode that resets us from the impacts of chronic exposure to adrenaline and cortisol exposure, and that helps to ramp up production and release of the hormones and neurotransmitters that restore our sense of emotional well-being, connection, control, and calm, while healing the physical damage and restoring our nervous, endocrine, and immune systems to a healthier baseline where we also feel resilience — and even hope, enthusiasm, and joy – again.

How do you know when you’re in it? It’s the feeling you experience when you let yourself take a nap, when you finally deeply relax in a massage, or the peace you feel when you lie in savasana at the end of a yoga class. It's also the feeling you get when you're ‘in flow' or in your ‘zone' – that creative place where you're so engaged in something you're passionate about that you lose yourself in it, forgetting time and space. This restorative mode helps us recover from the wear and tear of daily life and times of stress, and resets our mind, mood, and biorhythms.

Like everyone else, I also get stressed out, activated, mad, sad, or overwhelmed. So, I've been really, really, really making the extra effort to take more and better care of myself and the people. Following are a wealth of tools for weathering the storm when it’s swirling around you – as it has been swirling for most of us for at least the last two years -and for many, a whole lot longer. There are quite a few – so don't get overwhelmed. Read or even skim through and find those that resonate with you.

I love by bringing all of these practices into my life, some daily, some as needed. It truly does make a difference. I welcome you in joining me in making any – or all – of the following practices part of your life regularly, even daily.

1. Hit Pause More Often

Most of us don’t take time to hit the pause button often enough or at all because in our productivity-driven culture, and with very real work performance and economic pressures on we think we can’t – or shouldn’t. But intentionally taking time to recuperate after an unexpected stressful event – or regularly in times of crisis – can mitigate the impact and help us nurture resilience – literally the ability to bounce back.

Think of stopping as a spiritual practice, and something to be done daily. Whether it’s in the form of five-minute breaks during work or extended time off on the weekends, it’s vital to create more “you” time. Your work won’t suffer for it, I promise you. You’ll be more creative, more energized, more inspired, more effective, and you’ll have the longevity you need to be at it for the long run.

Here are a few other ways to hit pause and shift into calm:

• Breathe slowly and deeply for three minutes before you jump out of bed in the morning, and before sleep at night.
• Take a relaxing hot bath in the evening. Bonus: Add 5-7 drops of relaxing essential oil to get the benefits of bath + aromatherapy. Lavender is relaxing whereas deeper notes like amber and sandalwood are grounding.
• Attend a yoga class. Sweating it out can bust stress or a restorative class can deeply replenish.
• Spend some time outdoors, ideally in nature by taking a quiet walk at lunch or after work. But even if all you can do is sit by a sunny window, take it! Even having a few house plants can help you to un-stress.

Also, build a few ‘mental health days” off from work into your calendar. It can really make a difference have those to look forward too.

2. Get Enough Sleep

Resilience is almost impossible to maintain if we're living with a sleep deficit, which half of American women are. We need a minimum of seven hours of sleep most nights for optimal health. Without it, cortisol can get really out of whack. When this happens, it can affect almost everything in your body. To improve sleep, make it a priority to get to bed at the same time each night and wake up at the same time each day. Turn off all electronics – ideally an hour before you try to go to sleep. The blue light disrupts melatonin production, the counterbalance to cortisol, which also helps us detox our brains and hormones while we sleep. Finally, skip the alcohol in the evening. Even a glass of red wine has been shown to cause sleep disruptions.

3. Pay More Attention to Your Inner Life

Paying more attention to your inner life can help you more quickly recognize when you’re shifting from calm to chaos to crisis fatigue – and then you can use meditation, breathing, hitting pause, and other skills to bring you back to center. It helps to have a touchstone of how you want to feel so you can get there more easily.

This can be in the form of words you say to yourself like peace, ease, spaciousness; it can be a mantra you use to feel calmer, or a visual memory that is connected to an emotional feeling, like recalling a place or time you felt calm, happy, caring, joyous, in ‘flow’ – or however it is you want to feel. Visual memories might include a beautiful vista or sunset you experienced, someone who makes you laugh, a baby giggling, floating in the ocean or a pool, relaxing in a hammock, the feeling at the end of yoga class. Take 30 seconds now to tune inward and connect with how you want to feel and a time and place you felt that way. Really take in the sounds, scents, sights, and feelings and use this moment as a touchstone when you feel activated. And remember, the crisis will not last forever, as in, ‘this too shall pass.”  

4. Keep Your Blood Sugar Balanced

What’s blood sugar got to do with it? When your blood sugar is low because of running on empty, your brain thinks you’re in a crisis. That's because your brain uses about 80% of the energy you get from food just for basic functioning. We're not even talking about doing rocket science, here. Aside from carbohydrate and sugar cravings, this also causes you to lose energy, focus, and mental clarity. Keeping your blood sugar steady throughout the day is the secret to a focused mind, steady mood, and all-day energy. How? Make it a habit to eat within an hour of waking up and eat a snack or meal every 3 to 4 hours depending on your personal metabolism. And and stick to the right foods: every meal or snack should include a high-quality protein combined with a high-quality fat (i.e., nuts, a hardboiled egg, avocado). Avoid super low-carb and no-carb diets but keep your carb choices healthy including whole grains and healthful starchy veggies like sweet potatoes and winter squash.

5. Do Media Fasts

Crisis fatigue is fueled by media overload. While fasting is all the rage in the health world, I think we need to be talking about media fasting a lot more – intentional times where we just step out of the 24-hour news cycle which it’s so easy to get sucked into, and which doesn’t improve our health – or our ability to make a meaningful contribution – in fact, it saps both because it keeps us in chronic anxiety and crisis fatigue. You can still stay up to date with a daily news summary from your favorite media outlet instead of doom-scrolling, and you can set boundaries around when you’re tuning into crisis events. Consider a mid-afternoon media check instead of starting or ending your day with crisis news or ingesting it over a meal.  Start your new approach to media with a 3-day media fast. You’ll feel the difference in your mental well-being and that will help you keep your commitment to daily news boundaries.

6. Move Your Body

When I’m stressed out and overwhelmed, sad, or irritated, nothing soothes me more than putting on some music and dancing my ass off. It always brings me perspective and release – and no I don’t care what I look like doing it. Moving, stretching, sweating, getting physical in any way you love can be transformative for moving out of momentary stress and for shifting out of crisis fatigue. And it’s free. Set a committed schedule for yourself even if just a few days a week. Having a hard time getting motivated on your own? Buddy up with a friend, neighbor, or co-worker, join a class, and

7. Set More Boundaries

Part of how we get into the constant overwhelm that keeps us from hitting pause is by saying yes to too many things and people, partly because we have a difficult time saying no. Further, the pandemic has drastically blurred boundaries between home and work, downtime, and work hours, and has even brought remote work to the dining table, bedroom, and other places in your home that would previously have been restful, non-workspaces.

So set some boundaries – which for women can be hard as we’re so programmed to please, serve, and say “YES sure, I’ll add that to my list of a million things to do.”

Full stop! Make sure your hours and days off are really days off (did you know that in some countries it’s illegal for bosses to write employees after work hours and on weekends? Yes, illegal!).  Set boundaries between your home and work time. Take the work off the dining table, kitchen counter, or your bedside table at the end of work hours. Set up away messages and turn off ALL notifications on your phone, etc. especially for programs you might use like Slack or Asana. Put down the electronic devices during your times off.

And next time you’re about to say “yes” to something, pay attention to see if your inner self is saying “no.” Learn to listen to that voice – cause it’s your inner knowing and truth. Do you need to practice saying no? Do that. Starting now. I’ve got guidance for you in my mini-masterclass, Fear to Freedom, Perfectionism to Peace.

8. Phone a Friend

There’s a reason it feels so good to call a friend when we’re feeling anxious, down, or just freaking out! UCLA researcher Shelley Taylor, PhD, has identified this as the “tend and befriend” stress response which she and her research team believe is how women have sought to protect ourselves on an evolutionary basis. Put simply, it goes like this: Being pregnant or having small children around would have likely prevented women from running away from danger of being able to predictably fight and still protect the babies. Gathering for protection may have saved us, so we instinctively want to gather when we feel threatened or vulnerable. I know there have been many times I felt saved by a best girlfriend being on the other end of the phone for me!

It’s thought that what’s happening is that along with the adrenal stress response chemicals adrenaline and cortisol that get pumped out in a stress response, the body produces a small amount of oxytocin in response to a threat. Sometimes called “the cuddle hormone,” oxytocin triggers us to bond with others, which helps us feel safer and calmer and interestingly, also boosts our confidence. By connecting with another person, we amplify the oxytocin release – not only for ourselves – but for whomever we’re reaching out to! So instead of feeling badly for calling a friend when we’re in need, we can remember they are getting a boost by connecting, too. And you can bet on it that if you're experiencing crisis fatigue, so are some of those you're close to.

Though it might work better when we call another woman, this technique works with – and for – men, too.

Here’s how to shift from your stress response into tend and befriend mode:

• Connect with a friend on the phone or take a walk and talk it out. Studies show that verbalizing our concerns automatically turns off the sympathetic nervous system.
• Ask a neighbor or co-worker to join you for a walk. Even being together in quiet can help boost your tend and befriend response.
• Do something social – You don’t need to discuss problems to get the benefit of social bonding. You can go to a café and chat with someone, head to your local yoga class and make time to chat before and after, or if you belong to a group like AA or are a member of a church or synagogue, joining in a group event there can lighten your load.

9. Engage Excite and Delight Mode

While we tend to want to shut down and retreat when we feel internal pressure (that’s the “flight” part of fight or flight mode talking) and sometimes we do need to hit pause and take some quiet to ourselves, getting into something that engages your sense of curiosity or wonder can shift you from being in survival mode to a more relaxed inner state.

Marilee Adams, PhD, calls this curious mind a “learner mindset” which allows a challenging situation to become an opportunity to learn or experience something new. Curiosity expands your options for how to solve problems – and often resolves them more quickly and easily. The next you find yourself triggered by a stressful situation, rather than retreating into fear, or getting activated into a reactive, agitated mode, take a deep breath, and try asking yourself these 3 questions:

• What’s really happening here?
• What else might be going on that I’m not seeing?
• What’s interesting about this situation?
• What’s one thing I do or get involved in to make a difference/ 

Becoming more interested in what’s going on activates something called the “excite and delight” response. Because it gives you a gentle healthy boost of cortisol and adrenaline, you feel the same level of alertness and awareness as you do in fight or flight, but it feels good and can benefit you by boosting your cognitive function and your immunity!

Ways to do this include:

• Listening to music
• Studying a language or something new
• Going to museums (or looking at art books)
• Reading and studying things of interest to you
• Dancing

10. Act

Singer and social activist Joan Baez once said that the antidote to despair is action. Essentially, crisis fatigue is a feeling of despair, helplessness, and hopelessness. Acting can help us feel more empowered, engaged, and hopeful, rather than paralyzed. Find something – even if one small thing – that does excite you that you can get involved with that you feel can contribute to change – whether volunteering in your community, supporting a political campaign, or getting involved in a local network that supports the change you’d like to see and be in the world.

11. Find a Therapist

If you’re struggling to cope, or you’re finding this all too much to handle on your own, this is nothing to be ashamed of and there is help there in the form of therapists who can help you to reframe your thinking, make shifts in your life, or get medical support for your mental health if needed. Just like talking to a friend can help, simply the act of having a therapist to turn to can be transformative, and there are many forms of therapy to choose from, ranging from traditional talk therapy to more body oriented somatic therapy to art and music therapy options. Here’s a good article on mental health resources and another on how to find a therapist that’s right for you.

Let’s Do This Together!

As I’ve gotten a bit older, I’ve realized just how easy it is for so many of us to unwittingly stress our lives away. And there are plenty of opportunities for it these days. But I also realize that taking care of myself is a radical act of rebellion against a world that’s threatening to destroy our very basic well-being. Happier is healthier and that’s not a luxury – it’s meant to be our natural state. Staying chronically in a stress response really doesn’t help us much. In fact, it just makes us irritable, tired, and unhappy – and potentially sick as we pay for the consequences of adrenal imbalances with our health. I’ve also learned that I can choose how I respond in and to stress

Keeping your health intact, especially in undeniably demanding times, requires a commitment to prioritizing our well-being and intentionally doing things that build our resilience. This starts with realizing that you deserve to be happy and healthy. We all do. With some practice, you can use the new and more intentional “stress responses” above to consciously shift your body’s reaction from alarm to calm and build your resilience even in the face of the storms you’re facing in life.

I invite you to join me in flipping the switch on how you think you’re supposed to respond to stress and choosing something radically different – like phoning a friend – especially in these times when we all need each other so much.

The post How to Thrive When All You Feel is Turmoil: Moving Beyond Crisis Fatigue appeared first on Aviva Romm, MD.