Time for an emotional stimulus plan

Chicago Tribune (MCT) - Maybe it hits you only once in a while, whenever, say, you hear rumblings in the office that pink slips are coming, and suddenly there's that pang in your heart, the quickening of the thump-thump that are your pulse and your blood pressure rising like flames in a kindled inferno, and then, as if that's not enough, out pop the pearls of sweat.

This is the emotional underside of the recession, where nearly every day feels as though you're climbing aboard some whoopsy-doopsy roller coaster.

The news hits hard _ reports of job cuts, foreclosures, bankruptcies. All of a sudden, it's not so far away, this very bad news.

Geez, it's just down the block.

Or, worse, there at your very own kitchen table. Maybe, like David Kovacs, a Chicago scriptwriter with one kid in college and one about to take off, you've watched your work slow to a trickle and you, like he, "just wait for the other shoe to drop."

Or maybe, like Karen Rodriguez, the worst has come, and now you're feeling somewhat adrift without the job title that has so long defined you. A Gurnee, Ill., biochemist with three kids under 8, Rodriguez never dreamed she'd lose her top-level job, but she did last July.

There has been talk up, down and sideways about how to cut your budget and how to cobble together a resume, but what about the emotional underpinning to all of these tough times?

What do we need in our emotional repertoire to not only survive but perhaps even triumph? Could it be, some day down the road, we'll look back and think of this as the long, hard test that turned our whole life around?

The good news: You can, if you navigate with precision and pluck, triumph quite clearly. It's not magic, and it won't happen overnight, but what you may need most is a prescription that sounds not unlike what your grandma might have told you over and over again. It's plain common sense. Take good care of yourself. Surround yourself with good friends. Find your purpose in life.

More good news: Science, specifically advances in neuro-imaging _ that is, the scanners that peer deep in our heads _ has documented that the human brain is the key organ for adapting to stress. And, through a series of snapshots of parts of the brain under stress, neuroscientists now know what works and what doesn't.

And how we can enlist the brain to work for _ not against _ us.

It's one of the hot topics in psychiatry and preventive mental health, and it's called resilience.

Best news of all: We have the power to boost it, even when the stress in our lives goes on unabated.

"It's so simple and so basic. But there's real biology in all this. The brain is an adaptable organ; we refer to it as 'adaptive plasticity,' and it's reversible," says Bruce McEwen, a neuroscientist at Rockefeller University in New York City, who is considered "the king of resiliency" for his pioneering work in how the brain adapts to and bounces back from stress.

"They used to say, 'It's all in your head,' in a dismissive way," says McEwen, whose niche is neuroendocrinology, the study of hormones and the brain. "Well, in fact, it is (in your head) in a very real scientific way. The imaging does show exactly what happens in our brains."

Of course none of this will make the bills and the job pressures and the other losses go away. But the one thing you can control is your reaction to it all. Learn to manage those reactions _ negative and positive _ and the resulting resiliency can carry you through. Whereas anxiety and depression, in moderate doses, are part of the normal response to stress, they're programmed to fade as the stresses are lifted.

That's how the brain bounces back.

If the anxiety and depression don't ebb, then treatment _ with medications and psychotherapy _ is called for. McEwen has found that the changes those emotions create in the brain can't go on endlessly without harming the brain and the body, especially the cardiovascular and immune systems. He gives us hard scientific data that show common-sense prescriptions _ sleep, diet, exercise, among them _ go a long way toward giving the brain a chance to rebound.

While McEwen alone convinced us we could ride this out, we didn't stop there in exploring smart ways to do so. We also talked to a psychiatrist, a clinical psychologist, a licensed clinical social worker and a rabbi trained in psychotherapy who has been counseling clients for 40 years.

The clinicians all report surges in emotional turbulence due to the recession.

"Anxiety started increasing more and more in late summer and early fall, but now it's reached a fever pitch," said Lynne Knobloch-Fedders, a clinical psychologist at the Family Institute at Northwestern University, whose research focuses on how anxiety and depression affect couples' relationships.

"People already suffering from anxiety or depression find this latest layer _ the economic stressors _ an additional burden. Or, it's brought anxiety and depression to the fore in cases where it had been just under the surface. Other families, ones who'd not been afflicted, look around and see there's no certainty. They see neighbors and friends losing their jobs, or their homes, and they're all stressed."

Truth is, you were born to survive stress.

There is a whole range of emotions that, exercised smartly, can help you survive. Five key psychodynamics _ plus an all-purpose booster _ come into play here.

Three _ anxiety, depression and shame _ each work in responding to stress, but you don't want them to get out of hand, cloud your thinking or take over your life.

Two _ flexibility and creativity _ are ones you want to exercise, amplify, crank up a notch.

And, just as your grandma told you _ though not in such terms _ you can build up your emotional resilience.

1. ANXIETY

What it is: Fear of the unknown, what-ifs causing emotional turbulence.

What you need to know: Being anxious doesn't solve anything.

How to keep it in check: Exercise, meditate, socialize, acknowledge your fear and move on, suggests Pamela Duhl, a licensed clinical social worker. Set aside a time to worry. Don't get stuck in a rut. If you do let your anxiety run amok, you will start to believe that your anxiety is truth.

Try this mantra, says Duhl: "My anxiety is not in charge of me, I am in charge of me, and what can I do today? Today I can do these three things." You can't job-hunt 24/7. So allow time each day for pure distraction or delight.

Putting anxiety in its place is really important. "For people who don't have anxiety disorders, it's not that they don't worry," says Duhl, "it's that they don't get stuck in it."

Distraction is a key to managing anxiety. Aim for a balance of friends, some whom you can talk to honestly about what you're going through and others who can distract you.

Consider the worst-case scenario. Now, ask, what would you do? "Interminable anxiety comes when people don't actually face the worst case," says Dr. Joan Anzia, a psychiatrist at Northwestern Memorial Hospital. If you think through the direst outcome and figure out how you might handle it, well, then some of the anxiety simply evaporates.

Warning signs: If you notice a big change in eating or sleeping, or if you can't set aside your anxiety, then see a doctor. Same if you start to experience full-blown panic attacks, periods of up to 30 minutes in which you're lightheaded, your heart's racing and you feel as if you're about to die.

2. DEPRESSION

What it is: Sadness, a sense of loss, helplessness.

What you need to know: With depression, you have a hard time moving; with anxiety you have a hard time sitting still. Don't let depression run its course, warns Duhl. How to keep it in check: Try to make daily goals.

If you meet your goals, even if you feel lousy while doing so, you're doing OK.

Plain old exercise: Just 30 minutes of increased heart rate, says psychologist Knobloch- Fedders, has been proved to be "as good or better than an antidepressant or anti-anxiety drug."

Get up and get dressed: "In psychiatry, we try to get the basics back," says Anzia, who is also associate professor of psychiatry and behavioral sciences at the Northwestern University Feinberg School of Medicine.

Jim Warda, 44, a corporate communications executive who lost his job in October, finds that putting on work clothes and heading out to the local library every day from 9 to 5, to use the Internet and make follow-up calls, keeps him from sliding into a funk.

Gather your resources. Ask yourself: What can help me through this? Who's my support team? Should I exercise more?

Warning signs: If you feel immobilized _ can't get out of bed, don't want to talk to anyone _ for as long as a week, seek professional help. If you have any suicidal thoughts, call a doctor or go to the nearest emergency room.

3. SHAME

What it is: Sense of humiliation, perception of having failed. Worry that others are looking at you as a failure.

What you need to know: Depending on your neurology, that shame can lead to increased anxiety or increased depression. Remember: It's a normal human emotion. People who are able to get past it are people who are able to start problem-solving.

Growing up in a family where shame was dealt for every mistake, predisposes you to getting stuck in this rut.

How to keep it in check: One benefit of this recession's wide swath is that you don't have to look far to find someone else in the same boat. It's pretty easy to tell yourself it's not that you did something wrong, but that this is a turbulent time taking down plenty of folks.

It's important to do what psychologists call "normalizing" your situation: Am I the only one who lost my job? Am I the only one who has lost my house?

If you grew up being told it was always your fault, you can, with the help of a therapist, re-script that inner voice so you don't always blame yourself, says Ted Gluck, a Chicago rabbi trained in psychotherapy.

"Self-esteem is developed by doing esteemable things," says Knobloch-Fedders, quoting a favorite maxim. Try volunteering at a soup kitchen. Cut down on consumerism. Clean out a closet, and donate clothes to a shelter. You'll kick in a cycle that'll boost your battered ego.

Warning signs: If you can't get beyond the sense that you're a failure, and it's all your fault, if you're emotionally paralyzed, listless or have any thoughts of suicide, call a doctor or ER right away.

4. FLEXIBILITY

What it is: Capacity to readjust, realign, take new avenues. See the continuum, be willing to take a short-term, stopgap solution before arriving at your ultimate end point.

What you need to know: Having emotional flexibility frees up your brain to figure out if there's any other way you can do what it is you love. Or, if you're losing your house, it's the engine that will help you relish the chance to downsize into a two-bedroom apartment or move to a new neighborhood. It's what you need to take risks, and you won't move forward if you won't take risks.

How to boost it: Are you willing to take what Duhl refers to as "the Starbucks job," a temporary job that allows you time in the day to pursue a career goal, as well as time for purely enjoyable diversions?

Make lists of what you need to make yourself happy. You might be surprised. You might connect a few dots and sketch a new life-map.

Practice saying yes. Pay attention to how many times a day you say no, either to yourself or out loud, shutting off options, often before you've even thought it through. This is how you begin to practice taking risks, says Duhl. Maybe it's as simple as taking a new route on your walk. Or trying a new flavor of ice cream. Once you get used to trying something novel, you might muster the courage to really shake up your life.

Listen. Be open to other people's ideas. If you cut folks off, without hearing them out, you just might miss a dose of unsolicited wisdom.

5. CREATIVITY

What it is: Capacity to envision alternatives, make the most of the everyday, infuse some sense of adventure or delight into hard times.

What you need to know: This is your escape valve from the drudgery of worry, and where you start to look at the glass as half-full.

How to boost it: Look at the landscape, envision a new job path or a new living situation.

Enjoy the simpler lifestyle: Learn how to bake bread; start plotting a summer vegetable garden _ even if all you have room for is a pot of tomatoes on the fire escape.

DO NOT LOSE YOUR SENSE OF HUMOR.

(Did we say that loudly enough?) Invent joy. Here's one idea Duhl prescribes: "Say to yourself, 'OK, I can't go to Vegas for the weekend, but I can invite friends over and have Vegas night.'" Grab a few decks of cards; put out the chips and the dip. Costs little, fills the house with friends, makes you forget _ at least till the chips run out.

David Kovacs, the scriptwriter and corporate freelance writer, used downtime to restage a musical comedy he'd written back in the 1970s. "The Adventures of Captain Marbles and His Acting Squad" played at the city's DCA Storefront Theater in the Loop in November and December. Then, even though he barely got paid, he wrote the script for a benefit concert, "America in the Age of Obama," performed at the Auditorium Theatre last week.

"It would be easy for me to look at all of these past weeks as the abyss," says Kovacs, who is 56, "but I look at them as transition, a period of self-reinvention."

6. RESILIENCY

What it is: Your natural-born capacity to adapt to and bounce back from stress, short term or chronic. This is your all-purpose emotional ace in the hole.

What you need to know: It has been proved by neuroscientists that you can affect your brain's power to put up with stress overload.

How to boost it: Just as Grandma told you, and now backed up by one of the nation's preeminent neuroendocrinologists, here's Dr.

McEwen's daily prescription: Eat high-nutrient foods, watch out for calorie-dense cheap stuff; get regular exercise; try for eight hours of sleep; be sure you've got a strong social network; have a clear sense of purpose in life.

Sounds hokey, but psychologist Knobloch-Fedders swears this'll help: Every day, count your blessings. Five a day. Just like your fruits and vegetables.

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© 2009, Chicago Tribune.