Insights

Finding Resiliency

For most of us, cancer is a stressful experience that tests our resilience. It forces us to face the impossible, make major changes in our lives, and reassess our assumptions about the future. Some of us bounce right back, acclimate to the new reality and go with the flow. But for others of us, it can be hard to shake the fear and depression. We feel paralyzed by the sense of doom that descends with diagnosis. Finding a path to resiliency can make all the difference.

Resilience is the ability to bend but not break, to adapt to change, and find a way to cope with new realities. It’s not that resilient people never experience trauma. Rather, they seem to respond to stress differently, and like water in a brook, find ways to navigate between the rocks to move on.

What drives our response is a mix of genetic predisposition, learned behavior in the face of prior stresses, and the ability to tackle the current stress with the determination to adapt. Or, as Shakespeare once said of greatness, some of us are born resilient, some of us achieve resilience, and some of us have resilience thrust upon us. The good news is that no matter when the opportunity is thrust upon us, there are things we can do, even in the midst of trauma, to become more resilient.

Hitting the Genetic Jackpot

As with many other aspects of our emotions, research has shown that there is a strong genetic component to resilience. Our genes determine the responsiveness of our brains to negative stimuli such as stress. They also influence how sensitive our brains are to certain neurotransmitters that help us deal with stress and how interconnected various parts of our brain are that need to communicate during trauma. They even affect the starting size of those brain parts.[1]

How we were raised also plays a huge role in our propensity for resilience. A nurturing home life and a frequent exposure to minor or progressively more challenging stress (such as being bullied on the playground) seems to inoculate the brain against major stress as we mature. Too much stress without that nurturing support, however, and the system backfires, as in the case of severe childhood trauma or abuse, making resilience far more difficult as an adult.

But, it’s never too late to become more resilient. Even if we lived an idyllic life and never experienced stress or trauma as a child, or even if we lacked the nurturing home life that would have protected us against trauma, we all have the potential to strengthen our resiliency. Unlike old dogs, apparently even old brains can learn new tricks.

One Word, Plastics

People who are resilient have psychological and physiologicaladaptations to acute stress, trauma and chronic adversity.[2]The brain continues to grow and change throughout our lives—what scientists refer to as neuroplasticity—developing new brain cells and creating new connections between them (synapses). These new cells and synapses drive modifications in the neural circuits in our brain that affect the way we think and feel. They regulate reward, fear, emotion and social behavior, influencing how we experience stress and respond to trauma.

Exercise can help stimulate neuroplasticity. When you elevate your heart, more oxygen is delivered to your brain, which supports new cell growth and the production of neurotransmitters that help the brain respond to stress.[3]Exercise also changes the way our genes are expressed—which ones get turned off or on in the making of new cells.[4]But it takes more than exercise to train the brain in the right way—to ensure that the plasticity of the brain leads to improved coping and resilience.

Becoming More Resilient

Brains that are resilient have greater activity in the pre-frontal cortex, the area of the brain that controls rational thoughts and decision-making, and less activity in the amygdala, the area of the brain responsible for responding to stress and emotions. This activity balance allows the brain to suppress negative emotions and quiet the mind.[5]So how do you increase activity in your pre-frontal cortex and turn down the volume of your amygdala?

While lots of methods have been tried with mixed results, a handful of resiliency tools seem to consistently yield results. And everyone can benefit:

  • Meditation and mindfulness training help the brain soften the stress reaction and quiet the emotions while simultaneously strengthening cognitive control[6].
  • Social interactions stimulate the development of key neurotransmitters that facilitate resilience[7].
  • Active coping approaches strengthen executive function and cognitive flexibility to enhance connections in the pre-frontal cortex.[8]

Building Your  Resilience Plan

Some of the specific active coping measure you can try to create your own plan for increasing resilience include:

  • Start by taking responsibility for your own life. Set goals for yourself, no matter how small, and strive to achieve them. Challenge yourself to master something new. Find your inner fighter and refuse to be bullied. (I know that the next year is going to suck, but I will get through it. And, I can use the down time to learn Spanish, which I have always wanted to do.)
  • Practice being an optimist. It may not come naturally to you, but if you catch yourself being negative, try to turn the thought around. Rewrite your story, reframe the problem and put things in perspective. (Losing my hair to chemo is depressing, but at least I won’t have to spend money on haircuts for a while!)
  • Don’t personalize it. Life happens, people get sick. Accept that change is part of living and don’t blame yourself. Instead, remember the ways you have been courageous and strong in the past. (I climbed that tree when I was a kid to rescue the cat even though I was afraid of heights. I guess I am brave.)
  • Support others. Reach out to those you can help. Having a purpose by giving to those in greater need helps put our own problems in perspective. (On my good days, maybe I can bring a meal over to the old lady who lives alone down the hall. I bet she could use some company.)

Taking Care

Whatever approach you choose to build your resiliency, be sure to take care of yourself. Eat well, sleep well, and take breaks from the stress—go for a walk, visit a museum, listen to music, meet a friend for coffee. Most importantly, if you feel overwhelmed and you need help, talk to your medical team about getting emotional support. No one should face the challenges of cancer alone.

 

For more info and ideas:

American Psychological Association: Road to Resilience https://www.apa.org/helpcenter/road-resilience.aspx

Resilience: The Science of Mastering Life’s Greatest Challenges, by Steven M. Southwick and Dennis S. Charney

 

 

[1]Denis S. Charney, MD, “Resilience: The Science of Mastering Life’s Greatest Challenges, Mt. Sinai School of Medicine Grand Rounds, April 22, 2014.

[2]Adriana Feder, Eric J. Nestler, Denis S. Charney, Psychobiology and molecular genetics of resilience, Nature Reviews Neuroscience,vol 10., pgs. 446-457 (2009).

[3]van Praag, Henriette. (2008). Neurogenesis and Exercise: Past and Future Directions. Neuromolecular Medicine. 10. 128-40. 10.1007/s12017-008-8028-z.

[4]Sama f Sleiman, et al., Exercise promotes the expression of BDNF through the action of the ketone body -hydroxybutyrate, eLife,2016; 5: e15092.

[5]Aaron S. Heller, et al., Increased prefrontal cortex activity during negative emotion regulation as a predictor of depression symptom severity trajectory over 6 months, JAMA Psychiatry,vol 70,11 (2013): 1181-9.

[6]Gunes Sevinc, et al., Common and dissociable neural activity after MBSR and RR programs, Psychosomatic Medicine, vol 80, pgs. 439-451, 2018.

[7]Joel Salinas, Social Relationships, Serum Brain-Derived Neurotrophic Factor, and the Risk for Stroke and Dementia: The Framingham Heart Study, Neurology Apr 2016, 86 (16 Supplement) P1.098

[8]Feder, et al,Ibid.

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