G3.7: Work Burnout is a type of Dissociative Disorder called Depersonalization Disorder.

A more frequent problem than is recognized is a milder form of a dissociative condition called Depersonalization/Derealization Disorder, commonly known as “work burnout,” than the more well-known but rare “Multiple Personality Disorder.” That name has been changed to Dissociative Identity Disorder (DID).  Symptoms may include depersonalization and/or derealization without the presence of other psychosis or memory and identity disturbances. It is one of the Dissociative Disorders which also include Dissociative Amnesia  and Dissociative Fugue and Dissociative Disorder Not Otherwise Specified, in addition to the more severe DID, Dissociative Identity Disorder. The disorders may be underdiagnosed or misdiagnosed even though symptoms consistent the Dissociative Disorders are often reported by people with psychiatric illness who also have a history of having experienced trauma. (G3.30)

  • Read more: Stress and Trauma: Psychotherapy and Pharmacotherapy for Depersonalization/Derealization Disorder. (G3.30)

Techniques that help patients reach a deeply relaxed state can help reach the nonverbal emotions and memories from early childhood that may not have been stored as “words.” Art therapy, journaling or poetry, music and movement and meditation can all help access or nonverbal memories. EMDR therapy incorporates rapid eye movement or hearing a sound that switches from the right to the left side of the brain rapidly. The stimulation in a rhythmic pattern helps reach a relaxed meditative state that is not as deep as hypnosis but might be somewhat similar. The therapist then guides the patient with some questions about a traumatic event or memory in order to try to reframe the issue from an adult’s perspective, in order to help the little child within the patient understand the issue from a more adult perspective. Forgiveness for parents who didn’t know better might be part of reviewing a traumatic childhood from the viewpoint of an adult. Parents may have just been young and foolish once too.

  • Eye Movement Desensitization and Reprocessing, EMDR Therapy: Using EMDR to Find Your ‘Safe Place’ in Trauma Recovery. (G3.31)

/Disclosure: This information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes./

References:

  • G3.30: Stress and Trauma: Psychotherapy and Pharmacotherapy for Depersonalization/Derealization Disorder, by J.P. Gentile, M. Snyder, P. M. Gillig, Innov Clin Neurosci. 2014 Jul-Aug; 11(7-8): 37–41. (G3.30)
  • G3.31: Using EMDR to Find Your ‘Safe Place’ in Trauma Recovery. By Camille Larsen, Aug.15, 2016, (G3.31.goodtherapy.org)

G3.3: Negative stress can trigger the “fight-flight” response – Who’s at Risk?

Stressful times can make fear and anxiety more likely as our body’s instincts expect to either run from danger or to freeze in position, possibly in the hopes of not being noticed by a predator.

Who’s more at risk to experience negative stress?

Who is more at risk to experience a challenge with a negative fight, flight, or freeze stress response? (G.10)  Instead of having their body or mind perceive a stressor as a positive challenge and an exciting reason to get up each morning ready to say “Carpe diem”?   

Who is more at risk to experience stress as a negative stress response instead of seeing it as a positive challenge and reason to get up and get busy?

  • Answer: many groups are more at risk for having their bodies respond to an event with more of a negative stress response than the average person.     

People more vulnerable to the negative health effects of stress include:

  • older adults;
  • mothers and especially working mothers;
  • less educated individuals;
  • divorced or widowed individuals;
  • people with financial concerns or lack of health insurance;
  • isolated or lonely people;
  • people who are targets of racial or sexual discrimination;
  • people who live in cities,
  • and people with a history of childhood trauma can be more risk to feeling stress.
  • Summarized from “Stress“: (G3.5), University of Maryland Medical Center.

Antioxidant foods can help protect against negative effects from stress.

Eating antioxidant rich foods can help protect the body from negative effects that can occur due the waste chemicals produced during normal metabolism and increased during situations that cause more oxidative stress from  either emotional or physical reasons. Angry and tense due to having to hold in your temper at work, or angry and tense because the traffic was so physically dangerous to navigate simply to get to work in the first place; – both can increase the amount of oxidative stress occurring throughout the body.

Social contact with caring people can also help the body physically detoxify negative chemicals produced during stress or produce less of them in the first place, that will be discussed more in the next post. (G3.10)

The stress response produces chemicals which can cause other inflammatory reactions throughout the body. Having extra antioxidant rich fruits and vegetables and assuring adequate omega 3 fatty acids was shown to help reduce inflammation in autoimmune Celiac sprue. (G3.6)

Dark chocolate has also been shown to be beneficial antioxidant source. Forty grams (1.3 ounces approximately) per day of chocolate was found beneficial with a college student population. (G3.7) That is quite a bit of chocolate for someone with limited room for the empty calories from sugar. Sesame seeds would provide antioxidants with no added sugar.

Eating sesame seeds as part of the daily diet has been shown in sports research to help reduce oxidative stress. The trial subjects ate 2 tablespoons per day of the seeds. See: Effects of Sesame (Sesamum indicum L.) Supplementation on Creatine Kinase, Lactate Dehydrogenase, Oxidative Stress Markers, and Aerobic Capacity in Semi-Professional Soccer Players. (G3.8)

Using tahini in the diet regularly would have similar health benefits. Raw oil or seed butter products may have the most antioxidant content. Look for the phrase “unroasted” on a seed or nut butter product or “cold pressed” on the label of an oil or coconut oil product. Tahini is a sesame paste similar to peanut butter except it has different flavor. The flavor is stronger and to my taste does not go well with sweet jams or jellies like peanut butter or sunflower seed butter. I have found daily use of tahini to be more beneficial to my health then sunflower butter as a substitute for peanut butter – which I have to avoid. I have many dietary restrictions because I feel better without the foods, due to intestinal sensitivities and the autoimmune inflammatory reactions that can occur when I have even very small amounts of some things.

My easy answer to fueling my body so I can get back to what I like doing – reading and writing – is simply tahini spread on rice cakes. I’m used to it now and eat it plain but when I first started eating it I would drizzle a small amount of blackstrap molasses on as a sweetener with a stronger flavor and a good supply of iron and trace nutrients. Or more often I would sprinkle ginger powder on for a zingy accent that provides pain killing anti-inflammatory chemicals. Later in this section on oxidative stress TRP channels will be discussed and their unfortunate sensitivity to many common foods – including ginger. Sadly for my diet and inflammatory condition, I no longer can use ginger due to the intestinal overactivity of TRP channels – presumably, more on that in a later section –  however it may take a while, note the abrupt change in the next footnote number, there is some stuff in between the beginning and the end of the footnote list:

Chocolate and antioxidant foods and herbs found helpful for stress are discussed in more detail with references on a UCLA webpage providing information about integrating Eastern medical philosophies and treatments with Western medical methods. (G3.112)

To provide sustenance for the journey and a way to add chocolate to your diet for anyone who can’t think of any, see my antioxidant rich recipe for chocolate chip cookies. See the third version on this page of recipes and information about gluten free food sensitivity and autoimmune sensitivity for an egg free, butter free, gluten free cookie recipe. It is still a treat with calories and fat, but with fewer ingredients that contain inflammatory chemicals and more ingredients that are very good sources of antioxidants or healthy types of fats: G8.Chocolate Chip Cookies.

Regarding TRP channels – cinnamon is a spice that can activate a type of the membrane gates to allow nerve signals or other actions to occur. The spice has been to help reduce blood glucose levels for patients with diabetes. About one quarter to one half teaspoon per day was found helpful.  (G3.124) A half teaspoon of cinnamon powder is a large amount. Some people enjoy it stirred into a bowl of hot cereal in the morning. It could also be added in smaller amounts to a few cups of hot tea throughout the day, or an evening cup of hot cocoa. Cinnamon is a spice that I avoid due to migraines, it may be causative as a TRPA1 channel agonist. More is included in later sections on TRP channels and the foods that may cause problems for some people such as those with a tendency towards migraines or Irritable Bowel Syndrome or concerns with chronic itch or skin problems such as psoriasis or eczema.

The science regarding cinnamon and blood glucose is complex, some of these terms and chemicals will be discussed in more detail later, this is an introduction to the topic of oxidative stress and TRP channels:

Cinnamaldehyde is a phytonutrient found in cinnamon. It activates ion channels (TRPA1) found in membranes of nerve cells in the tongue and throughout the body. Activating the TRPA1 ion channels causes a release of proteins called peptides from the nerve cells. The nerve cells carry pain sensations and also supply nerve signals to blood vessels. Blood vessel and cardiovascular functions can be beneficially affected by the peptides (including “calcitonin gene-related peptide, (CGRP), and Substance P, (SP)”) and activation of the TRPA1 channels within nerve cells of the gastrointestinal tract can also signal satiety centers in the brain (satiety is the sense of fullness, and hunger signals stop). Cinnamon use by patients with Type 2 diabetes has been found to help decrease blood glucose levels. Release of insulin promoting hormones (glucose-dependent insulinotropic hormone (GIP) and GLP-1) by the TRPA1 ion channels may be the reason for the decrease in insulin levels with the use of cinnamon. (page 1118, G3.113) 

How much cinnamon, what type? Cinnamon that included another phytonutrient called linolool was found to be helpful to lower blood glucose levels in an animal-based study at doses of 12.5 or 25 mg/kg of body weight, and more was not better. Doses of 50 mg/kg no longer had the beneficial effect. (G3.124) For a human who weighs 150 pounds/68 kilograms, that might be a serving size of 850-1700 milligrams, which might be roughly ¼ to ½ teaspoon per day – and one teaspoon, 50 mg/kg, would not be more helpful. Many nutrients and other activities in life are good in moderation but may be not helpful or even harmful in larger amounts

See a healthcare provider for medical advice, diagnosis or treatment.

  • Disclaimer: Opinions are my own and the information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes.
  • The Academy of Nutrition and Dietetics has a service for locating a nutrition counselor near you at the website eatright.org: (eatright.org/find-an-expert)

References:

G3.2: Thinking flexibly may help against the negative effects of stress.

Chronic stress can damage the health of brain cells. Routines may help save energy for the brain but may also make it more difficult to change habits once the routine has been established.

Neuroplasticity refers to the connections and pathways that form between brain cells. Long term habits develop as routine nerve pathways between brain cells where an initial action may stimulate the rest of the routine habit. Having routines embedded in our memories may help to save us time when we’re performing routine activities like household chores or driving home from work but it may interfere when trying to replace an old habit with a new habit. Routines may save energy for the mind to wander to other thoughts while the familiar chore is being performed.

The ability to form new pathways in the brain may also help to reduce the negative effects of stress. (G3.1) Games that are designed to boost brain plasticity may simply be boosting our ability to take tests. 

When habits become an automatic part of life they can save energy by reducing the need to make minor decisions. Every decision or use of willpower that we perform throughout the day can deplete our mental energy and reduce our ability to resist making impulsive decisions. Isaiah Hankel describes a way to make habits that last by making smaller changes and attaching them to a routine that already exists. If you always brush your teeth each morning and want to be better about taking a vitamin supplement or medication every day attach the new habit to the old one by linking them consistently. Older research suggested it can take three weeks of consistency to build a new habit while more recent research suggests it may take closer to two months. For more information see Chapter 8: Automaticity, Scaling, and the Rise of Mental Loops, in the book by Isaiah Hankel, Ph.D. called The Science of Intelligent Achievement, (pp 52-58, G3.123).

More research is needed to better understand neuroplasticity and how we can change old habits by changing the old neural pathways. (G3.2) In the meantime learning new words has been found to stimulate reward pathways in the brain. And it was found that people with stronger connections between the two regions of the brain involved in the reward pathways were able to learn more words than people with weaker connections. (G3.3)

Poetry may activate the brain similarly to music by helping increase brain connectivity in a similar way to what occurs when someone is listening to or composing music. (G2.1)

Meditation & Mindfulness Training can help an overanxious brain.

Mindfulness Training can help increase awareness of the issues that may be exciting or infuriating, but at a wordless subconscious level so they may go unnoticed and lead to behaviors that don’t seem to have a obvious reason or cause: How Mindfulness Helped a Workplace Diversity Exercise: (12.22)

And other research suggests that meditation and having a sense of purpose in life may help reduce some of the negative effects of stress which include cellular changes associated with aging. (G3.4)

Communication or Assertiveness Training may help reduce stress by improving effectiveness of conversation and by increasing the likelihood of having pleasant exchanges rather than difficult ones.

Communication difficulties can lead to direct stress effects on the body that occur during the conversation, lack of oxygen itself from tensely holding the breath, talking too fast or crying, might also add to negative effects of oxidative stress.  Stress might also occur over time from the resulting lack of progress on the topic that was being discussed with difficulty instead of with clear exchange of each persons priorities, concerns, and goals.

Issues from our childhood with communication problems we observed in our parent’s or other caregiver’s conversation may show up in our own behaviors. Role playing in a group may help reveal where other people’s typical responses are different than what you might have responded yourself. Role playing can help provide a safe place to practice new communication techniques with people who understand the technique and that it is practice. The strategy is used in Family Systems Therapy but power struggles can be part of many types of relationships not just within families.

Training materials about equality within a conversation or within a relationship were developed for helping victims of domestic violence and batterers learn how to recognize problem behaviors within their communication and actions. The handouts may be helpful for most age groups as emotional manipulation or abuse of power and control can occur in many types of relationships not just between couples. Discussing the difference between equal exchanges in a conversation and unequal ones in a calm neutral setting may be helpful to prevent a difficult exchange from ever happening in the first place.

  • Power and Control and Equality Wheels  The Power and Control Wheel (I.21) was developed by the Domestic Abuse Intervention Programs (DAIP). (I.22) Manipulative behaviors are grouped into eight categories in the model. An additional Equality Wheel (I.23) was developed to help guide batterers and victims of emotional or physical abuse towards healthier ways to interact. It is grouped into eight equivalent categories with examples of healthier ways to interact with each other. Problems frequently can involve communication issues by both people in a relationship.

Crisis Hotlines and Resources:

  • U.S. National Suicide Prevention Hotline: Call 1-800-273-8255, Available 24 hours everyday. (I.16.suicidepreventionlifeline.org)
  • National Helpline: Substance Abuse and Mental Health Services Administration: “SAMHSA’s National Helpline, 1-800-662-HELP (4357), (also known as the Treatment Referral Routing Service), is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.”  (I.17.samhsa.org)
  • Rape, Abuse and Incest National Network, RAINN Hotline: 1-800-656-HOPE, (I.18.RAINN.org)
  • National Domestic Violence Hotline: 24/7 confidential support at 1−800−799−7233 or TTY 1−800−787−3224. (I.19.thehotline.org)
  • Child Welfare Information Gateway: a variety of toll-free hotline numbers for concerns involving the safety of children. (I.20)

See a healthcare provider for medical advice, diagnosis or treatment.

  • Disclaimer: Opinions are my own and the information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes.
  • The Academy of Nutrition and Dietetics has a service for locating a nutrition counselor near you at the website eatright.org: (eatright.org/find-an-expert)

References:

  1. Don Joseph Goewey, Stress, the Brain and the Neuroscience of Successs, Huffingtonpost.com, Aug. 10, 2014, http://www.huffingtonpost.com/don-joseph-goewey-/stress-success_b_5652874.html (G3.1)
  2. Gary Stix, Neuroplasticity: New Clues to Just How Much the Adult Brain Can Change. Scientificamerican.com, July 14, 2014,  http://blogs.scientificamerican.com/talking-back/2014/07/14/neuroplasticity-new-clues-to-just-how-much-the-adult-brain-can-change/ (G3.2)
  3. P. Ripollés,  Marco-Pallarés, U. Hielscher, A. Mestres-Missé, C. Tempelmann, H. Heinze, A. Rodríguez-Fornellsi, T. Noesselt, The Role of Reward in Word Learning and Its Implications for Language Acquisition, Current Biology, Volume 24, Issue 21, p2606–2611, 3 November 2014 http://www.cell.com/current-biology/abstract/S0960-9822(14)01207-X (G3.3)
  4. James Hamblin, Health Tip: Find Purpose in Life, theatlantic.com, Nov. 3 2014,  http://www.theatlantic.com/health/archive/2014/11/live-on-purpose/382252/ (G3.4)