Ask an Expert: Courtney Doherty Discusses Stress Management

Courtney Doherty, MCP, RCC, is a clinical counsellor with Parkinson Society British Columbia (PSBC). The Society offers free, short-term, confidential, and non-judgemental counselling services for people touched by Parkinson’s disease (PD). Counselling provides a safe and structured environment to discuss challenges, process emotions, and provide you with the extra support you and your loved ones may need. Our counsellors have experience working with people with Parkinson’s, and their carepartners and family members. They are able to help in dealing with a combination of issues including coping with a diagnosis, life transitions, grief and loss, depression, anxiety, and stress.

Courtney completed her Masters of Counselling Psychology at Adler University in Vancouver. She has been working as a Registered Clinical Counsellor (RCC) with the British Columbia Association of Clinical Counsellors for over 5 years, and has a part-time private practice. Courtney’s father was diagnosed with PD over 15 years ago, and successfully underwent Deep Brain Stimulation surgery. Believing that every individual has the potential to lead a happy and fulfilling life regardless of challenges faced, she brings a unique perspective and skill set to PSBC.

What exactly is stress?

Stress is the body’s natural response to danger. Our ancestors were faced with dangers in their environment and developed an effective response in order to survive as a species. This response includes a rapid series of physiological and psychological reactions that helps us decide whether to stay and fight, or run away to safety. This is known as the “fight or flight” response.

Fight or flight prepares the body to react to stress. When faced with danger, the sympathetic nervous system is activated, causing adrenaline and cortisol to be released into the blood stream. These hormones cause the heart rate and blood pressure to increase, directing blood to our muscles to increase strength; they also cause our pupils to become dilated so we can better see our surroundings, and our breathing to become rapid and shallow, boosting oxygen intake in preparation for a fight or flight.

This physiological response has helped humans successfully overcome many dangerous and threatening situations. Today, however, we are faced with different kinds of stressors than our ancestors once faced. This might include real physical threats (jumping out of the way of a moving vehicle), or perceived psychological threats (preparing for a deadline), but our brain and body still respond in the same way.

What is the difference between good and bad stress?

There are two kinds of stress: “bad” stress (known as distress), and “good” stress (known as eustress). We often talk about distress when referring to the experiences we face, but it is important to recognize that some things that are viewed as good or positive can also be stressors, like having a baby, buying a house, or getting a promotion at work. The more overall stress that we experience, the more taxing it is on our body and mind.

What are the effects of stress on one’s mental health?

A certain amount of stress is a normal part of life and can actually be beneficial for things like completing tasks or meeting deadlines. However, long-term or “chronic” stress can be harmful, and can lead to an increased risk for physical and mental health issues. If we are faced with chronic stress, our nervous system is constantly being activated, and this may make it difficult for us to return to a state of rest. If stress piles up, we can become overwhelmed and feel unable to cope with anything, which is commonly referred to as “burnout.” If we continue on without doing anything about the stress, it can lead to further health problems, including hypertension, heart disease, and anxiety.

How can stress manifest in the body?

Things like muscle tension, sleep problems, digestive issues, inflammation, anxiety, and low mood are among some of the most common ways stress manifests in the body. If the “fight or flight” response is frequently activated, the body will eventually have difficulty returning to a normal, balanced state. We therefore want to deactivate the sympathetic nervous system and activate the parasympathetic nervous system (PNS), commonly referred to as the “rest and digest” response. One of the easiest ways to activate the PNS is to practice deep diaphragmatic breathing (slow and deep breathing through your diaphragm). Other ways to activate the PNS include grounding exercises like naming 5 things you see in front of you, physical exercise, being out in nature, and practicing mindfulness and other relaxation techniques.

How can stress impact Parkinson’s symptoms?

Stress can make Parkinson’s symptoms worse, because it forces the body to prioritize basic functions in an attempt to cope. We might think we are managing our stress just fine, but stress can slowly accumulate, leading to an overload on our nervous system, which affects our overall health in the long run. Stress can lead to increased tension in muscles, inflammation in our cells, lack of sleep, increased pain, and digestive issues. Stress can also have a significant impact on our mental health leading to increased symptoms of anxiety and depression. These common reactions to chronic stress are also symptoms that people with Parkinson’s might already be facing, so it is imperative that we manage our stress before it manages us.

What about stress in carepartners?

Stress in carepartners is equally important to address, since caring for someone is a very demanding responsibility. Carepartners often fall into the role of caring for their loved one — a role they likely did not expect, and for which they may feel unprepared. This may come with a variety of emotions like anger, grief, and sadness, along with physical and psychological stress.

It is important to recognize and be honest about the amount of responsibilities we can handle as carepartners, and to reach out for support before it becomes overwhelming. It is important for carepartners to realize that they cannot care for another person if they are not caring for themselves first. Think of the age-old airplane analogy of putting on our own oxygen mask before we can assist others. We must think about how we can care for ourselves throughout the day to ensure that we avoid burnout. The concept of self-care is often misunderstood; it does not need to look like a bubble bath with candles. It can be much simpler. Self-care involves intentionally planning to do something that recharges your batteries. This can mean taking five minutes to appreciate your morning coffee, listening to a song that makes you feel good, or writing down three things for which you are grateful. We must deliberately practice caring for our needs throughout our day in order to take care of the needs of others.

What are some good ways to self-manage stress?

• Practice deep breathing, mindfulness, and grounding exercises.
• Seek psychological support through counselling.
• Reach out to loved ones.
• Focus on what you can control.
• Practice gratitude (name things you are grateful for).
• Exercise in a sustainable way (10-minute walks vs. 30-minute runs).
• Eat a balanced, nutrient-dense diet.
• Get adequate sleep in a good sleep environment (tidy, dark, distraction free).
• Take medications on time, and as directed by your medical practitioners.
• Self-care (in a simple, deliberate way) – enjoying good music or food, enjoying the view, looking at a calming photo.

How can seeing a counsellor help with stress?

Counselling can help reduce stress in many ways. It can help you identify factors in your life that cause you stress, and develop coping strategies to handle those stressors in healthy way. This might include things like making schedules to prioritize self-care, teaching you mindfulness and relaxation techniques, and providing you with skills to recognize and reframe negative patterns in your life. Counselling might also help you to realize different goals and motivate you to implement positive change. It can help reduce feelings of guilt and shame for carepartners who avoid caring for themselves. Counselling can also be a safe environment to talk about things that might be weighing on you emotionally, or to simply gain another perspective.

Parkinson Society BC offers free, short-term counselling for anyone affected by Parkinson’s disease. To learn more about our counsellors and how they can help you, visit www.parkinson.bc.ca/counselling.

This content was published in the Fall 2020 edition of our quarterly magazine, Viewpoints. The content was accurate as of this publication date.