I recently read an article about a young man who lost a leg to a land mine while hiking in a third-world country.   This stalwart outdoorsman was instantly transformed into a frightened victim with months of surgery, physical therapy, and prosthetic training in his future.  His journey was inspiring, as he battled (as you can imagine) deep depression and post-traumatic stress syndrome in addition to his physical wounds.  Eventually, he formed a support group for survivors, which eventually won a Nobel Peace Prize for their efforts to ban landmines.

Adversity

This got me thinking about adversity in general, and how the preparedness community could face plenty of it in the uncertain future.  Regardless of your level of preparedness, you will likely face your own metaphorical landmine or two after a major disaster.  How you deal with these issues will determine your ultimate success or failure.  As a doctor, what could I tell you that would help you overcome the challenges you would face and remain physically and mentally healthy?

Physically, the ability to overcome adversity is controlling the stress response.  Chronic exposure to stress will weaken your immune system.  Failure to control the physical effects of stress can lead to various ailments that will decrease your chances of survival. Besides depression,  these include ulcers, asthma, heart disease, and diabetes.  Stress can also lead to a cascade of destructive behaviors, such as alcohol abuse and smoking (such as: “Man, I am so stressed out!  I need a drink!”).

Surviving Adversity

Adverse events are part of any survival scenario.  Stress is not always bad: facing challenges can make your stronger. Who makes it and who doesn’t will depend on their resilience. Education, training, and experience is essential, but resilience, or the lack of it, is the factor that will assure success or failure.

A person’s tendency to overcome adversity is partly nature and partly nurture. Could this ability be inherited?  Certainly, some children warm up to new tasks or people more effectively than others. Yet, there are many environmental factors that play a part:  family support, financial status, quality of schooling, and various others.  An unemployed introvert is at a disadvantage when compared to the monetarily secure individual who belongs to a close family or active religious/social community.

Despite this, it is possible to increase your ability to overcome adversity through a disciplined approach.   You can:

• learn to regulate emotions
• adopt a realistic, positive attitude
• become physically fit
• develop a supportive community

Emotions/Attitude:   If you can control feelings of anger, fear, insecurity, and sadness, you can maintain a clear head in times of trouble.  Oftentimes, people interpret a negative event as being worse than it is. Studies at Columbia University show that people who intentionally “reappraise” an event, such as a rejected application, as being less negative actually increase the activity of the part of the brain that helps to plan and direct. Reappraisal also seems to inhibit the activity of the part of the brain that is involved in feelings of fear.  Study participants reported a stronger sense of well-being after adopting this strategy, which I call “looking for the silver lining in the storm cloud”.

This glass half-full approach could be useful everywhere from the athletic field to the workplace to the hospital room.  Those patients with the ability to find a neutral or positive interpretation of a negative event tend to live longer and have a better quality of life than those who don’t. In another study performed many years ago, a group of women were asked to write a life history.  These were rated accorded to the degree in which they expressed positive emotions.  34% of those who wrote negative history were alive after 80 years of age compared to 90% of the women who wrote positive histories.

In survival scenarios, however, the risk of positive reappraisal could lead to denial of negative events.  If this occurs, you might underestimate dangerous situations; realism and positivity have to strike a balance.

Physical Exertion:  It is well known that physical activity increases the “feel-good” substances in your brain known as “Endorphins” and improves your resilience.  It also inhibits the stress hormone known as “Cortisol”. Regular physical activity not only is good for your heart. Studies at the University of Colorado show that regular aerobic exercise have various benefits: a decrease in anxiety/depression and an improvement in attention span, decision making, and memory.  At the University of Illinois, moderate exercise study seem to indicate improved growth and repair of brain cells.  NOTE:  Always check with your physician to make sure an aerobic exercise program is safe for you.

Community: An effective strategy to improve your ability to overcome adversity is to establish and maintain strong relationships with other members of the preparedness community. A sense of security due to support from others allows you to deal with stressful events positively, and has even been shown to lower ill-effects suffered in veterans from Post-Traumatic Stress Disorder (PTSD).  A supportive community bolsters self-confidence and provides a safety net that minimizes the damage from failure.  Social bonds are the glue that will keep us together in dark times; make an effort to develop these now by joining your religious community, social organization, and otherwise connecting with like-minded individuals.

You may think you are connected well to others, but ask yourself some questions:

• Who do you interact with regularly?
• Who would help you in times of trouble without hesitating?
• Who would YOU help without hesitating?
• Who do you turn to for advice who is glad to give it?
• Who do you know who has bounced back from adversity?

If your answer is few or none to the above, spend some time and effort to develop new and stronger relationships.

We have to be prepared to deal with setbacks if the you-know-what hits the fan.  If we can see negative events as a bump in the road instead of the END of the road, we can succeed, even if everything else fails.

Dr. Bones