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PACEs in Medical Schools

Vital Self-Care for Adverse Childhood Experiences Recovery

 

         Glenn R. Schiraldi, Ph.D. Psychology Today blog post, March 6, 2024



This post is part of a series on adverse childhood experiences. Read the other parts here.



Taking good care of yourself is vital during and after the recovery process. Intelligent self-care:

  1. Signals that you matter, that you are worthwhile and valuable. This is an important counterbalance to the damaged self-esteem and disparaging self-talk that typically result from ACEs.
  2. Lifts the mood at the cellular level.
  3. Stabilizes and strengthens the brain, facilitating the formation of constructive brain patterns.
  4. Provides the energy needed to maintain healthy coping and functioning.



Here are three keys that dramatically affect day-to-day mood, functioning, and sense of well-being.



Mind your microbiome



Emerging research indicates that supporting beneficial gut microbes profoundly affects mood and brain health. For example, bacteria and toxins can breach the gut lining that is weakened by the shortage of good microbes. These bacteria and toxins reach the brain, causing depression, anxiety, brain inflammation, and cognitive dysfunctions. Good microbes produce neurotransmitters (such as serotonin), which communicate with the brain and affect mood. What strengthens the gut microbiome?

  • The nutrients found in fruits, vegetables, beans, nuts, seeds, and whole grains include fiber and other phytochemicals, which feed the good gut microbes.
  • Fermented foods contain good microbes. These include yogurt with live cultures, kefir, many cheeses (such as provolone, cheddar, cottage, Swiss, and soft cheese), sauerkraut, pickled vegetables, kimchi, and kombucha.
  • Using as little as a teaspoon of herbs a day (such as rosemary, basil, cinnamon, and ginger), rather than salt, has been found to increase gut health and microbial diversity.
  • Avoid highly processed foods (think junk food and sugary sodas, especially) that remove fiber but add sugar and emulsifiers that adversely affect the gut microbiome. Research shows that high sugar intake is linked to various mental disorders, such as depression, anxiety, and ADHD. Highly processed foods also often add fructose (as in high-fructose corn syrup), which can disturb the growth of brain cells and their energy production.



Eating habits that align with a Mediterranean-type diet optimize the gut microbiome (and brain health). The Mediterranean diet includes: abundant vegetables, fruits, beans, nuts, seeds and whole grains; healthy fat (including extra-virgin olive oil), fish (sometimes alternating with eggs or chicken); and regular, moderate use of fermented foods (such as cheese, yogurt, and kefir). This diet also minimizes animal fats (for example, red and processed meats and full-fat dairy), and processed foods (which often contain sugar, salt, simple carbohydrate, and preservatives).



Note that antibiotics can disrupt the microbiome. Minimize non-essential antibiotic use and consumption of meat and dairy raised on antibiotics.



Sleep Well



It is well established that sufficient, high-quality sleep is closely linked to mood, the ability to cope with stress, and general functioning. Good sleep also protects the brain from oxidative stress and inflammation.



Most adults are familiar with the general rules for good sleep: get 7-9 hours daily; adhere to regular times to go to bed and wake up (this favorably affects the microbiome and sleep rhythms); avoid blue light from electronics for at least 1-2 hours before going to sleep; block out light and noise from the bedroom; and keep the bedroom cool.



Less well recognized is the impact of eating habits on sleep. To reinforce your body’s sleep and microbiome’s rhythms, keep regular eating times. Avoid eating late at night, which alters the body clock. Eat most of your calories at the midday meal when your body can best accommodate them. As best you can, adhere to a Mediterranean-style diet, which is rich in melatonin and serotonin (these promote sleep quality and quantity). Finally, in the evening avoid sugary foods and drinks, caffeine, chocolate, processed meats, and citrus fruits.



If you are short on sleep, be careful about trying to compensate with caffeine. Excessive caffeine restricts blood flow to the brain. If you are tired during the day, aim to get better sleep. You’ll likely accomplish more and enjoy the day better.



Exercise Sustainably



Regular, moderate exercise has long been known to improve the quality of life, including mental and physical health, mood, and functioning. Researchers are in agreement: an achievable goal is to gradually build up to a total of 150 minutes per week or more (sustained or collective) of aerobic exercise, such as walking or biking, with This has been found to increase longevity up to six years, while reducing risk of all causes of death.



If you are short on time, consider twenty-minute periods of high-intensity interval training (HIIT), which alternates periods of high intensity (80-95 percent of maximum effort) with light activity. HIIT usually starts with a 1:2 ratio of work-to-rest intervals (for instance, 30 seconds of high-intensity walking where you can’t carry on a conversation alternating with a 60-second recovery period of light intensity walking).



Excellent results can be achieved with two or three HIIT sessions per week on non-consecutive days, combined with periods of moderate activity on the other days. Five to ten minutes of warm up, such as light walking and stretching, are especially important to prepare the body for HIIT, as is a cool down period of slow activity and stretching after exercising. It is also especially important to start very gradually and gently, and to discuss your plan with your healthcare provider.



If possible, try to exercise early in the day and outdoors in nature and sunshine, which seems to improve mood, cognitive function, and sleep. Benefits can be heightened by combining aerobic exercise with simple resistance and flexibility exercises several days a week..



Please note that low-grade, chronic inflammation seems to be the trigger for many chronic conditions, including dementia, depression, and anxiety. Inflammation can be curbed through simple nutrition, sleep, and exercise improvements—also by avoiding smoking, air pollution, and alcohol intake exceeding one drink per day or less.



Conclusion



Even small changes in eating, sleep and exercise have been found to bring huge benefits in life quality. This is why an increasing number of mental health professionals now encourage clients to develop their own written health plan that they can maintain for life. I’ve encouraged those I’ve worked with to make a simple written nutrition, exercise, and sleep plan, just setting goals that are easily reached. They are often surprised at how much their lives improve with small, simple changes. You’ll find that the efforts are worthwhile, because you are worth the effort.



Reference

Schiraldi, G. R. (2021). The Adverse Childhood Experiences Recovery Workbook: Heal the Hidden Wounds from Childhood Affecting Your Adult Mental and Physical Health. Oakland, CA: New Harbinger Publications.



About the Author

Glenn R. Schiraldi, PhD, has served on the stress management faculties at The Pentagon, the International Critical Incident Stress Foundation, and the University of Maryland, where he received the Outstanding Teacher Award in addition to other teaching/service awards. His fourteen books on stress-related topics have been translated into seventeen languages, and include The Adverse Childhood Experiences Recovery Workbook, The Self-Esteem Workbook. The Resilience Workbook, and The Post-Traumatic Stress Disorder Sourcebook. The founder of Resilience Training International (www.ResilienceFirst.com), he has trained laypersons, emergency responders, and clinicians around the world on the diverse aspects of stress, trauma, and resilience.

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