Stress has been called the silent killer—and for good reason.

It is the cause of 60% of all human disease. Three out of four doctor visits actually stem from a stress-related ailment. And 44% of stressed people lose sleep every night, causing lasting medical issues.

Tara Scott

It’s a topic that hits close to home for Tara Scott, medical director of integrative medicine at Summa Health and chief medical officer at Revitalize Medical Group, who shared her own personal journey overcoming stress at Tuesday’s Health & Benefits Leadership Conference.

A high-achiever as a child, Scott graduated high school at 17 and completed college just two years later; she was a medical doctor by the age of 23. She entered obstetrics—a field known for unpredictable schedules and high-intensity situations. But, she said, she still felt like she managed the stress well.

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Then, 13 years ago, her brother died of a heart attack at 38 years old. He had numerous risk factors—he was diabetic and a smoker with high cholesterol and a sedentary lifestyle as a lawyer—but stress was at the heart of most of it, Scott said.

“As a doctor, I feel that stress killed my brother,” she said. That changed the way she looked at medicine, and she pivoted her focus to integrative and functional medicine, concentrating on preventive health. Through that work, she began learning more about the crisis of stress in the country and helping patients to cope, using techniques that she built into her own life.

Those approaches became essential on July 19, 2019. Her husband, a doctor and a pilot, was flying the family to pick their daughter up from a summer program at Brown University when the plane started rapidly losing fuel.

“This was an opportunity for me to employ all the stress-management techniques I had been learning: Take some deep breaths and I turned to prayer. I felt calm,” she said, even as the plane started crashing into the tops of trees and ultimately landed 3/4 mile beyond the runway at the airport where it was aiming for an emergency landing. Scott’s husband, unconscious, was airlifted to one hospital, her son was taken to another for bumps and bruises, and her daughter was rushed to a third with a fractured vertebra. Emergency personnel gave Scott the choice of which hospital to go to—she followed her daughter, who appeared to have the most serious injuries, and spent seven hours waiting for her to get out of surgery, when a doctor delivered the news that she would never walk again.

“Life as I knew it changed from that moment on,” she said.

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Scott spent two weeks with her daughter at the hospital and then lived out of a hotel for six weeks while she was in rehab.

“I had to find my new normal,” she said. Because of her medical practice, she knew that normal needed to include stress management.

Self-care was key, she said. An avid exercise enthusiast under normal circumstances, Scott tried to build exercise into her new routine: taking the steps at the hospital instead of the elevator, walking the parking lot while on the phone with relatives. To keep up a good diet, she found a Whole Foods near the rehab facility and sought to avoid unhealthy hospital food. Gratitude was also part of her strategy.

“Having an attitude of gratitude does impact your healing and does help you. What it does is foster hope.” Tara Scott

She used a journal each morning to write three things she was grateful for, three things that would be positive if they happened during the day—achievable, controllable things like having a good reaction, not wishes like winning the lottery—and then at night looked back on three amazing things that happened during the day. Scott admitted that, while her daughter was recovering, it was sometimes hard to find sources of gratitude but she stuck with it.

Also see: 5 tips to help reduce employee stress

“Having an attitude of gratitude does impact your healing and does help you. What it does is foster hope,” she said, noting the difference between hope and optimism, the latter of which is a belief that everything will turn out OK. “Hope is the belief that you’ll be OK even in spite of difficulty.”

Scott also practices a number of in-the-moment stress-management techniques, which were essential during her daughter’s recovery. Box breathing, for instance, involves regulated, 4-second intervals of breathing and pausing; single-nostril breathing—holding one nostril for a breath in and switching to the other for the breath out—is also effective, she said.

Meditation is another tool. There has been a proliferation of mental health apps in recent years that offer guided meditation, along with YouTube videos, enabling quick, at-home meditation sessions that allow for deep breathing and a few minutes of unplugged time.

She also advocates for “heart math,” or measuring heart rate variability to uncover peaks of stress. In a study of 12,000 people who measured their heart rate and responded accordingly over a nine-week period, those who reduced their variability saw increased focus, sleep and calm, along with decreased anxiety and fatigue and a full 56% decrease in depression—a rate that Scott noted is better than the results of some prescription medications.

Having all of these tools in her arsenal before the accident helped her come out the other side of it, Scott said. And it’s also prepared her for ongoing stresses. She said the pandemic hasn’t seemed that stressful as she’s already lived through something much worse and known how to manage the stress.

That’s an important lesson for HR and benefits leaders about preventative approaches for stress—both on a personal scale and an organizational one.

Related: Improving workplace mental health must be a strategic initiative

Scott likened the need for preventative stress-reduction to a six-month oil change, regular dental appointments and retirement savings. None is mandatory but, if you’re proactive, you’ll see better outcomes eventually.

“Let’s treat our health this way,” she said. “There’s never a time more like the present to cultivate resilience.”

Cultures of resilience can also breed hope, she noted.

She points to her daughter as an example. She practiced many of the same stress-management techniques that Scott champions during her recovery. She’s become an advocate for people with disabilities and participates in a wheelchair dance team. Last year, she defied doctors’ predictions and walked for the first time with braces and a walker.

“I’ve got to believe a lot of it is because of her mindset and resilience,” Scott said.

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All conference sessions will be available on-demand through June 11 and registration remains open. Click here to view this entire session.