\u201cEverything can be taken from a man but one thing: the last of human freedoms \u2014 to choose one's attitude in any given set of circumstances, to choose one's own way.\u201d \u2014 Viktor Frankl, MD, PhD, author of Man\u2019s Search for Meaning and Holocaust survivor Two people are in a motor vehicle accident. They are trapped in the car and require that the rescuers use the \u201cjaws of life\u201d to pry away the twisted metal and pull them from the wreckage. Each sustains serious, but survivable injuries. When they are discharged from the hospital, one returns to work and resumes a \u201cnormal\u201d routine. The other experiences severe pain and has difficulty getting out of bed in the morning, let alone returning to regular activity. He is prescribed medications to quell the pain and finds that he develops a tolerance to them, such that he requires increasing amounts to experience relief. In short order, he has become addicted to the opiate effect. He exhibits symptoms of post-traumatic stress disorder, such as flashbacks and nightmares, difficulty driving and is emotionally triggered when going by the scene of the accident. What is the difference between them? Without knowing each person\u2019s physiological and psychological history, one answer might lie in neuropeptide Y (NPY), which is a 36-amino-acid peptide transmitter that works in forebrain limbic and brain stem areas. The purpose of these components of the brain is to control stress and emotionally stimulated behaviors. When someone has minimal amounts of this chemical in the brain, he or she is more inclined to respond negatively to the same stimuli as someone with an adequate quantity. Brian J. Mickey, MD, PhD, of the University of Michigan, spearheaded a study which indicated that people who have symptoms of depression were twice as likely as people without depression to have low levels of NPY. Further, it was found that in a \u201cwhich-came-first, the-chicken-or-the-egg?\u201d paradigm that there was a correlation between early trauma and a lower concentration of neuropeptide Y. Additionally, if someone were to be void of healthy and functional coping skills to face these challenges, the likelihood increases that the trauma could become even more entrenched, thus perpetuating the cycle. Stress hormones such as adrenaline, cortisol and norepinephrine kick the body and brain into high gear in response to trauma, while NPY dials down the reaction and helps the person to cope. \u201cIn resiliency, these brake systems are turning out to be the most relevant,\u201d says Renu Sah, a neuroscientist at the University of Cincinnati in Ohio. Does Learned Resilience Play a Part? Consider the horrendous kidnapping story of Elizabeth Ebaugh, who in 1986 was taken at knifepoint, sexually assaulted and left to die.\u00a0 Although she suffered PTSD in the early aftermath of the incident, she was proactive and immediately sought support from family and friends, as well as the legal system and a competent and caring therapist. She also used her internal resources, holistic modalities and spiritual practice to see her through. Ebaugh became what could be called a resilient thriver who used her own trauma to become a therapist herself and to treat others who have faced stress-inducing ordeals. The American Psychological Association defines resilience as, \u201cthe process of adapting well in the face of adversity, trauma, tragedy, threats or significant sources of stress \u2014 such as family and relationship problems, serious health problems or workplace and financial stressors. It means \u201cbouncing back\u201d from difficult experiences.\u201d Qualities of resilient people include: \tAn optimistic attitude that things will work in their favor \tAn ability to rebound from daily challenges \tA willingness to seek personal and professional support in the face of stressors \tA belief in their own skills and abilities to do what is necessary \tA conviction that since they survived the original incident, they will manage the aftermath \tA world view that looks for possibility rather than peril \tMore than adequate social supports in their daily lives \tA toolkit of self-care habits \tA means of refraining from identifying themselves as victims and instead as thrivers \tA willingness to surrender control of outcomes \tA sense of humor \tThe ability to differentiate between a problem and an inconvenience \tAre skilled at turning stumbling blocks into stepping stones \tHave had role models for resilience \tFlexibility and can bend like a willow, rather than stand fast like an oak tree \tKnowing that they can turn setbacks into comebacks \tAre not just problem-solvers, but solution-finders \tHave an internal locus of control so they are not always at the mercy of external circumstances \tFor some, a solid spiritual faith and practice bolsters them Even if you are unable to identify many of these traits in your own life, it is possible to learn resilience, by surrounding yourself with hardy people, reading books on the topic and having a sense of purpose, as did Candy Lightner who founded Mothers Against Drunk Driving (MADD) after her daughter was killed by a drunk driver. Additionally, healthy eating habits, exercise, spending time in nature and with those who love you can provide more robust resiliency muscles. Refraining from turning to substances to cope is, of course, in order as well.