Understanding Stress
No one gets through life without stress. In fact, a small amount of stress
is even good for you. But stress can be more than just uncomfortable.
Severe stress can feel overwhelming. Less severe chronic stress can
hurt your ability to function both at work and in your relationships. It can
even be physically harmful.
Stress becomes significant when it results in problems
of mood, anxiety, or
behavior. All hurt your ability to cope.
Mood:
Many people develop a depressed mood as a result of either chronic
stress or a temporary severely stressful situation. Feelings of
hopelessness and helplessness, with negative predictions for the
future can make a stressful situation feel even more severe. These
feelings often progress into a full-blown depression.
Feeling depressed as a result of stress is often accompanied by
anxiety or irritability.
If you have been dealing with a depressed mood on top of stress, and
you've felt this way for a week or more, you should seek treatment.
This is especially recommended if you are also feeling fatigued, have
difficulty concentrating, or if your sleep patterns or appetite have changed.
You can also learn more about
Major Depression by clicking on this link.
Anxiety:
Most stressful situations involve some amount of justifiable anxiety. The
difference between clinically significant stress and normal stress has to
do with the severity of anxiety and its persistence. Do you lay
in bed at night, turning your worries over in your head, time after time?
Are your worries distracting you at work? Are they interfering with your
duties as a parent or your relationship with your husband/wife? Do you
find yourself 'freezing' mentally or having difficulty making decisions?
Do you have moments of extreme anxiety?
Many people find it really difficult to put aside their realistic worries about
a stressful situation. This deprives them of rest. They may also
push away family members who are trying to give emotional support.
Anxiety can be caused by the catastrophic thinking
which often happens as a result of stress. Catastrophic thinking
works something like this.
If X (a bad thing)
happens, then Y (something even worse) will probably be
the result. If Y results, then Z (even more awful) will
probably also happen. People suffering from catastrophic thinking
worry about sequences of negative events occurring in a chain reaction,
like a multi-car accident on a foggy highway. Though each event
could actually occur, they are focusing on a series of worst possible
outcomes. They lose sight of all of the other possibilities.
Anxiety as a result of stress is often accompanied by
depression or
irritability.
If you've been feeling 'stressed out' and anxious for a week or more,
you should probably seek treatment. Anxiety symptoms can progress
into a full blown anxiety disorder.
You can also learn more about
Anxiety Disorders by clicking on this link.
Behavior:
The two most common behavioral effects of stress are sleep
disturbance and irritability. Sleep problems include
insomnia, difficulty staying asleep, and restless, unsatisfying sleep.
Sleep problems are almost universal when people are subjected
to severe stress. They tend to be intermittent, but recurring, when
a stressful situation is less severe, but chronic. I'm not sure which
sells more new mattresses, stress or backaches.
Sleep problems tend to make every other stress-related problem
worse. When you are sleep deprived you are more prone to
negative thinking and a depressed mood.
You are also less likely to be able to think clearly and counter
anxious thoughts. Naturally, you may
be irritable (see below).
Many people don't realize the way sleep problems affect their ability
to function. On objectively measured tests, people who are sleep
deprived have a poorer scores on tests of short-term memory,
long-term recall, and reasoning (verbal math problems). In other words,
stress-related sleep problems reduce your ability to function when
you need it the most.
Almost everyone experiences some increased irritability when stressed.
All of the other stress-related problems mentioned so far add to it.
Irritability becomes its own problem when it results in conflict on the job
or in the home. You may find yourself reacting to things that would only
annoy you in better times. You may also cut yourself off from friends
and family members who really want to help.
If you find yourself constantly angry at family members or if you have
angry outbursts you should probably get treatment sooner rather than
later. Irritability is a normal response to stress, but it causes too much
trouble to ignore.
All too frequently, people who are suffering from chronic stress deal with
it by engaging in self-destructive behavior. They may begin to
self-medicate using alcohol, marijuana, or prescription pharmaceuticals.
The 'work hard, party hard' philosophy has had more casualties than
anyone cares to count up. If you are thinking about entering a 12-Step
program for stress-related drinking or substance abuse, you should
also begin treatment for the stress itself.
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Short-term Therapy for Stress
My first goal in treating stress is to improve my patient's ability to cope.
My approach is multi-faceted and tailored both to the person and the
situation.
Behavioral Techniques:
My top three interventions all produce improvement rapidly. They are:
- Relaxation Training
- Exercise
- Sleep Hygiene
Relaxation Training involves non-religious meditative exercises
that enable the patient to feel calmer. They can be centered on breathing,
muscle tension, or guided imagery. The choice is made based on the
patient's symptoms, needs, and personal preference. Catholic patients
can learn to use the rosary as a tool for self-calming prayer.
Exercise is a great tool for improving mood and reducing the
feeling of muscular tension. It isn't for everybody, but many people
enjoy their workouts and find them very useful.
Sleep Hygiene involves a set of rules to follow to recover from
disrupted sleep patterns. Relaxation training and exercise also help
restore healthy sleep patterns.
Cognitive Techniques:
Patients suffering from excessive stress often use the same maladaptive
thinking patterns found in patients suffering from
Generalized Anxiety Disorder or
Depression, though usually in a milder form. The same cognitive
techniques used to treat the more severe disorders can be used for
treating stress.
Patients become aware of their tendency to think catastrophically
(presuming a chain of worst-case scenarios) and their excessive worrying.
They learn how to respond to their persistent worries using objective,
rational alternatives.
"It is what it is." has become a motto for acceptance in modern
life. But from a cognitive therapy perspective, "Things are what we
make of them," would be more accurate. Patients learn to examine
their assumptions, biases,
and unbalanced perspective of the situation, replacing them with equally
accurate, but less stressful ways of viewing things.
Change and Acceptance
There are many stressful situations that people shouldn't just cope with.
These include physical, verbal, and emotional abuse at home or at work.
Sexual harassment on the job or in school is something no one should
just put up with. When patients face situations like these, I provide
emotional support and an objective sounding board to help them
find safe and responsible ways to fight back or get away.
Finally, there are situations that just have to be accepted. Terminal
or chronic illness, disability, and loss of love fall into this category.
My supportive approach helps patients come to terms with the
inevitable so that they can live their lives to the fullest.
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