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Backgrounder
on Stress
From www.healthywomen.org, Health Center A to Z Overview Stress can be your friend or your foe. When stress fuels the spark of personal achievement, it can work to your benefit by making you more perceptive and productive, acting as a motivator and even making you more creative. But when stress flames out of control - as it often does for many of us today - it can take a terrible toll on your physical and emotional health, as well as your relationships. While stress is not considered an illness, it can cause specific medical symptoms, often serious enough to send women to the emergency room or their health care professional's office. In fact, 43 percent of adults suffer adverse health effects from stress, and 75 to 90 percent of all physician office visits have stress-related components, according to the American Psychological Association. In today's fast-paced world, women are experiencing more stress at every stage of their lives than ever before. Juggling jobs pressures, family schedules, money issues, career and educational advancement, child- and elder-care concerns are only a few of the common stressors confronting women. Working mothers, regardless of whether they are married or single, face higher stress levels -- both in the workplace as well as at home. The National Institute for Occupational Safety and Health (NIOSH), the U.S. agency responsible for conducting research and making recommendations for the prevention of work-related illness and injury, provides these statistics regarding stress in the workplace: * 40 percent of workers reported their job was very or extremely stressful * 25 percent view their jobs as the number one stressor in their lives * 75 percent of employees believe that workers have more on-the-job stress than a generation ago * 29 percent of workers felt quite a bit or extremely stressed at work * 26 percent of workers said they were "often or very often burned out or stressed by their work" * job stress is more strongly associated with health complaints than stress related to financial or family problems Stress can cause a variety of physical ailments, from headache to symptoms that mimic a heart attack. In addition, stress can cause the same symptoms as those caused by depression and anxiety. In either case, you should discuss your symptoms with your health care professional. A thorough assessment by your health care team will help determine the cause of these symptoms. You may find that stress has triggered an illness, such as high blood pressure. Stress and Your Body Research indicates that womens's biological response to stress is actually to "tend and befriend," i.e., make sure the children are safe and then network with other women; whereas men's biological reaction to stress is to go into the "flight or fight" mode. Studies indicate that the hormone oxytocin is released during stressful events or periods in both men and women but its effects are intensified in women by estrogen, causing them to seek social support during times of stress. This effect is diminished in men due to the hormone testosterone. Stress hormones including adrenaline and cortisol flood the body, in both females and males causing: * your body's need for oxygen to increase * your heart rate and blood pressure to go up * the blood vessels in your skin to constrict * your muscles to tense * your blood sugar level to increase * your blood to have an increased tendency to clot * your body's cells to pour stored fat into the bloodstream All of this can strain your heart and artery linings, so much so that if you already have coronary heart disease, stress might make you feel chest pain, called angina. The increased tendency for the blood to clot may predispose some people to develop a clot in their coronary arteries, causing a heart attack. The tendency for your bowel and intestinal muscles to constrict, also due to a sudden release of adrenaline, can lead to stomach problems. In addition, it can precipitate a number of mental illnesses like depression and anxiety. Stress doesn't cause these mental illnesses, but it can activate these brain disorders in people who may already be prone to them. Stress can cause "toxic weight." Cortisol is a powerful appetite "trigger." That's no surprise if you've found that you eat more -- and less-than-healthy food -- when you're under a lot of stress. Those extra calories are converted to fat deposits that gravitate to your waistline. Fat deposits around the abdomen -- the "apple-shaped" figure vs. the "pear-shaped figure" -- are associated with life-threatening illnesses such as heart disease, diabetes, high blood pressure, stroke and cancer. Chronically high levels of cortisol actually stimulate the fat cells inside the abdomen to fill with more fat. As you age, your expanding waistline can be life threatening. Too much stress can also affect your immune system, weakening it and making you more susceptible to colds, coughs and infections. Some
physical symptoms of stress include feeling anxious, depressed or
irritable, muscular tension, headaches and gastrointestinal illnesses. Stress Triggers Stress can be caused by both external and internal factors -- some you can control and others you can't, for example: * trauma or crises * small daily hassles * conflicts or unpleasant people * barriers that prevent you from reaching your goals * feeling little control over your life * excessive or impossible demands * noise * boring or lonely work * irrational ideas about how things should or must be; perceiving that life is not unfolding as you think it should * believing you are helpless or can't handle a situation * drawing faulty conclusions like "they don't like me" or "I'm inferior to them," or having unreasonable fears of dire events such as "I'll be mugged" * pushing yourself to excel and/or failing to achieve a desired goal * assigning fault for bad events, for example, placing blame on yourself or on others * realizing you may have been wrong but wanting to be right * overreacting to current stress as a result of intense stress years earlier, especially in childhood Stress is an individualized experience. What may be stressful to you may not affect someone else. Diagnosis If you are suffering from stress, you may be experiencing a variety of symptoms that feel severe enough to prompt you to see a health care professional. However, if you experience any symptoms that concern you, discuss them with your health care team -- don't wait until they get worse. Stress-related symptoms can include: * headaches * frequent upset stomach, indigestion, gas pain, diarrhea or appetite changes * feeling as though you could cry * muscular tension * tightness in your chest and a feeling as though you can't catch you breath * feeling nervous or sad * irritability and anger * having problems at work or in your normal relationships * sleep disturbance * apathy -- lack of interest, motivation or energy * mental or physical fatigue * frequent illness * hives or skin rashes * grinding your teeth * feeling faint or dizzy * ringing in the ears There isn't a specific test to diagnose stress. Typically, your health care professional will conduct a variety of tests (which may include a personal and family health history, blood and urine tests and other assessments) to rule out certain conditions. Because your symptoms may be similar to those of depression, your health care professional should also evaluate your mental state to determine if you may be suffering from a depressive disorder. Depression is diagnosed based on specific criteria and symptoms associated with depression must be present for two weeks or longer. In fact, the differences between symptoms caused by stress and symptoms associated with stress are their severity and duration. Symptoms associated with stress, anxiety and sleeplessness, for example, will subside when the stress triggering them subsides. When these same symptoms are caused by depression or another mood disorder, anxiety and sleeplessness don't subside without some sort of intervention. If
stress is identified as the culprit for your symptoms, you may want
to ask your health care professional for stress management strategies
and consider ways yourself for controlling the stressors in your
life -- before your health is at risk. Reducing or eliminating the things that cause stress, when possible, and changing how you react to it are the safest and most effective ways to treat stress. No single method of stress management is always successful, so you might want to try a variety of approaches. Treating any medical symptoms caused by stress is important. Work with your health care professional to determine what treatments work best for any stress-related illnesses you may have -- from headache to high blood pressure and irritable bowel syndrome. Part of your job will be to try and reduce your stress levels to improve your physical health. But, keep in mind that treating the stress may not cure the medical problems. However, a recent study indicated that stress management programs might reduce the risk of cardiac events -- like heart attack -- by up to 75 percent in people with heart disease. Reducing stress is difficult. Often people succeed in relieving stress in the short-term but return to old stress-producing habits. And, personal responsibilities don't always lend themselves to stress-reducing tactics. The process of learning to control or redirect stress is life long, but working to master it will improve your health. Cognitive-behavioral therapy, which helps you substitute desirable responses and behavior patterns for undesirable ones, is the most effective way to reduce stress. Your health care professional may refer you to a mental health professional to help you learn these techniques. They include: * Identifying sources of stress. You may want to keep a stress diary where you record the occasions that were stressful to you, triggered anger or anxiety or caused a physical response like sour stomach or headache. Jot down the time of day and the circumstances that led to it, then try to identify the types of events or activities that cause stress. See if you can alter or avoid these circumstances. * Restructuring priorities. Examine your priorities and goals to determine which stressful activities or situations can be eliminated. Learn to replace time-consuming chores that aren't really necessary with activities that are pleasurable or interesting, for example. Find ways to balance the stress inducers you can't eliminate -- like unpleasant working conditions, an unhappy family situation or a significant loss -- by including stress-reducing activities in your day. A recent study indicated that daily pleasant events have positive effects on the immune system. Making time for recreation is as essential as paying bills or shopping for groceries. * Adjusting your responses to stress. You can change the ways you respond to stress. Because you can't simply wish some stresses away -- you can't just quit your job or walk out on your family, for example -- you have to learn how to respond to stress to reduce its effects. Some ways of adjusting your responses to stress include: -- Discussing your feelings. Feeling of anger or frustration that are not expressed in an acceptable way may lead you to feel hopeless and depressed. The suggestion of letting your feelings out is good advice. The goal is to assert yourself and your needs in a positive way; doing so in a negative way (yelling and behaving aggressively, for example) can be counterproductive. Also important is learning to listen, empathize and respond to others with understanding. If you can't talk to a trusted friend, try writing in a journal or composing a letter. -- Keeping your perspective and looking for the positive. Focus on positive outcomes in stressful situations. It helps by thinking of the worst possible outcomes and assessing the likelihood of those coming to bear (usually small). Then, envision a positive outcome and develop a plan to achieve that outcome. Also helpful: remembering past situations that initially seemed negative but ended well. -- Using humor. Keeping a sense of humor during difficult situations is a common recommendation from stress management experts. Laughing releases the tension of pent-up feelings and helps keep perspective. Research has shown that humor is a very effective mechanism for coping with acute stress. In addition to cognitive-behavioral methods to approaching stress, learning relaxation techniques -- the natural unwinding of the stress response -- can be helpful. Your health care professional may refer you to a stress management specialist who can teach you some relaxation techniques, including: * Deep breathing. During stress, breathing becomes shallow and rapid. Taking a deep breath is an effective technique for winding down. Inhale through your nose slowly and deeply to the count of 10, making sure your stomach and abdomen expand but your chest does not rise. Exhale through your nose also to the count of 10. Concentrate fully on the breathing and counting. Repeat five to 10 times. The goal is to take six deep breaths per minute. * Relax your muscles. Sitting anywhere, even at your desk, relax your shoulders, let your arms drop to your side, rest your hands on top of your thighs; relax your legs, and don't forget your jaw muscles, which often tense with stress. Close your eyes and breathe deeply. You can also do this lying in bed: beginning with the top of the head and progressing downward, focus on tensing then relaxing all the muscles in the body one by one while maintaining a slow, deep breathing pattern. * Passive stretches. Allow gravity to help you relax and stretch your muscles. Relax your neck and let your head fall forward to the right. Then let it drop even more as you breathe slowly. Do the same with your shoulders, arms and back. * Visualization. Remember a relaxing time or place like a lakeside picnic or a beautiful beach scene. Close your eyes for a few minutes and picture it in your mind. * Meditation. The goal of meditation is to quiet the mind, to relax thought. Meditation can reduce your heart rate, blood pressure, adrenaline levels and skin temperature. It involves concentrating on a simple image or sound while in a comfortable place away from distractions. A number of organizations teach meditation. * Electromygraphic Biofeedback (EMG). During this totally painless process that is conducted in a health care professional's office, your relaxation skills are reinforced. You are encouraged to relax using methods such as those described above. Your brain waves are measured via electric leads taped to your head, and a biofeedback machine emits an auditory signal when it detects alpha waves -- a frequency, which coincides with a state of deep relaxation. By repeating the process, you associate the sound with the relaxed state and learn to achieve relaxation by yourself. * Massage therapy appears to slow down the heart and relax the body. Rather than causing drowsiness, however, massage actually increases alertness. Your health care professional will probably discuss other issues with you, such as the necessity of: * Maintaining healthy habits. People who are trying to deal with stress often resort to unhealthy habits including high-fat and high-salt diets, tobacco use, alcohol abuse and a sedentary lifestyle. * Avoiding stimulants like tobacco, which contain nicotine that makes you feel calm in the short run, but actually rev up your nervous system. The addictive characteristics of some stimulants like nicotine also leave you anxious until your next fix. * Getting regular aerobic exercise -- even a brisk walk -- can reduce the level of stress hormones in your blood. At least 30 minutes a day (or two 15-minute sessions) is best, but even three times a week offers benefits. In addition, as your body gets fit, its ability to withstand stress is enhanced and your mind is often better able to cope with stress and stay on an even, happier keel. Start slowly. Strenuous exercise in people who are not used to it can be very dangerous and any exercise program should be discussed with a health care professional. * Strengthening or establishing a support network, even having a pet, may reduce- medical problems aggravated by stress. Studies of people who remain happy and healthy despite many life stresses conclude that most have very good networks of social support. * Reducing stress at work by establishing a network of friends there, seeking out a sympathetic manager or scheduling daily pleasant activities and physical exercise during free time. For additional support, schedule an appointment with an Employee Assistance Program clinician at work, if your company offers that benefit. Prevention Of course you can't simply wish away stressful events from your life. The key is in handling the stress appropriately. The following practices may help you from becoming overwhelmed and overanxious, or can be used when you feel tension building up to a crisis point: * Eat a balanced, nutritious diet. General health and stress resistance can be enhanced by eating well and by avoiding intake of alcohol, caffeine, tobacco and junk food. * Exercise regularly, because exercise promotes emotional well-being as well as physical fitness. * Schedule your time more effectively using a calendar and to-do lists, prioritizing activities and realizing you can't do everything. * Learn how to say no to requests that add extra burdens and can wreak havoc on your day. * Insist on help with regular chores. * Balance work and play by planning time for hobbies and recreation -- activities that relax your mind and take you away from stresses temporarily. Even diversions like taking a warm shower, going to a movie or taking a walk can help you feel better. * Practice relaxation exercises every day, including visualization, deep muscle relaxation, meditation and deep breathing. * Rehearse for stressful events. Imagine yourself feeling calm and confident in an anticipated stressful situation. You will be able to relax more easily when the situation arises. * Let yourself laugh and cry. Laughter makes your muscles go limp and releases tension, so try to keep a sense of humor. Tears can help cleanse the body of substances that accumulate under stress. * Talk out troubles. It sometimes helps to talk with a friend, relative or member of the clergy. Another person can help you see a problem from a different point of view. * Help others. Because we concentrate on ourselves when we're distressed, sometimes helping others is the perfect remedy for whatever is troubling us. * Learn acceptance when a difficult problem is out of your control, which is better than worrying and getting nowhere. * Develop and maintain a positive attitude. View changes as positive challenges, opportunities or blessings. Facts to Know 1. Almost nine out of 10 adults have experienced serious stress. More than four out of 10 adults suffer adverse health affects from stress, and 75 percent to 90 percent of all physician office visits are for stress-related complaints. 2. Working mothers, in particular, are among the people most likely to experience stress. 3. Stress takes a toll on your body because it causes stress hormones such as adrenaline and cortisol to flood your system. These hormones cause your heart rate and blood pressure to rise, your muscles to tense, your blood sugar levels to increase and other physical symptoms. 4. The effects of stress can lead to actual medical illnesses, including heart problems, stomach problems and headaches. 5. While stress doesn't cause mental illnesses like depressive disorders or anxiety disorders, it often leads to feelings of depression and anxiety. It can precipitate mental illnesses in people predisposed to them. 6. Symptoms of stress include irritability, sleep disturbances, appetite changes, muscular tension, apathy, fatigue, headache and frequent illness. 7. Stress can be brought about by external factors such as conflicts in your relationships, job pressures and even traffic. In addition, internal factors -- such as a desire for perfection, a feeling of helplessness, blaming yourself for things that are out of your control or intense worry -- also cause stress. 8. The ways you react to stressful situations can be relearned. You can use cognitive-behavioral approaches in which you identify sources of stress and work to minimize them and adjust your responses to the stresses you can't eliminate. 9. Relaxation techniques help dispel stress and can actually cause adrenaline and cortisol levels in your blood to decrease. These techniques include deep breathing, muscle relaxation, stretching, visualization, meditation and biofeedback. 10. A nutritious diet and regular exercise not only prepare your body to withstand the physical affects of stress, but strengthen your mind to cope with stress and stay on an even keel. 11.
According to the National Institute for Occupational Safety and
Health (NIOSH), the U.S. agency responsible for conducting research
and making recommendations for the prevention of work-related illness
and injury, 40 percent of workers reported their job was very or
extremely stressful. Lifestyle Tips 1.
Eat your way to calm. 2.
Coping with fear and anxiety about war, terrorism and other public
threats 3.
Try writing out your stress 4.
When both partners are stressed 5.
Reduce Stress at Work 6.
Help your child cope with stress
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