Stress

Overview

Running ragged

Mid-term paper due in three hours? Late for work and snarled in traffic? Maybe you've got an important deadline to meet and your copier just broke down. Welcome to modern life, where even though technology is continually creating machines and techniques to save time, we are also continually finding that we have less time to get things done — which paves the way for stress.

Stress is our reaction to events that disturb our normal state of balance. For most people, coping doesn't prove too difficult. But for others, stress can feed on itself, turning into a runaway condition. Whether this is due to complicated organic problems, poor coping strategies, or other conditions, chronic stress may aggravate existing illnesses and cause a variety of serious health problems.

Many techniques help manage stress, but no single technique is best for everyone. First, identify those things that cause stress in your life and understand why they are stressful. Next, make a commitment to change those stresses — or your approach to them — and realize this may take time and energy to achieve.

Detailed Description

Doctors are recognizing that too much stress and an inability to cope with it is becoming a big health risk. While many people think of "stress" as a solely modern phenomenon, it has been around since the dawn of humanity, and our bodies have evolved over time in response to it. Stress is actually a physiological way in which your body protects itself. When you are frightened or presented with a life-threatening situation, your body goes into "red-alert" mode through a series of physical and physiological changes. The process is known as the fight-or-flight response and is marked by the following:

  • Adrenal glands releasing hormones (adrenaline, cortisone) into your bloodstream
  • Breathing rate increasing to take in more oxygen
  • Liver supplying more sugar (quick energy) into your bloodstream
  • Pancreas supplying insulin needed for sugar metabolism
  • Skin sweating to cool your body down, allowing it to burn more fuel
  • Muscles tensing in preparation to move
  • Heart pace quickening and blood pressure rising to ensure your brain and tissues receive more blood
  • Digestion slowing, allowing blood to be sent to more critical functions

These changes also occur to some degree when you're faced with everyday stresses, like someone cutting you off in traffic. Though necessary for life-threatening situations, this "red-alert" mode is not good for the body in everyday life. The effects of chronic stress can influence your body's health both directly and indirectly.

Stress exerts a powerful influence on the digestive system. Repeated shunting of blood away from the intestines can cause such specific disorders as constipation, gastrointestinal reflux disorder (heartburn), irritable bowel syndrome, and peptic ulcers. The emotional factors associated with stress can exacerbate or trigger the onset of an asthma attack. For children, this creates an even greater anxious state that can lead to an uncontrolled asthma attack.

Frequent rises in blood pressure and heart rate can take their toll on the heart and blood vessels. Studies have shown that people under age 60 with a family history of premature heart disease have a greater chance of developing it if they have exaggerated responses to mental stress.

Hans Selye, M.D., the father of modern stress research, believes the stress response is determined not by the thing causing the stress, but by a person's reaction to it. Different people react differently to the same stressor, suggesting that the experience of stress is highly subjective. To some degree, stress can help people attain difficult goals, perform at their peak, and achieve inner growth. But stress can only help us perform better up to a certain point. If you are stressed to your limit, additional stress will detract from your performance. Everyone handles stress differently, so it's important to know what your own limits are. Stress management is the key issue here, as are the methods you develop to cope.

How Common Is Stress?

Nobody is immune to stress; it affects men and women of all ages. The American Psychological Association reported that over two-thirds of all visits to the doctor are due to stress-related complaints. More than 40% of American adults suffer from adverse health effects due to stress. Stress costs an estimated $300 billion a year in lost work days, workers' compensation claims, reduced productivity, and other stress-related problems.

Conventional Treatment

Goals of Treatment

The goals of all forms of stress management are to identify the things that cause stress, avoid them when possible, and find improved ways of coping with them.

Treatment Overview

Stress can be treated effectively, but you first must recognize it. Awareness of stress can help resolve it. Your doctor should investigate the possibility of an underlying cause or condition; mood disorders and other conditions have symptoms that overlap with those of stress. If stress is the main issue, many treatment avenues are available.

Stress management techniques include identifying and reducing stressors, learning relaxation exercises, improving time management, and developing better interpersonal skills. Your doctor may add medication in certain situations?— for example, in the case of extreme anxiety disorder. Alternative therapies involve nutritional support and herbal remedies. Exercise is also important. To help monitor your progress, check in with your doctor or keep a journal.

Drug Therapy

Drugs most commonly prescribed

Celexa

On-Label Efficacy

Zoloft
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On-Label Efficacy

Prozac

On-Label Efficacy

Paxil
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On-Label Efficacy

buy Venlafaxine

On-Label Efficacy

Luvox

On-Label Efficacy

Elavil
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On-Label Efficacy

Stress management techniques

  • Exercise
  • Meditation
  • Yoga or tai chi
  • Biofeedback training
  • Aromatherapy
  • Massage
  • Herbal therapy
  • Improving time management
  • Developing better interpersonal skills

Appropriate Healthcare Settings

You will not need to stay in the hospital. You should consult a family physician or internist to make sure that other mental problems or underlying conditions do not exist.

Physicians Who May Be Involved in Managing Your Condition

Health professionals who help manage stress include:

  • Family physicians
  • Internists
  • Geriatricians
  • Psychiatrists
  • Psychologists

Activity & Diet Recommendations

Exercise can greatly benefit people under stress. Exercise or exertion puts stress on the body, but over time the body adapts to the exercise, becoming stronger and more efficient. The benefits of regular exercise include:

  • Less likely to feel fatigue
  • Less likely to feel tension
  • Improvement of mood and ability to handle stressful situations
  • Less likely to suffer from depression

Diet changes reduce the adverse effects of stress and include:

  • Cutting out caffeine. Americans drink an average of one to two cups of coffee every day. Though coffee can produce mental and physical stimulation, it can also contribute to anxiety and depression.
  • Cutting out alcohol. The chemical effects of alcohol on the body include sleep cycle disruption, disruption of brain chemistry, and increase of adrenal hormone production. Alcohol may increase anxiety.
  • Cutting down on sodium and consuming more potassium. Stress can affect the function of the renal gland. By consuming foods rich in potassium but low in sodium, you help ensure the proper functioning of the adrenal gland.
  • Cutting down on refined carbohydrates. Reduction of refined carbohydrates can help stabilize blood sugar levels. A steady fuel supply to the brain may help you develop a more resilient response to challenges.

Possible Complications

Possible complications that arise from or are aggravated by stress include:

  • Psychiatric disorders such as anxiety disorders, major depression, and bipolar disorder
  • Ulcers
  • Skin disorders
  • Arthritis
  • Musculoskeletal problems
  • Hypertension
  • Coronary artery disease
  • Angina pectoris (chest pain)
  • Frequent sickness (diminished immune system efficiency)
  • Digestive disorders like colitis (inflammation of the colon) and ulcers
  • Eating disorders like bulimia and anorexia nervosa
  • Chronic fatigue syndrome
  • Lung disorders like asthma and allergies
  • Pain syndromes like chronic back pain or headache
  • Sexual dysfunction
  • Alcoholism
  • Lupus and other autoimmune disorders

Considerations for Children and Teens

Some common causes of stress in children and teens include:

  • Recent death of a loved one
  • Loss of anything valuable to child
  • Changing school or moving to a new home
  • Parental divorce or separation
  • Trauma or illness
  • Conflict with another person

Help your child face new challenges. Relaxation techniques, communication skills, and adequate rest and exercise are important aspects of this approach.

Don't let your child go to bed with a problem. Spending a few minutes before sleep talking about the day and having children express themselves can help them better cope with the problem, plus get better sleep.

Considerations for Older People

Some common causes of stress in older people include:

  • Recent death of a loved one (especially a spouse)
  • Moving to a new residence
  • Divorce or separation
  • Trauma or illness
  • Sexual difficulties
  • Financial or business difficulties

Older people can employ many techniques to help with stress. Meditation can help, as well as exercise, or even just getting away from the stressful situation for a short period of time.

Stress

Last updated 25 May 2012


Causes

Established Causes

The stress response has developed over thousands of generations, and is provoked when an external stressor causes the body to undergo a physiological change known as the fight-or-flight response. While this response is useful in urgent situations, it may be out of proportion to the everyday events that can spark it.

Risk Factors

The possibility of increased stress is related to the following:

  • Lack of coping skills
  • Poor time management
  • Poor communication or interpersonal skills
  • Inability to develop a relaxation response toward the stressor
  • Poor diet or nutrition
  • Poor physical health
  • Existence of other disorders
  • The death of a spouse
  • Divorce
  • Changing residence
  • Changing jobs
  • Getting married

Symptoms & Diagnosis

The signs and symptoms of stress can take on many forms.

Emotional symptoms include:

  • Worry
  • Irritability
  • Sadness

Physical symptoms may include:

  • Diminished sex drive
  • Inability to sleep
  • Inability to stay focused or concentrated
  • Decreased appetite
  • Shaking and sweating
  • Headache
  • Constipation
  • Diarrhea

Conditions That May Be Mistaken for Stress

Pheochromocytoma is a tumor that produces hormones, including adrenaline, and can create stress-like symptoms. Women undergoing menopause or experiencing premenstrual syndrome also complain of symptoms similar to those seen in stress.

How Stress is Diagnosed

Your doctor will examine you physically and psychologically, and may order specific tests to look for an associated condition.