Stress

Stress Overview

Everyone is familiar with stress. We experience it in varying forms and degrees every day. In small doses, stress can actually be beneficial to us. It is only when the stress becomes too great, affecting our physical or mental functioning, that it becomes a problem.

• In small doses, stressors can help give us increased energy and alertness, even helping to keep us focused on the problem at hand. This type of stress is good. People may refer to the experience of this type of stress as feeling "pumped" or "wired."

• As the level of pressure gets too great, stress eventually surpasses our ability to cope with it in a positive way. Often, people describe themselves as being stressed out, burned out, or at wits end. At this point, it is important to find positive and productive ways to deal with the stress and, more importantly, to address the person or situation that is causing the stress.

• Everyone reacts to stress differently. Each of us has a different level of pressure and anxiety that we can handle without a bad outcome. Only you can assess your level of tolerance to stressful situations. The best treatment for stress is to prevent getting into situations that are likely to overwhelm your ability to cope. This is not always possible because the stressors may often come from outside sources that are beyond your control.

Stress Causes

The following are risk factors for uncontrollable stress:

• Social and financial problems
• Medical illness
• Lack of social support
• Family history

Stress Symptoms

• Stress usually first affects the inner emotions. Initial symptoms may include the following feelings:
  • Anxiousness
  • Nervousness
  • Distraction
  • Excessive worry
  • Internal pressure

• These emotional states can then begin to affect a person's outward appearance:
  • Unusually anxious or nervous
  • Distracted
  • Self-absorbed
  • Irritable

• As the stress level increases, or if it lasts over a longer period of time, a person may begin to feel more severe emotional or physical effects:
  • Excessive fatigue
  • Depression
  • Sometimes even think of hurting yourself or others
  • Headaches
  • Nausea and vomiting
  • Diarrhea
  • Chest pain or pressure
  • Heart racing
  • Dizziness or flushing
  • Tremulousness or restlessness
  • Hyperventilation or choking sensation

• In most cases, these symptoms are very minor and don’t last very long. If they become more severe or increase in frequency and severity, seek medical help.

When to Seek Medical Care

• You should call your doctor when you are unable to identify the source of your stress or anxiety and if the condition continues or comes and goes.
  • If, in conjunction with your friends, family, or spiritual advisers, you cannot identify a source or solution for your anxiety and stress, your first resource should be your doctor.
  • A physical problem may be causing your symptoms. There may be a hidden cause that requires the assistance of a counselor to help uncover. Once your doctor has ruled out a medical cause for your symptoms, your doctor can be a great resource for other options in treatment of your stress symptoms.
  • Primary care doctors have many resources that they can use to help get to the source of your stress. You should never be embarrassed about your situation or the fact that you are seeking help. It is the doctor’s role to help.
  • Remember, the sooner you get help, the sooner you will feel better. If you are having physical symptoms that seem either unrelated to stress or are worse than you have experienced in the past, you should consult your doctor immediately.
• You should call 911 or go to the nearest hospital’s emergency department if your stress is resulting in any of these symptoms:
  • Thoughts about harming yourself
  • Thoughts about harming others
  • Chest pain
  • Fluttering or rapid heartbeats
  • Headaches unlike your usual headaches
  • Any condition that you feel might cause you serious harm if not treated immediately

Exams and Tests

Your doctor needs to take a careful history and perform a physical exam in order to find any medical problems leading to your symptoms. The doctor looks for an underlying stress or psychological disorder that could be the source of your stress symptoms.

• Many times, a careful interview can be the best source of information about the cause of your symptoms. It is extremely important that you are completely honest and tell your doctor everything that you are feeling physically and emotionally and describe any situations that you think might be causing your problems or making them worse.

• The doctor then performs a physical exam that is focused on the symptoms you have described.

• Lab tests or other diagnostic tests such as an ECG (a heart tracing) may be needed to completely rule out an underlying physical cause for your symptoms.

• If these tests and your doctor’s exam findings are normal, the doctor may consult other specialists for further evaluation and treatment of your condition.

Stress Treatment

Self-Care at Home

When you find yourself feeling the bad effects of stress, you need to take action immediately. The sooner you begin the process of treatment, the easier it will be and the quicker you will be back to your normal state.

• The first step in the process is to try to identify the cause of the stress. Sometimes this is a known source such as a deadline at work, a pile of unpaid bills, or a relationship that is not working out. It can at times be more difficult to find the source of your problem.
  • Often, many relatively mild stressors occurring at once can bring on the same stress as a larger problem or known source of anxiety or worry.
  • Some people experience stress from events that occurred in the past (post-traumatic stress disorder).

• If you can identify the source of your stress, remove yourself from it or address the situation. That may be all that is needed to resolve the situation and your anxiety. Even if you are only able to get away for a few seconds or minutes, the break is important and can help you on the way to a more permanent solution.
  • This break can be accomplished by physically removing yourself from the provoking situation (such as an argument) or mentally removing yourself from the stressor (such as financial worries) through a mental distraction, often called a time-out.
  • The point of these actions is to allow you a moment to relax and formulate a plan for dealing with the problem at hand. Just having a plan can be a great stress reliever. It gives you a set of positive steps that you can work on to get yourself back to your baseline and out of the stressful situation.
  • These steps should be broken down into tasks you can accomplish easily. Working toward a goal is rewarding. It prevents the hopelessness and lost feeling that can accompany stress and make it worse.

• If you are unable to determine the source of your stress, you need to seek outside help. Sometimes discussing your situation with family, friends, or a spiritual adviser can be helpful. If these routes are not successful, you should make an appointment with your doctor or a mental health counselor to help determine the source of the stress and rule out any potentially reversible medical causes of your stress.

Medical Treatment

• The treatment of your stress will vary greatly depending on the types of symptoms you are experiencing and how severe they are.

• Treatment can range from simple reassurance to inpatient care and evaluation in a hospital setting. Some basic treatment recommendations are as follows:
  • Careful workup and evaluation by a doctor
  • Regular exercise program
  • Reassurance
  • Biofeedback as indicated
  • Counseling by qualified mental health professionals, as needed
  • Medical intervention for any physical problems discovered

Next Steps

Follow-up

Follow-up visits will be arranged by your primary care physician or other counselors as indicated.

Prevention

You can take steps to prevent stress in your life.

• Set realistic goals and limits for yourself.
• Put things into perspective and try not to get upset about insignificant or relatively unimportant matters.
• Take stress, time management, or anger management classes.
• Find activities that you enjoy and set aside time to participate in them on a regular basis.
• Participate in regular physical exercise.
• Maintain a positive outlook.
• Set goals and break them into easily achievable tasks.
• Reward yourself for the good things that you do each day.

Outlook

The prognosis for people suffering from the effects of stress is almost always outstanding. Most people recover completely once the stressor is identified and a plan is devised to remove or control it.

The key is to seek help early and be an active partner in your care and recovery. Just worrying about your problems will only make them worse. Call on your friends, family, clergy, and doctor to help you return to a full and productive lifestyle.

For More Information

The American Institute of Stress
124 Park Avenue
Yonkers, NY 10703
(914) 963-1200

Web Links

MedlinePlus, Stress

National Institute for Occupational Safety and Health, Stress at Work

The National Women's Health Information Center, Stress and Your Health