A Comprehensive Guide to Understanding and Coping with Stress
Stress is something that most of us have to deal with everyday. Whether its work related, family related or something else - we all go through it and all experience it. Stress can play a beneficial and positive role but more often than not in our modern society it plays a detrimental role. Here we give you a break down of stress, its symptoms and how to manage it effectively to stay healthy.
The Anatomy of Stress
What Exactly is “Stress”?
According to the American Medical Association, stress is “any emotional, physical, social, economic, or other factor that requires a response or change, such as dehydration (which can cause an increase of body temperature) or separation from parents (which can cause a young child to cry).” But most of us today are far more acquainted with the definition that most reflects our fast-paced modern times, that provided by the psychological community, “a psychological state associated with psychological and hormonal changes caused by conflict, trauma, or other disquieting or disruptive influences.” Indeed, life in these modern times often seems synonymous with “stress.” And for far too many of us, stress seems to be the only constant in our day-to-day lives.
Individual and Societal Stress
Although we tend to think in terms of “My stress level,” or “The stress I'm under,” in reality, individual stress is inseparable from societal stress. War, natural disasters, drought, population migration, and disease can have far-reaching side-effects—half a world away. Even localized events—the collapse of Detroit's automotive industry in the 1990s, Mexico's swine flu outbreak of 2009, and the UK's current mass immigration situation, for example—can have a ripple effect felt for thousands of miles. Thus, societal stressors invariably cast a wide shadow over our individual lives, effectively sensitizing us to small triggers effecting the way we perceive our personal stressors. In short, stress can be thought of as a physiological reaction to physical stressors we consider beyond our control.
Types and Sources of Stress
From the psychological perspective, there are three major types of events that can result in stress: frustration, conflict, and pressure.
Frustration is the emotional state or condition that results when a specific goal—be it personal, family- or work-related—is prevented or blocked. When we believe we cannot achieve a goal that is meaningful to us (often attributable to situations beyond our control), frustration can be triggered. Some frustrations are caused by external forces (as when we plan a long-overdue vacation only to have it ruined by bad weather), while others are people-specific (as when we rely on a friend to pick us up at the airport but something comes up to prevent their arrival—effectively stranding us).
Conflict is the emotional state or condition in which we have to make difficult decisions involving two competing motives, impulses, or behaviors. One example might be having to choose between two job offers; one of which pays more but is located in an inclement part of the country, one paying less but located in an ideal climate. Furthermore, conflict can take the form of what sociologists term the “approach-approach” scenario (having to choose between two equally-attractive alternatives), “avoidance-avoidance” scenario (having to choose between two equally-unpleasant alternatives), and “approach-avoidance” scenario (having to choose between two alternatives that possess both attractive and unpleasant aspects). Despite how different these scenarios are from one another, each can cause extreme confusion, panic, and frustration—leading to stress.
Pressure is the emotional state or condition resulting from the actual or imagined expectations of those around us. Most often associated with work, time, or typical life events, individuals with “high-stress” jobs (surgeons, air-traffic controllers) are prime candidates to be pushed to the edge by pressure. Similarly, those of us constantly rushing to meet deadlines (students, office workers) can feel overloaded and under extreme pressure far too often—nearly to the breaking point. Likewise, many typical life events (marriage, school graduation) can create a state of virtual panic—the pressure of needing to meet new expectations building to an intolerable level of stress.
But by and large, for most of us, these types of events boil down to everyday circumstances and occurrences that trigger stress: events concerning family and friends, money, work, time, housing, pets, and all our personal stuff. So, the operative question becomes: “What determines whether a particular circumstance or occurrence will be too stressful for a given individual?”
Responses to Stress
Depending on a number of factors (including but not limited to hereditary, biological, physiological, and environmental), no two of us react to stress in exactly the same way. The same exact event that may wreak havoc on the physical and mental stability of some--are quite harmless for others. Some of us experience only a relatively mild physiological reaction to stress (elevated heartbeat or perhaps edginess), while others may exhibit a more marked physical response (frequent headaches or rashes/hives). But for some, the reaction to stress can be quite extreme—even debilitating (causing severe panic attacks or heart palpitations). Psychologists relate the degree of severity we exhibit in reaction to stress to our “arousal” response, the physiological changes--increased muscle tension, acceleration of the heart, and secretion of dopamine, epinephrine, and norepinephrine--related to the so-called “fight-or-flight” response. And this brings us to the “cortisol connection” and the part testosterone plays in how some of us react to stress.
The Cortisol Connection
Essential to understanding the anatomy of stress is appreciating the function the steroid hormone cortisol plays in the body. Though frequently referred to as the “stress hormone,” cortisol, produced in the cortex of the adrenal glands, serves a number of basic but vital functions in the body including regulating blood pressure, cardiovascular functions, and the body’s use of fats, proteins and carbohydrates. Under normal circumstances, the body maintains or regulates our natural cortisol levels—providing a somewhat elevated level first thing in the morning (to provide us the get-up-and-go we typically need to get motivated) and a lower level at night (to prompt us to relax and decompress). Small increases in cortisol produce positive effects like improved memory, increased sustained energy, and reduced sensitivity to pain. But stress can throw this natural process completely off-balance. And “chronic” stress can cause elevated levels of cortisol that can negatively impact our health and well-being.
Under what the body perceives as a potentially stressful situation, the adrenal glands secrete more cortisol--part the body’s normal “fight-or-flight” response to stress (fear, surprise, confrontation). This sets off a cascade of stress-related involuntary changes in the body that continue until the perceived threat passes. And while our bodies are well-adapted to this circumstantial rise and drop in cortisol levels, prolonged or chronic elevated cortisol levels can result in serious side-effects such as suppression of thyroid function, cognitive impairment, elevated blood pressure, decreased bone density, and blood sugar imbalances. Long-term elevated levels of cortisol can also lower one's immunity and inflammatory responses, and even slow down the body's wound healing capabilities. Most significantly, chronically high levels of cortisol are toxic to brain cells and routinely cause short-term memory loss—a common sign of stress. (Studies suggest that a lifetime of high cortisol levels may be a primary cause of osteoporosis and contributor to Alzheimer’s disease and senile dementia.) Additionally, chronically high levels of cortisol in the body create the need for higher levels of other hormones (such as thyroid, insulin, estrogen, testosterone) in order to function at near-normal levels.
The Testosterone Context
In the study of the relationship between stress and cortisol, researchers discovered a context in which testosterone seems to play an as-yet-unknown but significant part. While studying aggressive behavior in young men, it was discovered that those men displaying higher levels of aggression likewise had higher levels of testosterone; lower aggression, lower testosterone. And while this biological connection has long been assumed among the medical and psychological communities, some studies suggest an interesting, opposite scenario: that acts of aggression spur an increase in testosterone. Furthermore, recent studies show that higher levels of stress are associated with higher level of testosterone. Thus, in that higher levels of testosterone are clear predictors of aggressive or erratic behavior, it may be that testosterone is responsible for prompting an individual (primarily men, but some women) to opt for aggression when acting under the “fight-or-flight” response prompted by stressful situations. (This context will require further study.)
Warning Signs and Symptoms of Stress
Although it is helpful to know the warning signs and symptoms of stress in order to get ahead of them--the physical, emotional, psychological/cognitive, and behavioral signals that something is amiss—it is important to understand that simply because certain symptoms manifest, that is not a clear indication that stress is the source. While stress can certainly exacerbate virtually any condition, and chronic stress can have devastating effects, the appearance of the warning signs and symptoms commonly associated with stress should not preclude the possibility of other causes.
Additionally, while there are a number of methods to cope with stress—before, during, and after the fact—such techniques may not negate the need to seek professional medical or psychological help regarding more severe, chronic cases. With that understood, considering the serious, even life-threatening toll prolonged stress can take on the body, it is better to err on the side of caution than simply ignore the signs and symptoms.
Generally categorized by the medical and psychological communities according to the body system effected (nervous, respiratory, musculoskeletal, endocrine, cardiovascular, gastrointestinal, reproductive), the following checklist is provided for the layman by the world-renowned Mayo Clinic.
Common Effects of Stress on:
- Upset stomach
- Muscle aches/tension
- Chest pain/hyperventilation
- Change in sex drive (increase or decrease)
- Sleep Issues
- Feeling overwhelmed
- Lack of motivation or focus
- Sadness or depression
- Over- /under-eating
- Angry outbursts
- Erratic decision making
- Turning to drugs/alcohol/tobacco
- Social withdrawal
- Exercising less
Coping with Stress
Psychologists who specialize in treating stress (and stress-related disorders) have discovered that an individual's perception of a potentially stressful situation (the severity of the situation and their ability to affect it), as well as that individual's ability to initiate a coping mechanism to deal with that situation, involves an ongoing transaction between environment and the individual they term “appraisal.” Not only does this appraisal determine whether or not stress will be experienced by an individual, it ultimately determines the effectiveness of an individual's coping strategy. Invariably, it comes down to two possible approaches—one automatic, one intentional.
Our Natural Defense Mechanisms
Although there is little doubt that we humans are not evolutionary adapted to handle the extreme levels of stress we find ourselves confronting in the 21st century, nature has, nonetheless, equipped us with a few natural defense mechanisms to help us cope—or at least render stressful situations less disruptive to our senses. Credited to world-famous psychiatrist Sigmund Freud, Freud argued that it is necessary for individuals to distort reality in some way to protect themselves from unconscious thoughts and realities they find unacceptable. And while these psychological mechanisms can be invaluable in providing temporary stability in stressful situations (and keep them from escalating), psychologists caution against relying on them solely in regards to stress management. Ideally, a structured plan that prepares for a stressful situation, provides coping methods to use in the moment, and then restores balance soon after the fact is desired. Among the natural defense mechanisms most commonly utilized in stressful situations are: denial, rationalization, projection, and reaction formation.
Denial is the refusal to even acknowledge the existence of something that could cause conflict within us. Individuals who find themselves in a financial bind, for example, may avoid the stress associated with unpaid bills by telling themselves “the bills will wait.” That everybody has unpaid bills--so why stress about it? They'll get paid when they get paid.
Rationalization, commonly utilized in “conflict” scenarios, is the act of altering one's personal view in order to make a decision easier to make, or to prolong indefinitely having to make it at all. For example, individuals under pressure to make a decision, and find themselves buckling under the stress of it, may tell themselves, “I'll deal with that tomorrow. What difference can one day make?” Another individual might rationalize, “I've got too much on my plate as it is! That will just have to wait!”
The projection defense mechanism is used to avoid acknowledging the inappropriateness of one's own behavior by projecting undesirable thoughts or actions on others, telling one's self that others secretly harbor the same thoughts and desires--and are driven by the same motives. An individual who typically reacts to stressful situations with hostility, for example, will tend to see others as acting in especially hostile ways—whether they are or not—thus allowing them to reduce the stress of the situation by venting hostility themselves.
Reaction formation, one of the more common defense mechanisms used in social situations, involves reacting the opposite of one's true beliefs or feelings while in public in order to avoid the stressful conditions their true beliefs would spur. For example, an individual will openly come out in favor of things they do not favor, hide what they recognize as their own insecurities by boasting of things they never accomplished, or cover certain urges they consider socially undesirable by condemning those who openly support those urges.
The problem with allowing our natural defense mechanisms to serve as our primary methods of coping with stress is, of course, obvious. Denial accomplishes little more than postponing the inevitable (and increases the likelihood of accruing serious consequences), rationalization promotes delusional thinking (that could hinder our ability to make rational decisions in the future), projection distorts our view of others and the world around us (and prevents us from taking substantive action to cope with future stressful situations), and reaction formation forces us to perpetuate any number of lies (which over time can seriously effect our identity and sense of self). Thus, finding an approach (or collection of approaches) to coping with stress—before, during, and after the fact—should be the objective. And the best place to begin is an understanding of how our perception of time effects our susceptibility to stress. In fact, for most of us, time is truly of the essence.
It would seem that since the dawn of civilization, we have been time-obsessed. “Time is the most valuable thing a man can spend,” noted the ancient Greek philosopher Theophrastus. “Better three hours too soon, than one minute too late,” observed William Shakespeare. “Determine never to be idle; no person will have occasion to complain of the want of time who never loses any,” wrote Thomas Jefferson. And even though “time” is a man-made construct--an illusion we've created, according to Albert Einstein--we've nonetheless come to grant it special priority in our day-to-day lives. Special power. And (arguably), not to our betterment.
In the formal study of stress, time is the one element common to virtually every case. Either the root cause of stress or a significant contributing factor in creating stressful situations, our perception of time imposes an inherent pressure to get things done in accordance with it. Due dates, deadlines, cutoff points, and time-frames have come to not only define our lives--they dictate how we live them. And it can truly make us crazy!
In the past decade alone, our perception of time has changed dramatically, in no small part due to the great technological advances made. The advent of personal computers, cell phones, the Internet, and computer programming (touted as making our lives easier and simpler) has launched business into a realm moving literally at the speed of light. And we've convinced ourselves that we're supposed to keep up with it. Little surprise, we are all suffering the consequences: stress and stress-related disease is skyrocketing across the globe. This means that any strategy to cope with stress must invariably include a way to help manage our time more effectively, or perceive time differently.
As previously noted, no two of us react to stress in exactly the same way. The same event that wreaks havoc on the physical and mental stability of some, are quite harmless to others. And while there are many variables contributing to how or if we respond to potentially stressful situations, one of the most influential is culture, or one's ethnic background. Thus, psychologists are quick to point out that in regards to formulating stress mitigating strategies, our day-to-day behavior and perception of our environment is shaped by the culture in which we grow up. Norms, ideals, social rules, patterns of communication, and personal beliefs are all products of our culture—as are our sense of self, sex, age, and sometimes, class. And in that culture ultimately shapes out individual personality, it frames our worldview and perception of our ability to affect it. Thus, while there are a number of strategies to help us cope with stress, cultural/ethnic differences can determine their appropriateness—and thus, their effectiveness.
Attitude and Perception
Without a doubt, any strategy we adopt to help us cope with stress will be more effective with the right attitude supporting it. And while a positive attitude can certainly bolster any strategy aimed at improving one's life, it is the concept of “perception” that is more critical in coping effectively with stress. For many, in fact, it is the key to getting the upper hand on potentially stressful situations.
Illustrated by the glass-half-empty, half-full scenario, how we view and respond to a given situation is largely a matter of how we choose to perceive it. Even though we may have little control over the occurrence of an event, we do in fact have considerable control over the importance we give it—and thus, to what level it effects us. (This could be one reason why the same event that wreaks havoc on one individual has no effect on another.) What at first strikes us as requiring our immediate attention—isn't nearly so urgent if we perceive it that way. What at first appears to be a no-win situation, has a number of solutions—if we perceive it that way. Not that we should become indifferent to events taking place around us, only that our responses be appropriate and proportional. And since it is often difficult to remember this concept in the heat of the moment, it is essential to pre-establish in the mind that although it may not seem so at the time, most situations in life are actually a matter of perception. We can choose how to view them.
One of the primary requisites of any successful psychological adjustment (including formulating a stress-coping strategy) is learning to accept what cannot be changed. Although there are many aspects of our lives we can affect, there are many we cannot—and we must learn to know and accept the difference. Trying to force things to meet our personal expectations or sense of how we think things should be, not only wastes time and energy, it ultimately contributes to our stress level. Expecting to change the unchangeable sets us up for disappointment (adding to our stress), feeds into our sense of helplessness and belief that all life's events are beyond our control (adding to our stress), and keeps us from effecting what we can. Thus, acceptance of the way things really are underlies any stress-coping strategy.
Advance Preparation (Lifestyle Adjustment)
To effectively gain an edge over stress, most find a three-pronged (three-phase) approach the most effective. This involves putting an advance preparation strategy in place (making lifestyle adjustments that lower baseline stress levels), formulating an in-the-moment strategy (designed to minimize the severity of a stressful event), and an after-the-fact strategy (that allows the body to return to normal as quickly as possible). Each of the following lifestyle changes should be considered.
Although many of us have come to believe that smoking a cigarette or having an after-dinner drink helps us relax and unwind, in reality, the toxins taken into the body through these habits only serve to further sensitize the body to stress. Nicotine and alcohol upset hormonal and brain chemistry levels, affecting our ability to think clearly and rationally. When taken into the body on a regular basis, these toxins alone can make normal events seem more stressful than they really are.
In addition to the many other health benefits regular exercise provides, few activities relieve stress better. Not only does regular exercise alleviate stress and keep it from building up in the body, it helps normalize blood pressure, clear the mind, and induce better sleep—all of which reduce stress.
There is no question but that those of us who consider carefully what foods we consume ultimately feel better and cope with stress better. It should go without saying that junk- and fast-foods contain vast amounts of sugar, salt, unhealthy fats and preservatives that make us more prone to ill-reacting to stressful situations--and should be avoided at all cost. This rule also pertains to prepackaged foods, processed foods, and most snack foods (even those touted as “healthy options”).
Anyone who has experienced bouts of insomnia or periods of too-little sleep is well-aware of how sleep deprivation can effect one's daily performance. Irritability, reduced cognitive functioning, slower reaction time, reduced motor functioning, elevated blood pressure, accident proneness—these are just part of an extensive list of side-effects. Facing the day with these impairments is a recipe for overreacting to potentially stressful situations. The elimination of toxins, regular exercise, and a thoughtful diet go a long way to setting the stage for deep, restful sleep.
Valued in the East for some two thousand years for its therapeutic qualities, yoga (and its primary component, meditation) is today receiving heavy endorsement in the West by both the medical and psychological communities. Renowned for its stress-relieving, holistic (body, mind, and spirit-balancing) qualities, yoga/meditation can bring a sense of calm to the body and mind that make potentially stressful situations, stress-less.
Mindfulness and (intentional) deep breathing
Usually considered modalities related to yoga, mindfulness and deep breathing are finding increasing support in the West. Mindfulness (the act of maintaining a moment-by-moment awareness of one's thoughts, feelings, bodily sensations, and surroundings) and deep breathing (a form of intentional breathing whereby breathing bypasses the nose and is limited to the throat passageway) are proven to clear the mind, relax the body, as well as lower blood pressure and decrease anxiety. In that both can be performed virtually anywhere, many individuals apply these techniques just prior to facing potentially stressful situations.
Despite our rhetorical insistence that we can “make time,” the reality is, we can only utilize it better. That doesn't mean tightening up our schedule to allow us to do even more (that would give us more to be stressed about), it means prioritizing, eliminating non-necessities, and streamlining our daily schedule to allow more time for the essential—and for ourselves. Avoid multi-tasking when possible. Delegate and/or accept help when possible. Set aside a specific amount of time each day to complete that day's responsibilities—and do not exceed it. Over time, these measures will not only reduce one's stress level (and susceptibility to potentially stressful situations), it will allow us to accomplish more in less time.
For those of us for whom individual strategies are only minimally effective or professional clinical intervention is not an option, limited social support can be very helpful. Whether it's a relative, close friend, or an acquaintance we trust, simply knowing we have someone who will make themselves available to us in stressful times can be a comfort. Psychologists caution, however, that since all social relationships carry inherent give-and-take costs, too many social contacts can actually increase stress levels. We should pick and choose wisely and be prepared to sever any relationship that compounds stress.
In most stress-related cases, once an individual's stress level reaches the reaction point, there is little they can do but endure it. Without an “in-the-moment” strategy to help nullify the effects, the individual has no recourse but ride it out and wait for their body to normalize. But fortunately, psychology provides three options that have proved quite effective in mitigating the intensity of stressful situations.
Wrist-Band Aversion Therapy
A particularly effective form of therapy for those dealing with relatively minor bouts of stress, this method utilizes a simple rubberband worn snuggly around the individual's wrist. At the first twinge of stress, the individual simply snaps the rubberband against their skin—and repeats this action every few seconds until the stress begins to subside. (Note: This method is not intended to cause pain.)
Clinical Stress Management
The preeminent in-the-moment psychological strategy for managing stress is a technique called “progressive relaxation.” Over a period of sessions, a therapist teaches the individual how to identify areas of tension in the body, then focus their attention on relaxing the associated muscles. Often incorporating controlled breathing, once the individual learns this technique, the duration of stressful situations is greatly reduced.
With more debilitating cases, psychologist-administered cognitive therapy may be the best approach to coping with in-the-moment stressful situations. Aimed at restructuring the individual's thinking, situations or circumstances perceive as extremely stressful are brought out into the light, examined, and tested until they are viewed as less stressful. Thus, upon confronting a stressful situation, the individual is able to reason themselves back to normal.
Once a stressful situation has been endured or mitigated through strategy, it is very important to take measures to reduce the after-effects. Stressful situations typically cause the release of a number of otherwise unneeded chemicals into the bloodstream that some describe as creating a “stress hang-over.” These chemicals prevent the body from normalizing and should be eliminated as quickly as possible by one of these methods.
Studies show that stress causes dehydration, and that even a small drop in bodily fluids can increase cortisol levels. Thus, immediately after a stressful situation, it is wise to stop and replenish the body's water supply.
The Power of Music
As unlikely as it may seem, music can have a profound effect on not just our state of mind, but our physiology. When the brain processes music (particularly music we enjoy) it essentially relaxes, sending an “everything is fine” signal to the rest of the body—which effectively shuts off the supply of stress hormones like cortisol and adrenalin, allowing the body to return to normal chemical levels.
The Power of Laughter
Although we have been reminded for decades that “Laughter is the best medicine,” most of us have not considered that this idea is based in hard science. Studies prove that laughter not only makes us feel lighter (through the release of endorphins, the body’s natural “feel-good” chemicals), is almost immediately causes a drop in stress and pain levels. In fact, laughter relaxes the entire body and does it faster and more dependably than anything—with the effects lasting up to 45 minutes afterwards. Thus, after a stressful encounter, popping in a funny movie or picking up a comical book is an excellent way of help the body normalize.
Outlook and Expectations
When we look at the bigger picture, we see that in these fast-paced times, most of us suffer some degree of stress. The vast majority of us struggle on a day-to-day basis to keep up with a world appearing to spin faster and faster—with no regard for our well-being. Thus, stress can appear to be the only constant in our lives—and unavoidable. But the fact of the matter is that if we are proactive in establishing a strategy to help us cope with stress, stress is indeed manageable. Stress need not dominate our lives. We can regain the control we often feel we have lost.
References and Resources
American Heart Association website: “How Does Stress Affect You?” Accessed via http://www.heart.org/HEARTORG/HealthyLiving/StressManagement/HowDoesStressAffectYou/How-Does-Stress-Affect-You_UCM_307985_Article.jsp#.V6nqweRTGNo
American Institute of Stress (AIS) website: http://www.stress.org/management-tips/
Black, A. (2014). Mindfulness @ Work. NY: Cico Books.
Brehm, S. and Saul Kassin. (2006). Social Psychology. NY: Houghton Mifflin Co.
Dworetzky, J. (2002). Psychology. NY: West Publishing Co.
Mayo Clinic website. “Stress Symptoms: Effects on Your body and Behavior.” Accessed via http://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress-symptoms/art-20050987
“Support Groups: Make Connections, Get Help.” Accessed via http://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/support-groups/art-20044655
Mental Health America website: http://www.mentalhealthamerica.net/find-affiliate
Posen, D. (2013). Is Work Killing You? Toronto: Anansi Press.
Shaw, G. (2015). “What's the Link Between Water and Stress Reduction?” Accessed via http://www.webmd.com/diet/features/water-stress-reduction#1
Sood, A. (2013). The Mayo Clinic Guide to Stress-Free Living. MA: Da Capo Lifelong Books.
Svoboda, E. (2011). “Eight Ways to Beat Your Stress Hormone.” Accessed via http://www.prevention.com/mind-body/
Weil, A. website: “Ten Ways to Reduce Stress.” Accessed via http://www.drweil.com/drw/u/ART00536/reduce-stress.html