Stress

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.
• It is important to distinguish between our response to usual stressors and other conditions that can feel like stress, such as panic disorders, anxiety disorders, or depression.

Picture of areas of the body that are affected by stress

Stress can be caused by any type of physical or emotional stimulus or situation. Often, people speak of different types of stress such as work stress, relationship stress, or parenting stress. Some kinds of stress may be related to specific stages of life such as aging, pregnancy, the teen years, or the menopausal transition. Children can also be affected by stress.

Despite its source, any type of stress can become unmanageable or overwhelming. The following are risk factors for uncontrollable stress:

• Social and financial problems
• Physical or mental illness
• Lack of social support networks
• Family history of stress or family discord

How Does Stress Affect the Body?

Stress usually first affects the emotions and causes psychological symptoms. Initial symptoms may include the following feelings:

• Anxiousness
• Nervousness
• Distraction
• Excessive worry
• Internal pressure
• Changes in sleep patterns

These emotional states can then begin to affect a person's outward appearance; the affected individual may seem

• unusually anxious or nervous,
• distracted,
• self-absorbed, and/or
• irritable or angry.

As the stress level increases, or if it lasts over a longer period of time, a person may begin to experience more severe emotional or even physical symptoms:

• Excessive fatigue
• Depression
• Thoughts of hurting yourself or others
• Headaches
• Nausea and vomiting
• Diarrhea
• Chest pain or pressure
• Heart racing
• Dizziness or flushing
• Tremulousness or restlessness
• Shortness of breath
• 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.

• You should call your doctor when you are unable to identify the source of your stress and if the condition continues or comes and goes.
  • If, in conjunction with your friends, family, or spiritual or personal advisers, you cannot identify a source or solution for your stress, your next resource can be your doctor.
  • A physical problem may be causing your symptoms. Or 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

A variety of mental-health care practitioners treat the emotional effects of stress and associated symptoms. Psychiatrists are medical doctors who are specialized in the care of mental illness and can prescribe medications if necessary. Primary care physicians, including internists and family practitioners, are often consulted by patients suffering from physical symptoms related to stress.

Your doctor needs to take a careful history and perform a physical exam in order to diagnose any medical problems leading to your symptoms. After ruling out medical causes for your signs and 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 electrocardiogram (ECG) 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.

When you find yourself feeling the bad effects of stress, you need to take action immediately. The sooner you begin the process of treatment to relieve stress, the easier it will be and the quicker you find relief and 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 chronic and sometimes severe stress from events that occurred in the past (a condition known as 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.

• Treatment for stress relief usually involves a combination of methods that can include lifestyle changes, counseling, and relaxation or stress-management techniques.
• 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.
• Once a careful workup and evaluation by a doctor to rule out medical causes of your symptoms and to assist in identifying stress-related or emotional conditions has occurred, there are several ways to relieve stress. Depending on your personality and lifestyle, one or more of these modalities may be right for you:
  • Regular exercise program
  • Healthy diet and nutrition habits
  • Reassurance
  • Biofeedback as indicated
  • Yoga or related exercise
  • Meditation
  • Acupuncture
  • Counseling by qualified mental-health professionals, as needed
  • Medical intervention for any physical problems discovered

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-management, 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.
• Consume a healthy diet.
• Avoid or reducing alcohol and caffeine intake.
• Maintain a positive outlook.
• Set goals and break them into easily achievable tasks.
• Reward yourself for the good things that you do each day.

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.

Complications of poorly managed or overwhelming stress can include persistent feelings of anxiety or depression, adopting unhealthy lifestyle habits such as the use of alcohol or other substances to "treat" the problem, worsening of certain medical conditions, and even self-harm or suicide.

The key is to seek help early and be an active partner in your care. 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.

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

MedlinePlus, Stress