No one gets through life without stress. In fact, a small amount of stress is even good for you. But stress can be more than just uncomfortable. Severe stress can feel overwhelming. Less severe chronic stress can hurt your ability to function both at work and in your relationships. It can even be physically harmful.
Many people develop a depressed mood as a result of either chronic stress or a temporary severely stressful situation. Feelings of hopelessness and helplessness, with negative predictions for the future can make a stressful situation feel even more severe. These feelings often progress into a full-blown depression.
If you have been dealing with a depressed mood on top of stress, and you've felt this way for a week or more, you should seek treatment. This is especially recommended if you are also feeling fatigued, have difficulty concentrating, or if your sleep patterns or appetite have changed.
Most stressful situations involve some amount of justifiable anxiety. The difference between clinically significant stress and normal stress has to do with the severity of anxiety and its persistence. Do you lay in bed at night, turning your worries over in your head, time after time? Are your worries distracting you at work? Are they interfering with your duties as a parent or your relationship with your husband/wife? Do you find yourself 'freezing' mentally or having difficulty making decisions? Do you have moments of extreme anxiety?
Many people find it really difficult to put aside their realistic worries about a stressful situation. This deprives them of rest. They may also push away family members who are trying to give emotional support.
Anxiety can be caused by the catastrophic thinking which often happens as a result of stress. Catastrophic thinking works something like this. If X (a bad thing) happens, then Y (something even worse) will probably be the result. If Y results, then Z (even more awful) will probably also happen. People suffering from catastrophic thinking worry about sequences of negative events occurring in a chain reaction, like a multi-car accident on a foggy highway. Though each event could actually occur, they are focusing on a series of worst possible outcomes. They lose sight of all of the other possibilities.
If you've been feeling 'stressed out' and anxious for a week or more, you should probably seek treatment. Anxiety symptoms can progress into a full blown anxiety disorder.
The two most common behavioral effects of stress are sleep disturbance and irritability. Sleep problems include insomnia, difficulty staying asleep, and restless, unsatisfying sleep. Sleep problems are almost universal when people are subjected to severe stress. They tend to be intermittent, but recurring, when a stressful situation is less severe, but chronic. I'm not sure which sells more new mattresses, stress or backaches.
Sleep problems tend to make every other stress-related problem worse. When you are sleep deprived you are more prone to negative thinking and a depressed mood. You are also less likely to be able to think clearly and counter anxious thoughts. Naturally, you may be irritable (see below).
Many people don't realize the way sleep problems affect their ability to function. On objectively measured tests, people who are sleep deprived have a poorer scores on tests of short-term memory, long-term recall, and reasoning (verbal math problems). In other words, stress-related sleep problems reduce your ability to function when you need it the most.
Almost everyone experiences some increased irritability when stressed. All of the other stress-related problems mentioned so far add to it. Irritability becomes its own problem when it results in conflict on the job or in the home. You may find yourself reacting to things that would only annoy you in better times. You may also cut yourself off from friends and family members who really want to help.
If you find yourself constantly angry at family members or if you have angry outbursts you should probably get treatment sooner rather than later. Irritability is a normal response to stress, but it causes too much trouble to ignore.
All too frequently, people who are suffering from chronic stress deal with it by engaging in self-destructive behavior. They may begin to self-medicate using alcohol, marijuana, or prescription pharmaceuticals. The 'work hard, party hard' philosophy has had more casualties than anyone cares to count up. If you are thinking about entering a 12-Step program for stress-related drinking or substance abuse, you should also begin treatment for the stress itself.
My first goal in treating stress is to improve my patient's ability to cope. My approach is multi-faceted and tailored both to the person and the situation.
My top three interventions all produce improvement rapidly. They are:
Relaxation Training involves non-religious meditative exercises that enable the patient to feel calmer. They can be centered on breathing, muscle tension, or guided imagery. The choice is made based on the patient's symptoms, needs, and personal preference. Catholic patients can learn to use the rosary as a tool for self-calming prayer.
Exercise is a great tool for improving mood and reducing the feeling of muscular tension. It isn't for everybody, but many people enjoy their workouts and find them very useful.
Sleep Hygiene involves a set of rules to follow to recover from disrupted sleep patterns. Relaxation training and exercise also help restore healthy sleep patterns.
Patients suffering from excessive stress often use the same maladaptive thinking patterns found in patients suffering from Generalized Anxiety Disorder or Depression, though usually in a milder form. The same cognitive techniques used to treat the more severe disorders can be used for treating stress.
Patients become aware of their tendency to think catastrophically (presuming a chain of worst-case scenarios) and their excessive worrying. They learn how to respond to their persistent worries using objective, rational alternatives.
"It is what it is." has become a motto for acceptance in modern life. But from a cognitive therapy perspective, "Things are what we make of them," would be more accurate. Patients learn to examine their assumptions, biases, and unbalanced perspective of the situation, replacing them with equally accurate, but less stressful ways of viewing things.
Change and Acceptance
There are many stressful situations that people shouldn't just cope with. These include physical, verbal, and emotional abuse at home or at work. Sexual harassment on the job or in school is something no one should just put up with. When patients face situations like these, I provide emotional support and an objective sounding board to help them find safe and responsible ways to fight back or get away.
Finally, there are situations that just have to be accepted. Terminal or chronic illness, disability, and loss of love fall into this category. My supportive approach helps patients come to terms with the inevitable so that they can live their lives to the fullest.