(D I S) S T R E S S: An “Ask the Experts” Edition

It is a term we are all-too familiar with. But how well do we really understand it, and better yet, how well do we DEAL with it? 

Asking the Experts

I sat down with health practitioners in Chicago to talk about what they see in their own practices, and here is what they had to say: 

What areas of life seem to cause the most (dis)tress for clients you encounter?

Kevin:

In my experience working with clients, work/career is the area in which a majority of people report feeling the most stress, though relationships are a close second.

Kuan:

My patients have expressed three main stressors which are work, family, and money.

Catherine:

Relationships, family and work would be the “big three.” There are special cases involving Post Traumatic Stress Disorders, or refugees coming from war-torn or impoverished nations…but for most patients in a psycho-therapy session, stress comes from interacting with other people, money—basically, all aspects of work and relationships.

What is the difference between stress and distress?

Kevin:

Distress tends to be an extreme feeling of anxiety or pain, possibly in response to a traumatic event, or stress that has built up over a period of time. Stress can sometimes be beneficial. When we experience things that challenge us, we may have a stress response, but ultimately we grow from the experience. People experiencing distress, on the other hand, often feel helpless and aren’t able to see “the light at the end of the tunnel” so to speak, and therefore, have difficulty moving forward.

Kuan:

Stress is a mental state your mind is in because of pressure due to overwork or worry. Distress is a result of a traumatic experience.

Catherine:

That is a good question. There is always stress in life, which can be good. If you have a presentation at work and you are both excited and nervous, that is stress. If you are a parent and your child is performing in a play or about to have a soccer match, and you find yourself worrying about how they will do, and hoping they will do well, this is also stress. But it isn’t a bad thing. It is excitement and investment. It is what you make it; it can be positive, negative or neutral.

Distress, on the other hand, is when stress becomes overwhelmingly negative. People feel helpless. We don’t foresee any positive outcomes.

What are some of the signs and symptoms that manifest when people are stressed?

Kevin:

Responses to stress will vary from person to person. However, common manifestations are physical tension and pain, disruption in sleep patterns, mood swings, short-tempers or heightened emotional states, inability to focus, and difficulty connecting with partners, family, and friends.

Kuan:

Stress can lead to very reactionary behavior (snappiness, agitation, loss of patience, difficulty focusing) as well as physical tension (tight shoulders, twitching/spasms, grinding teeth, headaches).  In Traditional Chinese Medicine (TCM) it can lead to the previously mentioned symptoms, but also an array of organ disorders including vomiting/nausea, palpitations, severe coughing or frequent sighing, issues with urinary incontinence and loose bowel movements, etc.)

Catherine:

I think most people know the physical symptoms: tension, headaches, sleeplessness, IBS-like digestion problems, things like that. But what may not be obvious to the person who is distressed is that their normal coping mechanism will stop working.

If you usually have one glass of wine at the end of a long day to relax, now you will have three or four. Or if you normally call a friend, after the phone call you are still not feeling satisfied. You think, “maybe my friend doesn’t care.” You might start negatively interpreting interactions, which amps up even more negative feelings.

Then there are people who already have stress built into certain relationships, unhappy marriages, dysfunctional relationships with siblings, things like that. The distressed person may try and reach out to vent, or for moral support to someone like that, and then things get a lot worse. “My husband just doesn’t understand me!” “Why is my sister always so rude?” Things like that, which just keep making the situation more and more negative and overwhelming.

How do you encourage or coach people in terms of stress reduction?

Kevin:

Stress and distress are almost always the result of an imbalance in certain areas of our lives. Through coaching, we examine an individual’s current circumstances and come up with a strategy for regaining some of that balance. Many people experiencing distress feel as though they have no control over their current circumstances.

Coaching empowers them to uncover the options they DO have and take action, thus giving them more of a sense of control.

Kuan:

Pattern Diagnosis is a big part of Traditional Chinese Medicine (TCM). Many times patients will come in with a major issue that they would like to work on. Stress, for instance, can have many causes that are exacerbated by life events but a stress reaction can be compounded by an imbalance in the body.

With TCM, we find that root cause and help the body come closer to natural equilibrium so that it is capable of taking on those stressors in a more balanced way. Also, I give patients simple advice on how they can help themselves between treatments to move the process along. Activity or relaxation, focusing on one task at a time or clearing your mind, long walks or short naps. People’s patterns are different and people are different so their needs will be different.   

Catherine:

One subject that comes up often is exercise. Research suggests that exercise, especially cardio-vascular exercise, is helpful for a myriad of problems like stress, anxiety, and depression. The problem is, if you are already stressed you don’t have the motivation or the energy to do it. You feel that you don’t have time, or are not healthy enough for it: “I’m too fat to go for a jog around the block.” Some people even have terrible memories from childhood PE classes, and just don’t see themselves as “jocks” or as being part of the physical fitness world. But you are better off taking a walk around the block than sitting at home eating popcorn and watching TV

I encourage people to figure out: what is it that is most stressful? And then in counseling we target it. If you have a friend who is constantly draining you, we work on setting limits and boundaries in that relationship. If what is most stressful to you is your dead-end job that gives you no joy, no appreciation, then I ask, “can you improve your job?” If your cubicle neighbor drives you nuts, can you wear headphones? Can you think of other jobs you might like? Or can you talk to supervisors about other job responsibilities that would be more fulfilling? I work with people to look outside the box. Finding ways to empower the “powerless,” encouraging the “giver” to “receive.” It’s all a deeper exploration of boundaries and habits.

The other big thing is a technique (based on meditation) called Mindfulness. It is so popular in the psychology community that it is almost cliché. This is learning to withdraw your focus from your (crazy rat on a wheel) thoughts or a difficult social interaction, and refocusing them on something tangible—on a sense perception in your immediate experience. Changing your habitual thought patterns can be really hard. You may be driving on the highway and thinking “That guy’s an a**hole! He just cut me off! What a jerk!” Which is a really negative, stressful thought. It would be almost impossible to instead think (all Mary Sunshine) in that moment, “We are all humans. Maybe he didn’t see me. Maybe he’s just having a bad day. I am sure he’s a real swell guy!” But instead you can use Mindfulness techniques to make neutral observations. You focus on the way that the steering wheel feels in your hands, or you focus on the color of the cars in front of you, or the way your body feels with the vibration of the car. This is doable. These techniques are also very useful in helping chronic anxiety and depression.

And finally, while I am not a moral philosopher, or a sociologist, I do notice many  people aren’t finding or placing value on things in their lives. Not values like chastity, or justice, or moral codes, but things like nature or creativity. Negative people often tend to be motivated from fear of consequences or punishment instead of a positive aspiration. Something bigger than themselves. I would encourage people with a lot of negativity to find something to value that is aspirational and enriching to their lives, to make it feel more meaningful. For some it is a creative outlet like writing poetry, gardening, or spending time in nature. For others, it is finding a group activity (yoga, church, school sports, volunteering). Things like this go a long way in improving mental health.

Can “busy” and/or “broke” people still have successful strategies or habits for dealing with stress?

Kevin:

Absolutely! Recognizing stress is the biggest step in beginning to mitigate its effects on you. I encourage people to take a step back from their current stressors and evaluate and prioritize. It’s easy for us, when in a state of stress, to feel overwhelmed, but if we’re able to take a step back and look at things more objectively, we’re more capable of coming up with effective strategies for managing our stress.

Also, simple things, like deep breathing and quick centering exercises, go a long way to reducing stress. And don’t forget to take breaks. If you’re dealing with a stressful task or circumstance, taking a 10 or 15 minute break can be great for clearing your head, moving your body, and renewing your energy.

Kuan:

Absolutely! Just because you have stress doesn’t mean that it will dominate your life, and if it does, many times it’s because you are letting that happen. De-stressing does not have to be expensive and take up hours at a time. Going for a quick walk to clear your mind, disconnecting for 5 minutes to disengage between meetings, simple exercise routines, meditation, or punching a pillow can all be very effective. Find what works for you and stick with it. Commit just 5 to 10 minutes a day and it can make a huge difference in your quality of life.

Catherine:

Yes. I think so. If someone doesn’t know where their next meal is coming from (Maslow’s Hierarchy of Needs) then a program on stress management won’t be helpful. And for some people who truly are “broke,” this is an issue. So we deal with this first. Could you apply for food stamps? Does your community have a food pantry? Do you have friends, family, or coworkers who might be able to help?

Society sometimes gives the impression that relaxation costs money (going out to the spa, meeting for drinks) but yoga, meditation, and walking are all free. Burnout is a big problem for “busy people.” First, acknowledge how busy you are. Then, look for times that you can do some mindfulness practices. Maybe on the El you disengage from your smart phone and watch people, or the buildings going by. Thoughts like, “I have to do this, I have to do that,” can lead to a lot of stress. Say you are a parent who has to get a lot of cleaning done before the children are home from school. Instead of thinking, “This place is a pig sty, I’ll never get this done, I feel like a maid,” you can refocus your attention on the smell of the fresh laundry, or imagining how nice the children will look in their freshly-pressed clothes.

Also, recognizing your achievements and victories (no matter the size) can go a long way in changing habitual thought patterns. So, instead of freaking out with thoughts about what a crappy job you’ll do and how your boss will fire you, if you celebrate the things that go well you can change that thought into something productive (and not Mary Sunshine) like, “well, actually the boss was pleased with my last presentation” and so forth. These practices are great at reducing stress, and are free!

Closing Thoughts

The National Institute of Mental Health defines stress as: “the brain’s response to any demand.” So “stress” isn’t inherently “bad.” However, this same biological response that can help protect you, promotes focus, allows you to perform under pressure, motivates you to action, and helps you aim for your best can also be hazardous to your health in larger doses. It’s an emergency state. And just like the ER of your local hospital, you don’t want to live there for all, or even most, of your day.

Effects of (Dis)tress

Unchecked stress can have major negative impacts on your health, mood, productivity and quality of life.

Cognitive Symptoms:
  • memory problems
  • inability to concentrate
  • poor judgement
  • seeing only the negative
  • anxious or racing thoughts
  • constant worrying
Emotional Symptoms:
  • moodiness
  • irritability or short temper
  • agitation
  • inability to relax
  • feeling overwhelmed
  • sense of loneliness
  • isolation
  • depression
  • general unhappiness
Physical Symptoms
  • aches and pains
  • diarrhea or constipation
  • nausea or dizziness
  • chest pain
  • rapid heartbeat
  • loss of libido,
  • frequent colds
Behavioral Symptoms:
  • appetite changes
  • sleeping increase or decrease
  • isolating self from others
  • neglecting responsibilities
  • self-medication
  • nervous habits (like pacing, nail-biting, etc.)

 

Mind-body synchronization is the path, and the breath is the best vehicle for this path.

Bodywork is also a valuable relaxation tool. But we all need more than one or two tools in our proverbial toolshed if we are to succeed.

Breathe. (It is called “inspiration” for good reason) Avoid stress when you can, and learn how to relate to  it when you cannot.

Take up Meditation (try Shambhala, a secular practice of mindfulness)

Chi Gong, Tai Chi, Pilates, and Yoga are all excellent practices that can help you synchronize your body and mind with breath.

Finally, having a solid base of support is also highly recommended, and that not only includes your friends and family, but also professional practitioners whom you trust.

Questions? Comments? I’d love to hear from you!

This interview was conducted and published in 2014. Dr. Catherine “Cathy” Wilson was diagnosed soon after with stage 4 cancer. She continued treating patients through 2015, even as she underwent many painful treatments herself. She never lost her sense of humor throughout. When asked how she was, she would often say things like, “cancer sucks” and “hospital food leaves much to be desired.” I never once heard her voice a more serious complaint. She was not only a magnificent counselor, she was a beautiful friend. Her kindness, generosity, and never-ceasing wisdom will never be forgotten.

In loving memoriam: 1945—2016