The Stress-free Marriage – Part 1

Comments Off

Safe Haven Marriage A good marriage is a stress-free, safe haven for both spouses. In its fold, both partners come to feel emotionally secure and emotionally stable. They become physically, emotionally and cognitively connected to each other. There is no challenge or difficulty that cannot be confronted and successfully managed together, as a couple.

In the safe haven of marriage, each spouse feels freer to be truly herself or himself. Both partners learn to make adjustments to better fit their personality to the other, and over time these changes become almost effortless, are positively motivated, and are long-lasting. Neither feels compelled to be significantly different from his or her true self.

When a marriage is emotionally secure for both partners, discrepancies in points of view do not cease to exist. A safe marriage is not a marriage without disagreement. It is a marriage where disagreement, when it occurs, is handled with fairness, mutual respect, and with an eye toward a mutually beneficial resolution.

Spouses that are in the habit of providing an emotionally safe environment for each other know how to externalize their problems in a way that does not make either spouse to be the problem. They know that the problem is the problem, not each other.

Both partners learn to work on their significant issues together. There is no problem of one spouse that does not automatically involve the other. The partners come to embrace each other’s challenges as their own and are empowered to confront them together. They know that two working together are stronger, safer and more effective than either working alone.

Two people can accomplish more than twice as much as one; they get a better return for their labor. If one person falls, the other can reach out and help. But people who are alone when they fall are in real trouble. And on a cold night, two under the same blanket can gain warmth from each other. But how can one be warm alone? –Ecclesiastes 4:9-11.

For a variety of reasons, marriages can start out to be or become emotionally unsafe. An unsafe marriage is one where both spouses co-create an emotional barrier that keeps them from being close to each other. This barrier can be made of negative experiences, negative expectations, or negative assumptions about each other and about the relationship. (more…)

PDF

The 4 Sources of Stress

By Dr. Z | At Home, At Work, Stress & Health

Comments Off

Sources of stress Stress, the reaction that mobilizes our resources against a potential danger (real or perceived), can be produced by an almost infinite variety of single triggers. This variety is produced by the many different situations that can cause stress, in addition to the individual differences among individuals in their perceptions of these triggers. It is not uncommon to see a threat where someone else may see an opportunity or a challenge, and vice versa. For ease of understanding, stress triggers may be classified into four major sources, which in turn can be further combined into two categories. The principal categories are: physical stressors and psychological stressors.

Physical stressors impinge upon the five senses and pertain to the domain of the tangible and concrete. These are stress triggers that we can see, hear, touch, smell or taste. A car coming straight at us on the sidewalk is a real, tangible and imminent physical threat, which must and does trigger an immediate stress reaction. We respond to this physical threat by stepping out of the way, instinctively and without giving it much thought. Included in the physical stressors is pain, which is the body’s reaction to a noxious agent that attacks its structure. Thus, illness, which frequently produces pain, is considered primarily as a physical stressor, rather than psychological. However, and it’s a big caveat, it would be a mistake to consider illness a purely physical stressor, as illness (especially if accompanied by pain) has a way of affecting the mind by producing negative thinking, negative self-appraisal, hopelessness, mental fatigue and other effects on the person’s spirit, attitude and worldview.

Psychological stressors are the most complex and perhaps the most frequent type of stressors we encounter in our daily lives. To understand psychological stressors it is important to remember that they can fall into two distinct categories: real or perceived. Real psychological stressors are produced by the perception of an emotional danger or threat, in other words by a concern over something that is based on reality and does or may objectively occur. An example of this may be an impending relationship breakup. Perceived psychological stressors are produced by the same mechanism, and are a concern over events or situations that are often based on reality but may be exaggerated or may in fact never occur. An example of the latter may be a worry or concern over an unnamed threat that may keep us from being able to take an elevator, or ride in an aircraft.

To summarize, the four principal sources of stress may be grouped as follows:

Environmental
- Includes physical stressors that impinge upon the five senses, such as weather, traffic, noise, pollution, disturbing images.
Social
- Includes psychological stressors triggered when demands are made on our time, attention and skills, such as in job interviews, public speaking, work presentations, interpersonal conflict, competing priorities, financial problems, and loss of relationships and loved ones.
Physiological
- Includes physical stressors that are produced at various stages in our life, such as during growth spurts in adolescence, menopause, lack of exercise, poor nutrition insufficient sleep, illness, injuries, and aging.
- Included in this category is also the physical stress produced by psychological stressors, which produce muscle tension, headaches, stomach upsets, anxiety attacks, and bouts of depression.
Cognitive-emotional
- The principal source of this type of stress is our own thoughts. Our brain interprets changes in our environment and body and conducts an automatic “threat assessment” to decide whether a danger is present and thus mobilize the body’s defenses. The good functioning, or poor functioning of our threat assessment mechanism determines whether we become alarmed appropriately or inappropriately, and whether to remain stressed or relax.

In all cases, the stress reaction and the response that follows begins with our ability to correctly assess the situation and to estimate danger. Stress researchers Lazarus and Folkman (1984) were the first to point out that stress begins with our appraisal of a situation. Instinctively, we first ask ourselves how dangerous or difficult a situation is and what resources we have at our disposal to cope with it. Self-confident individuals are more likely to conclude that, although the situation may be serious, they have what it takes to face it. Less confident individuals tend to conclude that the same situation requires resources that they either do not have or that they have in insufficient measure.

The stress response of fight, flight or freeze is directly correlated to our ability to interpret the danger correctly, and to select the best course of action that produces the wanted results. In some case, we will be able to eliminate the stressor (turn the source of noise off), in others we may simply need to distance ourselves from the stressor (flight response), and in some other cases it will be appropriate to do nothing and let the situation resolve itself (the freeze response). What we choose to do largely depends on our assessment of available resources: making the correct appraisal of what we are capable of can be the difference between the right response and the wrong one.

PDF

Stress and Memory: An Update

By Dr. Z | Clinical, Stress & Health

Comments Off

Salvador Dali Persistence of Memory at Stresshacker.com Stress can interfere with the functioning of memory by either augmenting the impact and persistence of the recollection of an event, or by diminishing both. A recent article by Schwabe et al. (2012) summarizes and updates the most recent findings on the effects of stress on memory. Their research concludes that the timing of the exposure to the stressor is crucial in determining whether memory is improved or impaired. Timing may explain why there are stressful situations in which we are unable to retrieve critical information that we have learned prior to the stressor, e.g. an important phone number or address. In contrast, experiencing stress at the same time as we participate in certain embarrassing, shameful, or frightening events can cause a dramatic enhancement of memory formation.

Schwabe and colleagues examine and attempt to integrate two models of how stress may alter memory processes, the “vertical” model (the mechanisms of stress on memory) and the “horizontal” model (the changes in stress effects on memory over time.)

The vertical perspective implicates principally the action of glucocorticoids (GC) and noradrenaline on the basolateral amygdala. In a typical stress reaction, the hypothalamus activates the hypothalamic-pituitary-adrenal (HPA) axis in response to input from several other brain regions and the sympathetic nervous system (SNS). Through the portal blood system, corticotrophin releasing hormone (CRH) and vasopressin flood the pituitary gland, which trigger its secretion of adrenocorticotropic hormone (ACTH). In response to ACTH release from the pituitary, the adrenal glands secrete glucocorticoids (GCs), of which cortisol is the principal component. GCs, which are lipophilic (fat-loving) steroid hormones, enter the brain relatively easily and can exert their excitatory effect in multiple regions throughout the brain. These effects are often mediated through the binding to the two receptors for the hormone: the mineralocorticoid receptor (MR) and the glucocorticoid receptor (GR). These two receptors differ in their affinity for cortisol (with the MR having a much higher affinity) and also in their localization in the brain. In addition, GCs can exert nongenomic effects (occurring rapidly and acutely) by influencing ion channels or neurotransmitter receptors at the membrane level. It is important to note that CRH, vasopressin, and ACTH can, on their own, influence cognition. When released in concurrence with a stressor, they can have an almost instantaneous effect on memory processes.

The horizontal perspective suggests that the memory of an event or cognition is enhanced when new information is acquired during the stressful situation, whereas the memory process is impaired for information that was acquired prior to or after the stressful situation. In these situations, the flood of GCs acutely enhances memory consolidation of emotional arousing material, while significantly impairing memory retrieval. At the moment of greatest stress, the memory of a significantly stressful event is instantaneously etched into the memory banks in vivid and abundant detail. The recollection of a sometimes important and well-known piece of information is inhibited. It is as if the whole of our attention is absorbed, or mobilized, toward the assessment of the threat presented by the stressor and in the formulation of a reaction to it. The excitatory hormones cursing through the blood system rapidly arouse the nervous, cardio-circulatory, respiratory, and endocrine system. There is no time or resource available for other activities that are not related to the defense of the organism against the perceived (or real) threat of the stressor. Included in these “secondary” activities that are postponed as non-critical is memory retrieval of old information.

Other important findings highlighted in this article are the effects of stress on the striatum, a brain structure that was originally associated with motor control but that is now receiving increased attention as one of the loci of mnemonic function. Secondly, memory is affected by stress not only in terms of its quantity, but also its quality. Lastly, the authors cite important research conducted in the last decade which points to the effects of maternal stress during pregnancy or early childhood stress as harbingers of an individual’s impaired performance as an adult in high-stress environments.

The article concludes with several important questions, which provide an indication of the limits of current research in explaining important aspects of memory formation. For example, it remains difficult to understand how the same neurochemicals can exert opposite effects on the same brain structures, or how individuals in similar situations exhibit such differing recollections of the same event, and other similarly unexplored mysteries. These limitations do not detract from the thoroughness and relevance of this article.

PDF

The Seasonal Stress Buster

By Guest | At Home, Stress & Health

Comments Off

Oh, for the good old days when people would stop Christmas shopping when they ran out of money. –Author Unknown

I’m not sure where this year has gone, but all of a sudden Christmas is here. With so much going on at this time of year it’s quite common to feel stressed and rushed off our feet. If you’re juggling a million different things, here’s a brilliant time management technique which might help.

I wish I could say that I thought of this technique myself, but must give credit to Time Management guru Mark Forster. According to Mark, we work much more effectively when we do things in short, concentrated bursts. This is definitely true for me. If I sit down at my computer to check emails I’m very likely to still be there an hour later. But if I know I’ve only got 15 minutes to do the task I’ll be considerably more productive.

So, using this principle, if you’ve got several jobs to do, write them down and assign each one a time limit (from 5 – 30 minutes). Set a kitchen timer, start the first task and when the timer goes you must stop and go onto the next one. Again set the timer for the allotted time, work on the task until the timer goes off and move on to the next. Don’t worry if the task isn’t finished; you can go back to the beginning once you’ve worked your way through the list.

This is the best time management technique I know and it works equally well when you have a big chunky job to do. Get stuck into the job for half an hour, have a break/do something else for ten minutes, then go back to it.

At this time of year, with so many demands on our time, this technique will help you to get everything done in the shortest time — leaving you more time to enjoy the seasonal activities.

2012 has been an unusually challenging year for many of us and so as it draws to a close I wish you a healthy and Happy Christmas and all good things in the New Year.

Annabel Sutton
ICF Professional Certified Coach
Author of 52 Ways to Transform Your Life

Connect with Annabel on LinkedIn: http://uk.linkedin.com/in/annabelsutton. Book a FREE Coaching Consultation with Annabel. Find out more about Life Coaching.

PDF

Sleep More, Stress Less, Live Longer

By Dr. Z | Stress & Health

Comments Off

People who are sleeping less than six hours a night are at risk for more cardiovascular events, more likely to develop diabetes, and more likely to die sooner, according to a recent study. People who sleep at least seven hours per night have better immune systems, less stress and lower body weight.

Sleep deprivation can be dangerous not only to one’s health but also to that of others around us. US statistics from the Department of Transportation estimate that 20% of drivers doze off regularly at the wheel, while the National Highway Traffic Safety Administration estimates conservatively that, during an average year, “drowsy driving” causes 100,000 automobile wrecks, 71,000 injuries and 1,550 fatalities. These staggering stats are supplemented by data from the US military, surveys of truck drivers, shift workers, couples, medical students. All pointing to one simple fact: if we can’t sleep, sooner or later the body will react negatively, sometimes with tragic consequences.

Physical Threats to Sleep

TIME

Sleep time is under attack from many sources. First and foremost, our work and leisure schedules allow too little time for sleep. While this may seem like a no-brainer and suggest that there is a simple remedy (just allocate more time to sleep!), the problem of sleep scheduling appears to be more complex and somewhat intractable. The reason for this may be below the surface and may be due to a change in how we perceive sleep. While we continue to proclaim its virtues and benefits, at least out loud, aren’t many of us secretly wishing that we could simply do away with sleep altogether?

LIFESTYLE

Many people have a more complex lifestyle that demand an ever finer slicing of time slots. Time is a finite resource that can be neither reduced nor expanded, which forces a setting of priorities. And here is the heart of another problem: for many people sleep is no longer a priority. In fact, it is often considered a time waster that can keep us from other, more important activities.

ENVIRONMENT

Another potential problem is that sleep is not as undisturbed as it once was, in environmental terms. There is the interference of noise, either unwanted or induced (as in keeping music, TV or noise-makers on to “help us fall asleep”). There is the interference of artificial light, or rather too much of it, which we have grown so fond of and subconsciously seek. There is the interference of artificially controlled air, which may be either too dry or too humid or too hot and all variables in between. The A/C or fan or heater is on, adding to noise. One just can’t win the environmental battle in the bedroom!

CHEMICALS

What we eat, drink, smoke, snort, inject, wear, rub or apply can interfere with sleep. Medications, self-care products and nutritional practices that are designed to address specific issues may be very effective, but can cause side effects that have a negative impact on our ability to sleep. These modern chemical helpers may be (or perceived to be) necessary to fix a specific issue, and thus take priority over side effects that may include a negative impact on sleep.

Psychological Threats to Sleep

Individual situations vary greatly, but the following are probably perceived by most sleep-deprived individuals.

STRESSORS

Our own individual and habitual way of reacting to stressors large and small may have a significant impact on sleep. By suppressing a necessary release of emotion in the face of a stressor, we may temporarily “bury” feelings, thoughts, and impressions that find a way of resurfacing later, just when we are trying to relax and fall asleep.

INADEQUATE COPING

Our inability to cope with significant stressors in a timely and effective way may impact our ability to sleep. Not all stressors can be taken care of, i.e. eliminated, in a swift and painless way. Many do linger on, while we are looking for the right solution. Many stressors can be reduced in intensity or frequency. Others can be tolerated or ignored, after a suitable period of adjustment. Some stressors are of such magnitude and impact that we can only resolve them by removing ourselves from their influence, i.e. by moving away. Whatever the case may be, our coping response to stressors is multidimensional along time, frequency, and severity scales, and sleep deprivation is often a byproduct of the coping process.

ALLOSTATIC LOAD

Our stress level may rise and remain at high levels throughout the day, including the time when we’d need it to be lower so that we can fall asleep. This phenomenon is called our individual allostatic load. Allostatic load is the piling up of stress reaction upon stress reaction, without resolution, and without a return to normal arousal levels. Over time, this situation has the effect of permanently raising the set point of our stress level, whereby it is very difficult if not impossible to turn it down at will when we are trying to relax and fall asleep.

The Path to Better and Longer Sleep

There are so many sleep aids available nowadays, it’s a wonder we can even stay awake! Fact is, most of them don’t work. The ones that do work do so by simply knocking us unconscious via powerful chemical agents. Is that real sleep? Many people report that it does not seem to refresh and restore, and chemically-induced relaxation simply bypasses the issues and turns the switch off. When we reawaken, these issues return and require another dose to be shut off again. This cycle repeats and repeats. Is that the way to fix this and get some rest?

The fix must start with identifying the stressors that keeps us from falling or staying asleep. Each night when you are trying to go to sleep, make a list of the thought-items that are swirling around in your mind. Do so for 7 nights. On the 8th day, look at the 7 lists, group thought-items together into issues. Now, you know within a good approximation what issues are keeping you awake.

Next, address the stressors so that they will no longer keep you from sleeping. Look at your issues and group them into three categories: the ones you can resolve, the ones you need to adapt to, and the ones you can ignore. Call upon your problem-solving skills and address the issues that can be resolved during the day. When you get to bed, intentionally stop trying to solve problems. Give yourself a break until the next day.

What about the issues I can’t resolve? Here’s a radically different piece of advice: don’t even try to resolve them now. Accept that they cannot be resolved at 10pm or 2am. And, even more importantly, accept the idea that working on these issues will make your sleep more difficult and that it’s an exercise in futility. Instead of becoming more and more frustrated and agitated because you can’t relax, choose not to acknowledge your situation and don’t fight its impact. This may be the time to read a good book, go get a cup of herbal tea, listen to the crickets, make your list, jot down a few ideas about the screenplay, instead of tossing and turning and trying in vain to go to sleep.

PDF

Sympathetic Muscle Tension and Stress

By Dr. Z | Clinical, Stress & Health

Comments Off

One of the well-known phenomena that accompany the stress response is the spontaneous and uncontrollable action of the sympathetic nervous system on the musculoskeletal structures of the body. Stress, muscular tension and pain often go hand in hand.

The Alarm or Stress Response of the Sympathetic Nervous System

When the sympathetic nervous system is suddenly stimulated by a stressor, there is an almost immediate increase in the body’s ability to carry out unusually vigorous muscle activity, even in individuals who would ordinarily not be capable of it.This almost prodigious increase in strength is facilitated by a cascade of physiological changes that is precipitated by stressful situations.

These changes, which take place in a matter of mere seconds, include:

Increased arterial blood pressure.
Increased blood flow to the muscles along with a corresponding decrease in blood supply to the gastrointestinal tract and the kidneys, which are not needed in mounting the body’s rapid response to the threat.
Increased rates of cellular metabolism, which speed up the body’s rate of functioning.
Increased blood glucose concentration, which provides increased levels of energy.
Increased glycolysis in the liver and in the muscle, also a factor in energy supply.
Increased muscle tension and preparedness to work, which increase tone and strength.
Increased mental activity, which provides acuity, alertness and greater focus on the threat.
Increased rate of blood coagulation, which protects the body from significant blood loss if it should sustain minor cuts and puncture.

The combined effects of the mobilization of virtually all principal organs is what enables the body to perform significantly more strenuous physical activity than it is ordinarily possible. Stress of any kind, physical, emotional or mental, excites the sympathetic system, whose purpose is to provide above-normal activation of the body’s resources. Because of this stimulation, the stress response is often referred to as the sympathetic stress response.

Emotional vs. Physical Stress

The sympathetic system is activated during physical danger, but it is also and more frequently activated by many real or perceived emotional stressors. Guyton-Hall cite the example of anger or rage,

…which is elicited to a great extent by stimulating the hypothalamus, signals are transmitted downward through the reticular formation of the brain stem and into the spinal cord to cause massive sympathetic discharge; most aforementioned sympathetic events ensue immediately. This is called the sympathetic alarm reaction. It is also called the fight or flight reaction because an animal in this state decides almost instantly whether to stand and fight or to run. In either event, the sympathetic alarm reaction makes the animal’s subsequent activities vigorous.
–Textbook of medical physiology by Arthur C. Guyton & John E. Hall, 11th ed.

Chronic Stress

The same exact response can be elicited even daily in individuals exposed to multiple or repeating stressors, such as a negative environment, a dysfunctional relationship, poor working conditions, or difficult socio-economic challenges. In this case, the muscle tension and sympathetic stimulation can be so great and so frequent that the body cannot return to a normal state of relaxation, in which case a chronic stress condition can ensue.

PDF

The John Lennon Syndrome

By Guest | Stress & Health

Comments Off

Life is what happens to you while you’re busy making other plans. John Lennon

I love this quote from John Lennon and often share it with clients when they’re feeling frustrated because things haven’t gone the way they planned; they haven’t made as much progress as they’d hoped; or perhaps a goal that was important to them hasn’t been achieved. Quite often this is due to the fact that ‘life’ simply got in the way.

Life Happens and sometimes it can throw up unwanted and unexpected challenges. I’ve experienced this myself in the past couple of months and have found myself having to deal with some very stressful situations. As a Life Coach I try to walk my talk and most of the time I feel I live a fulfilling and balanced life. But I don’t always get it right and there are times when everything is knocked for six. And I know that I’m not alone — this happens to everyone from time to time.

Here are a few of the things I’ve learned over the past few months:

Firstly, when we find ourselves in a stressful or challenging situation it’s really important to find ways to shore ourselves up and take care of ourselves. Take the pressure off — take it easy — don’t force yourself to do more than absolutely necessary. Try to eat well, take some exercise, perhaps book in for a massage or healing or reflexology — whatever you find to be therapeutic. If you’re feeling anxious, find something that will act as a distraction, be it listening to music, going to a movie, doing a hobby or taking a walk — whatever works for you.

Secondly, if you have limited emotional and physical energy and resources, it’s crucial to make smart choices and concentrate only on those things that are of the highest priority. What’s most important? Each morning ask yourself what are the three areas I need to focus on today? Forget everything else — just give yourself those three things to focus your attention on. If you can get more done then great, but don’t ask or expect too much of yourself.

Thirdly, reach out for support. It’s important not to try to soldier on and shoulder everything on your own. Seek out family and friends who you can talk to — share your concerns — spend time with people who care for, and will support, you. If you don’t have anyone to confide in, and your concerns are going round and round in your head, it can really help to get them out of your head and down on paper.

Finally, choose a positive image or mantra which you can use whenever you’re feeling stressed and overwhelmed — or if you’re finding it hard to sleep. Think of something that embodies strength or calmness, or whatever emotional state you feel you need.

Mine is taken from this beautiful stone carving: All shall be well.

No doubt many of you will have experienced what I call the John Lennon Syndrome in your own lives. Don’t be too hard on yourself when life gets in the way and you don’t achieve as much as you’d hoped. ‘Life’ happens. Be easy on yourself and go with the flow. That’s what I’m learning to do.

Annabel Sutton

ICF Professional Certified Coach
Author of 52 Ways to Change Your Life

Connect with Annabel on LinkedIn: http://uk.linkedin.com/in/annabelsutton. Book a FREE Coaching Consultation with Annabel. Find out more about Life Coaching.

PDF

When Stress Hits You On the Nose

By Dr. Z | Clinical, Stress & Health

Comments Off

Stress-induced upper respiratory symptoms are not unusual. Stress has a powerful effect on the immune system, as the circulation of high levels of the excitatory hormones that accompany stress undermines its defense mechanisms, often producing symptoms such as those of the common cold.

How Does It Work?

Stress suppresses the activity of the immune system, principally due to the effects of the stress hormone cortisol. When under the impact of a significant stressor, the immune system is “flooded” by cortisol and other hormones and its functioning is, at least temporarily, greatly reduced. Thus, pathogens, such as those producing the common cold, have a relatively easier time entering and proliferating in the upper respiratory system.

This is the most prevalent theory of why people get sick while under stress. It does not affect everyone in the same way, however. For some people, it is not until the stressor is removed that adverse symptoms begin to manifest. In this case, it is almost as if the relaxation produced by the removal of the stressor had the effect of making the individual more vulnerable.

What Can Be Done?

A doctor once was asked how long it would take to cure a cold. His answer was, “Oh, about seven days if you take this prescription, or about a week if you decide not to take anything.” Beside the joke, there is truth in the fact that there is no cure for the common cold, either stress-induced or otherwise. It will generally resolve itself, with or without medication, in about a week or so.

Something can be done however to reduce the effects of stress on the immune system. Some people find help in ingesting large quantities of vitamin C at the onset of their respiratory symptoms. Others find that remedies such as hot baths, hot drinks with honey, breathing exercises, yoga or meditation all have beneficial effects on the effects of stress, and thereby, on the immune system.

PDF

The Valor of Stress

By Dr. Z | At Work, Stress & Health

Comments Off

Unlike for physical injuries, no formal recognition is currently given by the US military for the biopsychosocial injuries sustained in combat, known as posttraumatic stress disorder or PTSD. It is as if the many behavioral, emotional, and social consequences of traumatic stress are perceived to be of lesser impact, and thus less deserving of acknowledgement. That they can be serious enough to warrant medical and psychological attention is now fairly well established.

The evidence is certainly not lacking, as serious outcomes of PTSD continue to occur. Most recently, the blog The Soldier’s Load reported the story of James “Rooster” Dixon III, an ex-Marine and long-time sufferer from PTSD who was killed by a State Police SWAT team in front of his house in Baxley, Georgia.

James sought treatment from the VA for his Post-Traumatic Stress Disorder (PTSD), but was unable to shake the constant anxiety and depression that are hallmarks of the disorder. On February 19, 2012 James decided to end his struggle by walking into the bullets of law enforcement: as much a casualty of the war as any service member who died in Iraq.

The blog’s editor, as someone with direct experience of war zone and combat stress and its psychological consequences, also offer insights into his own struggles with PTSD.

I became a functional recluse—avoiding social situations and new experiences that might trigger a panic attack. Friends and acquaintances got accustomed to me declining their invitations to socialize. Eventually they stopped asking. I drank heavily and destroyed romantic relationships in a depressing cycle of thrilling novelty, fear of entrapment and cold dismissal. After three years of struggling with the symptoms of my unknown malady, I chose to leave the Marine Corps. On my way out the door, the VA finally diagnosed me with combat-induced PTSD.

A Purple Hart for PTSD?

Events such as the tragic end of James Dixon highlight the important questions that still surround how PTSD is perceived, labeled, acknowledged and treated—including the idea of awarding a Purple Hart in recognition of this very serious constellation of injuries that are sustained by so many service men and women. According to the Military Order of the Purple Heart, the Purple Heart medal “is awarded to members of the armed forces of the US who are wounded by an instrument of war in the hands of the enemy and posthumously to the next of kin in the name of those who are killed in action or die of wounds received in action. It is specifically a combat decoration.” Should this wording be applicable to PTSD?

The Soldier’s Load asks,

Why do we fail to classify veterans with PTSD as combat wounded? I suggest that the reason has less to do with logic and more to do with the emotions surrounding a small bronze portrait suspended from a narrow purple ribbon. (…) Until we correctly label combat-induced PTSD as a “wound” suffered from contact with the enemy, we as a society will continue to view its sufferers as a shadow legion of men with strange habits and questionable character. We will not methodically identify the trauma, apply medical treatments, and provide appropriate rehabilitation and therapy during the recovery process. In short, we will draw distinctions between segments of combat veterans based on an arbitrary and antiquated determination that only the visible wounds of war are worth recognition, honor and treatment. Such a view will not be helpful to the thousands of combat veterans waging a daily war within, nor prevent some from ending that struggle before victory is won.

Read the full blog post. Do you support a Purple Hart for PTSD?

PDF

Allostatic Load: Stress Upon Stress

By Dr. Z | At Home, At Work, Stress & Health

Comments Off

Chronic stress is a potentially lethal condition that is characterized by long duration and effect accumulation. Humans respond to stressors such as physical or perceived danger, an infection, or a crowded and noisy environment, by initiating a complex biopsychosocial adaptation and coping response. This response is initiated by the sympathetic nervous system and leads to release of excitatory stress hormones (the catecholamines) and glucocorticoids from the adrenal cortex (the well-known adrenaline rush).

The objective of this rapid physical mobilization of the body’s resources is to engage with the stressor, resolve it and return to a more normal state of alertness. Regaining normal arousal levels through a response and adaptation to the stressor is called allostasis. A highly stressed state is meant to be temporary and to subside naturally when the challenge has passed.

There is never a shortage of situations that trigger the stress reaction, at work or at home. All of us face the not too uncommon challenge of having to cope with more than one stressor at once or a series of stressors that happen within a relative short time. Most individuals can cope with this type of demands and are able to regain allostasis once the stressor or stressors have been taken care of or have taken care of themselves.

When individuals are not able to cope effectively with the stressor and cannot regain allostasis, this creates an accumulation of allostatic load. In this situation, there is an incomplete return to the normal condition and a regaining of physical and emotional stability. In fact, a state of stress at relatively high levels becomes the “new normal.” Over many weeks, months, or even years, this exposure to elevated levels of stress hormones can produce allostatic overload, with predictably serious health consequences.

Type 1 Allostatic Load

If the physical and emotional energy required to meet the demands created by one’s cumulative allostatic load routinely exceeds the energy intake and what can be mobilized from one’s own resources, type 1 allostatic overload occurs.

Allostatic overload type 1 is characterized by a significant increases in the circulation of glucocorticoids in the bloodstream (and other hormones that regulate allostasis), which triggers physiological and behavioral changes. These changes refocus the individual from functioning at normal levels of stress in daily routines into a high-stress high-alert survival mode.

Type 2 Allostatic Load

If energy demands are not exceeded and the individual continues to take in or store as much or even more energy than he/she needs—perhaps as a result of stress-related food consumption, choice of a fat-rich diet, or metabolic imbalances (prediabetic state) that favor fat accumulation—then type 2 allostatic overload occurs.

Allostatic overload type 2 causes lesser but higher than normal levels of glucocorticoids (and other hormones that regulate allostasis), which do not trigger physiological and behavioral responses, in such a way the individual remains stuck in a situation of high allostatic load without resolution.

Allostatic Load and Its Consequences

Elderly people who have had a lifetime of sustained economic hardship can have a more rapid decline of physical and mental functioning. Hypertension is often an indicator of job stress, particularly in factory workers, in other workers with repetitive jobs and time pressures, and in workers whose jobs were unstable due to financial and market conditions.

In certain societies, conflict and social instability have been found to increase illness and mortality. For example, cardiovascular disease was found to be a major contributor to the almost 40% increase in the death rate among Russian males in the social upheaval which followed the fall of Communism. High blood pressure causes atherosclerosis as well as increased risk for heart attacks.

Abdominal obesity is another stress-linked change, which is often a precursor to more serious illness such as diabetes. The immune system is also a likely target of psychosocial stress, increasing vulnerability to the common cold and other more serious infections.

PDF

When Stress Becomes Trauma

By Dr. Z | Stress & Health

Comments Off

aaHiroshige_Takanawa There have been considerable advances in the last few years of our understanding of stress, its origin, its antecedents and the course of its manifestations. Significant progress has also been made in understanding what can help reduce its effects on functioning and mood. In spite of the barrage of advertising that promotes such “remedies” as prescription opioids and “benzos” and the ever-present allure of alcohol or marijuana, many people now know that exercise can work just the same, if not better, in reducing stress and anxiety.

There are certain stressors, however, that produce effects that go beyond and cross into a different domain, that of traumatic stress. Recent research places posttraumatic stress disorder (PTSD) within a theory of pathological anxiety, whereby the individual becomes vulnerable in two very important ways.

The first vulnerability precedes the traumatic stressor and is an innate, and therefore genetic, biological predisposition of the individual toward experiencing intense, negative emotions that can easily escalate into panic or degenerate into depression. This biological vulnerability can have many effects, chief among which is the inability to correctly assess the difference between true and false alarms and the subsequent inability to correctly decide on the most appropriate response between fight, flight or freeze. A true state of alarm arousal is the normal and most appropriate reaction to a truly threatening event or situation, i.e. what most people would find dangerous or risky. A falsely perceived state of alarm is one that causes a sudden and involuntary mobilization of the body and the mind’s defenses, in the presence of a situation or event that is objectively non threatening but is assessed as such by the individual who is genetically predisposed to an intense alarm reaction.

The second vulnerability is psychological in nature. Individuals who develop this sensitivity report a greatly reduced sense of control over events and situations. They tend to approach the present and imagine the future with anxious apprehension. Their mood is often characterized by an anxious state of exaggerated vigilance, whereby it is inherently hard to relax and enjoy life. Cognitively, they expect and anticipate the appearance of various threats, external and internal, with an attending constellation of negative emotions (fear, obsession, panic). This complex system of cognitive and emotional arousal usually promotes avoidance and triggers a near-constant state of worry.

When applied to traumatic stress, these vulnerabilities magnify the experience of a traumatic event and trigger a significantly more severe state of alarm at the time of the trauma. It is well known fact that some individuals appear able to remain relatively calm in the face of traumatic events, while others (who are more likely to have bio-psychological vulnerabilities to intense stressors) seem to quickly “fall apart” and be seemingly “destroyed” by the circumstance.

When the intense trauma passes, these individuals remain in a state of arousal that continues to trigger alarms in response to internal and external stimuli associated with the trauma, and their
initial response to it. For example, a sudden noise may trigger the stimulus associated with a bomb blast, or a burst of anger by another may trigger a stimulus associated with physical abuse. These learned responses to real or perceived threats produce a state of anxious apprehension which, in PTSD, includes the re-experiencing of emotions. This near-continuous state of alarm may, in time, be mitigated by coping mechanisms which generally consist of an individual’s efforts at avoiding the triggers of the learned alarms and the strong emotions associated with them. Intense avoidance of any stimulation that may results in a re-experience of the traumatic events and its associated emotions can eventually developed into a state of emotional numbing, where even those stimuli that should provoke a reaction do not.

PDF

“Rich” Nutrition Linked to Poor Mental Health

By Dr. Z | Clinical, Stress & Health

Comments Off

killer-fast-food Psychological stress is known to increase the production of pro-inflammatory cytokines. The deriving inflammation is accompanied by an accumulation of highly reactive oxygen species, also known as oxidative stress, which is a contributing factor in the development of severe depression. A diet rich in antioxidants, vitamins, minerals and fiber is associated with reduced systemic inflammation. Conversely, diets that are low in essential nutrients, such as magnesium and sugar- and fat-rich western diets are associated with increased systemic inflammation.

A new study of 3040 Australian adolescents 11 to 18 years of age collected information on diet and mental health by self-report and anthropometric data by trained researchers. Improvements in diet quality were mirrored by improvements in mental health over the follow-up period, while deteriorating diet quality was associated with poorer psychological functioning. Researchers concluded that the quality of one’s nutrition is associated with adolescent mental health both cross-sectionally and prospectively. Moreover, improvements in diet quality were mirrored by improvements in mental health, while reductions in diet quality were associated with declining psychological functioning over the follow-up period.

There are many ways in which an insufficiency of healthy foods and/or an excessive intake of unhealthy and processed foods may increase the risk for mental health problems in adolescents. Fruits and vegetables, as well as other components of a healthy diet such as whole grains, fish, lean red meats and olive oils, are rich in important nutrients such as folate, magnesium, b-group vitamins, selenium, zinc, mono- and polyunsaturated fatty acids, polyphenols and fiber. Many of these nutrients have already been reported as of importance in depressive illnesses, however the critical importance of these food components as modulators of reactive oxygen species (inflammation) and immune system functioning, both pathophysiological substrates of depressive illness is increasingly appreciated.

stressed-desserts A new meta-analysis, reporting on data collected at many time points and thus more reliable, has reported large generational increases in self-reported mental health problems among American high school and college students between the 1930s and 2007. Paralleling this increase in the rates of psychological illness among young people are data indicating a reduction in the quality of adolescents’ diets over recent decades. A report based on trends in adolescent food consumption in the US identified a reduction in the consumption of raw fruits, high-nutrient vegetables and dairy foods, which are important sources of fiber and essential nutrients, between 1965 and 1996, with an associated increase in the consumption of fast food, snacks and sweetened beverages.

Concurrently, population surveys demonstrate a substantial increase in overweight and obesity among children and adolescents over recent decades. Obesity does not necessarily indicate nutritional deficiency: paradoxically, high-energy foods typically have poor nutrient content.

Fast Food, Depression and Anxiety

Another study of 5731 men and women 46 to 49 and 70 to 74 years of age found that those with better quality diets were less likely to be depressed, whereas a higher intake of processed and unhealthy foods was associated with increased anxiety.

USA-Obesity-Rate A third study examined the extent to which the high-prevalence mental disorders are related to habitual diet in 1,046 women 20–93 years of age. Results showed that a “traditional” dietary pattern characterized by vegetables, fruit, meat, fish, and whole grains was associated with lower odds for major depression or log-term depression (dysthymia) and anxiety disorders. A western diet of processed or fried foods, refined grains, sugary products, and beer was associated with a higher prevalence of mental disorders. These results demonstrate an association between habitual diet quality and a higher prevalence of mental disorders.

In a fourth study (1999–2010) of 12,059 Spanish university graduates discovered a detrimental relationship between a diet rich in trans unsaturated fatty acids (TFA) and depression risk, whereas weak inverse associations were found for monounsaturated fatty acids (MUFA), polyunsaturated fatty acids (PUFA) and olive oil. These findings suggest that cardiovascular disease and depression may share some common nutritional determinants related to fat intake.

Most notably, results of a 2010 randomized placebo controlled trial showed that fish oil supplements prevented conversion from a subthreshold psychotic state to full-blown schizophrenia. Another recent randomized controlled trial study suggested that omega-3 supplements may help reduce anxiety.

PDF

Mindfulness for Absolute Beginners

By Dr. Z | At Home, At Work, Stress & Health

Comments Off

aaCarignano_Solferino Mindfulness meditation is the wonderfully effective relaxation technique that along with yoga, tantric meditation, mantra or transcendental meditation, has become an increasingly popular forms of stress management. The therapeutic value of meditation in producing positive effects on psychological well-being and ameliorating symptoms of a number of disorders has become widely studied and accepted. But, what is it and how does it work? Here is a primer for the absolute beginner, to start mindfulness relaxation today!

What Is It? The Way of Breath Awareness

Vipassanā (Pāli) or vipaśyanā (विपश्यना in the original Sanskrit) in the Buddhist tradition means insight into the true nature of reality. Vipassana practice, or insight meditation, makes use of breath to focus attention and to let go of quasi-obsessive analytical thinking, which can be very stressful. Breath is simply used to increase concentration. The focus on breath is a powerful way to redirect attention, because it is always readily available, is directly connected to the stress reaction, and is naturally rhythmic and repetitive. Mindfully redirecting attention to the breath when we feel particularly stressed reduces reactivity and provides a positive physiological feedback system that balances the responses of the nervous system.

How Does It Work? The Benefits of Open Awareness

Open awareness is the core objective of mindfulness meditation. The follo0wing are simple instructions to focus awareness on the breath and is the essence of the mindfulness technique (from Stress Management: A Comprehensive Guide to Wellness by E. A. Charlesworth—read the book review).

Find a quiet place and time. If you prefer, set a timer for 20 to 40 minutes. Become comfortable in your chair, sitting with a relaxed but straight, erect posture that is balanced but not straining. Allow your hands to rest comfortably in your lap. Loosen any tight clothing that will restrict your stomach. Gently close your eyes.
Simply allow your body to become still. Allow your shoulders, chest, and stomach to relax. Focus your attention on the feeling of your breathing. Begin by taking two or three deeper breaths from your diaphragm, letting the air flow all the way into your stomach, without any push or strain, and then flow gently back out again. Repeat these two or three deep breaths, noticing an increased sense of calm and relaxation as you breath in the clean, fresh air and breath out any sense of tension or stress.
Now let your breathing find its own natural, comfortable rhythm and depth. Focus your attention on the feeling of your breath as it comes in at the tip of your nose, moves through the back of your throat, into your lower diaphragm, and back out again, letting your stomach rise and fall naturally with each breath.
Allow your attention to stay focused on your breath and away from the noise, the thoughts, the feelings, the concerns that may usually fill your mind.
As you continue, you will notice that the mind will become caught up in thoughts and feelings. It may become attached to noises or bodily sensations. You may find yourself remembering something from your past or thinking about the future. This is to be expected. This is the nature of the mind. If the thought or experience is particularly powerful, without self-judgment, simply observe the process of the mind. You might note to yourself the nature of the thought or experience: “worry,” “planning,” “pain,” “sound.” Then gently return your attention to the breath.
And again, as you notice your mind wandering off, do not be critical of yourself. Understand that this is the nature of the mind—to become attached to daily concerns, to become attached to feelings, memories. If you find your mind becoming preoccupied with a thought, simply notice it, rather than pursuing it at this moment. Understand, without judging, that it is the habit of your mind to pursue the thought. When you notice this happening, simply return your attention to your breathing. See the thought as simply a thought, an activity that your mind is engaging in.
When you are ready, gently bring your attention back just to the breath. Now bring your attention back into the space of your body and into the space of the room. Move around gently in the space of the chair. When you are ready, open your eyes and gently stretch out.

How Long and How Often? Practice Makes Perfect

Mindfulness meditation, like all things worth doing, requires a certain amount of effort and the setting aside of a certain amount of time. Ideally, 20 to 40 minutes once or twice per day, for at least two months. Daily practice produces the best results in training the mind to shift into a mindful state. Shorter periods of time of 5–10 minutes are very helpful in specific situations, when a quick relaxation is needed. Only practicing mindfulness meditation situationally, however, will work when you have learned the technique well. It may not be as effective in the beginning, when it may take more than 5-10 minutes to relax, particularly in moments of high anxiety or stress.

PDF

Lower DHA Intake Linked to Higher Suicidality

By Dr. Z | Clinical, Stress & Health

Comments Off

ChileVolcanoEruption_EN-US1005377464 Low levels of docosahexaenoic acid (DHA), the major omega-3 fatty acid concentrated in the brain, may increase suicide risk. A retrospective case-control study published in the most recent issue of the Journal of Clinical Psychiatry of 1600 United States military personnel, including 800 who had committed suicide and 800 healthy counterparts, showed that all participants had low omega-3 levels. However, the suicide risk was 62% greatest in those with the lowest levels of DHA.

Our findings add to an extensive body of research that points to a fundamental role for DHA and other omega-3 fatty acids in protecting against mental health problems and suicide risks. — Joseph R. Hibbeln, MD, acting chief, Section on Nutritional Neurosciences at the National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland

DHA is found in naturally in fish and nuts and is also available in fish oil supplements. Fish oil supplements can help lower inflammation by decreasing the synthesis of proinflammatory molecules and have been proven beneficial in treating inflammatory diseases, such as rheumatoid arthritis and Crohn’s disease. Although fish oil has been shown to be less effective in treating other stress-related illnesses such as ulcerative colitis and asthma, some patients do benefit from its intake.

The omega-3 fatty acids EPA and DHA contained in fish oil are effective in treating both cardiovascular disease and depression, often in combination with other specific medications. Higher levels of EPA and DHA are also associated with increased stress resilience.

PDF

Just 14 of the Many Facets of Stress

By Dr. Z | At Home, At Work, Stress & Health

Comments Off

aaTintoretto_SanGiorgioDrago MRI scans have revealed that children of depressed mothers have a larger amygdala, a part of the brain associated with emotional responses, researchers from the University of Montreal explained in the Proceedings of the National Academy of Sciences (PNAS).

A new study published in the American Journal of Industrial Medicine reveals that the World Trade Center attacks affected the health of the New York City Fire Department (FDNY) resulting in more post-9/11 retirements than expected.

Researchers in the Hotchkiss Brain Institute (HBI) at the University of Calgary’s Faculty of Medicine have uncovered a mechanism by which stress increases food drive in rats.

Do you run when you should stay? Are you afraid of all the wrong things? An enzyme deficiency might be to blame, reveals new research in mice by scientists at the University of Southern California.

Constant bitterness can make a person ill, according to Concordia University researchers who have examined the relationship between failure, bitterness and quality of life.

Listening to music or sessions with trained music therapists may benefit cancer patients. Music can reduce anxiety, and may also have positive effects on mood, pain and quality of life, a new Cochrane Systematic Review shows.

Researchers at Harvard-affiliated McLean Hospital have found that those who believe in a benevolent God tend to worry less and be more tolerant of life’s uncertainties than those who believe in an indifferent or punishing God.

Knowing the right way to handle stress in the classroom and on the sports field can make the difference between success and failure for the millions of students going back to school this fall, new University of Chicago research shows.

An 8-week course of stress-reducing Transcendental Meditation resulted in a 50% reduction in PTSD (post-traumatic stress disorder) symptoms among Iraq/Afghanistan veterans, researchers reported in Military Medicine. The pilot study involved five veterans aged 25 to 40 years with PTSD symptoms – they had all served between 10 and 24 months and had been involved in moderate or heavy moderate combat.

When parents fight, infants are likely to lose sleep, researchers report. "We know that marital problems have an impact on child functioning, and we know that sleep is a big problem for parents," said Jenae M. Neiderhiser, professor of psychology, Penn State. New parents often report sleep as being the most problematic of their child’s behavior.

By helping people express their emotions, music therapy, when combined with standard care, appears to be an effective treatment for depression, at least in the short term, said researchers from the University of Jyväskylä in Finland who write about their findings in the August issue of the British Journal of Psychiatry.

Young adults whose mothers experienced psychological trauma during their pregnancies show signs of accelerated aging, a UC Irvine-led study found. The researchers discovered that this prenatal exposure to stress affected the development of chromosome regions that control cell aging processes.

A child who has a psychological adversity or a mental disorder that starts during childhood has a higher chance of developing a long-term (chronic) physical condition later on, researchers from the University of Otago, Dunedin, New Zealand reported in Archives of General Psychiatry. The authors explain that child abuse has been linked to a higher chance of adverse physical health outcomes.

Individuals with anxiety-related symptoms who self-medicate with drugs or alcohol have a higher risk of having a substance abuse problem and social phobia, researchers from the University of Manitoba, Winnipeg, Canada, revealed in Archives of General Psychiatry.

PDF

Category Archives: Stress & Health

The Stress-free Marriage – Part 1

The 4 Sources of Stress

Stress and Memory: An Update

The Seasonal Stress Buster

Sleep More, Stress Less, Live Longer