Business of Stress: CHD At Work

PointLobosLExp Researchers have substantially defined the specific characteristics of stressful occupations and have examined whether they promote the risk of coronary heart disease (CHD), which is the progressive and often fatal hardening of the blood vessels that surround the heart.

Specifically, the question of whether high job strain can be used to predict job stress-related CHD is worth asking in this era of constant communication and information flow.

What constitutes high job strain?

Although many subjective and environmental factors can determine the level of strain in any one individual, the accepted common-sense definition is circumstances of high demand and correspondingly few opportunities to control outcomes. 

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When Stress Hurts: The Credibility Gap

StMarksSquare_EN-US761640507How the brain processes and maintains psychogenic pain is the subject of this, the fifth post in the series on the close association between psychological stress and psychogenic pain. Hope is hard to come by for swift and lasting relief of chronic back pain, muscle pain, headaches, migraines, stomach pain, and other stress-related conditions. Medication can help but carries the dangers of addiction or dependency. Non-medical remedies do exist and can work well, but may not be as well known or easy to apply. So the pain continues without relief in sight. And then there is the credibility gap.

Unbelievable Pain That Is Hard To Believe

Even though there is no diagnosable medical condition in the body, and even though
the physical injury that may have originated the pain is now healed, the pain is real. Unexplained. Mysterious. Intense. This is hard to accept by the sufferer, by family and friends, by physicians and pharmacists. There is no “proof” of its existence or intensity that anyone can see. This apparent credibility gap, in itself, creates additional stress to the pain sufferer, which (you guessed it) creates even more pain.

The best illustration, and the best indirect proof that psychogenic pain is real, is offered by “phantom limb” pain, a well-known condition not uncommon among amputees. Significant pain is felt in an arm or a leg that has been amputated. Clearly, there can not be anything wrong with a limb that is no longer there—yet this pain can be excruciatingly intense. What’s going on? What we know about phantom limb pain is that it is created by overly sensitized nerve endings that stop at the point of amputation, but continue to transmit previously learned and now outdated pain information along “stuck” pathways to the brain, as if the arm or the leg was still there. These pathways produce a continuing cycle of pain that can last for months, years, or even decades.

A similar phenomenon of “stuck” pathways takes place in psychogenic pain. Let’s see how it works.

How the Brain Processes Psychogenic Pain

Psychogenic pain is produced when overly sensitized nerve pathways are established between the brain and certain parts of the body, which may be initially provoked and later maintained by a continuing psychological stressor.  The nervous system learns to process psychological distress along these neural pathways (exactly why this happens we aren’t quite sure) and the longer the stress goes unattended, the more sensitized and overactive these peripheral nerves become, producing significant amounts of pain to the muscles, the head and other parts of the body.

The brain interprets these nerve signals and transforms them into the experience of pain. The event that started this learning process in the nerves may have been an injury or a stressful event earlier in life, or the pain may just appear without any directly verifiable reason. Only a careful and detailed look at our current situation and life history can reveal the stressors that may have originated and continue to maintain psychogenic pain.

The Case for Fibromyalgia

Musculoskeletal pain localized in the lower back, shoulders, and arms appears frequently to be unrelated to physiological disease. Fibromyalgia has reportedly become one of the most frequent reasons for patient referrals to rheumatology clinics. It is a disorder that affects many musculoskeletal structures and is characterized by persistent pain, sleep and mood disturbances.

Fibromyalgia origins have been traced to stuck pain pathways in the central nervous system, which cause decreased levels of pain-reducing serotonin and increased levels of substance P in the cerebrospinal fluid. These pathways are further reinforced over time by a stress reaction to the pain. Just about everyone who has chronic fibromyalgia pain reacts to it with fear, anger, anxiety, frustration, and other negative thoughts and emotions. Anger and sadness specifically have been recently linked to an increase in fibromyalgia pain.

Psychological stressors, negative thoughts and emotions, conscious or subconscious,  thus appear to be major causative factors in psychogenic pain and its related syndromes, such as fibromyalgia. The decreased activity, diminished income, difficult relationships that are byproducts of constant fibromyalgia pain do nothing but add to the misery of it all, making the pain-producing nerve pathways even stronger.

In our next and final post on this series we will take a look at the medical and non-medical remedies that have been devised to cure psychogenic pain.

Previously in this series:


  • Medical and Non-Medical Treatments for Psychogenic Pain

Anger and Sadness Increase Fibromyalgic Pain

Turner_1835_DidoBuildingCarthage Perhaps another study that falls into the “I knew it all along” category: Anger and sadness increase pain in women who suffer from fibromyalgia.

A recent study conducted at the University of Utrecht on 121 women, 62 of which were suffering from fibromyalgia, confirmed a significant increase in pain levels in response to both anger and sadness. A greater angry or sad reaction was associated with a correspondingly greater amount of pain response.

Results of the study showed that in half of the female patients, the experience of anger or sadness in response to a significant daily emotional event predicted more pain at the end of that day. The anger–pain link was more pronounced among patients with a longer duration of fibromyalgia and among those with higher average anger levels. 

Among the study participants, pain levels were highest on Fridays and lowest on Sundays, which might reflect a gradually increasing pain during the work week. However, patients who worked did not show a more pronounced weekly pain increase than unemployed patients. Relaxing activities and quality time during the weekends of both working and non-working women appeared to reduce the pain.

‘Tis the Season … for Reflection

I’m finding it hard to believe that Christmas is only a few days away and it’s only two weeks until the end of the year. Where did this year go?
The space between Christmas and the end of the year can be a great time to take a step back and reflect on the ups and downs of the past year, see what lessons there are to be learned, and to create some plans for the coming year.

For those who really want to get their teeth into this, I recommend Jinny Ditzler’s book Your Best Year Yet!, which takes you through the process using ten specific steps. Here are a selection of those steps to get you started…

First, make an extensive list of all you’ve achieved during 2013. Include absolutely everything, big or small. If you do nothing else at the end of the year I strongly recommend you do this. You’ll be surprised at the number of things you have achieved and how good it feels to acknowledge them.

Secondly, consider anything that didn’t go as well as you’d hoped — or things that you’d intended to do but didn’t. What can you learn from this? Can you take this learning forward into 2014 to ensure that you don’t make the same mistakes again?

Thirdly, consider what you want your focus to be in the coming year. What are your priorities? What’s really important to you? What successes do you want to build on? Are there things in your life that you’d like to drop altogether? Is it time to take a risk and make some radical changes? Or perhaps 2014 will be the year when you really step out of your comfort zone and go for the big goal.

Having done that, come up with a list of your Top Ten Goals for 2014. Ditzler suggests that when pondering these goals it can help to consider all the different roles you play in your life (partner, parent, business owner, employee, community member, sports team member, volunteer etc) and link your goals to these roles. Don’t forget to include goals that relate to your role as ‘yourself’ as well … This helps to make sure you get a good balance between work and rest.

Whatever you decide I hope you have a wonderful Christmas and a happy, healthy and peaceful New Year.

Annabel Sutton

ICF Professional Certified Coach
Member International Coach Federation

Forced to Lie About Stress

aaDelacroix_1852_LaMerADieppeA full 36% say it’s stomach upset, 13% that it’s a cold; 12% claim to have a headache, 6% a medical appointment; 5% blame it on a bad back. The rest cite a variety of reasons, from housing problems to the illness of a loved one or the death of a beloved relative, for not showing up for work. None of it is true. What’s going on? In most cases, nothing more than an intense stress reaction forces 19% of workers to call in sick, yet as many as 93% feel compelled to lie to their boss and coworkers about the real reason for missing work.

Although employees are willing to go to great lengths to cover up their dangerously high stress levels, the vast majority do not like having to lie: 70% say that they long to be able to discuss stress with their employers. While some try, most can’t seem to find the courage to bring it up and remain hopeful that their boss will make the first move and approach them directly when they show signs of strain. Few employers do.

Millions of people experience unmanageable stress at work, and the fact that so many people feel forced to lie about it rather than finding a solution should be a major concern for our businesses. If employees don’t feel they can be honest about the pressures on them, problems that aren’t addressed can quickly snowball into low morale, low productivity and high sick leave. We’d urge employers to encourage a culture of openness at work so they can solve problems now, rather than storing up problems for the future.–Paul Farmer, Mind Research

These sobering statistics were published in a study released by the British mental health research group Mind, an organization which campaigns vigorously to promote and protect good mental health and advocates that people with experience of mental distress are treated fairly, positively and with respect.

Not being able to come clean clean on workplace stress claims its toll: 62% of employees feel their bosses aren’t doing enough to look after the well-being of their staff and resent this apparent neglect. One in five becomes physically ill from stress, but only 10% seek help from their doctor or from a counselor on specific issues of stress. Doctors and therapists are often told a different reason, at least initially, for the symptoms the individual may be experiencing.

Stress-related symptoms still appear to carry a stigma in the workplace, as stress may be associated, at least in Western cultures, with a negative perception of one’s ability to manage a heavy workload. In this day and age, the fear of being perceived as a stressed out (and therefore unproductive) worker may have the power to trump honesty and reasonable self-care.

Stress Like an Egyptian

hosni-mubarakPower stresses. Absolute power stresses absolutely. This easy paraphrase of a famous saying about the corruptive effect of political power can perhaps convey the enormous stress that tyrannical political power can cause at the micro and macro levels of a nation-state. The classic fight-flight-freeze stress reaction is magnified by the stark reality of the actual physical danger, and enormous emotional cost, that comes with ruling a country with an iron fist. An absolute ruler is nearly always unloved, feared, and only forcibly respected by his immediate entourage and of course even more so by his countrymen at large. This must be Mr. Hosni Mubarak’s plight right now, as his country of Egypt is in the throes of a more or less peaceful, and some say long overdue, revolution to overthrow his 40-year-old quasi-dictatorship. How is he coping?

The 82-year-old Mr. Mubarak is nothing if not a survivor of trauma. A seemingly perennial victim of acute traumatic stressors, he has survived three wars, an Islamic uprising and multiple assassination attempts. His beloved 12-year-old grandson, Muhammad, died suddenly of a brain aneurism. He came to power on October 7, 1981 when the president of Egypt, Mr. Anwar el-Sadat was assassinated not three feet away from then-vice president Mr. Mubarak in a hail of gunfire and grenades. It is possible that, since that day, Mr. Mubarak may suffer from posttraumatic stress disorder (PTSD).

This seminal traumatic event, and the others that followed, may have engendered in Mr. Mubarak a strong desire for safety and stability above all else. In the current circumstances, he has reacted to the calls for his resignation in true-to-character fashion with a staunch change-resistant response, which one Arab official has called, “his reflex adherence to the status quo.”

It is perhaps not coincidental that President Obama told reporters he believes that Mr. Mubarak’s decision not to seek reelection may represent an important “psychological break” that could transition the Egyptian president out of power. The decision must not have come easily for Mr. Mubarak, and must have required a significant departure from his usual modus operandi of maintaining the safety of the status quo.

Mr. Mubarak appears to have rationalized his deep-seated aversion to change and his need to ensure survival and safety for himself, his family and the country he rules, with a near-absolute belief that he is the only person who can guarantee Egypt’s political, economic and social stability. It is nothing short of a psychological drama that he is now the focus and the very symbol of Egyptian crisis, the very instigator of chaos on the streets and political and economic turmoil.

For 40 years, Mr. Mubarak has lived in splendid isolation from danger in the presidential palace in Cairo or at his private residence in the seaside community of Sharm el Sheik, both heavily guarded by a corps of bodyguards. His acquaintances describe him as a man who does not show emotion, who can be forceful and aggressive in pursuing his views, but maintains a near-absolute control over the privacy of his feelings. As if the world around him was just too dangerous to risk betraying the slightest hint of weakness.

The Stress of… Stress

ClareIsland_EN-US2748591595There are times in which the stress reaction and the level of anxiety caused by a stressor are so high that the body’s reactions become extreme and add to the burden. Stress becomes stressful in itself and a problem of its own. Although the stress reaction itself is normal and necessary for survival, learning and for personal growth, the body’s reaction to the increased alert level causes a predictable and rather universal set of physical changes. These include:

  • Increased central nervous system activity—a state of full awareness
  • Increased mental activity and brainwave activity—full mental alert
  • Increased secretion of adrenaline (epinephrine), noradrenaline (norepinephrine), and cortisol into the bloodstream—a state of endocrine mobilization
  • Increased heart rate, cardiac output, and blood pressure—the way in which the body prepares to meet the physical demands of the stressor
  • Increased breathing rate, breathing airways dilation—brings more oxygen into the lungs
  • Increased metabolism, oxygen consumption, oxygen to the brain—oxygen is the principal sustainer of life for brain cells and for the whole body
  • Blood is diverted away from the digestive tract and directed into the muscles and limbs—the processing of food become secondary to averting or confronting the danger
  • Increased muscle contraction, which leads to increased strength—for either fight or flight, muscle readiness is automatically brought to the highest levels
  • Increased blood coagulation (blood clotting ability)—helps the body minimize the impact of possible injuries
  • Increased circulation of free fatty acids, a source of cellular energy—contributes to the readiness of the body to greater energy expenditure
  • Increased output of blood cholesterol—makes the blood richer in nutrients to be carried to muscles and other organs
  • Increased blood sugar released by the liver, to nourish the muscles—another important source of energy for best performance and strength
  • Release of endorphins from the pituitary gland—an activating hormone that boosts alertness throughout the body
  • Pupils of the eyes dilate—increases field and acuity of vision
  • Hair stands on its end—a remnant from the time when hair covered the most vulnerable body parts
  • Blood thins—this speeds up blood circulation for faster travel from center to periphery and back
  • Sweat glands increase secretion—a well lubricated body presents a slippery surface in a fight and cools it down below dangerous heat levels
  • Increased secretion from apocrine glands resulting in foul body odor—designed to repulse enemies
  • Capillaries under the surface of the skin constrict with a consequent increases in blood pressure—blood pumping to all parts of the body is enhanced
  • Immune system is suppressed–the immune system may have energy made available for it via reduction of other activities, may change in energetically conservative ways when the protection it confers needs to be balanced with the energetic demands of other activities such as fight or flight, or may be suppressed when other activities are more important than immunity for total well-being
  • Reproductive and sexual systems stop working normally—in times of high stress, sex and reproduction take a back seat to survival and protection
  • Decreased perception of painthe analgesia system, a pain suppressing mechanism that effectively shuts off sensory transmission to the brain, so that we are permitted to go about the business of getting out of the gravest danger without the crippling sensations of pain.

Stressed_WomanNo command is needed to activate these reactions that are programmed in the genetic code. Moreover, they cannot be prevented from occurring, except to a limited extent. At best, one can learn to control what is visible to others and, in some individuals, the heart rate can be somewhat controlled.

This cascade of physical reactions is good in two ways. First, when there is a danger or threat of some sort (e.g., a bus coming straight at us) we are instantaneously aroused into action: we step out of the bus’s path without really planning to do so, automatically. In this way, we have a chance to avoid and/or survive many physical threats to our well being. This ability enabled a  physically weak human race to survive and thrive among larger and stronger animals, earthquakes, fires, and interpersonal conflict during our long history on this planet. Can we imagine surviving very long without the mobilization caused by the stress reaction alarm system?

Second, we are programmed to respond not only to physical threats but also, and more importantly in our society, to non-physical threats that are emotional, social or psychological in nature. This is of great value because most threats nowadays come from circumstances of social living, such as relationships, jobs, economics, politics, environment, and technology.

Unfortunately, the stress reaction can be so overwhelmingly strong that we become stressed by stress itself, incapable of moving beyond its mesmerizing message of danger. Changing back the focus from the stress reaction to the stressor is the key to making an appropriate use of this vitally important warning system. It is also the key to responding vs. simply reacting. Learn this, and stress becomes the alert system most useful in navigating the treacherous straits of modern life.

The Changing Face of Stress: Who Me? Worry?

14938596 Worried_Bernanke

There is a new way of managing stress and it’s called “don’t worry, be happy!” Yes, I know the Bobby McFerrin song that hit #1 on the charts before the French Revolution, that is, way back in 1988. This is 2010, however, and it’s way more than just a popular song.

It is the new creed of the Why Worry Generation, as it has been aptly named, which is also known as Generation Y or simply Generation Me. It is composed of the young people who grew up in the boom-and-bust years, that have known Columbine, September 11, and the biggest recession since the Great Depression. They have seen their parents lose their jobs, their bank go bust, their family savings evaporate; many have had their homes foreclosed. They have also experienced the skyrocketing cost of school, saw gas seesaw up to almost $5 per gallon and back. They have seen Katrina, the big spill in the Gulf. They have lived through Desert Storm, Iraq, Afghanistan. Many have died or been wounded there or know someone who did.

And yet, they are optimistic. They are positive about the future. Despite the fact that there are no jobs available. That the graduating classes of ‘08, ‘09, and ‘10 have had an increasingly hard and frustrating time in finding any decent job, let alone a good paying one or one with career advancement opportunities. That their parents and anyone older than 40 is walking around with good reasons to be gloomy and depressed.

These young adults seem to exude positive self-regard, ooze self-esteem, and a resilience that older generations may dismiss as foolish and reckless. Their self-confidence seems unfazed by having to live at home instead of getting their own place, or even having to move back into their parents’ home after a brief stint on their own.

There is another explanation for this resilience in the face of a steady barrage of bad news. It may be the result of adjusting to high stress levels and, over time, building up tolerance for change and uncertainty. This is what is predicted for individuals who are able to accept and rationalize adversity and turn it into a learning experience, instead of being destroyed by it. It is the ability to use the stress reaction to produce an adequate response to challenging circumstances.

So unlike the Greatest Generation, the Millennials, and of course the Baby Boomers, this generation is making good use of stress, making the changes that are called for, and refusing to worry or to feel sorry for themselves. Way to go, guys!

Stress, Women and Sound Sensitivity

SH Stress Women and SoundCourtesy of Stockholm University’s Stress Research Institute, a new study indicates that stress may make exhausted women over-sensitive to sounds.  The research offers evidence that women suffering from stress-related exhaustion exhibit hypersensitivity to sounds when exposed to stress.  In some cases, a sound level corresponding to a normal conversation can be perceived as painful.  This according to a study from Karolinska Institutet and Stockholm University’s Stress Research Institute which tested sensitivity to sounds immediately after a few minutes’ artificially induced stress.

The study, which is published in the online scientific journal PLoS ONE, involved exposing 348 people (208 women and 140 men) between the ages of 23 and 71 with low, medium or high levels of “emotional exhaustion” to five minutes of experimentally induced physical (hand in ice), mental (performance on a stress test) and social (being observed) stress.

The results show that women with a high level of emotional exhaustion exhibit higher sound sensitivity after an experimentally induced stress exposure than those who were not exhausted.  Some even experienced sound levels as low as 60 decibels, the level of normal conversation, as uncomfortably loud.  People with a low level of exhaustion, on the other hand, became less sensitive to sound immediately after being exposed to five minutes’ stress, a phenomenon that the researchers describe as “shutting their ears” – a normal stress reaction.  The same trends could be observed in men, but the differences were not statistically significant.  The researchers also point out that, interestingly, there was no difference in sensitivity to sounds between the groups prior to the stress exposure.

“When you are hypersensitive to sound, some normal sounds, such as the rattle of cutlery or the sound of a car engine, can feel ear-piercing,” says Dan Hasson, Associate Professor at Karolinska Institutet’s Department of Physiology and Pharmacology and affiliated to Stockholm University’s Stress Research Institute. “Given how common it is for people to work in environments with different kinds of disturbing sounds, this hypersensitivity can be really disabling for certain individuals.”

An earlier study by the same research group shows that some 32 percent of working Swedes report some form of auditory problem (impaired hearing, tinnitus or both). It has already been established that stress is linked to hearing problems, although the mechanisms are not fully understood; the present study, however, is the first to demonstrate empirically a direct association between experimentally induced stress in humans and hypersensitivity to sounds.

Can Environmental Stress Control Our Genes?

A_coign_of_vantage Environmental stress can destroy protective complexes in human cells and turn on or off selected genes, newly published research shows. External stress agents appear to “instruct” certain enzymes to modify gene behavior, whereby genes that should remain turned off are activated and disturb the development, functioning and growth of human cells. According to Dr. Simmi Gehani, principal researcher at the University of Copenhagen where the study was conducted, this means that external stress factors can control the activity of our genes.

Why is this important? The specific knowledge of how our genes are regulated is important in order to understand how stress can lead to development of disease. The genetic code contained in our DNA is the same as in the over 200 cell types found in our body. Based on the “instructions” contained in our DNA, individual cells develop in different and highly specialized ways. Many genes are only active at specific times during fetal development or in specific cell types in the adult body. The natural deactivation of certain genes at specific time points ensures normal development and maintains proper cellular identity and function.

The new research findings, published in the latest edition of Molecular Cell, show that stress-activating factors can turn on genes that were supposed to remain inactive. These external stress factors are pollution, tobacco smoke, alcohol, drugs, chemical contaminants, or bacterial toxins. They can put a significant stress load on cells, which must react to survive and maintain their normal function. These research findings may help explain the effects that environmental stressors can have on health and functioning.

Additionally, they may also explain the dangers of external stressors to the unborn. During fetal development, exposing human cells to a stress-activating agent can turn on previously inactive genes. This is significant because even small changes in gene activation can have disastrous effects in child development.

There is a widespread belief — often dismissed — that what happens during pregnancy can affect everything that a person becomes in life. This and other research, writes Annie Murphy Paul in her new book Origins: How the Nine Months Before Birth Shape the Rest of Our Lives, may provide evidence to support the claim.

Stress Relief: Taking Charge or Letting Go?

David_Marat Chronic stress can produce a feeling of being overwhelmed. It makes it difficult to shift perspective and see the stressor from a different angle. Rather than seeing stress as a useful signal and address the cause of it, the tendency is to focus on the stress reaction itself as something that can be just pushed away. The results are often the very opposite of what is intended: rather than going away, stress continues as a flashing light on the dashboard that just won’t shut off, while its cause continues to wreak havoc on the mind, the spirit and the body.

It doesn’t have to be this way. Taking responsibility for finding a solution to the stressor is the answer, of course. But how can it be done if all that we can see and feel are the emotional and physical symptoms of the stress reaction? The following are proven ways that can help in shifting perspective from the signal (stress) to its cause, the stressor itself.

Take Charge, List, and Delegate

When I ask general audiences if they can control their stress level to make it work for them, no more than half say they can. If I ask audiences of pilots or neurosurgeons the same question, they all say they can. –Esther M. Sternberg, M.D.

Airline pilots are trained to use the stress response as a useful way to monitor their own behavior. When a pilot flies an airplane through a storm, her heart races, her breath becomes shallow, and her attention is intensely focused on the job at hand. The pilot experiences to the fullest the physiological arousal that defines stress, without necessarily labeling the situation as stressful. Having done this before, the pilot knows what to expect, takes full charge of flying the aircraft and remains in control. On the other hand, the passengers aboard the aircraft may be far more uncomfortable because the plane is bouncing around and there isn’t anything they can do about it. They are stressed, and their racing heart, shallow breath, and intense focus on every bounce and every noise of the plane is coupled with the feeling of being at the mercy of the elements and in the hands of the pilot. Two similar situations, two very different stress reactions. The difference? Being able to take control.

Whenever possible, a shift of perspective can be facilitated by taking charge and exercising a greater control over our choices. When we believe we might be able to control a situation, and step up to try and resolve it, chances are that the very act of acting on it reduces our stress levels. We are finally doing something about it, and it feels good. Have you noticed how the toothache seems to go away, at least to some extent, when we arrive at the dentist’s office? Or our problems take a different, and often less dramatic tinge, when we open up and just talk to someone about them?

Another useful technique for making use of stress signals instead of being overwhelmed by them is to make a list of the stressors that need to be addressed, and front-load it with the ones that can be taken care of quickly. As we check off accomplishments, the feeling of being in control rises and stress begins to ease. It is also useful to take the list a step further and classify each stressor into one of three categories:

  1. Stressors that can be eliminated by making a choice, e.g. taking time off from work, saying no to another request, getting out of a noisy environment.
  2. Stressors that can be reduced or modified, e.g. working on a relationship problem, cutting down on caffeine, lightening the work load.
  3. Stressors that cannot be eliminated or reduced and therefore have to be managed, e.g. working through a loss and the grief caused by it, searching for a job, taking care of our own or a loved one’s illness.

A third technique is delegating, not just to coworkers but also to children, spouse, and friends. This may be difficult, as it appears to contradict the previous suggestion of taking charge of the situation. While taking control is a good stress reliever, it requires moderation and good judgment. One’s anxious need to be in direct personal control of everything at all times, or at least attempting to gain it, can create a stress of its own. Our finite resources of time, energy, and motivation can become exhausted. Anxious control ceases to be a step toward resolving our stressors, and can simply become an attempt to reduce our anxiety about getting everything done. Delegating is the answer.

Accepting That Life Is…Well…Stressful

No one can control everything. A child’s schedule may inevitably conflict with a work deadline. Bad weather may flood the picnic. There are literally thousands of situations when one task interferes with another, is interrupted, must be postponed, or ends up producing unexpected results. Is this because of poor control skills? Sometimes that is the case, but more often than not life is just full of surprising and unexpected turns.

Chronic stress can have a physical impact on the body. Interrupting the sequence of stressful moments with moments of calm and relaxation, i.e. letting go instead of taking control, can lessen that impact. This letting go may at times feel counterintuitive but it produces results. When a series of crushing deadlines looms at work, we can take some time off in between them. A weekend at the beach or the mountains can do wonders for the equilibrium. Distracting oneself with something soothing, such as cooking, knitting, or breaking out the watercolors can bring a smile to our face and a balm to the soul. And if taking off an entire afternoon is just not in the cards, just getting out for a walk can be a powerful stress reliever. Even a short stroll can make a difference.

Faith And Stress: The Connection

My view is that "bad" stress is handled through scripture, prayer, and faith. That is not naïve but a way to perceive the circumstances of life which would invade our peace and joy. –Doyle Kee

Hurricane at The belief in the existence of a supernatural being who has
a plan for each human being, and the opportunity to connect with others who share the same belief, can be powerful relievers of the stress of life. The psychological appeal of faith is beyond dispute: there are over 100,000 registered religions in the United States alone, and membership is constantly on the rise. An even greater number of people accept a form of personal spirituality which includes the belief in a higher being, without subscribing to any one specific movement.

Religious belief and affiliation appear to rise significantly in times of severe stress. Some of history’s most prominent, and some of the most unusual and charismatic, religious movements have arisen in times of great political, economic and societal turmoil. In times of war, widespread famine, poverty and natural disasters, and impending death and illness nearly all religious groups have seen and continue to see their appeal grow.

Sigmund Freud, in his book on The Future of an Illusion admitted, without accepting it, that faith in God could reduce psychological stress. Carl Marx famously stated, “religion is the opiate of the masses” in the introduction of his book Contribution to Critique of Hegel’s Philosophy of Right. And we can certainly consider the meaning attached to faith by the 9/11 suicide bombers who went to their death (and took many with them) as a testament to the power of their religious fervor.

The Connection Between Faith and Stress

Research has shown that faith in a supernatural being, with all its corollaries and attributes, appears to be particularly effective in relieving certain specific psychological stressors. Here are the most important ones:

  • Psychological and physical escape from stress: religious organizations offer physical as well as spiritual shelters where food, clothing, and healthcare are available, along with social support, structure, and spiritual guidance.
  • Consolation, devaluation of and disassociation from the illusory trappings of the material world, and the ephemeral appeal of beauty, money, success.
  • Appealing models of resilience and positive outcomes in the face of life-threatening stressors.
  • Cognitive and dialectical techniques that are useful in coping with stressors, such as individual prayers, group rituals and collective petitions. Nearly all religious movements provide ways of giving voice to individual and collective distress, including the fast-growing Internet-based churches.
  • Explaining the inexplicable: in a world that seems ruled by chaos and administered by randomness, faith in a superiorly organized universe is an appealing provider of stability. By prayer, penance, code, dietary laws, rituals, or positive thinking, faith-based movements promote a sense of personal control.
  • A meaning to life and to life’s end. Faith can promote a hopeful and optimistic outlook with its emphasis on a more peaceful (and stress-free) existence and its promise of life after death.
  • A refuge from aloneness and abandonment. The profoundly comforting sense of belonging to a community of mutual love and support, and the incomparable feeling of being loved unconditionally by someone who epitomizes love and trust are perhaps the most appealing attributes of faith.

As an intensely personal experience, faith remains beyond the investigation by scientific means. In psychological terms, faith can positively influence us in cognitive and emotional terms, in the way we come to perceive ourselves, our world, and our future. When embraced sincerely and whole-heartedly, it can become an important protective factor against the effects of stress in our lives.

Sleep More, Stress Less, Live Longer

iStock_000007980637XSmall 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


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?


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.


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!


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.


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.


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.


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.

Deflation: Chronic Stress on a National Scale

Palmyra_EN-US856764098"The economy isn’t recovering fast enough." One of the principal reasons is that sales of anything, from houses to double no-foam lattes, are down or flat across the board. American consumers are worried about their personal financial health, their jobs (or lack thereof), their families’ future, the sorry state of the economy, gridlock in Washington, and the fear of another bank/mortgage/stock market crash.

The piling up of this real heap of trouble over the last couple of years has caused most Americans to go into stress reaction mode: fight, flight or freeze. The evidence is mounting that most are choosing to freeze. Businesses that sell goods and services report flat or lower sales to fewer buyers. In a so far vain attempt to get the consumer economy moving again, prices have been and continue to be reduced through special offers, discounts, two-fers and other creative ways meant to entice more buyers.

As consumers refuse to take any risk, either because of their worries or simply waiting for prices to fall further, deflation may now be setting in. Deflation is the opposite of inflation and defines a situation when prices are mostly falling, sales stagnate or fall, with "lower business profits, which lead to layoffs and lower consumer spending and further price declines. [Deflation] makes it more difficult to pay off debt because the value of debt rises relative to income. It provokes hoarding, as consumers, businesses and banks hold on to cash, expecting that prices will keep falling," as characterized by the New York Times. In short, the paralysis of freeze

So it is that unending economic turmoil since 2008, record-high job losses, stagnating or falling employment, and the double-whammy mortgage/foreclosure crisis appear to be provoking one of the most severe stress reactions in generations, in individuals, families, and businesses across the nation. While a few are now fighting to get the economy moving again, a significant number may have left the fight and given up trying, and many more still could be just frozen in place, unable to move forward with their decisions, investments, and major purchases.

As understandable as it may be, this nationwide stress reaction is just what it is, a reaction. It is not a formulated response against a severe and persistent set of stressors, which would require the exercise of sound judgment, decision-making and risk-taking. Instead, the risk to the US economy is that this reaction may become chronic and take years before progressing toward an effective response.

The red lights are flashing and the alarm bells are ringing, urging meaningful action that will address the emergency. Not much appears to be happening. Until the paralysis of freeze is overcome and a real response begins, the alarm bells will continue to ring, while deflation takes hold. Chronic stress, on a national scale.

When Stress Hurts: Neurochemistry Cognates

In this third post in the series on the close association between psychological stress and psychogenic pain, we take a look at neurochemical substances that are involved in the process of psychogenic pain generation and reaction to psychological stress.

The Neurochemistry of Pain: Substance P

aaGiotto_DeposizioneSubstance P, discovered in the 1950s, is the quintessential pain neurochemical, which is activated in response to physiological pain as well as to psychological stress (DeVane, 2001). It is a prototypic neuropeptide of the tachykinin family that has been linked to the production of over 50 neuroactive chemical substances (Brain & Cox, 2006). Its best documented role is as the modulator of signals to nociceptive neurons that communicate the intensity of noxious or adverse stimuli, not only those caused by pain but also those produced by psychological stress (DeVane, 2001; Shaikh, Steinberg, & Siegel, 1993). Substance P receptors are found throughout the CNS but especially in the substantia gelatinosa of the dorsal horn, which is the first point of arrival of afferent pain signals to primary nociceptive fibers.

It is not coincidental that Substance P is also present in the limbic system of the CNS, in the hypothalamus and in the amygdala, all structures that are closely associated with the perception and processing of emotions (Bannon et al., 1983; Culman & Unger, 1995; DeVane, 2001; Stahl, 1999).

Some purely psychological and psychogenic reactions of the organism also see the involvement of substance P, such as the vomiting reflex, anger and defensive behaviors (Krase, Koch, & Schnitzler, 1994), changes in cardiovascular tone (Black & Garbutt, 2002), stimulation of salivary secretions, and other physiological responses that are associated with the general adaptation of the body (Selye & Fortier, 1950) to stressful stimulation.

Kohlmann and colleagues (1997) reported the discovery of substance P in blood pressure regulation in individuals with essential hypertension, a condition that has been related to maladaptive responses to stress (Palomo et al., 2003) and has been shown to respond to psychotherapeutic interventions (Amigo, Buceta, Becona, & Bueno, 1991). Other evidence of the concurrent role of substance P in signaling pain and in the stress reaction comes from animal studies that show an array of defensive behavioral and cardiovascular changes in animals subjected to stressful stimulation (Krase et al., 1994), as well as the detection of substance P in the amygdala of laboratory animals upon neonatal separation (Kramer et al., 1998).

The Neurochemistry of Stress

The neuroendocrine response to a real or perceived stressor consists of the near simultaneous release by the sympathetic nervous system (SNS) of the catecholamines norepinephrine (NE) and epinephrine, the release by the hypothalamus of corticotrophin releasing hormone (CRH), the inhibition by the hypothalamus of gonadotropin releasing hormone (GnRH) and pituitary gonadotropins, the release by the pituitary gland of prolactin (PRL), and the release by the pancreas of glucagon (Sapolsky et al., 2000).

Upon release of NE into the synaptic cleft, approximately 10% of it enters the plasma, thus making plasma NE levels one of the most reliable measures of SNS activity and the magnitude of the body’s response to stressors. Peroutka (2004) has proposed that a migraine attack may be triggered by a significant decrease of NE due to the excessive or prolonged release of adenosine, dopamine and prostaglandin by the over-stimulated SNS. Since sympathetic activation is the primary component of the stress response, stress is thus unequivocally linked to the onset and maintenance of migraine headaches.

The Closest Association: Stress-Induced Analgesia

Livingstone_LionRThe body’s reactivity to real or perceived stressors provokes measurable changes in the autonomic nervous system (ANS) and in the structures controlled by the hypothalamic-pituitary-adrenal (HPA) axis. These changes include blood pressure elevation, pupil dilation, and secretion of cortisol. In the presence of a significant stressor, the stress response also includes a “stress induced analgesia,” or a decreased sensitivity to further pain (as writer-explorer David Livingstone so eloquently reported). This antinociceptive action of the ANS translates into an inverse relationship between blood pressure and pain sensitivity in animals and humans, and is designed to maintain the integrity of the body’s defense systems. Additionally, the release of CRF by the hypothalamus has known analgesic effects (Okifuji & Turk, 2002).

The ANS was recognized by Cannon (1914; Cannon, 1933) as the originator and enabler of the “fight or flight” response to stress. Stress-related releases of adrenaline stimulate the feedback provided by the afferent and efferent vagal fibers. Once again, these same fibers are involved in the activation of endogenous pain modulation centers (Bielefeldt, Christianson, & Davis, 2005). Pain and stress just seem to go together.

Previously in this series:


  • Psychological Stressors and the Sudden Appearance of Psychogenic Pain
  • Fibromyalgia, Severe Headaches and Other Stress-Related Misery
  • Medical and Non-Medical Treatments for Stress and Psychogenic Pain