How is talking about my problem going to help? 10 reasons why it is better than not talking at all.

1. Talking about issues forces us to put them into words and thus can focus the mind on important details of the problem. This works very well in all circumstances, but especially if you have trouble concentrating your attention or if your thoughts and feelings about the issue feel like they are all jumbled together. Talking about thoughts and feelings helps bring more clarity to the situation and may be of significant help in coming up with possible solutions.

2. Telling the story to someone else, instead of just telling it to yourself over and over (also known as ruminating), helps you sort out what is often a confused mix of thoughts, emotions, opportunities and challenges. In solving a problem, the first step is to lay out as clearly as possible its dimensions, i.e., its scope, frequency and intensity. Talking about it helps you take this first step much more efficiently.

3. Talking about something that is heavy on our mind help release tension. Most people say that they feel better, and think more clearly, after they’ve had a chance to talk about a bothersome issue. Although just talking about the problem isn’t per se a solution, it is that crucial pre-requisite to finding just the right approach to solving it.

4. Talking is often perceived as an unburdening of the mind. The exploratory process that is inherent to putting things into words not only helps a person understand subtle and often unnoticed emotions, but it also helps in discovering alternative ways to manage strong and often uncomfortable feelings.

5. Talking to someone who’s a good, unbiased listener puts the talker in a position to receive someone’s care, compassion and undivided attention. Any problem is usually made much worse if we feel misundesrtood and uncared for. There are times in which keeping things to one’s self (perhaps motivated by a false need for privacy) may be the worst possible choice.

6. Talking opens up the possibility of receiving some useful advice. It is hard to see things clearly and objectively from within (as in, “not seeing the forest because of all the trees”). Moreover, none of us have all the experience and wisdom needed to address a situation in the most effective way, especially when we are stressed, tired, depressed, or anxious. Talking to someone who’s trained to listen and to counsel may not be the easiest thing to do, but it is almost invariably one of the best choices.

7. Talking and exploring the problem with someone else can help develop ideas and look at all possible strategies and solutions. You’ve heard the saying, “there is nothing new under the sun.” This happens to be true of all things human. Chances are, your problem has been successfully solved by many other people with the same challenges and in the same circumstances. Talking about your particular situation may allow you to take advantage of someone else’s experience.

8. Talking to someone relieves feelings of isolation and aloneness. These feelings are often caused by the very special circumstances or characteristics of the problem itself, which can give us the impression that “nobody would understand it.” This feeling can cause a person to isolate, refuse to address the issue, or resort to alcohol or drugs in an ill-advised attempt to get some relief. Talking is a much safer and more effective solution.

9. Talking about a serious issue with a professional makes you feel better very quickly. The very fact that you’ve taken the steps to make the appointment, go to the counselor’s office, and talk about your situation has an immediate beneficial effect. Most people report “feeling much better” after the very first session of counseling.

10. It’s better than medication alone. Major studies have found an effect size (which is a measure of treatment benefit) of up to 0.97 for talk therapy. For antidepressant medication, the average effect size is 0.31.

The Stress of Unbelief and the Courage of Faith

Not believing in anything beyond our finite life can be stressful. However, believing in a higher power and life beyond our earthly existence can also be stressful. How can these two radically opposed worldviews lead to the same outcome of stress? The obvious answer is that being alive and conscious is in itself a source of stress. Beyond the obvious, however, there are more subtle reasons for the stress caused by unbelief and belief alike.

Why not believing can be stressful

A fundamental tenet of unbelief in a higher power and life beyond death is that the purpose of life is life itself. In this view, there is no point in relying on outside help or comfort of a supernatural kind, because there is no entity out there to provide such help or comfort. Thus, the unbeliever believes that instinctive reactions and determined responses to life’s challenges produce either a positive or a negative outcome due to the simple interaction of forces within one’s self and in relationship to other people. In this view, chaos and randomness may reign supreme in helping provide an explanation as to why stressful situations occur.

A sense of powerlessness against fate, circumstances, random events, unpredictability can make the life of the unbeliever very stressful, at times. At other times, a sense of inner power due to the development of intellectual abilities, particularly good choices, clever decisions, and a good measure of luck can help carry the individual through difficult and stressful times and on to successful outcomes.

Successful outcomes can help promote the idea that one is the sole author of one’s destiny as well as the idea that unsuccessful people simply have not made the right decisions or have not developed their skills to the level necessary to achieve success. The most frequently used measures of human success are plainly visible: money, status, homes, cars, jewelry, fame and recognition, influence and power over others. The appeal of these measures of success is so powerful on the human psyche that many believers in a higher power and in life beyond have at times sought to incorporate them into a set of religious beliefs in spite of even the most glaring contradictions. This may help explain why Islam, a set of beliefs centered around peace has at times become synonym with terror and war.

In the Koran, therefore, the only permissible war is one of self-defense. Muslims may not begin hostilities (Koran 2: 190). Warfare is always evil, but sometimes you have to fight in order to avoid the kind of persecution that Mecca inflicted on the Muslims (2: 191; 2: 217) or to preserve decent values (4: 75; 22: 40). The Koran quotes the Torah, the Jewish scriptures, which permits people to retaliate eye for eye, tooth for tooth, but like the Gospels, the Koran suggests that it is meritorious to forgo revenge in a spirit of charity (5: 45). Hostilities must be brought to an end as quickly as possible and must cease the minute the enemy sues for peace (2: 192-3). –Karen Armstrong, Time Magazine

In a different manner, certain Christian leaders have promoted, and many continue to promote, the idea that earthly possessions, success and power can be an integral part of the life of the Christian believer, and that they are indeed to be pursued since the attainment of these measures of success may imply that multiple blessings are being bestowed by God to those who truly believe.  Herein lies a major source of stress for the unbeliever, or for the believer who chooses to focus on earthly achievements: in their absence (when illness, unemployment, poverty, disability, or financial reverses strike one’s life in spite of every best effort) there is no explanation available, nor is there any source of comfort or hope beyond the visible, the immediate and the tangible that may be available within one’s resources.

The courage to believe

In looking at the opposing view, faith in a higher power and in life beyond can also be stressful.  By definition, faith is a set of beliefs that does not rest on logical proof or material evidence. This virtually complete absence of visible proof is probably the reason why our faith can waver, ebb and flow with the circumstances, or even disappear altogether. Faith appears to run counter to how humans experience their life on this earth, i.e. as tangible, visible and immediate. Since faith has none of these attributes, its maintenance in the face of life’s many stressors becomes a matter of courage.

Courage is the presence of something that can transcend fear. Thus, courage is not the absence of fear. If that were the case, any foolhardy behavior could be called an act of courage whereas very often it is simply a product of ignorance, carelessness, disregard of common sense, substance abuse, or plain stupidity. Courage, therefore, appears to presuppose the presence and the awareness of fear in order to truly exist. Ask any combat veteran, any rescuer or any first responder and they will tell you that, in the moment, they were able to set their fear aside, manage it and act courageously in spite of it.

Faith has at least one feature in common with courage. It too presupposes the presence of something else in order to truly exist. That something is the awareness of doubt and the ability to manage it and to set it aside. I believe this may be the reason why faith that is allegedly without doubt and its awareness is often called blind, fanatical and sectarian. In the name of blind faith, acts can be committed that may clearly contradict its tenets, often without insight or awareness, or with intentional, callous disregard for them.

It takes courage to believe in spite of contradictory evidence or the lack of evidence altogether. It takes courage to manage doubt and to continuously recommit one’s existence to a higher power. It takes courage to rely on the help, hope and comfort that seem to come from nowhere at all. It takes courage to read or hear words that were written or spoken long ago, in far away places, and believe in their validity, reliability, and trustworthiness in our life today.

This type of courage is stressful, because faith itself is stressful. Faith without the courage to doubt and the ability to set doubt aside is blind.

A man of courage is also full of faith. –Marcus Tullius Cicero

Does Faith Help Prevent Depression?

There have been numerous reports in the medical press about the beneficial effects of faith-based beliefs as having a positive influence on stress, depression, and other behavioral health conditions, as for example a 90% decrease in the risk of major depression, assessed prospectively, in adults who reported that religion or
spirituality was highly important to them. There is evidence that this beneficial effect is independent of frequency of church attendance, which has not been positively related to depression risk. Brain imaging findings in the adult children of high-risk families conducted at Columbia University have revealed large expanses of cortical thinning across the lateral surface of the right cerebral hemisphere, which are due to the effect of depression on these brain structures.

To determine whether high-risk adults who reported a high importance of religion or spirituality in their lives actually had thicker cortices than those who reported moderate or low importance of religion or spirituality, researchers at Columbia conducted a new study of 103 adults (aged 18-54 years) who were the second- or third-generation offspring of depressed (high familial risk) or nondepressed (low familial risk) individuals. Religious or spiritual importance and church attendance were assessed at 2 time points during 5 years, and cortical thickness was measured on anatomical images of the brain acquired with magnetic resonance imaging at the second time point.

The results of the study show that, in individuals who cited religion or spirituality as important, and did not specify a high frequency of church attendance, thicker cortices were observable in the left and right parietal and occipital regions, the mesial frontal lobe of the right hemisphere, and the cuneus and precuneus in the left hemisphere, independent of familial risk. In addition, researchers report that the effects of faith importance on cortical thickness were significantly stronger in the high-risk than in the low-risk group, particularly along the mesial wall of the left hemisphere, in the same region where they previously reported a significant thinner cortex associated with a familial risk of developing depressive illness.

Although the researchers note that these findings are correlational and therefore do not prove a cause and effect association between importance of spirituality in a person’s life and cortical thickness, it is nevertheless evident that a thicker cortex associated with a high importance of religion or spirituality may have beneficial effects and help prevent the development of depression in individuals at high familial risk for major depression.

“Our findings therefore may identify a neural pathway through which the personal importance of spirituality or religion protects against major depressive disorder in people who are otherwise predisposed to developing it,” the researchers concluded.

“This study points to measurable, beneficial effects of presumably healthy spirituality, especially for individuals with biological predispositions to depression,” Mary Lynn Dell, M.D., told Psychiatric News. She is a professor of clinical psychiatry and pediatrics at Nationwide Children’s Hospital and Ohio State University and has studied spirituality and religion. The study, she continued, “adds to substantial and growing evidence that psychiatrists should support healthy development in that sphere of patients’ lives. Studies such as these may also inform the particular ways and methodologies religious professionals…employ to care for and work with depressed individuals, while at the same time staying true to their particular religious beliefs and traditions.”

How To Manage Stress in 90 Words

1. Stress is a necessary, useful part of life. EMBRACE IT.

2. Most stress is resolved in 1 of 3 ways: fight, flight or freeze. DECIDE WHICH IS BEST.

3. Stress triggers are known and predictable. BUDGET FOR IT.

4. Stress affects self-esteem/efficacy. WORK ON ITS CAUSE.

5. Stress affects mind and body. ATTEND TO BOTH.

a. Mind: SWITCH OFF AUTOPILOT AND MANAGE OUTCOMES

b. Body:
i. Use up nervous energy. EXERCISE
ii. Watch sugar/alcohol intake. NUTRITION
iii. Keep a notebook beside your bed. WRITE YOUR WORRIES DOWN AND SLEEP

Faith in God Positively Influences Treatment for Individuals with Mental Disorders

faith-healthBelief in God may significantly improve the outcome of those receiving short-term treatment for psychiatric illness, according to a recent study conducted by McLean Hospital investigators. McLean Hospital of Belmont, MA is the largest psychiatric affiliate of Harvard Medical School.

In the study, published in the current issue of Journal of Affective Disorders, David H. Rosmarin, PhD, McLean Hospital clinician and instructor in the Department of Psychiatry at Harvard Medical School, examined individuals at the Behavioral Health Partial Hospital program at McLean in an effort to investigate the relationship between patients’ level of belief in God, expectations for treatment and actual treatment outcomes.

“Our work suggests that people with a moderate to high level of belief in a higher power do significantly better in short-term psychiatric treatment than those without, regardless of their religious affiliation. Belief was associated with not only improved psychological wellbeing, but decreases in depression and intention to self-harm,” explained Rosmarin.

The study looked at 159 patients, recruited over a one-year period. Each participant was asked to gauge their belief in God as well as their expectations for treatment outcome and emotion regulation, each on a five-point scale. Levels of depression, wellbeing, and self-harm were assessed at the beginning and end of their treatment program.

Of the patients sampled, more than 30 percent claimed no specific religious affiliation yet still saw the same benefits in treatment if their belief in a higher power was rated as moderately or very high. Patients with “no” or only “slight” belief in God were twice as likely not to respond to treatment than patients with higher levels of belief.

The study concludes: “… belief in God is associated with improved treatment outcomes in psychiatric care. More centrally, our results suggest that belief in the credibility of psychiatric treatment and increased expectations to gain from treatment might be mechanisms by which belief in God can impact treatment outcomes.”

Rosmarin commented, “Given the prevalence of religious belief in the United States — over 90% of the population — these findings are important in that they highlight the clinical implications of spiritual life. I hope that this work will lead to larger studies and increased funding in order to help as many people as possible.”

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

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.

Mindfulness for Absolute Beginners

aaCarignano_SolferinoMindfulness 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).

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. 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.
  7. 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.

3 Good Ways of Responding To a Panic Attack

OBriensTower_EN-US194301618A panic attack ambushes the mind, the body, and the soul. Its targets are self-esteem, a balanced self-assessment and the ability to analyze situations and expected outcomes. When panic strikes, the present becomes a bleak landscape of dangers and the future includes a (seemingly) real possibility of annihilation. In the presence of a real (or perceived) significant stressor, one’s abilities to respond to the challenging situation becomes severely impaired. For the span of the panic attack, chest pains, shortness of breath, shaking, sweating, and even nausea and vomiting can give the sensations of impeding death. Can something be done to prepare for a panic attack with any degree of success?

One: Know Thyself

A first important tool is the ability to anticipate one’s own reactions, by getting to know them well enough so that they do not become stressors in themselves. Knowing the likelihood (and thus anticipating the possibility) of the physical sensations that go with feelings of panic (chest constriction, shortness of breath, increased heart rate, and sweating) may help avoid the distress that these symptoms can cause. The very fact of knowing that these physiological reactions will take place, and allowing them to happen as a natural and understandable reaction to a threat to our well-being, can be beneficial.

Two: Know About Panic

Panic attacks are about as close to feeling imminent death as one can get, as anyone who has experienced them in all their severity will attest. A panic attack occurs without anyone else’s intervention (usually no one else is present). It can be extremely frightening even when no real physical danger exists (it can strike a person comfortably seated in his or her favorite recliner). A panic attack, by definition, occurs without any clinical danger of death and cannot by itself cause death or serious injury. A the most, when it reaches a certain level, a panic attack may trigger a loss of consciousness through hyperventilation (prolonged shallow breathing). This usually resolves the physical symptoms by momentarily taking the brain out of the picture, whereby the body can returns to homeostasis. When the person comes to, usually the panic attack is gone just as suddenly as it came. Exhaustion is not infrequent at this stage, as a panic attack can be a real workout for the heart and muscles.

Three: Manage Your Response

BearAttackA useful tool in preventing the recurrence of panic attack is stress management. Allowing the body to react, in concert with the mind, to a situation that may objectively warrant fear, sadness or worry is not only strategically sound, it is also physiologically healthier. Just as courage is not the absence of fear but simply good fear management, allowing a naturally-occurring biopsychic reaction to a stressor is simply good stress management.

Thus, the key to successful panic attack management is not in denying or attempting to prevent the stress reaction, but in what to do next (our chosen response). After the initial physical reaction ebbs and subsides and the heart rate naturally returns to near-normal levels, the real stress management response has a chance to begin. This response should first and foremost consist of addressing the stressor that is causing the panic attack to occur.

3 Good Ways of Addressing Serious Stressors

Three options usually exists in addressing significant stressors:

  1. Eliminating the stressor that caused the panic attack to occur.
  2. Removing oneself from the stressful situation, if option 1 is not available.
  3. Reducing the impact of the stressor through relaxation techniques or good coping mechanisms, when options 1 and 2 are not available.

When Stress Matters Most, What Do You Do?

NeuschwansteinStress is the physiopsychological reaction to a challenge or a threat. It is particularly acute when the stressful event triggers the perception that one’s available resources are insufficient or poorly matched to successfully face it. Take for example our job, a purposeful activity that we engage in as a means of livelihood. On the job, our resources (finances, physical and mental abilities, time, image, and self-concept) are allocated and expended to adequately meet its demands, which carries great potential for stress. Being able to pay attention to warning signs of trouble, of which stress is certainly one of the most prominent, may make a difference in our ability to respond quickly and effectively.

Stress on the job is of the same kind as the threat of a saber-toothed tiger—not the same, but of the same kind. Should we ever find ourselves face to face with the feline, our body would instantly spring into full mobilization mode. The heart rate would go up, respiration would increase in depth and frequency, muscles would tense and pupils dilate, the stomach would contract, and adrenaline and other excitatory hormones would flood into the bloodstream. We would be faced with three possible choices: fight, flight or freeze.

When face to face with a job challenge of a serious nature (loss of a major client, a sudden promotion, the loss of the job itself, a major breakthrough), we are alerted to a threat and our body instantly springs into full mobilization mode, with the same biological changes as when in a close encounter with the wild cat. The threat or challenge may be very different, with linoleum under our feet instead of savanna grasses, but the body doesn’t care—a threat is a threat. We are faced with the same three possible choices: fight, flight or freeze.

Even when we know we are not going to suffer physical harm, the body can’t help but to prepare for the worst. Our chances of being killed by wildlife or to compete with the tiger for our lunch are abysmally small. The last saber-toothed tiger became extinct sometime between the Oligocene and the Pleistocene epoch. Yet, we humans continue to be instinctively and instantly mobilized when we perceive a threat of any kind. Which is a good thing.

The usefulness of stress throughout or history is undeniable. Many more of our ancestors would have been killed had they not perceived the appearance of predators as a possible threat. A great many probably did get killed when they chose the option to freeze. Others, owing to inadequate weapons, got killed while exercising their option to fight. And still others were not fast enough to take full advantage of the opportunity to flee. To be sure, one hundred percent of those who saw no threat in the approaching tiger and lingered to consider the size of her teeth, or in other words, those who felt no stress in the situation, were swiftly eliminated from the genetic pool by a process of natural selection.

Fast forward to the present, and General Motor and Chrysler executives must have felt pretty safe from the saber-toothed tigers of competition and market change, because up until the last minute they felt no real stress from their falling sales (except for SUVs) and dwindling customer base (except for SUV buyers). How many people lost their job in the current recession and never saw it coming? Or saw it coming and froze? Or didn’t flee soon enough, or did not fight for change? Stress told Ford executives to come up with a plan, a better plan as it turns out. One wishes that GM and Chrysler executives had felt a little bit more stressed out, a bit more mobilized into action, less complacent and relaxed. Stress is a bright amber light on the dashboard of our life that simply says, something requires our attention—NOW. More often than not, the light is right.

Widely Used, Unlikely Stress Reducer: Salt

Sunset at Sea, 1882There may be a very good reason for the impulse to reach for salt-laden foods and snacks. New research from the University of Cincinnati, reported in the April 6, 2011, issue of The Journal of Neuroscience, shows that elevated consumption of salt can reduce the body’s natural stress reaction. Sodium, the main ingredient of salt, inhibits the release of hormones along the hypothalamic-pituitary-adrenal (HPA) axis, which are released into circulation in reactions to stressors. More specifically, an elevated sodium intake limits the stress reaction by suppressing the release of the octapeptide angiotensin II (Ang II), which provides the major hormonal support of the growth and function of the zona glomerulosa of the adrenal cortex and the secretion of the excitatory hormone aldosterone. Conversely, higher sodium intake increases the activity of oxytocin, an anti-stress hormone.

Life stressors cause an immediate challenge to the body’s homeostatic balance, and cause physiological and psychological reactions that affect hormonal, cardiovascular, and behavioral responses. This new research examined the neural mechanisms underlying the stress reaction within the context of such a homeostatic challenge. The focus was on the impact of an elevated intake of sodium on the hypothalamic-pituitary-adrenal (HPA) axis, the cardiovascular system, and behavior in response to an acute psychological stressor.

Relative to controls whose sodium levels were normal, subjects with elevated salt intake showed a decrease in HPA activation in response to a psychological stressor. In addition, the increase in sodium also reduced the cardiovascular response and promoted faster recovery to pre-stress levels. Even more remarkable, subjects with increased sodium intake had significantly more oxytocin- and vasopressin-containing neurons within the supraoptic and paraventricular nuclei of the hypothalamus and greatly elevated circulating levels of oxytocin. The endocrine and cardiovascular profile of subjects with elevated sodium also produced a decrease in anxiety-like behaviors when they were put through a social interaction test.

The researchers concluded that the results single out sodium as a potent inhibitor of the HPA, cardiovascular, and behavioral aspects of the stress reaction.

Eat More Salt, Feel Less Stress?

Apparently, we are already doing so, by the millions of pounds. Americans have consistently consumed approximately 3,700 mg of sodium daily throughout the last three decades, or nearly 65% more than the recommended daily salt intake of 2,300 mg. Most restaurant food, prepackaged and processed food, deli food, table and bar snacks, and fast food are loaded with salt, sugars and fats. Sodium is added primarily as a flavor enhancer, but also to satisfy our hidden and very powerful salt appetite.

The downside of elevated salt consumption: too much sodium is a precipitating factor in heart failure, an increased risk for gastric cancer, a contributor to hypertension. In fact, the ill-effects of too much sodium consumption are so widespread throughout the body that salt-intake reduction is often one of the first approaches to the treatment of a variety of metabolic conditions. Could it be that this widely used (and tasty) stress reducer is not what it appears to be? Perhaps its “calming” and anxiety reduction effects—much like those of alcohol—come at a price that, if properly understood, we may not be willing to pay.

Angry? Aggressive? All You Need Is a Prayer

Pisa%20-%20Piazza%20dei%20Miracoli%20-%202Pray for Those Who Mistreat You: Effects of Prayer on Anger and Aggression is the descriptive title of a study published a few days ago in the peer-reviewed journal, Personality and Social Psychology Bulletin. According to its authors, Dr. Ryan H. Bremner of the University of Michigan, Ann Arbor, Michigan, Dr. Sander L. Koole of VU University, Amsterdam, The Netherlands, and Dr. Brad J. Bushman of Ohio State University at Columbus, prayer has a surprisingly strong and near instantaneous effect in reducing anger and aggression.

The study consisted of three experiments, which tested the hypothesis that the act of intentionally praying for others can significantly reduce anger and aggression after a provocation. In the first experiment, provoked participants who prayed for a stranger reported feeling their anger subside, whereas other participants who just focused their thoughts on a stranger did not report any lessening of their anger.

People often turn to prayer when they’re feeling negative emotions, including anger. We found that prayer really can help people cope with their anger, probably by helping them change how they view the events that angered them and helping them take it less personally.—Brad Bushman, Ohio State University.

In the second experiment, provoked participants who prayed for the individual who had angered them were less aggressive toward that person than were participants who just thought about the person who had angered them. In the third experiment, provoked participants who prayed for a friend in need reported acting less aggressively and feeling less anger than did people who simply thought about a friend in need.

These results are consistent with recent evolutionary theories, which suggest that religious practices can promote cooperation among unrelated people or in situations in which reciprocity would be highly unlikely. Also consistent with these findings are those previously published on Stresshacker about the connection between faith and stress, and that between longevity and spirituality.

Eat Your Way Out of Stress: Orthomolecularity

NabobPass_EN-US212192238The food most of us consume today is not as rich in nutritional value as it once was due to the significant industrial processing it must undergo to be preserved, packaged and shipped and to the significant effects of pollution in the air, water and soil. Therefore, the human body, especially in heavily industrialized societies, ends up receiving far fewer of the vitamins and minerals that are necessary for optimal health. Moreover, additional energy expenditures and therefore caloric consumption are often required to cope with the stress caused by environmental, situational, and psychological agents.

Thus, the use of nutritional supplements, especially vitamins and herbal extracts, has blossomed into a significant industry and constitutes an increasingly large share of how we obtain these essential nutrients. Generic symptoms such as fatigue, headache, and mood changes are now being treated not only with prescribed or over the counter chemical preparations but also through the consumption of mostly unregulated food supplements.

The Good

As far back as 1968, two-time Nobel Prize winner Linus Pauling pioneered scientific research on the beneficial effects of vitamin supplements and coined the term orthomolecular to describe a nutrition-focused therapy that included large doses of food supplements. His research built on the previous work of two Canadian psychiatrists, Abram Hoffer and Humphrey Osmond, who in 1952 had begun to use very large doses of vitamins, in particular those of the B group, for the treatment of psychiatric disorders. Pauling went one step further by attempting to demonstrate the effectiveness of taking very large doses of vitamins in prevention and in therapy. His studies focused on the antiradical effects of ascorbic acid (vitamin C) and of the liposoluble vitamins A and E in the stimulation of the immune system. Pauling’s view of the benefits of orthomolecularity launched the modern production and distribution of vitamins, minerals, herbs, or products made from plants, animal parts, algae, seafood, or yeasts.

The Bad and the Ugly

Lately, attention is also being paid to the increasingly worrisome phenomenon of self-medication with unregulated nutritional supplements, such as caffeine-laden energy drinks. A 16-ounce can of an energy drink may contain 13 teaspoons of sugar and the amount of caffeine found in four or more colas. Moreover, this potent mixture of sugars and stimulants is often mixed with alcohol. These products, whose catchy names are Red Bull, Rockstar, Monster and Full Throttle, are increasingly popular among teenagers and young adults, even as young as 10-12 years of age. Unfortunately, these concoctions of uppers and downers have dangerous, even life-threatening, effects on blood pressure, heart rate and brain function, according to a recently released report by the Mayo Clinic’s Foundation for Medical Education and Research.

Hear and Feel Your Stress Drift Away

aavanGogh_1888_ArlesDanceHallCan music reduce stress? Yes, and the evidence is strong. Music can reduce stress, lessen pain, diminish hostility and have a positive effect on emotions and cognition. Beginning with an experimental study by Hatta and Nakamura (1991), researchers have continued to investigate the effects of relaxing music on psychological stress, finding good evidence of its benefits. Rhythmic music may change brain function and treat a range of neurological conditions, including attention deficit disorder and depression, suggested scientists who in 2006 gathered with ethnomusicologists and musicians at Stanford’s Center for Computer Research in Music and Acoustics. The diverse group came together for the symposium, “Brainwave Entrainment to External Rhythmic Stimuli: Interdisciplinary Research and Clinical Perspectives.”

Music with a strong beat stimulates the brain and ultimately causes brainwaves to resonate in time with the rhythm, research has shown. Slow beats encourage the slow brainwaves that are associated with hypnotic or meditative states. Faster beats may encourage more alert and concentrated thinking… Most music combines many different frequencies that cause a complex set of reactions in the brain, but researchers say specific pieces of music could enhance concentration or promote relaxation… Studies of rhythms and the brain have shown that a combination of rhythmic light and sound stimulation has the greatest effect on brainwave frequency, although sound alone can change brain activity. This helps explain the significance of rhythmic sound in religious ceremonies. – Stanford University News Services, 2006

Music therapy is now considered a useful adjunct in the treatment of many illnesses including cancer, stroke, heart disease, headaches, and digestive problems. There are numerous reports that music played before, during or after surgery reduces anxiety, lessens pain, reduces the need for pain medication and reduces recovery time.

In 2010, Wesa, Cassileth & Victorson published evidence in Focus on Alternative and Complementary Therapies Journal that music dramatically decreases distress for women hospitalized in a high-risk obstetrics/gynecology setting.  In 2009, a group of scientists headed by Thaut & Gardiner confirmed that music therapy can improve executive brain functions and contributes to better emotional adjustment in traumatic brain injury rehabilitation. Their study examined the immediate effects of neurologic music therapy (NMT) on cognitive functioning and emotional adjustment with brain-injured persons and a control group. The patients who received the music treatment showed a statistically significant improvement in executive function and overall emotional adjustment, reduced depression, lessened sensation seeking, and lower anxiety. Control participants, who did not receive the music treatment, showed decreases in memory, less positive emotion, and higher anxiety.

An extensive study by Good, Anderson, et al. (2005) tested three non-pharmacological treatments—one of which was music therapy—for pain relief following intestinal surgery in a randomized clinical trial. The 167 patients were randomly assigned to one of three intervention groups or control. The results showed significantly less pain in the intervention groups than in the control group, resulting in 16-40% less pain.

Finally, a just published German study offers case-study evidence that music therapy has positive effects on basic vital signs, the reduction of pain and on neurological development in newborn babies with health problems. At the other end of life’s spectrum, a very recent study of patients suffering from dementia of the Alzheimer’s type who exhibited disruptive behaviors showed that weekly session of live music therapy- and occupational therapy-based structured activities over 8 weeks resulted in a significant improvement in disruptive behaviors and depressive symptoms.

Stress and the Female Brain Advantage

drlouannbrizendineIn 1994, Louann Brizendine, a neuropsychiatrist at the University of California, established the Women’s Mood and Hormone Clinic in San Francisco—one of very few such institutions in the world—and focused her attention on the etiology and functioning of the female nervous system.

In 2007, she published The Female Brain as the culmination of her 20 years of research and a compendium of the latest findings from a range of disciplines. It is a fascinating and, in some ways, startling revelation of the most noteworthy particularities that characterize the human female brain.

Size Does Matter… and So Does Density

Women and men have very nearly the same number of brain cells, even though the female brain is about 9% smaller than men’s. This fact had been known for some time and had been, more or less jokingly, interpreted as meaning that women were not as smart. Dr. Brizendine reveals a much simpler explanation: women’s brain cells are more tightly packed into the skull.

To further dispel any notion of masculine brain superiority, she says, women have 11% more language and hearing neurons than men and a larger hippocampus, the area of the brain that is most closely associated with memory. Much more developed in female brains than male’s is also the circuitry for observing emotion on other people’s faces. Dr. Brizendine concludes that, when it comes to speech, emotional intelligence, and the ability to store richer and more detailed memories, women appear to possess a richer brain endowment and thus a natural advantage.

The amygdala in males, on the other hand, has far more processors than in females, which could explain men’s greater intensity in perceiving danger and their higher proneness to aggression. The male body is much quicker to mobilize to anger and take violent action in reaction to an immediate physical danger.

Are women not as capable of reacting to danger? Dr. Brizendine says that a woman’s brain is as capable to perceive danger or deal with life-threatening situations, but that it mobilizes the body’s resources in quite a different way. The female brain appears to be wired to perceive greater stress over the same event than a man’s. This greater arousal and more forceful stress reaction appears to be a natural way to ensure adequate protection against all possible risks to her children or family unit. Brizendine suggests that this ancestral reason may account for the way a modern woman may view unpaid bills as catastrophic and naturally perceive them more intensely threating to the family’s very survival.

[amtap book:isbn=0767920104]

MRI scans have pushed knowledge much higher by allowing the observation of the workings of the brain in real time. The brain lights up in different places depending on whether it is stimulated by love, looking at faces, solving a problem, speaking, or experiencing anxiety. What lights up, where and when, is different between men’s and women’s brains. Women use different parts of the brain and different circuits to accomplish the same tasks, including solving problems, processing language, and generally experiencing the world.

This is a fascinating book for the scientist and the novice alike, well worth reading. It is the Stresshacker Recommended selection for this month.

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.