Christmas Stress Survival Kit

aaMantegna_1500_AdorazioneMagiThe holiday season is upon us — the cash tills are ringing — the car parks are chocka — the shops are heaving — and stress levels are rising. For all the perfectionists out there this time of year can be a real nightmare as The Need To Do Things Perfectly swings into overdrive.  Advertising induces huge pressure to roll out the perfect Christmas:  perfect gifts — perfect parties — how to cook the perfect turkey …   and so on. We put impossibly high expectations on ourselves and end up being unable to enjoy the celebrations.

So here are a few ideas to help ease the stress and allow you some space to enjoy the festive season.

► DELEGATE/ASK FOR HELP: If the majority of the work falls on your shoulders please don’t suffer alone.  If you do you’ll have an exhausting Christmas and probably end up feeling resentful.  Ask for help from those around you — partner, children, family, friends.  Preparing food or writing cards together feels very festive and will significantly ease the burden on you.

► BEWARE “SHOULDS”: Christmas is full of ‘shoulds’.  Be aware of the number of times you use this word.  It usually implies that you’re about to embark on something you don’t really want to do — but feel you ought to.  In other words, the impetus is stemming from external expectations.  The antidote is simply to supplant the word should with could. This instantly reintroduces the element of choice.  You DON’T have to brave the crowds to buy just one more gift … you could, but you might choose not to…

► TEMPER EXPECTATIONS … of others and, more importantly, of yourself.  Don’t sweat the small stuff. Please let go of the need to be perfect. If the turkey is a bit overcooked, or the Christmas tree lights go on the blink, or someone isn’t overjoyed with the gift you’ve bought them – how important is that in the great scheme of things?

► And finally … don’t forget to get out and do some exercise over the Christmas period.  We all eat and drink more than usual, so getting out for a walk and some fresh air always feels great and does you good.

Wishing you a happy, festive and stress-free Holiday Season.

fac_sutton_annabelThis guest post is courtesy of Annabel Sutton, a fully trained Life Coach and Author. In 2005 she was awarded the Professional Certified Coach credential. Her clients say that she inspires, energizes and motivates them towards success and she gets wonderful results. Email or visit for more information or to sign up for Annabel’s free Coaching Tips.

Stresshack #1: The Top 6 Job Stressors



The top six on-going job conditions, thus excluding exceptional events such as a job loss, that may lead to significant stress are:

6. The structural and environmental conditions in which we must perform our tasks, which can range from mildly unpleasant to physically dangerous. There may also be noise, bad breathable air, overcrowding or constrictive body positions, such as prolonged standing or sitting or heavy lifting, or even too much typing. Degree of control we can have over these stressors: Often none. Perception vs. reality of the stressor: These often are legitimate and objective constraints that would stress anyone under the same circumstances.

5. Career concerns we may harbor over various aspects of the position we occupy, such as the security of the job itself, due to job-specific or industry/general economy threats; rapid changes in the job description or its requirements for which we may feel unprepared; unfulfilled desires of growth opportunities, such as advancement, promotion or change. Degree of control we can have over these stressors: Ranging from limited to significant. Perception vs. reality of the stressor: A fear-induced highly negative perception of the precariousness of the job can be a significant factor, and may not be commensurate to the objective reality of the threat.

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Runaway Stress Attacks Financial Markets

High anxiety produced the equivalent of a panic attack in the world’s financial markets last Thursday. It was a day reminiscent of the high anxiety, high stress situation in the fall of 2008 when the markets lost almost half of their value in a few weeks.

On Thursday, from the Hang Seng to the Tadawul, from the DAX to Wall Street, fear gripped traders. On Wall Street, shares plunged by nearly 10% of their value and then regained it almost all back by closing time. Millions of dollars were lost and gained in minutes. Automatic halts on trading by computerized safeguards prevented a complete meltdown.

For at least “a discrete period” (i) of a few hours on Thursday, there was “a sudden onset of intense apprehension, fearfulness, or terror, often associated with feelings of impending doom.” (ii)

Among individual traders, “symptoms such as shortness of breath, palpitations, chest pain or discomfort, choking or smothering sensations, and fear of ‘going crazy’ or losing control” (iii) appeared and disappeared throughout the day.

This appeared to be the type of panic attack that was “situationally bound (cued)… occurring on exposure to or in anticipation of the situational cue or trigger.” (iv) The situational cue on Thursday was a real or perceived threat to the world economy by the crisis of confidence in Greece’s ability to meet the obligations of its national debt.

When the panic attack was over on Friday, financial analysts and the rest of us were left to wonder if” “the increased global anxiety threatens to slow the recovery in the United States, where job growth has finally picked up after the deepest recession since the Great Depression.” And if “it could also inhibit consumer spending as stock portfolios shrink and loans are harder to come by.”

For anxiety, stress and panic attacks to be linked to allegedly rational financial evaluations and transactions is nothing new.

The notorious tug of war between quantitative economists and those who believe that financial decisions are to a large extent irrational, continues unabated.

An April 2010 NOVA special on PBS, Mind Over Money asked a very straightforward question: Can markets be rational when humans aren’t?

Thursday’s events would seem to indicate, once again, that mathematically-bound, high-intellect frontal lobe activities such as financial markets are vulnerable to sudden irrationality.

Just like the rest of us.

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I Can’t Meditate To Save My Life

01740_rockefellersview_2560x1600 Meditation is hard. I get distracted very easily. I start noticing every noise, every wrinkle in my socks, and my stomach starts making the loudest noises. When I try to meditate, it feels like I am trying to stop the earth’s rotation—without any success at all, thank goodness. Too bad, because it’d be good for me… especially when I read the news item that follows.

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When Stress Hurts: Curing Psychogenic Pain

villa-Era-Vigliano-Biella_Current treatments that effectively reduce or eliminate psychogenic pain is the subject of this, the sixth and last post in the series on the close association between psychological stress and psychogenic pain. Encouraging news for psychogenic pain sufferers from the pharmacist: A growing number of patients reports that by taking antidepressants they have experienced a significant reduction in the frequency and intensity of pain. More specifically, relief of psychogenic pain with antidepressants has now been thoroughly documented in the treatment of pain associated with bulimia (Faris et al., 1998), vulvodynia (Stolar & Stewart, 2002), chronic pain of undefined origin (Davis, 1990; Pilowsky & Barrow, 1990), migraine headaches (Kaniecki et al., 2006), chronic pain associated with depression (Bradley, Barkin, Jerome, DeYoung, & Dodge, 2003), functional bowel disorder (Drossman, Toner, & Whitehead, 2003), neuropathic pain (Fishbain, 2000; Saarto & Wiffen, 2005), and post-herpetic neuralgia (Max, 1994).

Non-pharmaceutical Treatments

As we have seen in a previous post, there is a strong emotional and affective component to pain of any origin, whereby pain always has a depressive effect on our mood. There is also ample evidence that pain is often the unwelcome companion of depression, anxiety, psychological trauma, anger and irritability. Even the mere expectation of pain, in the absence of any noxious stimuli, appears sufficient to produce it  and its perception, as has been documented in functional MRI (fMRI) changes to specific brain structures (Fields, 2000; Keltner et al., 2006). Conversely, diverting cognitive attention or causing distraction can mitigate pain, as shown in PET scans of cortical activation (Petrovic, Petersson, Ghatan, Stone-Elander, & Ingvar, 2000).

SH_Rcmds_sm UnlearnPain_BookHoward Schubiner, MD and Michael Betzold are the authors of Unlearn Your Pain, an excellent book that seeks to help reverse chronic pain by promoting a thorough understanding of its principal cause, learned nerve pathways (see Stresshacker’s explanation of the concept in this post). It offers a revolutionary step-by-step process that has been reported to work well by many psychogenic pain sufferers. It is Stresshacker’s recommended book resource.

Psychological Treatments That Can Eliminate Psychogenic Pain

The effectiveness of purely psychological interventions in the relief of chronic or acute pain is supported by the fact that pain and stress share many of the same biochemical processes, neural pathways and CNS structures (see this post for a full explanation).

Decreasing psychological stress through better stress management or counseling has been documented as effective in treating low back pain that is co-occurring with depression (Middleton & Pollard, 2005). There is also evidence that psychosocial interventions are efficacious for pain secondary to arthritis or cancer (Keefe, Abernethy, & Campbell, 2005). Multidisciplinary approaches, including relaxation therapy, biofeedback, behavior modification, hypnosis, desensitization and cognition therapy, have also been proven successful in treating chronic pain of unknown origin (Singh, 2005). Biofeedback therapy can be particularly successful in reducing colorectal pain (Jorge, Habr-Gama, & Wexner, 2003). Hypnotherapy, cognitive therapy, and brief psychodynamic psychotherapy appear to work well in patients suffering from irritable bowel syndrome (Blanchard & Scharff, 2002). Hypnosis has been proven effective in relieving oral pain (Golan, 1997), cognitive behavioral therapy for functional bowel disorder (Drossman et al., 2003), behavioral therapy for the treatment of headaches (Lake, 2001); and family therapy interventions have been associated with successful psychogenic pain treatment (Liebman, Honig, & Berger, 1976; Roy, 1987).

Previously in this series:

Stress Task Manager: What Processes Are Running?


Being fired… Witnessing a crime… Getting bad medical news… Finding out you’re pregnant… The computer getting a virus… Coming into (big) money… Getting engaged… The laundry coming out pink… Being offered a new job… The pet running away… Getting lost in the woods… Losing the wallet… If any of these stressors have happened to you, then you are already very familiar with the way your body reacts to stress. Knowledge is power, and being familiar with our natural body reactions is conducive to a better handling of the situation. But what happens exactly at the moment of stress? Take the jump and find out.

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Lower DHA Intake Linked to Higher Suicidality

ChileVolcanoEruption_EN-US1005377464Low levels of docosahexaenoic acid (DHA), the major omega-3 fatty acid concentrated in the brain, may increase suicide risk. A retrospective case-control study published in the most recent issue of the Journal of Clinical Psychiatry of 1600 United States military personnel, including 800 who had committed suicide and 800 healthy counterparts, showed that all participants had low omega-3 levels. However, the suicide risk was 62% greatest in those with the lowest levels of DHA.

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

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

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

A Peaceful Christmas Everyone!

I heard the bells on Christmas Day
Their old, familiar carols play,
And wild and sweet
The words repeat
Of peace on earth, good-will to men!
And thought how, as the day had come,
The belfries of all Christendom
Had rolled along
The unbroken song
Of peace on earth, good-will to men!
Till, ringing, singing on its way
The world revolved from night to day,
A voice, a chime,
A chant sublime
Of peace on earth, good-will to men!
Then from each black, accursed mouth
The cannon thundered in the South,
And with the sound
The Carols drowned
Of peace on earth, good-will to men!
And in despair I bowed my head;
‘There is no peace on earth,’ I said;
‘For hate is strong,
And mocks the song
Of peace on earth, good-will to men!’
Then pealed the bells more loud and deep:
‘God is not dead; nor doth he sleep!
The Wrong shall fail,
The Right prevail,
With peace on earth, good-will to men!’

Christmas Bells: A poem by Henry Wadsworth Longfellow

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.

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.

Stress News: The Good, the Bad, the Ugly

Stress and the Unborn

Overexposure to stress hormones in the womb can program the potential for adverse health effects in those children and the next generation, but effects vary depending on whether the mother or father transmits them, a new animal study suggests. The results were presented this past Saturday at The Endocrine Society’s 93rd Annual Meeting in Boston.

Posttraumatic Stress Disorder

Depressed-Soldier-02A new study from the Journal of Traumatic Stress finds that for active-duty male soldiers in the U.S. Army who are happily married, communicating frequently with one’s spouse through letters and emails during deployment may protect against the development of posttraumatic stress disorder (PTSD) symptoms after returning home.

Veterans of the Iraq/Afghanistan wars showed a 50 percent reduction in their symptoms of post-traumatic stress disorder (PTSD) after just eight weeks of practicing the stress-reducing Transcendental Meditation technique, according to a pilot study published in the June 2011 issue of Military Medicine.

Individuals with post-traumatic stress disorder (PTSD) are likely to have a higher chance of developing heart disease and to die prematurely, US researchers reported in the American Journal of Cardiology. They found that those with PTSD were more likely to have coronary artery disease, an accumulation of plaque in the arteries that lead to the heart disease.

Stress and Multiple Sclerosis

Contrary to earlier reports, a new study finds that stress does not appear to increase a person’s risk of developing multiple sclerosis (MS). The research is published in the May 31, 2011, print issue of Neurology®, the medical journal of the American Academy of Neurology.

Stress and Alzheimer’s Disease

Stress promotes neuropathological changes that are also seen in Alzheimer’s disease. Scientists from the Max Planck Institute of Psychiatry in Munich have discovered that the increased release of stress hormones in rats leads to generation of abnormally phosphorylated tau protein in the brain and ultimately, memory loss and dementia.

Mild to Deadly: Stress At Work

CloudToGround_EN-US2741696585 Stress at work can take many forms and range in severity from mild annoyance to burnout. It may be relatively easy to tell if co-workers appear to be under severe stress by observing the appearance and persistence of certain characteristic behaviors. It may not be so easy to diagnose dangerous levels of stress in ourselves, however, especially when other considerations of self-esteem, personal ambition to succeed, economic pressure, deadline requirements, and career goals may interfere with a sound and unbiased self-diagnosis.

Mild vs. Severe Stressors: It’s About Control

The first consideration is the severity of the stressors. Are they mild and can they be addressed by making appropriate adjustments? Stressors such as a noisy environment, not knowing one’s job objectives, and skipping meals can be (although not always) addressed by closing the door, asking for clarification, and committing to take lunch and snack breaks as needed.

The second consideration is whether or not the stressors are under our control. The presence or lack of control creates an internal vs. external locus of control situation, with important psychological consequences (see this post on the difference between internal and external locus of control).

Stressors that are beyond our control are far more difficult to address, as for example when there are too many things to do and not enough resources to get them done. Its opposite, the situation when there is hardly anything to do at all, is also stressful and may not have an easy solution.

Other relatively difficult stressors that may not have a solution within our control is not enjoying the job, and not knowing what else one could be doing or being in a situation where a change of job is just about impossible. In the current job market, this may not be an uncommon situation, as jobs that used to be good have become more stressful and jobs that were bad to begin with have not gotten any better.

Another difficult stressor where external control may be an issue is the experience of being caught between conflicting demands, often with insufficient information or resources to address them appropriately. Not feeling appreciated or under-appreciated while putting in long hours and hard work can also create a considerable level of stress.

On the other hand, many stressors can be successfully addressed because they do fall within our control. The most common are interruptions and how they are handled (the well-known inability to say “no”). Another is poor delegation skills, or not sharing work responsibilities with others. These are two examples of stressors that, although not easily eliminated, at least can be controlled and limited in their impact by making changes that are well within our possibilities.  

When Stress at Work Is too Much: Burnout

There are times when the symptoms of stress are just too severe, too persistent and too intractable to be dismissed. They interfere not only with productivity and efficiency on the job, but they also have important negative health consequence in addition to being detrimental to interpersonal relationships at work and at home. The resulting complex cluster of psychological, physical and behavioral symptoms is defined as occupational stress or, for short, burnout.

The emotional exhaustion of burnout can result in diminished interest in work, fatigue, and detachment. Hopelessness is common: we "give in," "numb out," and "march like robots through the day."

The depersonalization of burnout, or the defensive distancing from the surrounding world, can result in diminished contact with coworkers and the public, withdrawal of psychological investment, self-absorption, and an overall negative attitude toward others.

The dissatisfaction of burnout, or the perception of unsatisfactory personal accomplishment, can result in feelings of failure, fatalism, diminished competence, and incapacity to respond to further job, personal and environmental demands.

Early Warning Signs of Work Stress

One of the first noticeable signs that stress is beginning to have a behavioral impact is irritability. Fellow workers will notice this first. They may or may not be able to point it out, but if they do, it is worth paying attention to their feedback and asking ourselves a few questions.

The second sign is fatigue. Even though it is hard to miss, fatigue very often goes unchecked not because it isn’t visibly affecting us but because we may refuse to acknowledge it. Pushing harder can become a mantra, a repetitive “principle-driven” set of behaviors that pushes rest and relaxation aside, with potentially serious health consequences.

Difficulty concentrating and forgetfulness are also early signs of severe stress. Sometimes, stress affects memory in such a severe manner that, by evening time, we can’t remember what we did all day, or what we ate for breakfast.

Sleep ceases to be a safe haven for regenerating and recharging and becomes a place of torture. Lack of sleep is linked to so many health consequences, and to stress itself, in a circular causality pattern. Less sleep means more vulnerability to stress, which leads to more stress by the time we get to bed, with even less chances of getting a good night’s sleep. A potentially deadly vicious cycle!

The body complains about stress, too. Its messages take the form of bowel irritation, chronic fatigue, asthma and other respiratory ailments, headaches, rashes, tics, cramps, and many more pains and problems that appear to come out of nowhere and stubbornly refuse to go away.

Finally, withdrawal and depression may raise their ugly head. Burnout has arrived. It may take a few years to get here, or maybe just a few months of severe stress. In any case, burnout may be the end game of one very simple losing strategy: ignoring the obvious, steaming through the warning signs and hoping that stress will just go away by itself.

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

eClass 3: Acute and Chronic Stress

Stress can affect us immediately (acute stress) and over time (chronic stress).

Acute (short-term) stress is the body’s immediate reaction to any situation that seems demanding or dangerous, as an instinctive reaction that goes beyond a normal state of alertness and wakefulness.


Tension is often the first signal of acute stress. Tense muscles are tight and feel "hard" to the touch. A tense mind makes us feel jumpy, irritable, and unable to concentrate. This is usually a signal that something about a situation, a relationship, or a condition requires our attention.

Stress acts like the light on the dashboard that starts to glow amber and may turn to red. Addressing the contingency has the effect of exercising control over it, and may provide immediate comfort and prevent the long-term effects of stress.

Common symptoms of acute stress indicate a rapid arousal of the body in response to the perceived threat:

  • Rapid heartbeat (increased blood flow)
  • Headache (increased blood flow to the brain and/or pericranial muscular tension)
  • Stiff neck and/or tight shoulders (muscular tension)

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