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Writer's pictureCarolyn Schmiedlin, RN

Stress: Conquering this Common and Often Underestimated Health Risk



What is Stress?


Stress can be defined as a state of mental tension resulting from a challenging situation. In response to a threat, whether real or perceived, the brain triggers a cascade of events within the body that equip us to either take a challenge head-on or flee. This is an advantage during momentary situations that require clarity and strength in order to succeed. This process can work against us, however, when triggering events happen continually, or when a situation that we perceive or experience as stressful persists over a long period of time. 


Stress has profound effects on us mentally, physically and emotionally. A little bit of stress can help us perform well during a high-intensity moment. But prolonged stress can cause health problems and worsen preexisting mental and physical conditions. It can lead to self soothing through sugary foods, alcohol, and other mind-altering substances. These behaviors then cause increased health risk and often lead to issues that complicate the same stressful situations that a person is trying to avoid.


Stress can be described as acute or chronic. Acute stress is a temporary response to a passing event, like a work deadline, a first date, a disagreement with a friend or family member, or a real or perceived physical threat. Chronic stress occurs when we are in a continued state of emotional or mental pressure. Some examples of chronic stressors may be job insecurity leading to financial problems, a long-term medical crisis, or improper coping mechanisms that exacerbate rather than alleviate the body’s stress response. When the body is in a prolonged “fight or flight” mode it becomes weary and more susceptible to deterioration both mentally and physically.


Symptoms of Prolonged Stress


The symptoms associated with stress are the result of the body preparing itself to handle threatening situations. The brain, through the autonomic nervous system (ANS), begins a chain reaction of events throughout the body that heighten awareness and equip us for physical exertion necessary to necessary to fight off an adversary or escape. Hormones that are released during acute stress increase blood pressure and heart rate and sharpen acuity of the mind and senses. Breathing increases and digestion slows down. A greater amount of oxygen reaches the brain, muscles, and heart which provides a momentary boost of focus, strength and energy. Our bodies are only intended to sustain this state for short periods of time followed by rest and recovery. 


When stress is prolonged the body begins to produce other hormones to attempt to sustain an increased need for energy. Cortisol stimulates the release of glucose into the blood for the brain to use as energy. If this continues for an excessive length of time it can lead to insulin resistance and metabolic issues. During acute stress digestion is inhibited, however when a stress is prolonged it produces cravings for high-calorie foods, sugar, salt, and fat. The demand for quality nutrition is often not met, resulting in further metabolic issues and fatigue. Excessive cortisol also inhibits the immune system and increases inflammation in the body.


This can lead to a variety of complications to one’s health including digestive complications, weight gain, cardiovascular problems, disruptions in sleep, inability to focus/concentrate, lack of motivation, anxiety, and depression. Prolonged stress causes preexisting conditions to worsen more rapidly and inflammatory issues to become exacerbated. Inhibited immunity means that people with chronic stress are more likely to pick up any other sicknesses that are going around, and also increases the risk of developing cancer. Muscle tension often accompanies the body’s stress response, which when continued for a length of time, can lead to pain, poor posture, and increased risk for injury. From a holistic health perspective mental, emotional, and physical health are all intertwined and directly influence each other. Studies conducted on stress and its affects on human health give a clear picture of this.


Stress Management Techniques


For many people stress reduces over time as the situation improves or as they learn to cope emotionally with whatever is going on. There are differences among individuals in factors that contribute to the experience of stress such as personality type, personal history, socioeconomic factors, and other variables. People develop different coping mechanisms throughout their lifetime- whether positive or negative- that contribute to their ability to handle stressful circumstances. What overwhelms one person may be reasonable and manageable to another. It is important to identify our own triggers and not compare ourselves to people around us. Below are some evidence-based tools to help manage stress and facilitate our best mental, emotional, and physical well-being.


Reevaluate priorities and eliminate stressors.

Not everything on your plate is worthy of your time and energy. Make a list of the things that you are giving yourself to and eliminate or postpone anything that does not serve you well to commit to right at this moment. This includes keeping healthy boundaries and saying “no” to some of the extra things that you are not able to take on right now. It also includes asking for help from others when needed.


Adjust your perspective.

The way that we see a situation greatly influences how we respond. When we cannot change the situation sometimes we can help relieve pressure by changing the way we think about it. A common evidence-based tool for stress and anxiety is cognitive behavioral therapy (CBT). This approach is based in the concept that our thoughts influence or emotions which then drive our actions. By changing the way we perceive something we can change how we feel and respond. This can include fact-checking ourselves when we are reacting to assumptions, identifying that a stressor is not actually that significant in the long run, or understanding that something is out of our own control and releasing our need for control while believing for the best outcome.


Be nice to yourself. 

Focus on the positive, gratitude, and what you can control. Set realistic expectations for yourself and plan smaller steps to larger goals. Celebrate the big and small victories along the way. Be encouraging and compassionate toward yourself. Remind yourself of the times when you have faced a similar situation and things turned out ok. Think of what you would say to someone else that you care about if they were facing the same situation, and then apply those words to yourself. Often we are much harder on ourselves than we would ever be to another person.


Exercise.

Physical activity can help relieve stress in the moment and a consistent habit of exercise increases mental and physical resilience to stress. It also improves the quality of sleep, which in turn reduces stress. Studies have shown that the hormones released in the body during exercise counteract some of the negative effects of stress on the immune system, cardiovascular system, and in the brain. The CDC recommends that adults get about 150 minutes of moderate level exercise per week. If this seems out of reach, then it is nice to know that even a little bit of physical activity will boost our physical and mental health to some degree.


Eat healthy.

Consume a diet high in fruits, vegetables, lean proteins, and whole grains and drink plenty of fluids. This type of diet provides energy and supports healing, healthy immunity, and resilience to stress. Some research indicates omega-3 fatty acids as helpful in regulating cortisol levels. We are encouraged to limit saturated fats, salt, artificial sweeteners and sugar. Often we are drawn to unhealthy foods during times of stress due to the dopamine release from the combination of sugars, fats, salt, and chemicals, and also due to the momentary boost of energy that sugar, sweeteners, and caffeine can provide. We are encouraged to remember that although these foods produce satisfaction in the moment they ultimately exacerbate our stress response in the longer term and slow down our bodies in ways that make it even harder to manage the stressful situations on our plate. 


Feed your spirit.

Prayer and other spiritual practices are shown in studies to reduce stress and improve resilience. This can include speaking to and connecting with God as we understand him, trusting our cares to him, and believing in the best for whatever situation we are facing. It may include joining others with similar beliefs or just spending time alone in nature. Nature itself is shown in some studies to have healing and stress relieving properties. Some studies have indicated that green space improves mood and relieves tension. Another study indicated that participants who watched nature videos recovered from stress much faster than other participants who watched videos of urban scenes. A moment outdoors can recenter the mind and quiet the spirit. 


Practice mindfulness.

Mindfulness meditation practices are shown in studies to significantly reduce stress and anxiety.. These can include short meditation breaks throughout the day or more lengthy sessions at specific times during the day or evening. Basic mindfulness exercises involve sitting in a quiet place in a comfortable position, focusing on taking deep breaths, and trying to let any tension or worrying thoughts pass on without holding on to them. When we try to sit still and be in the moment we start to realize the thoughts that pass through our minds that lead to tense feelings. Through this practice we identify what is there- without judgment- and then let it pass. We choose to stay centered and be in the present moment rather than carried away by our overactive minds. For people who are not used to this practice it may seem overwhelming and will likely require very short sessions at first. The purpose of this activity is to teach the mind to be present and in the moment, which increases focus and efficiency throughout the day and also lowers stress and anxiety.


Make time for fun.

Do not underestimate the power of laughter and enjoyment on your overall well-being. Take some time to laugh or do something fun. Make time to unwind after a long day. Life consists of many activities that are necessary but not necessarily fun. Make sure you are balancing that out with some things that you can look forward to. Schedule in some guilt-free time consistently for self-care and for something genuinely enjoyable.


Limit media.

Although it is good to be informed of current events, too much time following the news on television or online can lead to higher stress. Excessive use of social media is known also to have a correlation with higher stress, anxiety, and depression. Try limiting use of media to only certain times of the day or week. Use the do-not-disturb function, or turn devices off altogether, when trying to focus on family or on other tasks. Use of screens before bed can cause the brain to feel awake longer and impair our ability to fall asleep so we are encouraged to limit the use of electronic devices for 2 hours before bed. 


Sleep.

The CDC recommends that adults get about 7-9 hours of sleep per night. Healthy sleep and stress management often go hand-in-hand. Stress causes increased alertness which makes it harder to sleep, and poor sleep interferes with focus and mood regulation which can amplify the experience of stress. In addition to practicing other stress management techniques, try to keep good sleep hygiene habits. This includes keeping a consistent sleep routine that allows time to wind down before bed and trying to go to sleep and wake up around the same time each day. Avoid large meals, caffeine, and alcohol in the evening and also limit use of electronic devices before bed, including television. Use a noise machine, fan, or earplugs if sounds tend to wake you. Try to keep your sleeping area dark and comfortable.


Conclusion


Stress management is an often overlooked but powerful component of living our healthiest lives. Chronic stress is common among Americans and unfortunately so is chronic disease. At this time chronic stress is a known and studied risk factor in many chronic health problems. Prolonged release of stress hormones leads to deterioration of health mentally, emotionally, and physically. Ultimately, the best thing we can do for ourselves and the people around us is to take care of ourselves, which includes setting healthy boundaries, asking for help when we need it, and learning healthy coping strategies to most effectively manage the challenges of life. 



Sources:





https://www.apa.org/topics/stress/tips Assessed and Endorsed by the MedReport Medical Review Board



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