by Susan Andrews, PhD

Stress vs Anxiety: Can You Tell the Difference

Is there any difference between stress and anxiety? Of course, there is, but there are probably more similarities than differences. Some of the common symptoms between stress and anxiety include: sleepless nights and subsequent exhaustion, excessive worry, difficulty with focus, irritability, muscle tension, rapid heart rate, and headaches.

The differences between anxiety and stress are important. Stress is your body’s immediate reaction to a problem or coming event, or some sort of trigger. The trigger can be positive or negative. And, the stress reaction is normally short-term. Stress is normal for everyone. No one can live a completely stress-free life. But, usually when something triggers the stress
reaction, our body automatically reverses the physical reactions once the trigger is gone. For instance, when you have a deadline to complete an activity or a job, stress kicks in and actually can help you meet your deadline. That’s a good thing.

Anxiety, on the other hand, is not usually “short-term.” That is, when anxiety becomes a sustained problem, it then becomes a mental health problem. An alarming fact is that Anxiety Disorders are the most common mental health disorder in the United States, affecting 40 million adults and uncounted numbers of our children. This is at least 18 to 20% of the population.

The odd interaction or blending of the boundaries of these two similar mechanisms we use to deal with life is that stress can cause anxiety and anxiety definitely triggers stress. Anxiety causes stress because the excessive worry and constant thinking automatically triggers Cortisol, among other bodily stress reactions. That leads to being unable to rest or sleep, problems with focus and so on. In other words, stress and anxiety often go hand-n-hand.

In dealing with either or both, however, it all comes down to Thinking. What we think. How much we think. Whether or not we can let go of a negative thought or worry. Whether or not we can clear our mind of thoughts, positive or negative, to fall asleep or to rest for a few minutes. When we become unable to control our minds and what and how long we think, the inevitable result is a high degree of stress and anxiety that can cause all the negative consequences one can read about.

So, learning how to stop thinking, clear your mind, change the inner dialogue topic are the primary keys. How do we do that? Most people can recite a list now. However, reciting a list and actually doing some of the things on the list are two different things. The list includes: Breathing and relaxation techniques, Mindfulness, Meditation, Exercise, Changing what you are doing – like, taking a break in the activity that might be producing the stress and doing something else, and Music – either listening or if you are one of the lucky ones who learned how to play an instrument – playing music has amazing benefits for mental and physical health. As a group of mental health practitioners, we need to teach children how to control their thinking and how to clear their mind and relax. Children who grow up with those abilities will live longer, be more productive and live life with more joy. It’s never too late.

by Susan Andrews, PhD

10 Stress-Free Minutes a Day Keeps the Doctor Away

It is true that most of us cannot avoid stress, especially if we want to continue to be an active participant in the world. Stress goes with the territory of juggling a career, a family, and a  social life. Most of us understand only too well the dangers of continuing to schedule full days, of adding new projects to an already overlong list, and still trying to find some time for ourselves at the end of the day. We routinely overbook ourselves. Some of us have the grace to promise to do better next week and might even believe that we can make it up later. But, can we? Chronic stress is now linked to so many problems related to illness, chronic health problems, anxiety, loss of memory, and reduced longevity that it would take the rest of this column to simply list all the ways it affects our lives. We know, for example, that the things we think about and dwell on can have a direct effect on how much cortisol, or stress hormone, is produced in our body. Keeping the cortisol down has become a new goal for the health conscious.

Researchers from the University of California, Davis published findings from a long-term study, called the Shamatha Project, that studied how meditation influences the brain and mental health.  article published in the journal Health Psychology reports that meditation, and particularly mindfulness training, helps lower stress and cortisol levels, which in turn can help you lose excess weight and avoid developing “cortisol belly.”

Manage Your Stress…Not the Other Way Around

It’s time to draw a line in the sand and start reducing stress and cortisol. What I am proposing is not perfect, but it is a start that you can build on. If you keep waiting until you have the time, or until you can do it “right,” it could be too late. Stop letting your calendar manage you. Don’t “try” to do better. As Yoda says, “Do or Do Not!”

Begin Your 10 Stress-Free Minutes Today

You might think that 10 minutes a day is not much help. But it is. A few minutes goes a long way toward recharging your energy and breaking up your resistance to taking breaks. You can gradually add more mental “down time” and physical relaxation to each day. Get started by making yourself push away from your desk or daily routine for 10 minutes. Take this break with the intention of taking a brief mental holiday; give your mind a rest. Why not begin with 10 minutes of Mindfulness? Or, spend 10 minutes in focused breathing (with longer exhale). Add some music or put your feet up, close your eyes and direct your favorite piece of music. Remind yourself to do this daily by putting the reminder into your smart phone.

And, by the way, those of you who work with stressed-out clients, I have found that many  seriously stressed patients are so overwhelmed that they cannot even begin to think about how they can reduce their stress. The above suggestion that they start with just 10 minutes a day has helped many people start adding relief to their day. Once they begin, the time can be gradually increased. Psychology tells us that making a conscious choice with commitment is a powerful tool. Do as I say AND as I do.

by Susan Andrews, PhD

New Years’ Resolution: This Year I’ve Got to Manage Stress Better

It’s that special time of the year when we make those statements about our goals for better living for the coming year. I don’t know about you, but every time I make a resolution that resolution that involves diet or exercise or work habits, I tend to forget that I even made such a resolution by mid-March. Life happens, and we adapt and move on. The first thing to go for many people is exercise unless you are one of those people who have been focused on exercise and have made it a full-blown habit. Stress takes a big toll on most professionals who are building a career. Consider making a 2019 Resolution to manage your stress better this year. It will improve your health and your happiness.

Habits are very stubborn things. It is tough to break a habit. But, it is even tougher to build a new habit. A few new books have even been written about how to build good habits and keep them going strong. I recommend The Power of Habit: Why We Do What We Do in Life and Business, by Charles Duhigg (2014). This book was a New York Times Bestseller and available many places.

Developing a habit is like making a decision and then working to make it “automatic” behavior, things you do without planning them first or even thinking about them or making a list. Duhigg asked some great beginning questions in the prologue: What is the first thing you do in the morning? Hop in the shower? Brush your teeth? Grab your cell phone and check your messages? Duhigg’s basic message is that habits can be changed if you understand how they work.

William James wrote in 1892: “All of our life, so far as it has definite form, is but a mass of habits.” Whereas many of our habits get in our way and keep us in a loop, developing strong positive habits can make you more productive and effective at what you want to do.

Pick out one or two ways that you want to try to manage your stress better on a daily basis. We have gone over a large number of them. Don’t try to do too many at once. You are more likely to be successful if you start with one or two relaxation techniques that do not take a huge amount of time and that you think will really work for you. If successful, you can always add more down the line.

The key to building any new habit, even taking frequent relaxation breaks, is to repeat the new behavior frequently so that it can become an established pattern or link in your nervous system. Developing a habit basically means that a behavior becomes more or less automatic for you. Various experts offering advice on how long it takes to build a habit agree that it takes frequent repetition for 14 to 21 days. That means you have to be very aware of and conscious of repeating the same behavior each day multiple times. Any person who has made a New Year’s resolution to lose weight or start an exercise regimen knows that if you miss even a few days in the beginning of trying to start a new habit, you are probably not going to succeed. The old expression “just wait till next year” may come from that. There is no time like the present to start building a new habit of working with stress solutions. So, I leave you with the following message: This is a good time to take a relaxation break.

by Susan Andrews, PhD

Improved Sleep Reduces Stress, Improves Health

A recent article in the Healthcare Journal of New Orleans on The Art & Science of Sleep caught my eye this month. So many of us are burning the midnight oil trying to finish up reports and work for 2018. This article contained good “evidence-based tips for improving sleep quality.” Since everyone’s time is short these days, it is sometimes helpful to read a summary of key points instead of having to read a longer piece.

Have you noticed how many adults and kids go to bed with their phones. Kids are playing games up until parents force light out. Adults are reading email and new stories until their eyes force them to put it down. It is actually harder for most people to fall asleep if they are still pumping excess cortisol through their systems. It is harder to empty your mind and stop thinking under those circumstances. An important tip is to try to stop all games and reading at least 30 minutes before you hope to fall asleep.

Sleep is so important for losing weight, keeping your immune system healthy, and keeping your energy level up to the challenges of the new day. I was surprised at some of the “evidence-based” tips to improve sleep quality. The author of the article is Erin Baldwin and a good reference list from peer-reviewed journals is offered at the end of the article. These tips are derived from the 11 referenced journal articles.

Tip 1: Reduce exposure to blue light before bed and increase exposure to natural light during the day. This tip has to do with the effects of light exposure on the secretion of melatonin. Melatonin levels need to rise at night and drop in the morning. Exposure to light before bed suppresses melatonin secretion. Red light does not interfere with melatonin as much as blue light (sunlight and smart phone light) does. So, refrain from using electronics at least 30 minutes prior to bed. (Figuero & Rea, J. of Endocrinology, 2010)

Tip 2: Allow your core temperature to drop before bed. Warming your feet with socks can help. The National Sleep Foundation recommends a bedroom temperature of 65 degrees. Keep your head cool to help alleviate insomnia. (Nature 1999; Nofzinger et al, J. Clin Sleep Med 2006)

Tip 3: Make your bedroom a sacred place. Think of the classical conditioning work of Pavlov and his dogs.

Tip 4: Stick to a Sleep Schedule.

Tip 5: Wind down before bed. Allow your mind to slow down. Stop worrying over problems that make it hard to shut down thinking about. Listen to soft music or do a meditation. The article suggests using a drop of Lavender essential oil on your pillow or rub some into your hands and inhale from cupped hands.

Tip 6: Rethink your sleeping position. Alight and elongate your body, no joint stress.

Tip 7: Cut back on nighttime use of alcohol and anti-anxiety medications. While both cause you to fall asleep faster, they also decrease your sleep quality later in the night. Benzos can disrupt the normal sleep cycle and suppress REM sleep. (Pagel & Parnes, J. Clin Psychiatry 2001)

Tip 8: Reduce Stress. This is almost redundant, but the article highlights the value of regular physical exercise a few hours before bedtime.

Have a restful and happy holiday.

by Susan Andrews, PhD

APA Study:
Discrimination Leads to Stress

APA has done a survey every year on stress in America. In recent years the Harris Poll survey has focused on discrimination because it is a growing cause of stress. The news has reported numerous clashes between police and black people and Hispanic people. Sadly, there has also been examples of violence based on racial and religious discrimination.

According to an APA study based on a survey of 3,361 adults, more than half of U.S. adults say they have experienced discrimination at the workplace, from police or in other situations. Discrimination was linked to high stress levels and to poor health in those who reported discrimination as compared to the people in the survey who reported not experiencing
discrimination.

The survey respondents reported that their discrimination induced stress has risen over last year. The discrimination has taken the form of poor service, threats, lack of courtesy, lack of
respect shown, among other examples. More than 75% of black people said they experience day-to-day discrimination. Almost one-third of both black and Hispanic adults told the survey that they have become hypervigilant about their appearance in the hope of being treated more fairly.

What the survey does not say is that this type of discrimination-induced stress is chronic stress. Stress that one has little relief from means that the negative effects on one’s health are stronger. Negative effects include excessive fatigue, higher blood pressure readings, reduced immune system protection, among others.

Discrimination-induced stress begs the question of how to reduce such stress. It is pervasive, and its reduction depends upon a major change in people’s beliefs and attitudes. Obviously changes in beliefs and attitudes cannot be legislated. Psychology failed to change even minor beliefs and attitudes about eating organ meat (such as liver) during WW2, such that the more desirable meat could be sent to our troops.

And, when we have no answers or ideas of how to change a situation, it is hard to figure out how to end a column on a more positive note.

by Susan Andrews, PhD

One psychologist, Dr. Tammy Savoie, has taken those words to heart. Dr. Savoie decided to run for office because of the same stress that 63 percent of Americans reported last December in an APA poll. The stress – simply put – is concern about the division of neighbors and families over partisan bickering and an ineffective Congress, concern about the future of our country.

“Americans Are Freaking Out” was the headline conclusion of the 2017 Stress in America poll conducted for the APA by Harris. As I reported last year, nearly two-thirds of the people who responded to the Harris poll said that this is the lowest point in US history – and it is keeping a lot of them up at night. The poll, which was the 11th annual Stress in America survey done by the APA, was conducted online between August 2 and August 31 and included 3,440 respondents, aged 18 and over.

Those who are being kept up at night reported that they are worried about health care, the economy and an overall feeling of division and conflict between them and their neighbors. More Democrats (73 percent) than Republicans (56 percent) agreed that this was their top concern. Nonetheless, the sentiment was this is the lowest point in our nation’s history spanned generations, which includes World War II, Vietnam, and 9/11.

As we approach the mid-term elections, that stress has been building for many of us. Actually, many of us have complained for years about the qualifications of the politicians who are supposed to represent us. We complain but most of us will tell you that in truth they have not gotten involved, even with the local School Board elections. Sure, the most frequent answer: “Sorry, I am just too busy to volunteer.”

And, forget putting your hat into the Ring. That really would take too much time. This year is different, and as one who never volunteered before but complained a lot, I have been volunteering for Dr. Tammy Savoie’s campaign for two reasons:

1. She is a Clinical Psychologist, trained at Emory U., served for 23 years in the Air Force and retired in 2016 as a Lieutenant Colonel. Dr. Savoie was born and raised in the New Orleans area. As a Clinical Psychologist in the Air Force, she is naturally concerned about our veterans. As a Clinical Psychologist, Dr. Savoie understands the importance of a good education, proper child care, and good health care. Further, most people who choose a career as a Clinical Psychologist care about people and want to help them. More psychologists need to get involved actively in politics. We need people trained in critical thinking and objectivity; and Dare I Say It, more women.

2. I have been so stressed with concern about the future of our country that when I saw a woman with recognized credentials, not a professional politician, that I decided to put my time and energy where my mouth was. And, it has worked. Win, Lose, or Draw, I feel better knowing that I got involved. I hope we can have many more qualified candidates, like Dr. Tammy Savoie, in the future. I hope you Get Involved!

by Susan Andrews, PhD

“The greatest weapon we have against stress is our ability to choose one thought over another.” William James

This reminds me of a saying I once saw on a T-shirt: “Meditation: It IS what you think.” Of course, William James is taking for granted that most people are capable of controlling their minds well enough to actually choose to think about one thing and NOT to think about something else. Obviously, if everyone could do that, the world would be a much more relaxed and stress-free zone. The trouble seems to be coming from 2 possibilities: (1) many people do not realize that stress can be managed by controlling what they are thinking about and (2) too many people in the world today lack the ability to control what they are thinking.

Stress is absolutely a function of what we think. It is our thoughts about what is happening in the moment that actually trigger stress. And, as James points out, humans can choose to think about something that would normally cause them stress whereas nonhumans do not have that choice. For example, mice can be exposed to chronic stress in a laboratory a number of ways, such as by keeping them in a small space for 21 days. Mice, thus treated, show behavioral and brain cell changes in the amygdala associated with anxiety and depression1.

Research indicates that “reappraising” our situation – i.e., changing the way we think – can actually improve our body’s physiological and cognitive reactions to a stressful event. A team of Harvard and UC San Francisco researchers1 tested this theory by simply instructing participants in a reappraisal condition to think about their physiological arousal during a stressful task as “functional and adaptive.” There were two control conditions: attention reorientation and no instructions.

The participants instructed to “reappraise” their physiological arousal by thinking of the arousal as being more adaptive or functional showed measurably better cardiovascular stress responses (in terms of increased cardio efficiency and lower vascular resistance) and decreased attentional bias. Thus, changing our thoughts and thereby our perception can significantly improve the effects of stress on our body.

The suggestion to reappraise how we are looking at a stressful situation so that we think of it as somehow benefiting us or helping us do something better may be a much easier way to help people learn to control what they are thinking. Often when clients are instructed to try to control what they are thinking and NOT to think of the “X” that is upsetting them, they respond by saying they cannot control what they are thinking. Thus, using the suggestion of “reappraising” or reframing how they think about something may be much more successful at getting a stressed client to think differently – and feel less stressed.

______________
1 T Lau, B Bigio, D Zelli, B S McEwen, C Nasca. Stress-induced structural plasticity of medial amygdala stellate neurons and rapid prevention by a candidate antidepressant. Molecular Psychiatry, 2016.
2Jamieson, J. Nock, M. and Mendes, W. Brief Report: Mind Over Matter: Reappraising Arousal Improves Cardiovascular and Cognitive Responses to Stress. 2012. Journal of Experimental Psychology: General 2012, 141, 3, 417-422.

by Susan Andrews, PhD

Last column I started to describe a list of “20 Scientifically Backed Ways to De-Stress Right Now” from the HuffPost. We only got through 10 of the suggestions. The list is creative and offers some easy and very fast ways to take a quick relaxation break. I have tried the Naam Yoga Hand Trick and found that it totally works in moments. Apply pressure to the space between your second and third knuckle (the joints at the base of your pointer and middle fingers); it creates a sense of instant calm. Author Sharon Melnick of Success Under Stress, said that “it activates a nerve that loosens the area around the heart, so any of that fluttery feeling you feel when you are nervous will end up going away.”

The article suggests that if you do not have music or headphones handy, try humming or making your own music. Another suggestion was to use the internet to find guided meditations and/or uTube music for relaxation. A good laugh is always a winner to break into the mood. For example, a viral video. The Mayo Clinic explains that “laughter enhances your intake of oxygen-rich air, stimulates your heart, lungs and muscles, and increases the endorphins that are released by your brain.” Or, remember one of those times you were so tickled that you laughed until you cried.

Another of the 20 tips was to Eat a Banana (Or a Potato!). By way of explanation of the science behind this suggestion, the article said that potassium help regulate blood pressure. Eating a banana or potato also provides energy. They quoted the American Psychological Association as recommending eating a banana or potato to “stave off the physical detriments of stress.”

Try the Eagle Pose if you are a yoga practitioner. This is supposed to open the shoulders and relieve neck tension. The Eagle Pose, also known as Garudasana, improves your balance and stretches your upper back, shoulders and outer thighs. Regularly practicing this pose can strengthen your leg, knees and ankles. Your spine should be erect and hips and shoulder face forward.

Mindfulness and meditation teacher, Dr. Herbert Benson, has suggested that knitting fulfills two criteria of mindfulness practice: “the repetition of a sound, word, phrase prayer, or movement, and the passive setting aside of intruding thoughts and returning to the repetition.”

Finally, the list offers “Chew a Piece of Gum!” Honestly, the explanation is that chewing can relieve anxiety, improve alertness and reduce stress. They quote a 2008 study on the benefits of chewing gum.

To sum up the unusual list of 20 Scientifically Backed Ways to De-Stress Right Now:
1. Go for a 10-minute Walk
2. Breathe Deeply
3. Visualize
4. Eat a Snack (Mindfully!)
5. Buy Yourself a Plant
6. Step Away from the Screen
7. Pucker Up
8. Naam Yoga Hand Trick
9. Hang up, Then Turn Off Your Phone
10. Put on Some Music
11. Eat ONE Candy
12. Find web-based stress mgt program
13. Chew a Piece of Gum
14. Watch a Viral Video
15. Progressive Muscle Relaxation
16. Seriously, Turn off your phone
17. See your BFF
18. Eat a Banana or Potato
19. Try the Eagle Pose
20. Knit or cross-stitch

by Susan Andrews, PhD

Actually, I was about to say, “Practically Nothing,” when I happened upon an article in the HuffPost entitled, “20 Scientifically Backed Ways to De-Stress Right Now.” Okay, I agree that we have scientific evidence that a lot of methods work, but 20 ways to destress immediately might be pushing it. So, read on and discover a couple of new ways that you might not have known about.

The early part of the list was now new. Although these are great techniques to reduce stress, most everyone knows them, and few enough actually DO them. Number 1 is Go for a 10 Minute Walk, in a park or green space if you can. Number 2 should probably have been listed first as everyone knows the value of breathing. Deep slow breathing stimulates the parasympathetic nervous system, you yawn and feel better. Number 3 on the list was to do a short self-guided visualization or imagine a vacation you enjoyed or one you are looking forward to. The suggested visualization in the HuffPost list is to “picture yourself in an elevator, happily sandwiched between two hot actors of your choice.” Might work!

Taking advantage of the newly labeled “gut-brain-axis” is the 4th scientific way to destress immediately: Eat a Snack (Mindfully). The article draws on Dr. Drew Ramsey’s new book, The Happiness Diet. In Dr. Ramsey’s words, “After all, stress is a brain and immune system mediated phenomena, and your gut is the largest organ in your immune system.” Dr. Ramsey is an assistant clinical professor of Psychiatry at Columbia University College of Physicians and Surgeons.

But the surprise was that the Number 5 suggestion on the list was totally new to me: Buy Yourself a Plant. According to this article, Houseplants are not just beautiful air purifiers; they actually can help induce a relaxation response just by being around them. The science is that a Washington State University study found that a group of stressed-out people in a room full of plants experienced a 4-point drop in their blood pressure, while the control group in a plant-less room only dropped by 2 points. HuffPost included an article on the 10 Best Houseplants to De-Stress Your Home. They also quote a 2008 Dutch study that found that patients in a hospital with plants in their rooms reported lower stress levels than patients in rooms without plants. And, the # 1 top stress-reducing plant is the dangerously sharp-leaved Aloe plant. Not only does it have the ability to help heal burns and cuts, but also it cleans the air and the leaves act like canaries in a mine by displaying brown spots on the leaves when there are a lot of pollutants in the room air. (Important FYI, the aloe plant has other relaxing uses.) They list English Ivy as Number 2 and a Rubber Tree as Number 3. Number 4 is a Peace Lily and Number 5 is the Snake Plant. The only one I knew about was the Snake Plant or Mother-In-Law Tongue. And, I only knew about its air purification qualities. The bamboo palm made NASA’s list of top clean-air plants with a score of 8.4 for clearing out benzene and trichloroethylene. And, if those chemicals are in your house, you will need more than a plant to relax.

I kinda got sidetracked on the List of 20 Scientifically Backed Ways to De-Stress Right Now. And, I am running out of column space. So, I will quickly finish the list without much comment. Number 6 is Step Away from the Computer Screen – frequently. Number 7 is Pucker Up. Enough said. Number 8 is Try this Naam Yoga Hand Trick; it totally works. Apply pressure to the space between your pointer and middle fingers; it creates a sense of instant calm. Number 9 is Hang Up, Then Turn Off Your Phone. And, Number 10 is Put on Some Music. That is one of my favorites. I’ll save the other 10 for another time. These tips for instant relaxation are easy to do and I hope try them out.

by Susan Andrews, PhD

Do laypersons’ beliefs about stress influence their mental and physical health? In 2016, German psychologists from Berlin addressed this question and developed The Beliefs About Stress Scale (BASS), which is a standardized questionnaire to assess stress beliefs. The BASS consists of an item pool of 24 statements. To standardize the instrument, it was administered online to 455 university students at the start of term. Other information about students’ subjective stress levels, optimism, pessimism, neuroticism and somatosensory amplification was collected. A sub-group of these students were reassessed at the end of term exams 6 to 8 weeks later.

Analysis included factor analysis which suggested 3 dimensions of stress beliefs: negative stress beliefs, positive stress beliefs, and controllability. The item pool of 24 statements is given in the appendix of the publication. Some of the statements include:

“Being Stressed …
1 . . . is, for me, a sign of weakness 2 . . . impacts negatively on my ability to perform 3 . . . causes damage to my health in the long run 4 . . . is something I am able to influence through my actions 5 . . . enables me to work in a more focused manner 6 . . . makes me more productive 7 . . . makes my life more exciting in a positive sense 8 . . . causes damage to my health in the short-term

One study in 2016 by Drs. Johannes Laferton and Susanne Fischer, published in the International Journal of Behavioral Medicine, showed that students who held negative beliefs about stress being dangerous to one’s health did, in fact, complain of more somatic symptoms during a stressful period.

It is interesting to see the wide range of negative to positive statements included in the BASS questionnaire. Further research using the BASS with differing populations is needed.

In the light of these self-fulfilling and predictive beliefs, I might behoove all of us who are active and busy to take time to examine our own beliefs about stress. And, our beliefs about how well we believe we manage our stress is also critical. We may need to decide that Stress is NOT the “Bad Guy” after all. Dr. Kelly McGonigal, a health psychologist, gave a TED talk in which she said, “For years I’ve been telling people ‘stress makes you sick!’ …But I’ve changed my mind.” And, she quoted several large N studies to prove her point that changing how you think about stress can change the outcome.

by Susan Andrews, PhD

The above headline is the conclusion of the 2017 Stress in America survey
conduced by the Harris poll for the American Psychological Association. Nearly
two-thirds (63 percent) of the people who responded say that this is the lowest
point in US history – and it is keeping a lot of them up at night. The poll, which is
the 11th annual Stress in America survey done by the APA, was conducted
online between August 2 and August 31. Only Americans who are 18 and over
and living in the United States responded. Interviews were conducted in English
and in Spanish.

The group of 3,440 respondents was proportioned in the following manner:
1,376 men; 2,047 women; 1,088 whites; 810 Hispanics; 808 blacks; 506 Asians;
and 206 native Americans

The data was weighted by age, gender, race/ethnicity, region, education and
household income to reflect America’s demographics accurately.
Those who are being kept up at night reported that they are worried about
health care, the economy and an overall feeling of divide between them and
their neighbors. One comforting thought is that their neighbors very well may be
lying awake and worrying too. Many people reported being stressed about the
future of the nation. Past surveys have reported that the top stressors were
money (62 percent) and work (61 percent). This year 63 percent report that their
top concern is the fate of the nation. Of interest, more Democrats (73 percent)
agreed that this was their top concern than Republicans (56 percent).
Nonetheless, the sentiment that this is the lowest point in our nation’s history
spanned generations, which includes World War II, Vietnam, and 9/11. Only 30
percent said that terrorist attacks are a source of concern.

Even though politics and specific names were not directly questioned, many of
the issues identified as significant sources of stress, are policy issues.
Bloomberg generated a chart that is reproduced below.

Health Care ___________________________________________ 43%
Economy ___________________________________ 35%
Trust Gov? _________________________________ 32%
Hate Crimes ________________________________ 31%
Crime ________________________________ 31%
Wars _______________________________ 30%
Terrorist Att _______________________________ 30%
High Taxes _____________________________ 28%
No Job/LoWage_________________________ 22%
Climate Change________________________ 21%

However, keeping up with the latest developments is an even larger source of
stress for 56 percent. Further, sources of news which include social media, cell
phone news apps, and network news media blowing things out of proportion
causes them even more distress, a whopping 72 percent.

Dr. Anthony Rustain, a professor of psychiatry at U. of Penn. suggests the
following ways to cut down on stress. 1.) Set guidelines for Social Media time
and time spent watching/reading about the news. 2.) Complete all other
important tasks before checking with social media or with other new sources.
3.) Don’t lie in bed with your cell phone in your face, scrolling through the social
media and news sources. 4.) Don’t check your messages, social media, or
news frequently during the day. 5.) Balance your day with relaxation methods,
such as meditation, music, entertainment, and physical exercise.

And, above all, remember to breathe.

by Susan Andrews, PhD

For generations traditional medicine has refused to consider “stress” and
other emotional problems as having a direct effect on our body and health.
The doctor might nod sagely and say things like, “it’s all in your head or that
is just your imagination.” Slowly, persistently, the evidence built up showing
many direct effects of stress on the body. Then, the stress was shown to be
transmitted across generations – from a parent to the child, not just
environmentally, but also physically – in the developing brain of the neonate.

But, today, it appears as if stress as a topic of real consideration has come
of age. Cardiologists and internists are now overheard as saying, “next visit
we will talk about stress.” It is like the physicians have decided that stress
and its many “physical friends and relations” really should belong to
medicine, as much as if not more than it does to psychologists. This may
afford psychologists an opportunity to build working relationships with
medical practices. Medical professionals may be able to talk about stress in
physical and medical terms but stress is still best treated without medication
and before it causes illness.

Not only can physicians now be heard talking about stress to their patients,
but also more and more continuing education programs are focusing on the
topic. Most recently, the serious connection between stress and
inflammation is being taught around the world. This is hugely important as
unresolved inflammatory responses are fingered as the root cause of many
chronic illnesses and dis-eases, such as diabetes, metabolic syndrome,
age-related changes and neurodegeneration, heart disease, cancer, MS,
ulcerative colitis, Crohn’s Disease, and Rheumatoid arthritis.

You can appreciate how close the relationship between chronic stress and
chronic inflammation is when you look at the potential causes of just one
chronic inflammatory illness, such as chronic inflammation in the digestive
tract. The #1 cause is often listed as Emotional Stress in the form of panic
attacks, rapid pulse, with night sweats. This constellation of symptoms is a
sign of a cortisol-prompted inflammation. When cortisol remains high in the
blood (immune system and adrenals on overdrive), it results in dilated blood
vessels that force blood to your organs in preparation of an attack. The #2
cause is Physical Stress.

Another indicator that Stress has come of age is the number of related hits
Google gives you for a search on “stress.” Any guess between 115,000,000
and 150,000,000 is acceptable. Actually, today the result was 131,000,000.
The results range from causes and triggers of stress to Symptoms of
Anxiety and Stress to things stress is associated with to ways to manage
stress.

It is the ways to manage stress that we do best as psychologists. The bulk
of the 131 million websites that came up are focused on ways to reduce,
manage, get rid of, or lower stress. Many of these websites are very
superficial and even misleading. Or, they are aimed at selling their product.
Stress can almost never be properly managed by simply reading an article
or book or looking at a website. It takes time, determination and good
coaching or therapy for a person to begin to drop bad habits, learn how to
live a more healthy life, and then finally put what they learned into real
action. The techniques to reduce stress only work if you use them.

Psychologists well understand the consequences of trauma and forms of severe stress. And, even though they may not have all the words to describe what happens to them, almost every person who is intimately involved with a crisis, such as Harvey, knows the effects – “first-hand.” Property loss, health consequences for some, environmental devastation, and likely changes in schedule and lifestyle are just some of the more physical consequences. The
dollar cost of Harvey will be staggering.

However, the emotional impact will be far greater and impossible to place a “price tag” on. There is no recovering a lifetime of memories when your family photobooks or your mom’s china or your child’s school records are swept away by floodwater. I remember friends and family digging through the stench after Katrina’s floodwaters finally subsided, looking for anything that might have survived. Some of us can set that aside and not let the grief and
traumatic memories of the losses evolve into depression and anxiety-related disorders. Others are not that resilient.

But, there is another less known and understood consequence of trauma that I want to talk about today. Research I found when I was writing Stress Solutions for Pregnant Moms indicated that an unnamed group of victims can be the unborn children of women who are pregnant in the midst of a crisis. Medical historians long ago identified that war and natural disasters have significant effects on the children born to women who were pregnant during such events. The van Os study (British Journal of Psychiatry 1998) revealed an increase in schizophrenia among children born to women who were pregnant during the May 1940 invasion of the Netherlands. Laplante et al (Journal of the American Academy of Child and Adolescent Psychiatry 2008) explored the cognitive and linguistic functions of 5-year-old children whose mothers had been stranded in a Quebec ice storm. There are several important findings from this study: (1) Children of mothers who experienced high stress during the severe ice storm scored significantly lower on Full Scale IQ and on scales that measure verbal abstract reasoning and information as compared to children of mothers who experienced moderate or low stress during the same natural disaster. (2) The study suggests that timing of the exposure to the natural disaster is important, with poorer outcomes associated with first and second trimester exposure. (3) The negative effects associated with prenatal stress were seen at 2 years, 5 ½ years, and 8 ½ years of age, indicating relatively long-lasting effects.

Countless articles are being published in international journals on this topic leading the American Academy of Pediatrics to issue a landmark warning on January 1, 2012. In their report entitled “The Lifelong Effects of Early Childhood Adversity and Toxic Stress,” they reviewed converging lines of scientific evidence that illustrate how different types of stress can leave a lasting mark on a child’s developing brain and long-term health. The American Academy of Pediatrics’ position paper acknowledges that the period of time from conception through early childhood is critical. They include prenatal stress in their definition of toxic stress and say that children exposed to early stressful conditions are more likely to struggle in school, have short tempers, manage stress poorly, and tangle with the law.

And, while we know how damaging natural disasters are, we do not really know how to mitigate the consequences to people. I hope people can at least be conscious of the effects and work on solutions

by Susan Andrews, PhD

Researchers have long linked weight gain to stress, and according to an American Psychological Association survey, about one-fourth of Americans rate their stress level as 8 or more on a 10-point scale. Stress eating or “emotional eating” seems to be triggered almost automatically when stressed. A 2010 study from the University of Michigan indicated that when levels of the stress hormone, cortisol, are up because you are stressed, you eat more snack foods.

We increase fat, salt, sugar, and caffeine intake. • We skip meals regularly. • We eat more fast food, mindlessly munching. • We tend to seek out foods that we consider “comfort food.” • We drink less water. • We may drink more alcohol. • And, some who still smoke, will smoke more cigarettes.

Stress does not always cause us to overeat or to eat more high-fat, sugary comfort-foods. The first reaction of our brain and body to high stress is to shut down appetite. The hypothalamus produces corticotropin-releasing hormone, which suppresses appetite. The brain then sends a message to the adrenal glands to release epinephrine or adrenaline. This triggers the body’s fight-or-flight response and – once again – eating is put on hold.
Fortunately, or unfortunately, this does not last if the stress persists, then the adrenal glands release cortisol. Cortisol immediately increases your appetite. As long as the cortisol levels remain elevated, the fat and sugar cravings continue.

Women are more likely than men to turn to food, while men are more likely to turn to alcohol and smoking. In 2007, an ingenious study in Britain showed that people who responded to stress with high cortisol levels were more likely to snack in response to daily hassles in their regular lives than low cortisol responders.

WebMD offers some interesting thoughts on breaking the stress eating cycle and enjoy a healthy diet.

• Prepare your brain and body in advance of a known period of stress and you will be better able to handle stress when it happens. Keep your emotions in better balance by eating regularly every four or five hours.
• Eat Complex Carbohydrates, like oatmeal, bran, brown rice, vegetables, beans, and fruits. Complex carbs help your brain synthesize serotonin.
• Eat healthy fats, like avocado, nuts, seeds, fatty fish, nut butters, and olive oil.
• Recognize the stressful event or thoughts that trigger the urge to eat. Stop first and decide if you are really hungry. Remind yourself when you last ate.
• Try a little Mindfulness.
• Always keep healthy snacks available wherever you go. Small packets of nuts or trail mix. • Eat good protein in the morning and complex carbs during the day.
• Please do not forget your small piece of dark chocolate (72% cocoa is good).
• Have cut up celery and carrots in the refrigerator.
• Avoid driving or walking past snacks and vending machines.
• Put that music on and do some breathing!

• Remember: STRESS IS JUST WHAT YOU THINK.

by Susan Andrews, PhD

Think about your day today or any day. Is anything causing you to be upset or worried? Are you  working on a timeline, for example, or have a deadline? Is today one of those days that you have too many things on your list? Check the list below and assign a value based on the duration of the aggravation or situation. If the situation or problem lasts less than an hour, assign a number value of 1. If it lasts for several hours, give it a 3. If the situation is chronic, assign a value of 5. Continue reading →