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College Students at Risk for Mental Health Challenges

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The books are still fresh, the first exams not yet printed, but college students may have more on their mind than you think. A new study finds one in five students reported thoughts of suicide in the last year, and three out of four reported at least one stressful life event.

The study published in the journal Depression & Anxiety surveyed 67,000 college students across more than 100 institutions, finding high rates for stress events, mental health diagnoses, and the risk of suicide or suicidal thoughts. Minorities were found to be especially vulnerable.

Lead author Cindy Liu, PhD, says the findings are important for both families and colleges. In a news release from Brigham and Women's hospital she notes: “Some stressful events cannot be prevented and, in some cases, are completely normal. But for others, a plan should be in place for family, friends, and colleges to provide support. Our study highlights an urgent need to help students reduce their experience of overwhelming levels of stress during college.”

Liu works in the departments of psychiatry and pediatric newborn medicine at Brigham and Women's Hospital in Boston. Hospital officials say she and her colleagues analyzed results from a survey asking students a variety of questions related to depression and anxiety. That includes whether they had been diagnosed or treated for a mental health issue, if they had engaged in self harm, and considered or attempted suicide. The authors note that college years represent a time of increased vulnerability for a wide range of mental health issues, with many common psychiatric conditions beginning during this period of a person's life.

The survey also asked how many stressful life events students had experienced in the past year. Stressful life events are defined as exposures the student felt were traumatic or difficult to handle. They cover a lot of territory, including academics, career-related issues, the death of a family member or friend, family problems, intimate relationships, other social relationships, finances, a health problem of family member or partner. They may even include the student's personal appearance, personal health issues and sleep difficulties.

Some key findings: rates of stressful life events were high, and associated with mental health issues. Three out of four students reported having at least one stressful life event in the past year. And for more than 20 percent of students, there were quite a few events, reporting six or more in the past year. The stress events appeared to take a toll, with stress exposure found to be strongly associated with mental health diagnoses, self-harm, and suicidal thoughts.

Mental health issues and thoughts of suicide were common in the study. One in four students reported they were diagnosed or treated for a mental health disorder in the past year. One in five had thought about suicide, nearly 20 percent had harmed themselves, and nine percent reported attempting suicide.

Sexual minorities showed high rates of mental health disorders, thoughts of suicide, and self-injury, particularly transgender students. They showed elevated rates of all outcomes, with about two-thirds reporting self injury and more than one-third attempting suicide. More than half of bisexual students reported thoughts of suicide, with more than a quarter reporting a suicide attempt.

Racial and ethnic minorities were found to under-report mental health issues. The study found Asian students had a higher likelihood of suicidal thoughts and suicide attempts, but reported a lower rate of mental health diagnoses compared to white students. African American students showed a lower likelihood of reporting all outcomes compared to white students.

The survey results were all based on self-reporting, which the authors say needs to be taken into consideration. But they provide an eye-opening glimpse into obstacles college students may be up against.

“Colleges and family members who are sending students off to college need to remember that this is a phase of life where young people are confronted with expectations from new relationships and living situations and other encounters that are stressful,” said Liu.
She and her colleagues say their study's findings point to an urgent need for strategies on campus to help mitigate stress, given its relationship to mental health issues and suicidal thoughts, and get students the help they need during this key developmental period.


Eye Movement Desensitization and Reprocessing (EMDR): Efficient Approach to Resolving Psychological Distress

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Over the years Eye Movement Desensitization and Reprocessing (EMDR) therapy has become increasingly popular, evidence-based, therapy approach to resolving psychological distress. Initially used to relieve psychological distress related to clinical symptoms caused by traumatic experiences, its use has now spread to relieving psychological distress related to a number of different clinical symptoms that cause psychological distress and not only to clinical symptoms caused by traumatic experiences.

History of EMDR

According to Francine Shapiro (1989), sometime in 1987, she was walking in the park when she realized that eye movements appeared to decrease the negative emotion associated with her own distressing memories. Francine assumed that eye movements had a desensitizing effect, and when she experimented with this she found that others also had the same response to eye movements. It became apparent however that eye movements by themselves did not create comprehensive therapeutic effects and so she added other treatment elements, including a cognitive component, and developed a standard procedure that she called Eye Movement Desensitization (EMD). Over the following years, Francine continued to develop this treatment approach, incorporating feedback from clients and other clinicians who were using EMD. Consequently, sometime in 1991, she changed the name to Eye Movement Desensitization and Reprocessing (EMDR) to reflect the insights and cognitive changes that occurred during treatment, and to identify the information processing theory that she developed to explain the treatment effects (Shapiro, 1991).

Efficacy of EMDR

Even though criticized at first, over the years EMDR has got a broad base of published case reports and controlled research that supports it as an empirically validated treatment of trauma and other adverse life experiences.

According to the American Psychologist’s Association (APA), with a number of controlled studies of EMDR, EMDR is currently one of the most researched methods of psychotherapy used in the treatment of trauma. Its efficacy has been supported by a number of studies.

The Form of EMDR

At the moment EMDR is best described as a complex therapy approach that combines salient elements of the major therapeutic schools (e.g., cognitive, behavioral, psychodynamic, physiological, and interactional). Although the eye movement stimulation (and other forms of dual stimulation used in the approach) have garnered the most attention professionally and publicly, EMDR actually involves a much broader spectrum of interventions, which are organized into eight phases of therapy (Shapiro, 2001).

In the eight phases of EMDR therapy approach, attention is given to three time periods – the past, present, and future. During this, the attention is given to past disturbing memories and related events. And, also, to current situations that cause distress, and to developing the skills and attitudes needed for positive future actions.

The following is a more detailed overview of the eight phases of EMDR therapy, according to Shapiro (2001).

Phase 1:  The first phase is a history-taking session(s), where assessment of the a client’s readiness is performed, after which a treatment plan is starting to be developed. Within this phase, possible targets for EMDR processing are identified. These may include distressing memories and current situations that cause emotional distress. Other targets may include related incidents in the past.  Emphasis is placed on the development of specific skills and behaviors that will be needed by the client in future situations.

Initial EMDR processing may be directed to childhood events rather than to adult-onset stressors or the identified critical incident if the client had a problematic childhood.  By doing this, it is possible to generally gain insight into situations, which resolves emotional distress and starts to change the problematic behaviors.  The length of treatment depends upon the number of traumas and the age of onset of clinical symptoms.  Generally, those with single event adult onset trauma can be successfully treated in under 5 hours.  In this regard, multiple trauma victims may require a longer treatment time.

Phase 2:  During the second phase of treatment, the knowledge about different ways of handling emotional distress in raised. In this regard, the client may learn a variety of imagery and stress reduction techniques that can be used during and between sessions.
In general, the goal of EMDR therapy is to produce rapid and effective change while the client maintains equilibrium during and between sessions.

Phases 3-6:  In phases three to six, a target is identified and processed using EMDR therapy procedures.  These involve the client identifying three things:

1.  The vivid visual image related to the memory

2.  A negative belief about self

3.  Related emotions and body sensations.

In addition, during this stage, the client identifies a positive belief.  The therapist helps the client rate the positive belief as well as the intensity of the negative emotions.  After this, the client is instructed to focus on the image, negative thought, and body sensations while simultaneously engaging in EMDR processing using sets of bilateral stimulation.  These sets may include eye movements, taps, or tones.  The type and length of these sets are different for each client.  At this point, the EMDR client is instructed to just notice whatever spontaneously happens.

After each set of stimulation, the clinician instructs the client to let his/her mind go blank and to notice whatever thought, feeling, image, memory, or sensation comes to mind.  Depending on the client’s report, the clinician will choose the next focus of attention.  These repeated sets with directed focused attention occur numerous times throughout the session.  If the client becomes distressed or has difficulty in progressing, the therapist follows established procedures to help the client get back on track.

When the client reports no distress related to the targeted memory, (s)he is asked to think of the preferred positive belief that was identified at the beginning of the session.  At this time, the client may adjust the positive belief if necessary and then focus on it during the next set of distressing events.

Phase 7:  In phase seven, closure, the therapist asks the client to keep a log during the week.  The log should document any related material that may arise.  It serves to remind the client of the self-calming activities that were mastered in phase two.

Phase 8:  The next session begins with phase eight.  Phase eight consists of examining the progress made thus far.  The EMDR treatment processes all related historical events, current incidents that elicit distress, and future events that will require different responses
When it comes to different stages of EMDR therapy described above, it should be noted that currently EMDR is often used as a part of integrative therapy approach. Hence, at times, the form of EMDR therapy may deviate from the one described by Shapiro (2001).

Why EMDR?

As it was previously noted, the EMDR integrates many psychological theories including psychodynamic, behavioral approaches, and cognitive behavioral theory. This makes EMDR possible to use as a part of integrative therapy approach. This type of approach is, therefore, possible to use with a wide variety of client and in a wide variety of situations.

In addition, numerous studies have shown the effectiveness of EMDR. Much of the EMDR research has studied clients suffering from PTSD, particularly veterans. However, studies proving the efficacy of EMDR have been conducted on clients struggling with addictions, excessive grief, developmental traumas, sexual dysfunction, and dissociative disorders, to name a few.


Literature
Shapiro, F. (1989). Efficacy of the eye movement desensitization procedure in the treatment of traumatic memories. Journal of Traumatic Stress, 2, 199-223.
Shapiro, F., (1991). Eye movement desensitization & reprocessing procedure: From EMD to EMD/R-a new treatment model for anxiety and related traumata. Behavior Therapist, 14, 133-135.
Shapiro, F., (2001). Eye Movement Desensitization and Reprocessing: Basic Principles, Protocols and Procedures (2nd edition). New York: Guilford Press.

Veteran Shares How Accelerated Resolution Therapy Helped Him Overcome PTSD

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According to the United States’ Veterans Association, post-traumatic stress disorder (PTSD) can occur in individuals who have witnessed combat. Research shows that in excess of 20% of veterans who served in Afghanistan and Iraq suffer from PTSD.

Symptoms can include intrusive flashbacks and nightmares, emotional numbness, difficulty sleeping, feeling on edge, anxiety and panic attacks, and suicidal thoughts. If symptoms persist after a few weeks, an assessment is needed in order to determine whether a person is suffering from PTSD and if so, what kind of treatment is most appropriate.

For some, Accelerated Resolution Therapy (ART) may be the answer. ART is a four to five-session, evidence-based psychotherapy program that uses a combination of relaxation and memory visualization to resolve a traumatic memory. According to ART International, 70% of service members and veterans who completed treatment “substantially” reduced their symptoms of PTSD in an average of four treatment sessions and the U.S. Department of Defense is bringing ART to Ft. Hood, Ft. Stewart, Ft. Drum and Ft. Belvoir Community Hospital.

“ART is one of those therapies that was absolutely amazing for me and helped me walk this path that I’m on,” Brian Anderson, a veteran who struggled with PTSD told us.

Anderson joined the military after 9/11. He is a retired Army Green Beret with 14 years of service, 33 months in combat and three Bronze Stars. Anderson struggled with severe PTSD and had thoughts of suicide as he made the transition to civilian life.

“My third deployment was to Uruzgan Province Cobra Base (in Afghanistan),” Anderson told us. “Our very first firefight on Cobra Base was eight hours long and we killed 39 Taliban that day. This 12-man team went on to do a lot of fighting in that area and every single time we left the wire, we were in a heavy firefight. I was already angry and bitter with all the fighting and then September 29, 2010 came around, which was day two of Operation Sundown. My teammate, Calvin, wasn’t supposed to be on that operation but he went. We’re sitting there and watching a couple of helicopters fly into our base. We got a call on our radio that mail just came in. We were all excited and pumped for day two. We’re thinking that once we’re done this operation, we can open our mail.”

Calvin was killed that day along with Mark, Anderson’s combat controller. They were both killed by a high-ranking Taliban commander.

“I was right there when they were killed and took out the machine gun nest that was holding them next to the building,” Anderson told us. “They passed away and we took off the sensitive items from off their bodies, put them in body bags, put them on a plane and sent them out. We kept on with our operation for the next couple of weeks. We went through the rest of that deployment and there was still a lot of fighting. We had a couple more injuries and a couple more casualties. They were all difficult. Then we came home.”

Anderson wanted to leave the military. His team moved to Eglin Air Force Base and he stayed at Fort Bragg. That’s when he says he started feeling panic attacks.

“I started feeling symptoms of PTSD when I left active duty,” Anderson told us. “I was first diagnosed while I was still in service. I first went in because I thought I had blood pressure issues or diabetes. I was getting lightheaded and weak, and didn’t know what was causing this. When I got to the hospital they ran all the tests they needed to do. When I came back to the hospital for my follow-up visit, the doctors told me I was suffering from PTSD which was causing my panic/anxiety attacks.”

Anderson began a long road at trying to figure out what this meant and how he could recover.

“It got a lot worse before it got better,” says Anderson. “I started questioning my existence, whether I was alive, thinking I was in purgatory and thought I actually died in Afghanistan and had to right everything that went wrong. Then I started seeing Calvin and Mark. I started seeing Calvin driving the car next to me. I would see Mark walk past me. I would have images of bullets going through my head. I would imagine rage coming through the door.”

A friend pointed Anderson to ART.

“What was really interesting is after my session some of the scenery I would see on a regular basis - seeing Calvin driving the car next to me, Mark walking past me, images of bullets going through my head or rage coming through the door - all that stuff went away after one session,” Anderson told us. “I’ve really tried to push other warriors to see what this therapy – a therapy that I call brain fitness on steroids -- is really about. I didn’t go through another ART session for a year and a half. I did go through several more ART sessions after the year and a half for things like my time in war, people passing, survivor’s guilt and other stories. During these sessions, I would picture myself waking up in the morning and feeling this heavy guilt and shame, which expanded to the entire day. I would then envision what my perfect day was. That was about a year and a half ago and I haven’t had guilt and shame since then. I think ART absolutely is effective and it helped me out tremendously with overcoming some of these gaps that I’ve had. ART saved my life.”

Trump Era Politics Leading to Increased Stress in the Workplace

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It’s a phenomenon referred to by some psychologists as Trump Anxiety Disorder.

Political division is one of the most divisive topics in the United States with 86 per cent of people seeing strong conflicts between Democrats and Republicans.

Across the country, people are experiencing stress and lack of sleep due to their worries about politics in the Trump era. A recent study found one in seven Americans, about 34 million people, are struggling to sleep they are so stressed about politics.

But it’s not just sleeping habits that are being impacted by politics in the Trump Era. Political division is making its way to the workplace, and the consequences are significant.

Professor Wayne Hochwarter is a professor of Organization Behaviour at Florida State University and a Professorial Fellow at the Center for Sustainable Human Resource Management at Australia Catholic University. He wanted to see how significantly political division is impacting workplaces across the country.

He asked 550 full time employees to respond to statements on a variety of workplace issues, including workplace relationships to health and the impact of unwelcome political discussions. 

27 per cent of those who took part in the study agreed or strongly agreed that the workplace is now more tense due to political discussion. One third of the participants noted that talking about politics is distracting. One in four of those surveyed said they went as far as to actively avoid certain people they worked with, who were likely to try and influence their views. One in five had lost friendships at work due to partisanship.

“Over the first cup of coffee, it is common to start a conversation with “did you see what Trump had to say last night? Or the Democrats?’ People, by default, want to be part of something larger than themselves. Unfortunately, the divisiveness has given them an opportunity to perpetuate the separations that we are currently experiencing,” Professor Hochwater told Theravive. 

The average person spends around 25 per cent of their adult life at work. As workplaces become more tense, the impact on mental and physical health can be considerable. According to the American Psychology Association, stress at work can lead to burnout, emotional exhaustion and the development of cynical and negative attitudes. Burnout can also result in depression, which can lead to a number of other health conditions like obesity, diabetes and strokes.

Hochwater’s study found that more than a quarter of those surveyed said political division has resulted in increased stress levels in the workplace and interferes in their productivity in completing tasks. Of those who were experiencing increased levels of stress, nearly a third said they would call in sick on days when they didn’t feel like being in the workplace. Of those who don’t feel stressed due to politics, only 17 per cent said they would call in sick.

“Trump is part of the zero-sum phenomenon. You can’t really ‘kind of like him’ or ‘kind of not like him’. Because there are a few opportunities for compromise, it makes the situation very stressful. In the past, people would leave their political ideologies either at home or in their car before work. Now people are not afraid to voice their opinions. We used to tell our children not to ask other people about their income, their sex lives, or their political leanings. Obviously, we have not stayed true to one out of three of them,” Hochwater said.

It’s not just Hochwater’s study that suggests Americans are more stressed about politics than ever before. The American Psychological Association’s Report “Stress in America” found that 59 per cent of Americans consider this to be the lowest point in United States history in living memory. This includes World War II, the Vietnam War, the September 11 terror attacks and the Cuban Missile Crisis. 63 per cent or almost two thirds of Americans identified the future of America as a significant source of their stress, outranking even stressors like money and work.

When asked in 2017 to think about the state of the nation, six out of 10 adults, or 59 per cent, said the social divisiveness currently being experienced across the country is causing them stress.

That stress transcends party lines, though Democrats are more likely to experience stress due to politics. 73 per cent said politics was social divisiveness caused them stress compared with 65 per cent of Republicans and 59 per cent of independents.

“People are being pulled in a number of direction already dealing with work, families, the economy, aging parents, picking up dry cleaning, health care.  This is just one more cause of people having focus messed with,” Hochwater said.

He says there is not much companies can do about political division in the workplace.

“I think it would be incredibly challenging to prohibit talk of this nature. How do you do it? What are the penalties? Does this violate free speech mandates? 

At some point, one side is going to feel violated,” he said.

He argues managers should be proactive and focus on effective leadership to ensure a minimum amount of stress for employees.

“The best approach is to allow people open opportunities for civil discussion and also let people get professional help and guidance if the environment becomes too toxic as a result.”

News Headlines Causing Gen Z Significant Levels of Stress

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News headlines are causing significant stress for those in Generation Z. 

A recent study by the American Psychological Association (APA) that examined stress in America found 15-21 year olds are experiencing notable stress levels in response to what is happening in the news.

“Young people are coping with many of the same issues, especially related to issues in the news, that older adults face, but may have not yet developed the coping skills to effectively deal with them. This is especially important when you consider the developmental implications of stress,” Dr. C. Vaile Wright, psychologist and director of research in APA’s Practice Research and Policy Department told Theravive.

“Certain regions of the brain – notably, those regions that underlie planning, inhibitory control, and other higher-order cognitive abilities – do not fully develop until individuals reach their mid-20s, so Gen Z members are not biologically equipped to handle stress in the same way that adults do. Additionally, young people have not yet had the life experiences that many older adults have had, such as practice responding to and coping with a broad range of stressors,” he said.

75 per cent of the Gen Z members surveyed said mass shootings caused them a significant amount of stress. Overall, Gen Z were more stressed than adults about a number of issues in the news. 57 per cent of members of Gen Z reported they felt the separation or deportation of migrant families was a significant source of stress, compared with 45 per cent of adults surveyed. Over half of members of Gen Z surveyed (53 per cent) said they experienced stress due to news stories related to sexual assault and harassment, whilst only 39 per cent of adults reported this as a source of stress.

“Many of the big issues that Gen X say is causing them stress are related to uncertainty, whether it’s mass shootings, school shootings, the political climate or immigration,” Dr. Wright told Theravive.  

“We know that uncertainty can exacerbate stress. When things go as planned, we feel in control. But when life throws a curveball, it can leave us feeling anxious and stressed. Research shows that people react differently to uncertainty and that those with a higher intolerance for uncertainty may be less resilient and more prone to low mood, negative or down feelings and anxiety,” he said.

Although Gen Z appears to be more stressed by topics in the news when compared with adults, they are less likely to vote in elections. Just over half (54 per cent) of Gen Z adults between 18 and 21 said they intended to vote in the US midterm elections, while 70 per cent of adults surveyed said they intended to vote.

Wright says voting could actually assist members of Gen Z in dealing with their stress.

“Channeling tension, feelings of dissatisfaction and uncertainty toward something that is meaningful and productive is a healthy approach to managing stress whether it’s running for a position on the local school board, volunteering for a cause that focuses on problems that you want to change, or attending local town hall meetings with your state and Congressional representatives. Taking active steps to address your concerns can lessen feelings of stress. Voting is another active response to feeling overwhelmed about politics and things outside your control,” he said.   

Some amounts of stress can be positive, like the kind that helps motivate a person to study or do their best at work. But chronic stress that goes untreated can have serious health consequences.

More than nine in 10 members of Gen Z (or 91 per cent) reported having experienced at least one stress related physical or emotional symptom. Emotional symptoms may be feeling depressed, sad, and lacking in motivation or energy. Physical symptoms may include stomach aches or head aches. Only half of the members of Gen Z who were surveyed said they felt like they were doing enough to manage their stress.  

“While these common health symptoms might seem minor, they can lead to negative effects on daily life and overall physical health when they continue over a long period of time. Unlike everyday stressors, which can be managed with healthy stress management behaviors, untreated chronic stress can result in serious health conditions including anxiety, insomnia, muscle pain, high blood pressure and a weakened immune system.  It can also contribute to the development of major illnesses, such as heart disease, depression and obesity,” Wright said.

There are number of things Wright suggests people can do if they are feeling overwhelmed by what is in the news.  

Having strong social support networks assist individuals in coping with problems on their own, and improve self-esteem and a sense of autonomy. Three quarters of Gen Z said they could have had more emotional support in the previous 12 months.

Getting enough sleep, eating a well balanced diet, exercising and avoiding unhealthy coping mechanisms like substance abuse and alcohol are all helpful ways to cope with stressors in the news.

“If you are overwhelmed by issues in the news and it’s interfering with your daily life, take a break and manage your news consumption. Read or watch just enough to stay informed by putting some boundaries around how much, what kind, and how often you take in the news. Listen to your body to tell when you’ve had enough – if you are experiencing physical or emotional symptoms it may be a sign that you are stressed,” Wright said.

“If you have tried these tips and are still feeling overwhelmed, you may wish to consider seeing a mental health professional who can help you develop specific coping strategies,” he said. 

Study finds Stress-Related Searches Peak during Holiday Season

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Overwhelmed at the thought of buying gifts for everyone on your list? Panicked about meeting a year-end deadline at work? No idea how you're going to bake cookies for church, teachers, family, the mailman, dogwalker, and babysitter? Well, maybe one of them can do without cookies. But, know you aren't the only one feeling stressed during the holiday season.

Employees at Salt Lake City based TermLife2Go.com were curious if other people were feeling as stressed this time of year as they were, so they let their data analysts get to work. They turned to the same place most people do when they want an answer, Google! "We felt like it actually could be a good indicator of who's feeling the most stress, because when you think about it, where do we go first when we have a health question? We'd love to say it's our doctor, but most of the time it ends up being Google", says Nina Simmons, Community Manager at TermLife2Go.

Turns out, Google searches spiked in December of 2017 for stress-related terms. Analysts searched for terms like "stress relief", "psychological stress", "anxiety disorder", and "stress reduction". They found those terms among Americans started trending upward near the end of November, and peaked mid-December.

Once analysts discovered the trend, they decided to take it a step further, and work to figure out which states had the biggest volume of searches. "We ran those terms back through Google one at a time, each time looking at the specific time range of end of November to before Christmas. And, we looked for which states had the highest search volume for all of those terms combined during that time period, so during that holiday season", says Simmons.

Using that data, analysts determined the states with the most holiday stress are North Dakota, Nebraska, Oklahoma, New Hampshire, and Massachusetts. That collection wasn't what the researchers were expecting: "You weren't really seeing so many of the larger states, even though this wasn't done per capita", says Simmons. "That was actually pretty surprising to us, that some of the states with really large major cities weren't included in our top five."

If you are one of the millions feeling the stress of the holiday season, there are some things you can do to cope. Physically, the American Heart Association recommends keeping up regular healthy habits like eating well, exercising, and taking time to relax.

The Mayo Clinic also has a big list of suggestions, including planning ahead and learning to say no. Experts there suggest making sure you have time for yourself. They say just 15 minutes alone without distractions may refresh you enough to handle that lengthy to-do list. The most effective is described as an activity that clears your mind, slows your breathing, and restores inner calm. Some recommendations from the Mayo Clinic include taking a walk at night and stargazing, listening to soothing music, getting a massage, or reading a book.

Employees at TermLife2Go says the biggest takeaway they got from their data project was the reminder to take care of themselves during the holidays. "We're pretty much saying if you're feeling stressed over the holiday season, you're not alone", says Simmons. "As much as we'd like to think it's the happiest time of the year, know many people out there are feeling a little stressed."

Thinking About Romantic Partners May Help Ease Stress

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Feelings of stress happen to everyone at one time or another, and there are many different ways of coping. 

Some people may try going for a walk or spending time with their partner, but this is not always possible. Now new research from the University of Arizona has found that when under stress, just thinking about a romantic partner can help keep blood pressure levels under control just as well as if the person was there beside you.

“In terms of the impact of close relationships on cardiovascular health, the evidence is pretty clear that having more relationships, particularly more positive relationships, benefits physical health,” Kyle Bourassa, lead author of the study, told Theravive. 

“In the case of thinking about a partner, the mental image people carry around with them of their partner might act as a psychological resource during stress. When our partner is present, it may reduce the stress response to threat. Our study suggests that both might play a role, though more study is clearly needed before we can be sure of this,” he said. 

In undertaking his study, Bourassa and colleagues asked 102 study participants to complete a stressful task; putting their foot into cold water between 38 to 40 degrees Fahrenheit. The blood pressure and heart rate of participants was measured before they submerged their foot in the water, whilst their foot was submerged and after they had removed their foot from the water.       

All of the study participants were in a committed romantic relationship and were each given different instructions during the study in relation to their partner. Some participants had their partner sitting silently in the room whilst they submerged their foot in the cold water, other participants were asked to think about their partner as they completed the task and the final group of participants were not instructed to think about their partners at all, but rather to think about their day as they completed the task.

The researchers found that the participants who had their partners in the room during the task had a lower blood pressure response when their foot was placed in the cold water, when compared with the participants who were asked to think about their day. The participants who were asked to think about their partners during the task also had a lower blood pressure.

Previous research suggests either having a partner present in a stressful situation or visualizing a partner during a stressful situation helps the body cope with stress. This latest research suggests the two methods are equally effective in keeping blood pressure under control during stress.

“If these results hold in daily life, it might help people when they face stressful situations. Life can be full of stress, and one way we manage stress is through relationships. These findings suggest that thinking about your partner might be helpful in managing stress in the same way as actually having your partner there. This might help support people control their blood pressure during stressful situations like taking a test, presenting at a meeting, or going to the dentist,” Bourassa told Theravive.

It has long been established that positive relationships have a significant impact on both physical and mental health, even years after a partner dies.

“In a prior study, my colleagues and I found that the quality of life of a person's spouse predicted their partner's wellbeing, even years after they died. This led us to wonder what cognitions, or mental thoughts, about a spouse might influence people even when their partner isn't physically present. This combined with previous evidence that close relationships improve health led us to create the study to explore how mentally drawing on the image of a partner might influence people's physical health, as well as how this compares to actually having a partner physically present. The importance of the question is related to the importance of our relationships,” Bourassa said.

Healthy and positive relationships have been found to lower rates of depression and anxiety, improve self-esteem, strengthen the immune system, assist in recovery from illness and even prolong life. A lack of positive relationships and loneliness can result in an increase of the stress hormone cortisol, increased blood pressure, disrupted sleep, and increased risk for depression and suicide.

It turns out strong, positive relationships really can be a matter of the heart.

“Numerous past studies have shown that having high quality social relationships are associated with better health and lower likelihood of death. In my area of study, one way we have understood this effect is in the impact strong relationships have on cardiovascular health. People in positive social relationships generally have better heart health than those in high conflict relationships or who are socially isolated.”  Bourassa said.

“Positive, rewarding social connections have a variety of important impacts on health, and one way to benefit from your social connections is to draw on them as a resource during times of stress, even if they aren't physically present.”  

Working Mothers Experience More Stress Than Workers Without Children

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Ask any parent who works how their stress levels are and they’ll probably tell you they’re quite high.

It’s no secret that working parents juggle a lot, but now a new study has found that working mothers really do feel more stressed.

The study from the University of Essex and University of Manchester in the UK found that mothers who worked full time had considerably higher stress levels than those who work full time but don’t have children. Working mothers with one child were 18 per cent more stressed than their childless counterparts. And it didn’t get easier for parents with more than one child; working mothers with two children were found to be 40 per cent more stressed than those who didn’t have children.

In conducting the research, the investigators examined data from more than six thousand employed people in the UK Household Longitudinal Study. The study gathers data from households on topics like their experiences with stress, their working life, blood pressure and hormone levels.

The researchers found that not only did working mothers experience more stress than others, this stress didn’t improve when flexible working arrangements like different working hours or working from home were offered.

“We often hear that giving workers control over their work schedules (when they start and end their work for example) or work locations (working from home) could help to reduce their stress. So I wanted to test those ideas directly,” Professor Tarani Chandola, author of the study and Professor of medical sociology at the University of Manchester told Theravive. 

“I was surprised that flexitime (changing the start and end times of work) or flexplace (working from home) arrangements were not correlated with lower levels of stress related biomarkers. Only reduced hours flexible work (working fewer hours when needed by the employee) were correlated with lower stress levels,” he said.

Chandola and colleagues used 11 biomarkers to assess the stress levels of those in the study. 

“The 11 biomarkers are related to the biological stress response and are a mixture of neuroendocrine (for example hormones), metabolic (for example cholesterol), inflammation, cardiovascular (for example heart rate and blood pressure) and anthropometric (for example obesity) biomarkers. Individually, each biomarker in itself is not a measure of stress. However collectively, raised levels of these biomarkers indicate allostatic load, which is when a person cannot cope with the types of stressors they encounter and they have a biological stress response that is prolonged,” Chandola said.

Some levels of stress can be normal and even helpful in certain situations. Stress experienced before a job interview or presentation may motivate you to adequately prepare to perform well. If the body senses danger, stress manifests in the form of a speedy pulse, faster breathe, and tension in the muscles. This response to stress is a fight or flight response and can assist in responding properly to a bad situation.

In situations like that, stress can be a good thing. But prolonged, constant stress can be damaging both to mental and physical health. Constant stress interferes with the proper function of various systems in the body like the immune system, reproductive system and the digestive system. Stress can also interfere with sleep.

If stress continues without relief, there is a greater risk for health problems like heart disease, diabetes and high blood pressure. Those under constant stress are also at greater risk of developing anxiety or depression.

“These biological stress measures are correlated with a range of physical and mental health problems like early death, increased risk of heart attacks and depression. This is true for all adults, whether they are parents or not,” Chandola said.

Given the extra stress experienced by working parents, Chandola says more effort needs to be made to enable parents to reduce the amount of hours they work, even if this is more difficult for managers.

“It is clear that they should have the choice to reduce their working hours when they need to. Not having the ability to reduce their hours to cope with their family or other related issues could result in raised stress levels and potential future health problems, as well as leaving their job earlier than expected,” he said.

“For managers, the toughest part of managing flexible working arrangements is probably allowing workers to work part-time or reduce their hours when the workers need to. It is probably easier to allow for flexi-time or flexi-place arrangements for some workers. However, we show that it is reduced hours flexible work that can help workers cope with their stress levels, not flexi-time or flexi-place arrangements.”


Eczema Patients At Higher Risk Of Suicidal Thoughts And Suicidal Attempts According To New Study

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An interesting link has been found between the common skin condition known as eczema and suicide. According to a new study published in JAMA Dermatology, those who suffer from eczema are at a higher risk for suicidal thoughts and suicidal attempts.

“We were interested in seeing whether patients with eczema (atopic dermatitis) had higher risk of suicidality (suicidal thoughts, suicide attempts, and completed suicides) when compared to those without eczema,” study author, April Armstrong told us. Armstrong is a professor of dermatology (clinical scholar), at the Keck School of Medicine of the University of Southern California. “Previous studies have found that eczema creates a profound physical and psychological burden on patients."

Armstrong explains that eczema sufferers may experience debilitating symptoms of itch, burning, pain, and sleep loss. They may also experience feelings of shame, stigma, and embarrassment due to the visibility of their disease. The burden that eczema sufferers experience may be detrimental to their mental health and lead to a higher risk of suicidality. She and her colleagues hypothesized that eczema was associated with suicidality.

According to the World Health Organization, over 800,000 die by suicide each year which equates to one person every 40 seconds. It’s the second leading cause of death for those aged 15 to 29. 

“In clinic, we have noticed that eczema can take a heavy toll on the mental health of our patients,” Armstrong told us. “Many of our eczema patients lose hope in improving from their disease and begin expressing thoughts of suicide. This clinical finding motivated us to study the association between eczema and suicidality. We hoped to clarify this association and begin making strides towards improving the mental health of those who suffer from eczema.”

According to the National Eczema Association, two thirds of people with eczema say the condition interferes with their daily life including employment and household management. A whopping 40 per cent of adults with eczema said that they refused an employment opportunity because of their eczema.

“The current literature on the association between eczema and suicidality has been inconclusive,” Armstrong told us. “We hoped to clarify this association through a meta-analysis. We carefully synthesized the available studies on suicidality in eczema sufferers. We pooled and analyzed data from 15 different studies to determine whether eczema patients had a higher risk of suicidality.”

From their meta-analysis of 310,000 eczema patients and 4.4 million people without eczema, Armstrong and her colleagues found that eczema patients had a 44% higher risk of suicidal thoughts and a 36% higher risk of attempting suicide. Armstrong says that because of the known physical and psychological burden of eczema, she and her fellow researchers anticipated that there would be an association between eczema patients and suicidality. The results of the study confirmed their hypothesis.

“Suicide is a major health concern that affects millions of patients and their loved ones,” Armstrong told us. “We believe our results emphasize a need for dermatology providers and loved ones to pay closer attention to signs of suicidality in eczema sufferers. We hope that our results will eventually lead to updates of the eczema treatment guidelines to include mental health screenings.”

The economic impact of eczema in the United States is estimated to be $5.3 billion according to the National Eczema Organization. The costs associated with eczema include medical costs as well as indirect costs such as interference with employment.

“We hope that dermatology providers find our suicide screening recommendations practical and helpful,” Armstrong told us. “Through vigilant mental health screenings of eczema sufferers, we may be able to provide proper care to those at risk of suicide and prevent suicides from occurring.”

New Study Findings Explain Why Exposure Therapy For PTSD Might Not Work For Everyone

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Traumatic experiences create long-lasting memories that can negatively impact our lives in a myriad of ways. A common treatment to overcome fear is called exposure therapy, or fear extinction, where patients are repeatedly confronted with the source of the fear. This typically is effective at dampening the fearful response, however, the original fear tends to relapse outside of the clinic, limiting the effectiveness of the treatment. Anthony F. Lacagnina and fellow researchers at the University of Texas at Austin wanted to know how the brain changes to adapt to extinction training, and what happens when relapse occurs. To answer these questions, he and his colleagues got to work and shared their findings in a study, titled: Distinct Hippocampal Engrams Control Extinction And Relapse Of Fear Memory, recently published in the Journal of Nature Neuroscience.

“I've always been interested in the nature of memories; how they are formed, how they change over time, and so on,” Lacagnina told us. “Memories also have an emotional component to them, and so I've always wondered if it's possible to overcome our fears by understanding how they were formed and what happens when we are actively suppressing them. I realized there isn't a lot of research about what's happening in the brain when an animal is successfully suppressing it's fear (recalling the extinction memory), or about what happens when the original fear memory relapses (during spontaneous recovery).”

Russian physiologist, Ivan Petrovich Pavlov, was the first to describe that extinction memories tend to relapse over time, which he named spontaneous recovery, Lacagnina explained. This led to the idea that extinction learning does not erase the original memory, but instead creates a distinct memory trace that either inhibits or competes with the original one. Recent studies have shown that in the hippocampus, neurons active during the time of a fearful event can be reactivated at a later time point, showing that some component of the memory was stored in those cells. Lacagnina and his colleagues hypothesized that extinction learning might generate a new memory trace in this brain region, and that distinct populations of hippocampal neurons would represent the 'fearful' and 'safe' (or extinguished) memory.

To test out their theory, researchers placed mice in a chamber and delivered a mild foot shock, which causes them to form a fearful memory of the chamber. Later, researchers returned them to the same chamber day after day, never shocking them again, to show them that the chamber was no longer dangerous, which led to a reduction in fear. The mice were genetically altered to allow researchers to tag the population of neurons in the hippocampus that were active during either the day of their traumatic memory was formed, or when they were no longer expressing any fear. Using a technique called optogenetics, researchers could either stimulate or silence those populations of neurons. If the two memories existed in unique populations of neurons, researchers should expect to see different effects on behavior by manipulating them.

“We found that a new population of neurons, what we called ‘extinction neurons’, emerged after the extinction training,” Lacagnina told us. “The activity of these neurons were needed for the animal to continue to suppress their fear. If we silenced them, the original fear would emerge. Moreover, if we stimulated them, we could block natural forms of fear relapse, such as spontaneous recovery. Manipulating the fear neurons had the opposite effect - stimulating them could cause an animal to behave in a fearful way, while silencing them reduced the amount of fear relapse. We concluded that the hippocampus creates two unique and opposing memories of the experience; one to remember that the chamber was fearful, and one to remember that it was safe. We think that these two memories compete with one another to determine whether you will overcome your fear or succumb to it.”

Lacagnina told us that a couple of things were surprising to him and his fellow researchers. For one, the mechanisms of fear relapse are not well understood, so they were surprised to find that the neurons of the hippocampus involved in the initial traumatic experience played an important role in the phenomenon of spontaneous recovery. Second, they were surprised they were able to block fear relapse by activating the extinction neurons. Extinction learning is thought to be a weaker form of learning, Lacagnina explained, so it was unexpected that reminding the animal of the safe context was able to override the natural tendency to be afraid.

“There is still a lot more to learn about how both fear and extinction representations in the hippocampus compete for reactivation,” Lacagnina told us. “Why does the fearful representation win out during times of relapse, for instance. But if since we demonstrated that they exist in two populations of neurons, this gives us a useful target, to either strengthen the connections of the neurons related to the extinction memory, or weaken those related to the fear memory. We hope that this research and those like it will give us better insight into treating disorders like Post Traumatic Stress Disorder, anxiety, and phobias.”

Why Do Some Children Develop PTSD While Others Do Not?

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A new study from the University of East Anglia, published in the Journal of Psychology and Psychiatry looked at how common post-traumatic stress disorder (PTSD) is in children and adolescents in the initial weeks and months following a trauma.

“Why do some young people show no clinically significant PTSD symptoms early on,” study lead researcher, Dr. Richard Meiser-Stedman told us, “while others show a significant reaction?”

According to the U.S.National Center for PTSD, up to 43 per cent of children experience  trauma. Of those children who experience trauma, three to 15 per cent of girls and one to six per cent of boys go on to develop PTSD.

“We were really interested in the cognitive model of PTSD proposed by Anke Ehlers and David M. Clark,” Dr. Meiser-Stedman told us. “This model was proposed primarily with adults in mind.”

Ehlers and Clark are the authors of: A Cognitive Model of Post-traumatic Stress Disorder, published in 2000 in the Journal of Behaviour Research and Therapy. The model suggests that whether or not PTSD occurs in an individual depends on how that individual processes the trauma that happens to them. Simply put, a person who goes on to develop PTSD may have problematic behavioural and cognitive strategies which causes them to repeatedly harbour negative thoughts about the trauma.

“Mental health professionals have recognized for some time that post-traumatic stress in the immediate aftermath of trauma – the first few days and weeks – is normal,” Dr. Meiser-Stedman told us, “so how does it evolve into persistent PTSD in some children and young people?”

To test their theory, researchers conducted a prospective longitudinal study covering the early window of (potential) recovery, with interviews and Internet-delivered questionnaires at two to four weeks and two months post-trauma. Over 200 children and young people aged eight to 17 years were recruited for the study.

What researchers found was that children were more likely to suffer from PTSD if they thought their reaction to a traumatic event was not ‘normal’. Sadly, children who suffer from PTSD may continue to suffer into adulthood.

“I thought the appraisal processes – e.g. interpreting one’s reactions as being a sign that something is seriously wrong, that you won’t recover, that you cannot trust other people – would be important, but I didn’t think they’d be this important,” Dr. Meiser-Stedman told us. “We had guessed that maybe children and young people who deliberately try to ‘process’ their experiences would be at less risk of PTSD, but instead we found the opposite. It makes for a complex picture – on the one hand, many children with PTSD will be avoiding painful and shocking details from what happened in the trauma, but they are also deliberately trying to get it ‘sorted’ in their heads. We shouldn’t belittle the internal battles children and teenagers with PTSD are going through.”

Dr. Meiser-Stedman says support for children and young people soon after a trauma is a difficult topic. He says there’s little evidence that any specific interventions help, but PTSD is a serious, potentially chronic condition that needs to be prevented or treated as early as possible.

“The question is how?” Dr. Meiser-Stedman told us. “It may be that these findings give us more pointers on which children and young people might be at particular risk of having longer term difficulties, and how we might best support them. It’s always going to be a balancing act between the resources that are available, allowing children and young people the option to recover on their own, offering some sort of ‘lower intensity’ support (e.g. good education around PTSD and its causes) and knowing when it may be appropriate more intensively (e.g. with an evidence-backed therapy like trauma-focused cognitive behavioural therapy).”

Making the Right Choice Harder than it Looks

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When was the last time you felt overwhelmed by choice? Perhaps it was selecting your lunch from a lengthy menu, or purchasing a new pair of jeans from a selection of over 50 in the store. 

In some cases, more options can be helpful. But if faced with more options than a person can consider effectively, things can be much more difficult. It’s a phenomenon called choice overload, a topic explored in a new study from the University of Buffalo.

“My personal experiences sparked an initial interest in this area of study. I felt like everywhere I turned I was being presented with more options than I could reasonably consider. I rarely felt like I was picking the exact right option in these situations,” Thomas Saltsman, a graduate student in the UB Department of Psychology and co-author of the study, told Theravive.

“As I dug into the existent choice overload literature, I realized that much of the research studies examined people's feelings about their choice after-the-fact, but there wasn't a lot of research peering into their experiences and their motivations in the moment of choosing. I felt that tracking these experiences could be very important in gaining a full understanding of how choice overload actually works.”

Previous research has proven that choice overload can have negative outcomes for people, and the researchers from the University of Buffalo examined two previously understudied factors that motivated people in their decision making: the value of the decision to a person, and the degree to which they believed they were capable of making a good choice.

To explore this idea, the researchers enlisted 500 participants. 

Participants were asked to view dating profiles (fictional for the purpose of the study) and to consider who would be their ideal partner.

“While doing so, we measured cardiovascular responses that broadly capture how much people valued the decision they were making, and how capable or confident they felt in their ability to make this decision. Compared to people who chose one profile from only a few options and to those who gave an overall rating of many profiles, people who had to choose one profile from many options exhibited cardiovascular responses suggesting that they cared more about their choice, but also felt incapable of making their decision. Differences in these responses emerged very early on in this process, both while people were initially looking through their options and while they were making their decision,” Saltsman said.

Among the measures the team used in the study, they examined heart rate and how hard the participants’ hearts were pumping. When participants cared more about making a particular decision, their heart rate increased and their heart also beat harder. The researchers were also able to use other cardiovascular measures like blood vessel dilation and how much blood the heart was pumping to determine levels of confidence.

They found that when participants were faced with a larger number of profiles to choose from, their cardiovascular measures indicated participants felt their choice was both more important and more overwhelming than the participants who were asked to choose a profile from a smaller selection.

“Our findings show that having too many choices seems to create a kind of paralyzing paradox in the moment, where people really seem to care more about their decision, but at the same time, feel like they can't make a good choice. This combination of perceiving high stakes and low ability may contribute to a deep-seated fear that one will inevitably make the wrong choice, which could stifle the decision-making process and could eventually lead to people regretting their choice after-the-fact,” Saltsman said.

Although having more choices might appear to be an appealing prospect, when you actually have to choose, the reality is very different.

But even if faced with a variety of options, Saltsman says there are ways to ensure choice overload doesn’t negatively impact you.

“It may help to remember that many of the day-to-day choices you make—what to have for lunch, what Netflix series to begin binging—are ultimately not going to define who you are as a person and are not going to make a huge impact in the grand scheme of things. Even if you do not select the absolute best show or best sandwich, these kinds of menial day-to-day choices will likely not be forever self-defining or life-changing. When thinking in this way, the consequences associated with making the “wrong” choice become less scary, as they are often less dire than we might initially believe,” he said.

“On top of this, it may also be helpful to enter high choice situations with just a few clear guidelines and ideas of what you want from your desired option. Doing so may not only help scale down the number of possible choices (by eliminating options that do not meet these clear guidelines), but may also bolster confidence and trust in your ability to find a choice that meets your needs. Consistent with this, research shows that entering high choice situations with greater confidence and certainty about ones’ preferences can reduce choice overload’s negative effects.”

Women With Dissociative PTSD Have Higher Levels Of Stress Hormones

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According to the U.S. Department of Veterans Affairs, 50 per cent, or five out of ten women experience trauma at some point in their lives and women are more likely than men to experience child abuse or sexual assault. In the general seven or eight out of 100 people will suffer from PTSD at some point and approximately eight million people have PTSD in a given year.

A new study published in the Archives of Psychiatric Nursing looked at proposing a conceptual model to understand the mutual regulations between two stress-related hormones (cortisol and oxytocin) as a sign of resilience, and the mutual dysregulations between these two hormones as a marker of vulnerability in women with post-traumatic stress disorder (PTSD). 

“The neuroendocrine system, which produces cortisol, plays a significant role in stress responses,” study author Dr. Yang Li told us. “When stress occurs, cortisol is released and fights off stress. Oxytocin can help the cortisol levels return to the normal level. If these two hormones work well and interact well, women will be more likely to be resilient when traumatic events happen. Otherwise, if these two hormones do not function well and interact well, women will be more likely to develop PTSD after exposure to traumatic stress events. Childhood trauma is the root of problem, as it causes damage to the two stress-related systems.”

The model for the study was developed based on the concept of resilience and previous research findings. Not all women who have trauma history develop PTSD. When some traumatic events happen, some women remain resilient while others develop PTSD. The biological mechanism to explain this is still unclear. Given the mutual regulation between cortisol and oxytocin and their role in stress response, these two hormones may be able to explain this.

“We used a pre-existing small dataset to test the model,” Dr. Yang Li told us. “We found the highest levels of cortisol and oxytocin in women with the dissociative subtype of PTSD (feelings of detachment within the self and being unreal about the outside world) compared to women with PTSD and women with trauma history only.” 

Dissociative PTSD affects a person’s memory, consciousness, identity and self-awareness. It can make a person feel disconnected from themselves and their surroundings. They may experience flashbacks to traumatic events as well an blank out for a certain amount of time. 

The results of the current study were not surprising to researchers.

“The findings partially support our model,” Dr. Yang Li told us. “That is, cortisol and oxytocin systems did not function well among women with the dissociative subtype of PTSD. But because of the sample size, we were not able to detect the mutual dysregulations between these two hormones in relation to PTSD.”

The number of veterans who experience PTSD varies according to where they served. In Operation Iraqi Freedom and Enduring Freedom, between 11 and 20 per cent who served in those missions had PTSD in a given year. Sexual trauma in the military also happens. Twenty-three per cent of women in the military have reported sexual assault.

Dr. Yang Li said future studies with larger samples of women, repeated measures of cortisol and oxytocin, and measures of childhood trauma and PTSD are still needed to validate the model.

“We hope this model can help trauma researchers and psychotherapists better understand the causes of PTSD,” Dr. Yang Li told us, “and then help early diagnosis and better treatment of PTSD.”

Addressing Perfectionism Requires Facing Your Inner Critic

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In our driven culture, Type A personalities take pride in perfectionist tendencies. Yet recent research indicates perfectionism can predict depression or at least be associated with depression when there is additional life stress.  Mental health professionals address perfectionism in clinical sessions with clients and have similar thoughts about the increase and ways to treat it. 

Several experts, including  Dr. Roxy Zarrabi, Psy.Dpoint to social media as a culprit in perfectionist tendencies because it “contributes to unrealistic expectations and frequent social comparison which are often symptoms of perfectionism. Perfectionism can become exacerbated when someone starts a new chapter, such as a new school or job. In such situations, the person may feel as if they are a small fish in a big pond and nothing they do is good enough."

Although social media can be a “wonderful way to stay connected to the people who matter to you.”  Victoria Tarbell, a licensed mental health counselor, also has concerns about its use. She finds it “can be a breeding ground for comparison and feelings of inadequacy. Most people are familiar with the term ‘highlight reel’ and that’s often what we’re seeing from others on their social media accounts; the best, most interesting parts of lives, captured at the right angles, accompanied by perfectly crafted captions. Common thoughts from viewing the social media accounts of others are: ‘I’m not doing enough’ or ‘My life isn’t as interesting as everyone else’s’. These thought processes are very dangerous and can lead to anxiety, depression, and perfectionist tendencies.” 

Tarbell talks to clients about how thoughts, feelings, and behaviors are all connected and reinforce one another. “If you challenge or change one of these three, you disrupt the unhealthy cycle.” But she doesn’t tell clients to try to change feelings. “Your feelings are your feelings! But sometimes the thoughts that create our feelings deserves a bit of attention.”

She connects this to social media use. “If you are on social media and find yourself feeling depressed or anxious, take a pause and try to identify what thoughts are contributing to those feelings. Most likely, they will be ‘I’m not doing enough’ or ‘My life isn’t as interesting as everyone else’s’. Try to notice, challenge, and replace those thoughts with something more supportive of your well-being.  A replacement thought may involve acknowledging your own accomplishments (we tend to minimize these) or a reminder that ‘I’m only seeing this person’s highlight reel’. Try these thoughts on and see how they impact your feelings and behaviors.”

Tarbell’s approach addresses the inner critic which Zarrabi also believes is important in addressing perfectionism. Zarrabi says, “One of the most helpful ways to combat one’s inner critic and address perfectionism head-on is to practice self-compassion. So often people are their own worst critic and are compassionate towards others but have difficulty being supportive to themselves. When someone is feeling critical towards themselves, it can help to ask what they would say to a friend in a similar situation and then apply those supportive statements to themselves.” 

Rebecca Newkirk, LSW encourages clients to examine what it is the critics are protecting them from by pushing so hard. She explained that over time “the ‘self’ gains the trust of the inner critic, and shows it compassion and gratitude, giving it permission to relax and not hold the same role it has been holding all this time. In this perspective, we view all parts of self as well-meaning, even the critic, and we want to say to these parts, ‘I see you, you matter, and you can rest now.’ “

Susie Rinehart, MS, author of Fierce Joy; Choosing Brave over Perfect, advocates for focusing on progress to combat perfectionism. She says, “The opposite of joy is not sadness, but perfectionism. It prevents us from trying new things, asking for help, or feeling worthy. I work with clients to choose brave over perfect when making small decisions and encourage them to celebrate progress. Instead of asking, “What did I get done today?” ask “Where did I make progress today?” The world doesn’t need us to be perfect; it needs us to contribute to the common good.” 

One of the simplest solutions is redirecting ones’ attention. Jeff K. Larsen MA, MFT, a therapist, says he “instructs clients to place post-it notes on their bathroom mirror as well the inside of their front door which state ‘Perfectionism is neither the journey nor the goal’. Every time a client finds themselves in a tough situation where they seek to be perfect, I have them say out loud, ’Good Enough!’ Then I have them keep a journal about the number of times they have to do that in between sessions. The goal is to decrease the number of self interventions needed.” 

Although approaches to treating perfectionism vary, all agree that spending more time looking at one’s inside is a better path to self-care than looking at other’s outsides.

 

Why You Should Stop Stressing About Being Stressed

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These days, stress seems a standard part of the human condition. 

Last year, Americans were given the dubious honour of being among the most stressed out people in the world.

2018 Gallup poll found that 55 per cent of Americans stated they experienced stress a lot during the day. That finding placed Americans as among the most stressed of the 143 countries surveyed. The global average for experiencing stress a lot during the day was 35 per cent.

Experts note that in an ironic twist, many people are now so stressed, they find themselves getting stressed about their stress levels. 

But is stress really all bad?

Lisa Damour, PhD, a private-practice psychologist, doesn’t think so. 

“Stress and anxiety can both be good, and they can both be bad. Healthy stress happens when we are working at the edge of our capacities and thereby expanding those capacities. Stress becomes unhealthy when it becomes chronic - allowing no opportunity for recovery - or traumatic,” she told Theravive. 

Stress is unavoidable and, if in healthy levels, can play a useful role in a person’s daily life. Damour likens it to exercise, in that stress may not feel good whilst it’s happening but can actually be good for you in the long run.    

“Stress happens when we stretch ourselves and, amazingly, we've found that it has an inoculating function. People who weather difficult events effectively go on to be more resilient in the face of new difficulties. In other words, moderate levels of stress can help us become more emotionally durable,” she said. 

Managing stress can be complicated, and can depend on the form of stress a person is under. According to the American Psychological Association, stress can come in three forms: acute stress, episode acute stress and chronic stress.

Acute stress is the most common and might be due to things like a deadline at work, a car accident, or problems with children. Acute stress is typically only a short-term experience and because of this, doesn’t do the same harm as long-term stress. Some people do experience acute stress more frequently, and this is referred to as episodic acute stress. 

Stress becomes harmful if it reaches chronic levels. This may occur if a person is in a consistently bad situation they can’t find a way out of, such as living in poverty, an unhappy marriage, or working in a job that they hate. 

If a person’s stress exceeds a level that could enable them to become psychologically stronger, it is likely damaging. As well as the psychological impact, stress can cause physical symptoms and if left untreated can result in health problems, heart attacks and stroke.

Damour advises that those feeling overwhelmed by their level of stress should seek help from a professional who will assist them in developing strategies to cope with stress. Mindfulness techniques are one method that has been used in recent years for the management of stress and anxiety. 

Like stress, feelings of anxiety can be harmful in high levels, but Damour says this too can be useful. 

“Anxiety is healthy when it operates as an alarm system that alerts us to threats, such as a driver swerving in a nearby lane, or at the times when our own procrastination might lead to trouble. It's unhealthy when the alarm doesn't make sense - when it rings all the time for no good reason, or when it blares over minor concerns,” she told Theravive.

Damour says reframing how anxiety is viewed as helpful and even protective may assist people in making use of feelings of anxiety.

As well as writing the book "Under Pressure: Confronting the Epidemic of Stress and Anxiety in Girls", Damour works with teenagers in her private practice. She encourages them to harness their feelings of anxiety and pay attention to what those feelings may be trying to say. She uses the example of encouraging teenage girls to pay attention if they find themselves feeling anxious when at a party, as these feelings of worry may be correctly alerting them to an issue or problem.

In a similar way, she says that if a person is feeling anxious in the lead up to an important exam but is yet to start studying, this is a normal reaction and, if harnessed and acted upon by hitting the books, will enable that person to feel better (and hopefully ace the exam). 

Although around half of Americans say they experience stress throughout the day, this may be entirely normal, and of use to everyday life.

Damour says that is a person is worried, they should speak to a professional who will be able to discuss their stress, and determine if treatment is needed. 

She argues psychologists need to take on an active role in providing reasonable messaging to counter wellness companies that suggest people should feel relaxed or calm at all times.

Wellbeing is important, she says, but the goal shouldn’t be to be happy and relaxed at all times. She regards this as an unhealthy and potentially dangerous idea that is as unachievable as it is unnecessary.

If people are stressing about not being happy and relaxed, she says, their day to day life is likely to be an unhappy one.

 


WHO Reclassifies Burnout as a “Syndrome”

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Photo by Paul Bulai on UnsplashBurnout is a word commonly thrown around. People burn out from work and family obligations. From media consumption. From commitments.

Recently, the World Health Organization (WHO) updated its definition for the ICD-11 to identify burnout as a “syndrome”, tying it to "chronic workplace stress that has not been successfully managed."  (In the ICD-10, it was a “state of vital exhaustion”). I asked clinicians if they see a rise in burnout symptoms and what the new definition could mean for treatment (and stigma) now that it’s recognized as a syndrome.

 

Jessica "Jess" F.B. Jefferson, LCSW believes “WHO’s recognition of burnout as a syndrome tied to workplace stress now provides permission for helpers and healers to bring their struggle to the surface and seek help and healing for themselves. “
 
Dr Kate Tulenko, MD, MPH, MPhil, FAAP, CEO of Corvus Health, sees a potential benefit when it comes to health insurance. “More health insurance companies may now pay for its treatment. Defining it as a specific, codable syndrome, also make it easier for researchers to organize around and share information on developing and testing treatments,” says Tulenko.
 
Viewing burnout as a serious problem though is not new. “Researchers and mental health professionals have long accepted burnout as a serious problem for many Americans. It is because the term is thrown around so loosely that it loses some of the gravity of how serious burnout can be on your physical health”, says Kirsten Fescoe, Resility Health.
 
Several professionals commented on the implications for stigma. “On a psychological level,” says Tulenko, “it’s helpful for people who suffer from burnout because now society understands that it’s a real condition and not in their heads. Healthcare suffers one of the highest rates of burnout due to the stressful work conditions and often high rates of educational debt among health workers.
 
Nikola Djordjevic, MDadds that “breaking the stigma around burnout is important and classifying it as a syndrome is one good way of doing it. It’s important to send a message to people that they’re not weak and worthless if they feel burned out and to find a legitimate name for what they’re feeling. To break any stigma you need to recognize what’s happening and start talking about it.”
 
Although the term burnout is heard in relation to work, Lana Banegas LMFT, a marriage counselor, sees this happening in the home too. She notes that “although the ICD-11 describes burnout as ‘chronic workplace stress that has not been successfully managed’, I see burnout in stay-at-home moms as much as in top executives of large corporations. Burnout happens when we do not engage in adequate self-care, practice boundary setting, and when we focus on our performance rather than on our relationships. Burnout is on the rise, due to social pressure to perform and the expectation to succeed in all areas of life - to be awesome across the board - in career, family life, social life, and physical appearance.”
 
Banegas believe burnout depends on “one’s ego strength, coping skills, and unique personality traits. Such traits and skills affect our ability to set healthy and clear boundaries with others, manage time well, and produce the messages we send ourselves when we fail or succeed. They also create the expectations and drives we have for ourselves.”
 
For anyone experiencing burnout, whether at home or at work, Jefferson empowers clients by providing “the tools, liberty and permission to be a person first, to unpack their perception of and feelings about how others view them in their role as a helper or healer, and to create a space where they experience support and acceptance during their own healing process. I teach them that it is imperative that they save themselves first—it is only when you are well and functioning optimally that you can effectively save and serve others.”
 
Whether receiving guidance from a professional or practicing it at home, Dr. Donese Worden, NMD, points out that self-care is not complicated. “We need time to heal and decompress, thus some of the best treatments are meditation, music, and vacations. Even a five-minute prayer or meditation in the morning before you start your day and another one at night to calm the mind before sleep can make big changes.”
 
Regardless of one’s profession or home environment, Banegas believes everyone can be empowered to avoid burnout through self-care. She says “to guard ourselves against burnout, we resolve past issues, strengthen our sense of self, learn how to enforce healthy boundaries with others, care for our selves and prioritize what is most important in life: relationships not achievement or social accolades.” The hope is that recognition from WHO - and health insurance providers - will increase treatment possibilities when individual self-care practices are not enough to recover from burnout.
 
 

 

Higher Stress During Mid-Life Is Associated With Greater Memory Decline In Women

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Stress is on the rise for women and it can lead to a host of health problems over the lifespan including depression, anxiety, obesity, and Alzheimer’s disease, an incurable brain disorder that destroys memory and the ability to perform simple tasks. Women, in fact, are more likely than men to develop Alzheimer’s disease. At first, researchers thought this was because women lived longer than men, however, more and more research is pointing to other factors, including stress.

A new study published in the International Journal of Geriatric Psychology sought to find out whether stressful life experiences such as divorce, and more significant traumatic events, such as physical assault during midlife are associated with memory decline in later life, and if so, whether that association was apparent in both men and women.

“We have long known that stress can cause memory impairment in some individuals, and that experiencing stress increases the risk for dementia, including the most common cause of dementia in older people, Alzheimer’s disease,” study author Dr. Cynthia A. Munro. “This is thought to be due to the effects of the stress hormone cortisol on the hippocampus, which is the part of the brain that is crucial for memory. Interestingly, the effects of aging on the cortisol response to stress is much greater (three times greater) in women compared to men. Given these associations, we theorized that perhaps the reason women are more likely than men to develop Alzheimer’s disease is because with advancing age, women become increasingly vulnerable to the effects of stress on memory. In this study, we predicted that we would find a link between stress at midlife and later memory decline in women but not in men.”

Women have a one in five chance of developing Alzheimer’s disease by the age of 65 compared to men who have a one in eleven chance. Over 60 per cent of people with Alzheimer’s disease are women. In the U.S., that means over three million women are living with the disease out of a total of five million people who struggle with Alzheimer’s each day.

Dr. Munro believes that the real key to battling Alzheimer’s disease is to prevent it altogether. One way to do that is to delay or prevent the development of memory decline, which is often the first symptom of Alzheimer’s disease and other types of dementia.

“Given what we know about sex differences in stress and risk of Alzheimer’s disease it makes sense to focus on how we respond to stress as a way to reduce the risk of Alzheimer’s disease,” Dr. Munro told us. “My hope is that treating people who are most vulnerable to the effects of stress early in life will go a long way toward preventing the development of dementia in later life.”

Researchers looked at data from a study of 909 men and women who were interviewed as part of their study visits. At the third interview, which took place when they were in their late forties on average, researchers asked them to report whether they experienced various stressful life experiences such as divorce or job loss, and whether these experiences occurred more recently or over a year ago.

“We also asked participants whether they experienced any traumatic experiences, such as combat or rape, again either within the prior year or in the remote past,” Dr. Munro told us. “At both study visits, participants completed memory tests. To test our theory, we analyzed whether the change in memory test performance between the third and fourth visits was related to the amount of stressful experiences and traumatic events reported at the third visit.”

Researchers also examined whether events that occurred within the past year of the third visit or those that were reported to have occurred more than a year prior to the third visit predicted memory decline between the third and fourth visits.

The researchers found that higher stress during mid-life was associated with greater decline in memory over a decade later in women, but not in men. And specifically, stressful life experiences that occurred within the year prior to the third visit, but not those that occurred over a year prior to the third study visit. In contrast, traumatic events during mid-life, regardless of when they occurred, were not related to memory decline in men or women.

“I am always surprised when a study turns out the way I predict, as so many factors could affect the outcomes, but we had predicted that we would find an effect of stress in women but not in men, so I was relieved that our prediction was borne out by our findings,” Dr. Munro told us. “I was surprised that having traumatic stressors were not related to memory decline in either sex. Because traumatic experiences are stressful, I assumed that if anything, trauma would lead to greater memory decline than stressful life experiences.”

Dr. Munro and colleagues believe that this might be because stressful experiences such as divorce or death of a family member leads to ongoing changes that result in other stressors (such as negotiating child custody arrangements or moving to a new home). They suspect that because even though traumas are by nature severe, they are often time-limited, albeit this is certainly not always the case.

“My hope is to prevent Alzheimer’s disease in everyone, not only in women, and I don’t think that the path to developing the disease is necessarily the same for everyone,” Dr. Munro told us. “However, if we are correct that reducing the stress response will reduce the risk of dementia, it remains to be determined whether this approach will be an effective treatment for everyone.”

The Unexamined Crisis

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In mental health circles there is discussion and research on depression and anxiety.  For years, clinicians have attempted to find ways to alleviate thought disorders in a way that doesn’t bring include noxious side effects. 

There is another human problem that is, seldom, addressed directly.  Extensive segments of the population, worldwide, struggle with feelings of being overwhelmed.  Overwhelmed does not hold its own position in the diagnostic and statistical manuals. 

Overwhelmed is often tucked into the diagnosis of adjustment disorder.  Yet, it is found to be the underlying trigger behind many of the conventional issues that contribute to impaired mental health.

Even the most self-confident individual can feel overcome by competing bids for attention.  Whether it is the ever-present cell phone, notebook, watch or other device, most people must learn to endure interruptions in the daily routine.  Some can split their concentration with ease. For others, it is painful.

Not so long ago, if a person was not home, those wishing to make contact had to leave a message or hope the callee will be home soon.  There was no such thing as robo calls.  Certainly there were fewer scams when grifters had to work harder to get the public’s attention.  Social media is one source of the assumption of availability that has entered lives in the 21st century.

Feeling overwhelmed is not a comforting experience.  It doesn’t feel good.  The stress that accompanies feeling flustered ( and that’s putting it mildly) contributes to depression, anxiety, and self-doubt.  A continual belief that one is not enough lays the groundwork for addiction, procrastination, and inefficiency.

The inner critic, or monkey chatter, that insults and condemns one on a continual basis is stirred up and exacerbates the negativity felt by those who feel useless.

For individuals who are especially vulnerable to feeling overwhelmed the sad and extreme outcome may be suicide.  Why try when convinced that the only possible outcome will be negative? The authentic self becomes buried in an effort to live up to inner and outer expectations.  If an individual loses his/her sense of authenticity, then life, itself becomes a charade.

Learn more about yourself.  You may achieve this through books, seminars and psychotherapy.  If you know that you begin to panic when rushed, try to plan your time. Although it won’t be foolproof, this habit will eliminate some of the stress.

Others who are overwhelmed may be trying (even if unconsciously) to get you to take on some of that overload for them.  If you can do that with serenity, great. If not, don’t take on the burden.  If you spend the greater portions of your life rescuing, you will fall by the wayside.  Take stock of what you believe life is for.  

Thought processes can swerve to thinking that is out of control.  When unconstrained, a panic attack may ensue. Some of these onslaughts occur without apparent cues.  Some are a result of a particular trigger, like claustrophobia.  Others set in after the disturbing event.  The sufferer may experience chest pains and an intense need to escape.

The suggestion is not to completely withdraw from social media (that is part of a black and white point of view that ignores balance).  The helpful tool in this, as well as other life situations, is to set boundaries.  If one has an emergency on-call situation, then boundaries must be relaxed.  But, in everyday life, it is not necessary to reply immediately to every demand for attention that comes along.

It is important to prioritize.  What must be dealt with immediately and what can wait?  Suppose that a hospital, good friend, or telemarketer simultaneously attempt to reach you.  This is an easy one.  It is not necessary to respond, at all, to the telemarketer.  If a wonderful opportunity is ignored, you can be sure you will receive another call.  The hospital:  is it a demand for payment or a test result?  Your friend:  is it chit chat or does he/she need a ride to the aforementioned hospital? 

It is essential, if one seeks peace of mind, to understand the validity of each plea.  If you are, as Malcolm Caldwell posits in his book Blink, able to easily discern the importance of each bid for attention, this is probably already a part of your repertoire.  If making a decision is difficult, it’s not a bad idea to become familiar with your personal values.  Is this life or death? The demand of an individual who is needy?  A case where timing is everything?  The decision is yours.  It’s a good idea to claim or reclaim your inner power.

It’s sort of like the truism that not every question must be answered.  Just because someone wants to know something doesn’t mean you are required to tell all.  Example:  “I’m not going to discuss that” will do the job.  No need to fish around for explanations.  If you commit to yourself that “no” means “no” then the rest of the world has no choice but to accept your word.

Enough sleep and proper nutrition play a role in all of this.  When stressed the body produces extra cortisol, the hormone that carries apprehension. Stores of serotonin (the chemical that helps us feel better) become reduced.  It is always a good idea to get a medical checkup.  From a holistic point of view, the mind and body work together.

Sometimes when an individual’s thoughts go a little haywire, it can feel like life is collapsing.  Your temporary state of mind is not your entire life.  As a rule it’s never as bad as you think it is.  If it is that frightening, you will need your wits about you so that you will be able to turn in a different direction if necessary.

Admitted or not, everyone has times when they are at a loss.  Anyone who claims that has never happened is in deep denial.  Reminding oneself of other challenges that have been conquered can bolster your confidence that you already have the tools to handle anything.

As someone (don’t remember who) said:  There’s a difference between a lapse, a relapse and a collapse.

 

 

             


 CITATIONS

 

Dubois-Maas, J(01/11/19) “How to Manage When We Feel Overwhelmed” talkspace.com

 

Farrell, P “Feeling Overwhelmed by Social Media? Me Too” medium.com

 

Michaelson, P.(06/20/12) “The Origins of Feeling Overwhelmed” whywesuffer.com

 

Michaelson, P (12/12/11)”The Hidden Causes of Clinical Depression” whywesuffer.com

 

Star, K. (09/09/19). “Signs and Treatments of Panic Attack” verywellmind.com

 

Wang, S.Y. (07/19/18) “What To Do When You Feel Overwhelmed” forbes.com

Mass Shootings, Politics and Health Care Among Main Causes of Stress for Adult Americans

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A year out from the 2020 Presidential election, Americans are reporting issues like politics, health care and mass shootings as the main issues causing them significant stress.

Every year, the American Psychological Association conducts a Stress In America survey. This year 3617 adults in the US were polled.

More than 7 in 10 (71 per cent) of adults said mass shootings were a significant source of stress in their lives. This is up from 2018 when 68 per cent said mass shootings significantly stressed them. Hispanic adults are most likely to cite mass shootings as a source of stress with 84 per cent indicating they felt significant stress due to mass shootings. This was followed by black adults, Asian adults, Native American adults and white adults.

Shane Owens, PhD, a board-certified psychologist, says stress surrounding mass shootings can be amplified by media coverage.

“Those are acts of violence against the most vulnerable people in places where they should be safest. It’s natural for that to shock us. It’s important to remember that school shootings are very rare. School shootings appear to happen more frequently than they actually do because of the ways the media covers them. Nothing inspires anxiety as much as constantly running looped b-roll of people being led out of a school with their hands up. The anxiety is magnified by not breaking for commercials and the pulsating, urgent music the media uses to accompany their coverage,” he told Theravive. 

Fifty-six per cent of those surveyed said the 2020 US Presidential election was a significant cause of stress in their life, up from 52 per cent from those who were asked in the lead up to the 2016 election. 

Owens says he isn’t surprised people are stressed out by politics, even though the Presidential election is still a year away. 

“Politicians and the media want people to be stressed. Politicians need you to believe that the world will end if you do not cast your vote for them. The media sell more ads by covering the most sensational news, even if they have to create that themselves. People tend to overdose on coverage of the election and politics in general,” he told Theravive. 

He advises people adjust the way they consume news and media in the lead up to the election.

“The best thing you can do is watch the news sparingly, especially if you tend to watch cable news. In addition, pay more attention to webpages and sections of the newspaper that cover things other than politics,” he said. 

Among the other issues causing Americans stress, 69 per cent of those surveyed said they were significantly stressed about health care. Of the 47 per cent who said they stressed about health care at least sometimes, 64 per cent said it was the cost of health care that caused them the most stress. The 71 per cent of adults surveyed with private insurance were more likely than the 53 per cent with public insurance to say they were stressed by the cost of health care. More than half of those surveyed (55 per cent) worry they won’t be able to pay for health care they might need some time in the future. 

Stress related to climate change has been on the rise since last year. 56 per cent of those surveyed in 2019 say they are stressed about climate change, compared with 51 per cent last year.

Discrimination is another source of stress that has increased. In 2015, 20 per cent of those surveyed said they were stressed about discrimination, whilst in 2019 25 per cent said they were worried about the issue. 

64 per cent of LGBT adults said discrimination stopped them living a productive and full life. 63 per cent of people of colour felt the same way in 2019. In 2015 less than half of people of colour felt like that. 

Not all stress is bad, and Owens says in some cases it can inspire positive action. 

“My general rule is that stress is a problem when your coping is unhealthy. If you handle your stress by reading about candidates and issues, becoming politically active, and voting, then you are likely OK. If you cope by trolling people with whom you disagree on social media while drinking a half a bottle of whiskey, you need a new outlet. Generally, if you can find personally meaningful ways to cope with your stress while managing to eat well, exercise, and get enough sleep, you are doing fine,” he said. 

But he warns that too much stress can be damaging, and those experiencing significant constant stress should seek help. 

“Even if you cope well with it, constant, inescapable stress has negative long-term effects on health. These include gastrointestinal issues, cardiovascular problems, obesity, substance abuse, anxiety, and depression.”

Movement, the Key to Unlocking Chronic Stress

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Exercise, meditation, yoga, breath work, it does not take therapy or a therapy blog for you to know that these practices help with stress. What many people do not yet know is the WHY behind the practice. We as a society get that we need to cope or “handle” our stressors. We create to-do lists, we have our inspirational Instagram pages we follow to motivate us to “hustle” or whatever it is that inspires us to get the work done to take care of the stressor. Additionally, we know to create boundaries or take out negative stressors from our life. These are practices that specifically deal with our stressors. However, exercise, meditation, yoga, and breath work are the practices that deal with the stress

 

According to Emily Nagoski, PhD and Amelia Nagoski, DMA in their book, Burnout, dealing with the stress means completing the stress cycle. As Americans, we are chronically stressed, which is leading to burnout. The average work week for Americans is 44 hours per week, with merely 15 days allotted for vacation and time-off a year. Let’s then take into account that the majority of households are dual income and on average spend 7 to 8 hours cleaning the home a week in addition to working outside the home. This does not even include time spent on childcare- a recent study by Welch’s reported that the average mom clocks in 98 hours a week. These stats make it clear why we as a nation are stressed and burnt out.

 

To understand what it means to complete the stress cycle, you have to learn about fight, flight, or freeze and what happens to our body when we are stressed. Fight, flight, freeze is an evolutionary adaptive response to stress - when chased by an animal we would benefit from hormonal activation that helps us survive by pumping blood into our muscles, our heart races, while endorphins allow us to ignore the physical discomfort. In sum, our body and mind changes to prepare for the threat to allow for the best chance for survival. While our stressors have changed in time, our body still responds in the same way. To complete the stress cycle in the past, meant you either lost the battle or you survived by outrunning or battling the animal. In sum, the survival was a signal to the body that the stress was removed, and you can relax- hence the stress cycle is completed, and you are no longer in danger.

 

In today’s world, we are constantly feeling the threat of stressors, but the fight, flight, freeze response does not help us. Our stressors are no longer animals trying to kill us. Instead, we are under pressure of balancing all of life’s demands, such as keeping our boss happy, making a deadline, etc. We go home and still feel the stress because we have not completed the stress cycle; subsequently, we have a hard time relaxing when we get home. Many will turn on Netflix, maybe pour a glass of wine and wait for the stress to go away. It doesn’t. This pattern of chronic stress eventually leads to burnout. Herbert Freudenberger coined the term burnout in 1975. He noted that burnout included feeling emotionally exhausted, experiencing depersonalization - the lack of empathy and experience of compassion fatigue, and a feeling of decreased sense of accomplishment when it feels like nothing you can do will make a difference. Because we are not dealing with the stress, we are not completing the stress cycle each day. Each day our body feels more stress, and each day we need to signal to our body that we are safe by completing the stress cycle.

 

Burnout is happening because we are chronically stressed from not completing the stress cycle. We are not signaling to our brain that the danger is no longer there. Exercise is the most efficient way to complete the cycle,  but most people do not want to add to their daily responsibility by having to come home each day to exercise. Vegging out and watching a movie certainly sounds better than going to the gym or streaming a yoga video, but it is not addressing the stress. Many people reading this might ask what to do if they do not enjoy working-out. I encourage everyone to find something that they enjoy whether it is a spin class, tennis, running, a kick-ball league, walking the dog, yoga, or weight lifting. When you enjoy doing something, you are more likely to  do it consistently. I know, I know, some of you are still thinking, but I don’t enjoy any exercise! No fear, there are other things we can do to complete the stress cycle. According to the book, Burnout, we can utilize positive social interaction, laughter, affection, such as the 6 second kiss or hugs, and/or creative expression to complete the cycle. In addition, a good ole’ cry can also be used to complete the emotional cycle. Yes, I am giving everyone permission, at times, to put on that romantic comedy that brings the tears every time, and allow yourself to complete the emotional cycle to feel better. While these are great alternatives, it should be noted that physical activity is still known to be the most efficient way to complete the cycle.

 

Many people understand that exercise will complete the stress cycle, but the most common question that comes up for me is, “How do I know if I did enough and completed the cycle?”  The easiest answer is you will just know. Many times after a run or finishing a spin class, I have what many people describe as a “runner’s high.” A runner’s high is known by many as the reduction of stress and feeling of elation due to the release of endorphins. You just know that you feel better because you actually feel better. The worst and hardest part of going to the gym is actually going to the gym. Coming home almost everyone describes as feeling better. This better feeling is the feeling of completing the stress cycle.

 

Emily Nagoski, PhD and Amelia Nagoski, DMA noted that stress is not bad for us, but instead, it is being stuck in the stress that is bad. They note that “Wellness is not a state of being, but a state of action.” That is, moving from life stressors, to completing the stress cycle and enjoying life’s goodness. No stage will last forever but we have to remember to move through stress and complete the cycle. In sum, our life journey is similar to a novel. Life is full of transitions from one chapter to the next. Some of the chapters are a series of stress, defeat, and difficulties while others are full of hope, excitement and newness. The one certainty of our life story is that we keep moving to the next page and chapter while holding the stories from past that have helped shape us.  Movement is the state of wellness in our world. We are well when we move from state to state. Movement completes the stress cycle. Movement is wellness. 

 

 

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