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As we mark April as Stress Awareness Month, I know there are many things that need to be emphasized—mass shootings, wars around the world, the long-term effects of pandemics, and the daily stresses of living and working in the 21st century. I’m sure you got your list.
Everyone experiences stress at various times in their lives. But when is stress a problem that needs our attention? What symptoms should people look for? What are the health effects of long-term stress? What are healthy and unhealthy coping mechanisms? And what strategies can help cope with and prevent stress?
Fresh off dropping my kid off late at school (sorry, kid, my fault), I looked forward to this advice from CNN medical analyst Dr. Leanna Owen. Wayne is an emergency physician and professor of health policy and management at the George Washington University Milken Institute School of Public Health. He previously served as Baltimore’s health commissioner and chair of Behavioral Health Systems Baltimore.
CNN: Let’s start with the basics. What exactly is stress?
Dr. Liana Owen: There is no single definition of stress. The World Health Organization definition refers to a state of anxiety or tension caused by a difficult situation. Many people experience stress as mental or emotional stress. Others also have physical manifestations of stress.
Stress is a normal reaction. It is a human response that prompts us to respond to challenges and perceived threats. Some stress can be healthy and motivate us to fulfill our obligations. Perceived pressure can motivate us to study for an exam or complete a project by a deadline. Virtually everyone experiences this type of stress to some degree.
CNN: Why can stress be a problem?
Wayne: The same human reactions that motivate us to work hard and finish a project can also lead to other emotions, such as not being able to relax and becoming irritable and anxious. Some people develop physical reactions, such as headache, upset stomach and trouble sleeping. Long-term stress can lead to anxiety and depression, and it can worsen symptoms for people with pre-existing behavioral health conditions, including substance use.
CNN: What are the signs of stress that people should look for?
Wayne: In addition to feeling irritable and anxious, people experiencing stress can feel nervous, uncertain, and angry. They often exhibit other symptoms, including a lack of motivation; having trouble concentrating; And tired, overwhelmed and burned out. Many times, people will report feeling sad or depressed in stressful situations.
It is important to remember that depression and anxiety are separate medical diagnoses. Someone with depression and/or anxiety may exacerbate their symptoms when they are going through a stressful time in their life. Long-term stress can also lead to depression and anxiety.
One way to think about the difference between stress versus anxiety and depression is that stress is usually a response to an external problem. External reasons can be good and motivating, such as the need to finish a project. It can also be a negative stressor, such as an argument with a romantic partner, worries about financial stability or a challenging situation at work. The stress should go away when the situation is resolved.
Anxiety and depression, on the other hand, are usually persistent. Even after a stressful external event has passed, these internal feelings of apprehension, inadequacy, and sadness are still there and interfere with your ability to live and enjoy life.
CNN: What are the health effects of long-term stress?
Wayne: Chronic stress can have long-term consequences. Studies have shown that it can increase the risk of heart disease and stroke. It is associated with poor immune response and decreased cognitive function.
People experiencing stress are also more likely to endorse unhealthy behaviors, such as smoking, excessive drinking, substance use, lack of sleep, and physical inactivity. These lifestyle factors can in turn lead to poor health outcomes.
CNN: What strategies can help cope with stress?
Wayne: First, awareness is key. Know your own body and your response to stress. Sometimes, anticipating that a situation may be stressful and being prepared to deal with it can reduce stress and anxiety.
Second, identifying symptoms can help. For example, if you know that your stress response includes feeling your heart rate increase and becoming agitated, you can recognize the symptoms and be aware of stressful situations when this occurs.
Third, learn what stress relief techniques work for you. Some people are big fans of mindfulness meditation. Those, and deep breathing exercises, are good for everyone to try.
For me, nothing beats stress relief like exercise. For me, what helps is exercise, especially swimming. Aerobic exercise is associated with stress relief, and mixing it with high-intensity regimens can also help.
Many people have other specific techniques that help them. Some people clean their house, tidy their closet or work in their garden. Others spend time walking in nature, writing in a journal, knitting, playing with their pets, or riding bicycles.
I would suggest that you experiment with what works, take stock of existing techniques that help you, and incorporate some of those exercises into your regular routine. Then, in times of stress, these are good tools that you know will help you.
CNN: What unhealthy coping strategies should people avoid?
Wayne: Definitely. In an effort to make themselves feel better in the short term, people turn to things that can actually make things worse. Excessive alcohol consumption, drug use and smoking are not healthy coping strategies. The same goes for staying up all night, eating and drinking, and taking out your frustrations on loved ones. These have wide-ranging consequences and should be reconsidered if you have dealt with them in the past.
CNN: When is it time to ask for help?
Wayne: If the stress you’re experiencing consistently interferes with your work, social, or personal life, or if you’re experiencing signs and symptoms of depression, anxiety, and other mental health disorders, it’s time to seek help.
Consider talking to your primary care physician to get a referral to a therapist. Your workplace may have an employee assistance program that you can go to as well. And the federal mental health crisis hotline number, 988, is another resource.
This April, for Stress Awareness Month, I hope we can all assess our own stress levels as well as our responses to stress. We should identify what helps reduce and relieve stress in order to improve our physical and mental well-being.