Overwhelmed With Stress?

You Are Not Alone.

Life can be overwhelming, but knowing your stressors—and strategies to tackle them—can make all the difference.

We all get stressed now and then, and life can be overwhelming. That’s pretty normal. In fact, a certain amount of stress is good. It gives us motivation to get things done and to meet deadlines. But when it gets to be too much for too long…well, that’s another story. Then you are talking about anxiety.

What is stress?

Stress is a reaction to a trigger or a concerning situation, like projects, work, overworking, school, life events, relationships, the media, money, religion, politics, health problems, pain, and environmental problems; even good things can cause stress!

When You re Overwhelmed with Stress: The Physical Effects of Stress​

Stress can affect your mind and your body. It is usually a response to something real, but sometimes the brain plays tricks on you and it perceives a stimulus as worse than it is. Stress can cause so many problems, like insomnia, headaches, pain, stomach problems, mood problems, high blood pressure, and it can lower your resistance to illness. One of the greatest examples of lowered immunity is stress-related shingles (and a few other viruses like HSV - herpes simplex virus): When a person gets stressed, the immune system weakens, herpes zoster becomes activated, and a painful shingles rash breaks out. I see this frequently when someone has come into the clinic with a nasty case of shingles. Upon further questioning, I learn that they have recently been working 80 hours a week or there is a major family problem they are dealing with. It is like clockwork. I call shingles a barometer of your mental and physical health.

Stress

Other common effects that stress can have on your body include: 

• Fatigue

• Difficulty sleeping

• Difficulty concentrating

• Upset stomach

• Irritability

• Headaches

Common Sources of Stress

The Overachiever - Being an overachiever is tough. These folks strive to do the incredible:

I see a lot of young students struggle. They push themselves by taking two or three advanced courses at the same time and feel a need to get all A's. I also see workaholics. They expect perfectionism from themselves and tend to be very self-critical, in turn, creating stress for themselves. For some people, achievement is tied to self-worth and a need for acceptance. For others, it is a way to avoid other difficult things in their lives. Either way, unless these folks burn out first, they are often very, very successful.

Care for Overachievers: There can be some rewards to overachieving. Praise and recognition and monetary rewards, but what good are those things if you cannot enjoy other, very important parts of your life? Overachievers must take time for themselves, striving to create a balance between work and life, giving attention to their families, social lives, recreation, nutrition, and sleep. Relaxation exercises, meditation, yoga, tai chi, and deep breathing may all help. And, while it may be difficult, try to realize that perfection is not a necessity in life. Self-esteem can come from a lot of other things. If you can achieve success in school or work, you can also achieve a work-life balance with that same persistence.

Bullying/Intimidation - There is social bullying and cyberbullying. And, it does not just happen to kids; it happens to adults, too. Bullies tend to cause stress and anxiety through taunting, name-calling, creating rumors, embarrassment, and sometimes even physically abusing their target. They berate their victims, and the latter tend to internalize the problem, in turn, developing low self-esteem and a stress response. If it is an isolated incident, it can cause stress. If it is a long-term problem, it often develops into an anxiety disorder, especially social anxiety.

What to do? Nip it in the bud early. If you can safely do so, confront the bully directly. If it is safe to do so, try to talk about it with the person who is doing the bullying. Establish limits by saying something like "I do not like that behavior, it makes me really uncomfortable, please stop". Or ask them the reason for their behavior. Maintain distance. If you feel it is unsafe to speak to them, report them (especially if you are a child/adolescent - report it to parents, teachers, or counselors). If it is cyberbullying, block them and report them. Speak to a friend, family member, or counselor - tell someone. And, very importantly, bullying is a problem the perpetrator has: Try not to make their problem your problem!

White Coat Syndrome is another story. This is a conscious (or unconscious) stress response that occurs when a patient is getting their blood pressure checked in a healthcare provider's office. A persistent and predictable problem in certain people, the blood pressure spikes every time a healthcare provider takes a person's blood pressure in the clinic or office B,UT it is normal when the patient checks it at home. Some current beliefs attribute this to a possible neuroendocrine response where the anticipation or "fear" of having high blood pressure (in a healthcare provider's office) travels to the limbic area of the brain, causing an increase in chemicals that transiently elevate the blood pressure. Most sources consider white coat syndrome readings around 140/90 (either or both numbers can be elevated but usually it is the top or systolic reading). 

What to do? Check your blood pressure when you get home from the healthcare provider's office to be sure it really is coming down. Be sure your blood pressure monitor is accurate - compare it with someone else's. If it is white coat syndrome, there are relaxation exercises (below) you can try just before your appointment.

If it is only a transient and relatively low spike, it is fine. My question is, if it becomes elevated at the healthcare provider’s office, what does it do when you are stressed at work? When driving in traffic? When “debating” with a family member? Is your blood pressure that sensitive to stress? Monitor your blood pressure: Continue to check it periodically to be sure it is not trending upward anyway. If you have concerns about the problem, speak to your healthcare provider.

Everyday Stressors: Is it any wonder these days that people have fears and phobias with all of the negative social media and news events in the world we live in? You don't want to live in a bubble, but try to avoid negative media a bit.

When Does Stress Become Generalized Anxiety? During stressful times, hormones (catecholamines, epinephrine, norepinephrine) increase temporarily and activate the brain's amygdala (center of emotion and ”fight or flight” responses)(see below). If the stress continues to bombard the amygdala over time, a person can develop a more complex generalized anxiety disorder. So it is good to head off stress at the pass.

Overwhelmed With Stress: Ways to Handle It

• Decide if, when, and how you can deal with the stressful situation or how to avoid it (if it is avoidable)

• Avoid fatigue - practice sleep hygiene

• Eat a nutritious diet

• Yoga

• Massage

• Meditation - Find a quiet place and try some meditation:

-Deep breathing exercises - This helps release endorphins in your brain, which are"feel good" hormones. This technique is practiced by taking a deep breath through your mouth using your diaphragm muscle located just beneath your lower ribs (instead of using neck, shoulder and upper chest muscles), pausing and then releasing the breath through the mouth. Repeat this several times.

-Guided Imagery - Think of a relaxing situation or a place, somewhere that you have been, somewhere that you love. Focus on only that - focusing on texture, smells and visuals. Relax, concentrate and visualize.

-Use Mindfulness - This is when a person focuses on the present moment, feeling and experiencing the moment with awareness and acceptance, not judgment. This reportedly helps the fronto-limbic area of the brain areas of the brain in emotional regulation and processing, as evidenced by MRIs,

-Try Progressive Muscle Relaxation Exercises: This is done by tightening muscle groups for eight seconds then relaxing them for several seconds: Begin with facial muscles, with the face, moving to the scalp - tighten muscles eight seconds, then relax; then the neck, doing with each muscle group of the chest, back, pelvis, extremities and so on. This releases some tension and stress. If you do not have time to move through all of your muscle groups, do this with those muscles you believe have the most tension.

-Analytical Meditation - This meditation involves focusing on an object or a concept and focusing on only that.

-Body Scanning-Focus on a part of your body and feel relaxation, warmth, release of tension

• Biofeedback

• Listen to Music - Music can promote the release of neurotransmitters, endorphins ("the happy hormone"), and hormones responsible for relaxation.

• Talk to friends or relatives: Discuss your troubles with them. Or if you do not feel comfortable with that, talk to a counselor.

• Read books about others in similar situations

• Limit or avoid the news - try going tech-free for a while (a "digital detox"). Focus, instead, on the good things in life around you (yes, there are good things, sometimes you do not find them because you do not look).

• Build resilience - a strength and flexibility to face challenges in life

• Assuming that your stressful thoughts are tolerable and non-threatening:

-Accept your stressful thoughts - assure yourself that you will be okay

-Be willing to accept your stressful thoughts and experience them as just part of your complex life

-Compartmentalize or transcend: Realize that you have a life aside from the stressful part of you. Put your stressful thinking "away" for a while. Send it to another room.

-Try not to fixate on things you cannot change: change focus to those things you can change.

-Think ahead to your goals

• If you are not interested in traditional therapy or medications and wish to approach this from a more philosophical standpoint, there is a practice called Reiki, which helps a person internalize positive energy, drawing from positive natural forces. For some, Reiki promotes mental, physical healing, and overall well-being. There are people especially trained in this.

• Poetry in a pill? For those looking for a unique source of comfort and emotional support, I was recently introduced to "poetry in a pill". A person can order capsules online that contain poetry focused on a particular mood.

Medicinal and Herbal Approaches to Stress

Many of the following are used for both stress and stress:

Over-the-Counter Approaches to Anxiety

There are no actual over-the-counter medicines for stress, although a sedating antihistamine might help a person feel more relaxed.

• Benadryl/diphenhydramine (25-50 mg every 4-6 hours - up to 300 mg daily) as directed over the counter. Start low.

Considered Alternative and Herbal Approaches to Stress and Anxiety

• L-Theanine

• Ashwagandha

• ​Lemon balm

• ​Valerian

• Magnesium

• Kava kava

• CBD or medical marijuana

• Vitamins  B6 and B12 (increases serotonin and melatonin) vitamin D and Omega 3s

• Aromatherapy (especially lavender, chamomile, and others)

• 5-HTP

• Turmeric/Curcumin

Prescriptive Treatments

The following medications are primarily used for anxiety. They re not first-line medications for stress. If a person is experiencing an acute stress response, a healthcare professional might prescribe one to the following on a short-term basis. Most can work well alone, but usually work best if used in conjunction with adjunctive approaches (above)-

• Barbiturates and benzodiazepines increase GABA, which calms activity in the amygdala (it also works in other areas of the brain, but the amygdala is the area of focus here). These work very well for significant episodes of anxiety but are also potentially very addictive and, because of this, should not be used on an ongoing or daily basis.

• SSRIs - Selective serotonin reuptake inhibitors (common: Celexa/citalopram, Lexapro/escitalopram, Prozac/fluoxetine, Luvox/fluvoxamine, Paxil/paroxetine, Zoloft/sertraline, Trintellix/vortioxetine). These increase the availability of serotonin neurotransmitters for use in the brain. These work by enhancing cortical (thinking) processes (assists well with therapies). They help decrease excitation in the amygdala (emotion center). excoriation disorder or dermatillomania - skin picking

• SNRIs - Serotonin-norepinephrine reuptake inhibitors - (common: Effexor /venlafaxine, Cymbalta/duloxetine, and Pristiq/desvenlafaxine). These medications help decrease activity in the amygdala.

• Other Antianxiety Medications - Remeron/mirtazapine is used off-label for anxiety (not FDA approved for this problem). This medication actually causes greater production of serotonin in the brain. Buspar/buspirone increases serotonin and decreases dopamine (an excitatory neurotransmitter in the amygdala).

No relief from stress? You might be dealing with more than everyday worries. Learn more about Generalized Anxiety Disorder and how to manage it.