TOXIC STRESS AND HOW TO OVERCOME IT, Part 1

I have been working for the past two weeks on a paper on stress for a workshop I will be presenting soon. After giving it a lot of thought, I decided to divide it in three parts which will be the subjects of the next three blog posts:

Part 1: What stress is and what is a healthy adaptive reaction to manageable stress
Part 2: How much damage toxic (unmanageable) stress can cause us mentally and physically
Part 3: How to effectively manage toxic stress, overcome stress related complications of anxiety and depression, and how to find one’s way toward happiness


To help you better cope with this potentially stressful subject, STRESS, I have peppered the posts with details of my recent paintings. Hopefully they will lighten the subject.


Part 1:

What stress is and what is a healthy adaptive reaction to a manageable stress





What is stress?
In general, any change in our environment that requires or triggers a mentally or physically painful adjustment can be perceived as stressful.


Types of stress:

Eustress: Dr. Selye coined the term Eustress to differentiate positive stress from toxic stress. Eustress—the optimal stress level of each individual. It is commonly perceived as a feeling of “rush” and excitement, like skiing fast down the mountain or riding the bike with the wind blowing in your hair and you only want to go faster and faster. Eustress is a manageable type of stress that leads to taking on and conquering new challenges or getting excited about performing well on a project or on the stage. It drives positive changes in one’s life.

Try this:
Can you think of examples from your own experience of “positive stress?”
How did it feel? What were you able to accomplish in that state?

Acute Stress: brief, intense, stressful episodes like narrowly avoiding an accident or dealing with the mess in your teenager’s room.

Episodic Acute Stress: recurrent, repeated episodes of stress creating a chaotic day-to-day life; leads to feelings of being overwhelmed by the never ending “small stuff.”

Chronic Stress: a long term stressful situation like a dysfunctional marriage or chronic illness that seems inescapable and without an end in sight; usually leads to burnout if no intervention is made.

Burnout: the feeling of inescapable stress with no end in sight; inability to function; feeling paralyzed mentally and powerless to make the changes that will solve the problem; usually accompanied by anxiety and/or depression.

Major types of stressors:


Biological: an illness or physical discomfort
Life situation: breakups, marriage, divorce, empty nest syndrome, the death of a parent
Behaviors: addiction, poor coping
Cognitive Activities: mental challenges like sitting for an exam,
Occupational stress: losing or starting a job, coping with the corporate world, patient’s demands and distress, finding the balance between the empathy we feel for our patients and our inner emotional resources to avoid burnout.

The nature of stressors:


The impact of stressors depends on how they are perceived by each individual who experiences them:
Importance assigned to a stressor: a breakup versus losing a job
Duration: we may manage one week but one day more than that may become too stressful
Cumulative effect: having a demanding job and a difficult boss and tight deadlines
Multiplicity: job change plus illness plus relocation
Imminence: how soon the stressor will end
Expectation: we expect a stressor of one kind, but we get hit with one that we have not anticipated; or we expect one stressor to last a certain time, but it ends up lasting much longer.

Try this:


In managing stress it is useful for you to know what your stress level is on average.


Take your stress temperature: think about the last five days. What was your stress level by evening of each day, on a scale of 1 to 10?


This simple exercise will help you develop more awareness of your stress. Be honest with yourself. Acknowledging your feelings, even feelings of stress, anger and fear, is not a sign of weakness but of strength. Only by being aware of your feelings will you be able to take corrective actions.


HEALTHY RESPONSE TO MANAGEABLE STRESS

Nervous system’s reaction to stress:


Activating the sympathetic response of “fight or flight” reaction:
• Dilates the pupils to improve vision
• Quickens blood clotting to reduce bleeding from lacerations and other possible wounds
• Raises the blood sugar level by mobilizing the glucose and fat from storage tissues and thus provides fuel for the muscles and brain
• Increases blood flow to the brain to facilitate decision making
• Diverts the circulation from the internal organs, like digestive system, into the muscles to provide them with oxygen, glucose and rapid disposal of metabolic waste to ensure best conditions for muscle strength to prepare for combat

Endocrine changes induced by stress:


The stress hormones are adrenaline and steroids. Their effects potentiate each other’s actions and complement the nervous system’s reaction to prepare the body for “fight or flight” reaction:
• Adrenaline rush within seconds triggers the fight or flight response with vasoconstriction, increased heart rate and muscle tension
• Increase in glucocorticoids, steroid hormones, will continue the effects of adrenaline for minutes and hours facilitating the stress response by enhancing the power of heart pulsations and mobilizing energy resources like glucose, which make energy available to the muscles to do their job
• Increase in prolactin in stressful situations inhibits the release of sexual hormones during the “fight or flight” state—thinking of sex while running for your life could get us killed
• Increase in vasopressin, which contributes to an increase in heart rate and blood pressure
• From the pituitary gland and the brain, endorphins and enkephalins are secreted, which blunt the pain perception
• In some women, the oxytocin secretion increases—dulls out the aggressive instinct and induces a “let’s befriend my enemy instead of fighting him” type of reaction (perhaps the biological basis of passive aggression???)

(For this section I used information from the book Why Zebras Don’t Get Ulcers by Robert M. Sapolsky, professor of biology and neurology at Stanford University, who dedicated his research to stress and stress related problems in humans and primates.)

Try this:
What has been your experience with the “fight or flight” reaction? How did you manage it?


How did or would you manage this reaction in your patients? Have you had any incidents you would like to share with the group?


Learn how to listen to your body: Where does your body feel tense?


Follow your breath. Take five slow, deep breaths and watch what happens. Are the tension areas loosening up a bit?

Cognitive response to stress


• “Freezing”—being unable to think straight or remember important information
• Tendency to simplify one’s thoughts, feelings and actions, which reduce them to a minimum because the brain needs to focus on the stress (emergency) and shoots down other functions not involved in managing the stress
• Stress triggers an intense negative emotional reaction.
• The importance of learning how to cope and adapt to stress, which triggers in the brain the formation of new connections, highways of information, leading to actually changing the inner structure of the brain—neuroplasticity.


Emotional Response to Stress


• The instinctive emotional reaction to stress was first presented by Dr. Selye in his classic General Adaptation Syndrome (GAS): stage 1: alarm reaction—the first encounter with stress in the form of novelty or threat; stage 2: recovery or resistance—the organism repairs itself and stores energy trying to get back in balance; stage 3: exhaustion—if the stress continues burnout sets in, represented by emotional flatness, loss of drive and motivation, dulling of responsiveness to the needs of others.
• Challenging events are stressful “only when accompanied by negative emotions” according to Arnold Lazarus (1993)
• When we feel in control of a stressful event, the event becomes less stressful
• Stress is not an inevitable consequence of a particular event but rather depends on how we appraise and interpret the event
• Trying to appraise stress realistically and learn from it transforms the negative emotional perception into constructive lessons
• Managing the expectations of a stressful situation contributes a great deal to managing the situation itself. Stressful events that are expected, anticipated, and in some ways prepared for emotionally, have less damaging consequences.


(For this section I used notes from the on line book Psychology: An Introduction by Russel A. Dewey, Ph.D.)