Take Charge of Your Stress

WebMD Live Events Transcript

Confirmed: you're under stress. Don't be a victim. Fight stress with tactics from biofeedback to family meetings. WebMD's in-house expert Patricia Farrell, PhD, author of 'How to Be Your Own Therapist', joined us on Nov. 9th, 2004, to talk about getting tough on stress.

The opinions expressed herein are the guests' alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

MODERATOR:
Welcome, Dr. Farrell. With the emotional roller coaster of stress, how do we begin to become the boss of our feelings again?

FARRELL:
The first thing that you need to do is go back to the time when you were a child. Take an example from that children's game called Pick Up Sticks -- the one where you threw sticks into a pile and then you had to gradually remove them without disrupting the pile.

That's what you do with stress. Don't try to handle the whole thing at one time. Do one little thing at a time and work toward your goal. Start this way:

• Make a list of the things that are causing you the stress.

• Then, sit down and figure out simple ways that you can make changes that in the long run will result in a significant reduction in your stress.

It's really up to you to find out how to do this, because you are the authority here. It is possible, you can find ways, and you will. But it may be a slow process. Don't get discouraged.

MEMBER QUESTION:
The stress at home is always high. How can I create a better environment without allowing my children to turn into TV zombies?

FARRELL:
I'm a firm believer in family meetings. At family meetings everyone has an opportunity to bring up their own issues and the things that are upsetting them.

If you are a working mother, perhaps some of your issues are around things that need to be done in the home, and this is where the family needs to come together to help with these chores.

If it's a child with a serious illness or disability, find out how the family, friends or some other person or group can be brought in to help out. For example, I know of families where one of the members has Alzheimer's disease, and outside agencies provide what is called respite care.

Finding help allows family members to have some free time, without guilt. The collective family mind can be brought to bear here, and though there will always be things to discuss, you can begin to get agreement and/or help. Sometimes just having an opportunity to speak about difficulties to the rest of the family can be very helpful and stress reducing.

MEMBER QUESTION:
My children's whining or crying really sets me off. I can't stand to hear it! Is this a stress reaction or an anger reaction or something else?

FARRELL:
It really depends on whether we're talking about children who are expressing their natural frustration or perhaps overindulged children, or are they kids who haven't received what you might consider sufficient attention? Let's just say they do get sufficient attention.

In that case, depending on their ages, it may be helpful to keep them busy with something, give them a helpful task because children love to feel helpful. Helping is also very good for their self-esteem and it tends to divert them from their complaints.

You also need to know that you don't have to respond immediately. Give yourself a slow count to 10 before saying anything, and remember, you're talking to a child, not an adult; they're not always going to be reasonable. You may have to wait many years for that to happen, but you are laying a very important foundation for them right now.

"Sometimes just having an opportunity to speak about difficulties to the rest of the family can be very helpful and stress reducing."

MEMBER QUESTION:
How do I accept a health condition like acid reflux? The more my health is ailing the more I am consumed with stress.

FARRELL:
Acid reflux can be a result of overanxious behavior or thought. If that is the case, you can begin to help yourself by using one of the many self-help techniques available, such as relaxation breathing, positive self-talk, mild exercise, or even watching an amusing video, because laughter defeats anxiety and depression.

The more you concentrate on the fact that you are anxious and that you do have acid reflux, the more you reinforce your problem. So the idea here is to divert your attention away from it and into other activities that would be enjoyable and less problem-centered.

Also, control over your own health can be an issue. If you've been told by medical professionals that there are no other treatments they can offer, then I would think there has to be a psychological treatment that can be offered.

The treatment actually might be in terms of a medication for handling stress, plus learning new coping mechanisms for stress. I believe a combination of the two will help you.

MEMBER QUESTION:
My husband has chronic pain, some doctors suggest it might be prostititis, others think it might be stress, and more recently they suggest its all in his head, like he is imagining the pain . Can stress cause chronic pain?

FARRELL:
Stress can absolutely cause an increase in the sensation of pain because stress and anxiety lower the pain threshold.

When we are stressed or anxious, we are less able to deal with pain, so that intensifies the pain for us. I'm surprised that no one thought to refer you to someone who might help with biofeedback for the pain. It is very helpful in many cases and I would think is worth a try.

Generally, your husband will be taught methods he can easily use whenever he feels the need. And that's important, because pain research shows that the more you believe you have control over the pain, the less pain you feel or the less pain medication you need.

These studies, I should add, were done with patients who had chronic cancer pain and I believe they are a good illustration of how you can more capably manage your pain better than you thought.

MEMBER QUESTION:
I'd like some constructive ways to reduce stress.

FARRELL:
One of the most important things about stress is also understanding that you are not helpless. Again, I point to some research that was done with people in nursing homes where just believing that they had control over their lives actually decreased their depression and their anxiety scores. The belief that you have control is very important.

The question then becomes, how do I control it? I always recommend that people keep journals. In the journals put down what stresses you. It must be something particular, not just some kind of cloudy stress that constantly circles around you -- delineate the things that are stressing you and then think about what you might do about them.

Remember, you are important, you have a right to a happy life, and you have a right to decrease your stress. Sometimes stress is caused by being too willing to accommodate others and not to think about yourself, because you believe that thinking about yourself is selfish, but that's not so. It's self-protective.

MEMBER QUESTION:
How do I deal with a bully of a boss, who is constantly picking and criticizing?

FARRELL:
This really depends on where you work. Generally, larger corporations tend to have policies regarding how management can treat employees. Remember, anyone who is a bully is telling you an awful lot about them. The way to deal with these people is to try to understand what motivates them and to put that in perspective.

This can often help you to become less enmeshed, allowing you to maintain a certain healthy distance as you look at this person and say to yourself: "He's got real problems and he's taking them out on me. I can imagine what his home life is like."

Dale Carnegie courses used to say "Just imagine that person sitting there in his underwear, and he becomes more human and less of an ogre." You can deal with humans. It's difficult to deal with ogres. So humanize him.

"Sometimes stress is caused by being too willing to accommodate others and not to think about yourself, because you believe that thinking about yourself is selfish."

MEMBER QUESTION:
My brother-in-law has the most stressful job I have ever seen, but he claims to love it. He is pretty macho and likes to say things like "Stress is good" and "My job is supposed to be hard. That's why I make so much money." I see him gaining lots of unhealthy fat, losing his hair, and never sleeping. Is he on track for big problems, or do some people really thrive on stress like this?

FARRELL:
Some people do have what is termed a Type A personality, and that means they are always on the fast track going full tilt; however, the description that you're providing makes me believe that what he's doing is lying to himself about how stressful his job really is.

The weight gain and the problems with sleep would make me believe that his reaction is one of overeating, under-exercising, and not getting sufficient rest. It's a formula for health problems in the future.

MEMBER QUESTION:
What are ways to reduce stress to heal from a past trauma? I hold on to stress and anger by my nonforgiveness.

FARRELL:
Ask yourself one question: what is this doing for me?

If it's not doing anything positive for you, if it hasn't helped you to learn something either about life or how to handle something and it is just a painful wound, I would have to wonder what is the reason you keep revisiting this.

If this is an instance of what is called post-traumatic stress disorder, then I would recommend you consult a mental health expert to help you with this serious problem.

MEMBER QUESTION:
My mother has been having TIAs weekly. Her doctor says there are arteries clogged in her brain. He basically said that if she didn't get her diabetes and blood pressure under control she was headed for a major stroke. This visit left us hopeless and depressed.

FARRELL:
Certainly TIAs are a serious concern, and anyone who is experiencing them must be seen by a competent cardiologist and a neurologist. It is not a hopeless situation, but anyone who has both diabetes and hypertension does have a very serious problem that needs expert ongoing care.

Most probably, she is going to begin to experience some memory impairment and this can be quite a problem with someone who most probably has to take medications for her illnesses and who could easily become dizzy, suffer a fall, or have other problems related to these TIAs.

I suggest she be taken to the nearest medical center that specializes in these types of problems. And I do agree with you that it needs to be taken seriously ASAP.

MEMBER QUESTION:
How do you convey to your family that the undue stress that they put upon you is truly affecting your health?

FARRELL:
How come they won't listen to you? Is it because you've done everything for them and now they see they may have to change their lives because you're not always going to be there? Are they not willing to listen to you because they're afraid you may be ill?

Sometimes people handle their own anxiety by denying reality, and you might just confront them with the harsh reality of what is happening. Perhaps you've been too considerate of them and now it's their turn to learn to be considerate of you. Is this selfishness?

MEMBER QUESTION:
What's the difference between learning to relax and being a couch potato? My husband says he has to sleep late on Saturdays and watch football all day on Sunday because he has such a stressful job. Now I'm stressing because I never get to spend any real time with him. His de-stressing is hurting our marriage. What do I do?

FARRELL:
A very good question. Certainly we have a major problem in the winter and fall called "football widows." You and your husband really need to sit down and come to some compromises so that you can spend time together.

Perhaps you might learn to enjoy football. You never know. But certainly some exercise besides sitting on the couch would be very helpful for him in terms of his stress. And the two of you might find some exercise that you can do together for an hour or two on the weekend.

You're not asking for the entire weekend, you're not saying he can't watch football, you are saying you enjoy his company and would like to have some time to share with him. It may come to the point where you will have to go to a marriage counselor for a few sessions to resolve this. I hope you can do it on your own.

MODERATOR:
With the holidays nipping at our heels what can we do now to meet stress head on?

FARRELL:
The first thing to understand is that you create your own stress around the holidays. You add this to the stress being created by your family, friends and coworkers so that the holidays become not a joyful time, but one where we are constantly running, trying to please others.

Remember, if there's one gift you should give yourself during the holidays, it's the gift of not immediately responding to stressful requests from anyone. Slow down, don't run around shopping, take your time, enjoy the holidays.

As I've told some of my patients, traditions can be changed to suit the situation. So you can begin a tradition of allowing each other less stress this year. In fact, you could give each other a small box with a little note indicating "I will give you X number of stress-free hours this holiday time."

Your children can give that to you, you can give it to your husband, mother, whoever. And they can decide when that time can be. I think it's the best gift you can give to anyone.

"If there's one gift you should give yourself during the holidays, it's the gift of not immediately responding to stressful requests from anyone."

MEMBER QUESTION:
I want simple holidays, my family wants extravagance. I want to draw names, they want to buy gifts for every niece, nephew and second cousin. How do I opt out of this and not be a Scrooge or feel guilty?

FARRELL:
This sounds like something that requires you going into substantial debt for the holidays. Creating debt for yourself is very stressful, especially if it's unnecessary. If your family is being unreasonable, I believe you have a right to tell them, you'll buy 150 gifts if they want, but the gifts will only be 50 cents. They can decide.

MEMBER QUESTION:
Is dealing with the stress of a phobia different than the stress of a chaotic household or being laid off? I am afraid of crowds and wonder if "normal" stress reduction techniques would work for me.

FARRELL:
Phobias, in order to be a phobia, must be of such intensity, in terms of the anxiety that it brings on, that you totally divorce yourself from that activity, area, environment, whatever it is.

I believe many people have a form of social anxiety disorder, whereby crowds make them very uncomfortable, but it is generally not followed by agoraphobia. The person, therefore, can leave the house but tries to avoid crowds.

The avoidance of crowds is something that certainly can be handled either with behavioral therapy and/or mild medications, if needed. No phobia can make you a prisoner, and there is help for just about everyone out there.

MODERATOR:
In a perfect world is it better to try to eliminate the stressors in your life or to find a stress-reduction method that works for you so you can deal with any stress life throws your way?

FARRELL:
Stress is a part of normal living. I would agree with you that the better thing to do would be to find ways of coping with any stressful situation that might come along in your life.

In this way, you will be prepared, and being prepared gives you a sense of power. Power is a way of combating stress, because stress is dependent on a feeling of helplessness.

MEMBER QUESTION:
Do you put any stock in hypnosis to deal with everything from stress to quitting smoking?

FARRELL:
The jury is out on hypnosis, as far as I'm concerned. It is a useful relaxation technique, and while some people claim extraordinary gains with hypnosis, others don't seem to benefit. My thinking is if it works for you, it's fine.

MODERATOR:
Dr. Farrell, do you have any final words for this week's discussion?

FARRELL:
Let's not let stress be in control of our lives, let us be in control of the stress in our lives.

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