Your Stress Type

WebMD Live Events Transcript

You know something isn't quite right. You feel pressured to do more in less time, to move faster at work, to be the perfect parent. But what is the type of stress that damages your health? How do you recognize it? WebMD's in-house expert Patricia Farrell, PhD, author of How to Be Your Own Therapist, joined us on Oct. 26, 2004, to talk about it.

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:
Dr. Farrell, stress is out there, and it affects people in different ways. Can you explain that for us?

FARRELL:
There are really two types of stress. The kind that is imposed on us by the environment and type we impose on ourselves. In many instances the demands we place on ourselves are really more stressful than those from the environment. So you might say this is a form of beating ourselves up. And it serves no useful purpose whatsoever.

MEMBER QUESTION:
Does the source of stress have an impact on how we deal with it -- whether it's kids or bosses or money, etc.?

FARRELL:
The source would certainly either limit or broaden your ability to cope with the stress. For instance, if it was from your children, you certainly have a great deal more power to come up with coping strategies than if it was from your boss. So stress, by and large, and our ability to cope with it may be a function of the source as you have indicated; therefore, we need to have flexible ways of dealing with any stress. One way may not work in all situations.

MEMBER QUESTION:
The ultimate question for me is when to be concerned that stress is harming me. A stress-free life is impossible unless we're dead, right? So where's the line?

FARRELL:
You're absolutely right. As long as you're alive, you will be stressed. But there's one thing to remember: There are also two additional considerations regarding stress. There is good stress and bad stress. Both of which can cause physical or mental problems. Good stress is stress that comes from an event that should bring you happiness, such as:

• A promotion
• The birth of a child
• A vacation
• A major accomplishment

Bad stress, on the other hand, would be from:

• A medical illness
• The loss of a loved one
• The loss of a job

But the point is that both can cause stress. And when we think about stress, some people also include the idea of anxiety. Unfortunately, anxiety is usually seen as a negative. In fact, anxiety in an appropriate amount, acts as a motivator. So that both stress and/or anxiety can be good things if they help us to make important healthy choices in our lives.

MEMBER QUESTION:
How do we help our stressed loved ones recognize and deal with bad stress?

FARRELL:
It's always a challenge when we have a loved one who is stressed. The things you can do are:

• Be understanding
• Help them to learn either ways of changing the situation, or of coping with the situation, which can't be changed immediately

This has to be done in a sensitive way, because someone who's under a great deal of stress usually has difficulty dealing with their irritability, and they may not "hear" what you mean to say to them, and may instead hear it in a negative way. So it's important that you phrase what you say carefully.

MODERATOR:
Does this mean we just offer help and support in general terms without "confronting" them about their stress?

FARRELL:
I think that it's always important to let someone know that you support them in whatever they're going through and you're willing to listen to them and to be helpful in whatever way they believe might be helpful to them.

MODERATOR:
How can you tell if there's an anger/stress connection?

FARRELL:
Stress certainly lowers our ability to deal with our anger, simply because a stressed person generally has an increased feeling of helplessness. They see themselves in a situation where a resolution is not immediately apparent. That increases their anxiety and decreases their ability to appropriately handle emotion.

Sometimes if it's reaching the point where the person is constantly angry and irritable and possibly has problems sleeping, interacting with others, etc., it might be helpful for them to have a discussion with their family physician, because stress that reaches that level is quite dangerous for physical health in the long run.

MEMBER QUESTION:
I haven't been able to control my stress lately -- how can I change this? I have had headaches for a week now and on Sunday was at the point of passing out twice -- and I have a 16- month-old baby! Also, I work full time, so all my spare time I want to spend with her.

FARRELL:
It sounds like you are experiencing a high level of stress, certainly having a 16-month-old can be very difficult, and I would wonder how much free time you have in your life for yourself.

I don't think that it's good for anyone to give up certain things that are needed to maintain a good, healthy outlook on life. One of the things would be to have some free time for yourself to do something that is just enjoyable. I would say take a look at your life, make a list, and see what you've done for yourself lately that's fun and enjoyable; not something that you needed to do.

I think this may help you to change things around a little bit so that you can get a break. Remember, stress is like pain. If you don't get it at the beginning and allow it to go on, it is more and more difficult to deal with it and to take appropriate action. So do something now to decrease the probability that you will get more stressed. Your headaches are probably related to your stress level and you may also want to see your doctor about this.

As far as spending all your free time with your baby, you have to ask yourself what is the quality of the time that you are giving your daughter, and wouldn't it be better if you had a little time to yourself so that you could help yourself not be irritable around her? Which is best, more time or better quality time?

MEMBER QUESTION:
How do we get people to see that certain seemingly benign behaviors they have are indicators of stress that needs to be addressed?

FARRELL:
This is sometimes a very difficult thing to do. You have to approach it quite delicately, because what you're telling this person, in effect, is they may be making you miserable and a stressed person does not want to hear that.

So you know them best, and you know how to phrase things that they will find acceptable. Choose your time carefully when you will do this, choose your words carefully. Don't allow yourself to become emotional during this conversation, because it is a conversation, not an argument, and don't allow it to become an argument.

You might just start out by saying, "We have something that we need to talk about." The two of us need to work on something. You have to indicate that this is a two-way street and not that you're blaming this person for anything, simply that you wish to help them and yourself, so that the burden of change will be shared by both of you.

MEMBER QUESTION:
What if you are already physically ill from stress -- IBS-D, ulcers, fatigue -- and don't realize when you are stressed out?

FARRELL:
Those are primarily GI problems, and that's quite common, and you probably are taking some medication for all of these physical problems. I would wonder, however, if you have been referred to someone who might help you with some biofeedback training and/or some self-help techniques, because this, together with your medications, might be the best way to go.

IBS certainly is exacerbated by stress, so you need to learn self-help coping mechanisms that you can use anywhere. There is a variety that you can use, including relaxation breathing.

For those who don't know, biofeedback is making use of sophisticated machinery, to help you train yourself to control body functions that you didn't think you could control, such as:

• Blood pressure
• Heart rate
• Perspiration in your hands

You can do it very well and can very quickly learn to bring your blood pressure down, your heart rate down; you can learn to relax, using a simple machine that provides you usually with some sound, which tells you when you're controlling those functions or you might see it on a computer screen that's on a graph. It's something you almost do unconsciously.

MEMBER QUESTION:
Putting pressure on yourself versus stress from others -- do we reduce both in the same way?

FARRELL:
Internal stress usually comes from making extraordinary demands of ourselves, and also giving ourselves negative messages about our abilities or how we handle things. It's usually tied to a low sense of self-esteem, feelings of helplessness and hopelessness, and by that, depression usually is a component.

So the way we usually handle that is to try to help the person increase their realization of a higher level of self-esteem and competency and also to help them give themselves positive messages; in other words, positive self-talk.

If you ever saw Jimmy Conners playing tennis, that was a supreme example of positive self-talk on the tennis court, where he told himself, "You can do it, come on." He was his own coach, which is what we help people to become.

External stress, on the other hand, usually requires that you do a careful evaluation regarding where it's coming from and what ways you might better handle it. If you work at a particularly stressful job, you might begin to think of ways that you can decrease the stress at the job.

Sometimes it can be handled by learning better time management techniques. Sometimes it can be handled by job change within the company or change in responsibilities, asking for help, going for additional training. So look at all the possibilities there might be for change. Begin to keep a journal and look over the areas where you might be able to make some change; it may take time. And remember, not everything happens quickly. It may take planning. So begin now to take an inventory of where the internal stress is coming from.

MEMBER QUESTION:
Does how we react to stress, whether it's by being angry, or crying, or eating compulsively, provide a health provider with clues for how to treat the stress?

FARRELL:
Sometimes your particular mode of reacting to stress is helpful for the health care provider.

For instance, if you are a stress binge eater, which is quite common, you need to work with the doctor on what are the triggers that cause you to binge eat and how might you help yourself not to do it. In other words, eliminate foods that you enjoy binge eating on in your home or in your office. If you're someone who angrily lashes out, what you need to do is begin to learn a few anger management techniques.

This doesn't mean you need to go to a group. You can look up ways to do it on the Internet, in the local bookstore, and in the library. There are plenty of things you can do. Decide what's your usual reaction to stress, and then pick the means that's best for you.

MEMBER QUESTION:
How can one deal with constant negative remarks from others in regards to protecting ones own self-esteem?

FARRELL:
Remember one thing: When someone is constantly making negative remarks about you, they are picking the things about themselves that they find most disturbing. The comments tell you more about the person than anything about yourself. Don't take the bait. And remember, they're telling you their vulnerabilities.

MEMBER QUESTION:
Do professionals still put stock in such descriptions as "type-A personality"? If so, are there certain types of people who are more susceptible to stress?

FARRELL:
There seems to be some ongoing belief that there are type-A personalities. Generally, these are people who need to overachieve. They also might be people who are biologically more driven than other people.

They might even, in today's world, have a certain level of overactivity that needs to be contained. We understand that some people have higher levels of certain brain chemicals that may cause them to be more hyperactive than others, and generally this may be treated with some mild medication --because they can actually cause themselves to burn out.

MEMBER QUESTION:
Does untreated stress always lead to anxiety or depression?

FARRELL:
Untreated stress can cause serious medical illnesses, because your body is constantly in a state of alarm. Stress is really waiting for the angry dog to come down the street with its teeth bared, but there's no dog. Your body gets ready to escape, and it starts using up its resources and actually pouring out a stress hormone that is physically damaging. One of the effects can be that certain chemicals in your body can be depleted, leaving you more prone to anxiety and depression.

MEMBER QUESTION:
I stress out so much about not getting enough sleep. If my child wakes up a lot at night or I know I have to get up extra early the next morning, I can hardly sleep for worrying about how much sleep I'm losing! Any idea how to tackle this issue?

FARRELL:
Online there are a number of resources about helping you to learn how to sleep better. It's called Sleep Hygiene. There's been a lot research and written about it. I would refer you to those resources. Also, try two things:

• Set your alarm (and I wouldn't have a blaring alarm, I would have something soothing to wake you up).
• And use positive self-talk. Say to yourself, "My job is to go to sleep right now; it's OK for me to do that. I need to get my rest."

If you can't get enough rest, try to get more rest on the weekend, if you can take naps, do so. Remember, Michelangelo never slept more than 15 minutes at a time for his entire life. So naps work wonders.

MEMBER QUESTION:
With treatment can you get the depleted chemical back from stress?

FARRELL:
Yes, absolutely. That's one of the things you're going to do when you go to your MD, because one of the things he or she will find, probably, is there may be an electrolyte imbalance. That's one of the reasons people are now advised to take multivitamin and minerals.

It's not a waste of money, it's trying to help with the stress, because, and this is particularly important if you take certain diet advice or you're on certain cardiac medications, the nervous system has a very high sensitivity to changes in sodium and potassium, two things can really change that: coffee and medication. Once that balance is changed, you become more prone to anxiety and depression -- and even worse.

MEMBER QUESTION:
Is stress something that can be treated with drugs or over-the-counter meds or supplements?

FARRELL:
Supplements, any physician will tell you, serve a purpose, but there's no purpose if all you're going to do is take pills and not make a lifestyle change. Remember, there's a danger in taking over-the-counter medications. Unfortunately, too many people see either herbs or vitamins as only beneficial, and in large doses those herbs and vitamins can actually be injurious. So don't assume that just taking an over-the-counter medication is going to do everything for you.

MEMBER QUESTION:
Can you get the same benefits by eating a diet rich in various vitamins and minerals? Does a vegetarian diet provide these benefits?

FARRELL:
I'm not a nutritionist or dietician, so I'm really not qualified to talk about diet. I think the only way to find out if your electrolytes are within normal limits is to go to your doctor and have a blood test. There's no other way you're going to know if they're back up to normal.

MEMBER QUESTION:
I know some stress is needed to keep us going and push us to succeed, but my tolerance is so low that I avoid confrontations, challenging projects at work, and other "normal" stress situations. How do I raise my ability to absorb normal stress levels?

FARRELL:
I don't believe that it's your inability to handle stress that you're talking about, I believe what you're talking about is that you have a concern you may not be able to do the job, and that's really a matter of self-esteem and an anxiety around taking on a new challenge.

MODERATOR:
Dr. Farrell, do you have any final words on stress for us?

FARRELL:
I think everybody should understand there's going to be stress in their lives, they will find ways to handle it, it's not hopeless, believe me, and they do have more power than they ever thought they did, and they will prove it in the future. Just work at it.

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