April is National Stress Awareness Month

What it is

A dictionary will define stress as a state of mental or emotional strain or tension resulting from adverse or very demanding circumstances. Practically speaking, we may define stress as how we react when we feel under pressure or threatened and it usually happens when we are in a situation that we don’t feel we can manage or control.

We all experience stress – yet we may experience it in very different ways. Because of this, there is no single definition for stress, only that a physical, mental, or emotional strain or tension triggers it. Simply put, stress is a reaction to a situation where we feel anxious or threatened.

Likewise, there is no one set of signs and symptoms that your body, mind, or spirit could be under too much pressure.

How to manage stress

Research has concluded time and time again that stress management is not about what we implement externally but what we achieve internally. To this end, here are some healthy ways to manage stress (in no particular order):

• Deep breathing

• Activity and exercise

• Getting outside

• Developing a hobby

• Healthy eating

• Spending time with a pet

• Mindfulness and meditation

• Sleep

• Decreasing the amount of time spent following the news

“We need to become much more conscious about what we consume in terms of information in this digital, repetitive, overstimulating informational culture,” says Gurmeet Kanwal, M.D., clinical associate professor of psychiatry at Weill Cornell Medicine and associate attending psychiatrist at NewYork-Presbyterian Hospital. “Turn off the TV. Don't allow every news channel to send you notifications on every device and listen to the news one or two times a day instead of all day long. Burnout is your brain’s way of protesting the injustice and brutality of too much information, too much stress, and too much repetition.”

Chronic stress is damaging

Experts agree that to a point, it's important that we feel anxious sometimes because it boosts our alertness, awareness, focus, and performance. However, long-term stress (also called chronic stress), the type most often experienced by family caregivers, is unhealthy.

The most dangerous feature of chronic stress is that it happens over such a prolonged period that we adjust and adapt to it, to the point where we fail to recognize we are stressed.

According to the American Psychological Association (APA), our bodies can handle stress in small doses. However, if we experience chronic stress, our bodies respond negatively. Chronic stress affects several body systems:

• Cardiovascular

• Endocrine

• Reproductive (male and female)

• Gastrointestinal

• Musculoskeletal

Impact

Mental health can positively or negatively impact your physical health and contribute to poor health behaviors linked to increased risk for heart disease and stroke. It is also a driver for poor health behaviors with serious consequences.

• Smoking

• Overeating

• Lack of physical activity

• Unhealthy diet

• Being overweight or obese

• Not taking medications as prescribed

Caregiver stress

Organizations like the American Association of Retired Persons (AARP) and Family Caregiver Alliance (FCA) conduct regular research on family caregivers that provide insight into the psychosocial and socioeconomic status of family caregivers, finding that they are especially burned out, depressed, and financially burdened.

• 57% report high levels of stress, anxiety, and/or depression.

  • Large studies, going back to the early 2000s, are finding that 29–32% of caregivers are clinically classified as depressed and report poor health. This is four times the national average among adults.

  • Caregiver self-reports of depression symptoms range from 40–70%.

• 8 out of 10 family caregivers performing medical/nursing tasks report that managing their loved one’s pain is stressful.

• Caregivers spend an average of $7,000 (26% of their income) on out-of-pocket costs related to caregiving. This approaches $9,000 for those caring for someone with dementia.

• Nearly half (47%) of caregivers experience at least one financial setback as a result of caregiving, and more than half (53%) experience at least one work-related impact.

• 67% of caregivers have made at least one personal sacrifice due to the cost of caregiving (trips or vacations, eating out, going to the doctor, groceries).

Fun Fact

Hans Selye published his work on 'general adaptation syndrome', or as we know today 'biologic stress', in the journal Nature in 1936, and after 40 years of study (in 1976), he introduced two categorizations of stress - distress (bad or detrimental stress) and eustress (good or beneficial stress). Healthcare professionals still operate on these constructs today.

There is also an often-overlooked third type of stress (or lack thereof) called sustress, which means "inadequate stress", indicating that someone is not challenged enough. While this may sound ideal, it can bring on feelings of boredom (lack of stimulation) or stagnation, which can be stressful for those who enjoy experiencing achievement.