Stress Assessment & Intervention Overview
Stress has been in the spotlight quite a bit over the last twenty years and it continues to be a hot topic. For good reasons. Our neighbors, physicians, corporate leaders, therapists and news reporters can all be found talking about the causes and harmful effects of stress. Excessive stress hurts people and families and it doesn’t stop there. In 1992 the United Nations’ International Labor Organization already identified occupational stress as “epidemic,” and in 1996 a World Health Organization report called stress a “worldwide epidemic.” Unfortunately, things haven’t improved any since then.
- 44% of Americans reported an increase of stress over the 5 years before the study was done.
- “The most common reason given by adults for not doing more to manage their stress was being too busy or not having enough time.”
- About 40% of adults in the study reported overeating or eating unhealthy foods because of stress.
- Irritability, fatigue and lack of motivation were the most commonly reported physical symptoms of stress.
- 64% of adults indicated managing stress is important but only 32% made progress in reducing stress.
- 35% of adults in fair to poor health have been told by their health care provider to reduce their stress.
The bottom line?
- Increasing and relentless demands on people and businesses are taking a severe personal and economic toll
- Researchers and health professionals devote time to understanding the causes and effects of stress
- Not enough is being done to effectively reduce the impact of stress across the board
Understanding and reducing the effects of stress can be challenging. We constantly hear:
- “Am I really that stressed?”
- “How does my stress compare to other people?”
- “Is stress really costing us money?”
- “Is my stress causing – or being caused by – problems at work?”
- My doctor says I’m too stressed and it’s hurting me. What do I do?”
It all starts with recognizing stress. Even this is a problem because many people fail to recognize when stress has become excessive.
Types of Stress*
No matter which type of stress described below is of concern to you or your organization, we have solutions.STRESS REDUCTION FOR INDIVIDUALS STRESS REDUCTION FOR ORGANIZATIONS
By far this is the most common type of stress. It is a short term condition provoked by the pressures and demands of recent or anticipated events (or threats). The “fight or flight” reaction is triggered, and nearly all bodily systems show patterns of increased arousal. People always know when they are feeling acute stress because it comes on quickly and draws attention to itself. In small doses, it may be experienced as motivating or even exciting for some people, but most people find it uncomfortable. Because it is short lived, acute stress does not cause the degree of emotional and physical damage seen in long term stress. The most common symptoms of acute stress are:
- Emotional distress, excessive anger, irritability, depression and anxiety.
- Muscular problems in the form of tension headaches and back pain, jaw pain or TMJ (temporo-mandibular joint), and tension induced muscle pulls, tendon or ligament problems.
- Gastrointestinal problems such as heartburn, acid stomach, ulcers, flatulence, diarrhea, constipation, and irritable bowel syndrome.
- Heart and circulation problems including temporary blood pressure elevations, rapid heart beat, sweaty palms, heart palpitations, dizziness, migraines, cold hands or feet, shortness of breath and chest pain.
TREATMENT: These short-lived symptoms can effectively be managed with a combination of self-regulation methods and stress reduction resources. Some symptoms may resolve without treatment.
Episodic (Repeated) Acute Stress
Some people find themselves in repeating episodes of acute stress; in some cases these episodes develop into a state of constant crisis. Constant disarray and turbulence become a fact of life, and people often become overextended. They live in “high gear” as they try to maintain some level of organization in their activities. Everything begins to feel like a demand or pressure, and the world is seen through “stress colored glasses.”
People with episodic acute stress are usually short-tempered, irritable, anxious, tense and generally over-aroused. Others may see them as having excessive “nervous energy.” They are abrupt with others and sometimes others see their irritability as hostility. Close personal relationships can suffer and deteriorate, particularly when others don’t understand the reasons for the stressed person’s behavior. The symptoms of episodic acute stress are similar to those of simple acute stress but more severe. They include:
- Persistent tension headaches and migraines.
- Hypertension, chest pain and heart disease.
- Psychological and emotional symptoms including anxiety, anger and depression.
- Gastrointestinal problems including diarrhea and irritation of peptic ulcers and colitis.
TREATMENT: Successful treatment of episodic acute stress generally requires professional help and may take many months.
Chronic stress typically occurs when pressures and demands are relentless and when they become a permanent element of the day-to-day landscape. At first people may try to improve things or adjust, but over time they give up hope that things can change. The helplessness and loss of hope discourages the individual who will often give up trying to find solutions. Seeing the world as a threatening place causes near constant arousal of the biological “fight of flight” reaction. This causes progressive and severe deterioration of physical and psychological systems and the effects of stress escalate.
Chronic stress can be lethal. Suicide, violence, heart attack, stroke, and even some cancers have been linked to chronic stress. People wear down and a physical or emotional breakdown can happen.
Chronic stress is also unique. Being human, people try to adjust to stressful situations, and over time some become accustomed to how they feel, however unpleasant it is. They fail to recognize what others see easily and they feel surprised when a loved one or colleague thinks they’re stressed. It is as if the stress has become like an old, familiar, inescapable aspect of life. These individuals gradually forget about or ignore the stress effects, and they pay little or no attention to the increasing costs to their physical or psychological health.
TREATMENT: Because physical and mental resources are depleted over time in chronic stress conditions, the symptoms are difficult to treat and may require extended medical support as well as behavioral treatment and stress management.
Traumatic stress comes from experiencing or witnessing life-threatening events such as war, natural disasters, serious accidents, or violent personal assaults such as rape. Threats to psychological or social integrity can also be traumatic. Most survivors of trauma return to normal within about six months, but for others, the intense stress reactions persist. Untreated, they may even worsen over time.
People with Post-Traumatic Stress Disorder (PTSD) often have intrusive memories of events associated with the trauma. Flashbacks and nightmares may occur, and they often have physical symptoms of over-arousal along with extreme emotional reactions to relatively minor events. These individuals may also experience emotional numbness and loss of feelings. Some work to avoid reminders of the place the event happened and of the event itself. They also may show extreme distress when exposed to the reminders or thoughts that trigger the stressful memories. Impulse control problems, diminished concentration, problems with decision making and memory problems can all occur and interfere with daily life.
Long-term psychological consequences such as depression, anxiety, behavioral disorders, emotional numbing, or suicidal impulses are often seen in PTSD. Several other factors may intensify the stress :
- Nature of the trauma (deliberate vs. accidental).
- Presence of ongoing stress (e.g. lawsuit, severe injuries) causing shronic stress.
- Trauma frequency (single occurence vs. repeated events); repeated traumas causes both acute and chronic stress if there is little hope of escape (soldiers in combat, child abuse victims, etc.).
- When the trauma is caused by a responsible, supposedly protective individual or loved one, the PTSD is complicated by loss of trust.
TREATMENT: PTSD treatment is specialized and will vary to some degree according to the various factors noted above. Professional assistance is nearly always required.
* Descriptions of stress types adapted with permission from The Stress Solution by Lyle H. Miller, Ph.D., and Alma Dell Smith, Ph.D. with permission.
Stress is a very complex subject, but most stressed people just want to be healthier, feel better, and enjoy life more. Information on causes of stress, stress effects, susceptibility to stress, biological stress, “good” stress, “bad” stress, stress symptoms, stress resilience, stress reduction and stress management is widely available. And sorting through it can be overwhelming. It can be a real challenge for one person (or even a team) to work through the available information on stress, and then decide how to proceed with positive change. But there is a way.
“Don’t guess about stress. Measure it.” ™
STRESS REDUCTION FOR INDIVIDUALS STRESS REDUCTION FOR ORGANIZATIONS