Stress is a feeling that people have when they are struggling to cope with challenges related to finances, work, relationships, environment, and other situations. Moreover, stress is felt when an individual perceives a real or imagined challenge or threat to a their well-being. People often use the word stress interchangeably with anxiety, feeling anxious, fearful, nervous, overwhelmed, panic, or stressed-out.
Stress is the body’s natural defense against real or imagined danger. It flushes the body with hormones to prepare systems to evade or confront danger. This is known as the “fight-or-flight or freeze” response.
The body is an intelligent operating system, but the body can not determine the difference between life threatening external threat from imagined or perceived non-life threatening stressors. The body reacts the same either way. The body produces significantly greater quantities of the chemicals cortisol, adrenaline, and noradrenaline. The Neurobiology of stress is a complex operating mechanism.
According to American Psychological Association (APA), there are 3 different types stress — acute stress, episodic acute stress, and chronic stress. The 3 types of stress each have their own characteristics, symptoms, duration, and treatment approaches.
Stress management can be complicated because each of the 3 different types of stress can present as single, repeated, complicated, or chronic. Therefore, they require different levels of treatment interventions, management, and psychological treatment modalities due to the nature of the person’s environment, lifestyle, developmental history, coping resources, and personality.
Acute stress is usually brief. It is the most common and frequent presentation. Acute stress is most often caused by reactive thinking. Negative thoughts predominate about situations or events that have recently occurred, or upcoming situations, events, or demands in the near future.
For example, if you have recently been involved in an argument, you may have acute stress related to negative thoughts that are repetitive about the argument. Or you may have acute stress that is about an upcoming work deadline, again the stress is thought induced. However, most often when the thinking induced stress is reduced or removed the stress will subside too. However, if the stress meets DSM-5 criteria, then individual may be diagnosed with Acute Stress Disorder
Acute stress causes signs and symptoms in the body + brain + emotions, but does not cause the significant amount of damage as Episodic Stress and Chronic stress.
Short-term Effects of Acute Stress
The most common signs + symptoms:
- Transient Emotional distress — some combination of anger or irritability, anxiety and depression.
- Transient Muscular distress—tension, headache, back pain, neck pain, jaw pain, and other muscular tensions that lead to pulled muscles and tendons and ligament problems.
- Transient stomach, gut and bowel problems, heartburn, acid stomach, flatulence, diarrhea, constipation.
- Transient hyperarousal—elevated blood pressure, rapid heartbeat, rapid pulse, sweaty palms, heart palpitations, dizziness, migraine headaches, cold hands or feet, shortness of breath, sleep problems, and chest pain.
Acute stress can present in anyone’s life.
It is highly treatable and manageable.
However, repeated acute stress can become very harmful for your physical and mental health.
EPISODIC ACUTE STRESS
People who frequently experience acute stress, or whose lives present with frequent triggers of stress, have episodic acute stress.
The individuals who frequently suffer acute stress often live a life of chaos and crisis. They are always in a rush or feel pressured. They take on many responsibilities, and usually can not stay organized with so many time demands. These individuals are perpetually in the grips of acute stress overload.
There are 2 main personality types that frequently present with Episodic Acute Stress: 1) “Type A” personality 2) The “Worrier”
“Type A” personality: Type A personality have an excessive competitive drive, aggressiveness, impatience, abrupt, and a sense of time urgency. In addition, Type A personality presents as reactive with hostility, and almost always a deep-seated insecurity about performance. These personality traits create frequent episodes of acute stress for the Type A individual. The cardiologists, Friedman and Rosenman found Type A’s to be significantly likely to develop coronary heart disease.
The “Worrier”: The Worrier presents with almost incessant negative thoughts causing episodic acute stress on physical and mental health. “Worry warts” project probable disaster and negatively forecast catastrophe in almost every situation. They have core beliefs that the world is a dangerous, unrewarding, punitive place where something awful is always about to happen. These negative binge thinkers also tend to be over aroused and tense, but are more anxious and depressed than angry and hostile. Their thoughts are frequently filled with “What if….” statements that are with projected negative outcomes. They are often diagnosed DSM-5 with generalized anxiety disorder.
Episodic Effects of Acute Stress
The most common signs + symptoms are similar to acute stress, but due to the extended frequent over arousal or extended hyperarousal there is ongoing damage and suffering.
- Emotional distress —anger or irritability, anxiety and depression, short-tempered, impatient, tense.
- Cognitive distress: compromised attention/concentration, compromised processing speed, compromised new learning and new learning memory consolidation and retrieval, and mental fatigue.
- Interpersonal relationships deteriorate, The workplace becomes a very stressful place for them.
- Muscular distress—tension, headache, back pain, jaw pain, pulled muscles, tendons, and ligament problems.
- Stomach, gut, bowel problems, heartburn, acid stomach, flatulence, diarrhea, constipation, irritable bowel syndrome (IBS).
- High blood pressure, rapid heartbeat, sweaty palms, heart palpitations, dizziness, migraine headaches, cold hands or feet, shortness of breath, insomnia, chest pain, and heart disease.
- Immune System Compromise: frequent colds/flu, allergies, asthma, and other immune system compromise illnesses.
Episodic acute stress leads to more pronounced health issues such as, high blood pressure and heart disease, and irritable bowel syndrome (IBS).
Treatment for Episodic Acute Stress
Episodic acute stress requires intervention on a many levels. The treatment requires professional help spanning many months.
Most often the lifestyle and personality characteristics are so ingrained and habitual that these individuals may see nothing wrong with the way they conduct their lives. It is common for these individuals to blame their problems on other people and external events. Frequently, they see their lifestyle patterns, and their patterns of interacting with others, and their ways of perceiving the world as an essential or integral component of their personality and therefore are often resistant to seek professional psychological help.
These individuals can be very resistant to change their behaviors and thinking patterns. It is common for these individuals to only seek psychological treatment when physical pains and discomforts become too much.
Chronic stress is the most harmful type of stress. If chronic stress is left untreated over a long period of time, it can significantly and often irreversibly damage your physical health and deteriorate your mental health.
For example, long term poverty, repeated abuse in any form, unemployment, dysfunctional family, poor work environment, substance abuse, or an unhappy marriage can cause significant chronic stress.
Chronic stress can also set in when an individual feels hopeless, does not see an escape from the cause of stress, and gives up on seeking solutions.
Chronic stress can be caused by a aversive experiences in childhood or traumatic experiences later in life.
When an individual lives with chronic stress, his/her behavioral actions and emotional reactions become ingrained. There is change in the hardwiring of the neurobiology of the brain and body. There by making them constantly prone to the hazardous stress effects on the body + mind+ cognitive regardless of the scenarios.
People with chronic stress have the list of signs and symptoms previously mentioned, but the signs and symptoms are chronic and can result in a physical and mental breakdown that can lead to suicide, violent actions, homicide, psychosis, heart attacks, and strokes.
Chronic stress is grinding stress. It wears people away day after day, year after year. Chronic stress destroys lives, bodies, and minds. It wreaks havoc through long-term attrition. It is the stress of poverty, dysfunctional families, violence, abuse, trauma, despised job, ethnic rivalry, war.
Treatment for Chronic Stress
When a person never sees a way out of a miserable situation, feels anxiety of unrelenting demands and pressures for seemingly interminable periods of time. With no hope, the individual gives up searching for solutions.
Some chronic stressors or triggers stem from traumatic early childhood experiences that become internalized and remain forever painful and present. Early childhood experiences profoundly affect personality; often resulting in core belief systems that are created by causes of unending stress for the individual (e.g., the world is a threatening place, you must be perfect at all times). When personality or deep-seated convictions and beliefs must be reformulated, recovery requires active self-examination with professional psychological help. Good news is psychological treatment is very effective.
The worst variable of chronic stress is that some people habituate to it. They almost forget it is there. In some ways, one could say it is an adaptation in the form of a ultimate psychological defense mechanism. People are immediately aware of acute stress because it is new. However, individuals with chronic stress frequently ignore all of the signs and symptoms because it is old, familiar, and also because often they feel helpless and hopeless.
Chronic stress kills through suicide, violence, homicide, heart attack, stroke and, perhaps, even cancer. People wear down to a final, fatal breakdown. Their physical and mental resources are depleted through long-term attrition. The signs and symptoms of chronic stress are difficult to treat, but not impossible to treat.
People with Chronic Stress require extended medical and psychological treatment that includes behavioral and stress management.
How we react to a difficult situation will affect how stress affects our life and our physical and mental health. A person who feels they do not have enough resources to cope will be more likely to have a stronger reaction that triggers significant physical and mental health problems. It is paramount to remember that the mind and body are connected — meaning that psychological factors affect how a person feels physically and the longevity of the body.
A persistently negative response to challenges can have a detrimental effect on mind + body + emotions. However, being aware of how you react to stressors and seeking professional help can help reduce the negative feelings and effects of stress, and to manage it more effectively.
Get help. If you continue to feel stress, anxious, overwhelmed, panic, stressed-out, then consult with a licensed clinical psychologist who can help you learn how to manage stress effectively. He or she can help you identify situations, thoughts, and behaviors that contribute to your stress and anxiety. Treatment will involve developing an action plan to get you healthy. Your health depends on your environment, body, mind, thoughts, and emotions.
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Peace, Dr. Freshwater