Stress Check. How are You Doing? Part 2. Types of Stress and Common Causes.

Stress is a normal biological reaction to what is perceived to be a potential threatening or challenging situation. But is all stress bad? Simply stated, no. Stress can be healthy when it helps one avoid an accident, meet a tight deadline, or helps keep one focused amid today's chaos. An example of stress that many may have experienced stems from public speaking. Some of my students enjoyed the thrill of speaking while others were paralyzed at the very thought of speaking in front of peers and professors.

Stress should only be temporary. Once a person has passed the fight-or-flight moment, heart rate and breathing should slow down and muscles should relax. Soon thereafter, the body should return to its natural state without any lasting negative effects. But is that the always the case? This brings us to the types of stress:

1. Acute Stress - This happens to everyone. It can be defined as the body's immediate reaction to a situation such as a flat tire or surprise quiz. Acute stress is usually not harmful as the body recovers quickly and returns to normal.
2. Episodic Acute Stress - This is exactly as it sounds. A person will experience frequent episodes of acute stress. Some professions are more prone to experiencing episodic acute stress. They include Emergency Room Physicians and Nurses, Police and Fire Fighters. Other Health Care professional may also experience episodes of acute stress. Episodic acute stress may adversely impact one's health.
3. Chronic Stress - This condition occurs when a person experiences high stress levels for an extended period of time. Long-term stress can have negative impacts on one's health and may contribute to:

• anxiety
• cardiovascular disease
• depression
• high blood pressure
• a weakened immune system

Yes, children are also at risk and more often than one may think. One result of the COVID-19 pandemic was school shutdowns and remote or distance learning for young students many of whom were not mature enough to handle the burden associated with remote learning. Consequently, many fell behind which is now causing chronic stress. According to The PEW Charitable Trust, "After more than 18 months of school closures and social isolation, the nation’s more than 50 million public school children are mostly back at their desks. But two months into the fall semester, teachers and students already are saying they need a break. The grief, anxiety and depression children have experienced during the pandemic is welling over into classrooms and hallways, resulting in crying and disruptive behavior in many younger kids and increased violence and bullying among adolescents. For many other children, who keep their sadness and fear inside, the pressures of school have become too great."

The message is clear. No one is immune from stress.

But how does stress make one feel? Under stress a person may exhibit one or more of the following:

• Irritable, angry, impatient or wound up
• Over-burdened or overwhelmed
• Anxious, nervous or afraid
• Like one's thoughts are racing and can't be switched off
• Unable to enjoy oneself
• Depressed
• Uninterested in life
• In some, stress manifests as lost sense of humor
• A sense of dread
• Worried or tense
• Neglected or lonely
• Existing mental health problems getting worse

Physical Signs of Stress:

• Difficulty breathing
• Panic attacks
• Blurred eyesight or sore eyes
• Sleep problems
• Fatigue
• Muscle aches and headaches
• Chest pains and high blood pressure
• Indigestion or heartburn
• Constipation or diarrhea
• Feeling sick, dizzy or fainting
• Sudden weight gain or weight loss
• Developing rashes or itchy skin
• Sweating
• Changes to period or menstrual cycle
• Existing physical health problems getting worse

Although stress has many triggers, the following appear to be most common:

• Personal Situations such as medical conditions. A personal example occurred when my wife was diagnose with breast cancer the day before Thanksgiving 2017. It was stressful to say the least. The ensuing year and a half of treatments were stressful.
• Friends and Family can lead to stress. Nothing like good old fashion family drama, for example, to raise stress levels.
• Employment and Study lead to stress. Many people are unemployed and are desperately seeking employment opportunities in their chosen profession, some without much success. Others are facing retraining. Let's not forget the college students shouldering mountains of homework or dreading the mid-term, final exam or perhaps the final paper upon which a significant portion of his or her grade will depend.
• Housing has become even more stressful than it has been. Rental costs have escalated and new home prices are astronomical. Add the rising interest rates to the mix and we have a perfect storm leading to stress.
• Money is not a stranger to the arena of stress and now is playing and increasingly greater role in producing stress. Rising costs for goods and services are outpacing raises. Many more on fixed incomes are being forced to change their spending habits. Some are skipping a meal or two throughout a week while others are weighing importance of food vs. fuel for example.
• Social Factors have and continue to be a source of stress for many. Further polarization of the population by politicians has taken a toll on relationships (family, friends, co-workers). Even social media attacks are common place.

Sometimes it seems that everywhere we turn we face stress triggers. But is all stress bad? Stress can be healthy when it helps one avoid an accident, meet a tight deadline, or keep one's wits amid chaos. We all feel stressed at times, but what one person finds stressful may be very different from what another finds stressful. As I have said many times before, "We are unique just like everyone else." But stress should be temporary. Once a person is passed the fight-or-flight moment, heart rate and breathing should slow down and muscles should relax. In a short time, the body should return to its natural state without any lasting negative effects.

Those of us in various healthcare fields are at risk. Daily we work with patients/clients presenting with stress or stress related illness. That exposure, in and of itself, can trigger stress. Workloads can be overwhelming. So I ask again, "How are you doing?" Each of us should take time to perform periodic self assessments to ensure we recognize stress in ourselves so that we may proactively avoid the consequences that adversely impact our well-being as well as those around us. There are many "stress assessment" tools available. however, I do not endorse one over another nor are they a substitute for a professional diagnosis. They are just a tool so long as the individual answers each question introspectively and honestly.

While stress is a normal part of life, too much stress is clearly harmful to one's physical and mental well-being.

Fortunately, there are ways to manage stress as well as anxiety and depression that may be connected with stress. We will take a look at those in "Stress Check. How are You Doing? Tools to Manage Stress. Part 3."

*I considered adding a discussion on stress hormones but decided that should be another article.