Tag Archives: Stress management

On Taking My Own Medicine

lexaproI resisted for six months or so despite having promised myself last time this happened (the year I changed jobs and our first daughter was born) that I would probably need the extra help whenever life changed in a major way. I told myself I could do it without the help, that lots of people struggle and who was I to complain or ask for extra help. I thought I could manage by trying harder: at self-care, willing away the worried thoughts, meditating more, praying more, exercising more, journalling more.

But the anxiety went with me on vacation. The second half of my family vacation to some of the most beautiful beaches in America (Malibu, Palos Verdes, Manhattan–all in the Los Angeles area) was punctuated with intrusive thoughts about stressors, fears of failing, money worries, and guilt about worrying while I should have been relaxing (ah, “should,” how much of our pain is caused by that word?) At home, my wonderful partner told me in a moment of honest confession she felt the worry had become a third member of our relationship. Ouch.

I reflected. I considered re-starting the antidepressant medication that had helped me with the anxiety in the past. After all, anxiety tends to run in my family–a sibling, a parent, at least one grandparent, and lots of cousins, aunts, and uncles all struggle with it. There is most likely some biological component of this. An inner thermostat set lower than average, when stress heats up, it kicks on the worry and forgets to switch it off. Plus, my own Holmes-Rahe Stressful Life Events score for 2013 was 248. Big changes in my life included a new house, new practice with all the major schedule changes it brought, moving a disabled parent to less than a mile from our home, a child starting pre-K, and the other normal life stuff that comes with working and having young children. And some of those big life stressors touched some of my personal worry buttons: the perfectionistic desire to be extra good at my job, the painful history with that parent I was now taking more care of. Some of them touched buttons that I’m convinced are pretty universal: income, bills, children, fear of failure in my career. So I was kind of due.

A month later, I’m managing much better with a little pharmaceutical support. I’m leaving the work worries at the office and enjoying the mental space it’s created for birthday parties, playing My Little Pony with the girls, walking to the park, talking with my spouse about what she wants to talk about, planning trips, and simply enjoying the way the earth is being reborn for another Spring.

I share all this for three reasons: First, to remind me and anyone who reads it that being a helping professional means not that I do not struggle with the very things my clients do, but that I do. Remembering that helps us all be fully present to the struggle together–and that’s what therapy at its best really is anyway. Second, I’ve come to appreciate (again) how hard it is for someone to admit it’s time to get help. I suspect we all wait too long as often as not. Third and most important for me personally: I believe that the most powerful antidote to perfectionism is honesty about my struggles and vulnerabilities.


Stress is Unavoidable and Cumulative

I think all therapists have a handful of themes they return to over and over. One of mine is “stress is cumulative.” Lots of people who seek help in offices like mine could list current stressors in their lives that would bring anyone to their knees. The other names people give to their problems–kids’ behavior, marital problems, depression, anxiety–are made worse by the pile-up of life events that have eroded the family’s ability to cope. In some ways, for nearly every problem, stress is part of the problem.

Some background:

English: Bust of Hans Selye Magyar: Komárom - ...
English: Bust of Hans Selye Magyar: Komárom – Selye János szobra a Tiszti pavilon udvarán Slovenčina: Komárno – socha Jánosa (Hansa) Selyeho vo dvore Dostojníckeho Pavilóna (Photo credit: Wikipedia)

Has Selye was an endocrinologist in the middle of the last century, a prolific researcher who coined the term “stress” in the way that most of us use it today. He noticed that organisms (people and mice!) who had many demands on them seemed to have more problems, emotional, medical, and social. To describe this phenomenon, he borrowed a term from metallurgy. “Stress” is what happens to an object when forces press against it repeatedly. With enough stress, the substance will bend or break. Same with people. When many forces are pressing, we may bend or break too. Selye defined stress as “a nonspecific demand for change.” Translated into everyday language, stress is any new or repeated demand on our time, energy, or attention. He also noted there are good stressors like promotions, new friendships, or marriage. And there are bad stressors like not having enough money or a hole in the roof. He also noticed there are three states in the biology of stress responses: alarm, resistance, and exhaustion. When we first experience a new stressor, our systems rev up to adapt, producing more physical and mental energy. After awhile, we settle down into the resistance stage, where we draw on our reserves to cope. When our reserves are depleted, we get burned out, or exhausted. This sounds dire, but the good life is about growth and change. So there is no getting out of new demands. Stress is unavoidable.

Not long after Seyle’s initial research, two physicians, Holmes and Rahe, noticed that patients were more likely to get sick after they had experienced stressful events in life. They came up with a list of stressful life events, weighted for how much impact they seemed to have on people: from “death of a spouse” (100) to “revision of personal habits” (24) to “Christmas” (11). They called the list the “Holmes-Rahe Stressful Life Events Scale” (of course). The more points you get in a year, the more likely you are to get sick. Stress is cumulative.

More to Come:

I started this post three weeks ago, but kept thinking of more I wanted to put in. Soon, it was way part internet-attention-span length. A web designer I knew from Mercer said, “Never put anything you want people to read below the fold.” I got way past the fold. Way. So, there are two posts to come: One on Saying “No” and Making Time for Rest and Play, and another on Cultivating Self Compassion