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Updated: Aug 19, 2023

What do you feel like when you are experiencing stress? Is it excitement? Is it dread? Is it sleepiness? Is it discomfort, anger and anxiety? The stress response is actually all of the above and more.

Stress or stressing out is conventionally thought of as something that is unwanted, uncomfortable and even unwarranted when in fact, sometimes we are experiencing eu-stress, "eu" as a prefix in latin for 'good' where we are alert, in an optimal amount of arousal in our sympathetic nervous system, and we are performing our tasks on a high level. This is the Yerkes-Dodson law of stress/arousal and performance.


While the above are two states of the sympathetic nervous system, on the opposite end of the spectrum of the stress response continuum, though, there is a state of our nervous system where we are not responding to any external stressor, good or bad. We are for example deep in sleep and the parasympathetic nervous system, characterized by digest, and recovery, is fully online. What we usually refer to as the "stressed out" state of the stress response is actually only when the sympathetic nervous system has been kicked into overdrive, beyond the optimal level of arousal and especially for a length of time where the body's resources are becoming too depleted and homeostasis is difficult to achieve.


All three of these nervous system states are a part of normal human functioning; the only caveat is that the sympathetic nervous system was only meant to be motivated into overdrive fight, flight, freeze (and fawn) for a short amount of time, such as when a sabre-tooth tiger is coming to threaten our lives!

We are then motivated to run, fight, or blend into the environment when we are able to escape danger. It is a survival mechanism completely normal to every mammalian nervous system.


The problem appears when we have these survival responses activated too much and/or too long.


According to the Cleveland clnic, some common signs of stress include: [1]

  • Changes in mood

  • Clammy or sweaty palms

  • Decreased sex drive

  • Diarrhea

  • Difficulty sleeping

  • Digestive problems

  • Dizziness

  • Feeling anxious

  • Frequent sickness

  • Grinding teeth

  • Headaches

  • Low energy

  • Muscle tension, especially in the neck and shoulders

  • Racing heartbeat

  • Trembling [1]


When our nervous system gives us feelings and thoughts of "stressing out" we often feel relatively high rates of irritability, fear, and perhaps anger and sadness. We may overwork or underwork and experience frustration and feelings of exhaustion and burnout; we may also increase participation in addictive habits to escape a feeling of inability to cope.


We may sometimes fight and behave with irritability and anger with our loved ones with disproportionate intensity. Sometimes our flight response may be kicked in and we use all kinds of habitual avoidance strategies. We may also compartmentalize these feelings so much so that we may not even be able to identify the stress at the moment. I often have clients notice that they are "numbed out". Their rational brain may think everything is OK, but their bodies have kicked in an avoidance coping skill of dissociation in order to cope with the feelings of exhaustion, burnout, and inability to cope. Sometimes we may freeze or fawn, collapse within, and behave outwardly in a people-pleasing manner that may be not truly authentic to ourselves.


According to Elizabeth Scott [2], some tangible signs of our nervous system on overload status can be:

  • Psychological signs such as difficulty concentrating, worrying, anxiety, and trouble remembering

  • Emotional signs such as being angry, irritated, moody, or frustrated

  • Physical signs such as high blood pressure, changes in weight, frequent colds or infections, and changes in the menstrual cycle and libido

  • Behavioral signs such as poor self-care, not having time for the things you enjoy, or relying on drugs and alcohol to cope [2]


Coping Skills to Practice in Regulating our Stress Response


According to the NIMH [3], some coping skills that may help are

  • Keep a journal.

  • Download an app that provides relaxation exercises (such as deep breathing or visualization) or tips for practicing mindfulness, which is a psychological process of actively paying attention to the present moment.

  • Exercise, and make sure you are eating healthy, regular meals.

  • Stick to a sleep routine, and make sure you are getting enough sleep.

  • Avoid drinking excess caffeine such as soft drinks or coffee.

  • Identify and challenge your negative and unhelpful thoughts.

  • Reach out to your friends or family members who help you cope in a positive way.[3]

Treatments for Stress



In treating a stress-related disorder, we must ascertain whether this is an acute response or a chronic response. Once there is an understanding of where the root causes are, we can target treatment accordingly. Treatment may range from learning new internal self-regulation skills to stabilizing external circumstances such as in our relationships and careers to find a good enough sense of emotional homeostasis and safety. Examples of coping skills may include communicating and reinforcing proper boundaries, mindfulness, and relaxation techniques that promote para-sympathetic responses. With chronic stress, the nervous system may have undergone changes from long-term over-activation of the sympathetic nervous system which sometimes presents as insomnia or reduced ability to self-regulate. In these cases, the sympathetic nervous system is a bit "stuck" and not as fluent in toggling back to rest/recover/digest mode of the parasympathetic. Depending on the severity of impact of the chronic stress activation on the nervous system, medication and alternative medicines in conjunction with therapy can also be helpful.


Psychotherapy

In treating stress-related disorders, many clinicians use modalities such as cognitive behavioral therapy (CBT) and mindfulness-based stress reduction (MBSR). CBT focuses on examining and exploring the client's beliefs (cognitive) to facilitate the creation of preferred behavior changes/goals. MBSR utilizes meditation and mindfulness to reduce sympathetic nervous system responses. More often than not, stressors may come from triggers of old neuro-networks from unprocessed historical trauma. Parts work from the Internal Family System and EMDR are trauma-processing modalities that can alleviate distressing symptoms of a stress-related disorder. EMDR in particular has had now over thirty years of neuro-scientific research data supporting the efficacy of this treatment modality.


Medication

Medication may sometimes be prescribed to address some specific symptoms that are related to stress. Your family doctor as well as a psychiatrist would be able to assess and determine if this would be right for you.


Complementary and Alternative Medicine

Some complementary approaches that are often helpful relieving symptoms from stress-related disorders are acupuncture, aromatherapy, massage, yoga, and meditation.[4]


I wish you peace and healing in your journey.

[1] (2021, January 28) https://my.clevelandclinic.org/health/articles/11874-stress

Stress: Signs, symptoms, management & prevention. Cleveland Clinic. (n.d.). https://my.clevelandclinic.org/health/articles/11874-stress [2] Elizabeth Scott, P. D. (2022, November 7). How is stress affecting my health? Verywell Mind. https://www.verywellmind.com/stress-and-health-3145086 [3] U.S. Department of Health and Human Services. (n.d.). I'm so stressed out! fact sheet. National Institute of Mental Health. https://www.nimh.nih.gov/health/publications/so-stressed-out-fact-sheet [4] Elizabeth Scott, P. D. (2022, November 7). How is stress affecting my health? Verywell Mind. https://www.verywellmind.com/stress-and-health-3145086

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Anxiety is a response to perceived or real uncertainty and danger created in our mammalian nervous systems to help motivate us to find safety in face of impending danger and it is often expressed as a feeling distressing uneasiness to intense panic.


[1] Even though anxiety of functions as a way to keep us safe, when someone suffers from an anxiety disorder can be feel incredibly crippling. Research has shown that in general, anxiety disorders affect anywhere between 20-33% of adults each year. [2] Many people suffer through their anxiety symptoms, white-knuckling through, "power through" as many of my clients report and thus it directly affects their quality of life. In this way, many people go undiagnosed and it can be even normalized into our psyche as a part of life; this insidious normalization can stem from the macro system of society/culturally condoned practices as well as family systems and thereby integrate into our individual inner worlds. Anxiety may also be associated with other co-morbidities. Another reason for being undiagnosed may be hesitation to seek help. This is also an effect of some culturally sanctioned dynamics we might catch and/or pass on from generation to generation.


According to Stenson and Lott 2022 [3], Clinically anxiety disorders can be possibly categorized as follows:


1. Anxiety disorders: characterized by a general feature of excessive fear (i.e. emotional response to perceived or real threat) and/or anxiety (i.e. worrying about a future threat) [3]


2. Obsessive-compulsive and related disorders: Obsessive-compulsive and related disorders are characterized by intrusive ruminations (e.g., constantly worrying about staying clean, or about one's body size) that trigger related, compulsive behaviors (e.g. repeated hand-washing, or excessive exercise). The thoughts and behaviors here are paired in the nervous system with the latter as way to temporarily relieve the discomfort coming from the former [3]


3. Trauma- and stressor- related disorders: Trauma- and stressor- related anxiety disorders often are rooted in experiences of trauma through significantly stressful events such as death and divorce, family of origin traumas, grief and loss in all kinds of life transitions.[3]


According to the Mayo Clinic [4], common anxiety signs and symptoms include:

· Feeling nervous, restless, or tense

· Having a sense of impending danger, panic, or doom

· Having an increased heart rate

· Breathing rapidly (hyperventilation)

· Sweating

· Trembling

· Feeling weak or tired

· Trouble concentrating or thinking about anything other than the present worry

· Having trouble sleeping

· Experiencing gastrointestinal (GI) problems

· Having difficulty controlling worry

· Having the urge to avoid things that trigger anxiety [4]


Also according the Mayo Clinic [5], common risk factors for developing an anxiety disorders are:


*Those, especially in childhood, who endured abuse, trauma or witnessed traumatic events have a higher risk of developing anxiety disorders.

*Neuroscience evidence in the last few decades have shown time and time again that our physical bodies are directly related to our non-tangible emotional bodies. We can all suffer stress due to an illness especially if the illness is serious and/or terminal, such as cancer, heart disease, dementia etc.


*In the same vein, chronic stressors that overextend the capacity of our nervous systems also can create over time a stress buildup that can cause serious damage, beginning with a possibility of developing an anxiety disorders. The mammalian nervous system handles stress brilliantly with it's fight, flight or freeze mechanism, but this was meant for a limited time, time enough just to get away from the sabre tooth tiger, not to sustain the stress response in a chronic long term time frame.


*One's personality, especially in the dimension of Neuroticism in the modern personality testing paradigm of the five factor model, correlate with developing an anxiety disorder [6]


*Anxiety disorders may have heritability and can run in families. Having blood relatives who have anxiety disorders is a risk factor for developing the disorder. [7]


*Substance Use can exacerbate symptoms of an underlying anxiety disorder and/or lead to developing the disorder.


There are many ways to manage and alleviate anxiety. Some examples of common coping skills are mindful meditative practices, breathing exercises, management of sleep, diet, physical exercise and stress management. We also may find safety in connection to something greater than ourselves and also with safe, trusted significant others. Since anxiety commonly presents as a symptom of deeper-rooted causes it is often beneficial to seek professional counseling with or without the combination of psychiatric medications.


I wish you peace and healing on your journey.


[1] Jovanovic, T. (2022, November 21). Anxiety " what is anxiety? signs, causes, symptoms. Anxiety.org. https://www.anxiety.org/what-is-anxiety

[2] Leonard, M. (2022, May 17). Anxiety disorders: Affecting Americans by the Millions: Lifeskills. Lifeskills South Florida. https://www.lifeskillssouthflorida.com/mental-health-blog/anxiety-disorders-affecting-americans-by-the-millions

[3] Stenson, Anais, & Lott, Abigail. (2022, November 21). https://www.anxiety.org/what-is-anxiety. [4] Mayo Clinic Staff (2022, Oct 12) Anxiety Disorders, Mayoclinic.org, Anxiety disorders - Symptoms and causes - Mayo Clinic [5] Mayo Clinic Staff (2022, Oct 12) Anxiety Disorders, Mayoclinic.org, Anxiety disorders - Symptoms and causes - Mayo Clinic

[6]Ormel, J., Jeronimus, B. F., Kotov, R., Riese, H., Bos, E. H., Hankin, B., Rosmalen, J. G. M., & Oldehinkel, A. J. (2013, July). Neuroticism and common mental disorders: Meaning and utility of a complex relationship. Clinical psychology review. Retrieved January 1, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4382368/

[7]E;, D. K. M. (n.d.). Genetic factors in anxiety disorders. Modern trends in pharmacopsychiatry. Retrieved January 1, 2023, from https://pubmed.ncbi.nlm.nih.gov/25225016/








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