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Understanding Stress

by Martin K. Diner, MD

Stress is ordinarily experienced by a person as discomfort in the body, distress in the mind or emotional upset.

The body may show stress by having muscle tension, back pain, headache, stomach upset, vomiting, diarrhea, constipation, chest pain, palpitations, skin rashes, dizziness, twitches, trembling, fatigue and other physical symptoms.  Some people find that a physical condition or disease that they already have gets worse.

Mental distress may lead to intense worrying, expecting something terrible to happen,
losing confidence, not liking oneself, developing fears of people or places and moving away from people and social activities.

Emotional upset can be shown by much stronger emotional reactions to casual and ordinary events.  Many people feel very angry, frustrated, depressed, fearful and cry a great deal.  These emotions may interfere with sleep, eating, concentrating, finishing chores, or working effectively.

Usually body discomforts, mental distress and emotional upset occur at the same time.  However some people can demonstrate stress in some of these ways and not in the others.  It should be pointed out, of course, that the physical and mental changes described above can be signs of disease, sometimes serious.  Therefore it is wise to be checked by a physician before assuming that your symptoms are only manifestations of stress.

Many people think that when they experience one or more of the behaviors that were just described, it is entirely caused by an event or a person who is giving them the stress.  A sick or dying relative, a demanding supervisor or boss at work, a child who doesn’t listen, or who takes drugs, a divorce or death, are all examples of events or people that are thought to cause the stress that a person experiences.  If it is true that these events or people cause you to experience stress then it appears that the only way you can get rid of your stress is to change the event or person.  For example, in order to feel better you would have to make the relative well or change the supervisor’s attitude or make your child behave and stop using drugs or not get divorced.  Since it is extremely difficult to do any of these things, people usually become even more stressed as they realize they cannot do anything to change things.

Fortunately, however, it is not true that you need to change the situation in order to lessen your stress.  It is true that the events just described act as stressors and upset your usual stability; sometimes with great force.  However, the events themselves are not responsible for the intensity of what you experience.  Rather, it is how you understand or think about the event, how much importance you give to it, whether you see the event as a threat to your well-being, and, most importantly, whether you believe that you can cope with the event, that determines how much stress you will have.  Whether or not you can actually cope with a situation is different from whether you believe you can cope.  Many people experience a large threat when objectively the threat is small.  In a similar way people often think they cannot cope with an event when in fact they can.

Once you realize that you contribute to your experience of stress, you can begin to do something about it.  You may not be able to change the stressor itself, but you can learn to respond differently to it, and lessen the stress that you actually experience.  It is possible to learn certain ways of breathing, meditation, and muscle relaxation that can calm your body and can especially counteract the automatic emergency activating system of your body.

In addition, you can attempt to change your attitudes and ways of understanding things.  Since stress depends on your appraisal of threat and your ability to cope, you can lessen your stress a great deal if you look at the attitudes you have.  For example, you may believe that you are a good person if you take care of other people and a bad person if you take care of yourself.  If you were to do something that was in your own best interest you might experience the mental distress of feeling guilty and also experience stress in your body.  You may develop palpitations or headache, a low self image and express feelings of anger more intensely.  By changing this basic attitude so that you feel competent rather than guilty when you take care of yourself, you can prevent or minimize your experience of stress.

Some of your most basic beliefs and attitudes were learned when you were growing up and have not been questioned.  By changing these attitudes you may become able to have your well-being less threatened by outside stressors and consequently decrease your experience of stress.


Cognitive Symptoms

Anxious thoughts, fearful anticipation, poor concentration, difficulty with memory

Emotional Symptoms

Feelings of tension, irritability, restlessness, worries, inability to relax, depression

Behavioral Symptoms

Avoidance of tasks, sleep problems, difficulty in completing work assignments, fidgeting, tremors, strained face, clenching fists, crying, changes in drinking, eating or smoking behaviors.

Physiological Symptoms

Stiff or tense muscle, grinding teeth, sweating, tension headaches, faint feelings, choking feeling, difficulty in swallowing, stomachache, nausea, vomiting, loosening of bowels, constipation, frequency and urgency of urination, loss of interst in sex, tiredness, shakiness or tremors, weight loss or gain, awareness of heart beat.

Social Symptoms

Some people in stressful times tend to seek out others to be with.  Other people withdraw under the stress.  Also, the quality of relationships can change when a person is under stress.


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