There are several factors to consider when we look at how to manage stress. The first is to be aware of when we're going through difficult times. It's important to remember that even positive life changes can be stressful, so things like moving, getting a new job, getting married, even those can be stressful and it's important for us to be aware of that. The second thing to note is: what are your personal signs and symptoms of stress? Do you tend to have a difficult time falling asleep? Do you get sick more frequently? Do you notice pain in your neck and shoulders or stomach upset? Knowing how you in particular respond to stress can help you be aware when you're actually under stress. The third step is to practice really good self-care. This starts with physical practices like being conscious of our nutrition, exercise, sleep, hygiene, and then also considering other practices such as meditation, journaling, and making sure that we're connecting with family and friends. And the fourth thing to be aware of is to know when we get really overwhelmed that that's when it's important to reach out for professional support. Looking for a therapist, a psychologist, a psychiatrist, or even your primary care doctor to get additional support and resources when you're starting to feel really overwhelmed.
Stress is something that we talk quite a lot about but actually is very subjective and difficult to define. In many ways, stress has become synonymous with distress, but if we look at the original definition, it came from someone by the name of Hans Sealy in 1936 who was one of the original stress researchers and he defined stress as "the changes that occur in the body in response to any type of new or different situation that arises in our environments." We often think of stress as a bad thing, but in many ways we actually need stress. A certain amount of stress allows us to be productive, allows us to be motivated. However, when stress exceeds a certain point and interferes with our ability to function, then it becomes difficult and we need to address how we're managing our stress. The other thing that's important to consider is that positive life changes can also be stressful. Sometimes we think of things like getting married or getting a new job or moving as exciting, and we don't realize that even though they are positive changes, because there are different and new, they actually can create stress for us. So how do we know when we are stressed? Actually, stress looks very different for every individual. We can divide the experience of stress into emotional and physical. When we feel stressed emotionally, we often feel worried. We feel anxious, we might have racing thoughts, we could have difficulty falling asleep, but we also can have physical symptoms. For example, people can develop a racing heart, they can feel short of breath, they can develop stomach upset, and even get sick more often than usual.
Anxiety has to do with worry and when we talk about anxiety disorders, we're talking about worry that is taken to more of an extreme. Anxiety disorders cover a spectrum of conditions that range from the most generalized in the form of generalized anxiety disorder, which involves worrying for an extended period of time about multiple problems in your life to things as specific as phobias, which I'm sure you've heard of. Things like being afraid of spiders or heights or even clouds. Your worries might have more to do with public situations like of being in a public environment that feels unsafe and that you're unable to escape for some reason, which is the case in agoraphobia. Or it might relate to a fear of being embarrassed in public, such as the case in social anxiety and in one of its most debilitating forms - panic disorder - you can be left feeling so worried and afraid that you feel short of breath and an impending sense of doom coming over you. So if you're experiencing any sense of worry or fear that is impairing your ability to function or to meet your social obligations in life, please go see a mental health professional who can help you understand what is happening and how to feel better.
Worry is a very normal and useful emotion that we all experience. In fact, even though worry feels pretty uncomfortable at times, we need it to motivate ourselves in life. However, anxiety can begin to feel like it's out of control and become an anxiety disorder. Anxiety disorders have a lot of different features. There are many different types of anxiety disorders, but what they all have in common is there is a fundamental inability to function in life that occurs. So if you notice that your worry has become so overwhelming that you're unable to function in your roles - such as at work, at home or in relationships - then that's a sign that it might be time to get treatment, as you may be experiencing an anxiety disorder.
Research into anxiety and its treatment and causes has been ongoing for decades and as technology advances, then new areas for research are opening up. One such area is being explored by neuroscientists right now who are trying to identify specific brain cells - specific neurons - that are implicated in anxiety. A study recently found that certain cells in the hippocampus are very important in the way anxiety works in our brains. Most of these tests are being done currently on mice - not in humans yet - but they're hoping to further this research and identify more and more specific neurons in the brain that are implicated in anxiety's mechanism in our brain so that down the road, additional drug therapies might be developed to turn certain of these neurons on and off and provide relief for people who suffer with anxiety.
Of course, if you're experiencing anxiety and think you may have generalized anxiety disorder, then it's important to find and seek help from a mental health professional in your area. They can provide a complete assessment and help you understand what it is you're experiencing and why and help you to feel better. I also encourage you to check out the website for the National Alliance on Mental Illness, which NAMI.org. There - and in particular in the anxiety disorders section - you can find all kinds of information about anxiety and also support group resources that may exist in your area.
A common question that's asked is: should a person start with therapy or with medication? As with so many things, there's no one-size-fits-all right answer, but there are some things to consider: therapy works well. Medications work well. The combination of the two seems to work better than either one by itself, and so oftentimes they will be combined. I often recommend it to patients if the clinical situation is appropriate to start with therapy. Therapy being a little bit more of a conservative option without the side effects that you necessarily could see from medication. If a course of therapy really doesn't seem to be helping, then consider adding on medication. That being said, every situation is unique and it has to be assessed individually, so there are no hard and fast rules, but that is one potential way to consider.
Our bodies work on what's called a circadian rhythm, which is where our bodies are awake during the day when it's light out and asleep at night when it's dark. Similarly, when our environment is bright, our body thinks I should be awake, and therefore as you get closer and closer to sleep time, your room should get progressively darker and darker. When a person is suffering from anxiety, oftentimes they'll have racing thoughts and find it difficult to fall asleep. Conversely, when people are depressed, they'll want to sleep all day long and spend all the time in their bed. Neither of those situations are ideal for sleep. It's really important to get a very steady seven to eight hours of sleep daily, depending on your own cycle.
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