Break the Cycle: Managing Stress and Prioritizing Mental Health

According to the American Psychological Association, more than three-quarters of adults experience stress affecting their daily lives. The causes of stress vary among individuals but most commonly are in response to work, family life, finances, and, most recently, the current political state of our country. While most people experience stress at some point in their lives, untreated stress can lead to a variety of mental and physical health symptoms, including anxiety, depression, and cardiovascular problems.

Understanding Stress

Stress is a psychological and physiological response to perceived challenges or threats, involving tension and anxiety. It can arise from external factors (work, relationships) or internal factors (self-esteem, expectations), triggering the body's fight-or-flight response as protection from danger.

Types of Stress

• Acute stress. Acute stress passes quickly and can be triggered by something positive or negative, like slamming on the brakes in your car or riding a roller coaster.
• Episodic acute stress. This is when acute stress happens often, and you don't get time to return to a relaxed state. This can occur in high-stress positions like healthcare or with firefighters or cops.
• Chronic stress. Chronic stress is more long-term stress that can persist for weeks or months and can be triggered by family troubles, financial worries, or issues at work.

Recognizing Signs of Stress

It's important to recognize signs of stress and identify coping strategies before the stress becomes overwhelming.

Physical Symptoms

• Body aches that can't be explained by a medical condition or illness.
• Chest pain or irregular heartbeats.
• Exhaustion or trouble sleeping.
• Headaches, dizziness, or shaking.
• High blood pressure (hypertension).
• Muscle tension or jaw clenching.
• Digestive issues.
• Weakened immune system.

Emotional and Behavioral Symptoms

• Increased emotions such as anger, irritability, or sadness.
• Feeling anxious, overwhelmed, nervous, or on edge.
• Feeling sad or depressed.
• Feeling restless.
• Eating more or less than usual.
• Procrastinating at work or home.
• Avoiding your friends and family; isolating yourself from others.
• Increasing absenteeism at school or work.

Cognitive Symptoms

• Trouble keeping track of or remembering things.
• Difficulty getting your work done, solving problems, making decisions, or concentrating.
• Lack of motivation.
• Negative thinking patterns.

The Link Between Chronic Stress, Anxiety, and Depression

Stress, anxiety, and depression all have a lot of overlaps. Stress triggers fight-or-flight, which is often where anxiety lives. People under stress experience mental and physical symptoms, such as irritability, anger, fatigue, muscle pain, digestive troubles, and difficulty sleeping.¹

Anxiety and Stress

Anxiety and stress share many symptoms, including insomnia, difficulty concentrating, fatigue, muscle tension, and irritability. Coping skills for stress and anxiety often look the same, including exercise, a healthy diet, socialization, and engaging in pleasurable activities.³

Depression and Stress

Depression and stress can be cyclical, meaning depression can cause stress, and stress can cause depression. Struggling with chronic stress and depression can create a vicious cycle that exacerbates both conditions. Prolonged exposure to stress or chronic stress can alter brain function and lead to depressive symptoms like sadness or fatigue.²

Studies indicate that about 50% of individuals with acute stress disorder develop major depressive disorder, and around 30% to 60% experience comorbid anxiety disorders.²

Risk Factors and Protective Factors

Environmental Factors

Environmental factors include noise, clutter, or high-pressure situations at work and at home. While some things like noise might be unavoidable, there are protective factors you can take, such as making sure your space is tidy and orderly, using noise-canceling headphones when applicable, and making a to-do list to prioritize tasks.¹⁶

Lifestyle Factors

Lifestyle factors include harmful choices such as lack of sleep, poor diet, and lack of physical activity. Even something as small as going for a walk or trying to go to bed fifteen minutes earlier is a step in the right direction.¹⁶

Protective Factors

There are several effective stress management techniques and protective factors for stress that can help build resilience and reduce levels of stress. Protective factors include:¹⁷

• Positive social supports.
• Regular physical activity.
• Eating a balanced diet.
• Mindfulness or meditation.
• Building a growth mindset.
• Healthy sleep habits.
• To-do lists.
• Develop and maintain hobbies.

Holistic Approaches to Stress Management

Holistic approaches to stress management focus on addressing your whole self — mind, body and spirit — while promoting overall well-being.

• Yoga promotes physical, mental and emotional well-being by reducing the body's stress response, lowering levels of cortisol and increasing relaxation through breath control, physical postures and mindfulness.⁴
• Mindfulness allows individuals to become more aware of their thoughts and feelings by focusing on the present moment which can help with better emotional regulation.⁷
• Common herbal supplements include Ashwagandha, which reduces cortisol levels, Rhodiola rosea, which improves mood and reduces fatigue, and chamomile, which helps promote relaxation.⁵

When to Seek Professional Help

It's important to know when to seek professional help due to stress. Some signs to watch out for include:¹⁵

• Physical symptoms such as frequent headaches, GI issues or aches and pains that can't be explained by another medical condition.
• Emotional changes such as increased irritability, anxiety, and feelings of being overwhelmed.
• Sleeping too much or too little.
• Trouble concentrating, remembering things, completing basic tasks.
• Isolation and withdrawal from friends and family.
• Unusual appetite changes.
• Using substances to help cope.

Mental Health Treatments for Stress

Psychiatry and Medication Management

Not at all stress necessitates medication, but if your stress becomes overwhelming and you and your psychiatrist agree that medication is the best course of treatment, here are some potential options:⁶

• Antidepressants such as SSRIs like Prozac or Zoloft.
• Anti-Anxiety medications like benzodiazepines.
• Beta-Blockers like Propranolol.
• Buspirone.
• Mood stabilizers.

Therapy

CBT is one of the most effective types of talk therapy for treating stress.

Key components of CBT for stress include:⁴

• Cognitive restructuring — identifying and challenging negative thoughts or beliefs.
• Behavioral activation — this encourages clients to engage in pleasurable activities.
• Relaxation techniques such as mindfulness, meditation, and yoga.
• Goal setting by establish realistic goals to provide a sense of accomplishment.

Other effective therapies include:

• MBSR, or mindfulness-based stress reduction, was designed to help people manage stress through mindfulness and meditation including body scans, and breathing techniques.^8,9
• DBT focuses on mindfulness and teaches skills to identify, understand, and manage emotions more effectively.¹¹ DBT also uses a principle called distress tolerance, which involves developing healthy strategies to cope with stressful situations.¹²

TMS Therapy

Depression and anxiety are more commonly treated with TMS, but patients suffering from stress will also benefit. Transcranial Magnetic Stimulation (TMS) uses magnetic fields to stimulate nerve cells in specific areas of the brain, particularly the dorsolateral prefrontal cortex (DLPFC), which is involved in major depressive disorder and generalized anxiety disorder.¹⁰

Stress Relief and Professional Support

Stress can affect all aspects of our lives, but relief is possible through therapy, medication, and self-directed techniques such as yoga, meditation, and boundary setting.

To find a therapist, please visit the Psychology Today Therapy Directory.

References

1. What's the difference between stress and anxiety? (2022, February 14). APA.
2. American Psychiatric Association. (2020). Diagnostic and Statistical Manual of Mental Disorders (5th ed.).
3. National Institute of Mental Health. (2021). Anxiety Disorders.
4. Hofmann, S. G., Asnaani, A., Vonk, I. J. J., Sawyer, A. T., & Fang, A. (2012). The Efficacy of Cognitive Behavioral Therapy: A Meta-Analytic Review. Cognitive Therapy and Research, 36(5), 427-440.
5. National Institute of Mental Health. (2021). Psychotherapies.
6. Cuijpers, P., Karyotaki, E., Weitz, E., Andersson, G., Hollon, S. D., & van Straten, A. (2016). The effects of psychotherapies for major depression in adults on remission, recovery and improvement: a meta-analysis. Journal of Affective Disorders, 202, 511-519.
7. Kabat-Zinn, J. (2003). Mindfulness-Based Interventions in Context. Clinical Psychology: Science and Practice, 10(2), 144-156.
8. Grossman, P., Niemann, L., Walach, H., & Schmidt, S. (2004). Mindfulness-Based Stress Reduction and Health Benefits: A Meta-Analysis. Journal of Psychosomatic Research, 57(1), 35-43.
9. Chiesa, A., & Serretti, A. (2009). Mindfulness-Based Stress Reduction for Stress Management in Adults: A Systematic Review. Journal of Health Psychology, 14(3), 388-402.
10. Grossman, P., Niemann, L., Walach, H., & Schmidt, S. (2004). Mindfulness-Based Stress Reduction and Health Benefits.
11. Linehan, M. M. (2014). DBT® Skills Training Manual (2nd ed.).
12. Neacsiu, A. D., & Linehan, M. M. (2014). Dialectical Behavior Therapy: An Overview.
13. Keng, S. L., Smoski, M. J., & Robins, C. J. (2011). Effects of mindfulness on psychological health: A review. Clinical Psychology Review, 31(6), 1041-1056.
14. Selye, H. (1976). The Stress of Life (2nd ed.).
15. McEwen, B. S. (2007). Stress, Stressors, and the Brain: A New Perspective. Brain Research, 5(1), 2-6.
16. American Psychological Association. (2021). Stress: The Different Kinds of Stress.
17. Cohen, S., Janicki-Deverts, D., & Miller, G. E. (2007). Psychological Stress and Disease. JAMA, 298(14), 1685-1687.