Knot Now!

Knot Now!

It’s time to seek professional help if anxiety turns your nerves into a tangled mess

By Donna Shryer

When studies said that red wine—in moderation—reduces the risk of coronary heart disease, we toasted the news. When research divulged that moderate exercise is just as beneficial as vigorous activity, we jumped for joy. The same sweet response greeted news that dark chocolate, when reasonably nibbled, helps lower blood pressure.

It seems that moderation is the Holy Grail of health. And that includes moderating your stress, too. A modicum of stress can be empowering. The trick to managing this potentially debilitating state is to understand its symptoms and incarnations.

Stressing the Positive

Before trading in your Bottega Veneta briefcase for a surfboard and a stress-free life on the shores of Oahu, Hawaii, you need to know that stress can be your friend.

“During stressful events, your adrenal glands release adrenalin, a hormone that activates the body’s defense mechanisms and gives you the strength and focus to escape or fight when facing an acute threat,” explains Zahava Davidson, a licensed clinical social worker at NorthShore University HealthSystem. For example, if you see a car headed straight for you, stress activates alertness and energizes you to get out of the way.

Good stress also keeps the mojo flowing through hiccups that come with even the most joyful event, like a first date, planning a wedding, nailing a high-profile work project or having a baby.

In life’s big picture, Davidson says, “we often experience cognitive and emotional growth as a result of some stressful experiences.”

Stress Fractures

When stress slogs on without a break or comes on in one crippling deluge, it can become negative stress, or distress. If a person has insufficient coping skills to deal with this level of stress, functioning becomes difficult,” says Allison G. Johnsen, licensed clinical professional counselor and community relations coordinator for Cadence Health Behavioral Health Services.

“Mental health is a continuum, like sadness and depression, anger and rage, stress and anxiety,” says Johnsen. “At one end, you’re functioning well; at the other end, you stop functioning.

“Think of stress as a bell curve; your ability to perform is optimal with some stress but begins to decline as stress increases. At first, stress gets you going. But as stress escalates, you may skip meals, [or] skip breaks and sleep, still plugging away late into the night,” she says. “If there are too many rocks (responsibilities and stressors) in the sack on your back, and if you don’t take care of yourself, you could start showing clinical signs of an anxiety disorder.”

Physical signs of distress may include headaches, back pain, sleeping problems, upset stomach, weight gain or loss, muscle tension, and frequent or more serious colds. Emotional symptoms for anxiety include self-doubt, nagging worry, irritability and often a sense of feeling trapped with no way out.

At the farthest point on the stress continuum are clinical anxiety disorders that must not be ignored or brushed off with a quick, “Oh, it will go away.” Such disabling disorders include posttraumatic stress disorder, anxiety attacks, panic attacks, uncontrollable obsessive-compulsive disorders, phobias and depression.

Side Dishes

For many, managing stress begins with a psychotherapist who specializes in cognitive behavioral therapy, which means a psychiatrist, psychologist or other mental health provider who can help reverse negative thought patterns that produce unhealthy behavior.

For example, you may need help filling your glass. “People who always see the glass half empty tend to constantly worry about real and perceived stress,” says Cynthia Gordon, MD, JD, and medical director of the Illinois Professionals Health Program at Advocate Health Care. If worry becomes an all-consuming event, 24/7, “that’s when symptoms of anxiety begin.”

After investigating your glass, take a look at your plate. “It’s not unusual for high achievers to experience symptoms of anxiety at some point in their lives. They may take on projects and responsibilities until they’re overwhelmed, and then, functioning declines,” Johnsen says. One aspect of treatment in cognitive behavioral therapy may be the learning of how much responsibility and stress you can put on your plate without causing damage to yourself.

Mental health is a continuum, 
like sadness and depression, 
anger and rage, stress and anxiety. 
At one end, you’re functioning well; 
at the other end, you stop functioning."

Physical Attraction

In addition to seeing a psychotherapist, resolving anxiety issues typically includes a commitment to physical wellness, which is tightly linked to emotional health. For example, chronic stress causes the body to secrete excessive amounts of cortisol, a stress hormone that can trigger multiple health problems such as heart disease, obesity and suppression of the immune system. Because anxiety is a natural reaction to illness, a vicious cycle begins.

Physical activity is one way to help break the cycle. In addition to building strength and endurance, “exercise releases endorphins and positive hormones in the body that help us deal with stress and combat excessive amounts of cortisol,” explains K. Luan Phan, MD, director of the Mood and Anxiety Disorders Clinical and Research Programs at the University of Illinois Hospital Health & Sciences System. If traditional exercise isn’t possible, Phan recommends yoga, meditation or any other mindfulness strategy.

“What you want to do is divert your attention away from the negative feelings associated with stressors and toward a more calming state.”

A nutritionally balanced diet and sleep also play vital roles in preventing and treating anxiety. “This is not about weight loss.” Johnsen says. “Nutrition, exercise and sleep alone may not cure your anxiety, but they are part of the picture.”

And science agrees, with two recent Australian studies pointing to a direct link between diet quality and a potential role in preventing and treating mental illnesses such as depression and anxiety.

The Last Word

Any discussion about anxiety would be incomplete without mentioning the anxiety meds. While prescriptions can be “enormously beneficial,” Gordon also says that she and her patients often find behavioral changes and healthy lifestyle choices to be better than prescriptions.

“Medications may be a recipe for disaster if that’s the only change you’re making.” The reason, Gordon explains, is because many medications for anxiety are habit forming, which could result in replacing one problem for another. In addition, many of the most effective anxiety medications were never intended for long-term use. Their purpose is to “calm things down, which can allow you to focus on making healthy behavioral modifications,” says Gordon.

“Today we have a number and variety of good treatments to help people deal with stress and anxiety,” Phan says. In combination, the results can be dramatic. So there are ways you yourself can overcome stress and anxiety, but if needed or desired, you can also get effective help from psychiatrists, psychologists and other mental health providers. That’s important to remember.”

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Body of Knowledge

Studies conducted at Ohio State University identified several ways in which psychological stress can affect the body’s immune system and its ability to heal.

  • The stress a married couple feels during an ordinary half-hour argument is enough to slow the body’s ability to heal from wounds
  • by at least one day.
  • Certain stress hormones appear to stimulate certain tumor cells’ growth.
  • Stress can re-activate the Epstein-Barr virus.
  • Even a slight increase in stress and anxiety can substantially worsen a person’s allergic reaction to some routine allergens

Published in Chicago Health Winter/Spring 2014