Understanding Stress: The Multifaceted Nature, Diverse Experiences, andHolistic Management Strategies

Stress is complex, affecting every individual differently. Stress is often perceived as a vague concept, but understanding its drivers is crucial in establishing healthier living. We will briefly cover the concept of stress, including its effects on both the body and mind, as well as the impact of diversity, gender, social support, and self-care in coping with stress.

Let's explore Work-Life Imbalance with this example:

Malik, a 32-year-old software engineer at a high-pressure tech startup, has been increasingly stressed due to long work hours (sometimes exceeding 60 per week) and difficulty balancing his personal life. He becomes easily agitated and short-tempered with coworkers, leading to strained relationships and a tense work environment, while constantly feeling overwhelmed and unable to relax or disconnect from work. This has led to physical symptoms such as migraines and muscle tension, as well as strains in his relationship with his spouse, whom he argues with about his demanding job. Instead of seeking support, Malik tends to isolate himself, feeling lonely and disconnected from loved ones. Malik's parents, both healthcare professionals in stressful roles, have offered advice on managing stress through mindfulness and setting boundaries. Despite this, Malik is now experiencing anxiety and depression, along with weakened immune function. With the help of a therapist he is actively trying to improve his overall well-being by attending therapy, working on communication skills with his spouse, identifying cognitive distortions, and setting aside time for his hobby of restoring vintage model trains.

Let’s embark on a journey of sobriety and self-care with this example:

Samantha, a 28-year-old IT project manager, is overwhelmed by her high-pressure job.  Samantha, once cheerful and lively, now works late nights and weekends, leaving little time for self-care, as she procrastinates on important tasks due to fear of making mistakes, resulting in even longer hours, a withdrawn demeanor and constant fidgeting, picking, and biting her nails—a nervous habit developed over time. The stress has caused tension headaches, gastrointestinal issues, and a decrease in energy levels. Despite having a history of marijuana use, she has been sober for the past year and a half with support from family and colleagues. However, she now needs to find healthier ways to cope with work-related stress. Seeking therapy for the first time, Samantha hopes to learn communication skills and set boundaries to prioritize her well-being while managing her demanding job. In collaboration with her therapist, she has identified stress relief and anxiety management as crucial components of maintaining her well-being. To address these needs, she has incorporated yoga and jogging into her daily routine, providing herself with healthy outlets to manage stress and promote overall wellness.

Let’s situate the role of stress in trauma, burnout, and healing in this example:

Paul, a 35-year-old new parent and paramedic, has been battling acute stress and panic attacks after a traumatic work incident. Without proper support or resources from his colleagues and management, he has struggled to handle the high-pressure situations he regularly encounters. As he prepares for his shift and responds to emergency calls, Paul experiences rapid breathing, heart palpitations, trembling hands, restlessness, agitation, a clenched jaw, and tense muscles. His shaking hands make it difficult for him to administer IVs to patients. The intrusive thoughts, flashbacks, and nightmares greatly affect his daily life and his ability to navigate fatherhood. Additionally, Paul deals with chronic insomnia and sometimes turns to alcohol for solace, aware that this behavior should not continue as his son enters pre-school.

Overwhelmed and burnt out, Paul has prioritized seeking professional help. He benefits from a combination of group support meetings with fellow paramedics who have experienced similar incidents and one-on-one therapy sessions with a Prolonged Exposure specialist. Having a provider who he feels understands the challenging process of dealing with the emotions related to the incident has been crucial for Paul. He also manages his stress levels through mindfulness meditation, which he has found helps calm his breathing and reduce the physical symptoms of anxiety.

An Investigation of Stress:

Stress responses are triggered by the sympathetic nervous system, including the hypothalamus, pituitary gland, and adrenal gland. Experiencing chronic stress can lead to these glands having a negative feedback loop, leading to exhaustion. Stress manifests through psychological and physical symptoms, such as irritability, anger, nervousness, lack of motivation, fatigue, headaches, and upset stomach. A number of factors contribute to stress, including household hassles, health concerns, time pressure, financial responsibilities, and work-related issues. Chronic stress can have severe consequences on an individual's health and well-being. It weakens the immune system, making one more vulnerable to illnesses like the flu or even cancer. Additionally, stress impairs cognitive functioning, affecting memory, problem-solving abilities, and focus.

Health disparities exist among various ethnic and racial groups, with African Americans experiencing disproportionate levels of stress and health issues due to socioeconomic factors, and exposure to racism and prejudice. Cultural differences related to beauty standards and communal sentiments can actually serve as resilience factors for some minority groups. Gender also plays a significant role in the experience and management of stress. Men and women face different health risks, such as heart disease, and may receive disparate treatment. Women also contend with gender-specific stressors, such as menstruation and premenstrual syndrome, as well as societal expectations and stigma surrounding body image and eating disorders that disproportionately affect women and gay men. Acknowledging gender-based differences in stress and health, as well as recognizing the unique stress and resilience factors faced by diverse populations, is the key to providing targeted support, developing culturally sensitive stress management approaches, and promoting health equity.

Furthermore, social support acts as a buffer against the negative effects of stress. Research has consistently shown that individuals with larger social networks and more friends have better immune functioning and are more resistant to common illnesses. Underlying all of these factors is the critical importance of providing sensitive, culturally competent therapeutic support. By acknowledging the context of one's stress and hardship on both a psycho-pathological, physiological and human level, therapists have a unique understanding of the challenges faced by their clients. Cultivating a strong support system can help individuals cope with stress more effectively, maintain better overall health and well-being, and foster resilience in the face of life's challenges, while a holistic approach allows for the creation of comprehensive and effective strategies for managing stress and promoting overall well-being.

Citations:

• Bach, J. F. (2002). The effect of infections on susceptibility to autoimmune and allergic diseases. New England Journal of Medicine, 347(12), 911-920.
• Cohen, S. (2004). Social relationships and health. American Psychologist, 59(8), 676.
• Goßrau, G., Förderreuther, S., Ruscheweyh, R., Ruschil, V., Sprenger, T., Lewis, D., ... & Jürgens, T. P. (2023). Consensus statement of the migraine and headache societies (DMKG, ÖKSG, and SKG) on the duration of pharmacological migraine prophylaxis. Der Schmerz, 37(1), 5-16.
• Hance, K. W., Anderson, W. F., Devesa, S. S., Young, H. A., & Levine, P. H. (2005). Trends in inflammatory breast carcinoma incidence and survival: the surveillance, epidemiology, and end results program at the National Cancer Institute. Journal of the National Cancer Institute, 97(13), 966-975.
• Hassinger, H. J., Semenchuk, E. M., & O'Brien, W. H. (1999). Appraisal and coping responses to pain and stress in migraine headache sufferers. Journal of Behavioral Medicine, 22, 327-340.
• Hoes, M. J. (1986). Stress and strain: Their definition, psychobiology and relationship to psychosomatic medicine. Journal of Orthomolecular Medicine.
• Hostinar, C. E., Sullivan, R. M., & Gunnar, M. R. (2014). Psychobiological mechanisms underlying the social buffering of the hypothalamic–pituitary–adrenocortical axis: A review of animal models and human studies across development. Psychological Bulletin, 140(1), 256.
• Jemmott, J. (1983). Psychosocial stress, social motives, and disease susceptibility.
• Lurie, N., Slater, J., McGovern, P., Ekstrum, J., Quam, L., & Margolis, K. (1993). Preventive care for women--does the sex of the physician matter? New England Journal of Medicine, 329(7), 478-482.
• Miller, G. E., Chen, E., & Zhou, E. S. (2007). If it goes up, must it come down? Chronic stress and the hypothalamic-pituitary-adrenocortical axis in humans. Psychological Bulletin, 133(1), 25.
• Nesdale, D., Maass, A., Kiesner, J., Durkin, K., Griffiths, J., & James, B. (2009). Effects of peer group rejection and a new group's norms on children's intergroup attitudes. British Journal of Developmental Psychology, 27(4), 799-814.
• Pope, C., Ziebland, S., & Mays, N. (2000). Analysing qualitative data. BMJ, 320(7227), 114-116.
• Quinn, D. M., Williams, M. K., Quintana, F., Gaskins, J. L., Overstreet, N. M., Pishori, A., ... & Chaudoir, S. R. (2014). Examining effects of anticipated stigma, centrality, salience, internalization, and outness on psychological distress for people with concealable stigmatized identities. PLOS ONE, 9(5), e96977.
• Roberts, A. L., Gilman, S. E., Breslau, J., Breslau, N., & Koenen, K. C. (2011). Race/ethnic differences in exposure to traumatic events, development of post-traumatic stress disorder, and treatment-seeking for post-traumatic stress disorder in the United States. Psychological Medicine, 41(1), 71-83.
• Vaccarino, V., Rathore, S. S., Wenger, N. K., Frederick, P. D., Abramson, J. L., Barron, H. V., ... & Krumholz, H. M. (2005). Sex and racial differences in the management of acute myocardial infarction, 1994 through 2002. New England Journal of Medicine, 353(7), 671-682.
• Wonderlich, J. A., Breithaupt, L., Thompson, J. C., Crosby, R. D., Engel, S. G., & Fischer, S. (2018). The impact of neural responses to food cues following stress on trajectories of negative and positive affect and binge eating in daily life. Journal of Psychiatric Research, 102, 14-22.