I cannot count the number of patients who come into our Williamsburg office with a physical ailment and we end up talking about their overwhelming level of stress. Job, housing, kids, relationships, money and health: Anxiety overshadows pleasure and relaxation tenfold. With today’s modern conveniences, why does life seem MORE stressful instead of more relaxing?
I never claim to have the answer to this oft-repeated question. It is a struggle for me personally as much as I imagine it is for any of my patients. My medical school graduation speaker urged us blooming physicians to remember one thing upon graduation: “to take it easy” as we went out into the world. I keep coming back to this advice because it seemed so silly and striking at that time, and now seems so wise and insightful.
How Do You Express Your Stress?
Stress will never quit the onslaught on our lives, but the way we learn to manage it defines our health. The human body varies from person to person in how it copes with stress in daily life. Many people get stomach upset like gas/indigestion or pain and ulcers; others may vomit or get diarrhea with abdominal cramps. Many others experience panic attacks and are plagued by anxiety that crops up during a subway ride or in the middle of the night when they fling awake with racing thoughts. Yet others don’t realize they are under stress, but then have angry outbursts and become impatient with their loved ones.
The key to making stress work for us is to understand how it manifests itself in our bodies. Take a step back for a moment and look at how you express your stress: Do you get flutters in your chest? Headaches? Diarrhea? Do you pick a fight with your partner or your kids or your best friend? Do you eat more fatty foods or smoke a cigarette or reach for alcohol? Do you globalize the feeling and start to feel down about everything?
Make Room for Relaxation
Once you discover how your body channels your stress, start to look for ways that you can release it and relax. Each of us has the opportunity to examine our lives and goals and begin to make decisions that give space to the things that calm us down. This could be physical activity like taking a walk, mental work like writing in a journal, or talking on the phone to an old friend. It could be cooking or dancing or woodworking. Or, you can search out and try new things that resonate with your personality.
Mindful Awareness
My favorite recommendation is to try “mindfulness.” This is the act of being present. It means to be in the moment no matter what you are doing. It is a simple idea and can be revolutionary to your health. But it takes practice. I suggest you start by learning to breathe. Of course, we all know how to “breathe,” but we don’t really know how to be fully aware of our breath.
There are many free podcasts and instructions on breathing and mindful practices. The best resource I have found is the University of Wisconsin’s integrative medicine website. Once your mind learns to breathe and let frenetic thoughts pass by like a loud train, it will start to respond differently to everyday stressors. It is a slow process, but it can make simple, everyday tasks serve as a release and a comfort.
I am so glad that Dr. Enschede highlights something that we in the mental health professions have been shouting about for a very long time. To expand further on what she says, over 60% of all visits to primary care offices have no organic basis, which most likely means that somatization of emotional problems is occurring. Beyond that, mental health problems, and stress in particular, affect the immune system so that the body becomes more susceptible to cancer, heart disease, and infectious diseases. Emotional factors also come into play in considering compliance with treatment for diabetes, obesity, and post-operative recovery, among others. And this leaves out the whole interplay between alcohol, drug (including tobacco) and other addictions and medical problems. I could go on and on.
With all this, one would think that more healthcare resources would be channelled into mental health and substance abuse treatment, right? Well one would be wrong. In the last 25 years the percentage of funds going to mental health and substance abuse treatment of the entire health care dollar has shrunk from 6% to under 3%. Most of this has been because of economic pressures brought about by insurance companies who can get away with cutting rates in a “non-essential” area and by government-run medicaid which can likewise get away with cutting reimbursement rates to mental health providers to a level where it is almost not possible to stay in practice.
Anyway, thanks for calling attention to this vital isssue. I think learning to practice stress-management techniques and incorporating lifestyle changes is a great start, but in truth the problem calls for a comprehensive restructuring of the entire healthcare system, where collaborative approaches are instituted that aim at real outcomes rather than putting mental health into a separate silo that aims at profit and cost-cutting.
Good article and good comments from Don Rhoades ,MA.
You both might be interested to know that here in Oregon since Sept 2012 there has been the roll out of a CCO concept, applicable to all Medicaid recipients. A Coordinated Care Organization focuses on the entire patient and their environment–.(Developing a Medical Home for each patient) Mental Health issues popped to the top of the list of priorities on which to focus. The win-win for everyone is better care for more patients, more efficiently and with significant cost savings. (dealing with the real reason for whatever the presenting symptom is). It is too early to say much about results. I anticipate that this approach will be successful and will be emulated gradually throughout the entire population.