There has been a lot of buzz about the American Psychological Association’s recent Stress in America survey. Some question whether it really represents the state of the nation’s stress, others question whether or not we can really do anything about our stress, and some wonder if it even matters.

After all, everyone always has to deal with some stress, right?

Deborah Kotz of the Boston Globe’s Daily Dose questioned whether the APA’s survey results were accurate. She did her own (though admittedly unscientific) poll online.

Interestingly at the time I wrote this post, her results  mirrored those of the APA survey, and in fact, made the situation even more alarming. Her results indicated that 34.28 percent of Americans described themselves as extremely stressed, have gained weight and are having other health problems. And another 29.32 percent of Americans feel frazzled a lot and don’t believe they are dealing well with stress.

Her article has generated lots of comments by people frustrated at the lack of available services. The stigma they feel is attached to a diagnosis of mental illness and the cost of getting help. Others have pointed out the need for increased education about  stress and mental illness and the benefits to individuals and their families.

Here are some very important facts:

• People with serious mental illness have a 25-year shorter life span than those who do not. Three out of five of these people die of mostly preventable conditions, such as obesity and heart disease.
• Estimates are that 11 percent to 36 percent of primary care patients have a psychiatric disorder.
• One recent survey of mental health conditions in urban family medicine practices revealed that more than 40 percent of survey respondents met criteria for a mental health disorder. But, many come to the physicians’ offices with complaints of headaches and stomach issues such as irritable bowel. Too often patients are told to lose weight, take it easy or handed a prescription with no follow-up.

The American Academy of Family Physicians noted the following:

Psychiatric problems are a major health issue. In the United States, neuropsychiatric disorders have now surpassed other disorders such as cardiovascular diseases and malignant neoplasms as the number one cause of disability as expressed as disability-adjusted life years.

According to the most recent data available, mental health expenditures in the United States, expressed as a percentage of total health care expenditures, were more than 6 percent.

Most family practice physicians are not well trained to manage psychiatric issues. As a result, lots of unnecessary and very expensive medical tests are performed when psychotherapy might be what is needed.

So the answer is yes, stress matters! And yes, we need to learn to better manage our stress.

We need to learn about mental illness and make sure we provide and receive appropriate treatment. Financially, we can’t afford not to. The loss of life is so often unnecessary. There is no price to put on the life and unnecessary death of a loved one.

While I recognize that simply taking a bubble bath, as one person commented, will not solve the tremendous financial and family pressures that  people currently are facing, reducing our stress levels in areas where we have control–such as exercise, breathing techniques, massage, meditation and even bubble baths–can clear our minds so we are capable of making better choices and decisions and can be more resilient.

And remember: This is today. It does not mean things will be like this forever.

Photo by isabisa via Flickr

When we are stressed we have higher levels of a chemical (cortisol) that damages our system. It’s like a little hammer chiseling away at our healthy insides. (Watch the effects of stress on the body with this cool graphic.)

The problem is that not everyone understands just how unhealthy this is on our physical health. Because of this, many people may be less likely to use stress management strategies that improve their health.

Have you looked at the recent findings of APA’s Stress in America survey? This survey highlights the negative impact of stress on physical health, and it shows that not all survey respondents were aware of the connection.

According to the survey,

“Although the majority of adults understand that stress has a strong impact on a person’s health,  a sizeable minority still think that stress has only a slight or no impact on their own physical health (31 percent) and mental health (36 percent).”

Notice that reference to mental health. Depression also comes into play. Research shows they are related, but it’s thought to be bidirectional. That means that the more depressed you are, the more you engage in unhealthy eating and physical activity habits; and the more you engage in these behaviors, the more depressed you become. It creates a vicious cycle from which it’s tough to break.

More from APA’s stress survey

Obesity and depression are often exacerbated by stress. Those who suffer from these conditions report that they are unable to take the necessary steps to relieve their stress or improve their health and, therefore, engage in maladaptive coping behaviors.

• People with depression (27 percent) or obesity (24 percent) are more likely than the general population (20 percent) to report feeling dissatisfied with their lives and less likely (76 percent for the general population vs. 69 percent for those depressed or obese) to report feeling satisfied with family relationships.
• Those with depression (33 percent) or who are obese (28 percent) are significantly more likely than the general public (21 percent) to say they do not think they are doing enough to manage their stress.
• As compared to the general public (11 percent), more people who are obese (34 percent) or depressed (22 percent) report that their disabilities or health issues prevent them from making positive changes in their lives (i.e., reducing stress and improving health).

The good news is that research shows that depression, obesity, and stress share common effective treatments. Each can be improved (i.e., increased positive mood, weight loss, and lower stress) by a variety of methods, including cognitive (the way we think) and behavioral (what we do) components.

Here are two techniques to help you started on the road to a happier, healthier, more relaxed life.

Rate your mood before and after an activity. Then, rate your feelings of accomplishment before and after this activity. Begin to recognize those that improve your mood (not just in the moment, but later on) and make you feel better about yourself.

You may find that some of your favorite activities (Friday morning trips to the donut shop or Tuesday night carryout pizza) may cause momentary happiness, but lower your self-confidence in making positive choices or decreased physical health that creates more stress and depressed feelings.

Move more and sit less. Research has linked higher BMIs (indication of overweight) with higher rates of screen time (time spent with TV, video games, cell phones, computer, etc). Make your goal simple. Say something like “I will get a few tasks accomplished before I plop down on the sofa and catch up on TV.” For kids, this could be as simple as having them pick up their belongings and engage in a productive, physical activity prior to watching TV or playing video games.

By starting with these two things, you may find that you are identifying activities that make you less stressed, help you get healthier, and improve your interactions with others. You’re putting down that stress chisel, and improving your mental and physical health.

Photo by practicalowl (via Flickr)

APA released its annual Stress in America survey yesterday, and we have again found that our nation is under pressure. Yes, average stress levels have declined somewhat from their max in 2007 and 2008, but that was at a time of extreme economic uncertainty when the housing crisis began to bubble, and the nation’s economy was on the cliff, about to take a deep fall.

But even as the nation’s economy begins to improve, we found that yet again, the majority of people surveyed said they are experiencing very high degrees of stress at levels that are higher than they consider healthy.

Our snapshot of stress is even bleaker for those who said they are caregivers or living with a chronic condition. Caregivers reported higher levels of stress, poorer health and a greater tendency to engage in unhealthy behaviors to alleviate their stress than the general public. They report feeling overwhelmed by the amount of care their aging or chronically ill family member require of them.

And those with chronic conditions, such as depression, obesity and Type 2 diabetes, are also caught in a vicious cycle. They said they were unable to take necessary steps to reduce their stress and engaged in unhealthy behaviors to manage their stress, thereby reducing their ability to appropriately manage their illness.

We have said for years that people need to be more aware of their stress levels; need to recognize what triggers stress for them; need to recognize how stress can damage their health; and need to manage their stress more effectively.

But while the majority of Americans know this is true, let’s face it, change isn’t easy.

There are a lot of reasons that Americans aren’t taking better care of their stress and their bodies. I believe, along with many others, that while we’re all responsible for our own health, change cannot happen in a vacuum. Aside from individual efforts, supportive social and community networks, as well as a responsive health-care system are needed to help individuals make the changes needed for better health.

We all need to think differently about health and illness.

Most chronic conditions can be prevented by better managing our stress and making better choices about our nutrition, activity level, alcohol and tobacco use, and our strategies for managing stress. By understanding the relationship between stress and chronic illness, we can all take steps to make better choices.

Psychologists working side by side with physicians—as part of someone’s personal health-care team—enhance the possibility that health care focuses on the whole person, not just an illness. Access to the right kind of care from the right kind of health-care provider must be assured in our evolving health care system. More focus on prevention will save lives and health-care dollars in the long run.

We need big changes in our evolving health-care system.

I believe they can happen. They need to happen.

Until then, do your best to make small changes and practice better stress management strategies.

• Engage understanding people who support the changes you want to make for yourself.
• Increase your activity level, and make better food choices.
• Set realistic expectations.

And if your efforts aren’t paying off for you, consider talking to a psychologist who can help you identify and remove those barriers that are standing in the way of the changes you want.

Photos by hradcanska and yourdon (via Flickr)

As a psychologist, I think a lot about creating and maintaining mental health.  It’s a challenge that each of us face daily. 

For example, how do we:

• keep our stress at healthy levels?
• maintain strong relationships?
• utilize good communication skills with friends, co-workers, and neighbors?
• manage conflict when it arises?
• understand our moods, what affects them, and how they affect others?

Creating and maintaining mental health can be a tricky business.  But sometimes we have the skills to cope with life’s challenges and stressors–and don’t even give ourselves credit! 

That’s often the case with creativity.  Many of us use creative outlets to help manage stress, frustration, disappointment, but don’t realize the good we are doing in terms of our mental health. Research has shown creative outlets and creativity can be helpful as a part of therapy.

Quilting bees, “paint and sip,” art studios and scrapbooking nights: These and many other techniques have been used by women for generations to talk through problems, brainstorm solutions, and simply have a place to blow off steam.

Embrace the creative outlets you already use, and give them credit for what they are: effective, highly do-able, and super fun ways to keep up mental health.  Need some ideas on how to get creative?  Check out the blog party on my own blog, Dr. Stephanie , CREATE Mental Health.  Happy creating!

Does taking time out to be creative help you destress? Help you find balance? Tell me what activities you like best.

Photos by justmakeit and Contemporary Jewish Museum via Flickr

The weather outside is getting warmer, the days are growing longer, events like graduations and weddings and outdoor barbeques are looming on the horizon. People expect you to be happy right now, but instead you actually feel more depressed and irritable than in the winter.

 Why?

Despite what you think, you aren’t alone feeling this way. In fact, in late spring and summer, admissions to psychiatric hospitals actually increase from the winter months. There’s a name for what you might be feeling– seasonal affective disorder (SAD), summer variant.

Summer seasonal affective disorder is different than the more well-known, winter seasonal affective disorder, and it’s also rarer. Unlike the winter variety of SAD, which affects 4-6 percent of the U.S. population, summer SAD affects less than 1 percent of the U.S. population and is more common in warmer climates in the United States and in countries near the equator. But like the winter SAD, it affects primarily women in their 20s to 40s.

Summer SAD is thought to be related to increases in temperature and decreases in melatonin. Severe fluctuations in barometric pressure and rainfall also seem to exacerbate mood changes associated with summer SADS. 

The primary symptoms of summer SAD are the following:

• Poor appetite
• Insomnia
• Increased anxiety
• Increased irritability and/or agitation
• Weight loss
• Increased sex drive
• Loss of interest in your usual activities
• Hopelessness
• Feelings of Depression
• Suicidal thoughts

 So, what can you do if you think you might suffer from summer seasonal affective disorder? Here are some recommendations.

 Tips for coping with summer seasonal affective disorder 

• Recognize that there is help! If you are struggling for more than two weeks with the symptoms listed above, get help from a psychologist or other licensed mental health professional. In rare cases, the symptoms of summer SAD can be the beginnings of a manic episode, or they can turn into a major depression, if you do not get some help.

  A psychologist can help you by using certain therapy techniques, such as cognitive behavioral therapy, which have been proven to be very effective in treating seasonal affective disorders. Cognitive therapy works by teaching you strategies to “reframe” or think more positively and flexibly about your situation. This leads to increased self control, improvements in mood and lessening of anxiety and helplessness. Medication may be useful too.

•  Limit your exposure to heat. Stay indoors in air conditioning on extremely hot days.    
• Keep up a regular exercise schedule (stay indoors on hot days). 
• Get enough sleep. Try to get at least 7-8 hrs a day. This will definitely make you feel better. 
• Plan your vacation to a cooler climate, if possible. 
• Finally, recognize that you are not alone in feeling sad and uncomfortable. This time of year is particularly hard on single, divorced or widowed people, especially those who have lost loved ones in the summer months.

 The contrast between what we think we should feel (joy, happiness, delight in the “carefree summer”) and what we may actually feel (sad, anxious, irritated, uncomfortable with our body) can definitely lead to feelings of irritability and depression. Remember, even though it may seem as if everyone else is having a wonderful time frolicking in the sun, many people are not and are coping with some of the same issues as you!

Photo by Chapendra via Flickr