To Your Health With Dr. Jim Morrow: Episode 15, How Stress Affects You and What You Can Do About It

Dr. Jim Morrow, Host, “To Your Health With Dr. Jim Morrow”

Episode 15, How Stress Affects You and What You Can Do About It

According to an American Psychological Association survey, 75% of adults questioned reported moderate to high levels of stress in the past month and nearly half reported that their stress has increased in the past year. On this edition of “To Your Health,” Dr. Jim Morrow discusses different stress levels, stress triggers, and what you can do to reduce the effect of stress in your life. “To Your Health” is brought to you by Morrow Family Medicine, which brings the CARE back to healthcare.

About Morrow Family Medicine and Dr. Jim Morrow

Morrow Family Medicine is an award-winning, state-of-the-art family practice with offices in Cumming and Milton, Georgia. The practice combines healthcare information technology with old-fashioned care to provide the type of care that many are in search of today. Two physicians, three physician assistants and two nurse practitioners are supported by a knowledgeable and friendly staff to make your visit to Morrow Family Medicine one that will remind you of the way healthcare should be. At Morrow Family Medicine, we like to say we are “bringing the care back to healthcare!” Morrow Family Medicine has been named the “Best of Forsyth” in Family Medicine in all five years of the award, is a three-time consecutive winner of the “Best of North Atlanta” by readers of Appen Media, and the 2019 winner of “Best of Life” in North Fulton County.

Dr. Jim Morrow, Morrow Family Medicine, and Host of “To Your Health With Dr. Jim Morrow”

Dr. Jim Morrow is the founder and CEO of Morrow Family Medicine. He has been a trailblazer and evangelist in the area of healthcare information technology, was named Physician IT Leader of the Year by HIMSS, a HIMSS Davies Award Winner, the Cumming-Forsyth Chamber of Commerce Steve Bloom Award Winner as Entrepreneur of the Year and he received a Phoenix Award as Community Leader of the Year from the Metro Atlanta Chamber of Commerce. He is married to Peggie Morrow and together they founded the Forsyth BYOT Benefit, a charity in Forsyth County to support students in need of technology and devices. They have two Goldendoodles, a gaggle of grandchildren and enjoy life on and around Lake Lanier.

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Dr. Morrow’s Show Notes on Stress

Stress can be good for you.
- It keeps you alert, motivated and primed to respond to danger.
- As anyone who has faced a work deadline or competed in a sport knows, stress mobilizes the body to respond, improving performance.
- Yet too much stress, or chronic stress may lead to major depressionin susceptible people.
Everyone knows that bad things in life are stressful
- But the good things (marriage, new job or new house) are also very stressful.
The “good life” doesn’t happen in a vacuum, it takes a lot of mental and physical work.
Many of my patients are stressed because they are doing too much for too many people in too short a period of time and with too few resources.

There Are Basically 3 Types of Stress

Acute stress
- Acute stress is the most common form of stress.
- It comes from demands and pressures of the recent past and anticipated demands and pressures of the near future.
- Acute stress is thrilling and exciting in small doses, but too much is exhausting.
  - A fast run down a challenging ski slope, for example, is exhilarating early in the day.
  - That same ski run late in the day is taxing and wearing. Skiing beyond your limits can lead to falls and broken bones.
- By the same token, overdoing on short-term stress can lead to psychological distress, tension headaches, upset stomach and other symptoms.
Examples of Acute Stress
- the auto accident that crumpled the car fender,
- the loss of an important contract,
- a deadline they’re rushing to meet,
- their child’s occasional problems at school
Emotional distress causes
- Muscular problems including
  - tension headache,
  - back pain,
  - jaw pain and
  - the muscular tensions that lead to pulled muscles and tendon and ligament problems.
- Stomach, gut and bowel problems such as
  - heartburn,
  - acid stomach,
  - flatulence,
  - diarrhea,
  - constipation and
  - irritable bowel syndrome.
- Transient over-arousal leads to elevation in blood pressure, rapid heartbeat, sweaty palms, heart palpitations, dizziness, migraine headaches, cold hands or feet, shortness of breath and chest pain.
Episodic acute stress
- There are those who suffer acute stress frequently,
- whose lives are so disordered that they are studies in chaos and crisis.
  - always in a rush, but always late.
  - If something can go wrong, it does.
  - They take on too much,
    - have too many irons in the fire, and
    - can’t organize the slew of self-inflicted demands and pressures clamoring for their attention.
    - They seem perpetually in the clutches of acute stress.
It is common for people with acute stress reactions to be
- over aroused,
- short-tempered,
- irritable,
- anxious
- Often, they describe themselves as having “a lot of nervous energy.”
  - Always in a hurry,
  - they tend to be abrupt, and
  - sometimes their irritability comes across as hostility.
  - Interpersonal relationships deteriorate rapidly when others respond with real hostility.
  - The workplace becomes a very stressful place for them.
The cardiac prone, “Type A” personality is
- similar to a constant extreme case of episodic acute stress.
- Type A’s have an
  - excessive competitive drive,
  - aggressiveness,
  - impatience, and
  - a harrying sense of time urgency.
  - In addition there is a
    - free-floating, but well-rationalized form of hostility, and
    - almost always a deep-seated insecurity.
    - seem to create frequent episodes of acute stress for the Type A individual.
    - Type A’s are found to be much more likely to develop coronary heart disease than Type B’s, who show an opposite pattern of behavior.
The symptoms of episodic acute stress are
- persistent tension headaches,
- migraines,
- hypertension,
- chest pain and
- heart disease.
- Treating episodic acute stress requires intervention on a number of levels, generally requiring professional help, which may take many months.
Often, lifestyle and personality issues are so ingrained and habitual with these individuals that they see nothing wrong with the way they conduct their lives.
- They blame their woes on other people and external events.
- Frequently, they see their lifestyle, their patterns of interacting with others, and their ways of perceiving the world as part and parcel of who and what they are.
Sufferers can be fiercely resistant to change.
- Only the promise of relief from pain and discomfort of their symptoms can keep them in treatment and on track in their recovery program.
Chronic stress:
- While acute stress can be thrilling and exciting, chronic stress is not.
- This is the grinding stress that wears people away day after day, year after year.
- Chronic stress destroys bodies, minds and lives. It wreaks havoc through long-term attrition.
- It’s the stress of poverty,
- of dysfunctional families,
- of being trapped in an unhappy marriage
- or in a despised job or career.
- It’s the stress that the never-ending “troubles” have brought
  - to the people of Northern Ireland,
  - the tensions of the Middle East
  - the endless rivalries that have been brought to the people of Eastern Europe and the former Soviet Union.
Chronic stress comes when a person never sees a way out of a miserable situation.
- It’s the stress of unrelenting demands and pressures for seemingly interminable periods of time.
- With no hope, the individual gives up searching for solutions.
Some chronic stresses stem from traumatic, early childhood experiences that become internalized and remain forever painful and present.
- Some experiences profoundly affect personality.
- A view of the world, or a belief system, is created that causes unending stress for the individual (e.g., the world is a threatening place, people will find out you are a pretender, you must be perfect at all times).
- When personality or deep-seated convictions and beliefs must be reformulated, recovery requires active self-examination, often with professional help.
One of the worst aspects of chronic stress is that people get used to it.
- They forget it’s there.
- People are immediately aware of acute stress because it is new; they ignore chronic stress because it is old, familiar, and sometimes, almost comfortable.
Chronic stress kills through suicide,
- violence,
- heart attack,
- suicide,
- stroke and,
- perhaps, even cancer.
- People wear down to a final, fatal breakdown.
  - Because physical and mental resources are depleted through long-term attrition, the symptoms of chronic stress are difficult to treat and may require extended medical as well as behavioral treatment and stress management.
Why is too much stress bad for you?
Too much stress can be detrimental.
- Emotional stress that stays around for weeks or months can weaken the immune system and
- cause high blood pressure,
- fatigue,
- depression,
- anxiety and
- even heart disease.
- In particular, too much epinephrine can be harmful to your heart.
Sustained or chronic stress, in particular, leads to elevated levels of cortisol, the “stress hormone,”
- As well as reduced levels of serotonin and other neurotransmitters in the brain, like dopamine
- These hormone changes have been linked to depression.
- When these chemical systems are working normally, they regulate biological processes like sleep, appetite, energy, and sex drive, and permit expression of normal moods and emotions.
- When the stress response fails to shut off and reset after a difficult situation has passed, it can lead to depressionin susceptible people.
- No one in life escapes event-related stress, such as
  - death of a loved one,
  - a job loss,
  - divorce,
  - a natural disaster such as an earthquake, or
  - even a dramatic dip in your 401(k).
- A layoff — an acute stressor — may lead to chronic stress if a job search is prolonged.
Loss of any type is a major risk factor for depression.
- Loss of a loved one is a huge stressor
  - Grieving is considered a normal, healthy, response to loss, but if it goes on for too long it can trigger a depression.
- Loss of health –
  - A serious illness, including depression itself, is considered a chronic stressor.
- Loss of independence –
  - When patients lose their ability to live alone, or to drive they are very stressed
- Loss of financial stability –
  - Regardless of cause
- What you can do?
  - Watch out for signs of stress overload.
    - Symptoms of too much stress can be
    - physical,
    - emotional,
    - mental and behavioral.
    - While everyone is different, some common signs are:
    - memory problems,
    - trouble concentrating,
    - racing thoughts,
    - irritability,
    - anger,
    - sadness,
    - headaches,
    - frequent colds and
    - changes in sleep or appetite.
Know your stress triggers.
- Stress and its triggers are different for everyone.
  - Certain people, places or situations might produce high levels of stress for you.
  - Think about what causes you stress, and brainstorm solutions.
    - If public speaking or presentations make you stressed, start researching early and practice several times.
    - If there are friends or social situations that cause extreme stress, you may want to avoid them when you are already feeling tense or overwhelmed.
- All forms of exercise
  - reduce stress hormones,
  - flood the body with feel-good endorphins,
  - improve mood,
  - boost energy and
  - provide a healthy distraction from your dilemmas.
  - Plus, exercise may make you less susceptible to stress in the long run.
  - Find physical activities that you enjoy and try to devote about 30 minutes to them each day.
- While it’s impossible to eliminate all negative stress from your life, you can control the way you react to stress.
- Your body’s natural fight-or-flight response can take its toll.
- When you’re faced with a stressful situation that your mind perceives as a threat,
  - it sends various chemicals, like adrenaline and cortisol, throughout your body.
  - As a result, heart rate and breathing speeds up and your digestion slows down. This tires out the body.
  - Relaxation techniques are a huge help in calming you down, boosting mood and fighting illness.
    - Try a variety of techniques — like
      - yoga,
      - breathing exercises,
      - meditation and visualization — to see what works for you, and schedule a relaxation break every day.
Manage your time well.
- Time can seem like a luxury, but there are various ways to manage it effectively.
  - First, focus on one task at a time.
    - Multitasking rarely works.
    - Jot down everything you need to do in a calendar or a task management app/program,
      - prioritize your list and break projects into single steps or actions.
Be realistic.
- Pulling yourself in different directions will only stress you out, so try not to over-commit yourself or do extracurricular activities when you’re super busy with school.
- Learn to say NO
Curb your caffeine.
- Caffeine might help you study in the short term, but it interrupts sleep and makes you
  - more anxious,
  - tense and jittery
  - This obviously ups your stress level.
  - Try and drink no more than one caffeinated beverage a day.
- Don’t self-medicate.
  - Some people
    - drink,
    - take drugs,
    - smoke and
    - use other unhealthy behaviors to cope with stress.
    - However, these behaviors can exacerbate stress by negatively affecting your mood and health.
Reach out.
- If you’re stressed out,
  - talk to your friends and family.
  - If you feel like you can’t handle the stress on your own, schedule an appointment with a counselor or therapist.