Ask the Expert: Understanding Stress

Dr. Mark Melden, DO, a psychiatrist affiliated with Sharp HealthCare, answers some common questions about stress.

Can stress be both positive and negative in our lives?
Stress means a lot of things to a lot of different people. A lot of time we think of stress as negative. But there are positive kinds of stresses such as going from one job to another or moving out of the city, relocating to another area. If you look at people that have dealt with major trauma in their lives or major terror in their lives, some people come away with it unscathed. Other people go away with it and they’re completely numbed up and they can’t deal with life anymore.

How can stress hurt my health?
If you deal with stress when you’re younger quite well and come away with things not feeling stressed out, oftentimes in your later years you’re often the same way. People with high blood pressure, high cholesterol, all this stuff can kind of build up due to stress.

What is the benefit of understanding your stress?
If you’re relaxed and you’re not stressed out you have less chances of having things like heart attacks, less chances of having colds. There’s definitely a relationship between your health and the way you deal with things. But if you have chronic stress that keeps going and going and going like that it actually will take a toll on you.

How is stress related to the body?
There’s a huge connection between the mind, body and spirit. I don’t necessarily mean a God-like force but the energy that’s coming from the body and emitting outward. The brain is an organ and it relates to the body in chemical messengers. And the whole body will feel. When you’re feeling like you’re in love your whole body gets sort of tingly. It gets…it has a way of reacting to it. If your body’s angry it also has a way of reacting to it. You can feel your palms getting sweaty. Your eyes will actually dilate. You start feeling like you’re feeling a little jittery. This stuff happens naturally and it comes from the brain and moves downward. I break it up into two categories. The first one are reactions to stress and the other one are subjective responses to stress.

What are reactions to stress?
When we talk about reactions to stress we talk about how our mind works and what we do when we deal with stress. One thing is we deal with stress in a way that looks more like a person that’s depressed and anxious where you start having symptoms of decreased appetite. Sometimes you’ll have increased appetite or you’ll have decreased sleep, poor concentration, poor energy. Also, another reaction to stress is running away. Say that you have this job and it’s causing you to feel like you’re incompetent. Well, you’re calling in sick now and now you’re not coming to work. You’re running away from the stress.

What are other types of reactions?
Another way is drinking. If you’re feeling stressed and you’re feeling like you need to decrease the amount of stress some people will drink so they can remove themselves from the stress. This can be a huge problem, especially if it goes on chronically. For men, sometimes, and women, when they get into a stressful situation at their house or at home with their wife they feel like the grass is greener on the other side so oftentimes they’ll start an affair. They’ll look for other women in other relationships so they can feel better about themselves.

These are things that people will do when they react to stress.

What are subjective responses to stress?
Now the subjective response to stress has to do with how you’re feeling about it. Oftentimes you’ll get the fear reaction which causes the body to react in a way that’s very stressful which is an increase in adrenalin ultimately increasing cortisol which is a detrimental chemical in your body that can actually, long-term, cause problems with white blood cells, breaking them apart and causing people to have heart attacks and strokes.

Are there other types of subjective responses?
Another way you deal with stress as a subjective response is anger or rage. You get frustrated that you’re feeling stress for so long. You’re not able to get help. You feel like you’re on a short fuse where, you know, you can’t deal with your children or you can’t deal with your husband you just get angry and the easiest emotion to deal with is rage.

Another subjective response is guilt. Oftentimes, when people are stressed out they’ll have a child that is crying and yelling and when they’re feeling okay they’re able to deal and calm the child. But if they’re not able to calm the child sometimes you feel like wringing their neck. When you feel like wringing their neck oftentimes you start feeling guilty about the feeling of wringing their neck and then you have more stress. It’s not like you’re going to kill them but the feeling of just wanting to have them stop crying can be so overwhelming that they can feel this overwhelming sense of guilt. And then oftentimes people will feel so helpless that they can’t get over the stress that they’ll start feeling ashamed.

At what point should someone seek medical help for stress?
If your stress lasts for more than two weeks with ongoing thoughts of constant thinking about what you have to do or worrying and you’re feeling like you can’t relax, you’re not sleeping well, you’re not able to concentrate all that well, these are signs that you need help.

How can I deal with my stress?
Now the help you can get doesn’t have to come from a psychiatrist or a psychologist. I mean you can go run around the block for about 25 minutes every single day or walk for 10 minutes if that’s all you can do or take yoga or do whatever it takes to make yourself feel … take a vacation for two or three days can sometimes bring you back into feeling better.

What else can I do to start feeling less stressed?
When you exercise you bring up your endorphin level. Endorphins in your body actually help you feel a sense of well-being. Your heart’s in good shape. Your vessels are opening up. You’re able to feel and be better. If you’re feeling bad I think you owe it to yourself to start feeling better. And I think that you do. I think that you shouldn’t let the idea of going to a psychiatrist and making you feel like you’re going to a psychiatrist is a bad thing. I think what you should look at is how you’re going to feel better.

For More Information
To learn more about Sharp's mental health services or to find a Sharp-affiliated doctor, search for a San Diego psychiatrist or call 1-800-82-SHARP (1-800-827-4277), Monday through Friday, 8 am to 6 pm. To find general information about mental health, visit Mental Health Disorders in Adult Health or read the Mental Health News archive.