Stress is something everyone experiences, but it doesn’t always look or feel the same from person to person. From everyday pressures to major life changes, stress can affect both mental and physical health.
For Stress Awareness Month in April, Christine Danner, PhD, LP, with the University of Minnesota Medical School and M Health Fairview talks about the impacts of stress, its relationship with anxiety and ways to cope.
Q: What is stress?
Dr. Danner: According to the American Psychological Association, stress is a physiological or psychological response to internal or external stressors (or pressure). Stress can be acute or chronic. Some amount of stress is normal and experienced on a frequent basis (when was the last time you had a 100% stress-free day?). Stress isn’t all bad. Think about a time when you faced a stressful challenge, but came out on the other side having learned something important or developed a new skill or strength. Navigating challenges and manageable stressors can increase our self-confidence and resilience.
That being said, while exposure to manageable, acute stress can be good for you, chronic stress over months or years can exceed our body’s ability to manage in a healthy manner, lead to emotional distress and negatively impact our health via long-term increases in inflammation, oxidative damage and immune system suppression. This is why we want to pay attention to our stress load and be mindful of how we manage it.
Q: What is the relationship between stress and anxiety?
Dr. Danner: While stress is generally caused by external factors (relational conflict, work pressures, experiences with discrimination, etc.), anxiety is an internal experience of fear or worry that can persist even in the absence of a specific stressor or threat.
While both stress and anxiety have a bad rep, the healthy function of both is to get your body ready to take on a challenge or threat. Both can trigger fight, flight or freeze responses, resulting in a release of adrenaline and cortisol. In the right circumstances, this can be helpful, but prolonged stress can create problems. Symptoms may be physical, including elevated blood pressure, heart palpitations, insomnia, headaches, and muscle tension or emotional — including feelings of anxiety, restlessness, irritability or difficulty concentrating. Both anxiety and stress can put your brain on alert for danger, amplify physical pain and decrease quality of life.
Q: How should I think about stress? What can I learn from it?
Dr. Danner: Your perception of stress significantly impacts its effects. A 2012 study showed that high stress levels, combined with the belief that stress is harmful, predicted worse health outcomes and increased the risk of premature death by 43%. Conversely, a 2014 study found that re-interpreting the high arousal state of stress or anxiety as excitement or readiness can improve performance and lessen distress.
Stress can be an important messenger and teacher. Don’t ignore it! Determine if the source of your stress is in your sphere of control. The experience of stress may be pointing you to make needed changes in your life. For example, if the stress we are experiencing is self-inflicted (e.g., overcommitment, procrastination, etc.), we can make changes to reduce our stress (e.g., say no more often, plan our time better, etc.). In circumstances where stress is outside our control, focus on how we respond to stress to mitigate the negative impact. Acceptance, self-compassion and values-based action (e.g., I can’t control the behavior of others, but I can always act in accordance with my own values) can also be important strategies to reduce stress.
Q: What are some additional strategies to manage stress?
Dr. Danner: Connecting with others is an important strategy for managing stress. In addition to stress causing a release of adrenaline, the body releases oxytocin in response to stress and primes you for social contact. It’s a natural anti-inflammatory and protects the heart. Call up a friend or family member or go for a walk with a trusted colleague. If the current political climate is a source of stress for you, spend time with like-minded people to advocate for solutions.
And yes, listen to your grandmother’s wisdom – go to bed at a reasonable time to get some sleep, get outside for some fresh air, eat something healthy from the garden, practice gratitude and take a few slow deep breaths. Try to avoid creating a new problem for yourself by turning to drugs or alcohol to distract yourself from your discomfort. If stress remains unmanageable, consider seeking support from a mental health professional. Approaches like Mindfulness Based Stress Reduction (MBSR), Acceptance and Commitment Therapy (ACT) and Cognitive Behavioral Therapy (CBT) can all be helpful in learning ways to manage stress.
Q: How does your work improve health in Minnesota?
Dr. Danner: I work as the Director of Behavioral Health in the Department of Family Medicine and Community Health at the University of Minnesota Medical School. My job, and that of my colleagues, is to educate doctors on the importance of caring for the whole patient, including their mental and behavioral health. While not everyone in the state of Minnesota may have access to a mental health specialist, most have access to a primary care doctor. The majority of Minnesota’s physicians trained at the medical school, so our efforts can make a big difference in care across the state. Integrating behavioral health providers into primary care and training physicians to care for the whole person, including their mental health, improves health outcomes, increases access to care, lowers cost and decreases stigma.
Dr. Christine Danner is an assistant professor in the Medical School’s Department of Family Medicine and Community Health and a psychologist with M Health Fairview. Her clinical interests include providing integrated behavioral health services across the lifespan in the primary care setting, refugee mental health, addressing equity gaps in the mental health care system, healthy lifestyle promotion and chronic pain management. ~ The University of Minnesota Medical School