STRESS MANAGEMENT FOR RESPONSIBLE PARENTS

LECTURE GIVEN TO MEMBERS OF ROTARY INTERNATIONAL, DISTRICT 914, AT ENUGU IN 2010 ON STRESS MANAGEMENT FOR RESPONSIBLE PARENTS

By:

Dr Jideofo Kenechukwu Danmbaezue, D.Sc.

Consultant Clinical Psychologist & Existential Family Therapist

Kenez Health Klinik & Happy Family Network International

5 Church Street, Federal Housing Estate, Trans-Ekulu, Enugu

Phone: 0803-9097614 or 0805-1764999, E-mail: saintkenez@yahoo.co.uk

You can also visit my website: www.happyfamilynetwork.hpage.com for more

GENERAL INTRODUCTION

In this brief discussion, I will first give you what scientists call AN ABSTRACT, which is a resume or summary. This is the essence of advanced level lecture procedures practised in international circles. The bones are in the first two pages. The meat occupies other pages! This lecture ends with the commonest ego defence mechanisms most parents live with all through their lives. These are those of us who do not realise that they are never completely healthy nor are they completely sick most of their lives. Most of us usually resort to religious or superstitious methods for coping with it and die without knowing we were ill!

My respected fathers and mothers, times are hard and as each of us ages, stressors in our homes and/or places of work, irregularity of public utilities like electricity, water supply and coping with traffic congestion irritate us on a daily basis. The average adult living in the present global village dominated by electronic gadgets has many stressors to respond to and react to. For most parents therefore, the job of rearing their children becomes more cumbersome as the control of what they watch on television, what they browse in the Internet or restriction of when, why and how cellular phones are to be used is irritable as well as how these influence their moral development is stressful to every responsible parent.

What is stress? Stress in scientific psychology and biology is any strain or interference that disturbs the functioning of an organism. The human being responds to physical and psychological stress with a combination of psychic and physiological impulses or stimuli. When the stress is negative, the individual unconsciously responds with a variety of self preservative tactics, which we label “ego defence mechanism”. Inappropriate use and regular abuse of a particular ego defence mechanism results in anxiety neurosis, depression or another variety of personality disorder. Further inappropriate reliance on this translates into psychosomatic or mental disorders that result if the stress is too powerful or the individual’s defence is inadequate. This is the main topic we are here to discuss with all of you. I will teach you how to identify and manage these inappropriate response patterns that may eventually land you, your spouse or children in clinics, hospitals or prayer houses and/or crusade grounds!

RECOGNITION OF STRESSFUL EVENTS

Stress is an unavoidable aspect of modern living especially in urban cities and its effect on family life is specifically complex in an advanced technological society. There is little doubt that an individual's success or failure in controlling potentially stressful situations can have a profound effect on his ability to live a healthy life, have a good job and care for the spouse or love, manage and/or function adequately as a responsible parent. Neglect of these things results in high blood pressure, which may end in stroke!

The ability to “cope” with stress has figured prominently in psychosomatic research. There is a statistical link between coronary heart disease and individuals exhibiting stressful behavioural patterns designated “Type A.”  I have a 35-slide PowerPoint on this.

These patterns are reflected in a style of life characterised by impatience and a sense of time urgency, hard-driving competitiveness and preoccupation with vocational and related deadlines. Various strategies have been successful in treating psychological and physiological stress;

·         Moderate stress may be relieved by exercise and any type of meditation (e.g., yoga or Oriental meditative forms).

·         Severe stress may require psychotherapy to uncover and work through the underlying causes.

·         A form of behaviour therapy known as biofeedback enables the patient to become more aware of internal processes and thereby gain some control over bodily reactions to stress.

·         Sometimes, a change of environment or living situation may produce therapeutic results.

One of the basic BEHAVIOUR THERAPUETIC methods that I often use in my practice is:

Biofeedback basically is the in-born information supplied instantaneously by one’s nervous system about an individual's own physiological processes and so is only used when handling educated patients who know a little about the central nervous system.

In a laboratory set-up, data concerning a person's cardiovascular activity (blood pressure and heart rate), temperature, brain waves or muscle tension is monitored electronically and returned, or “fed back”, to that person by a gauge on a meter, a light, or a sound. Though such activity of the autonomic nervous system was once thought to be beyond an individual's control, it has been shown that an individual can be taught to use the biological data to learn how to voluntarily control the body's reactions to stress or “outside-the-skin” events. An individual learns through biofeedback training to detect his physical reactions (inside-the-skin events) and establish control over them. Biofeedback training is a type of behaviour therapy that attempts to change learned responses to stressors. It can be very successful in alleviating symptoms (e.g., pain and muscle tension) of a disorder, and its effects can be especially lasting if used in combination with psychotherapy to help the patient understand his reactions to stress.

Complaints that have been treated by biofeedback training include migraine headaches, gastrointestinal cramping (e.g., colitis), high blood pressure, tics, and the frequency and severity of epileptic seizures. Theoretically, many psychologists believe it possible to bring under partial control any physiological process that can be continuously monitored and displayed, including electrophysiological activity of the limbic system and other homeostatic processes. Biofeedback training with brain waves has also been useful in enhancing mental functioning. “Alpha (wave) training” elicits the calming and integrative effects of meditation. Theta wave training has led to more focused attention, the control of “mental blocks” during examinations, and the control of anxiety.

The major disadvantage of this therapy is that it is limited to only educated people. This brief is merely an introduction. The full paper can easily be found at my major website for health issues; https://sites.google.com/site/kenezhealthklinik/ where you can read more.

You might also be lucky to find it at another website I dedicated to responsible parents:

https://sites.google.com/site/integrationalspiritanmovement/

ABOVE WAS THE PRÉCIS, NOW THE FULL PAPER UNABRIDGED

STRESS MANAGEMENT FOR RESPONSIBLE ROTARIAN PARENTS WORLDWIDE

By:

Dr Jideofo Kenechukwu Danmbaezue, D.Sc.

Consultant Clinical Psychologist & Existential Family Therapist

Kenez Health Klinik & Happy Family Network International

5 Church Street, Federal Housing Estate, Trans-Ekulu, Enugu

Phone: 0803-9097614 or 0805-1764999, E-mail: saintkenez@yahoo.co.uk

You can also visit my website: www.happyfamilynetwork.hpage.com for more

GENERAL INTRODUCTION

My respect Rotarians of the Enugu District 914, this day marks my sixty-third year on planet earth as a prisoner of over-developed conscience. You will agree with that times are hard and as each of us ages stressors in our homes and/or places of work, irregularity of public services and coping with traffic congestion irritate us on a daily basis. The average adult living in the present global village dominated by electronic gadgets has many stressors to respond and react to. For Christian Rotarian parents therefore, the job of rearing their children becomes more cumbersome as the control of what they watch on television, what they browse in the Internet or restriction of when, why and how cellular phones are to be used and how these influence their ethics and moral development is stressful.

What is stress? Stress in scientific psychology and biology is any strain or interference that disturbs the functioning of an organism. The human being responds to physical and psychological stress with a combination of psychic and physiological responses. When the stress is negative, the individual has to respond with a variety of self preservative tactics, which we label “ego defence mechanism”.

Inappropriate use or abuse of a particular ego defence mechanism results in personality disorder. Further inappropriate reliance on this translates into psychosomatic or mental disorders that result if the stress is too powerful or the individual’s defence is inadequate. This is the main topic we are here to discuss with all of you. I am here to teach you how to identify these inappropriate response patterns that may eventually land you, your spouse or children in clinics, hospitals or prayer houses and/or crusade grounds!

MLA Style:   "stress." Encyclopædia Britannica. Encyclopædia Britannica 2009 Ultimate Reference Suite.  Chicago: Encyclopædia Britannica, 2009.

RECOGNITION OF STRESSFUL EVENTS

Stress is an unavoidable aspect of modern living especially in urban cities and its effect on family life is specifically complex in an advanced technological society. There is little doubt that an individual's success or failure in controlling potentially stressful situations can have a profound effect on his ability to live a healthy life, have a good job and care for the spouse or love, manage and/or function adequately as a responsible parent. Neglect of these things results in high blood pressure, which may end in stroke!

The ability to “cope” with stress has figured prominently in psychosomatic research. There is a statistical link between coronary heart disease and individuals exhibiting stressful behavioural patterns designated “Type A.”  I have a 35-slide PowerPoint on this.

These patterns are reflected in a style of life characterised by impatience and a sense of time urgency, hard-driving competitiveness and preoccupation with vocational and related deadlines.

Various strategies have been successful in treating psychological and physiological stress;

·        Moderate stress may be relieved by exercise and any type of meditation (e.g., yoga or Oriental meditative forms).

·        Severe stress may require psychotherapy to uncover and work through the underlying causes.

·        A form of behaviour therapy known as biofeedback enables the patient to become more aware of internal processes and thereby gain some control over bodily reactions to stress.

·        Sometimes, a change of environment or living situation may produce therapeutic results.

Biofeedback is the in-born information supplied instantaneously by one’s nervous system about an individual's own physiological processes. In a laboratory set-up, data concerning a person's cardiovascular activity (blood pressure and heart rate), temperature, brain waves or muscle tension is monitored electronically and returned, or “fed back”, to that person by a gauge on a meter, a light, or a sound. Though such activity of the autonomic nervous system was once thought to be beyond an individual's control, it has been shown that an individual can be taught to use the biological data to learn how to voluntarily control the body's reactions to stress or “outside-the-skin” events. An individual learns through biofeedback training to detect his physical reactions (inside-the-skin events) and establish control over them. Biofeedback training is a type of behaviour therapy that attempts to change learned responses to stressors. It can be very successful in alleviating symptoms (e.g., pain and muscle tension) of a disorder, and its effects can be especially lasting if used in combination with psychotherapy to help the patient understand his reactions to stress.

Complaints that have been treated by biofeedback training include migraine headaches, gastrointestinal cramping (e.g., colitis), high blood pressure, tics, and the frequency and severity of epileptic seizures. Theoretically, many psychologists believe it possible to bring under partial control any physiological process that can be continuously monitored and displayed, including electrophysiological activity of the limbic system and other homeostatic processes. Biofeedback training with brain waves has also been useful in enhancing mental functioning. “Alpha (wave) training” elicits the calming and integrative effects of meditation. Theta wave training has led to more focused attention, the control of “mental blocks” during examinations, and the control of anxiety.

• APA Style:   stress. (2009). Encyclopædia Britannica. Encyclopædia Britannica 2009 Ultimate Reference Suite.  Chicago: Encyclopædia Britannica.

LET US LOOK AT AN EARLIER TELEVISION PROGRAMME I DID IN NTA- AM EXPRESS IN 2005

STRESS MANAGEMENT IN CLINICAL PSYCHOLOGY

Presented as News Item on NTA-AM EXPRESS & broadcast on 7^th Sept’05

PREAMBLE:

In our country today, there is economic recession. The poverty line has never been as low as it is now! This is despite the foreign debt relief that the present administration has been hailed for achieving. Presently, the price of crude oil worldwide is at its peak and the nation is ranked as the sixth oil producing country in the world! Despite all the adulation, messages of congratulations and advertorials in the mass media, these gains have not translated into cheaper costs in fuel, food, school fess and medical bills for the average Nigerian! One is bound to ask; Why? The present oil boon has been orchestrated beyond imaginable limits; nevertheless, high blood pressure is on the increase at cardiovascular clinics nationwide! Why is it so?

Our educational system is so bad with expo and other forms of examinations malpractices that many parents are now sending their children to Ghana for secondary and university education. Do you blame them when certificates from Nigeria are no longer recognised by foreign countries? Our roads are so dilapidated that hundreds lose their lives in daily mishaps despite the kangaroo efforts of the FRSC, another waste pipe that drains our economy. Our hospitals are so poorly equipped that the rich go abroad for minor surgeries while the poor die premature deaths! If government policies are so corrupt and anti-people, that strikes and rallies are the hallmarks of the pseudo-dictatorship we operate under the guise of democracy, do you blame those who scram overseas to become slaves under the bogus American visa lottery programmes? Others go to Italy or the Arab world!

Many graduates and ex-youth corpers are roaming the streets chasing jobs below their university qualifications and expertise! Parents and guardians who sweated throughout the protracted period of paying for education in the country that is not subsidised are frustrated! The youths have diverted their I.Q. into nefarious pastimes; the males engage in, shady deals, cultism and armed robbery whereas the females thrive on part-time prostitution and Abuja-contracts! Social ethics and morality have become obsolete, as most religious leaders who are supposed to be role models are knee deep in prosperity gospel. They exploit the masses that in their economic strangulation chase signs and wonders from one crusade ground to another! These constitute the variety of crises and stresses in the polity!

So, we may honestly ask: What is a stress or a crisis? How do we manage either?

In this lecture, the two are treated as synonymous since only a faint line differentiates them! 

 INTRODUCTION

Stress, when used, as a term in psychology is an unpleasant state of emotional and physiological arousal that people experience in situations that they perceive as dangerous or threatening to their well-being. The word stress means different things to different people. Some people define stress as events or situations that cause them to feel tension, pressure or negative emotions such as anxiety and anger. Others view stress as the response to these situations. This response includes physiological changes—such as increased heart rate and muscle tension—as well as emotional and behavioural changes. However, most psychologists regard stress as a process involving a person’s interpretation and response to a threatening event.

Stress is a common experience. We may feel stress when we are very busy, have important deadlines to meet, or have too little time to finish all of our tasks. Often people experience stress because of problems at work or in social relationships, such as a poor evaluation by a supervisor or an argument with a friend. Some people may be particularly vulnerable to stress in situations involving the threat of failure or personal humiliation. Others have extreme fears of objects or things associated with physical threats—such as snakes, illness, storms, or flying in an airplane—and become stressed when they encounter or think about these perceived threats. Major life events, such as the death of a loved one, can cause severe stress.

Stress can have both positive and negative effects. Stress is a normal, adaptive reaction to threat. It signals danger and prepares us to take defensive action. Fear of things that pose realistic threats motivates us to deal with them or avoid them. Stress also motivates us to achieve and fuels creativity. Although stress may hinder performance on difficult tasks, moderate stress seems to improve motivation and performance on less complex tasks. In personal relationships, stress often leads to less cooperation and more aggression. If not managed appropriately, stress can lead to serious problems. Exposure to chronic stress can contribute to both physical illnesses, such as heart disease, and mental illnesses, such as anxiety disorders. The field of health psychology focuses in part on how stress affects bodily functioning and on how people can use stress management techniques to prevent or minimize disease.

Microsoft ® Encarta ® Encyclopaedia 2004. © 1993-2003 Microsoft Corporation.

SOURCES OF STRESS

The circumstances that cause stress are called stressors. Stressors vary in severity and duration. For example, the responsibility of caring for a sick parent may be an ongoing source of major stress, whereas being stuck in a traffic jam may cause mild, short-term stress. Some events, such as the death of a loved one, are stressful for everyone. Nevertheless, in other situations, individuals may respond differently to the same event—what is a stressor for one person may not be stressful for another. For example, a student who is unprepared for a chemistry test and anticipates a bad grade may feel stress, whereas a classmate who studies in advance may feel confident of a good grade. For an event or situation to be a stressor for a particular individual, the person must appraise the situation as threatening and lack the coping resources to deal with it effectively.

Stressors can be classified into three general categories: catastrophic events, major life changes and daily hassles. In addition, simply thinking about unpleasant past events or anticipating unpleasant future events can cause stress for many people. Both the economic depression and other socio-political instabilities can cause the greatest stress to the average Nigerian who is neither a politician nor a ‘419ner’! This paper addresses the health problems associated with this social malaise!

A

Catastrophes

A catastrophe is a sudden, often life-threatening calamity or disaster that pushes people to the outer limits of their coping capability. Catastrophes include natural disasters—such as earthquakes, tornadoes, fires, floods, and hurricanes—as well as wars, torture, automobile accidents, violent physical attacks, and sexual assaults.

In Nigeria, besides the civil war that lasted three years, the military inter-regnum that engulfed the country for more than a quarter of a century is enough catastrophe that has had traumatic effects and caused long-lasting disillusionment on the psyche of her citizenry! Catastrophes often continue to affect their victims’ mental health long after the event has ended.

B

Major Life Changes

The most stressful events for adults involve major life changes, such as death of a spouse or family member, divorce, imprisonment, losing one’s job, and major personal disability or illness. For adolescents, the most stressful events are the death of a parent or a close family member, divorce of their parents, imprisonment of their mother or father, and major personal disability or illness. Sometimes, apparently positive events can have stressful components. For example, a woman who gets a job promotion may receive a higher salary and greater prestige, but she may also feel stress from supervising co-workers who were once peers. Getting married is usually considered a positive experience, but planning the wedding, deciding whom to invite and dealing with family members may cause couples to feel stressed.

C

Daily Hassles

Much of the stress in our lives results from having to deal with daily hassles pertaining to our jobs, personal relationships and everyday living circumstances. Many people experience the same hassles every day. Examples of daily hassles include living in a noisy neighbourhood, commuting to work in heavy traffic, disliking one’s fellow workers, worrying about owing money, waiting in a long line, and misplacing or losing things. When taken individually, these hassles may feel like only minor irritants, but cumulatively, over time, they can cause significant stress. The amount of exposure people have to daily hassles is strongly related to their daily mood. Generally, the greater their exposure is to hassles, the worse is their mood. Studies have found that one’s exposure to daily hassles is actually more predictive of illness than is exposure to major life events. Traffic congestion, unemployment of the youth, neglect of pensioners, non-availability of public utilities and loss of jobs by parents are examples that many Nigerians face!

EFFECTS OF STRESS

A person who is stressed typically has anxious thoughts and difficulty concentrating or remembering. Stress can also change outward behaviours. Teeth clenching, hand wringing, pacing, nail biting and heavy breathing are common signs of stress. People also feel physically different when they are stressed. Butterflies in the stomach, cold hands and feet, dry mouth, and increased heart rate are all physiological effects of stress that we associate with the emotion of anxiety.

A

The Stress Response

When a person appraises an event as stressful, the body undergoes a number of changes that heighten physiological and emotional arousal. First, the sympathetic division of the autonomic nervous system is activated. The sympathetic division prepares the body for action by directing the adrenal glands to secrete the hormones epinephrine (adrenaline) and nor epinephrine (nor adrenaline). In response, the heart begins to beat more rapidly, muscle tension increases, blood pressure rise, and blood flow is diverted from the internal organs and skin to the brain and muscles. Breathing speeds up, the pupils dilate and perspiration increases. This reaction is sometimes called the fight-or-flight response because it energizes the body to either confront or flee from a threat.

Microsoft ® Encarta ® Encyclopedia 2004. © 1993-2003 Microsoft Corporation. All rights reserved

Another part of the stress response involves the hypothalamus and the pituitary gland, parts of the brain that are important in regulating hormones and many other bodily functions. In times of stress, the hypothalamus directs the pituitary gland to secrete adrenocorticotropic hormone. This hormone, in turn, stimulates the outer layer, or cortex, of the adrenal glands to release glucocorticoids, primarily the stress hormone Cortisol, principally derived from hydrocortisone, a survival chemical that the body produces. Cortisol helps the body access fats and carbohydrates to fuel the fight-or-flight response.

Canadian scientist Hans Selye was one of the first people to study the stress response. As a medical student, Selye noticed that patients with quite different illnesses shared many of the same symptoms, such as muscle weakness, weight loss and apathy. Selye believed these symptoms might be part of a general response by the body to stress. In the 1930s, Selye studied the reactions of laboratory rats to a variety of physical stressors, such as heat, cold, poisons, strenuous exercise and electric shock. He found that the different stressors all produced a similar response: enlargement of the adrenal glands, shrinkage of the thymus gland (a gland involved in the immune response), and bleeding stomach ulcers. Selye proposed a three-stage model of the stress response, which he termed the general adaptation syndrome. The three stages in Selye’s model are alarm, resistance and exhaustion. The alarm stage is a generalized state of arousal during the body’s initial response to the stressor. In the resistance stage, the body adapts to the stressor and continues to resist it with a high level of physiological arousal. When the stress persists for a long time, and the body is chronically overactive, resistance fails and the body moves to the exhaustion stage. –

It should be noted that at this critical stage, the body is easily vulnerable to disease and even death.

B

Disease

Physicians increasingly acknowledge that stress is a contributing factor in a wide variety of health problems. These problems include cardiovascular disorders such as hypertension (high blood pressure); coronary heart disease (coronary arteriosclerosis, or narrowing of the heart’s arteries); and gastrointestinal disorders, such as ulcers. Stress also appears to be a risk factor in cancer, chronic pain problems and many other health disorders. See Stress-Related Disorders.

Researchers have clearly identified stress, and specifically a person's characteristic way of responding to stress, as a risk factor for cardiovascular diseases. The release of stress hormones has a cumulative negative effect on the heart and blood vessels. Cortisol, for example, increases blood pressure, which can damage the inside walls of blood vessels. It also increases the free fatty acids in the bloodstream, which in turn leads to plaque build-up on the lining of the blood vessels. As the blood vessels narrow over time, it becomes increasingly difficult for the heart to pump sufficient blood through them.

People with certain personality types seem to be physiologically over responsive to stress and therefore more vulnerable to heart disease. For example, the so-called Type A personality is characterised by competitiveness, impatience and hostility. When Type A people experience stress, their heart rate and blood pressure climb higher and recovery takes longer than with more easygoing people. The most “toxic” personality traits of Type A people are frequent reactions of hostility and anger. These traits are correlated with an increased risk of coronary heart disease.

Stress also appears to influence the development of cancer, but the relationship is not as well established as it is for cardiovascular diseases. There is a moderate positive correlation between extent of exposure to life stressors and cancer—the more stressors, the greater the likelihood of cancer. In addition, a tendency to cope with unpleasant events in a rigid, unemotional manner is associated with the development and progression of cancer.

C

Decreased Immune Response

Ordinarily the immune system is a marvel of precision. It protects the body from disease by seeking out and destroying foreign invaders, such as viruses and bacteria. However, there is substantial evidence that stress suppresses the activity of the immune system, leaving an organism more susceptible to infectious diseases. An organism with a weakened immune system is also less able to control naturally occurring mutant cells that overproduce and lead to cancer.

Numerous studies have linked stress with decreased immune response. For example, when laboratory animals are physically restrained, exposed to inescapable electric shocks or subjected to overcrowding, loud noises or maternal separation, they show decreased immune system activity. Researchers have reported similar findings for humans.

One study, for example, found weakened immune response in people whose spouses had just died. Other studies have documented weakened immune responses among students taking final examinations; people who are severely deprived of sleep; recently divorced or separated men and women; people caring for a family member with Alzheimer’s disease; and people who have recently lost their jobs.

Stress appears to depress immune function in two main ways. First, when people experience stress, they more often engage in behaviours that have adverse effects on their health: cigarette smoking, using more alcohol or drugs, sleeping less, exercising less and eating poorly. In addition, stress may alter the immune system directly through hormonal changes. Research indicates that glucocorticoids—hormones that are secreted by the adrenal glands during the stress response—actively suppress the body’s immune system.

At one time scientists believed the immune system functioned more or less as an independent system of the body. They now know that the immune system does not operate by itself, but interacts closely with other bodily systems. The field of psychoneuroimmunology focuses on the relationship between psychological influences (such as stress), the nervous system and the immune system.

D

Mental Illness

Stress influences mental health as well as physical health. People who experience a high level of stress for a long time—and who cope poorly with this stress—may become irritable, socially withdrawn, and emotionally unstable. They may also have difficulty concentrating and solving problems. Some people under intense and prolonged stress may start to suffer from extreme anxiety, depression or other severe emotional problems. Anxiety disorders caused by stress may include generalised anxiety disorder, phobias, panic disorder and obsessive-compulsive disorder. People who survive catastrophes sometimes develop an anxiety disorder called post-traumatic stress disorder. They re-experience the traumatic event repeatedly in dreams and in disturbing memories or flashbacks during the day. They often seem emotionally numb and may be easily startled or angered.

COPING WITH STRESS

Coping with stress means using thoughts and actions to deal with stressful situations and lower our stress levels. Many people have a characteristic way of coping with stress based on their personality. People who cope well with stress tend to believe they can personally influence what happens to them. They usually make more positive statements about themselves, resist frustration, remain optimistic and persevere even under extremely adverse circumstances. Most importantly, they choose the appropriate strategies to cope with the stressors they confront. Conversely, people who cope poorly with stress tend to have somewhat opposite personality characteristics, such as lower self-esteem and a pessimistic outlook on life.

A

Coping Strategies

Psychologists distinguish two broad types of coping strategies: problem-focused coping and emotion-focused coping. The goal of both strategies is to control one’s stress level.

In problem-focused coping, people try to short-circuit negative emotions by taking some action to modify, avoid or minimise the threatening situation. They change their behaviour to deal with the stressful situation.

In emotion-focused coping, people try to directly moderate or eliminate unpleasant emotions. Examples of emotion-focused coping include rethinking the situation in a positive way, relaxation, denial, and daydreaming (wishful thinking).

To understand these strategies, consider the example of a premedical student in college who faces three difficult final examinations in a single week. She knows she must get top grades in order to have a chance at acceptance to medical school. This situation is a potential source of stress. To cope, she could organise a study group and master the course materials systematically (problem-focused coping). She could also decide that she needs to relax and recollect herself for an hour or more (emotion-focused coping), before proceeding with an action plan (problem-focused coping). She might also decide to watch television for hours on end to prevent having to think about or study for her exams (emotion-focused coping). In general, problem-focused coping is the most effective coping strategy when people have realistic opportunities to change aspects of their situation and reduce stress. Emotion-focused coping is most useful as a short-term strategy. It can help reduce one’s arousal level before engaging in problem-solving and taking action, and it can help people deal with stressful situations in which there are few problem-focused coping options.

B

Social Support

Support from friends, family members and others who care for us goes a long way in helping us to get by in times of trouble. Social support systems provide us with emotional sustenance, tangible resources and aid, and information when we are in need. People with social support feel cared about, valued by others and feel a sense of belonging to a larger social network.

A large body of research has linked social support to good health and a superior ability to cope with stress. For example, one long-term study of several thousand California residents found that people with extensive social ties lived longer than those with few close social contacts did. This confirmed the benefit of the African Extended Family system! Another study found that heart-attack victims who lived alone were nearly twice as likely to have another heart attack as those who lived with someone. Even the perception of social support can help people cope with stress. Studies have found that people’s appraisal of the availability of social support is more closely related to how well they deal with stressors than the actual amount of support they receive or the size of their social network.

Research also suggests that the companionship of animals can help lower stress. For example, one study found that in times of stress, people with pet dogs made fewer visits to the doctor than those without pets.

C

Biofeedback

Biofeedback is a technique in which people learn voluntary control of stress-related physiological responses, such as skin temperature, muscle tension, blood pressure and heart rate. Normally, people cannot control these responses voluntarily. In biofeedback training, people are connected to an instrument or machine that measures a particular physiological response, such as heart rate, and feeds that measurement back to them in an understandable way.

For example, the machine might beep with each heartbeat or display the number of heartbeats per minute on a digital screen. Next, individuals learn to be sensitive to subtle changes inside their body that affect the response system being measured. Gradually, they learn to produce changes in that response system—for example, to voluntarily lower their heart rate. Typically, individuals use different techniques and proceed by trial and error until they discover a way to produce the desired changes. Scientists do not understand the mechanisms by which biofeedback works. Nonetheless, it has become a widely used and generally accepted technique for producing relaxation and lowering physiological arousal in patients with stress-related disorders. One use of biofeedback is in the treatment of tension headaches. By learning to lower muscle tension in the forehead, scalp and neck, many tension headache sufferers can find long-term relief.

D

Relaxation

In addition to biofeedback, two other major methods of relaxation are progressive muscular relaxation and meditation. Progressive muscular relaxation involves systematically tensing and then relaxing different groups of skeletal (voluntary) muscles, while directing one’s attention toward the contrasting sensations produced by the two procedures.

After practicing progressive muscular relaxation, individuals become increasingly sensitive to rising tension levels and can produce the relaxation response during everyday activities (often by repeating a cue word, such as calm, to themselves).

Meditation, in addition to teaching relaxation, is designed to achieve subjective goals such as contemplation, wisdom, and altered states of consciousness. Some forms have a strong Eastern religious and spiritual heritage based in Zen Buddhism and yoga. Other varieties emphasize a particular lifestyle for practitioners. One of the most common forms of meditation, Transcendental Meditation, involves focusing attention on and repeating a mantra, which is a word, sound, or phrase thought to have particularly calming properties. Both progressive muscle relaxation and meditation reliably reduce stress-related arousal. They have been used successfully to treat a range of stress-related disorders, including hypertension, migraine and tension headaches, and chronic pain.

E

Aerobic Exercise

Aerobic exercise—such as running, walking, biking and skiing—can help keep stress levels down. Because aerobic exercise increases the endurance of the heart and lungs, an aerobically fit individual will have a lower heart rate at rest and lower blood pressure, less reactivity to stressors, and quicker recovery from stressors. In addition, studies show that people who exercise regularly have higher self-esteem and suffer less from anxiety and depression than comparable people who are not aerobically fit. The American College of Sports Medicine recommends exercising three to four times a week for at least 20 minutes to reduce the risk of cardiovascular disease. Every culture has its traditional ways of coping with stressful events and situations. Take the example of long funeral ceremonies, the dancing, sing songs, eating and drinking and boisterous milling around of relatives who had come from far and near. To the average European, it does not make sense, but when you view the emotional, social and moral support it gives the sorrowing family, then you appreciate the wisdom of African Extended Family System.

Contributed By: Stephen Auerbach, Sandra E. Gramling & Kenez J. Danmbaezue

Stress-Related Disorders

I

INTRODUCTION

Stress-Related Disorders are diseases brought on or worsened by psychological stress. These disorders commonly involve the autonomic nervous system, which controls the body’s internal organs. Disorders that can be caused by stress include hypertension (high blood pressure), headaches, back pain, skin disorders, irritable bowel syndrome and ulcers. Stress is also believed to contribute to coronary heart disease (atherosclerosis, or narrowing of the heart’s arteries) and some cases of cancer.

Physicians have long recognized that people are more susceptible to diseases of all kinds when subjected to great stress. Negative events, such as the death of a loved one, seem to cause enough stress to lower the body’s resistance to disease. Positive circumstances, however, such as a new job or a new baby in the house, can also upset a person’s normal ability to fend off disease. Social scientists have devised a list of life events and rated the relative stressfulness of each. Thus, the death of a spouse rates a 100 on the scale; getting divorced, 73; marital separation, 65; going to jail, 63; death of a close family member, 63; major personal injury or illness, 53; and so on. People also experience stress from daily hassles, such as living in crowded, noisy conditions, commuting to work, and waiting in line. Although these are minor irritants when experienced individually, the cumulative effect of daily hassles can cause substantial stress.

II

CAUSES

Stress hampers function of the immune system, leaving people more vulnerable to many diseases. It also affects some disorders directly. When people experience stress, their heart beats faster, blood pressure rises, and other body systems prepare to meet the perceived threat. When a person does something active to cope with a threat, these systems return to normal. Running away or fighting—the so-called flight-or-fight response—are both successful ways of coping with many physical threats. Problems arise, however, when the body is prepared to cope with danger but cannot do so. Being caught in a traffic jam, for example, can cause the body to prepare for a flight-or-fight response, but when no action can be taken, the body’s systems remain overly active. Similar repeated experiences of this frustrating nature can lead to conditions such as high blood pressure. Scientists attribute at least part of this effect to evolutionary history. They reason that at one time, people had to live with constant physical threats from wild animals and the elements, as well as from one another, and that the body developed in a way that helped it cope with these physical stresses.

Certain personality traits may also lead to stress-related disorders. The so-called Type A personality, characterized by competitive, hard-driving intensity, is common in American society. Although early studies suggested a link between Type A behaviour and coronary heart disease, most studies since the 1980s have failed to find such a relationship. However, research has consistently demonstrated that people who show a high level of hostility, anger, and cynicism—often components of Type A behaviour—have a higher risk of coronary heart disease than people without these traits. See Heart: Heart Diseases.

III

KINDS

High blood pressure, or hypertension, is one of the most common disorders made worse by stress. About 25 percent of adult Americans have high blood pressure. Although it has no noticeable symptoms, hypertension can damage the kidneys and can lead to stroke or heart attack. Gastrointestinal problems are an even more common result of stress. Peptic ulcers (see Ulcer) are sores in the lining of the stomach or the duodenum (the upper part of the small intestine).

Most researchers believe that stress contributes to ulcers by causing excessive secretion of hydrochloric acid. Normally this acid aids digestion by breaking down food in the stomach. But when the stomach produces excessive acid in the absence of food, the acid can eat through the protective mucous lining of the stomach or duodenum.

Other stress-related gastrointestinal disorders include irritable bowel syndrome and some inflammatory diseases of the colon and bowel, such as regional enteritis. Stress can also contribute to some respiratory disorders. For example, stress can trigger an attack of asthma (see Asthma, Bronchial). Asthma attacks are characterized by wheezing, panting, and a feeling of being suffocated. In addition, emotional stress can cause or aggravate many skin disorders, from those that produce itching, tickling and pain to those that cause rashes and acne.

Major traumatic events such as accidents, catastrophes, or battle experiences may bring on a condition called post-traumatic stress disorder. Once known under war conditions as shell shock or battle fatigue, post-traumatic stress disorder gained its current name after it appeared in many veterans returning from the Vietnam War (1959-1975) as they tried to readjust to civilian life. Symptoms may appear long after the initial trauma. These include re-experiencing the trauma through disturbing nightmares and memories, emotional numbness, nervous irritability, depression, and sleep difficulties.

IV

TREATMENT

Treatment of stress-related disorders depends on the specific disorder. In some cases, treatment is limited to relieving the particular physical symptom involved. Psychological treatments are directed at helping the person to relieve the source of stress or else to learn to cope more effectively with it. Physicians often recommend combinations of physical and psychological treatments.

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EPILOGUE:

It should now be evident that crisis intervention is not exactly the same as stress management. Any other socio-political instability that does not present as health problems for the individual but translates into problems that affect the larger community falls into crisis intervention/management. Natural disasters like Tsunami and Katharina are recent examples! How has Nigeria fared as a nation since independence and what has been its major crisis management history. We shall cite the political inequalities that bedevilled the nation at the end of the civil war as a veritable example! Military dictatorships have been our albatross!

CONCLUDING WITH THE COMMONEST PROBLEMS IN SOCIETY

This lecture ends with the commonest ego defence mechanism most parents live with all through their lives. Those who are never completely healthy nor are completely sick most of their lives are neurotics. Most resort to religious or superstitious methods for coping with it and die without knowing they were ill!

Neuroticism, which is a fundamental trait in the study of personality disorders in clinical psychology, is an enduring tendency to experience negative emotional states. Individuals who score high on neuroticism are more likely to experience such feelings as anxiety, anger, guilt and depressed mood than the average individual.

·        They respond to environmental stress more negatively than others, and are more likely to interpret ordinary situations as threatening and minor frustrations as hopelessly difficult.

·        They are often self-conscious and shy, and

·        They have trouble controlling urges and/or delaying gratification.

Neuroticism is associated with low emotional intelligence, which involves emotional regulation motivation and interpersonal skills. It is also a risk factor for "internalising" mental disorders such as phobia, depression, panic disorder, and other anxiety disorders (traditionally called neuroses). On the opposite end of the spectrum, individuals who score low in neuroticism are more emotionally stable and less reactive to stress. They tend to be calm, even tempered and less likely to feel tense or rattled. Although they are low in negative emotion, they are not necessarily high on positive emotion. Being high on positive emotion is an element of the independent trait of extraversion. Neurotic extraverts, for example, would experience high levels of both positive and negative emotional states, a kind of "emotional roller coaster". Individuals who score low on neuroticism (particularly those who are also high on extraversion) generally report more happiness and satisfaction with their lives. Neurotic anxiety occurs when unwanted impulses overwhelm the egos defences and try to come into action.

THESE ARE THE REGULAR CUSTOMERS TO SPIRITUAL HEALERS WHO ASK THEM TO USE INCENSE, GREEN, YELLOW OR RED CANDLES. OTHERS ARE ADDICTS TO MIDNIGHT CRUSADES WHERE THEY INDULGE IN DENIALS AND EUPHORIA TILL THE NEXT MORNING. THE RESPONSIBLE PARENT CAN ATTEND MY CLINIC ON WEDNESDAYS FROM 9.00 AM TILL 5.00 PM TO LEARN BIOFEEDBACK OR EXISTENTIAL METHODS OF TREATING AND MANAGING STRESS. GOD BLESS US.

DR. J. K. DANMBAEZUE (a.k.a. Rev. Prof. J. J. Kenez ) is a sixty-three year old research scientist privately self-employed as an existential therapist currently resident and practising in Enugu, with a headquarters in Ihiala, Republic of Biafra, where he treats people with personality disorders and counsels young adults about to wed by administering standardised psychological tests and utilizing the results to counsel, re-direct incompatible couples and conduct group sessions for other couples .

He has three Community-Based Organisations for this project;

 1. KENEZ HEALTH KLINIK, an interdisciplinary therapeutic clinic, where a patient is seen contemporaneously by three consultants in physical, social & psychological medicine

2. HAPPY FAMILY NETWORK INTERNATIONAL, an intercultural fraternity, which aims at the globalization of the principles he has neatly encapsulated in THE KENEZIAN CREED and his LETTER TO ALL EDUCATIONISTS.

3. INTEGRATIONAL SPIRITAN MOVEMENT, a fellowship of natural scientists who seek for the unification of all religious thoughts & practice to reflect the harmony embedded in the eternal laws that govern human existence.

For the past twenty five years he has been a student of the Holy Spirit of God, the Creator of the universe we share with other beings. His ministry as of today encompasses the unification of all religious faiths, while his lay apostolate for the entire human race aims at institutionalising the equality of peoples of all nations irrespective of race, creed, colour, and social status.

The concise motto; “ONE ALMIGHTY CREATOR, ONE CREATED UNIVERSE & ONE HUMAN FAMILY” translates into enthronement of brother/sisterhood of all mankind, the liberalisation of all social contracts and the integration of all belief systems so as to ensure optimum health, success and happiness for every home worldwide and for humanity at all times; now and in the future. Professionally, he is a Consultant Clinical Psychologist, an Existential Family Therapist and a Research Psychometrician. Currently he is leading a team of medical experts in finding an alternative management strategy for the pandemic HIV-AIDS based on natural ingredients from the tropics.

He is happily married and has three kids. He holds Bachelor’s degrees in both Philosophy and Psychology, a Pass Junior Staff College (abbrev; pjsc) from the Nigerian Air Force, a Master’s degree in Clinical Psychology and finally a Doctor of Science degree in Psychometrics besides being a Fellow of the African College of Research Scientists.

   

Dr Jideofo Kenechukwu Danmbaezue, D.Sc.

E-mail: agunabu1948@gmail.com & saintkenez@yahoo.co.uk 

Feeling like there are too many pressures and demands on you? Losing sleep worrying about tests and school work? Eating on the run because your schedule is just too busy? You're not alone. Everyone experiences stress at times — adults, teens, and even kids. But there are ways to minimize stress and manage the stress that's unavoidable.

What Is Stress?

Stress is a feeling that's created when we react to particular events. It's the body's way of rising to a challenge and preparing to meet a tough situation with focus, strength, stamina, and heightened alertness.

The events that provoke stress are called stressors, and they cover a whole range of situations — everything from outright physical danger to making a class presentation or taking a semester's worth of your toughest subject.

The human body responds to stressors by activating the nervous system and specific hormones. The hypothalamus signals the adrenal glands to produce more of the hormones adrenaline and cortisol and release them into the bloodstream. These hormones speed up heart rate, breathing rate, blood pressure, and metabolism. Blood vessels open wider to let more blood flow to large muscle groups, putting our muscles on alert. Pupils dilate to improve vision. The liver releases some of its stored glucose to increase the body's energy. And sweat is produced to cool the body. All of these physical changes prepare a person to react quickly and effectively to handle the pressure of the moment.

This natural reaction is known as the stress response. Working properly, the body's stress response enhances a person's ability to perform well under pressure. But the stress response can also cause problems when it overreacts or fails to turn off and reset itself properly.

Good Stress and Bad Stress

The stress response (also called the fight or flight response) is critical during emergency situations, such as when a driver has to slam on the brakes to avoid an accident. It can also be activated in a milder form at a time when the pressure's on but there's no actual danger — like stepping up to take the foul shot that could win the game, getting ready to go to a big dance, or sitting down for a final exam. A little of this stress can help keep you on your toes, ready to rise to a challenge. And the nervous system quickly returns to its normal state, standing by to respond again when needed.

But stress doesn't always happen in response to things that are immediate or that are over quickly. Ongoing or long-term events, like coping with a divorce or moving to a new neighborhood or school, can cause stress, too.

Long-term stressful situations can produce a lasting, low-level stress that's hard on people. The nervous system senses continued pressure and may remain slightly activated and continue to pump out extra stress hormones over an extended period. This can wear out the body's reserves, leave a person feeling depleted or overwhelmed, weaken the body's immune system, and cause other problems.

What Causes Stress Overload?

Although just enough stress can be a good thing, stress overload is a different story — too much stress isn't good for anyone. For example, feeling a little stress about a test that's coming up can motivate you to study hard. But stressing out too much over the test can make it hard to concentrate on the material you need to learn.

Pressures that are too intense or last too long, or troubles that are shouldered alone, can cause people to feel stress overload. Here are some of the things that can overwhelm the body's ability to cope if they continue for a long time:

• being bullied or exposed to violence or injury
• relationship stress, family conflicts, or the heavy emotions that can accompany a broken heart or the death of a loved one
• ongoing problems with schoolwork related to a learning disability or other problems, such as ADHD (usually once the problem is recognized and the person is given the right learning support the stress disappears)
• crammed schedules, not having enough time to rest and relax, and always being on the go

Some stressful situations can be extreme and may require special attention and care. Posttraumatic stress disorder is a very strong stress reaction that can develop in people who have lived through an extremely traumatic event, such as a serious car accident, a natural disaster like an earthquake, or an assault like rape.

Some people have anxiety problems that can cause them to overreact to stress, making even small difficulties seem like crises. If a person frequently feels tense, upset, worried, or stressed, it may be a sign of anxiety. Anxiety problems usually need attention, and many people turn to professional counselors for help in overcoming them.

Signs of Stress Overload

People who are experiencing stress overload may notice some of the following signs:

• anxiety or panic attacks
• a feeling of being constantly pressured, hassled, and hurried
• irritability and moodiness
• physical symptoms, such as stomach problems, headaches, or even chest pain
• allergic reactions, such as eczema or asthma
• problems sleeping
• drinking too much, smoking, overeating, or doing drugs
• sadness or depression

Everyone experiences stress a little differently. Some people become angry and act out their stress or take it out on others. Some people internalize it and develop eating disorders or substance abuse problems. And some people who have a chronic illness may find that the symptoms of their illness flare up under an overload of stress.

Keep Stress Under Control

What can you do to deal with stress overload or, better yet, to avoid it in the first place? The most helpful method of dealing with stress is learning how to manage the stress that comes along with any new challenge, good or bad. Stress-management skills work best when they're used regularly, not just when the pressure's on. Knowing how to "de-stress" and doing it when things are relatively calm can help you get through challenging circumstances that may arise.

Here are some things that can help keep stress under control:

·         Take a stand against overscheduling. If you're feeling stretched, consider cutting out an activity or two, opting for just the ones that are most important to you.

·         Be realistic. Don't try to be perfect — no one is. And expecting others to be perfect can add to your stress level, too (not to mention put a lot of pressure on them!). If you need help on something, like schoolwork, ask for it.

·         Get a good night's sleep. Getting enough sleep helps keep your body and mind in top shape, making you better equipped to deal with any negative stressors. Because the biological "sleep clock" shifts during adolescence, many teens prefer staying up a little later at night and sleeping a little later in the morning. But if you stay up late and still need to get up early for school, you may not get all the hours of sleep you need.

• Learn to relax. The body's natural antidote to stress is called the relaxation response. It's your body's opposite of stress, and it creates a sense of well-being and calm. The chemical benefits of the relaxation response can be activated simply by relaxing. You can help trigger the relaxation response by learning simple breathing exercises and then using them when you're caught up in stressful situations. (Click on the button to try one.) And ensure you stay relaxed by building time into your schedule for activities that are calming and pleasurable: reading a good book or making time for a hobby, spending time with your pet, or just taking a relaxing bath.

·         Treat your body well. Experts agree that getting regular exercise helps people manage stress. (Excessive or compulsive exercise can contribute to stress, though, so as in all things, use moderation.) And eat well to help your body get the right fuel to function at its best. It's easy when you're stressed out to eat on the run or eat junk food or fast food. But under stressful conditions, the body needs its vitamins and minerals more than ever. Some people may turn to substance abuse as a way to ease tension. Although alcohol or drugs may seem to lift the stress temporarily, relying on them to cope with stress actually promotes more stress because it wears down the body's ability to bounce back.

·         Watch what you're thinking. Your outlook, attitude, and thoughts influence the way you see things. Is your cup half full or half empty? A healthy dose of optimism can help you make the best of stressful circumstances. Even if you're out of practice, or tend to be a bit of a pessimist, everyone can learn to think more optimistically and reap the benefits.

·         Solve the little problems. Learning to solve everyday problems can give you a sense of control. But avoiding them can leave you feeling like you have little control and that just adds to stress. Develop skills to calmly look at a problem, figure out options, and take some action toward a solution. Feeling capable of solving little problems builds the inner confidence to move on to life's bigger ones — and it and can serve you well in times of stress.

Build Your Resilience

Ever notice that certain people seem to adapt quickly to stressful circumstances and take things in stride? They're cool under pressure and able to handle problems as they come up. Researchers have identified the qualities that make some people seem naturally resilient even when faced with high levels of stress.

If you want to build your resilience, work on developing these attitudes and behaviors:

• Think of change as a challenging and normal part of life.
• See setbacks and problems as temporary and solvable.
• Believe that you will succeed if you keep working toward your goals.
• Take action to solve problems that crop up.
• Build strong relationships and keep commitments to family and friends.
• Have a support system and ask for help.
• Participate regularly in activities for relaxation and fun.

Learn to think of challenges as opportunities and stressors as temporary problems, not disasters. Practice solving problems and asking others for help and guidance rather than complaining and letting stress build. Make goals and keep track of your progress. Make time for relaxation. Be optimistic. Believe in yourself. Be sure to breathe. And let a little stress motivate you into positive action to reach your goals.

Reviewed by: D'Arcy Lyness, PhD

Date reviewed: August 2010

What Is Anxiety?

Liam had always looked out for his younger brother Sam. But whenever Sam took the late bus after soccer practice, Liam worried about him so much he couldn't concentrate on his homework. Liam watched the clock, worrying and imagining the worst — picturing bus accidents and fearing, for no particular reason, that Sam might be injured or dead. Only when Sam arrived home safe could Liam finally relax.

It's completely normal to worry when things get hectic and complicated. But if worries become overwhelming, you may feel that they're running your life. If you spend an excessive amount of time feeling worried or nervous, or you have difficulty sleeping because of your anxiety, pay attention to your thoughts and feelings. They may be symptoms of an anxiety problem or disorder.

Anxiety is a natural human reaction that involves mind and body. It serves an important basic survival function: Anxiety is an alarm system that is activated whenever a person perceives danger or threat.

When the body and mind react to danger or threat, a person feels physical sensations of anxiety — things like a faster heartbeat and breathing, tense muscles, sweaty palms, a queasy stomach, and trembling hands or legs. These sensations are part of the body's fight-flight response. They are caused by a rush of adrenaline and other chemicals that prepare the body to make a quick getaway from danger. They can be mild or extreme.

The fight-flight response happens instantly when a person senses a threat. It takes a few seconds longer for the thinking part of the brain (the cortex) to process the situation and evaluate whether the threat is real, and if so, how to handle it. If the cortex sends the all-clear signal, the fight-flight response is deactivated and the nervous system can relax.

If the mind reasons that a threat might last, feelings of anxiety might linger, keeping the person alert. Physical sensations such as rapid, shallow breathing; a pounding heart; tense muscles; and sweaty palms might continue, too.

Normal Anxiety

Everyone experiences feelings of anxiety from time to time. Anxiety can be described as a sense of uneasiness, nervousness, worry, fear, or dread of what's about to happen or what might happen. While fear is the emotion we feel in the presence of threat, anxiety is a sense of anticipated danger, trouble, or threat.

Feelings of anxiety can be mild or intense (or anywhere in between), depending on the person and the situation. Mild anxiety can feel like a sense of uneasiness or nervousness. More intense anxiety can feel like fear, dread, or panic. Worrying and feelings of tension and stress are forms of anxiety. So are stage fright and the shyness that can come with meeting new people.

It's natural for new, unfamiliar, or challenging situations to prompt feelings of anxiety or nervousness. Facing an important test, a big date, or a major class presentation can trigger normal anxiety. Although these situations don't actually threaten a person's safety, they can cause someone to feel "threatened" by potential embarrassment, worry about making a mistake, fitting in, stumbling over words, being accepted or rejected, or losing pride. Physical sensations — such as a pounding heart, sweaty hands, or a nervous stomach — can be part of normal anxiety, too.

Because anxiety makes a person alert, focused, and ready to head off potential problems, a little anxiety can help us do our best in situations that involve performance. But anxiety that's too strong can interfere with doing our best. Too much anxiety can cause people to feel overwhelmed, tongue-tied, or unable to do what they need to do.

Anxiety Disorders

Anxiety disorders are mental health conditions that involve excessive amounts of anxiety, fear, nervousness, worry, or dread. Anxiety that is too constant or too intense can cause a person to feel preoccupied, distracted, tense, and always on alert.

Anxiety disorders are among the most common mental health conditions. They affect people of all ages — including adults, children, and people in their teens. There are many different types of anxiety disorders, with different symptoms. They all have one thing in common, though: Anxiety occurs too often, is too strong, is out of proportion to the present situation, and affects a person's daily life and happiness.

Symptoms of an anxiety disorder can come on suddenly, or they can build gradually and linger until a person begins to realize that something is wrong. Sometimes anxiety creates a sense of doom and foreboding that seems to come out of nowhere. It's common for those with an anxiety disorder to not know what's causing the emotions, worries, and sensations they have.

Different anxiety disorders are named to reflect their specific symptoms.

• Generalized anxiety. With this common anxiety disorder, a person worries excessively about many things. Someone with generalized anxiety may worry excessively about school, the health or safety of family members, and the future. They may always think of the worst that could happen. Along with the worry and dread, people with generalized anxiety have physical symptoms, such as chest pain, headache, tiredness, tight muscles, stomach aches or vomiting. Generalized anxiety can lead a person to miss school or avoid social activities. With generalized anxiety, worries can feel like a burden, making life feel overwhelming or out of control.
• Obsessive compulsive disorder (OCD). For a person with OCD, anxiety takes the form of obsessions (bad thoughts) and compulsions (actions that try to relieve anxiety).
• Phobias. These are intense fears of specific situations or things that are not actually dangerous, such as heights, dogs or flying in an airplane. Phobias usually cause people to avoid the things they are afraid of; like fear of snakes, height, darkness.
• Social phobia (social anxiety). This intense anxiety is triggered by social situations or speaking in front of others. An extreme form called selective mutism causes some kids and teens to be too fearful to talk at all in certain situations.
• Panic attacks. These episodes of anxiety can occur for no apparent reason. With a panic attack, a person has sudden and intense physical symptoms that can include a pounding heart, shortness of breath, dizziness, numbness or tingling feelings caused by over activity of the body's normal fear response.
• Agoraphobia is an intense fear of panic attacks that causes a person to avoid going anywhere a panic attack could possibly occur.
• Posttraumatic stress disorder (PTSD). This type of anxiety disorder results from a traumatic or terrifying past experience. Symptoms include flashbacks, nightmares, or constant fear after the fact.

How Anxiety Disorders Affect People

For people dealing with anxiety disorders, symptoms can feel strange and confusing at first. For some, the physical sensations can be strong and upsetting. For others, feelings of doom or fear that can happen for no apparent reason can make them feel scared, unprotected, and on guard. Constant worries can make a person feel overwhelmed by every little thing. All this can affect someone's concentration, confidence, sleep, appetite, and outlook.

People with anxiety disorders might avoid talking about their worries, thinking that others might not understand. They may fear being unfairly judged, or considered weak or scared. Although anxiety disorders are common, people who have them may feel misunderstood or alone.

Some people with anxiety disorders might blame themselves. They may feel embarrassed or ashamed, or mistakenly think that anxiety is a weakness or a personal failing. Anxiety can keep people from going places or doing things they enjoy.

The good news is, doctors today understand anxiety disorders better than ever before and, with treatment, a person can feel better.

What Causes Anxiety Disorders?

Experts don't know exactly what causes anxiety disorders. Several things seem to play a role, including genetics, brain biochemistry, an overactive fight-flight response, stressful life circumstances, and learned behavior.

Someone with a family member who has an anxiety disorder has a greater chance of developing one, too. This may be related to genes that can affect brain chemistry and the regulation of chemicals called neurotransmitters. But not everyone with a family member who has an anxiety disorder will develop problems with anxiety.

Things that happen in a person's life can also set the stage for anxiety disorders. Frightening traumatic events that can lead to PTSD are good examples; car accidents, fire burns, attack by armed robbers, loss of a dear friend, explosions the killed a dear one, e.t.c

Growing up in a family where others are fearful or anxious can "teach" a child to view the world as a dangerous place. Likewise, someone who grows up in an environment that is actually dangerous (if there are regular physical fights in the home or violence in the family or community, for example) may learn to be fearful or expect the worst.

Although everyone experiences normal anxiety in certain situations, most people — even those who experience traumatic situations — don't develop anxiety disorders. And people who develop anxiety disorders can get relief with proper treatment and care. They can learn ways to manage anxiety and to feel more relaxed and at peace.

How Are Anxiety Disorders Treated?

Anxiety disorders can be treated by mental health professionals, or therapists. A therapist can look at the symptoms someone is dealing with, diagnose the specific anxiety disorder, and create a plan to help the person get relief.

A particular type of talk therapy called cognitive-behavior therapy (CBT) is often used. In CBT, a person learns new ways to think and act in situations that can cause anxiety, and to manage and deal with stress. The therapist provides support and guidance and teaches new coping skills, such as relaxation techniques or breathing exercises. Sometimes, but not always, medication may be used as part of the treatment for anxiety.

What to Do

Getting the problem treated can help a person feel like himself or herself again — relaxed and ready for the good things in life. Someone who might be dealing with an anxiety disorder should:

• Tell a parent or other adult about physical sensations, worries or fears. Because anxiety disorders don't go away unless they are treated, it's important to tell someone who can help. If a parent doesn't seem to understand right away, talk to a school counsellor, religious leader or any other trusted adult.
• Get a check up. See a doctor to make sure there are no physical conditions that could be causing symptoms.
• Work with a mental health professional. Ask a doctor, nurse or school counsellor for a referral to someone who treats anxiety problems, preferably a clinical psychologist. Finding out what's causing the symptoms can be a great relief.
• Get regular exercise, good nutrition, and sleep. These provide your body and brain with the right fuel and time to recharge.

Try to stay patient and positive. It can take time to feel better, and courage to face fears. But letting go of worry allows space for more happiness and fun.

Reviewed by: D'Arcy Lyness, PhD

Date reviewed: October 2010

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