Stress affects us all. While having a brain injury can certainly complicate stress management, dealing with chronic stress is very similar to dealing with traumatic brain injury or any other kind of acquired injury to the brain.
What is Stress?
Stress is a conditioned response that has both physical and mental attributes. We, meaning all of us, usually refer to the mental aspects by saying, “I had a terribly stressful day at work.” In this sense we are referring to a feeling; stress is what you feel when you think you have more things to deal with than you normally do.
That stress thought triggers physiological responses inside your body. Adrenaline and cortisol production speed up to allow you to either overcome the situation or run from it. Referred to as the fight or flight response, your heart speeds up, you breathe faster and you actually have a burst of energy.
Your body prepares itself for your next decision. That increased energy will help you stand and fight, or it will give you added strength to head for the hills. All of this is normal. The fight or flight response helps us react quickly to situations; it helps us work harder to complete a work assignment.
Usually, however, when you and I say we had a terribly stressful day we are not referring to the good side of stress. When we feel stress for prolonged periods of time in a day or for numerous days we discover the dark side of the force: headaches, upset stomach, ulcers, back pain, and sleeping difficulties. Overabundant stress can weaken your immune system, making it more difficult to fight off medical issues and can actually cause a health problem to worsen.
You become moody, tense or depressed. This can trigger a complete new set of issues that can cause even more stress. While your body is prepared for fight or flight, your mind is leaning toward flight more and more as time passes. Let’s dig a little deeper into this phenomenon.
Stress is normal. It begins when we perceive a threat, and that threat can be real like being in a car accident or it can be imagined simply by seeing a car accident and thinking there must be a lot of crazy drivers on the road.
The Brain Responds to Stress
When you perceive a threat, your brain jumps into action to prepare you to fight the threat or to run from it. This is called the fight or flight response. Your brain tells your body to get ready by:
- increasing your heart rate and blood pressure
- slowing down your digestive processes
- decreasing blood flow to your extremities and increasing it to your major muscles
- increasing production of adrenaline
- increasing production of cortisol
Cortisol is used by your body even when you are not in a stressful situation but it is called the stress hormone because of its role during times of stress. Cortisol is produced by the adrenal glands and plays a significant part in:
- making certain glucose metabolizes properly in your body
- regulating blood pressure
- releasing insulin for proper blood sugar balance
- helping your body’s immune system
- helping your body respond to inflammations
There are two types of stress we’ll discuss in the next part of this article. Acute stress (the good kind) finds cortisol performing at its best. Small increases in cortisol will:
- increase memory functions
- lower our sensitivity to pain
- provide a quick burst of increased protection to our immune system
- provide a quick burst of energy
Chronic stress (the bad kind) causes us to have too much cortisol in our bloodstream for too long a period of time. This causes impaired cognitive performance, high blood pressure, increased abdominal fat and more!
Increased abdominal fat?!? I don’t know about you, but that will certainly create even more stress for me. So let’s learn more about the types of stress in the next part of this article.
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The Two Types of Stress
Understanding the two types of stress and how our body and brain respond to them is a major step toward learning how to manage stress in your life.
Acute Stress
Acute stress is good stress. This is the body’s normal response to a perceived threat. That perceived threat can be physical, emotional or psychological and it can be real or imagined. It is your perception, what you think, that triggers what your body and mind do next.
Your body has an autonomic nervous system that is activated during times of acute stress. This is what causes the increased levels of adrenaline and cortisol and other hormones that we discussed in the article, Stress Causes Physiological Changes. You will actually experience higher blood pressure as your body redirects blood flow from your extremities to the big muscles in preparation for fight or flight..
The autonomic nervous system (ANS) is the part of the nervous system in charge of regulating involuntary vital functions such as your heart, digestive system and glands. In other words, it senses a need and automatically responds to it. Your ANS has two subsystems.
The sympathetic nervous system is the one that prepares the body for fight or flight. The parasympathetic nervous system is the other side. It is your relaxation response. Think of these two subsystems as a light switch. The sympathetic system speeds the heart rate, constricts the blood vessels, decreases digestive activity, raises blood pressure and says, “Bring it on.” The parasympathetic system says, “Turn it off.” It slows the heart rate and returns those other body functions to normal.
The parasympathetic system, when activated, relaxes your muscles. Think about that tense neck and shoulders you felt when stressed. Now we’re beginning to see the problem more clearly. For most of us, “bring it on” happens far more often than “turn it off.”
Chronic Stress
Chronic stress is defined as a state of ongoing physiological arousal due to a perceived threat. That threat is running through your nervous system flipping every light switch it can find and not turning any of them off. Those two subsystems are designed to work in harmony. Remember that famous phrase from the movie Karate Kid? “Wax on, wax off.” Well, imagine waxing your car using just one side of the equation: wax on, wax on, wax on, wax on. What would your car look like if you continued adding wax and never removed it?
That is the way chronic stress works. The two subsystems are not working in harmony. The fight or flight response is being triggered time after time after time but the relaxation response is not being activated. The perceived threat is not going away.
Once upon a time we looked at certain jobs as high pressure jobs such as those in the sales and medical professions. Today – what job is not high pressure? Is your company planning layoffs? Could your company benefits be decreased? Will your salary keep up with rising costs? Each of these questions poses a perceived threat simply because you may or may not know the answer to any of them.
The workplace, unfortunately, is not the only source of stress. If all family relationships were in perfect harmony there would be no divorce. Why is there such a thing as road rage? Well, things on the highway are not in perfect harmony either, are they? What about your love life? What love life, you say. Exactly! Loneliness is a horrible threat. And we sometimes feel alone in a crowded room. Do you have a loved one subject to military service? Do you have a loved one on the wrong side of the legal system?
Piling on generates an unnecessary roughness penalty in football. Think of chronic stress as piling on. In this case, however, the referee, our autonomic response system, falls into the pile under the weight of the ugly, nasty, very bad chronic stress.
So, it’s up to us to deal with it.
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The Effects of Stress
The effects of stress mirror how it affects our whole body. There are both physiological and mental issues associated with being stressed out.
Physical Effects of Stress
The most common physical effect of stress is a headache possibly accompanied by a stiff neck. Your whole life just seems to be wrong when you are suffering from a headache. It’s difficult to concentrate when you have a headache, and that makes it much easier for confusion to set in.
In many cases, soothing music and guided imagery can play a role equal to over-the-counter medication. More information follows about the value of music therapy and guided imagery therapy; both are therapies you can do yourself.
Stress also causes other physiological changes including increased heart rate, high blood pressure, impaired cognitive performance and increased body fat in the abdominal area. Any one of those four are reasons to seek good stress management techniques.
Of course, families dealing with brain injury go through a learning experience about impaired cognitive performance. In those cases, it’s closely tied to memory problems.
For those of you who haven’t lived with brain injury, imagine your world turning upside down and nothing today being like it was yesterday. Do you think that would cause added stress in your life? You bet it does.
Mental Effects of Stress
Confusion is both a result of stress and also contributes to more stress. You sit and stare in wonderment at your computer screen not knowing what to do next. The project you have been working on for months now looks like something you’ve never seen before.
Stress causes mental fatigue
Those of you familiar with the book, Brain Injury Survivor’s Guide, know that Chapter Six is devoted to what the author called the Cycle of Response.
You can think of the Cycle as a ladder. The first rung is mental fatigue, followed by confusion, frustration, guilt and depression. Stress, by causing mental fatigue, puts you on the first rung of the ladder and, by causing impaired cognitive performance (confusion) moves you right up to the second rung.
You’re tired, you’re not thinking straight; that certainly makes it easy to move right up the ladder to frustration.
Stop the Cycle Right Now!
When you feel yourself getting more and more frustrated, it’s time to take action and back down the ladder.
Why?
The next two rungs of the ladder, guilt and depression, will throw you into a serious funk. I recently took a health assessment for an insurance company. After answering the normal questions about allergies, diseases and family history there was a lengthy section about how I viewed life in general.
It was the insurance company’s way of finding out where I was on the ladder. In fact, several questions related to being depressed now or in the past month, six months, year, or five years.
The insurance company offers about 50 or so newsletters that I could have subscribed to: one, of course, about dealing with stress. It’s that important..
Let’s take a look at some ways we can deal with it.
Dealing with Stress
Dealing with stress is one thing we all must do. Knowing where you are on the ladder, or Cycle of Response, is a good indicator of action you need to take right now!
While there are long term solutions that will reduce stress in the future, we need to begin by looking at short term solutions.
Stress Relaxation
Do something you enjoy. Listen to music. Work on a puzzle (if you enjoy working puzzles and they don’t cause additional stress.) Have some “me time” and perhaps, even, a “me place.” Get a hobby. Learn something new. Don’t learn something because you must learn it; learn something because you want to know more about it.
Satisfy yourself
I never was a great hunter or very good at fishing, but I spent a lot of time in the woods and casting bait into water. It was “me time” in which nothing else mattered. The woods were a “me place” where I could go and get away from the world.
B and I are fortunate to live very close to several fishing holes, and we once went fishing almost every day after work. It might only be for an hour, but we “got away” from the office and everything else that happened during the day.
Some days we might stand twenty or thirty yards apart while fishing. Even though we were together, each of us was able to experience “me time.” Well, until she needed more bait on her hook!
Sex, of course, is a great way to relax. I wouldn’t recommend it at work, though. That could have the opposite effect. A set of headphones and good music would be a much better choice.
Music Enhances Stress Relaxation
The American Cancer Society states that music therapy is used in cancer treatment to help reduce the pain, anxiety and nausea caused by chemotherapy.
Other clinical trials have shown that music therapy reduces blood pressure, heart rate, depression and anxiety. In other words, music therapy does what the parasympathetic nervous system is supposed to do during the body’s normal relaxation response.
Music is magic
When B sustained her anoxic brain injury, she awoke to a new world. She did not know who I was. She did not know she was married and had children. Yet she remembered words and melodies from music that had been part of her life. She also remembered our Cocker Spaniel, and I can’t explain that.
In fact, I’m not really sure I want to know why she remembered the dog and didn’t remember me.
B was able to find comfort in music as she struggled in a new, strange world.
Judy Martin-Urban watched her daughter, Courtney, fight through her new life after suffering a traumatic brain injury in an automobile accident. Judy wrote, “I’m confident that music will take its place among medical therapies. To me, there is no doubt that music is a wonderful gift to us and has many roles in our lives. Nothing is as soothing or as freeing to the soul as music.”
There is another stress relaxation therapy we want to discuss in detail and that is Guided Imagery, the next part of this article.
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Stress Management With Guided Imagery
Guided imagery relaxation is a stress management solution used by professional counselors. Psychologist Joyce Surbeck-Harris uses a guided imagery CD in her practice. She says, “It aids my clients in deep relaxation and helps to guide them to that inner core that is so important in healing.”
Louis DiStasio agrees with Dr. Surbeck-Harris. He says, “This … is a wonderful tool for my patients who wish to relax as well as create a place in their mind where they can get away from life’s stressors. I highly recommend it to reduce stress, find a quiet place to creatively problem solve or to deepen your spiritual connection.”
What is Guided Imagery?
Think of guided imagery as daydreaming with a purpose. Rather than directing your imagination, however, you have a guide that does the work for you.
Having a guide allows you to totally relax as you listen to the soft sounds and soothing voice. Many years ago there was a huge demand for subliminal message recordings that supposedly directed subconscious thoughts in a particular direction.
Guided imagery is similar to those recordings with the exception that the message is not hidden inside the music. The public did not like the idea of subliminal anything. Subliminal advertising was outlawed. We want to know what, if anything, is going into our thoughts. Guided imagery is far more successful, and there are many testimonials to its effectiveness.
Kate from Illinois said, “This … can take you to a place where you have nothing but peace. I suffer from anxiety and really needed a tool to help me relax. I can … feel a difference instantly. I consider [the] voice and guidance to be life changing.”
Guided imagery, like music therapy, helps the parasympathetic nervous system do its job. Remember, chronic stress is due to the body jumping into fight or flight mode but not coming back into relaxation mode. Guided imagery creates a slideshow in your brain that’s like a mini-vacation at an all-inclusive Caribbean resort where the staff caters to your every need. Lying there in the warmth of the sun without a care in the world you simply relax, relax, relax.
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Long Term Stress Management
Stress management requires that we identify lifestyle changes that help reduce stress in our lives. We’ve reviewed how chronic stress can wreak havoc on both our bodies and our minds. That is not how we want to live on a daily basis.
Create a Journal
B and I have advocated the value of keeping journals to assist with memory and cognitive therapy for a long, long time. Journals hold the same value for dealing with stress.
A journal can be helpful in several ways. It provides a place for you to write down your thoughts as well as things you did during the day. After a period of time you might even notice patterns develop in your writing. You may see several different things that are causing stress as you write to relieve stress.
Knowing what is causing stress is similar to developing a Know Your Enemy strategy. When you identify a problem only then can you begin to develop things to do to overcome it. Sometimes, you just need to communicate with yourself before you can communicate with others.
You could also write simply for the pleasure of writing. You could write articles about things you know. You could write short stories. Fiction? Non-fiction? It’s up to you. Earlier I mentioned that you could learn something new; write about what you are learning.
Writing also helps you track progress you are making in your life. You develop a goal to do something and you write a little bit each day about your goal. By having it in writing you can identify different directions you may need to pursue…or not pursue.
Develop a Schedule
Yes, this is another strategy we use for living successfully with brain injury. It is a strategy that is explained in detail in the book, Brain Injury Survivor’s Guide, but it is a strategy that works equally well for long term stress management.
Develop a schedule? In today’s world?
Okay, I’m not talking about a rigid schedule like the world will end if you haven’t finished cleaning the kitchen by 8:13. This is more of a time management schedule. There are things we must do each day or week or month or year
B and I must pay sales tax to the State of Arkansas by January 20, income tax to both the federal and state government by April 15 and property tax to the county government by October 10. We put that information on a schedule to insure that it gets done on time.
On a monthly basis, we know there are bills to pay. On the schedule they go. This also makes it easy for you to determine if you’ll have extra money during the month to do something special. The trash collector comes by every Thursday so time must be allowed on Thursday mornings to prepare his gift.
Of course there are things to be done on a daily basis. This is the difficult one for me since I work at home. I sometimes get so involved in writing and web design that time flies right by and I find myself rushing to shave, shower and get cleaned up before Beth gets home from work. Yes, I admit that happens on occasion. How do I overcome it? I can schedule time when she’s getting ready for work and get ready for work, too.
Include a time for exercise. Exercise, itself, reduces stress so add it to your stress reduction schedule. I’ll say more about this later. Do you remember us talking about how increased levels of cortisol during times of chronic stress actually causes increased abdominal fat? That’s even more reason to schedule an exercise routine.
Exercise
Since you put it on your schedule, you need to do it to prevent the world from ending at 8:13 p.m. Actually, you need to find ways to add a little bit of exercise throughout the day. When you walk to the mailbox, take ten minutes and walk around the block.
Get a small dumbbell and exercise your arms while watching tv. You don’t even have to use dumbbells. Use a bottle of water. Beth and I use Wii Fit and Wii Sports for both stress relief and exercise. The people who developed the Wii put plenty of humor into the program to keep you smiling. For more information about the Wii, you can read our Squidoo lens titled Wii Fit 4 All.
The key to long term stress reduction is to make slight changes to your lifestyle that you continue to develop more fully.
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