Stress and Anxiety

I tend to write fairly often about the subjects of stress and anxiety. Why? Statistics show that about 1 in 5 of the adult population of the US are affected by an anxiety disorder each year. 31% of adults will experience an anxiety disorder sometime in their life. For adolescents the percentage is slightly higher at 32%. That would make it the #1 issue facing the mental health community.  

How is stress different from anxiety?

Stress is your response to a change in your environment, be it positive or negative. Anxiety is an emotion that’s characterized by a feeling of apprehension, nervousness, or fear.  Acute anxiety is temporary, like a roller coaster ride, and can be positive, whereas chronic anxiety is pervasive and long term and likely to cause very negative results.

Chronic stress is long-term stress, such as that caused by traumatic events or miserable living conditions. Untreated chronic stress can contribute to major depressive disorder, a form of intense depression that lasts for long periods and can prevent someone from living a normal life. Chronic stress also can contribute to physical illnesses, including high blood pressure, heart disease, depression, and obesity.

Money, work, and the economy continues to be the most cited (75%) causes of stress for Americans.

I see stress separate from distress. Whenever I visit a brand new place, particularly when it is very unfamiliar, I tend to feel stress. But I am not distressed, just excited. Distress comes when I cannot maintain a degree of control in the new environment.

Here are some truths about stress and some myth-busters.

• Stress does not cause your hair to turn grey.
• Cuddling your pet, significant other, child or listening to music lowers your stress. 
• Stress does not cause ulcers, it just makes them worse. 
• There is no link between stress and infertility. 
• According to the American Cancer Society, no definite link between stress and cancer has been found. 
• Stress can cause erectile dysfunction and loss of libido. 
• Women are twice as likely as men to be affected by generalized anxiety disorder. 
• Daily exercise greatly helps to reduce the effects of stress. 
• Anger or hostility releases stress hormones into the blood and can cause heart problems. 
• Smoking cigarettes does not reduce stress. 

Focusing on the positive (gratitude), speaking soothing words to yourself, praying and practicing deep breathing can be very helpful. The combination of medications and psychotherapy is highly effective with anxiety issues. 70-90% of people experience an improvement.  

Learn to set realistic goals for yourself at home and at work, and have good boundaries with people. If it is hard for you to say “no”, then you need to enlist some help. Prepare for change as far in advance as you can, and lower your expectations. You will likely lead a much calmer life.

Hanging On In Tough Times

Therefore since we are surrounded by such a great cloud of witnesses, let us throw off everything that hinders and the sin that so easily entangles. And let us run with perseverance the race marked out for us, fixing our eyes on Jesus, the author and perfector of our faith. Heb 12:1-2 

No one escapes tough times – rich or poor, young or old. Circumstances may be different for each of us, but whatever it is, we will be challenged by it. For some it may be finances, for others it might be health or relational difficulties. 

But whatever you face, you will likely be angry or scared or hurt or frustrated. Perhaps you will feel all of these emotions.

Many years ago Nan & I hit a relational wall. We were emotionally disconnected, living nearly separate lives. Both of us wondered if this was the end of our marriage. We both felt lonely and misunderstood. Would we end up another ugly marital statistic? Fortunately Nan dragged me to counseling (kicking and screaming I might add) and things eventually got better – after they got worse for a while. We came out much stronger – and I came out a saved believer in Christ.

What did I learn from those hard times?

• Face the problem. It does no good to pretend that it doesn't exist. You may not have a solution at the moment, but it is unlikely to go away if you ignore it. Sometimes it takes me a while to break denial, but experience tells us that procrastination usually makes things worse.

• Brainstorm. There might be little you can do, but throw around a lot of ideas. It will give you a feeling of some kind of control. You won’t feel quite as hopeless. Then take any reasonable action you can. Keep searching for options even when you don’t feel like it.

• Manage your emotions. In the midst of difficulties you may feel like lashing out and blaming others or even God. Or you might want to turn it inwards and take a downward spiral into depression. You may need a moment to control your reactivity. Do your best not to feed your brain anxious and negative thoughts. Instead practice self-soothing.  

• Don’t compound the problem. Resist the urge to medicate the pain with substances or behaviors that will only make the problem worse.    

• Share your struggle with safe people. We need to let others come alongside our burdens. This is particularly important if your tendency is to withdraw. If married, make sure you stick to same sex friends or a trusted counselor. You don’t want to make it worse with an emotional entanglement.

• Pray – don’t deny the power of God. There is a tendency to rely only on the tangible when we are in the midst of something difficult. We can end up feeling hopeless when we run out of steam. If we remember to pray first, not last, it could make a big difference in our approach and sense of balance.  

We have a lot of empathy for people going through hard times. That’s why we counsel.  

Mind Clutter

I came across this passage in “Here and Now” by Henri Nouwen (yes, I am temporarily addicted to Nouwen).

“Whether we ask for it or not… we simply cannot go far without being engulfed by words and images forcibly intruding themselves into our minds. But do we really want our mind to become the garbage can of the world? Do we want our mind to be filled with things that confuse us, excite us, depress us, arouse us, repulse us or attract us whether we think it is good for us or not?

That leaves me considering what power I have over those things. Certainly I cannot avoid the world. But I do have a certain amount of control over my world. All my electronic devices have off as well as on buttons. (Some of you are saying to yourself “I never knew that.”)

I have noticed that the unrestrained input of news on a daily basis tends to make me depressed and cynical. It is also quite addictive. I often find myself punching buttons on the car radio out of habit, even when it is turned off! When I reach this stage I know that it is time for a fast from news media and talk radio, etc.

How about the other media in our lives: movies, television, books, music, etc? Do we choose wisely or do we feed ourselves things that are of questionable worth – or that compromises our values? Do we hide some of those things from a spouse or friends? Do we have the willpower to discontinue reading or viewing something when we find it objectionable? Have you ever walked out on a movie for that reason?

Do you intentionally feed your mind good things? I try to always have at least a couple of really good books nearby. I don’t want to make it hard on myself to make positive choices. I am always tempted to snack on junk food for the mind.

Do you have a belief that everything is worth knowing? Or are you afraid off missing out on something important? Does this lead you to collect massive amounts of mind clutter? Once something is stored, it may become difficult or even impossible to discard. Think of violent or pornographic images both visual and written.

Perhaps we need to hit a reset button on some of our acquired habits and rethink what we want to allow into our head and heart.

Philippians 4:8 And now, dear brothers and sisters, one final thing. Fix your thoughts on what is true, and honorable, and right, and pure, and lovely, and admirable. Think about things that are excellent and worthy of praise.

Reducing Stress

No one contests that we live in stressful times. When we talk about “the news”, it’s almost always about bad news. When we talk about finances, it’s usually not about a “windfall” we have received. When the subject of jobs or parenting or close relationships comes up, it frequently is about the difficulties in maintaining a good attitude in the midst of the struggles. All of this produces stress, or more accurately, distress.

So much of what challenges us cannot be eliminated, but sometimes its toxic effects on our emotions can be reduced. The secret is to control what is in our power to control, and to release the rest to God in prayer. Wisdom lets us know what is controllable and what is not.

One powerful tool is developing protective filters.

I can decide what enters my consciousness to a great degree by intentionally limiting the input of stressful data that I have little or no control over. I have the ability to choose what I want to read, watch, and listen to on a regular basis. I can control the telephone; I don’t have to let it control me. I can regulate the noise level in my environment whenever possible. I can manage my time commitments by learning to say “no”. I can intentionally feed myself uplifting media and positive self-talk.

The second powerful tool is using relaxation exercises. The following is borrowed from Dr. Siang-Yang Tan.

Four Muscle Group Relaxation Exercise (Tan)

This relaxation technique involves the alternate tensing and then relaxing or letting go of various muscle parts of your body. First, sit in a comfortable chair or recliner, in a room and at a time when you will not be disturbed. Give yourself at least 15-20 minutes of uninterrupted “relaxation time” to practice the relaxation exercises, beginning with the leg muscles and ending with the arm muscles. It helps to close your eyes.

            Leg muscles. You can tense your thigh and calf muscles by pointing you toes toward you face and tensing these muscles hard. Hold the tension for 7-10 seconds by counting slowly up to 5. Then let go and allow the muscles to go limp. Now use self-talk: tell yourself to “just relax, let go of all the tension….allow the muscles to smooth out….take it easy….just unwind and relax more and more….” Continue with this relaxation patter for 20 seconds or so before proceeding to repeat this exercise. Do this exercise a total of 4 times. Then proceed to the next one.

            Upper-body muscles. After completing the exercise for the leg muscles, focus your attention on the muscles of your upper body --- your chest, stomach, shoulders, and back. Tense them by taking in a a slow, deep breath, holding it for a count up to 5 (about 7-10 seconds), pulling your stomach in, and arching your back (unless you have a back injury or back pain, in which case you should not arch your back). When you reach a count of 5, slowly exhale and let go of all the muscle tension, again telling yourself mentally to relax and take it easy, using the relaxations patter or self-talk for about 20 seconds or so before repeating the exercise. Do it a total of 4 times.

            Face and neck muscles. Focus your attention on the muscles of your face and neck regions. Tense these muscles by closing your eyes tightly, biting you teeth, smiling back, pushing your chin down as if to touch your chest, but not allowing it to touch your chest. Hold the tension for a count up to 5 (7-10 seconds), and then relax and let go of these muscles, again using the relaxation patter for up to 20 seconds or so. Repeat this exercise for a total of 4 times before proceeding to the final exercise.

            Arm muscles. Now focus your attention on the muscles of your arms. Tense them by clenching your fists and flexing you biceps…..Hold the tension for a count up to 5 (7-10 seconds), and then relax and let your arms flop down limp by your sides. Again, engage in the relaxation patter for 20 seconds or so before repeating the exercise, doing it a total of 4 times.

            At the end you should give yourself a couple more minutes to just sit quietly and enjoy the feelings of deeper and more complete muscle relaxation that you are experiencing by this time. Then, count from 1 to 5 as you slowly move your muscles, and eventually open your eyes at the count of 5, feeling very relaxed and refreshed.

            In addition, if you wish, once your have done the above exercise you can remain seated quietly, eyes closed, and then breathe through your nose and then say a word such as “peace” or “shhhhhhh” (as in quiet) as you slowly exhale through your mouth while envisioning a beautiful safe place. Maintain a quiet and passive attitude throughout for a total time of about twenty minutes, even if you have distracting thoughts at times.

Try this exercise and let me know how it worked for you.

     

When Life Overwhelms

Have you ever felt like your life was a confluence of negative events with murky outcomes? I know I have at times. People often joke that bad stuff happens in threes and so it’s wise to be prepared for the worst. In reality there are times when I would welcome only three stressors to deal with at once.

Here is what I have learned.

I am still standing even though there have been times when I wondered how I would get through something.

Often I feel more powerless than I really am. In the midst of what may feel like a crisis, my emotions may tend to get the better of me. Depending on my temperament, I may either rush to action, or shut down and freeze. The solution is to calm myself down and take a little time to think things through and then take some action. Sometimes the best first action is to contact someone I trust to help me process my thoughts.

If I look at things one at a time and deal with them individually I will feel less overwhelmed.

If I let my anxious thoughts overtake me by grouping all my stressors into one big cloud of worry I am less likely to see my options. Why? The solutions to the individual problems will often need different actions. Money will only solve money problems. Reconciliation will only solve relationship issues. You get the point.

Sometimes prayer is the best and only thing I can do at the moment.

Prayer should be an ongoing action. Once I have done whatever is possible to do I must continue to surrender to God in prayer. If my child has been hospitalized and I am waiting for an outcome, I have done all I can do in the natural world. Now it is time to enter more deeply into the supernatural and pray for the power of God to intervene.

We must remember that we are not alone. As hard as it can be, we must remember to trust.

Ps 46:1 God is our refuge and strength, an ever-present help in trouble.

Matt 11:28 “Come to me, all you who are weary and burdened, and I will give you rest.” Jesus

Hurry Sickness

A while ago we were hanging out with my father-in­­­­­-law waiting for something (I can’t remember what it was), but he seemed agitated. Nan asked him if he was in a hurry. On reflecting about it for a second he answered:

“No, I’m not really in a hurry, I’m just impatient.”

It has become one of those answers that we both remember when we approach things throughout the day.

How often do we find ourselves rushing around as if we are being chased by some unknown force? Where does the feeling come from? Is it real?

For some it may simply be habit, perhaps a habit instilled by parents early in our development. How many times as a child were you encouraged to hurry up, when enjoying the wonders of discovery? Or perhaps you were often perceived as “idling” during a task and were yelled at.

We can have this sense of needing to hurry because we “might miss out on something” and yet to hurry is to miss out on something: the joy in the journey, the blessing of “now”. This anxious feeling is the very thing that makes it hard for me to pray, to study, to reflect, to think deeper thoughts than just my daily tasks.

Solutions for deeply ingrained behaviors are difficult. They require discipline, which requires intentionality (a favorite concept of mine in many areas of life).

Often we are not in hurry because we are impatient by temperament, but because we are overcommitted. It is much easier to say “no” to the distasteful things in life than it is the desirable ones. But it is often the good things that must fall away to leave room to really enjoy the best. If I try to include everything, I will often find myself not fully present when engaged in the things I truly love, with the people I care about the most.

I have read recently that anxiety is rising in very young children because of the pressure being put on kids to participate and succeed in an ever-increasing amount of extracurricular activities. In an attempt to give their children an “advantage or head start” in life, they are really crippling them emotionally – and perhaps stressing the family out financially as well. The distress felt by kids to achieve academically to please their parents is, in some cases, related to teen suicide.   

When I become aware of feelings of hurry whether as a result of a state of mind or circumstances, I practice my self-soothing technique. I take the thoughts captive and slow myself down, both mentally and physically. Especially when I am actually pressed, I need to tell myself that I have enough time to accomplish my task.

Is this an area you need to work on in your private life or as a parent?

Thoughts or comments?

Clutter

Whenever I begin to feel overwhelmed in my work life, the first thing I do is organize my desk. I don’t know about you, but when my mental world is in disarray, I try to control my physical one. I can usually do this in a few minutes and it somehow settles my inner world.

For some people this is not an easy task. Their physical space is so cluttered that the thought of bringing order to it causes them to feel significant stress, even panic. For some, this inability to control their environment is an expression of their internal chaos. For others it is the result of a shopping and spending addiction. For still others it is the failure to hold boundaries with kids.

Out of control clutter is such a pervasive problem that there are Clutterers Anonymous groups all over the country. When cluttering is excessive or turns into hoarding it is usually considered a symptom of OCD (obsessive compulsive disorder) and must be dealt with clinically.

Clutterers Anonymous describes clutter as both physical and emotional:

“Clutter is anything we don't need, want, or use that takes our time, energy or space, and destroys our serenity. It can be outgrown clothes, obsolete papers, broken toys, disliked gifts, meaningless activity, ancient resentments, or unsatisfying relationships. We may be selective in some areas, but not in others. Objects may be strewn about or wedged into drawers; neatly stacked or stowed in storage.” 

I have seen marriage and dating relationships break apart because of this issue. One partner cannot control this aspect of their life and the other cannot agree to live (or continue to live) in the chaos. Often there is deep shame for the sufferer and a lot of blaming going on. The cluttering can be labeled as an aspect of moral failure due to laziness or selfishness when in reality it may be a serious anxiety disorder. What is inescapable is the pain that it can cause when out of control.

If you are in doubt whether you qualify, Clutterers Anonymous has a handy self-assessment. It might make you uncomfortable or it might bring you peaceful relief, but either way it is a worthwhile check-up.  

http://clutterersanonymous.org/am-i-a-clutterer/

Sometimes de-cluttering is simply an act of the will, an intentionality to create serenity within one’s own environment. I can either surround myself with beauty and meaning or I can allow my world to be encroached upon by a random process (junk mail, unwanted gifts, un-thoughtful purchases, lack of self-discipline etc.)

We live in a culture of materialistic and experiential excesses. It is no surprise that this area is a challenge for so many people.  My goal is to live in freedom, and that often means living in a very counter-cultural fashion. It is a constant but worthy struggle.

Hebrews 12:1 Therefore, since we are surrounded by such a huge crowd of witnesses to the life of faith, let us strip off every weight that slows us down, especially the sin that so easily trips us up. And let us run with endurance the race God has set before us.

MARGIN - do you have it?

I love my job at C.A. (so does Nan). It is what I believe God designed me to do. It is challenging and satisfying and I love the people I work with. So when I feel myself pulling back from it or getting irritable, I know something is wrong.

A few years back Nan & I invited Dr. Richard Swenson to speak at Christian Assembly. He is the author of a book entitled “Margin: Restoring Emotional, Physical, Financial, and Time Reserves to Overloaded Lives.”  This concept of ‘margin’ struck a loud chord in my soul and it has been a theme I have been talking about (and paying attention to) ever since.

Margin is the space between your load and your limit.

If you have $3000 (limit) coming in and $2700 (load) going out, you have a margin of $300. You can relax in the area of finances. But if you spend or commit the $300, you have no margin. Any expense you incur after that throws you into a deficit position and you are in financial pain. Your load has just exceeded your limit. It is always sad to see someone who is so burdened by debt that their options have been virtually eliminated. It is doubly painful when they are the perpetrator of their own financial imprisonment.  

The same thing applies to time. When I am fully or over committed and have left insufficient time for rest or recreation I can begin to resent even the positive things in my life. Any new opportunity seems like a burden instead of a possibility.

In the same way we can run down our health by overeating (or eating junk food), under-exercising, under-sleeping. We use up our reserves and fuel ourselves with coffee and adrenaline and our body suffers.

I often see couples stress each other out with emotional baggage to the point that all the grace is used up. At times I have heard someone in counseling declare “I have reached my limit. NO MORE!” At this point the relationship is in real trouble and there is no margin for future error. Any new stressor may result in the total breakdown or breakup of the relationship.

So how are you doing in those areas in your life? Where do you lack margin?

The solution is to take positive control over your own life. Learning to say ‘no’ to yourself and others may be a challenge. It’s never easy to turn down fun opportunities, or resist spending money or take the extra energy to prepare a healthy meal. But the reward of margin will far outweigh the effort. It will allow you to be able to say ‘yes’ to really significant things as they present themselves. And you will experience joy in doing them instead of pain.

Wrap your mind around the concept of margin and reap the harvest.

People Pleasers

The nicest clients I work with are from the group we call “people pleasers”. They often seek counseling readily, and are very faithful at attending and doing the “homework” that is assigned (after all, they also want to please me, the counselor).

But lasting change for people pleasers is often more difficult. There are many voices in their lives calling out to them to satisfy relational demands – and it becomes hard deciding which voice to heed, especially when there are competing requests.

People pleasers are “feelers” and making balanced decisions becomes a challenge. “Do I lean in the direction of my head or my heart”? Feelers usually lean towards the heart. “Do I honor myself or honor others?” People pleasers usually sacrifice themselves first.

Unfortunately people pleasers make good victims. They often believe the best in others, and as a result others may take advantage of their good nature and willingness to serve. In the extreme they can end up abused employees, wives, husbands and volunteers.

How would you rate yourself as a people pleaser? Ask these questions.

• “Can I say ‘no’ when I need to?”

• “Do I feel guilty holding boundaries even when I know I am right?”

• “Am I afraid that people won’t like me if I don’t agree with them?”

• “Do I do things for other people that I know they can and need to do for themselves?”

• “Do I think of myself as a ‘rescuer’ and like to take on people as projects?”

There are many more similar questions you could ask yourself, but you get the gist.

We, as believers, are called to serve one another, but people pleasers often find themselves the only one serving (one-way relationships) or resistant to allowing other people to serve them.

If you are a people pleaser, you will have to learn to go against your feelings and endure the anxiety that will surely follow. It can be a slow process and you may need help. But the result is that you will not ‘burn out’ early and will develop true friendships that are based on mutual care. Those are the relationships that are both deeply satisfying and lasting.

     

Crisis or Chronic?

It is very typical for someone to come to counseling when in a crisis situation. That is the time when a person has the most ‘felt need’ to seek some relief from pain or fear or loss.
But the other condition under which people will seek help is when stuck in a chronic situation.

A crisis is defined as: a dramatic emotional or circumstantial upheaval in a person's life. It usually has the condition of being immediate and time limited.

On the other hand a chronic condition is defined as: continuing a long time or recurring frequently.

Both of these situations have the potential to cause great pain in a person’s life. And both of them have an additional risk of generating feelings of hopelessness.

When a crisis is not handled well it could turn into a chronic situation. This might occur if we do not face a situation head on, and allow it to get worse over time. That is why it is important to grieve losses, and to refrain from burying feelings, except as a temporary protection until we have enough strength to process the loss.

We can even have both conditions present at the same time, when a chronic condition erupts into periodic crises. For example, I can be chronically late, but when I miss an essential airline flight it might become a crisis.

• Not all crises turn into losses, but all crises generate anxiety and fear and can cause secondary problems. In a relationship a secondary problem might be having to deal with the hurt feelings I caused because I got angry and impatient in my anxiety. In my personal life I might deal with a particular crisis by throwing money at it, only to have to face the resulting financial stress when the bills become due.

• Of the two situations, a chronic situation is usually much more difficult to deal with. Behavior patterns may have become deeply embedded  Anger may have had plenty of time to develop into hardened resentment. Hopelessness may have raised its ugly head, obscuring our belief in the promises and comfort of God. And above all it might require a great deal more time and effort to break free of its grip.

We sometimes have the ability to hold off or prepare for a crisis – but more often we have the opportunity to avoid chronic problems by dealing with them as they come and before they become large.

Just something to think about.