About

Let’s talk about the four basic kinds of stress.

• Acute stress has to do with the way you respond to individual situations or events. For example, getting a call from your child’s school telling you he’s being expelled, hitting every red light on your way to work, finding out you’re going to be audited by the IRS, or a huge project that’s due at the end of the week. With acute stress, you almost always know exactly what the cause is. And because the situation is usually resolved within a day or two, there isn’t enough time to do any long term damage. Still, acute stress can cause headaches, irritability, anxiety, pain in the jaw, back, or neck, adult acne, and some short-term stomach problems such as irritable bowels, diarrhea, and heartburn.

• Ongoing acute stress is similar to acute stress, except that the situation or event that’s causing the stress doesn’t end. What we’re talking about here is that pile of work that you’re never quite able to dig your way out from under, always being in a hurry but never managing to get anywhere on time, your inability to say “No” to people and then getting angry that you didn’t stand up for yourself, or the feeling you can’t seem to shake that something terrible is about to happen. People who have ongoing acute stress can seem nervous, and are often perceived as rude, short-tempered, tense, or abrupt. Physically, they can suffer from an increase in blood pressure and pulse, sweatiness, dizziness, headaches, chest pain, and difficulty taking a full breath.

• Chronic stress is like ongoing acute stress except on an even larger scale. Chronic stress can be caused by poverty, being trapped in an unhappy marriage, a job you hate but can’t quit because your family needs the money, or a chronic illness. It’s pretty hard not to notice acute stress, but chronic stress can become so much a part of your day-to-day life that it’s easy to ignore it and resign yourself to never finding a way out of your current situation. But ignored or not, chronic stress wears you down every day of your life and may cause many serious long-term physical and emotional health problems, including heart attack, stroke, violence towards others, and even suicide.

• Post-traumatic stress is the fallout from a terrifying or catastrophic event in your life, usually something where you, or someone close to you, were in danger of being seriously hurt or killed. It could be a car crash, being a witness or the victim of a violent crime, serving in combat, or living through a natural disaster such as a hurricane or earthquake. Many people who experience traumas recover quickly and get back to their normal lives. But not everyone. Some develop Post-Traumatic Stress Disorder (PTSD). They may re-live the event over and over, in nightmares at night and scary thoughts during the day. They may go to extraordinary lengths to avoid any reminder (people, places, smells, etc.) of the event. They may also develop symptoms of any or all of the other types of stress discussed above. Those symptoms, if they occur, usually appear around three months after the event, although it could be as much as a year or longer.

WHAT CAUSES STRESS?

Stress is your brain’s and body’s reaction to a situation you can’t (or don’t think you can) cope with. Acute or chronic stress can be caused by a lot of things, but we can divide them into three categories: at home, at work, and everywhere else. (Post-traumatic stress has other causes, which we’ll discuss below.) Let’s take a look at each group in detail.

Sources of stress at home:

• Death of your spouse or life partner
• Death of a close relative or friend
• Divorce, separation, or breaking up a long-term relationship
• A tense, rocky, or hostile relationship with your spouse
• Frequent heated arguments with other family members or neighbors Injury or illness—yours or anyone else’s close to you
• Money trouble—due to the loss of a job, high debts, home foreclosure, not having enough to meet your monthly expenses, or simply not having enough money to do the things you want to do
• Marriage—yours or the marriage of a close relative
• Pregnancy or the birth of a new baby (while this is usually a time of great joy, the increased responsibilities and pressures that go along with being a dad can be very stressful)
• Your children’s behavior at school or at home–or their grades.
• Moving to a new home—even if it’s in the same city.
• The slow build-up over time of many negative life events.

Sources of stress at work:

• Losing your job or having been unemployed for a long time
• A new job
• Your relationship with your coworkers
• Your relationship with your boss
• Trouble managing or training those under you
• The workplace atmosphere
• Whether you have a good friend at work
• The amount of pressure you’re under—deadlines, sales quotas, “making your numbers”
• How many hours you work—not enough or being forced to work overtime, weekends, or holidays
• Feeling unappreciated or not valued by your employer or boss
• Being passed over for a promotion or pay raise

Sources of stress everywhere else:

• Abusing drugs or alcohol
• Your overall environment—the size of your home or apartment, the neighborhood you live in, traffic, availability of public transportation, air or noise pollution, distance from parks and other recreation
• Fears about safety—your safety and the safety of those close to you
• Your mental health—depression and anxiety can cause and be caused by stress
• Feeling helpless
• Negative thinking—questioning your own judgment, feeling that you’re going crazy or are about to snap, considering yourself a failure, criticizing yourself for your perceived shortcomings
• Having unrealistic goals
• Loneliness or not feeling you’re important or a part of anything
• Trouble making friends or maintaining friendships
• A fight with a friend
• Worries about the political situation
• Poverty
• Feeling that you don’t have a support system, people to whom you can turn if you need help

Sources of post-traumatic stress:

PTSD has more extreme causes, usually a very disturbing or frightening experience such as:

• Surviving a serious accident—car or plane crash, boating accident, fire
• Surviving a natural disaster—hurricane, earthquake, tsunami
• Surviving a terrorist attack
• An event where you thought you were going to die
• Shooting or being shot at in combat
• Surviving a violent crime—mugging, assault, rape
• Sustaining a particularly sudden and devastating injury—an industrial accident, a severe shark bite, losing a limb
• Having seen any of the above happen to someone else
• Serving in a high-risk civilian occupation

FYI

Stress affects both the mind & body, and impacts overall health & well-being.

Unmanaged stress can increase the risk of conditions such as infection, illness, diabetes, obesity, and heart disease,  as well as depression and anxiety.

Symptoms

Stress can cause a huge variety of physical, emotional, and behavioral symptoms. When you’re dealing with acute, ongoing acute stress or the early stages of post-traumatic stress, you may experience one or more minor symptoms such as:

• Headaches
• Stomach trouble, nausea, indigestion, constipation, or diarrhea
• Shortness of breath
• Sleep issues—either too little or too much

But if you develop chronic stress or don’t get treatment for your post-traumatic stress, the symptoms may get progressively worse. These may include:

 Physical Symptoms:

• Chest pain or tightness
• Unintended weight loss or gain
• Aches and pains that seem to have no particular cause
• Acne and other skin problems
• Hair loss
• Loss of interest in sex
• Excessive sweating
• High blood pressure
• Heart disease
• Stroke
• Ulcers
• Diabetes
• Reduced immunity, which can result in infections and can aggravate conditions such as herpes, AIDS, and HIV
• Over reaction of your immune system, which can lead to asthma and psoriasis, or auto-immune conditions like rheumatoid arthritis and lupus.

Emotional Symptoms:

• Mood swings
• Feelings of anxiety, depression, or extreme frustration
• Feelings of apathy
• Nervousness
• Feelings or guilt, shame, or of being helpless or out of control
• Poor self-esteem or a lack of confidence
• Feelings of failure
• Constantly second guessing yourself and questioning your own judgment
• Eating disorders

Behavioral Symptoms:

• Irritability or outbursts of anger
• Maladaptive behavior, such as drinking too much, smoking, eating unhealthy food, and not getting enough exercise
• Inability to concentrate
• Memory lapses, forgetfulness, or short-term memory loss
• Problems with relationships
• Poor performance at work
• Inability to manage time effectively
• Overreacting to minor irritants

If you have PTSD, your long-term symptoms may also include:

• Anti social behavior. You may feel that you can’t trust other people, which could lead you to withdraw from friends or family, or cause relationship problems at home, school, or work.
• Intrusive symptoms, such as flashbacks and nightmares. These are often so vivid that it may feel like you’re going through the trauma again. You may feel as scared as you were when it actually happened. Instead of (or in addition to) flashbacks and nightmares, you may suddenly feel a wave of fear, panic, anger, or crying that comes completely out of the blue.

Avoidance of activities and situations that remind you of the event or that you worry might remind you or trigger a flashback. For example, if you served in combat, you would probably try to stay away from any place where there might be loud noises.

• A constant agitated state, which may include elevated blood pressure, muscle tension, difficulty falling or staying asleep, irritability, outbursts of anger, sweating, and being easily startled.
• Emotional numbness. In an attempt to avoid remembering or reliving the event, people with PTSD often shut down their emotions—the good ones as well as the bad ones.
• High—and gradually increasing—risk of committing suicide.
• Having other mental health issues.

About 80% of people with PTSD also suffer from depression and/or anxiety.  Although men and women both suffer from stress, we have very different ways of coping with it. Women generally do what mental health professionals call “tend and befriend,” meaning that they reach out to others around them, look for friends and family to lean on, and talk about what’s bothering them. Men, on the other hand, have a tendency to cope with stress in pretty much the same way as we cope with other problems. We bottle it up and refuse to talk about it; we escape, either by trying to get away physically or by denying to ourselves and everyone else that there’s a problem at all; we try to cover it up, often with illegal drugs or alcohol; or we get angry and aggressive.

As you’ve probably guessed, none of those approaches is particularly effective. In fact, they almost guarantee that the physical and emotional symptoms will get worse. Unfortunately, when that happens, most guys don’t take the hint and get help. Instead, they keep on ignoring their symptoms until a crisis—like severe chest pains —happens, and they add “worrying about my health” to the list of things that cause stress.

ARE YOU OVER-STRESSED?

Whether stress is good or bad depends on the situation and the people involved. For example, some of us love speaking in front of crowds, others cannot stand to do so. Some love the adrenaline rush that comes with riding in the front car of a roller coaster or jumping out of a plane, while for others, the mere thought of either one of those activities is enough to send their pulse through the roof. For some guys, two weeks on the beaches in Hawaii would be wonderfully relaxing. But for someone who can’t really afford to take the time off, or who’s worried about how much work he’ll find piled on his desk when he gets back to the office, every day of that “vacation” will be incredibly stressful.

With that in mind, read through the following statements and take note of how many apply to you:

• I recently got married, divorced, or separated
• I was recently injured or have been sick
• I’m having major financial problems, such as bankruptcy or a home being foreclosed
• I work more than 10 hours per day
• I was recently fired from my job
• I hate my job or some of the people I work with or for
• I haven’t had a vacation in three years or longer
• My partner is pregnant
• I always seem to be coming down with a cold or other illness
• A close friend or relative is ill
• I’ve got a child who’s leaving home for college
• My family recently moved to a new home
• I get less than six hours of sleep every night
• I’ve been getting into more and more arguments with my spouse, friends, or coworkers
• I hardly have any time to myself to read, exercise, or just relax
• It’s been a long, long time since I did something just for fun
• I’m always in a hurry but never manage to get anywhere on time
• I drink more than three caffeinated drinks every day
• I have trouble falling asleep, staying asleep, or think I have insomnia
• I don’t have any close friends or relatives I can turn to for emotional support
• I recently experienced or witnessed an event where I felt incredibly afraid or helpless
• At night I have nightmares about the event. During the day, memories keep popping into my head and I feel as though I’m reliving it over and over again
• I get very upset by anything that reminds me of what happened (my heart pounds, my muscles tense, I start to sweat or feel nauseated)
• I go to extreme lengths to avoid activities, places, or people who remind me of what happened
• I have a tough time trusting other people or allowing myself to feel close to anyone

Chances are, at least 5 or 6 of the above statements are true for you. And that’s no surprise. Stress is so widespread that many mental health professionals consider it to be America’s biggest health problem. The American Institute for Stress estimates that 75-90% of all visits to primary care healthcare providers are for stress-related issues.

Prevention

Eliminating stress from your life is not possible. What you can do, however, is pay close attention to the things that cause us stress and develop some healthy ways to cope. As with depression and anxiety, symptoms are only a problem when they affect you negatively or interfere with your enjoyment of life. If they do, do not ignore your symptoms. Untreated, your stress levels will get worse and can endanger your physical and mental health and your relationships with family, friends, and others.

Try to reducing the stress in your life. If you’re suffering from acute or ongoing acute stress, these activities may reduce—or eliminate—your symptoms. If you believe that you have chronic stress or PTSD, these activities will help, but we strongly suggest that you also see your primary care health care provider. Chronic stress and PTSD are extremely difficult to manage without medical intervention.

• Exercise. While any kind of exercise is good, aerobic exercise—say 20-30 minutes three or four times per week—is especially good. Studies have shown that aerobic exercise can reduce your stress by as much as 50%.
• Relax. Try to get some downtime every day, even if it’s only 10 or 15 minutes. Take walks, meditate, listen to music, or just sit and read. Biofeedback, massage, and acupuncture are also helpful.
• Eat healthy and take your vitamins. Getting good nutrition is key to managing your physical and mental health. In addition, some research shows that stress causes the body to use B and C vitamins too quickly. Taking supplements (with your healthcare provider’s approval) may help you cope better.
• Have some fun. Play a game, go to a movie, or do anything else that’s low on stress and high on enjoyment.
• Breathe. Sit or lie down in a comfortable place. Close your eyes and focus on your breathing, making your belly—not your chest—rise and fall. In, out, in, out. Inhale for five seconds, hold for one, exhale for five, hold for one, and so on.
• Rest. Try to get at least 6—and not more than 8—hours of sleep every night.
• Watch the caffeine. If you’re drinking more than three cups of coffee, tea, or other caffeinated drinks (like Coke or Red Bull), cut back. But don’t do it suddenly, otherwise you may get nasty caffeine withdrawal headaches.
• Quit smoking. Of course you already know that, but it’s hard to do on your own—especially if you’re depressed. If you’re having trouble quitting by yourself, or if you’ve quit and gone back to smoking, talk to your healthcare provider about whether you could benefit from one of the prescription medicines that help people get and stay off cigarettes.
• Don’t self-medicate. Abusing legal or prescription drugs and having more than seven drinks of alcohol per week will do you far more harm than good by damaging your health and raising your stress levels.
• Try not to worry about things you can’t control. Like the weather or someone else’s driving habits. Spend less time looking backwards at shoulda, woulda, coulda. What’s past is past and there’s nothing you can do about it now. Instead, spend time looking forward, at what you’re going to do in the future to make life more enjoyable.
• Talk. Having an ally, someone who’s got your back, is extremely important for your overall mental health and can greatly reduce your stress levels.
• Don’t compare yourself to others. Different people can—and do—respond differently to the exact same circumstances. This is especially true with PTSD: what one person finds traumatic might not faze the guy standing right next to him. It’s important to keep in mind that having PTSD or any other stress condition is not a reflection on your worth as a man. The real measure of your strength is whether you have the courage to ask for help when you need it.

Questions to Ask Your Health Care Provider

It’s important that you become a proactive partner in your healthcare in order for you to get the best treatment. Here are some questions you can ask your healthcare provider about stress.

• What’s the cause of my stress and how severe it is?
• What are the symptoms associated with this disorder?
• Are there other health conditions that could be causing or worsening my stress?
• What steps do you recommend that I take to better manage my stress and why?
• Should I see a psychiatrist, psychologist or other mental health provider?
• Would medication help? If so, is there a generic alternative to the medicine you’re prescribing?
• Do you have any printed material that I can take home?
• What local support groups do you recommend?

Treatments

If you’re suffering from stress or PTSD, and you’re afraid you’re going to snap or burn out, you must get help. The first thing your healthcare provider will do is try to rule out any of medical conditions that, as with depression and anxiety, can cause symptoms that look a lot like stress.

Here are some ways you healthcare provider may treat your stress:

• Medication
• Psychotherapy, either individual or group
• A combination of therapy and drugs.

FAMILY AND FRIENDS: HOW YOU CAN HELP

If you think your loved one is suffering from severe stress or PTSD and isn’t taking active steps to seek out treatment, he needs you. The most important thing you can do is to be understanding and supportive. Talk with him about what he’s feeling and remind him that stress—even PTSD—is treatable and doesn’t mean he’s weak or flawed in any way. Encourage him to go out for a walk with you, or suggest low-stress, just-plain-fun activities. Helping him keep his expectations and goals reasonable can be a huge help.

If you feel that your loved one needs more than you can provide, help him get what he needs. This may mean that you’ll have to take the initiative and make medical appointments for him, and take him there if he’s unwilling or unable to do it himself. Most important, be patient. Recovering from stress will take some time. And when it comes to PTSD, there is no quick cure. But the condition can be effectively managed and symptoms greatly reduced. Finally, be sure to take care of yourself. Your man’s stress can spill over into the lives of everyone around him. Caring for another person requires love, commitment, and patience. And you can’t possibly take care of someone else if doing so is stressing you out.

Resources

To find out more about stress visit the following:

Medline Plus
National Institutes of Mental Health
The American Institutes of Stress
Men’s Health Network