MANAGING STRESS IN OUR LIVES

Entries in coping (3)

Friday
Mar032017

WHEN ARE PHYSICAL SYMPTOMS SIGNS OF ANXIETY?

It is clear that stress can lead to many types of physical symptoms. It seems that some of the physical symptoms we have are related to past physical symptoms we had that did not appear to be caused by stress. I wonder if the brain thinks that a new situation that we react to in a similar way as our reaction to the original physical symptom, requires the same type of symptom to help us to cope. This may be what happens when people have "pseudoseizures" as these look like actual seizures but there is no evidence of electrical disturbances in the brain that characterize actual seizures.  On the other hand, there is a strong correlation between pseudoseizures and actual seizures as if the actual seizures may have been the model for the pseudoseizures. Then there are physical symptoms that seem related to the impact of chronic stress.  Dr. Sapolsky at Stanford University, in a lecture series from "The Great Courses" entitled "Stress and Your Body," reports that chronic stress can lead to chest pain [heart muscle lack of oxygen], headaches from high blood pressure, obesity, abdominal pain or bloating, acid reflux, difficulty getting pregnant, increased miscarriages, low libido, etc. Some of these symptoms may be caused by actual neuronal cell death that is caused by the repeated stress reactions.

Importantly, even intermittant but repeated experiences of stress can lead to the same type of symptoms. This intermittant stress may represent what happens with PTSD, when past stresses are repeatedly recalled. It takes our brains longer and longer to recover from our brain's response to stress, thus becoming like a constant stress reaction. Apparently our lives are not supposed to be made up of frequent stresses, as our brains have trouble managing these. 

There are a number of physical symptoms related to stress that are familiar to us from our own experiences.  These include: gatrointestinal [GI] symptoms such as pain, cramping and diarrhea; neck pain and pain in the occipital [back of the head] area of the head; and pain in muscles as stress can cause us to tense muscles for extended periods. Stress can also lead to changes in women's menstrual cycles including stopping them. 

I wonder if these physical symptoms are ways that our brain's are helping us cope with the stress even if these symptoms are uncomfortable. What do you think?


Friday
Mar012013

PROCRASTINATION AND ADHD

There are a number of reasons that any person might have difficulty concentrating or focusing.  I have had young adults in their 20's come to me convinced that they have Alzheimer's [Dementia] because they can't remember to do things even after a short amount of time.  Inevitably, they are experiencing stress and their brains automatically devote brain activity [and energy] to trying to understand and reduce the stress. The things that the person is trying to remember are not a high priority for their brain and so it is not remembered.  Once the stress is reduced or eliminated, the person's concentration [and memory] returns. People who are depressed also will not concentrate well, likely for the same reason as it represents a stress that the brain automatically focuses on.  Also, infectious illnesses, hormone imbalances, sleep disturbances, and other illnesses can reduce focusing and concentration. Once these problems are resolved, the concentration returns to normal.

Differentiating concentration problems that are related to ADHD is helped if there is a childhood onset of distractibility and difficulty sustaining concentration, except for preferred activities.  Also, reading comprehension is often compromised.  In addition, there is a tendency to interrupt others, become irritable during longer conversations and have difficulty making decisions.

I have found that procrastination [waiting until the last minute to complete a task]  is found very frequently in people who have ADHD.  Other people might procrastinate and yet those with ADHD actually use the deadline pressure to complete the task and are not overwelmed by the last minute pressure to finish the task.  Other people without ADHD who procrastinate are often so stressed by the deadline that they cannot finish the task.  

As with some of the other symptoms [behavior patterns] that are associated with ADHD, procrastination serves a purpose and actually helps the person complete the task.

Sunday
Feb242013

MEDICATION FOR PTSD

A number of different medications have been prescribed for PTSD.  These mostly include antidepressants. At times this can be helpful as chronic stress associated with PTSD can lead to depression that can be relieved, at least in part, by medication.  I say in part because if the stress connected to PTSD is ongoing then depressive symptoms can be precipiated again or never resolved with medication and therapy.  

Anxiety triggerd by events that remind the brain of past traumas is the main symptom of PTSD.  This anxiety is related to the almost instantaneous alarm response of the brain as it tries to avoid a catastrophic response.  It seems that frequent alarm reactions is better than being completely overwelmed.  Anything that can reduce the intensity of the anxiety response or reduce the frequency of anxiety responses will be helpful.  Medications targeting this have included propranolol, atypical antipsychotic medications and benzodiazepines.  Propranolol reduces the physical reactions to stress and thus can reduce the intensity and frequency of these reactions.  Atypical antipsychotic medications are also able to significantly reduce anxiety reactions and at lower doses are usually well tolerated without side-effects.  It may be difficult to explain why an antipsychotic medication is helpful and yet the intensity of the anxiety response in PTSD benefit from this type of medication. Benzodiazepines can temporarily reduce anxiety but often have side-effects and will over time be less effective.  There can also be dangerous withdrawal symptoms for the shorter acting benzodiazepines.