Frequently Asked Questions Stress

Q: What is stress?

A: Stress is more or less the opposite of relaxation. It can be defined in terms of four components:¹

1. A stressor or trigger is present (e.g., deployment, combat exposure, deadline, traffic, uncertainties)
2. The individual finds the stressor or trigger to be stressful (not all people view the same events or triggers as stressors)
3. The individual experiencing stress is attempting to cope with the stressful demands. Some people will be more effective at coping with stress than others.
4. A complex set of reactions takes place in both the mind and the body. Again, stress reactions are experienced differently by everyone.

Stress management can be complicated and confusing because there are different types of stress—acute stress, episodic acute stress, and chronic stress—each with distinct characteristics, symptoms, duration, and treatment approaches. More

Q: How does stress affect health?

A: Individuals experience a number of physiological symptoms in response to stress, such as sweaty hands, racing heart, nausea, headaches or muscle tension.² Stress is related to many physical problems, such as diabetes, ulcers, irritable bowel syndrome, cancer, coronary heart disease, hypertension, high blood pressure, gastrointestinal disorders, low back pain, asthma, skin disorders, and tension headaches.^3,4,5,6,7,8 Stress can impair a person’s ability to pay attention and can cause people to continually think about situations or triggers that are perceived as stressful.⁹ Individuals who experience stress may feel overwhelmed, anxious, or depressed.^10,11 Some people cope with stress by overeating, smoking, drinking, or isolating¹¹, which in turn reduces a person’s ability to cope effectively. When an individual is feeling stressed, they may become hostile or irritable towards others, and so a cycle of stress affected relationships can become an ongoing vicious cycle, leading to more stress.¹¹

Q: Is stress considered a psychiatric disorder?

A: Stress alone is not a psychiatric disorder, even though symptoms of stress overlap with many psychiatric disorders. Post-traumatic Stress or Acute Stress Disorders are very specific reactions to stressful events. People who do not effectively cope with stress may develop psychiatric disorders, including depression¹², substance abuse¹³, or pathological gambling¹⁴.

Q: How common is stress?

A: Stress is an inevitable part of everyday life. An estimated 75% of all office visits to a primary care physician in the United States are for stress-related complaints.¹⁵ Service members and their families will likely experience stress, particularly during a deployment, or when exposed to combat. Because everyone experiences stress differently, the type and severity of reactions will vary. It is important to acknowledge and seek support before a minor problem turns into a crisis. People sometimes develop depression, anxiety, or addictive disorders when minor problems go untreated.

Q: How do people cope with stress?

A: Coping strategies refer to specific effort to deal with a stressful event. Some people cope by doing something active to reduce a stressor. For example, people change deadlines when they feel overwhelmed by demands, take an alternate route when stuck in traffic, or make payment arrangements when faced with financial problems. Some people cope by dealing with feelings related to stressors. For example, people talk to others about their feelings, try to relax, or change the way they choose to think about things to decrease unpleasant emotions. Both problem–focused and emotion–focused strategies are effective strategies for coping with most stressful events.¹⁶ Some people are more comfortable using one strategy over the other. Problem–focused strategies are helpful in situations where you have control and can actually solve the problem. Emotion–focused strategies may be more useful in situations that are less solution–oriented.

Q: What resources are available for stress management?

A: Most reactions to life stressors are considered normal and do not develop into a psychiatric disorder. Therefore, becoming educated, seeking support, and taking steps to maintain a healthy lifestyle are effective coping strategies. Check out Stress Self Help Tools. If you develop a disorder, such as depression, anxiety, or substance use disorder, medical treatment may be necessary.

Keep in mind that treatment for stress, as an independent condition, is not generally a covered TRICARE benefit. Stress can be associated with other behavioral health issues. For benefit questions, please refer to your TRICARE Covered Treatments or for TRICARE Reserve Select members or call 1-888-TRIWEST.

Q: Do I have to see a specialist in order to get help?

A: No. Your primary care doctor may be able to prescribe medication for your symptoms. Discuss any concerns with your doctor. There are a number of things you can take on your own to manage stress. Check out the self-help tools. Finally, not all help requires medical intervention. Often family, friends, and clergy are excellent sources of support.

References:

This was modified from Fletcher, L., Woodward, L. & O’Donohue, W. (in press). Stress. In J. E. Fisher & W. O’Donohue (Eds.), Practice Guidelines for Evidence Based Psychotherapy. New York: Springer Publishing Company.

¹ Lazarus, R. S. (1993). From psychological stress to the emotions: A history of changing outlooks. Annual Review of Psychology 44, 1-21.

² Guthrie, G. M., Verstraete, A., Deines, M. M., & Stern, R. M. (1975). Symptoms of stress in four societies. The Journal of Social Psychology 95, 165-172.

³ Brand, N., Hanson, E. & Godaert, G. (2000). Chronic stress affects blood pressure and speed of short term memory. Perceptual and Motor Skills 91(1), 291-298.

⁴ Hafen, Brent Q., and Karen, Keith J., Frandsen, Kathryn J., and Smith N.Lee (1996) Mind/Body Health: The Effects of Attitudes, Emotions and Relationships. Needham Heights, MA: Allyn & Bacon.

⁵ Krantz, D. S. & McCeney, M. K. (2002). Effects of psychological and social factors on organic disease: A critical assessment of research on coronary heart disease. Annual Review of Psychology 53(1), 341-368.

⁶ Mrazek, D.A. & Klinnert, M. (1996). Emotional stressors and the onset of asthma. In: Pfeffer, C.R. (Ed.) Severe stress and mental disturbance in children. Washington, D.C.: American Psychiatric Association.

⁷ Robert-McComb, J. J. (2001). Eating disorders in women and children: Prevention, stress management and treatment. Boca Raton, FL: CRC Press.

⁸ Taylor, S. E. (1999). Health psychology. New York: McGraw-Hill.

⁹ Lepore, S. J. (1997). Social-environmental influences on the chronic stress process. In B. H. Gottlieb (Ed.), Coping with chronic stress. New York: Plenum.

¹⁰ Lazarus, R. S. (1999). Stress and emotion: A new synthesis. New York: Springer.

¹¹ Sarafino, E. P. (2002). Health psychology: Biopsychosocial interactions. New York: John Wiley & Sons, Inc.

¹² Voelkner, R. (2004). Stress, sleep loss, and substance abuse create potent recipe for college depression. Journal of the American Medical Association 291 (18), 2177-2179.

¹³ McQuaid, J.R., Brown, S.A., Aarons, G.A., Smith, T.L., Patterson, T.L, Schuckit, M.A. (2000). Correlates of life stress in an alcohol treatment sample. Addictive Behaviors 25(1), 131-137.

¹⁴ Coman, G.J., Burrows, G.D., Evans, B.J. (1997) Stress and anxiety as factors in the onset of problem gambling: Implications for treatment. Stress Medicine 13 (4), 235-244.

¹⁵ Hughes, G. H., Pearson, M. A., & Reinhart, G. R. (1984). Stress: Sources, effects and management. Family & Community Health 7(1), 47-58.

¹⁶ Folkman, S., & Lazarus, R. S. (1980). An analysis of coping in a middle-aged community sample. Journal of Health and Social Behavior, 21, 219-239.