Ben Franklin famously said that the only things guaranteed in life are death and taxes. But he missed one additional element of life that we all must cope with from time to time: change.
As it turns out, most of us don’t really like change. We like routine and predictability, and change in all its many forms reminds us that we often don’t have as much control over situations as we might like to pretend we do. As such, change can be a source of extreme stress for many people, says Dr. Matthew Chang, director of RUHS Behavioral Health, part of the Riverside University Health System in Moreno, California.
“Some of the greatest stress in life can come from changes — both positive and negative,” he says. These extremely stressful changes are often related to employment, living situations, relationships, health and finances.
Unexpected changes are even worse. “Research surveys show that the two most stressful experiences that people go through on average are the death of a child and divorce,” says Dr. Ernest Rasyidi, a psychiatrist with St. Joseph Hospital in Orange County, California.
“The common thread in both those two experiences is the unexpectedness. A sense that ‘this shouldn’t happen’ and that ‘this was not what was intended,'” can be especially stressful, Rasyidi notes. “Generally, people don’t enter marriage expecting it to end in divorce , and there’s a sense that when a child passes before a parent that this is not the natural course of how things are supposed to go.”
Again, we’re reminded of the lack of control over we have over a change that’s being forced upon us. “During uncertain times, we may feel that a lot of things are beyond our control, and that can be daunting,” Rasyidi says.
And depending on the situation, the extreme stress such situations create can lead to health problems. But there are things we can do to keep the toll of extreme stress at bay:
— Start small.
— Talk about it.
— Write it down.
— Break it down.
— Get organized.
— Get to the root of the problem.
— Realize that stress is normal.
— Avoid unhealthy coping mechanisms.
— Talk to a professional.
— Reassess what’s most important.
— Keep the faith.
How Stress Impacts the Body
When we’re under extreme stress, the body reacts. “The brain sends a signal to the nervous system at the onset of a stressful situation to release stress hormones — adrenaline, noradrenaline and cortisol,” Chang says.
This cascade of chemical events “prompts the body to redirect blood flow to the large muscles and heart,” which in turn “elevates respiration, pulse and blood pressure and prepares the body for a physical response.” Skeletal muscles also activate, resulting in tension that can help guard against injury or prepare the body to escape the situation.
This is the famous “fight or flight” response that our ancestors relied on to flee from predators or stand their ground to defend their territory. It’s a robust system that was well designed to cope with the challenges of survival in a harsh, ancient environment but now can seem excessive when triggered by bad traffic, a fight with a spouse or a pink slip at work.
Nevertheless, this response is hard-wired, and it’s difficult to disengage. But if it’s triggered too much or too often, that can become problematic. “In the short term, these physiologic changes are intended to increase one’s chances of survival,” Rasyidi says, but “unfortunately, these involuntary, unconscious systems are not well designed to deal with chronic, long-term stresses, particularly those of a mental or emotional source.”
Over time, extreme stress can contribute to a broad range of health problems including:
— High blood pressure.
— Elevated blood sugar and decreased sensitization to insulin, which are precursors to developing diabetes.
— Increased risk of obesity, particularly in the abdominal area or midsection.
“Extreme stress that extends over a prolonged period of time can prompt the onset of serious health conditions that interfere with a person’s mental and physical health and can even be life threatening,” Chang says. Anyone who’s experiencing chronic stress “should take action to reduce stress levels and allow their bodies to return to a normal state.”
Managing Extreme Stress
If you’re coping with an extremely stressful situation, consider using the following techniques to manage and ease those feelings. Deploying multiple stress management strategies can help you move forward in a more productive way.
— Start small. “Often times, starting with even small measures, such as keeping a regular schedule, maintaining routines and even changing out of your pajamas can help give a sense of order,” Rasyidi says. Remember, stress often arises out of a feeling of inadequate control over a situation. By imposing some order or routine to your day, that may help you feel more in charge.
— Talk about it. Chang recommends “giving voice to the things that may be causing us stress by simply recognizing them. We can start to take away the power of stressors — the people, things and situations around us — by identifying them and understanding that we have a choice in how we react.” Work to shift your focus from feeling like a victim of stress to looking for remedies and solutions.
— Write it down. “When your shoulders are in your ears and your heart is beating fast, the best management technique is to write things down,” says Darby Fox, a child and adolescent family therapist based in the greater New York City area. Writing everything down relieves some of the pressure, Fox says, because “we’re taking it out of the brain and allowing ourselves to look at it from a different perspective.” She likens it to trying to sort a box of jumbled up socks. The best way to do that is to dump them all out of the box and spread them out to sort and match, rather than digging through the pile and trying to pair them up one at a time while they’re still all piled up. Putting your thoughts, feelings and to-do list on paper removes them from your overcrowded mind where you can take a look at them from a different angle and potentially find solutions or better ways of managing.
— Break it down. If a large project or big undertaking is the cause of extreme stress, breaking that effort down into smaller, more manageable chunks can also help significantly reduce the amount of stress you’re feeling about it. Rasyidi recommends setting small goals that can build up over time, such a trying one new recipe a week. Setting a reasonable goal and then achieving it can help you feel more motivated to push through other challenges you may be dealing with. Plus, being able to cross something off your to-do list can help ease some of the stress of having too much on your plate and show you in very tangible terms that you are making progress, even if it doesn’t always feel that way.
— Get organized. In addition to writing down what’s stressing you and breaking it into smaller steps, organize your thoughts about whatever’s stressing you most. Again, writing it down can help here, Fox says. Organizing your thoughts and feelings around a matter of great stress can help take some of the emotion out of those feelings and let you be more analytical about what the real issue is. Similarly, making a to-do list and carefully planning your day can help you stay on top of your stressors and reduce the chances that you’ll forget something important.
— Get to the root of the problem. Fox encourages those coping with extreme stressors to shift how they’re thinking about the problem and rather than feeling helpless to control it, get curious about what underlying issues may be making it harder for you to manage the situation. “Be curious about why is this creating so much pressure for you. Think about whether there’s an emotional tie that’s triggering something from your past,” she says. Thinking about current stressors in the context of past events and our established patterns of reacting to them can sometimes mitigate a measure of the power those past situations and emotions still hold over us.
— Realize that stress is normal. “Large scale emotions that open up our feelings of vulnerability can make us feel stuck and hopeless,” Chang says. But it’s important to “acknowledge these feelings and recognize that they are natural, normal and part of our humanity. Our feelings are not bound by normative definitions of good or bad.” They just are, and giving those feelings space to exist can be part of the solution.
— Avoid unhealthy coping mechanisms. Not all coping mechanisms are created equal, so if you feel like you’re reaching for alcohol, drugs or another unhealthy or self-destructive coping mechanism, you should stop and redirect your energy into “activities you know to be supportive of your emotional health,” Chang says. Examples of healthy coping mechanisms might be creating art, knitting, cooking or getting some exercise.
— Talk to a professional. If you’re feeling overwhelmed, stressed out and are having difficulty working your way through it, reach out to a mental health professional for assistance. Often, talking about what’s bothering you most with someone who’s trained in assisting clients in working through major stressors can help you gain that perspective that you might be too close to see on your own. And if you’re in crisis, don’t hesitate to call a crisis hotline for immediate assistance.
— Reassess what’s most important. Stressful times have a knack for putting a really fine point on our top priorities. Listen to that inner voice, and if there’s something less important that you can let go of, do that to free up more space and energy for what really matters.
— Keep the faith. Rasyidi says staying hopeful and remembering your own power is a key component of being resilient in the face of daunting pressures, grief or uncertainty. He often recommends that people “remind themselves of hardships and difficulties they’ve been through because the past is the greatest predictor of the future. It’s important to remember that we’ve been through difficult times before and that we’ve already managed to find our own victories, great and small.” Trust that you’ll be able to bear the extreme situation you’re in now because you’ve dealt with tough stuff plenty of times before.
Lastly, through all this, Rasyidi recommends aiming for a holistic approach that serves the three major areas of need:
— Mind. Seek “mental stimulation through reading, good conversation and even games.”
— Soul. “Caring for one’s soul is something that the greatest thinkers have struggled with for all of human history, but this generally takes the form of participation in religious services, meditation or some quiet time spent reflecting on your hopes and values,” he adds.
“Above all, it’s important to know that our feelings are a process and not a destination,” Chang says. “We’re all capable of moving through our current situation and coming out the other side.”
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