Wednesday 23 May 2018

Are you stressed?

Stress - a little of it is helpful, but a lot quickly becomes toxic. Over the following pages, Dr Harry Barry looks at how much is too much, the science behind stress and what it does to your body. He explores how to manage stress through diet, exercise, sleep and mindfulness. And finally, how to build emotional resilience to help you deal with life's challenges and, in the process, rewire your brain to protect your mental health from stress

Dr Harry Barry
Dr Harry Barry

Imagine the following: Susan is a 39-year-old mother of two and she is constantly tired. Both she and Tom, her partner, are working in full-time stressful jobs. His work involves some travel so Susan is often left carrying the can. Both their children are in creche and it is a constant battle to drop them off and collect them as she commutes a distance to work.

Recently Susan has been promoted, but she is struggling to keep all the balls in the air. She lives in a state of constant anxiety with tension headaches, sleep difficulties and teeth grinding at night. A drip-feed of caffeine is needed to counteract her exhaustion, and she is losing weight because she just feels too wired - and exhausted - to eat healthily.

Susan is a perfectionist who procrastinates at home and at work. As a result, problems are mounting up. She is also a chronic catastrophiser and that ratchets up her stress levels. On top of all that, her mother has developed early dementia and much of the responsibility of finding a carer and dealing with any problems falls to Susan.

Struggling to cope, Susan finds her usual glass of wine turning into two or three as she tries to wind down in the evenings. She depends on social media to keep in touch with her friends. At night she is exhausted but too wired to sleep and instead spends hours browsing online. When she does sleep, the nightmares are horrendous. Her libido plummets and Tom is not happy about the disappearance of their sex life. Things come to a head.

She finally breaks down in front of Tom. She has had an awful day, ending with a full-blown panic attack in her car. She got phone calls at work from both the creche and her mum's carer, all looking for an instant response. She feels tired, and weepy.

Susan's story mirrrors many of those who come to see me. She says her life is a mess and she feels such a failure. All her friends are coping with their lives. What is wrong with her?

The answer to Susan's question lies in two words - toxic stress. Remember her situation because it embodies what many of us experience, and we will return with solutions to her dilemma (page 4).

But first, what is toxic stress and why is it an increasing challenge to our mental and physical health?

Stress is nothing new

Stress has always been a part of life: short periods of stress such as sitting exams, job interviews or giving public presentations, or longer periods of stress such as long commutes, financial difficulties or relationship conflicts.

But what happens when toxic stress or burnout comes calling?; when it is so persistent and pervasive that it overwhelms our physical and psychological reserves with dire consequences for our health?

The long-term consequences of toxic stress can be serious, with an increased risk of heart attack, high blood pressure, cardiac arrhythmia, stroke and cancer as well as the mental health risks of bouts of depression, anxiety, addiction and self-harm.

But it is on the up

There is little doubt that toxic stress in Ireland is increasing. But why? There are several reasons. Life is moving faster and faster, putting enormous pressure on our brains and body. Many of us feel powerless, having little control over so many facets of our modern lives. Take the example of the housing/rental sector where countless couples and families live in a state of complete uncertainty and are unable to plan their lives accordingly. They are forced to live further away from their places of work so long commutes become a daily reality. Lack of close family and community supports adds to their sense of isolation.

Interpersonal conflicts are a powerful cause of toxic stress, whether between spouses, parents and children, siblings or others. Financial difficulties, especially debt, are often a significant issue. Health issues, either personal or involving family members, such as looking after a child with special needs or, like Susan, caring for an elderly parent with dementia, can overwhelm us. Loneliness is one of the most hidden and destructive causes of toxic stress but poverty and addiction are also potent sources.

Work too can trigger toxic stress. Finding yourself in a job you hate or struggling to fit in with the ethos of a company can be very challenging. Bullying can be a subtle but significant cause of toxic stress, as are unrealistic targets or unreasonable expectations. The current spate of poorly paid, short-term and zero-hour contracts may also create toxic stress.

Technology has arrived to create the perfect backdrop for toxic stress. We are like automatons - slaves to our smart phones. Families and couples, eyes down while out in restaurants where once they would switch off and chat, are now busy on their devices. We are being bombarded with continuous information - most of it irrelevant - overwhelming our brains' ability to run efficiently. Work emails follow us home, clamouring to be answered, day and night. Keeping up with our social media is adding further pressure. When even our bedrooms are being invaded, with serious consequences for sleep, toxic stress is waiting in the wings.

And our children are affected too

Smart phones and social media are also impacting on the lives of our young people, removing forever, elements of their childhood. They are bombarded with a frenzy of social media, cyberbullying, exposure to pornography from an early age and a constant need to be 'liked' online through a variety of apps by their peers. It is not surprising that they are one of the most stressed groups of all with high rates of anxiety, depression, eating disorders and self-harm. They are in danger of becoming less emotionally resilient than former generations.

As we will see, our capacity to learn and develop key emotional resilience skills is what decides how adaptable we are to stressors. Technology is making that more difficult.

Modern Irish society is a melting pot - a breeding ground for episodes of toxic stress and I see its consequences every day in my clinics. All of us are at risk, so must become attuned to the warning signs and consequences, and develop the emotional skills to manage and prevent such episodes. This is the first step to developing those skills.

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