When people feel unable to cope with stress, their mental well-being may be at risk.
Life is full of experiences that people find stressful-driving in traffic, waiting in line, working against a deadline, arguing, or performing demanding tasks. However, it is not these stressors themselves, but rather people’s perceptions of them, that cause stress. The level of stress that people experience is related to their sense of how adequately they can control or cope with stressful situations. When people feel that they do not have the resources to handle stressors, their level of stress increases sharply.
The emotions set off by stressful situations vary considerably. The same stressor might excite one person and fill another person with fear. A confrontation with an angry lion, for example, would produce a much different reaction in an experienced big-game hunter carrying a large rifle than it would in a tourist armed with nothing but a camera. Emotional reactions are specific to each person and depend on the significance or meaning the individual attaches to a particular stressor. In the example just cited, the hunter sees a trophy, while the tourist sees a terrifying predator.
Individuals who feel threatened by a situation typically experience fear. Fear can arise from the threat of immediate physical harm or from the more subtle threat that people may feel when starting a new job or meeting a group of strangers. A feeling of fear is normal and appropriate. It acts as a danger signal that informs us of the need to deal with a threat.
People deal with perceived threats and other stressors in various ways. The process of managing the discrepancy between demands and personal resources is referred to as coping.
Learning to cope
Problem-focused coping is a behavioral effort to reduce the demands of a stressful situation or to expand one’s resources. Everyday life provides many examples of problem-focused coping, such as quitting a difficult job, devising a new work schedule, seeking medical or psychological treatment, or learning new job skills.
Emotion-focused coping, on the other hand, aims at controlling emotional responses to a stressful situation. People often use emotion-focused coping when they feel helpless to change a stressor and so seek to reduce its impact. This kind of coping may involve activities that distract attention from the stressor, such as participating in sports, watching television, or finding support from friends or relatives.
When people feel overwhelmed by life and unable to cope, stress becomes a serious problem. People experiencing sustained stress may grow socially isolated, uncaring, or angry. Anger may lead to aggressive behavior. For example, a man who is angry and frustrated over the loss of a job may respond by abusing his children.
High levels of stress can damage one’s mental health in a variety of ways. If stressors are prolonged or intense, or if a person lacks the resources to handle them, a stress-related illness may develop. When stressors are extreme and overwhelming, a condition known as post-traumatic stress disorder (PTSD) may result. Other mental illnesses can also be triggered by stress.
Early warning signals that stress is affecting the mind may be emotional or intellectual. Emotional reactions include feeling burned-out or sad for long periods of time or feeling devoid of all emotions except anger and irritation. Familiar signs of intellectual strain are an inability to concentrate, forgetfulness, and difficulty in making decisions.
Unhealthy behaviors may also be indications that a person is overcome by stress. Society is full of props that people use to distract their attention from stressors. These props include alcohol, caffeine, tobacco, tranquilizers, and illicit drugs. People may come to rely heavily on these substances and lose their ability to manage stress without them. In the short run, it may be easier to pop a pill or have a stiff drink than to make an appropriate change in one’s life.
People also use food to distract themselves from the stressors in their lives. If work isn’t going well, a bar of chocolate may provide immediate comfort. Such stopgap behaviors can become dangerous if they are perceived as a necessary part of life.
Alcohol use and carelessness, two common behavioral responses to stress, probably play a role in the relatively high accident rates of people in stressful circumstances. Studies have found that individuals experiencing high levels of stress are more likely than other people to suffer accidental injuries at home, in sporting activities, on the job, or while driving a car.
Post-traumatic stress disorder
Some people are exposed to extreme, devastating stressors that are outside the range of normal human experience. These stressors include fires, floods, and other disasters; military combat or other violent situations; and train and aircraft accidents. Such extreme stressors can produce severe mental health problems.
The most common disorders occurring in the aftermath of devastating personal experiences are anxiety and depression, a number of studies have shown. These disorders are far more serious than the worries, fears, or sadness that everyone experiences at one time or another. The diagnosis of an anxiety disorder or depressive disorder is made when a person feels profoundly out of control and is unable to function effectively following a traumatic experience.
A substantial number of people exposed to severe stressors of a life-threatening nature develop PTSD or related syndromes. The symptoms of PTSD vary considerably, but researchers have found that they can be classified into three groups.
Recognizing the symptoms
One group of symptoms is known as reexperiencing. People with this form of PTSD become preoccupied with a trauma they have lived through, and thoughts and memories related to the event continually intrude upon their daily lives. Reexperiencing also takes the form of recurrent nightmares. Unlike normal dreams, these nightmares feature a relatively realistic replaying of the traumatic event. Even more literal reexperiencing can take the form of flashbacks, episodes in which a person feels as if he or she is once again in the midst of the trauma.
Another group of PTSD symptoms includes emotional numbing, in which people lose interest in activities, experience feelings of detachment from others, exhibit a restricted range of emotion, and have a pessimistic outlook on the future. People with this form of PTSD may also try to avoid thoughts, feelings, and situations that remind them of the traumatic event.
Heightened arousal is another major symptom group. People with these symptoms of PTSD may have difficulty sleeping. They may be constantly “on the alert” and easily startled. For example, war veterans who have not recovered from the trauma of their wartime experience may respond to a car’s backfiring by taking cover. People with heightened-arousal PTSD may also suffer panic attacks, during which they experience breathing difficulties, an increased heart rate, dizziness, and nausea.
Who is most vulnerable?
Research has found that certain character traits may make a person more vulnerable to PTSD. Shyness, irritability, impulsiveness, and pessimism may increase a person’s risk of developing PTSD,according to findings reported in May 1996 by psychologist Paula Schnurr of the National Center for Post-Traumatic Stress Disorder at the Veterans Affairs Medical Center in White River Junction, Vermont. Schnurr based this conclusion on psychological tests given to college students who later fought in the Vietnam War during the 1960’s and 1970’s.
Other studies suggest that a family history of depression may put people at higher risk of PTSD, which indicates that heredity is sometimes involved. Education and intelligence seem to protect against PTSD, however. Studies of people in the war-torn country of Bosnia have found that those who did not finish high school had a 50 percent greater risk of developing PTSD than those who got their diplomas. All of this research suggests that traumatic experiences do not in themselves cause PTSD. A variety of factors seem to determine how a person responds to an extreme stressor.
A number of studies suggest that major psychiatric disorders, such as clinical depression, may be brought on by stress in people who are vulnerable to such disorders. Most people do not become mentally ill, even if they are confronted by major life stressors. But for those who are susceptible to depression, the disorder may be triggered by deaths and other stressful events. Further, people are more likely to develop depression if they confront a number of major life stressors simultaneously than if they meet them one at a time.
Stress alone does not threaten mental health. To the contrary, good mental health can help us cope with stress. But everyone has a breaking point, and prolonged, severe, or overwhelming stress can push the mind to its limits. It is vital that we get the stress in our lives under control before that limit is reached.