On Managing Stress

Stress levels in young adults are higher today than ever, with anxiety having overtaken depression as the number one reason college students request counseling. In Benoit Denizet-lewis’s article “Why Are More American Teenagers Than Ever Suffering From Severe Anxiety?” it is reported that an American College Health Association survey revealed that 62% of undergraduates currently suffer from “overwhelming anxiety” as compared to 50% in 2011 (Denizet-lewis). Medical professionals have turned to benzodiazepines as a solution, but the potential for addiction and abuse has proven to be extremely risky. With that in mind, is it time for society to look into other avenues of stress management and preemptive measures to protect against anxiety?

Benzodiazepines, the favored drugs for combatting anxiety, include household names such as Halcion, Xanax, and Ativan; Valium, another “benzo,” is one of the most prescribed drugs in history. This class of drugs has a sedative effect, and works by boosting the activity of the neurotransmitter GABA, which suppresses the activity of nerves. However, according to Dr. Anna Lembke, an associate professor of psychiatry and behavioral sciences with the Stanford University School of Medicine, people overestimate the benefits and underestimate the risks of benzos; “They are effective for a panic attack or severe insomnia, but when taken daily long-term, people develop tolerance and dependence. They stop working and they can even make anxiety and insomnia worse,” (Thompson). This consequence has increasingly become a widespread issue as prescriptions have gone up by 67% percent from 1996 to 2013, with the quantities of the drugs tripling (Thompson). As a result, more people are becoming addicted and overdosing; “Overdoses involving the drugs multiplied sevenfold between 1999 and 2015, increasing from 1,135 to 8,791 deaths.” (Thompson). The growing appearance of Xanax in particular at college party scenes is especially frightening, as it is often mixed with alcohol–another depressant–to multiply the sedative effects, potentially leading to dangerous outcomes such as comatose or death.

One potential alternative to medication lies within our own perception of stress given a “stressful” situation. Once our body’s “stress alarm” is sounded by activating the sympathetic nervous system, we enter “fight or flight” mode: epinephrine and norepinephrine are secreted, our heartbeats accelerate, our lungs expand, and our body prepares for action. According to newer research, the way we interpret this immediate sympathetic response to a stressor determines how our body responds and our overall mindset later. By reinterpreting the meaning of a stimulus to view it in a more balanced, positive light, negative thought patterns may be nudged back towards more effective ones.

This strategy, known as cognitive reappraisal, is extensively described by Dr. Kelly McGonigal, a Stanford University psychologist, in her TedTalk “How to Make Stress Your Friend.” McGonigal describes a study in which 30,000 American adults were asked about how much stress they’ve had within the past year, and whether they believe stress is harmful for one’s health. Eight years later, public death records revealed that those who reported experiencing a lot of stress in the previous year had a 43 percent increased risk of dying (McGonigal). However, this was only true of those who had viewed stress as bad; the people who had experienced a lot of stress but did not view it as inherently harmful actually had the lowest risk of dying of anyone in the study, including those who had relatively no stress (McGonigal). Since then, multiple studies, including one at Harvard University, have been run to test and prove that one’s outlooks on stress changes how we mentally and physiologically experience it. By viewing our natural stress response as our body helpfully preparing us to rise to a challenge, we may find ourselves, “less stressed out, less anxious, more confident,” (McGonigal). Additionally, in a typical stress response, our blood vessels constrict; this is why prolonged stress may lead to cardiovascular disease. However, Harvard’s study demonstrated that when people viewed their stress response as helpful in stressful situations, their blood vessels stayed relaxed; their hearts still pounded, but in a much healthier way, fitting cardiovascular profiles similar to those seen in moments of joy or courage (McGonigal). This finding could be key for the plethora of stressed out students described in Denizet-lewis’s article. Denizet-lewis reported, “Among many teachers and administrators I spoke to, one word–’resiliency’–kept coming up. More and more students struggle to recover from minor setbacks…students stop coming to school, because they just can’t.” If students learned to use their “fight” response to view their struggles as challenges or chances to reach out for help instead of using their “flight” response to shut down and stop going to school altogether, they may be better equipped to handle their situations more efficiently.

Another useful tool for parents could be stress immunization: the hypothesis that mild stress early on in life makes an individual better able to handle stress later in life, but only if they receive comfort after their original dealings with stress. In one study, a group of rat pups were forced into the stressful situation of being handled by humans. Later, these rats were less susceptible to adult stress than rats who had been left alone as pups. Research suggests that this was because the pups had been comforted–licked and groomed–by their mother upon returning from the stressful handling. Those who received the most care after the stress demonstrated the most resiliency later on. This is because the comforting exchange not only palliated the pups in the moment, but instilled confidence and the knowledge within them that if they ever were in stressful situations again and needed to reach out for help, it would be readily available. This information could again be useful to the students described in Denizet-lewis’s article. Suniya Luthar, a professor of psychology at Arizona State University, stated that most of them, “never get to the point where they can say, ‘I’ve done enough, and now I can stop,’…Kids have a sense that they’re not measuring up,” (Denizet-lewis). The need for authoritative, supportive parenting is as strong as ever; parents must acknowledge the stress of their child, and be encouraging and congratulatory after triumphs through hardship. Through strong communication, the child may grow up with a realistic understanding of both their potential and limitations, find pride in their own accomplishments, and know that help and comfort is always available.

The main takeaway from these findings is that stress is not inherently bad, but rather it’s our own outlook and response that dictates how we are affected. Stress is inevitable, but we are in control of whether we defeat it or let it overtake us. Additionally, accepting the support offered to us or going out of our way to ask for it if needed is key, and should be encouraged above all else.

References:

Denizet-lewis, Benoit. “Why Are More American Teenagers Than Ever Suffering From Severe Anxiety?” The New York Times, The New York Times, 11 Oct. 2017, http://www.nytimes.com/2017/10/11/magazine/why-are-more-american-teenagers-than-ever-suffering-from-severe-anxiety.html?rref=collection%2Fsectioncollection%2Fhealth&action=click&contentCollection=hea.

McGonigal, Kelly. How to Make Stress Your Friend. How to Make Stress Your Friend, TED Conferences, LLC, 4 Sept. 2013, http://www.ted.com/talks/kelly_mcgonigal_how_to_make_stress_your_friend/details.

Thompson, Dennis. “Xanax, Valium Looking like America’s next Drug Crisis.” Chicagotribune.com, Chicago Tribune, 26 Feb. 2018, http://www.chicagotribune.com/lifestyles/health/sc-hlth-xanax-valium-next-drug-crisis-0307-story.html.

3 thoughts on “On Managing Stress

  1. Thank you for this really interesting article! I enjoyed the combination of psychopathology as well as the developmental approaches (e.g. about parental influences) you brought into the article. I think the idea you touched upon about the dangers of some of these prescribed medications that have depressant effects being combined with alcohol is important to acknowledge in the discussion of how to best handle anxiety treatments. Because of the number of teenagers and emerging adults that are on medications for anxiety (e.g. Xanax), using medication alone can be dangerous as this age group is also where we see an increase in alcohol consumption. Many young adults on medications will either stop taking their prescription in order to drink, or will continue on the medication while drinking. The interaction of alcohol and other medication can be very dangerous as the depressant effects on the GABA system affect such structures like the medulla which regulates basic processes like respiration and heart rate. It is thus important for articles like this to inform people about other methods for anxiety besides medication.

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  2. I think this is an extremely eye-opening way of looking at a profound issue in college students. Specifically, I think the argument that one should “fight” stress rather than using our “flight” response should be widely encouraged. I also thought it was really interesting to learn that the typical drug used, benzodiazepine, can create a tolerance and dependency issues. Although I am wondering, what if the combination of the “fight” mindset and medicinal treatment of a different class of drug, can be used to fully combat the issue. I would love to learn more about whether other classes of drugs along with this new mindset, can really help students suffering from this anxiety.

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  3. Thinking of stress as resiliancy rather than as anxiousness seems like a good way to combat personal issues with stress as it relates to academic work too. If cognitive evaluation of your anxiety can help how your body responds to stress, then the potential for you to retrain your brain to the same stimulus looks promising.

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