Stress and Mental Illness
"Stress" is a term people often use to describe a feeling of pressure, strain, or tension. People often say that they are "under stress" or feel "stressed out" when they are dealing with challenging situations or events.
Everyone encounters stressful situations. Sometimes the stress comes from something positive (like a new job, new apartment, or new relationship) and sometimes from something negative (like having an argument with someone, or being the victim of crime).
Stress is an important factor in mental illness because it can worsen symptoms and lead to relapses. If you can decrease stress, you can decrease symptoms.
Nobody has a stress-free life and probably nobody would want to! Stress is a natural part of life. In fact, to pursue important personal goals, you need to be willing to take on new challenges, which can be stressful. Being able to cope effectively with stressful situations can minimize the effects of stress on you and your symptoms. This can enable you to continue to pursue your goals and enjoy life.
Different people find different things stressful. For example, some people enjoy the hustle and bustle of a big city, while others don't like the crowds and noise and find it stressful. Some people enjoy going to a party and meeting new people; others find it stressful. Knowing what you personally find stressful will help you cope better.
There are two main types of stress: life events and daily hassles.
Life events refers to experiences such as moving, getting married, the death of a loved one, or having a baby. Some life events are more stressful than others; for example, getting a divorce is usually more stressful than changing jobs.
To see how many life events you have experienced in the past year, complete the following checklist:
Life Events Checklist
Put a check mark next to each event that you have experienced in the past year.
___ Moving
___ Getting married
___ New baby
___ Divorce or separation
___ Injury
___ Illness
___ New job
___ Loss of a job
___ Inheriting or winning money
___ Financial problems
___ Injury or illness of a loved one
___ Death of a loved one
___ Victim of a crime
___ Legal problems
___ New boyfriend or girlfriend
___ Broke up with a boyfriend or girlfriend
___ Stopped smoking
___ Went on a diet
___ New responsibilities at home
___ New responsibilities at work
___ No place to live
___ Hospitalization
___ Drinking or using street drugs caused problems
___ other:______________________________
___ Total number of life events checked off.
moderate stress=1
high stress=2-3 events
very high stress=more than 3 events
Daily hassles are the small daily stresses of everyday life that can add up if they occur over time. Examples of daily hassles include dealing with long bus rides, working with unpleasant or critical people, having conflicts with family members or close friends, living or working in a noisy chaotic place, and being rushed to do things.
The following checklist will help you evaluate how many daily hassles you are dealing with:
Daily Hassles Checklist
Place a check mark next to each event that you have experienced in the past week:
___ not enough money to take care of necessities
___ not enough money to spend on leisure
___ crowded living situation
___ crowded public transportation
___ long drives or traffic back ups
___ feeling rushed at home
___ feeling rushed at work
___ arguments at home
___ arguments at work
___ doing business with unpleasant people (sales clerks, waiters/waitresses)
___ noisy situation at home
___ noisy situation at work
___ not enough privacy at home
___ minor medical problems
___ lack of order or cleanliness at home
___ lack of order or cleanliness at work
___ unpleasant chores at home
___ unpleasant chores at work
___ living in a dangerous neighborhood
___ other:__________________________
___ Total number of hassles in the past week
moderate stress=1 or 2 daily hassles
high stress=3-6 daily hassles
very high stress=more than 6
When people are under stress, it affects them physically and emotionally. It also affects their thinking, mood, and behavior. Some people show only physical signs of stress, such as muscular tension, headaches or sleep problems. Others have trouble concentrating or become irritable, anxious or depressed. Still others may pace or bite their nails. Each person's response to stress is individual.
Being aware of your own personal signs of stress can be very helpful, because once you realize that you're under stress you can start to do something about it.
Signs of Stress Checklist
Put a check mark next to the signs you notice when you are under stress:
___ headaches
___ sweating
___ increased heart rate
___ back pain
___ change in appetite
___ difficulty falling asleep
___ increased need for sleep
___ trembling or shaking
___ digestion problems
___ stomach aches
___ dry mouth
___ problems concentrating
___ anger over relatively minor things
___ irritable
___ anxious
___ feeling restless or "keyed up"
___ tearful
___ forgetful
___ prone to accidents
___ using alcohol or drugs (or wanting to)
___ other:__________________________
Putting energy into preventing stress can pay off. If you eliminate some of the avoidable stress in your life, it frees you up to enjoy yourself more and to accomplish more of your goals.
Be aware of situations that caused stress in the past. If you found a situation stressful before, it will probably cause problems again.
Schedule meaningful, enjoyable activities. Having activities that you enjoy makes a significant difference in reducing stress.
Schedule time for relaxation. It's important to take time to relax each day, to refresh your mind and body from the tensions of the day.
Have balance in your daily life. Being active and involved is important to keeping stress low, just don't overdo it.
Develop a support system. Seek out people who are encouraging and supportive, rather than critical and pressuring. It's very helpful to have relationships with people you feel comfortable with.
Take care of your health. Eating well, getting enough sleep, exercising regularly, and avoiding alcohol or drug abuse helps prevent stress.
Talk about your feelings or write them down in a journal. Holding in your feelings can be very stressful. It helps to have an outlet for your feelings; so that you don't keep them bottled up.
Avoid being hard on yourself. Some people increase their stress by being critical of themselves and what they are accomplishing. Try to be reasonable about what you expect from yourself, and give yourself credit for your talents and strengths.
Strategies for Preventing Stress Checklist
Coping effectively with stress is a key to living a successful and rewarding life and being able to pursue your personal goals. Some examples of strategies for coping with stress include:
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Talking to someone about the stress you are experiencing
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Using relaxation techniques
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Using positive self-talk
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Maintaining your sense of humor
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Participating in religion or spiritual activity
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Exercising
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Writing in a journal
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Making or listening to music
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Doing art or going to see art
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Playing games or developing a hobby
This article is adapted from the Illness Management and Recovery Workbook, an Evidence-Based Practice, available on the Substance Abuse, Mental Health Services Administration (SAMHSA) website, a branch of the United States Department of Health and Human Services.
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