Stress Archives – A Healthy State of Mind

In this article I want to help you to get to know your heart. Knowing more about your heart (specifically your heart rate variability) can improve your awareness of how stressors impact your mind and body. To evaluate the health of your heart and nervous system, you just need a heart rate variability monitor (typically […]

Chronic Stress In a prior blog post, I wrote about managing stress and gave some tips for gaining control and a greater sense of calm when facing short-term stress, but what about stress that is unrelenting or chronic? How does one maintain health with persistent exposure to stress? The short answer is that one typically […]

This post is to update my current and future patients and readers that I recently attended a five-day intensive continuing medical education course offered by The Institute for Functional Medicine (IFM), located in Federal Way, Washington. Applying Functional Medicine in Clinical Practice addresses one of the key issues in healthcare practice today – improving the […]

With a New Year upon us, many are inclined to set resolutions for the year ahead – many of which relate to health. To ensure that your goals (health or otherwise) are more realistic and successful, I wanted to share with you about ‘SMART’ goals. The goal setting tools that it provides, coupled with the […]

‘Sensitivity’ can be a loaded term in our culture and has a number of connotations, many not very positive. Elaine Aron, Ph.D., author of The Highly Sensitive Person book, defines a sensitive person as one who is aware of subtleties in their surroundings, more readily overwhelmed after being in a stimulating environment for too long […]

The holidays are a time of increased stress for many and as year-end tasks pile up, it can make it challenging to get the support and perspective one needs to re-prioritize. As stress can be cumulative, and is also hard to objectify, I think that introducing a scale to assess the burden of stress in […]

May is National Physical Fitness and Sports month, and with the warmer days and more sun, it hopefully is easier for people to get motivated to move! Doctors have a tendency to overlook or understate the value of exercise in being busy to find the best treatment(s) for a patient’s ills, but the effects of […]

Anxiety Archives – A Healthy State of Mind

In this article I want to help you to get to know your heart. Knowing more about your heart (specifically your heart rate variability) can improve your awareness of how stressors impact your mind and body. To evaluate the health of your heart and nervous system, you just need a heart rate variability monitor (typically […]

Chocolate can nurture and nourishes. It is derived from the cacao tree (Theobroma cacoa). The word Theobroma means ‘food of the gods’. Americans consume, on average, 11 pounds of chocolate per person per year and we are ranked as the 5th major consumer of chocolate worldwide. Research on the health benefits of chocolate shows it […]

Micronutrients in Mental Health Series II Vitamin B12 is nutrient is critical in proper mental functioning and overall health.  If intake or absorption of vitamin B12 is insufficient, a wide array of psychiatric (anxiety, depression, psychosis to name a few), cognitive (memory loss and confusion) and gastrointestinal (constipation and low stomach acid) can result. Vegetarians and […]

Sleep is something so many take for granted and yet sleep problems or insomnia affects a large proportion of the population, 22.1% by recent estimates .  Untreated insomnia can lead to psychiatric disorders such as anxiety and depression and insomnia commonly occurs in those with psychiatric disorders. Treating the underlying psychiatric disorder will generally improve […]

Recent evidence suggests that the status of our gastrointestinal (gut) flora may affect mood and behavior. This evidence, derived from a study conducted by Bravo et al. and published in the Proceedings of the National Academy of Sciences, suggests that bacteria in the gut can communicate with the brain and vice-versa via the vagus nerve1. […]

Well it is hard to not notice the collective stir around love & relationship in February and it prompted me to reflect on the power of relationship to heal. This power is undoubtedly important in any healing dynamic (doctor-patient relationship), but as Dr. Heron so aptly states, perhaps even more so when one suffers from […]

‘Sensitivity’ can be a loaded term in our culture and has a number of connotations, many not very positive. Elaine Aron, Ph.D., author of The Highly Sensitive Person book, defines a sensitive person as one who is aware of subtleties in their surroundings, more readily overwhelmed after being in a stimulating environment for too long […]

The holidays are a time of increased stress for many and as year-end tasks pile up, it can make it challenging to get the support and perspective one needs to re-prioritize. As stress can be cumulative, and is also hard to objectify, I think that introducing a scale to assess the burden of stress in […]

May is National Physical Fitness and Sports month, and with the warmer days and more sun, it hopefully is easier for people to get motivated to move! Doctors have a tendency to overlook or understate the value of exercise in being busy to find the best treatment(s) for a patient’s ills, but the effects of […]

Improving Your Resilience to Stress

The holidays are a time of increased stress for many and as year-end tasks pile up, it can make it challenging to get the support and perspective one needs to re-prioritize. As stress can be cumulative, and is also hard to objectify, I think that introducing a scale to assess the burden of stress in the past year may help to gain some perspective on the toll stress has taken before the demands of a new year are upon you.  I will also provide you with tips on how to improve your resilience to stress which will hopefully make for a healthier year ahead!

But before I discuss this scale in depth, let me elaborate a little on the effects of chronic stress on both psychological and physical health. Over time, continued stress can lead to anticipatory anxiety, depression, learned helplessness, PTSD (post-traumatic stress disorder), low self-esteem and self-efficacy, pessimism, transient psychosis, substance abuse, insomnia and nightmares. Physically there are a myriad of deleterious effects: neurological complaints (migraine headaches, Raynaud’s), cardiovascular disorders (angina, high blood pressure, atherosclerosis, arrhythmia, atrial fibrillation & heart attack), gastrointestinal disorders (irritable bowel syndrome & leaky gut), autoimmune disorders (allergies, multiple sclerosis, Hashimoto’s thyroiditis & pernicious anemia), endocrine disorders (amenorrhea, metabolic syndrome and infertility, erectile dysfunction, preterm labor & miscarriage), connective tissue/dermatological disorders (acne, eczema, low back pain, muscle strain, osteoporosis), respiratory disorders (asthma and hyperventilation) and accelerated aging and cancer. As long as this list is, it does not encompass all of the effects of stress – which really can cause or contribute to almost any illness.

The Holmes-Rahe Stress Scale was developed to attempt to quantify the effects of life changes in a year in terms of stress on the individual’s health in the following year. The scale consists of 43 life events and the relative weight of these stressors on well-being. These findings are translated into ‘Life Change Units’ listed in the table below. It is worth noting that even so-called positive or enjoyable life transitions are not without stress in this scale. (This has long been known in homeopathy with several remedies indicated for ‘Ailments from excessive joy’.)

To determine your score, add each relevant event (from the past year) with the corresponding life change unit score to obtain a total. (See how to interpret your score in the information following the table1).

A total score of:

≥ 300 is associated with an 80% risk of illness in the following year

150-299 is associated with a 50% risk of illness in the following year

Use your score to determine your need to make life changes and seek support to protect your health in the New Year. Implicit in this scale is the understanding that stress has a more negative effect when it is unrelenting. Whatever can be done to spread out or pace life transitions and stressful events will help lower your stress levels and allow you to better recover psychologically and physically. If you are interested in assessing how your body is coping with stress further, you can complete the Adrenal Stress Profile Questionnaire posted in another blog post.

A discussion on the impacts of stress would not be complete without looking at the positive sides of stress and also how to improve your capacity to deal with stress (known as ‘resilience’). Genetic (Down’s syndrome), cognitive (depression and defeatist beliefs) and sociocultural variables (limited financial resources, poor nourishment, limited access to health care and poor access to advancement) can decrease stress tolerance, whereas behavioral skills, cognitive strategies, a healthy sense of self-efficacy, confidence and motivation, good physical and emotional health and supportive relationships can improve stress tolerance/resiliency.

As with many things in this culture, stress gets polarized as ‘bad’ (and less often as ‘good’), wherein in reality a balance is the best way to conceptualize stress. Too little stress and people suffer from low motivation and impaired learning and performance, too much stress and illness, impaired learning and performance can result. Eustress (or a healthy amount of stress), as termed by Hans Selye (who conceptualized the General Adaptation Syndrome Model of stress) is what is needed to learn and perform well; promoting the neurological connections and coordination to analyze, respond to and learn from a challenge and thus to grow.

Preliminary research discussed by Stanford health psychologist, Dr. Kelly McGonigal, adds an intriguing and hopeful look on how to understand and overcome the impacts of stress on our health and how to improve resilience; adding a new dimension to the work of Holmes & Rahe. Dr. McGonigal’s work is summarized in this TED Video, in which she describes a study in which one’s beliefs or interpretation of stress plays a significant role in one’s response to stress:

People who experienced a lot of stress in the previous year had a 43% increased risk of dying. But this was only true for the people who also believed that stress is harmful for your health!”

Dr. McGonigal also discusses how caring for others helps increase one’s resilience to stress.

So as the new year begins, may your score from the Holmes-Rahe scale, Dr. McGonigal’s research and a realization that challenges and stressors are integral to growth, help you to navigate it less stressfully and with more support. All the best for a healthier and happier year ahead!

If you would like to be notified of future blog posts by email and would like to receive our e-newsletter, sign-up here.

References:

Sahler, O.J.Z. & Carr, J.E. (Eds.). (2012). The Behavioral Sciences and Health Care. (3rd ed.). Cambridge, MA: Hogrefe Publishing, 52-60.

McGonigal, K. (2013, June ). Kelly McGonigal: How to Make Stress Your Friend. [Video file]. Retrieved from http://www.ted.com/talks/kelly_mcgonigal_how_to_make_stress_your_friend.html

Depression Archives – A Healthy State of Mind

In this article I want to help you to get to know your heart. Knowing more about your heart (specifically your heart rate variability) can improve your awareness of how stressors impact your mind and body. To evaluate the health of your heart and nervous system, you just need a heart rate variability monitor (typically […]

Chocolate can nurture and nourishes. It is derived from the cacao tree (Theobroma cacoa). The word Theobroma means ‘food of the gods’. Americans consume, on average, 11 pounds of chocolate per person per year and we are ranked as the 5th major consumer of chocolate worldwide. Research on the health benefits of chocolate shows it […]

Micronutrients in Mental Health Series II Vitamin B12 is nutrient is critical in proper mental functioning and overall health.  If intake or absorption of vitamin B12 is insufficient, a wide array of psychiatric (anxiety, depression, psychosis to name a few), cognitive (memory loss and confusion) and gastrointestinal (constipation and low stomach acid) can result. Vegetarians and […]

Micronutrients in Mental Health Series I The role of optimal nutrition in depression, and a number of other mental health conditions, is often overlooked, but plays a critical role in health and well-being. Iron deficiency, even without being diagnosed with anemia, can lead to low energy, fatigue and depression.  Many of my patients who have […]

The Centers for Disease Control and Prevention (CDC) Data Brief, (in which they report that the rate of antidepressant use among all ages) reports a nearly 400% increase in medicine for depression since 1988-1994. Some salient features of this report are: Females are more likely to be on antidepressant pills than males Greater than 60% of Americans […]

Sleep is something so many take for granted and yet sleep problems or insomnia affects a large proportion of the population, 22.1% by recent estimates .  Untreated insomnia can lead to psychiatric disorders such as anxiety and depression and insomnia commonly occurs in those with psychiatric disorders. Treating the underlying psychiatric disorder will generally improve […]

Recent evidence suggests that the status of our gastrointestinal (gut) flora may affect mood and behavior. This evidence, derived from a study conducted by Bravo et al. and published in the Proceedings of the National Academy of Sciences, suggests that bacteria in the gut can communicate with the brain and vice-versa via the vagus nerve1. […]

Well it is hard to not notice the collective stir around love & relationship in February and it prompted me to reflect on the power of relationship to heal. This power is undoubtedly important in any healing dynamic (doctor-patient relationship), but as Dr. Heron so aptly states, perhaps even more so when one suffers from […]

The holidays are a time of increased stress for many and as year-end tasks pile up, it can make it challenging to get the support and perspective one needs to re-prioritize. As stress can be cumulative, and is also hard to objectify, I think that introducing a scale to assess the burden of stress in […]

Seasonal changes are known to affect those suffering from a number of psychiatric complaints. Seasonal affective disorder (S.A.D.) is the most common diagnosis for those suffering from seasonal changes. S.A.D. affects about 6% of the U.S. population. A milder form of S.A.D., known as the Winter Blues or Subsyndromal S.A.D.,  affects approximately 14 % of […]

Improving One’s Resilience to Stress | A Healthy State of Mind

Posted by Mary R. Fry, N.D. on Tuesday, December 17, 2013

The holidays are a time of increased stress for many and as year-end tasks pile up, it can make it challenging to get the support and perspective one needs to re-prioritize. As stress can be cumulative, and is also hard to objectify, I think that introducing a scale to assess the burden of stress in the past year may help to gain some perspective on the toll stress has taken before the demands of a new year are upon you.  I will also provide you with tips on how to improve your resilience to stress which will hopefully make for a healthier 2014!

But before I discuss this scale in depth, let me elaborate a little on the effects of chronic stress on both psychological and physical health. Over time, continued stress can lead to anticipatory anxiety, depression, learned helplessness, PTSD (post-traumatic stress disorder), low self-esteem and self-efficacy, pessimism, transient psychosis, substance abuse, insomnia and nightmares. Physically there are a myriad of deleterious effects: neurological complaints (migraine headaches, Raynaud’s), cardiovascular disorders (angina, high blood pressure, atherosclerosis, arrhythmia, atrial fibrillation & heart attack), gastrointestinal disorders (irritable bowel syndrome & leaky gut), autoimmune disorders (allergies, multiple sclerosis, Hashimoto’s thyroiditis & pernicious anemia), endocrine disorders (amenorrhea, metabolic syndrome and infertility, erectile dysfunction, preterm labor & miscarriage), connective tissue/dermatological disorders (acne, eczema, low back pain, muscle strain, osteoporosis), respiratory disorders (asthma and hyperventilation) and accelerated aging and cancer. As long as this list is, it does not encompass all of the effects of stress – which really can cause or contribute to almost any illness.

The Holmes-Rahe Stress Scale was developed to attempt to quantify the effects of life changes in a year in terms of stress on the individual’s health in the following year. The scale consists of 43 life events and the relative weight of these stressors on well-being. These findings are translated into ‘Life Change Units’ listed in the table below. It is worth noting that even so-called positive or enjoyable life transitions are not without stress in this scale. (This has long been known in homeopathy with several remedies indicated for ‘Ailments from excessive joy’.)

To determine your score, add each relevant event (from the past year) with the corresponding life change unit score to obtain a total. (See how to interpret your score in the information following the table1).

Death of spouse

100

Divorce

73

Marital separation

65

Jail term

63

Death of close family member

63

Personal injury or illness

53

Marriage

50

Being fired

47

Marital reconciliation

45

Retirement

45

Health change of family member

44

Pregnancy

40

Sexual difficulties

39

Having a baby

39

Change in finances

38

Death of a close friend

37

New line of work

36

Increased fighting with spouse

38

Large mortgage

31

Foreclosure

31

Son or daughter leaving home

30

In-law troubles

29

Spouse starts or stops work

26

Begin or end school

26

Trouble with boss

23

Moving into new home

20

Change in sleeping habits

16

Change in eating habits

16

Vacation

13

Total: _______

A total score of:

≥ 300 is associated with an 80% risk of illness in the following year

150-299 is associated with a 50% risk of illness in the following year

< 150 is associated with a slight risk of illness in the following year

Use your score to determine your need to make life changes and seek support to protect your health in the New Year. Implicit in this scale is the understanding that stress has a more negative effect when it is unrelenting. Whatever can be done to spread out or pace life transitions and stressful events will help lower your stress levels and allow you to better recover psychologically and physically.

A discussion on the impacts of stress would not be complete without looking at the positive sides of stress and also how to improve your capacity to deal with stress (known as ‘resilience’). Genetic (Down’s syndrome), cognitive (depression and defeatist beliefs) and sociocultural variables (limited financial resources, poor nourishment, limited access to health care and poor access to advancement) can decrease stress tolerance, whereas behavioral skills, cognitive strategies, a healthy sense of self-efficacy, confidence and motivation, good physical and emotional health and supportive relationships can improve stress tolerance/resiliency.

As with many things in this culture, stress gets polarized as ‘bad’ (and less often as ‘good’), wherein in reality a balance is the best way to conceptualize stress. Too little stress and people suffer from low motivation and impaired learning and performance, too much stress and illness, impaired learning and performance can result. Eustress (or a healthy amount of stress), as termed by Hans Selye (who conceptualized the General Adaptation Syndrome Model of stress) is what is needed to learn and perform well; promoting the neurological connections and coordination to analyze, respond to and learn from a challenge and thus to grow.

Preliminary research discussed by Stanford health psychologist, Dr. Kelly McGonigal, adds an intriguing and hopeful look on how to understand and overcome the impacts of stress on our health and how to improve resilience; adding a new dimension to the work of Holmes & Rahe. Dr. McGonigal’s work is summarized in the following TED Video, in which she describes a study in which one’s beliefs or interpretation of stress plays a significant role in one’s response to stress:

People who experienced a lot of stress in the previous year had a 43% increased risk of dying. But this was only true for the people who also believed that stress is harmful for your health!”

Dr. McGonigal also discusses how caring for others helps increase one’s resilience to stress.

So as the new year begins, may your score from the Holmes-Rahe scale, Dr. McGonigal’s research and a realization that challenges and stressors are integral to growth, help you to navigate it less stressfully and with more support. All the best for a healthier and happier year ahead!

If you would like to be notified of when a new blog entry is posted and/or would like to receive the clinic’s quarterly newsletter, be sure to sign up!

References:

Sahler, O.J.Z. & Carr, J.E. (Eds.). (2012). The Behavioral Sciences and Health Care. (3rd ed.). Cambridge, MA: Hogrefe Publishing, 52-60.

McGonigal, K. (2013, June ). Kelly McGonigal: How to Make Stress Your Friend. [Video file]. Retrieved from http://www.ted.com/talks/kelly_mcgonigal_how_to_make_stress_your_friend.html

Categories: Uncategorized Tags: Hans Selye, Holmes-Rahe Stress Scale, Kelly McGonigal, resilience, stress, TEDS

Naturopathic Mental Health Blog| Psychology & Psychiatry | A Healthy State of Mind

Posted by Mary R. Fry, N.D. on Friday, November 4, 2016

  Have you ever gone to your doctor feeling that something was off, but testing revealed that ‘nothing’ was wrong? At least nothing according to conventional medical diagnosis of disease and interpretation of laboratory test results… In naturopathic and functional medicine, however, we are taught to use laboratory testing (along with an in-depth physical exam…> read more

Categories: Depression, Hormones Tags: Functional medicine, Laboratory Testing, nutrient deficiencies, Thyroid, Vitamin D

Posted by Mary R. Fry, N.D. on Saturday, March 26, 2016

I was interviewed for the article posted below in conjunction with teaching a Nutrition-Focused Physical Exam class for Doctoral Nutrition Students at Maryland University of Integrative Health. I will share more of my teaching work in a future post/website update. For now I will leave you with this article – I hope that you find…> read more

Categories: Diet & Nutrition Tags: minerals, nutrient deficiencies, Physical Signs and Symptoms, vitamins

Posted by Mary R. Fry, N.D. on Friday, October 17, 2014

To my readers: I so enjoy writing about naturopathic health-related topics in mental health and keeping interested readers, patients and colleagues informed. At times there are just too many demands to put together a cogent blog post and newsletter…and now is one of them! I am currently working on several fronts in both my practice,…> read more

Categories: Uncategorized

Posted by Mary R. Fry, N.D. on Tuesday, May 27, 2014

May is National Physical Fitness and Sports month {http://www.fitness.gov/}, and with the warmer days and more sun, it hopefully is easier for people to get motivated to move! Doctors have a tendency to overlook or understate the value of exercise in being busy to find the best treatment(s) for a patient’s ills (I include myself…> read more

Categories: Anxiety Disorders, Depression, Exercise, Psychiatric Medications, Schizophrenia & Psychosis, Sleep Tags: exercise, insomnia

Posted by Mary R. Fry, N.D. on Thursday, April 3, 2014

In naturopathic school, I tired of hearing, no matter what the health complaint, ‘Treat the Gut’! Really?! At first it was a little hard to swallow that one’s gastrointestinal (GI) tract could affect so much.  I must say that this is now much easier to swallow after seeing the improved mental health in so many…> read more

Categories: ADD/ADHD, Anxiety Disorders, Bipolar Disorder, Depression, Diet & Nutrition, Digestion & Gastrointestinal Health, Schizophrenia & Psychosis Tags: Campbell-McBride, diet, Food allergies, GAPS, Gastrointestinal Health, GI, Gut and Psychology Syndrome, gut flora

Posted by Mary R. Fry, N.D. on Thursday, February 27, 2014

Signs of spring are starting to show – with bulbs pushing through the soil and buds on trees forming. With the first day of spring still a few weeks away, now is the time to plan for a spring cleanse. Cleansing has been performed for centuries, but is perhaps all the more important in our…> read more

Categories: Diet & Nutrition, Environmental Medicine Tags: Ayurveda, cleansing, detoxification, spring

Posted by Mary R. Fry, N.D. on Friday, January 31, 2014

Folic acid has been widely researched for the treatment of depression. In this post we will continue our Micronutrients in Mental Health Series, covering the 3rd nutrient implicated in depression and anemia with our discussion of folate. The name ‘folate’ is derived from the Latin ‘folium’ which means foliage, as it is abundant in leafy…> read more

Categories: Depression, Diet & Nutrition, Supplements Tags: 5-MTHF, Anemia, anticonvulsants, Deplin, genetic polymorphism, medication, Metafolin, Mood, MTHFR, oral contraceptives, proton pump inhibitors, vegetables, vitamins

Posted by Mary R. Fry, N.D. on Tuesday, December 17, 2013

The holidays are a time of increased stress for many and as year-end tasks pile up, it can make it challenging to get the support and perspective one needs to re-prioritize. As stress can be cumulative, and is also hard to objectify, I think that introducing a scale to assess the burden of stress in…> read more

Categories: Uncategorized Tags: Hans Selye, Holmes-Rahe Stress Scale, Kelly McGonigal, resilience, stress, TEDS

Posted by Mary R. Fry, N.D. on Friday, July 26, 2013

In last month’s blog post on iron’s role in mental (and physical) health, we covered one of a trio of ferromagnetic metals found in nature. Cobalt is another such metal that has a prominent role in our mental (and physical) health. Cobalt is seldom found in its free form, needing to exist in compounds with…> read more

Categories: Anxiety Disorders, Depression, Diet & Nutrition, Schizophrenia & Psychosis, Supplements Tags: celiac disease, Cyanocobalamin, memory, nutrient deficiencies, vegan, vegetarian, Vitamin B12, vitamins

Posted by Mary R. Fry, N.D. on Tuesday, June 18, 2013

In the coming months, I will be covering different vitamins and minerals and their role in mental (and physical) health.  In mental health I think that the role of optimal nutrition is often overlooked. This blog series Naturopathic Mental Health Blog| Psychology & Psychiatry | A Healthy State of Mind aims to change that and to offer you a glimpse into homeopathic forms of…> read more

Categories: Depression, Diet & Nutrition, Homeopathy, Psychiatry, Supplements Tags: Anemia, Dysthymia, Hormonal imbalances, Iron-deficiency Anemia

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