Stress can be caused by any number of things whether they are happy or sad. Of course divorce is stressful, however so are things like getting married or moving home.
Stress is the key to understanding mental health issues. Whatever causes stress - the event acts as a trigger - however, it is how you manage the stress internally that is the most important factor.
What is Stress? And it’s normal?
We need a tiny bit of stress because without it we wouldn’t even bother getting out of bed! This is normal stress. The stress response is triggered by chemicals in the body when an experience requires us to ‘fight’ or ‘take flight’, in other words – hold our ground or run, as our ancestors had to do thousands of years ago when it was a life or death situation.
Stress is a high state of arousal and it makes it possible to do things; but when it is out of control it makes it hard to cope because ways of dealing with it in the past are not working now. (https://www.mind.org.uk/information-support/types-of-mental-health-problems/stress/signs-of-stress/#.W23TRC2ZMWo)
There are different types of stress – but these do not damage mental or physical health and well-being. Short-term stress will dissipate when the emergency is over and does little harm. However, long-term, persistent chronic stress leads to powerlessness and can impair health, for example, due to being worried by your job and lack of financial security or loud and aggressive neighbours.
Our body automatically has hormones (bio-chemicals) whizzing around to deal with internal conditions and external stimuli – all of this goes on out of our awareness. This chemical cocktail helps us to manage life, so ordinarily cortisol is there early in the morning to give us an energy boost and eases off, normally, later in the day whilst serotonin enables relaxation.
The brain is a powerhouse where these biochemical are concentrated and it checks moment-by-moment experience and arranges the reactions to these. If there is an overload experienced around social settings that cause fear or challenge it sends messages to the amygdala. This sends further information to the adrenal glands which give an adrenaline push to get out of the stressful situation whilst everything else is on hold such as the immune system. However, if the person is constantly feeling distressed then this feedback loop has got stuck and caught up in anxiety, depression or stress. It is important for the person to find someone to talk to help become ‘unstuck’.
How does Cortisol affect stress?
The stress hormones and especially cortisol are major contributors to anxiety, depression and physical manifestations of emotional pain, especially if it has gone on for a while. This is how I explain to clients who are showing signs of the above or have suicidal feelings, in non-scientific terms, about what goes on in the brain: the amygdala is normally the size of an almond in the middle of the brain, due to stress it gets bigger and so other bits of the brain don’t work so well. When the amygdala is bigger, it causes cortisol to flow like a tap and vice versa, which then means that the depression, anxiety and stress gets worse. To stop the flow and make the amygdala its normal size again takes a while, but it can be done. The person becomes less susceptible and can manage the stress for the long-term in a different way to before.
Stress makes you Stupid!
If there is too much cortisol, because it affects parts of the brain that are responsible for memory and learning, you start to forget things and it becomes difficult to remember things that were relatively easy or straight-forward. So stress does make us stupid – more below. When this happens there is a tendency to withdraw from other people, by initially not being involved in activities and isolation in extreme cases.
Do you need a blood test to check cortisol levels?
It is easy to monitor the effects of cortisol because a complicated and expensive blood test is not needed – a saliva test can be taken at different times of the day to identify the causes of stress and the particular individual’s reaction to the stress and the impact on their body and mental health. (https://guardian.ng/life/wellness/stressed-by-work-a-saliva-test-can-detect-it)
Stressed Parent = Stressed Child
Children pick up the feelings of an anxious or depressed parent and this will play out as poor mental health in their childhood, teenage years and into adulthood. Where a parent is preoccupied and distracted with adult concerns say with money issues, this lead to high levels of anxiety in a child. Where there have been traumatic events, such as divorce or abuse, Australian researchers state it shows as high cortisol levels in hair samples of children. The saliva test does not work so well in children. (https://www.theguardian.com/society/2016/jan/07/cortisol-levels-in-childrens-hair-may-reveal-future-mental-health-risk)
Are some people more Susceptible to Stress than others?
We all produce different levels of cortisol dependent on genetic factors, personality, life experience and attachment issues.
Those who are high reactors of stress will not need much stimuli to release a lot of cortisol – they can become easily depressed or anxiety-ridden and or overweight. However, if it is comfort-eating or bingeing, it leads to resultant guilt which can also be stressful and the cycle begins again. (https://www.health.harvard.edu/newsletter_article/why-stress-causes-people-to-overeat)
Heightened cortisol is linked with the right frontal lobe of the brain which causes fear, being ill-tempered and withdrawal and isolation from others. This can lead to psychological problems such as suicidal ideation, anxiety, depression, and also obesity, sexual abuse, eating disorders and addictive behaviours such as gambling, and using legal and illegal drugs.
High cortisol levels also effect the body – the immune system is compromised leaving the person vulnerable to infections and fearfulness hinders the ability to retrieve memory and manage behaviour.
Those who are low reactors to stress appear to those around them as though they are coping yet there will be outbursts of very aggressive behaviour. These people often have a ‘stiff upper lip’ or are stoic.
When someone has been subjected to high cortisol exposure their body will shut down the cortisol receptors and that may be why the person is a low reactor to stress. It is also a defence mechanism to avoid psychological and emotional pain leading to disassociation and numbness. Which may lead to hostility and anger outbursts. These people also struggle with articulating their feelings into words.
We have to be careful about these artificial labels as people can be quite fluid, but one way of looking at this is to think in terms of the high reactor to stress as a person who is actively engaged with their distress, whilst the low cortisol person is not acknowledging their level of distress and denying it to themselves and others.
How do we go about becoming unstuck?
First, we have to acknowledge we are in trouble and not be stoic and continue and hope the stuckness passes – basically the cortisol ‘tap’ has been turned on and so has to be slowly turned off – there is no quick fix. To appreciate that getting back to ‘normal’ is going to take time means there has to be patience, kindness and compassion towards oneself to build self-love, self-esteem and self-confidence which dwindle away with distress and not being able to be how we were before. It is important to not get caught up in self-sabotage, guilt-tripping or giving yourself a hard time.
Methods you can employ to reduce cortisol are:
· Doing exercise
· Breathing deeply
· Keeping a gratitude journal – being thankful for 5 things each day initially
· Stopping negative self-talk
· Doing the things you used to enjoy doing.
Talking to a therapist, family and friends combined with the above will enable you to get better.
Why do I need to work outside of the therapy room?
Lets take the issue of smiling – if someone only smiles in the therapy room, that is an hour or 50 minutes maximum, the chances are unless they are having laughter therapy that isn’t going to happen! If they smile for half the time they are awake in a week, then on average that is 7 x 8 hours = 56 hours. Smiling, even a fake smile, gets the dopamine and serotonin levels in the brain working which help to reduce cortisol levels – just imagine how much a real smile would affect the cortisol levels!
By virtue of talking through what the depression, anxiety or stress feelings and thinking are and the commensurate coping mechanisms used to get by, the person can start to break old habits, find different methods of coping and try new ways of dealing with the distress and the corrosive effects of cortisol.
Those with a strong immune system will have a better emotional intelligence and therefore be able to manage their cortisol levels and stresses more easily. Just because someone has struggled with their responses to stress in the past, it does not mean they will continue to replicate that pattern, they can shift to a healthier place.
Kala Patel MA, Counsellor and Psychotherapist MBACP, PGCE (Oxon)