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Stress

With Mayo Clinic oncologist Edward T. Creagan, M.D.

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April 10, 2008 8:24 a.m.

There's no simple test for stress

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By Edward T. Creagan, M.D.

A cornerstone of medical management is the history from the patient; a physical examination; and appropriate X-rays and blood studies. For example, if a patient develops cough, thick sputum production, shortness of breath, and fever, and with a haziness on the chest X-ray and an abnormal blood count, the diagnosis in all likelihood is pneumonia and treatment can be prescribed.

What about stress? There is no simple blood study. There is no simple CT scan or X-ray to diagnose the condition. We may be stressed out, frazzled, and not know it.

Let me explain. A recent press release from Southern California addressed the following situation. The patient was a woman in her late forties who was juggling a career; caring for her elderly parents; managing a household; and dealing with the trials and tribulations of two young children. Over a number of months, our individual became irritable; put on 20 pounds because of a voracious appetite; had a profound feeling of unhappiness; and experienced overwhelming fatigue.

A variety of studies were essentially normal, yet the patient was miserable. A conscientious family practitioner took a careful history and added up the number of hours per week that this individual was devoting to others such as her job, her husband, her children, and her parents. "When is it time for me," the patient asked? The doctor informed her that she had to be proactive, she had to be preemptive and carve out time each day for yoga, for meditation, for walking, or just quiet reflection unplugged from all the gadgets that drive us crazy.

So, an important lesson. If we do not take care of ourselves, we are hardly in a position to care for others and after all, if our health deteriorates, nothing else really matters.

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10 comments posted

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April 17, 2008 10:36 a.m.

Hi Roberta: The amygdala is a part of the brain which processes emotions. In response to a perceived threat the amygdala starts a process increasing the stress hormone cortisol which can profoundly influence immune function and quality of life. Some studies suggest that meditation may alter our handling of stress. I do not know about the role of the MMPI but would like to hear from others. All the best.

- Dr. Ed

April 16, 2008 10:05 a.m.

What part does the amygdala play in stress? I happen to be a hypersensitive introvert trying to get along as a minority in an extrovert world. Would the MMPI test discover this cause of stress?

- Roberta S.

April 15, 2008 3:21 p.m.

Not everyone has great skills for managing stress. Stress management skills can be learned through taking either an anger management class or a stress management class. As an instructor of anger management classes for several years as well as publishing two books that cover skills in stress management, I strongly urge anyone with a stress problem to get some help by learning new coping skills.

- Ari Novick, Ph.D.

April 16, 2008 12:49 a.m.

Stress is the one thing in my life I can't control. Every day regardless of how I feel something will stress me out. If I am having a good day, the most minor thing can cause me stress to ruin the rest of my day. Managing this is a challenge but After reading alot about self stimulation and mood switches I have been able ot really change my perception.

- Ali S.

April 15, 2008 10:00 a.m.

Women! I am speaking to you as caretakers. Stephen Covey says to take care of the golden goose. You are the golden goose and if you do not take care of yourself, eventually you will be unable to help your family. Do everything within your power to reduce your stress: move to a less expensive house; pay off bills; stop competing with the neighbors; get rid of the tv and cable; fix healthy meals and exercise. Caretaking begins with the self. Our addictive behavior (e.g. caretaking others and not ourselves) destroys our health. Remember, you are the golden goose producing the golden eggs.

- Jo Anne

April 14, 2008 2:10 p.m.

Wow! there are all kinds of stresses, mine deals with white coat syndrome, like anything to do with medical test scares the devil out of me, and I have lots of problems with illness. Big problems that call for me to see my medical Doctors often. I am now diagnosed as Anemic and must get another blood test next month and I am very scared, what it is now??? Also I have to get a Abdominal Ct scan in a month for my AA. I pray that I will not be so frightened, but I am failing and I am worried the stress will cause me more problems and effect my test. Boy do I need a shoulder to cry on. Thanks for allowing me to use yours.

- Barbee Wheeler

April 13, 2008 9:28 p.m.

I haven't had a panic attack since I was diagnosed with Thyroid cancer. It just hit me one day and virtually left me paralyzed. Fortunately I had an excellant GP. Now because of serious financial and legal complications involving my immediate family I find myself having them again. My insurance doesn't cover psychiatric help and frankly, its just too expensive for me right now. I know I'm not the only person in this situation so I am very open to suggestions. I have increased my exercise, I have tried to be more social and certainly less self absorbed. But its an awful feeling to be filled with dread and I try to shake myself out of it because I know logically things will eventually improve. So again, any suggestions will be appreciated!

- Lore

April 12, 2008 9:46 p.m.

I'm really glad to find this blog. I wrote a book on stress when I first got out of graduate school and thought that the efforts made by researchers would have had more of an impact by now. Of course, I thought we'd see commercials with men grinning and mopping floors, too. I'm writing on people, relationships, and stress management through developing as a self defined person. I'll be back. Thanks. mysteryshrink.com

- Barbara Rice DeShong, Ph.D.

April 12, 2008 4:27 p.m.

Ellen Sims, I feel for you. Keep speaking out. Let America know your situation, especially now with the election coming. Call Michael Moore. Tell your children, maybe they can help you sell your house and find assisted living nearer to them. See if you can get your medicine from Canada. Find others who are in the same situation as you and bring a united voice to you State government. Don't give up. America is a great country and you deserve better.

- Tracy

April 12, 2008 1:06 p.m.

I'm so stressed out I don't know where to start...money? Since Medicare covers so little and costs so much, if I go to the doctor I can't buy the ever more expensive groceries. If Medicare part D doubles in cost again next year I won't be able to get subscriptions anyway. (I'm already cutting down on taking them...half an Atenolol,for instance. You'd never guess that the nice but not at all fancy neighborhood I live in has become high crime since assisted living was put in a few blocks away (and my guilt about my anger is another stress...these people and their children are supposed to live where?)My storm door was ruined and my front door threshold pried up about an inch at one end one night...There is no point in calling the police..they are overwhelmed just like the schools and the hospitals here. I ask myself."Have I become prejudiced or am I just being realistic?" My home is paid for, but it is a mess I keep struggling with against dirt and my own bad health, and with all the people out of work, all the State sends me for the "wonderful" keep old people in their homes program are "assistants" who know nothing except how to steal...I stopped the program because I could not keep up financially with what they were carrying off.(I did have a couple of exceptions for a few days, ones who were waiting to be called to better jobs) I have wonderful children, who live far away, and lying to them so they won't worry about things they can do nothing a

- Ellen Sims