"There are no drugs that will make you immune to stress or to pain, or that will by themselves magically solve your life’s problems or promote healing. It will take conscious effort on your part to move in a direction of healing, inner peace, and well-being. This means learning to work with the very stress and pain that are causing you to suffer.” ― Jon Kabat-Zinn
Erica's story of getting help with health anxiety and medical stress
When Erica* arrived in my office, she was nervous. She managed to smile, and yet I could tell it was difficult for her to make eye contact. She was pregnant, and she was struggling with panic attacks.
"I get to where I can't breathe. I am afraid I am going to pass out. I keep thinking there is no way I am going to be a good mom. I get this dread in the pit of my stomach, and I feel horrible about it. I should be looking forward to being a mom. I shouldn't be so stressed. It can't be good for the baby for me to get so upset."
Erica's husband was in the military. She could admit that aspects of being a military spouse were stressful. There were times when she felt extremely isolated. When she had imagined having a baby, she'd pictured having friends there to support her. Unfortunately, she was new to this military base, and knew no one. Adding to her stress were memories of her own childhood. Over the course of treatment, as we got to know each other better, she shared painful memories of her own mother's struggle with addiction and what this was like for her. For Erica, she had no template to follow for how to be a mother. This was a source of considerable stress and self-doubt, and she needed help for her health anxiety and medical stress.
What are medical stress and health anxiety?
Stress is a state of tension that occurs when the demands of our environment exceed our coping resources - when we are challenged by difficult circumstances. Medical stress occurs when the particular challenge we face has to do with our health and well-being. Medical stress is present when we experience emotional and psychological strain in medical environments or in response to medical conditions.
Some common sources of medical stress include:
· Receiving a diagnosis
· Uncertainty regarding a diagnosis, or lack of clarity regarding symptom causes
· Undergoing medical procedures or treatments
· The ongoing or chronic experience of illness, pain and discomfort
· Communication challenges in medical systems
· Confusion regarding treatment plans and provider roles
· Financial strain
· Loss and grief
· Healthcare disparities
· Medical trauma
Everyone experiences stress to some degree. Stress is a normal human response to challenging circumstances. That said, the way we interpret stressful events in our lives can make a big difference to our overall mood and sense of well-being. We can interpret stressful events as positive or negative occurrences in our lives. Positive events can create a state called eustress, also known as "beneficial stress." For example, if childbirth is something anticipated with happiness and joy, the brain may interpret the birth itself as positive – and yet, as anyone who has birthed a child will tell you, childbirth is still stressful. It taxes the body and the central nervous system.
Negative events create a state called distress. If the birth of a child is anticipated with dread and worry, the brain may interpret the birth itself more negatively.
Whether a stressful medical event is interpreted as positive or negative, it is challenging – to our bodies, our relationships, our finances. When working with medical stress, even the best of scenarios requires adjustment. For Erica, the birth of her child involved "typical" stressors such as understanding changes to her body, multiple physical examinations by healthcare professionals, and changes to family dynamics with her partner. On top of those expected parts of the birth process, she needed to think through how to gain more support for herself, and what types of boundaries she needed to have in place with her family of origin in order to parent safely. For many, stressors that accompany childbirth include fertility treatment or exploring surrogacy options, thinking about career and money in new and different ways, understanding how chronic illness might impact the pregnancy, and adjustment to the role of "parent." Medical events rarely just impact our bodies. They impact our whole identity.
The human stress response involves activation of our sympathetic nervous system – our fight or flight response. The stress response is complex and involves cognitive, affective, behavioral, social and physiological components.
Signs and signals that your stress response is active include:
· Physical Symptoms: headaches or migraines, muscle tension and aches, fatigue and low energy, sleep disturbances, digestive issues, changes to appetite, rapid heartbeat/palpitations, sweating or clamminess
· Emotional Symptoms: Irritability or anger outbursts, anxiety or constant worry, feeling overwhelmed or unable to cope, restlessness or agitation, difficulty relaxing or feeling “on edge,” feeling hopeless or helpless, having crying spells
· Cognitive Symptoms: difficulty concentrating or making decisions, difficulty with attention and focus, feeling “scattered,” memory problems or forgetfulness, racing thoughts, negative thinking or pessimism, thoughts of hurting yourself or others
· Behavioral Symptoms: changes in eating or sleeping habits, aggressive or impulsive behavior, nail-biting, fidgeting or other nervous habits, increased substance use, withdrawal from typical activities or from relationships, procrastination or avoidance of responsibilities
· Interpersonal/Social Symptoms: increased conflict, difficulty expressing or communicating needs, increased isolation and decreased participation in community
Erica noticed symptoms including fatigue, rapid heart rate and breathing, trouble concentrating, and feeling irritable and edgy. As she began to better understand her body's response to stress and where it was coming from, she began to feel safer and more relaxed. She could observe her symptoms with more compassion, rather than getting upset at herself for having symptoms at all.
How to get help with health anxiety and medical stress
Coping strategies for stress include seeking trusted social supports, finding ways to make our environment more predictable and safe, and accessing knowledge and skills to help us to soothe ourselves. For Erica, understanding the nature of panic and trauma, learning relaxation and mindfulness skills, cultivating trusting connections and setting healthy boundaries helped her feel more confident that she could be the kind of mother she wanted to be - the one she'd needed as a child.
If you or a loved one are struggling with stress related to medical events, psychotherapy can help. Evidence based treatments such as Mindfulness Based Stress Reduction or Cognitive Behavioral Therapy are effective tools to reduce stress and promote well-being. Reach out today to learn more.
*Name and identifying details have been changed to protect confidentiality.
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