How do you know when your stress has mushroomed to a danger point? Learn the signs—and what to do to stay healthy.

 April is Stress Awareness Month—but most people feel stress every day. In fact, at any given time about half of Americans report feeling stress, and that’s just those who are conscious of it. Marta Obler, MD, is chief of Mental Health at the Kaiser Permanente Fresno Medical Center and has been practicing for 20 years. She identifies key stresses and stress management.

What are the main stresses for adults?

Stress can be produced by many things, but in my practice, I see patterns. One is family and marital issues, another is medical stress, such as chronic pain. Unfortunately, I am seeing a rise in work-related stress since there have been a lot of job losses here in the Central Valley.

Not all stressors are bad. For example, major life changes such as marriage, buying a home, having a child, or getting a promotion are positive. But people can still feel stress around those.

Is stress on the rise? If so, why?

I have seen an increase among my patients. It may be that the pace of life is more hectic, and they are having to do more within less time. They also can’t seem to unplug, and feel compelled or obliged to check their devices. There is also a domino effect, which people aren’t always aware is happening. If you are too busy, you are not relating, which can erode home life. Or if you lose your job, that can affect your self-esteem and finances, which can negatively affect interactions with family and friends.

What are symptoms of extreme stress?

Acute or chronic-acute stress can be caused when you feel overwhelmed and overloaded for an extended period of time. You might find yourself getting angry or crying, and not able to stop negative thoughts.

Essentially, hormones are released and your body is responding with flight or fight. This could result in high blood pressure; neck, stomach, and intestinal issues; irritability, depression, and anxiety; and memory lapses or losses that can impact your performance at work, school, and home. One of the worst symptoms is insomnia because sleep is core to physical and mental health. This could lead to substance abuse, too.

What are some basic rules of thumb for managing stress?

First and foremost, you need a good support system of people, which could range from family to a religious advisor. It’s essential to be able to express your feelings — to laugh, cry, get angry, and just  talk.

You also need to eat healthy, sleep, exercise, and generally enjoy life. Everyone needs to take time to have fun and do what they love—paint, write, listen to music, what have you.

People who are prone to stress should have a regular relaxation technique such as walking, meditation, or yoga. I also suggest journaling for expressing oneself. At Kaiser Permanente we offer excellent stress-management classes, therapy, and medication when necessary.

In the moment, if you find yourself overreacting, it can be good to take a five-minute break and just remove yourself from a situation to regroup.

We need to realize that everyone will run into stress. So it’s key to be aware of your own triggers, to manage it healthily, and to be courageous in getting help if you need it.

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