Health problems lead the list of stress-inducing events experienced by Americans last year. But while health, work, finances and family can all set people on edge, there are ways to cope, experts say.
The Robert Wood Johnson Foundation, NPR and the Harvard School of Public Health teamed up to ask 2,505 adults about stressful situations in their lives. In "The Burden of Stress in America" poll, 49 percent reported major stress during the year. Of those, 43 percent named health, including illness and disease (27 percent), or the death of a loved one (16 percent) as causes of stress. The next-most-common stressors were work (13 percent), life changes and family issues (9 percent each) and problems with personal relationships (6 percent).
More than a third said their stress levels had been high in the last month, and health again figured prominently: Those same people cited poor health (60 percent), disability (45 percent) and chronic illness (36 percent) as major stressors. Not having enough money and facing danger were also named by 36 percent of these respondents, barely edging out single parenting and raising teens (35 and 34 percent). Findings have a 2.4 percent plus or minus confidence level.
"We were particularly interested in this topic because stress has a huge impact on a family's ability to be as healthy as possible," said Kristin Schubert, director of the foundation's Vulnerable Populations Portfolio. "If a person is stressed on a day-to-day basis, a biological response in the body can undermine health and well-being. We wanted to understand what kind of stress people are experiencing and to raise awareness about it. I do not know if people all draw the connection between stress and well-being."
One surprise in the poll, she noted, was how many people experience stress daily. "All of us can relate to the stressful day. You get over it. For a lot of people, that kind of stress happens day in and day out, and the more challenges a person has going on in life, the greater the chance," Schubert said, adding that some of it is toxic, causing health to deteriorate over time.
Stress is designed to be a protective factor, tripping a "fight-or-flight" response that can save people from harm. But when stress remains high over time, it takes a major toll. The Mayo Clinic says effects can include anxiety and depression, stomach and heart problems, disordered sleep, weight gain and impairment of memory and focus.
Stress also increases conflict, putting pressure on relationships, said Don MacMannis, a Santa Barbara, California, psychologist and the co-author of "How's Your Family Really Doing?" The brain sends hormones into the body, kicking off the "fight-or-flight" response — and often, it's "fight." "If I am upset inside, I am more likely to find something to pick at about you. I might have rolled with the punches, but with stress, I criticize you."
One person's stress can take out an entire family. Discoveries about the brain's neurons have led some researchers to conclude that "emotion is contagious" within families, MacMannis said. Work stress, for instance, gets passed around the clan.
Robert Wood Johnson Foundation president and CEO Dr. Risa Lavizzo-Mourey said recognizing the presence and roots of stress can lead to creating better home, workplace and community environments.
Who feels stress
The women polled were far more likely than men to say they'd experienced major stress in the last month (48 percent vs. 25 percent). For low-income families — those with incomes below $20,000 — 7 in 10 cited finances as a major stressor, compared with 35 percent of those with larger incomes.
Too much responsiblity, financial challenges and work problems were also listed as causes of major stress in the poll results.
Psychologist David Simonsen, from the Seattle, Washington, area, sees those same stressors in his clients. A lot of single parents tell him they feel they're drowning in responsibility — "usually mothers who have to figure out how to nurture and do the discipline alone." Many say they feel inadequate, he said. He also sees families who struggle to make ends meet, especially if they are financially overextended.
Peer pressure can fuel adolescent stress, which teens pass on to parents. Even something like wanting to have a cellphone can add to the pile of stress. Simonsen predicts families will feel even more stress now that recreational pot is legal in some areas as teens pressure each other and push boundaries.
Simonsen has seen stress trigger depression and other mental health issues that may pose lifelong challenges. It can make people short-tempered and unreasonable in their demands. When parents are unreasonable, kids don't respect and won't listen to them. That can escalate into other issues.
"I think the way to reduce that is to realistically look at the things causing stress, like single parenting. If you recognize that 'this is a thing that stresses me out' and have some kind of support network, stress is more manageable," Simonsen said.
Like a dog chasing its tail, stress makes sleep elusive and lack of sleep increases stress — and both increase irritability, said MacMannis. Missing sleep is also problematic because "over 90 percent of daily replenishment of serotonin happens during the REM sleep cycle," which is shortchanged by inadequate sleep.
MacMannis said it's crucial to remember that "quality of time with family members is more important than quantity." That's one reason couples who neglect their relationship have more stress. Being loving, kind and affectionate with each other is a gift parents can give the whole family, he noted. "Have a date night and also develop tools to handle issues as diligently as you attend to the chicken bones in the kitchen garbage. No one lets those sit around because it starts to stink."
In McMannis's practice, finance shows up as a major stressor for families. Jobs worries, lack of time, pressure to help kids get into the "right" schools and other factors also challenge family composure and balance.
It's not always possible to oust stressors, MacMannis said. But you can change how you deal with your feelings. You can get enough sleep and exercise as a way of finding your center. You can try different forms of relaxation. For a few minutes each day, he said, "take a slow, deep breath. Take a bath, take a walk, listen to good music."
Those polled cited time with family or friends, prayer and meditation, outdoor activities, eating well, exercise, hobbies and pets as ways they coped with stress in the past month. Some, though fewer, said they sought help, from getting a prescription to having therapy or taking time off.
Schubert emphasizes the solvable nature of stress. While she believes America "needs some big changes to better support families," she also sees "small changes we can all make to help parents and families be less stressed."
Those include providing a meal to a family with a new baby or offering to watch a single mom's kids while she runs to the store. Empathy is a big stress buster.
"There are smaller actions that really count at the end of the day to help people better manage," she said.
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