Magazine article American Nurse Today

Subduing Stress: A Physiology-Based Approach: Learning How to Handle Your Stress Can Make a Demanding Nursing Career More Manageable

Magazine article American Nurse Today

Subduing Stress: A Physiology-Based Approach: Learning How to Handle Your Stress Can Make a Demanding Nursing Career More Manageable

Article excerpt

Stress can influence disease development and exacerbation--but managing it effectively can reduce its effects. To promote our own wellness, we need to develop strategies to reduce the effects of stress and protect against it.

How you perceive stress is important. Researchers Richard Lazarus and Susan Folkman proposed that stress is a two-way street involving both the production of stress by the environment and the response of the person subjected to it. So, in a sense, stress is a series of transactions between the individual and the environment. Stressful events have an interactive effect with our immune system, physical and mental health, and future responses to stress.

Lazarus' model asserts that our emotions are determined by our appraisal of the stressor. Based on our personal characteristics and experiences, we evaluate how harmful or challenging the stressor is (cognitive appraisal) and to what degree we feel capable of responding to it. If the stressor seems manageable, its physical effects are reduced. (See Cognitive appraisal of stress: Two phases.)

Stress may cause illness if the threat overwhelms our ability to respond, as during an acute trauma, an unresolved chronic exposure, or cumulative exposure to stress. But if you've used effective coping strategies in the past, you're likely to be able to cope with similar situations effectively in the future with diminished health consequences.

Making connections: Stress, disease, and wellness

Stress-related diseases may include cardiovascular disease, metabolic syndrome, diabetes, and obesity. Evidence also suggests stress plays a role in tumor formation, depression, mental illness, and autoimmune disorders (including systemic lupus erythematosus, rheumatoid arthritis, and inflammatory bowel disease). These conditions are intimately connected with chemical messengers that relay information about the physical and emotional environment to and from the brain, immune system, and endocrine system.

Although the traditional medical model is beneficial in treating chronic disease symptoms, it may be insufficient when it comes to systemic dysregulation. The theory that the stress response and immune systems communicate, with one another has revolutionized our concepts of disease and wellness and led to development of, and continued interest in, the connections between physiology and our thoughts and emotions. It has also opened exciting new avenues for exploring disease development and progression. Perhaps more important, it has helped healthcare practitioners, researchers, and patients envision new pathways to wellness and healing.

New interventions and prevention methods exist for treating the whole body rather than just disease signs and symptoms. Knowing how dysregulated stress responses and systems contribute to disease empowers us to identify and engage in behaviors that may stabilize or return a dysregulated system to a more properly functioning state.

Instead of operating from a pathogenic model that focuses on symptom management, we can focus on a holistic perspective that helps us see how certain behaviors contribute to health and wellness, which in turn may help stave off disease.

Effective stress-management strategy

Here are three basic steps for managing stress effectively:

1. Change the stressor. Determine if you can eliminate what's causing stress. For instance, perhaps you could ask your mother-in-law not to come for a 3-week visit. Of course, she may come even if you ask her not to. Unfortunately, we don't always have control over our stressors.

2. Change how you feel about the stressor. We can't always change how we feel about a stressful situation, but it's worth a try. For example, you might feel better about your mother-in-law's visit if you planned a pleasant trip with her to the farmer's market or asked her to teach you that family recipe you've been meaning to make. …

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