The New York Times
April 15, 2003

Stress: It's Impossible to Avoid, but Possible to Conquer


I pick up my morning newspaper and flip directly to the sports pages because almost every article on Page 1 is about the war. I turn on the radio to get the traffic and weather reports only to hear that American troops have been hit by fire from their own side or that they have killed Iraqi civilians trying to escape the war zone.

Throughout New York City and elsewhere, there are subtle reminders police officers carrying gas masks, soldiers with rifles at airports and toll booths that any of us at any time could be struck by another terrorist attack equal to the devastation of Sept. 11, or worse.

Bankruptcy or insurmountable debt seems to be looming everywhere, resulting in growing unemployment and reductions in services vital to our quality of life.

Then there are the daily reports of a deadly and highly contagious respiratory ailment called SARS that seems to be spreading rapidly worldwide, despite valiant attempts to contain it. A person coughs on a train or in a theater or, worse yet, on a plane, and a thought leaps to mind: does he have SARS?

Members of my East Coast family, including my twin grandsons, are about to fly to California for a joyous family event, and I can't help but wonder whether we'll all arrive and return without incident.

And I know I'm not alone.

These are unusually stressful times. The depressed economy is not the only reason for widespread cancellations of nonessential travel that have left Caribbean beaches, hotels and cruise ships half empty. And more and more employees are working from home, while companies conduct virtual meetings.

Stress, to be sure, is a normal part of life. Stressful events, good and bad, happen all the time.

People become ill, injured or die, marry, divorce, miscarry, give birth, change jobs, move, lose money, struggle to make ends meet, fail at important tasks or work against impossible deadlines.

Somehow, most of us learn how to weather or adapt to such stresses or at least cling to the hope that this, too, shall pass and the future will be brighter.

Coping With Excessive Stress

Sometimes the burden of ever-increasing stresses can overwhelm a person's ability to cope, resulting in depression, confusion, anger, paralyzing fears and even suicidal thoughts. Certainly, the uncontrollable stress of war, even a war being fought on other soils, and fears of terror at home, compounded by economic uncertainty and a ravaging, mysterious disease, can easily mount to the point of being overwhelming.

Stress is particularly challenging if you can do nothing to change the circumstances that provoke it, when your only choice seems to be to find some way to escape it.

"If you are feeling overwhelmed, confused or distressed by the war in Iraq or the uncertainty of the future, or if you're having anxious thoughts and occasional nightmares, that is normal," said Dr. James Gordon, a psychiatrist and director of the Center for Mind-Body Medicine in New York.

"Feeling in shock, not able to take it all in, feeling irritable, anxious, depressed, experiencing mood swings these reactions are temporary and normal, how our bodies respond to too much information, uncertainty and lack of control," explained Dr. Barrie Cassileth, a psychologist and a medical social worker who is the director of integrative medicine at Memorial Sloan-Kettering Cancer Center.

Even though these feelings are normal, you can still take steps to alleviate them, she and Dr. Gordon said.

Dr. Cassileth works daily with patients and families facing life-threatening disease, teaching them how best to cope with what life has handed them. Dr. Gordon has worked for six years in war and postwar situations in Bosnia, Kosovo and Macedonia, and he works with firefighters who lost friends and family members on Sept. 11. The two are experts in mind-body techniques and other readily accessible methods for alleviating stress, fear and anger.

STAY WELL-INFORMED Ignorance is not bliss. Whether the issue is war or illness, what you imagine may well be worse than the reality. Knowing what is actually happening and how you can best deal with the situation or protect yourself and your family from harm may be difficult and painful but can help you stay grounded.

AVOID OVEREXPOSURE Don't spend hours reading, listening to or watching coverage of the war. Get the bare facts and move on to something else, lest you become overwhelmed, numbed or both. My home and car radios are set to an all-music station. I read mostly about news in the arts, sports and science. Our television set plays old movies that we rent or borrow from the library.
SEEK OUT SUPPORT Turn to friends, family, colleagues and groups, and talk with them, Dr. Cassileth suggested. Share your concerns. Dr. Gordon noted that "people in Bosnia and Kosovo, and also in New York City post-9/11, who did not discuss their feelings had significantly more emotional and physical problems than those who did." Even without talking, it helps to be with someone you feel comfortable with. On a particularly stressful day this month, I called a friend and asked if I could come over and knit with her for an hour.

ADOPT A ROUTINE "Structure is crucial to normal functioning," Dr. Cassileth said. "People can feel very uncertain without any pattern to their lives." She urges people to schedule regular times for meals and sleep. "Having a schedule, a routine, is essential to well-being."

GET OUT AND EXERCISE Not just you get your friends and family to join you. "Physical exercise releases stress, makes you feel stronger and can become part of a pattern of existence," Dr. Cassileth said.

SET PRIORITIES It is easy to feel overwhelmed when too many things happen at once and you don't know where to begin. "Prioritize: take things one at a time, deal with what you have to deal with, and gradually things will fall into place," Dr. Cassileth suggested.

EXERCISE THE MIND-BODY CONNECTION If you can relax your mind, your muscles will follow and vice versa, Dr. Cassileth said. Learn techniques like slow, deep breathing and meditation, tools that relax the mind that you can take with you and use whenever you need them.

Dr. Gordon teaches: "Close your eyes, breathe deeply, in through the nose and out through the mouth. Imagine your belly is soft. Say to yourself `soft' as you breathe in and `belly' as you breathe out. If thoughts come, let them come and let them go." Relax your body through massage or yoga or, as Dr. Cassileth also advised, "by taking a warm bath with a scented bath oil while listening to music: the more senses you indulge, the better."
VOLUNTEER "Reaching out to help others is very healing," Dr. Cassileth said. It gives you a sense of control, makes you feel useful and productive and takes your mind off other things for a while.

SPEAK OUT If you feel strongly about the war, don't keep it to yourself, Dr. Gordon advised. "Those who take action, whether writing members of Congress or demonstrating in the streets, deal with the stress of war and its consequences better than those who stay silent."

Copyright 2003 The New York Times Company |