Mental health and wellness is the state at which one feels, thinks, and behaves. Mental health can be viewed on a continuum, starting with an individual who is mentally well and free of any impairment in his or her daily life, while someone else might have mild concerns and distress, and another might have a severe mental illness.

Everyone has “stuff” that they keep contained in a tightly sealed plastic bag. There are some who occasionally can’t help but let the “stuff” leak, and there are those with the bag wide open.

However, in our society, we still tend to stigmatize those who let their “stuff” leak out instead of helping them, understanding them, or simply not judging them. Just as we all know someone with cancer, we all know someone with a mental health disorder.

Mental health is just as vital as physical health. In reality, the two coexist and should not be treated separately. There are many mental health disorders that exacerbate physical concerns or disorders, and vice versa.

For instance, someone who suffers from chronic migraines might also suffer from an anxiety disorder. Obesity contributes to the severity of symptoms of depression. Poor anger management is associated with high blood pressure. Behind every medical illness, it is possible to find a mental health concern as well.

It is also possible that a boost to mental health can alleviate symptoms of a medical condition. As an example, those who receive art therapy or pet therapy in hospitals are shown to have a speedier recovery than those without, as well as a decrease in severity of symptoms experienced.

A holistic approach for individuals needs to be the standard. Physicians, nurses, dentists, psychiatrists, psychologists, mental health counselors, and other mental health professionals need to collaborate to provide a complete treatment plan. A medical doctor who doles out prescriptions for irritable bowel syndrome also can refer the patient to a therapist for stress management. A dentist whose patient is suffering from extreme anxiety can have a mental health professional onsite or have one to whom to refer the patient. A psychologist can suggest that his patient see a specialist for any symptoms that can be contributing to his or her eating disorder.

As reported by the National Institute of Mental Health, more than 26 percent of the adult U.S. population has a mental health disorder, with over 22 percent of cases being considered “severe.” Mental health disorders include anxiety disorders, attention-deficit/hyperactivity disorder, autism, eating disorders, mood disorders, personality disorders, and schizophrenia.

Still, only 1 in 3 individuals will seek treatment for his or her disorder. It’s as if only 1 in 3 individuals who suffered from a high fever or a broken bone sought out a doctor.

We tend to view mental health as something that is an illusion, “all in one’s head,” or that certain disorders are overdiagnosed. Has anyone ever exclaimed that “cancer is overdiagnosed”? Yet, I have heard countless times that attention deficit hyperactivity disorder (ADHD) is being diagnosed too loosely in children and adolescents.

This month is to advocate for the awareness of mental health; however, it should be a consistent concern. Recent events have brought mental health awareness to the surface. We need to know what that means. This does not mean all catastrophic events are caused by those who are mentally ill and therefore we need better treatments. In fact, statistics show that those who are severely mentally ill are more likely to be victimized than to do harm.

It is easy to blame or stigmatize a certain group when events that cannot be understood occur and we grasp for any bit of reasoning we can. But it is neither accurate nor fair. This is the time that we educate ourselves and become properly informed, and develop compassion and understanding.

References

Brodie, S. J., Biley, F. C., & Shewring, M. (2002). An exploration of the potential risks associated with using pet therapy in healthcare settings. Journal of Clinical Nursing, 11(4), 444-456.

Demyttenaere, K., Bruffaerts, R., Posada-Villa, J., Gasquet, I., Kovess, V., Lepine, J. P., … & Chatterji, S. (2004). Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. JAMA: The Journal of the American Medical Association ,291(21), 2581.

Monti, D. A., Peterson, C., Kunkel, E. J. S., Hauck, W. W., Pequignot, E., Rhodes, L., & Brainard, G. C. (2006). A randomized, controlled trial of mindfulness‐based art therapy (MBAT) for women with cancer. Psycho‐Oncology, 15(5), 363-373.

Then I was going to relate the story about how, in the summer of 2002, I chose to stop taking my medicine the way my doctor directed me to take it, and then I stopped taking my medicine at all.

This was a bad choice. As a result, my illness became an emergency.

Nine hours in the ICU, four days in a private room, and two more weeks of hospital care brought a bill that topped $95,000.

The cost of nine years of care was eaten up by just a few weeks of my irresponsibility. That was cost that the health care industry, including my insurance company, would not have had to bear if I had only taken my medicine as directed.

It then seemed easy for me to extend this argument to all patients with any chronic disease. Do what your doctor tells you and your condition should improve, or, at least, be far less likely to worsen. By patients only complying with their prescribed treatment regimens the cost of health care in the United States would go down.

How much? A lot. As a matter of fact, a New England Healthcare Institute study of health care costs in the United States pegged the added cost of care due to patient noncompliance at $290 billion. That’s 15 percent of the country’s total annual health care cost. And a Medco study found that only 50 to 65 percent of patients with chronic conditions adhere to the medication therapy prescribed for them.

It seemed clear. I am, for my lost summer, and everyone else who does not take responsibility for their own treatment, everyone who does not comply with their doctor’s orders, are responsible for the high cost of health care in the United States.

When noncompliant, a person does not take his or her medicine as directed. This often leads to their condition worsening and results in higher costs of doctor visits, emergency room visits, and hospitalizations. On the other hand, medication compliance can significantly reduce these costs.

According to Medco, for every dollar spent on diabetes medication medical cost savings are $7.00, for every dollar spent on high cholesterol medication medical cost savings are $5.10, and savings of $3.98 are found for every dollar spent on prescription medication for high blood pressure. Mental illness costs are surely similar.

So if simply taking one’s medicine can lead to lower total health care costs, why are so many patients not taking their medication as prescribed?

Reasons for noncompliance include side effects, lack of continuing symptoms, and, yes, irresponsibility. But cost may loom largest.

I have always had health insurance. The co-payment for my medicine is $49 per month when I’m stable (it was higher, but one drug went generic). It goes up during rough patches. I’m responsible. I pay it. I’m well. I thought, perhaps I adhere to my treatment regimen because I am so heavily invested in it.

Maybe if everyone paid a larger share of his own health care bill, compliance with treatment would increase. Maybe personal responsibility, sacrifice when necessary, and more participation by each individual in the cost of his or her care would improve compliance rates and reduce the overall cost of health care.

But the cost of medication to the individual must be considered. As costs increase, fewer can afford to pay them. A study from the National Bureau of Economic Research finds that an increase in medication co-payments from only $6 to $10 results in a 6.2 percent increase in noncompliance and a 9 percent reduction in the share of fully compliant persons. The same study finds that increases in coinsurance lead to even larger increases in noncompliance. As for the uninsured, the American Public Health Association has found that 89 percent have not filled a prescription due to cost.

What was lost on me was some very simple economics. If each individual pays less for his or her prescriptions, compliance increases and the nation and insurance companies pay less of a total health care bill. Unfortunately, the trend in health insurance is for each individual to pay higher co-pays or coinsurance. As these costs go up out-of-pocket expenses may exceed one’s ability to pay. The choice? Noncompliance or increased debt and possible bankruptcy.

So yes, compliance is a choice. And noncompliance greatly increases the nation’s health care bill. Every proposal on the table that makes an individual pay more for his medicine will increase noncompliance and add even more to the nation’s health care bill. High deductibles and higher co-payments charged by insurance companies against each individual will only make the problem worse. Paradoxically, as cost-driven noncompliance pushes total health care costs higher, these same insurance companies may find themselves less profitable over the long run as they face the higher cost of complications caused by medication noncompliance.

Perhaps if insurance companies lowered prescription co-payments more patients would take their medicine as directed and the insurance companies, with fewer complication-related charges against premiums, could actually increase profits. Pharmaceutical companies would benefit as well as more prescriptions would be filled. We should have no problem with health insurance and pharmaceutical companies making more money if the profits they earn come from lower total health care costs and healthier individuals.

As for my, and others’, idea that if people pay a larger percentage of their health care costs they will live healthier, more compliant, lives, the truth is that health and compliance can be expensive. Low-cost prescription benefits must be considered as we approach ideas to lower total healthcare costs. Higher costs to individuals for medication lead to higher rates of noncompliance, which lead to a higher national health care bill that, one way or another, we all must share.

References

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3326767/

http://www.hreonline.com/HRE/view/story.jhtml?id=5059249

http://www.nber.org/digest/apr05/w10738.html

http://www.commonwealthfund.org/~/media/Files/Publications/Issue%20Brief/2010/Jun/1408_Morgan_Prescription_drug_accessibility_US_intl_ib.pdf

People who are all about thinspiration engage in disordered eating in order to be as thin as possible — a common symptom of anorexia. But they don’t see it as a disorder or a problem, making this an insidious problem.

Nonetheless, such eating and self-image problems can result in health problems, even putting the individual’s life at risk.

Some people have sought to get common words or terms that people engaged in thinspiration use banned from social networking websites. One such woman is Torri Singer, a broadcast journalism major who has recently begun a petition to get such terms banned from Twitter.

Many social networks have already climbed aboard the bandwagon, including Tumblr, Instagram, Facebook and Pinterest. And while such policies have been implemented, thinspiration content is still easily found on many of these networks. I suspect that’s one of the challenges of implementing a policy like this — it’s extremely difficult to police, especially if people can just slightly alter the terms they use to talk about these issues.

But that hasn’t stopped Torri from putting Twitter on notice.

“[I want] to raise awareness about the harm of destructive thinspiration messages, and to prompt Twitter to make real change in order to stop the spread of this preventable growing trend,” Singer recently told me. Her inspiration for this campaign came from family:

My sister suffered on and off with eating disorders in her early adult life, so preventing other intelligent, strong, and beautiful girls from forming or elongating their disorders has always held a place of importance in my life. I know how difficult it is to be a girl and have constant exposure to beauty ideals, I don’t think we need any more pressure from self-generated pro-eating disordered “lifestyle” hashtags.

But when a website or social network changes its Terms of Use to remove such discussion from their networks, can it be an effective deterrent? “There is no doubt that other media sites such as Facebook, Instagram, Pinterest, and Tumblr have a long way to go before they are really safe and free of thinspiration triggers,” replied Singer.

“But they have made the first steps toward taking action and being responsible for the safety of their users.”

She also addressed people trying to change the spelling of terms they were using to get around the service’s policing efforts: “Instagram’s initial attempt to limit thinspiration led users to create new spellings (such as thynspo). Instead of giving up on the effort, Instagram revised the policy, stating it will disable “any account or hashtag found to be encouraging eating disorders.”

“The first step is ensuring that these messages are not readily available, and that is where policy change comes into play and really matters.”

Of course, trying to stamp out discussion of a topic on the Internet is impossible, given the hundreds of millions of websites, social networks, forums, and online communities. “By reducing the number of mainstream venues where these pro eating disorder messages are displayed,” Singer says, “we are reducing the exposure, and therefore the dangerous behavior that results (or continues) because of these online interactions.”

I agree — efforts such as Singer’s can make a perceivable impact on the popular, mainstream sites, reducing the likelihood of exposing this ideology to a new, naive audience. Especially when that site is a social network as large as Twitter.

“Banning thinspiration terminology means less accessibility to damaging phrases, encouragement, and images that propel disorders,” notes Singer. “It will prevent susceptible people from forming eating disorders, and people recovering/struggling with eating disorders from exposure to triggers.”

“In my mind, just getting people to have this conversation means that it has been some degree of successful. It is really amazing to see people who sign generating comments about their personal stories and their struggles. Many have said that thinspiration has been a big trigger in their lives and that they support any effort to ban it from impacting others like them.”

Efforts such as Singer’s are a good attempt at bringing attention to the problem and helping people understand that use of these kinds of keywords and hashtags only reinforce the disordered behavior — on a scale that wasn’t readily possible just five years ago. We applaud and support Singer’s petition and efforts to help reduce thinspiration messaging on mainstream social networks.

We encourage you to sign the petition:
Twitter: Restrict use of thinspiration language and hashtags

One of those things was eat ice cream. A lot. So I gained a few pounds. It was time to buy new pants anyway. The only important thing was that my medicine was working and I was feeling good. I felt like participating in my life again. Feeling good and eating ice cream were natural.

But then I broke the couch.

Maybe it was a coincidence that I was the one whose bottom touched the couch and made it go POP and collapse. But it had occurred to me, in that moment I felt the couch break underneath me, that I had gained a lot of weight. And that was enough to tell me that all this weight gain was starting to bother me.

I finally realized that as my mood had gone up, so had my weight; maybe my medicine came with a trade-off. I’d never had a medicine that made me gain weight before or gave me cravings that led to weight gain. But here I was.

I’d always told people in the same situation that it didn’t matter if they gained weight. Obviously mental health is more important than gaining a few pounds.

But is there a line that can get crossed, where weight gain can make the scales tip in favor of switching meds? What’s the number? 15 pounds? 25 pounds? 30 pounds? 50 pounds? In what span of time? One month, three months, a year? What is OK and not OK?

Mental health is most important, but at what point does weight gain also affect health? It affects physical health, like blood pressure and risk factors that come with obesity (I am now technically obese), but I’m not even talking about the physical drawbacks of weight gain. What I’m irrationally worried about is the emotional toll that weight gain can cause.

I’m not satisfied with what the medicine is doing with my body. I don’t feel like myself. I feel like myself when I was pregnant, only without a baby, meaning I feel too big and tired and slow. That is affecting my mental health. Not in a serious, clinical way. But in a way that is still real.

Still, I would never stop a drug that’s working in favor of nothing, or one that didn’t work, to be able to lose weight. I’ve been in the dark hole that depression is, and there’s no way I would jeopardize my own quality of life or my family’s with my vanity. But it’s a little tempting, when I’m still on my meds and they’re working well, but there’s just this one side effect…. And I think, maybe I could stop. But I wouldn’t just stop; I would switch to something else, after talking with my doctor like I should. I’m more vain than I realized, but I’m also even more terrified of falling into depression again.

One of the most disconcerting things is the feeling that I don’t have power over my body. Even when I eat well, and exercise, and sweat off what feels like pounds of water, it turns out I have actually gained weight. I haven’t lost a single pound since I started my medicine several months ago. That unsettles me and makes me feel a tiny bit like I do in a depressed state: I am not in control of my body.

This doesn’t cause me to lose hope in general, to think that there won’t be a better time. But it does cause me to lose confidence in myself. I’m already on shaky ground, living with mental illness. Will I feel good today or bad? How am I feeling? But now, I add, How do I look? How much have I gained? to the daily evaluations. I can’t always depend on my mind; now I can’t depend on my body.

Having a mental illness throws new challenges at me at every turn. Even when I feel well, it still reminds me of its presence, in this case, through these extra pounds clinging to me. I believe that there might be side effects and trade-offs to medication, but I also believe they saved my life, or at least saved the quality of my life, and that it’s worth it. And I believe the perfect medication might be out there, waiting to still be discovered for me.

Maybe I’ll always have to make the decision between effective medicine and side effects like weight gain. But I have hope that someday I won’t have to.

While every situation is unique, Christina Steinorth, MFT, a psychotherapist and author of Cue Cards for Life: Thoughtful Tips for Better Relationships, offered her suggestions for helping aging parents.

1. Empathize with your parents.

Sometimes you might be taken aback by your parents’ frustration, moody behavior or neediness. In fact, on some days, they might be downright unpleasant to be around. But it’s important to be empathetic and understand where they’re coming from. According to Steinorth, “Aging is a series of losses — loss of employment, health and energy, friends, mobility, and independence.” Consider how you’d feel if you were in their situation, she said.

2. Call them regularly.

When Steinorth was researching her master’s thesis, the number one thing aging parents wanted from their kids was simply to hear from them. She suggested setting a reminder on your phone to check in with your parents and see how they’re doing.

3. Get other family involved.

When helping your parents, don’t take on all the responsibility yourself, unless you have to, Steinorth said. For instance, she knows of one family who emails updates to each other any time a sibling visits their parents. This not only provides information on their parents’ health and current situation, but it also makes it easier to coordinate visits and share responsibilities, she said.

Communication among family members also is key when parents need financial help. “Sometimes siblings will help offset expenses by giving your parents a little bit of money every month — they just need to know what the financial need is in order to be able to make the decision to help,” Steinorth said. (She also suggested seeing a financial advisor who specializes in elder care issues to discuss your options.)

4. Seek out potential problems.

Walk around your parents’ home, and scrutinize the surroundings for any necessary repairs or changes. For instance, look out for uneven flooring, handrails and well-lit hallways and stairs, she said. Also, check if essential items are within reach and emergency contact information is next to the phone. If something major requires repair, find out if your state offers low-interest loans to seniors, Steinorth added. She suggested visiting this website for more information.

5. Advocate for them.

If your parent has an illness, make sure both of you have a good grasp of what that means and what treatment entails. For instance, know the medications they’re taking and when they’re supposed to be taken. If you’re accompanying them to appointments, ask questions, and take notes, she said.

6. Encourage them to be active.

Many aging parents tend to be isolated, because they stop driving, get tired easily or have hearing or vision loss, Steinorth said. She stressed the importance of helping parents stay both socially and physically active.

“Talk to them about their friends, senior groups, and church or synagogue members. Find out what parks, the library, museums, nearby universities, and community centers offer in the way of organized activities.”

Physical activity is key for improving mood, endurance, balance and strength and delaying cognitive decline, she said. For instance, aging parents can walk, or participate in exercise programs for seniors.

7. Help them downsize without being bossy.

When helping your parents downsize, don’t tell them what they should and shouldn’t keep or toss anything unless you have their permission, she said. “Realize that your parents have many memories and treasure things that remind them of relatives and happy events — these are specific to the individual and just because you don’t see the value in certain items, doesn’t mean your parent shares your view.”

8. Help them create a memory book.

It’s common for seniors to experience short-term memory problems, according to Steinorth. Reminiscing might help. She suggested creating a scrapbook for your parents, filled with photos and names of the people, places and pets from their past. If you have time, work on the scrapbook together, she added.

What To Do When Parents Don’t Want Help

It’s not uncommon for parents to refuse their kids’ help. Try to have this conversation before your parents need immediate assistance, Steinorth said. If they’re not open to your help right now, over time, they might change their minds, she said.

Another approach is to ask others to intervene. For instance, you might ask your siblings, close relatives or even their doctor to talk to your parents, she said. “Sometimes hearing the need for additional help from an outside source can help your parents really hear what is being said and therefore may also make them more open to your help.”

Finally, if your parents are a danger to themselves or others and still refuse your help, contact the department of social services to step in, Steinorth said. Be prepared for your parents to be upset with you. But their anger will probably dissipate, she said, because they’ll be less emotional and understand you had their best interests and safety in mind (and in your heart).

In my 20 years living in the Boston area, I cheered on the runners on many occasions and now, even from far way, these events feel close to home.

Experiencing trauma can have a dramatic effect on our bodies and our minds.  And although it’s a different experience to witness a trauma on television, it still can affect us.

When you perceive a threat, the body activates the stress response. The stress response occurs in both your body and brain.

The body’s response to acute stress is a preparation for emergency.  Adrenaline and other hormones are released.  The body shuts down processes associated with long-term care.  When under immediate threat, digestion, reproduction, cell repair and other body tasks related to long-term functioning are unimportant.

Of immediate importance is survival.  Increased blood sugar can provide extra energy for muscles. Increases in cortisol counter pain and inflammation. Blood pressure increases. Blood is diverted from our extremities to our major muscles to provide us with extra strength. Increased endorphins can help us ignore physical pain.

You can see the effects of these changes to the body in many of the symptoms of stress, such as racing heart, dizziness, nausea, shortness of breath, shaking, feeling hot and flushed, and sweating.

But it is the impact of trauma on the mind that is often the most disturbing.  Traumatic events can leave us feeling unsafe.  They can disrupt our beliefs and assumptions about the world. Your sense of your ability to control your life may be shattered. You may question how much influence you have over your life and your life choices.

A trauma, such as the one the occurred at the Boston Marathon, can leave us distrustful of other people.  You may question your basic trust of other people in the world.  Trauma can affect your ability to be intimate with others and may impact your feelings of self-worth.  Those who survive the trauma often feel guilt and wonder why they lived when others were less fortunate.

As we grow, change and have varied experiences throughout life, our beliefs and assumptions typically evolve over time.  With trauma, those beliefs and assumptions that we use to make sense of the world around us change nearly instantaneously.

It’s common to experience a wide range of psychological symptoms, including intrusive thoughts, worry, difficulty sleeping, trouble focusing, bouts of crying, blame or self-judgment and lack of satisfaction.

The effects of trauma also can cause intense emotion, including extreme emotional fluctuations, unhappiness, anxiety, loneliness, anger, and irritability.

Multiple traumas or repeatedly being exposed to life-threatening events can have a further impact on your body and mind. Parts of the brain can become sensitized, causing you to be on high alert and to perceive threats all around, leaving you jumpy and anxious.

Other parts of the brain associated with memory can actually shrink, making it difficult to consolidate and form new memories.  Prolonged stress can effect the development of a number of health issues, including diabetes, obesity and hypertension. And repetitive stress affects our moods, brings on anxiety disorders, and affects our experience of chronic pain and our ability to control food intake.

But when horrible events occur, such as those that occurred at the 2013 Boston Marathon, we also see the generosity and caring that is a large part of human nature.

Countless individuals ran to help without a second thought.  First responders, medics, EMTs and even bystanders jumped into action to do what they could to save lives.  Runners crossed the finish line and kept on running straight to give blood.

As we deal with the impact of violence, we can also keep in our minds the heroes and the strength of the human spirit that brings us together when we are faced with senseless tragedy.

Image: Wikimedia Commons: Aaron “tango” Tang

We stay silent. We say stupid things. We go from being sensitive, sensible, kind adults to rambling niceties or making downright rude remarks.

Illness, understandably, makes us nervous.

Fortunately, Pogrebin’s book helps us navigate the muddied waters of illness and mortality. It’s packed with practical tips and valuable insights.

Pogrebin was inspired to write the book after observing the varied reactions from her own friends to her breast cancer diagnosis. Some friends misunderstood her needs and acted awkwardly. Others were supportive and compassionate.

In the book, she shares these personal experiences, along with powerful accounts of people offering support to others. She also shares the words of almost 80 of her fellow patients at Memorial Sloan Kettering Cancer Center. She interviewed these individuals to find out how they really wanted to be treated.

Here’s a snippet from Pogrebin’s book on communicating with a sick friend.

What Not To Say To A Sick Friend

Pogrebin advises against saying phrases like “Everything happens for a reason” and “You need to be strong for your kids.”

Even seemingly positive statements become anything but. For instance, let’s say you’re trying to cheer up a friend who just received a cancer diagnosis. You might say something like, “I know ten women who’ve had breast cancer, and they’re all doing fine” or “My sister had a double mastectomy, and she’s climbing mountains!”

One cancer patient told Pogrebin that these comments were insulting and dismissive. They also didn’t mean anything to her: “Every woman and every cancer is different,” she said.

Another seemingly positive but problematic phrase is “You look great.” According to Pogrebin, when you focus on your friend’s appearance, it can discourage them from telling you how they truly feel; if they don’t look good, they won’t believe anything you say; and if you don’t compliment their appearance in the future, they might assume they look worse.

What To Say To A Sick Friend

Pogrebin stressed the importance of being honest with your sick friends. She also notes that everyone should be able to say these three statements: “Tell me what’s helpful and what’s not;” “Tell me if you want to be alone and when you want company;” and “Tell me what to bring and when to leave.”

In addition to honesty, it’s also important to express empathy and availability. Pogrebin includes a list of seven phrases that sick people want to hear. All of these include empathy or availability or both elements.

• “I’m so sorry this happened to you.”
• “Tell me how I can help.”
• “I’m here if you want to talk.”
• “Just give me my marching orders.”
• “That sounds awful; I can’t even imagine the pain.”
• “I’m bringing dinner.”
• “You must be desperate for some quiet time. I’ll take your kids on Saturday.”

The Commandments of Conversing

In her book, Pogrebin features a list of 10 commandments for conversing with sick friends. For instance, she suggests celebrating your friend’s good news and not downplaying their bad news. This doesn’t mean sugarcoating or “slapp[ing] a happyface decal on a grim diagnosis,” she writes. Instead you can say, “Tell me what I can do to make things easier for you — I really want to help.”

Also, treat your friends the same way you always have, but don’t forget their new circumstances. For instance, tease and joke around with them, but “indulge their occasional hissy fits.”

Talk about other things. According to Pogrebin, this helps “speed the journey from the morass of illness to the miracle of the ordinary.”

Similarly, emphasize their skills and talents, which will help them feel valued. This can be anything from asking a poker aficionado for pointers on playing to asking a retired teacher for guidance on college applications for your teen.

Unless you’ve been there, avoid talking about yourself or telling your friend that you understand what they’re going through. Avoid complaining about comparatively small things. (“Don’t tell someone with congestive heart failure that you have a migraine headache, as painful as it may be,” Pogrebin writes.)

Before saying anything, make sure you know the facts of your friend’s sickness and situation. Pogrebin shares the story of one woman who had three friends tell her that they were glad the cancer was caught early. It wasn’t.

Don’t treat your friend like a child or pressure them into being positive. Positive thinking can help people endure tests and treatments, but it’s not a cure. Don’t imply that negative thinking caused or exacerbated their illness. As Pogrebin says, the last thing your friend needs to be doing is blaming themselves.

When thinking about how best to approach a sick friend, Pogrebin quotes Hillel’s famous words: “Do not say unto others what you would not have them say unto you. All the rest is commentary.”

At one time in my life, this used to bug me. I would look at the clock and think, “oh no, I must get back to sleep or I’ll be so tired in the morning.” And then I’d spend the next hour or two willing myself to go back to sleep: tossing and turning, demanding that I slip back into unconsciousness; huffing and puffing that I wasn’t sleeping. I’d even check the clock every 10 minutes to see if I’d slept.

But the reality was, and still is, the more that I demand something of myself, the less likely I am to achieve that goal — and that really is the principle of living an unhappy life.

Sure I want to go back to sleep. I would even really, really, really, prefer to be sleeping right now, but I’m not. So, instead of lying there, beating myself up for waking when I “absolutely shouldn’t have,” I get up. I grab a drink, get something to eat and power up my laptop.

I realized a while back that, for me, it’s easier to get up and do something I enjoy. Use the extra time I have to write something, read, watch some TV, or just get lost in the weird and wonderful things people upload on YouTube.

This extra quiet time can be a bonus, before the world machine cranks up, and I slip into my lane on the daily highway of life.

Sure, I might be a little tired later, but the reality is that a few hours less sleep every now and then is not going to affect my performance. It will only affect that if I’m constantly telling myself, “I won’t be able to cope with work/life/kids because I woke so early and I’ll get tired.”

If you’re the type of person who uses that snippet of destructive thinking, then you’ll start sabotaging yourself. Sometimes after not sleeping well, people even play the ‘poor me card.’ They tell work colleagues how little sleep they’ve had, and how they won’t be able to do so-and-so job, or how they might need to go home early because of exhaustion.

Thinking and behaving like this can be quite common, and its roots can usually be found in childhood messages such as “You’ve got school tomorrow. You need to get your sleep or you won’t be able to do well.”

Really? How many times did you hear this, yet still stayed up late reading about dinosaurs, and made it through school the next day?

Even scientists don’t know how much sleep people need.

Each person’s sleep patterns and needs are different. You might be somebody like me, who likes around eight hours a night, or you might need fewer, such as four. Trouble is, if you’re the type of person who needs four, but you think you should have eight, that is where your problems will start.

Sleep problems can start if, instead of embracing your pattern and learning to live with it, you start to create your own anxiety around not getting enough sleep. Soon enough, sleeping will start to be a problem because you’ll be worrying about it before you go to bed, and that worry will interfere with your sleep pattern.

Soon you’ll be going to sleep, only to wake yourself so you can check that clock to see if you’ve been sleeping. And as you can tell, that irrational behavior will confirm that you haven’t slept as much as you demand because you woke yourself up!

The next step from there is usually some type of insomnia, because you’ve worked yourself up into such anxiety about sleeping. After a while you will be tired and your cognitive functioning will be impaired. You’ll be worrying during the day whether you’ll even sleep at night; and nearer to sleep time you get, the more anxious you’ll become and the more your body won’t be able to relax, so the more impossible it is to sleep. Catch-22, created by you.

If you do wake early, then make the best of that time. If your sleep pattern is such that you sleep a few hours a night, but need a nap during the day, then do it. Stop telling yourself you “must sleep now or else.”

I’ve found my way with managing my occasional lack of sleep. What about you? Is there a pattern you could change? Are you demanding something of yourself that leads to sleep problems? If so, these need to be addressed. So go do it — go change.

Then, I walk into the lab next door for a blood test and the line I hear is: “Oh, your blood pressure was high, let me see if I can draw your blood now.”

Wait, what? Do they actually think that these comments will make me feel more relaxed?

I’ve also experienced more direct unpleasantries from doctors who project an icy, or even a rude demeanor. A poor bedside manner does affect a patient’s emotional disposition; it does heighten any anxiety, and it certainly ensures difficulty in forming a positive bond with a professional who’s in a field that’s supposed to alleviate illness.

“A bedside manner refers most often to the way a medical professional interacts and communicates with patients,” a 2012 post on Wisegeek stated. The post stresses that a doctor with a good bedside manner demonstrates empathy,¹ and emits an aura of ease for the patients, while also involving them in health decisions. On the flip side, poor bedside manners reflect rudeness, cold attitudes, inadequate listening skills, and a complete disregard for the patient’s fears.

Why are such mannerisms prominent in the medical field?

Lorianna De Giorgio’s 2012 article in the Toronto Star discusses why positive relationships between patients and doctors may be lacking in the profession.

Adam Waytz, assistant professor of management and organizations at Northwestern University, explained that a process of “dehumanization” lies behind an unfortunate patient-doctor rapport. Dehumanization may occur due to psychological demands placed on practitioners, and from ongoing advances in technology as well. Waytz determined that a bulk of medical decision-making gives way to a very mechanical method of thinking; problems are often solved and issues are fixed without recognizing the patient’s feelings.

While many individuals enter the medical field for humane reasons, “they get into the system, and the system is so stressful that sometimes the humanity is just beaten out of them,” notes Marjorie Stanzler, senior director of programs at the Schwartz Center for Compassionate Healthcare.

Waytz and Stanzler advocate that a proper bedside manner would result in improved psychological and physical outcomes for the patients in treatment.

A 2008 blog post entitled What Bad Bedside Manners Really Mean reviews the negative impact and consequences of these adverse behaviors:

“Doctors are supposed to be in the line of work of helping people. With this profession comes a lot of responsibility. The medical field is not supposed to be simply diagnosing a problem, handing out a few pills, and moving onto the next patient. It means much more. It means being a physician, and a physician means being a healer.”

I could not agree more. Patients may feel naturally anxious, waiting on an impending prognosis (especially if the condition has the potential to be serious). Do they really need aloofness on top of that?

“If the doctor seems disinterested in what you are telling him, there are greater chances of him missing something that you said,” the post stated. “If he seems put-out or preoccupied, the patient might be more likely to leave out pertinent information.” Furthermore, if the doctor is disrespectful, it may discourage patients from seeking medical assistance altogether.

Due to a distressing environment and technological developments, I can understand why medical practitioners may harbor some poor bedside manners, but that doesn’t make their etiquette right or beneficial.

I think it’s important for them to remember why they’ve entered the field in the first place; if it’s because they sincerely want to help people, it’s crucial to know how to relate to patients on an emotional level.

1. l personally think medical schools should have official courses on being more empathetic

It doesn’t matter that I wake up most mornings to swim 160 laps, am borderline obsessed with eating salads and whole grains, and that I haven’t drank a drop of alcohol in 24 years; that I do yoga twice a week, keep a mood journal, engage in cognitive behavioral therapy, and have a rich spiritual life; that I take omega-3 fish oil capsules, vitamin D, calcium, and other supplements with my extra-pulp juice in the morning; or that I work really hard at communicating anger, frustration, and disappointment so that the repression of feelings doesn’t end up as a tumor somewhere inside my body.

I can’t get an individual or family plan short of signing up for a $10,000 deductible.

Because I have a history of depression.

My illness falls under the ABCs of the non-insurable, the “preventable” illnesses that solicit the red flag of “no way in hell” she’s getting coverage:

A – Asthma (and, hell, let’s throw in Arthritis)
B – High Blood Pressure
C – Cardiovascular Disease (and Cancer, sometimes classified – I know – “preventable,” but which is surely a insurance-killer)
Double D (think bra size) – Diabetes and OF COURSE Depression

Now I’m not so naïve that I dismiss the economic toll these illnesses take on an already fragile economy. Here’s the chronic disease price tag, estimated annual direct medical expenditure, according to the Center for Disease Control, which used different methodologies in calculating costs:

Cardiovascular disease and stroke: $313.8 billion in 2009
Cancer: $89 billion in 2007
Smoking: $96 billion in 2004
Diabetes: $116 billion in 2007
Arthritis: $80.8 billion in 2003
Obesity: $61 billion in 2000

Not mentioned here is clinical depression, which, left untreated, is as costly as heart disease or AIDS to the U.S. economy, according to Mental Health America. It costs over $51 billion in absenteeism from work and lost productivity and $26 billion in direct treatment costs.

Depression tends to affect people in their prime working years and may last a lifetime if untreated. According the MHA:

• Depression ranks among the top three workplace problems for employee assistance professionals, following only family crisis and stress.
• Three percent of total short-term disability days are due to depressive disorders and in 76 percent of those cases, the employee was female.
• In a study of First Chicago Corporations, depressive disorders accounted for more than half of all medical plan dollars paid for mental health problems. The amount for treatment of these claims was close to the amount spent on treatment for heart disease.
• The annual economic cost of depression in 1995 was $600 per depressed worker. Nearly one-third of these costs are for treatment and 72 percent are costs related to absenteeism and lost productivity at work.

That’s not to mention the human toll: seven out of ten deaths among Americans each year are from chronic diseases. Heart disease, cancer and stroke account for more than 50 percent of all deaths each year. Almost 15 percent of those suffering from severe depression will die by suicide.

And there is much we can do to prevent it. Four culprits are responsible for much of the illness, the suffering, the costs, and the early death associated with chronic diseases:

• Lack of physical activity
• Poor nutrition
• Tobacco use
• Excessive alcohol consumption

But allow me to climb back onto my soapbox. It’s still not fair. It’s not fair to those of us who go to great lengths to pursue healthy living and do everything in our day in the name of recovery – those of us who get up every morning with a pair of boxing gloves on, ready to fight for our health. It’s just not fair and it’s wrong.

I look forward to my meetings with health insurance brokers less than I do my yearly Pap. As much as I try to mentally prepare myself for the blow – “Repeat to yourself: You’re not going to like what you hear. It’s going to be unfair. You need to stay calm” – I still leave infuriated, which then, of course, has me checking off two of the ABCs: depression AND high blood pressure. That would probably bring my deductible up to $12,000, God forbid.

Originally published on PsychCentral.com

I first decided to try it in 2010 to see if it would be able to help ease my lifelong sleeping issues.

Usually I put a lot of thought into the medical providers I work with. In this case, I did not do any research into which practitioner I wanted to use; I simply chose the acupuncturist located one block from my house. It was certainly convenient, and seemed like a good idea at the time.

I recall those sessions as being strange. In addition to needles being placed all over my body, my sessions also involved smoke and fire. Sometimes, an herb would be placed on top of the acupuncture needles, then set on fire. Smoke was used in a procedure called “cupping” where glass jars were suctioned all over my back.

Craniosacral therapy was also used on me. My acupuncturist would rub two bones on the back of my skull at a very specific point. All of this was supposed to make me sleep. When pressed as to how this would all work, my acupuncturist would sometimes use the word “magic.” Magic? Really?

I went to these sessions four times, as I was told this was how many visits were needed to assess if my treatment was working. I saw no difference after four visits and stopped going. My western mind told me the process was all a bit much for me. If I felt the magic was working, I could have gotten over it, but I saw no progress. Plus, acupuncture is not covered by health insurance and my visits were getting expensive.

A few months ago, I started to feel my inability to sleep was at a point where it was greatly affecting my life. I have a variety of sleeping pill prescriptions, but nothing seemed to be helping me as much as I hoped. I was starting to feel desperate and out of control. This is when I thought again of acupuncture.

I wondered if a different practitioner might be able to help me more than the first one had. I did a good amount of online research and settled on someone. I’ll admit, aside from good online reviews, part of the appeal of this new provider was that everyone in the office was from China. I thought that a practitioner of Chinese medicine who was actually from China may have different viewpoints and use an alternative approach. This supposition was really based on nothing, but it made sense to me at the time.

When I called to make an appointment, the person on the phone did not ask me any questions or tell me what to expect. She simply wanted to know when I would come to the office. When I went to the office at that specified time. I found a dark hallway and a locked door. When I called the office’s phone number, I could hear the phone ringing on the other side of the door. No one answered; no one was at the office. I had been stood up.

I soon received a call explaining there had been a scheduling error. I understand that these things happen, but decided not to make another appointment. I had a bad first impression of that acupuncturist’s office and did not want to move forward with them.

This led to more Internet research. I settled on a group of acupuncturists not far from my house. When I called to inquire, the person who answered the phone asked me a great number of questions about why I wanted to come and what my symptoms are. This made me feel comfortable.

I filled out a lot of paperwork before the first visit. The paperwork contained very personal questions about my body and health, with some of the questions being highly detailed. I answered to the best of my ability.

At my first appointment, I handed in my paperwork to the acupuncturist and we talked for a long time. She wanted to know more about my patterns of insomnia and anything else that was wrong with my well-being. We settled on insomnia as my primary issue, but also addressed headaches, nausea, and neck pain.

This acupuncturist did not use smoke, fire, or magic. She simply asked me to remove my shirt and lie face down on a table. She then placed needles all over my neck, shoulders, back, and calves. I lay like that for around 20 minutes, then the needles were removed. I replaced my shirt, then turned onto my back. The acupuncturist then placed needles in my forehead, arms, wrists, and legs.

The next two sessions proceeded much like the first, but with less interviewing. Each time I would go, we would check in on my sleep and other ailments, then I would lie still while needles were placed in various areas of my body. The needles would sometimes feel uncomfortable, but the sessions were, overall, relaxing.

At my third visit, I was given my assessment. I was informed I had imbalances in the Chinese medical organ systems of spleen/stomach, heart/small intestine, and liver/gall bladder. I was also told my blood needed additional nourishment. I did not understand what this meant, but went along with it.

To help my treatment of these problems, I was given a prescription of Chinese herbs. I was prescribed the herb blend of Suan Zao Ren Tang. This came in a powder and I was instructed to mix five scoops of granules with a cup of water. I was told to take it at night, two hours after eating dinner. It seemed imperative that I take the herbs on an empty stomach and with no other medicine.

The herb drink did not taste good, but it wasn’t terrible. The flavor reminded me of celery. I began drinking my prescribed dose every night.

When I started taking the Suan Zao Ren Tang, I began to feel like I was falling asleep with more ease and had less frequent headaches. I began feeling positive about the acupuncture treatments and my herbs. I felt like it was all working.

My acupuncturist soon added another herb blend to my routine. I started taking Si Wu Tang in the morning. This one came in pill form and I took seven of them as soon as I woke up. I found swallowing seven pills immediately upon waking to be strange.

This was followed by a bad couple weeks of sleep and I became discouraged. During that time period, I had an acupuncture treatment that did not seem to help. I couldn’t help but associate the downward turn with the addition of the Si Wu Tang pills. When the bottle ran out, I did not buy more.

I started to feel more negative about my acupuncture treatments. For the price I was paying, I wanted to be sure it was doing something. At my next session, I asked the acupuncturist what I could reasonably expect from the treatments. She said she did not understand my question. I found this vaguely annoying — if a health-related service is being provided, I think it is fair that a client understands how long interventions will take and how to assess if they are working.

The acupuncturist reviewed my paperwork with me and pointed out the areas in which I was making progress. She had a point on some of the issues. I was then given the unsatisfying answer that treatment takes time and everyone responds differently. Because we were trying to fix the underlying cause of my insomnia rather than mask its symptoms, it would take an undetermined amount of time. I understood what the acupuncturist was saying, but would have preferred to assign a time and price assessment to my treatment. The costs of the treatments and the herbs were quickly adding up.

At that same visit, my Si Wu Tang was officially discontinued. It was replaced by something called Free and Easy Wander Plus. This was in a pill and I was instructed to take five of them when I woke up in the morning. I started taking these the next day.

I have now had eight acupuncture sessions and have purchased three more. I am still unsure as to if this is working. I seem to be sleeping a little bit better, but I don’t know if this is because of the acupuncture or other factors. When all my acupuncture sessions are done, I will have spent $800, plus the cost of the Chinese herbs. I would like to know if this money has helped me with my insomnia, but how can I tell for sure? This makes me feel highly frustrated. I had hoped my results would be more concrete.

People seem to have strong pro or con opinions about acupuncture. I am still somewhere in the middle. I’m desperate to have help with my sleeping issues, but am unwilling to pump endless money into a practice that may not be doing much for me. The experience has left me feeling both confused and hopeful, a strange combination to figure out as it continues to unfold.

So what is alternative treatment? You may already have some experience with the most popular, according to the Monitor on Psychology. Meditation, biofeedback, hypnosis and progressive muscle relaxation are all popular complementary or alternative psychological treatments. 

Although you may be familiar with the most popular, there are dozens of alternative and complementary treatments, which typically fall into four categories:  mind-body medicine, biologically-based practices, manipulative and body-based practices and energy medicine.

The Monitor article reports that, although these, and many other, alternative and complementary treatments have been around for thousands of years, the National Institute of Health (NIH) has been studying their usefulness, safety and role in improving health and health care for only a little more than a decade.

But many people embrace these treatments and are visiting alternative medicine practitioners more frequently than they visit their primary care doctors.  And these treatments are big business. A 2007 study found that $34 billion is spent each year on products and services for alternative and complementary medicines.

Continued research on the effectiveness of these treatments is ongoing and crucial.  However, current research suggests that many are effective for treating a wide range of problems, ailments and disorders.

There are too many to document in one post, but the following are the top 4 according to frequency of use, as reported in the Monitor.

1. Dietary Supplements.

Dietary supplements are used to promote general health, as well as to improve depression and anxiety and to decrease pain.  Common supplements reported in the Monitor include ginkgo biloba, St. John’s wort and vitamin supplements.  Although regulated by the FDA, they are held to very different quality standards than more conventional medicines.

• Caution: The FDA does not review the safety and effectiveness of any supplement before it is sold to consumers.  Supplements can vary widely from brand to brand and may interact with other medications. They should not be used without the knowledge of a physician.

2. Meditation.

Meditation is a process in which people learn to focus their attention in a particular way and on purpose.  It is used to treat a variety of symptoms, including high blood pressure, chronic pain, anxiety, depression, stress and insomnia.  It is also used to promote general health and well-being.

Meditation is integrated into many psychological treatments and practices with positive results; however, there are no formal qualifications necessary to practice it.  It is important that those who use this method receive appropriate training.

3. Chiropractic.

Chiropractic physicians use noninvasive treatments, such as spinal manipulations or chiropractic adjustments, with the aim of improving nerve and organ functioning by aligning spinal vertebrae.  These treatments are used to treat an array of ailments, from pain and headaches to stress and ADHD, among others.

Becoming a chiropractic physician requires several years of graduate work.  Most psychologists are unlikely to hold a chiropractic degree and, if they did, it would not be appropriate to serve as both a psychologist and chiropractor for the same client.

4. Aromatherapy.

Aromatherapy uses smells and aromas naturally extracted from plants to balance, harmonize and promote health of mind, body and spirit.  It is used clinically to relieve symptoms typically addressed in psychotherapy; holistically, to improve overall well-being; and aesthetically, in various oils and skin care products.

The Monitor cites recent research that indicates that aromatherapy can help treat pain, anxiety and agitation specific to dementia.  However, while certification is not required, it is recommended.  There are also risks related to toxicity, skin irritation and dosing regulations that require a competent professional to oversee, the article states.

Reference

Barnett, J.E., Shale, A.J.,(2013). Alternative Techniques.  Monitor on Psychology, 44(4).

Chen can only move her big toe. She writes emails and communicates with others using special technology. Composing an email with five short sentences takes her 20 minutes. But she continues to email with her family, friends and other ALS patients. She also visits patients in person with the help of her caregivers and relatives.

Chen’s remarkable story is featured in Richard Cheu’s empowering book Living Well With Chronic Illness: A Practical and Spiritual Guide. Cheu provides pastoral counseling to patients in New York City medical and hospice centers. He helps patients find peace with their illness and live their lives to the fullest.

Getting diagnosed with a chronic illness is overwhelming. It can unleash a range of reactions, from shock to fear to grief, said Cheu, also a stress management consultant, Catholic deacon and a caregiver himself. The diagnosis can shatter your self-image, he said. It’s as though you draw a line in the sand, one side representing you before the diagnosis, the other side representing you after.

While chronic illness changes your life, it doesn’t have to stop you from enjoying it. Chen is just one example of many individuals who’ve carved out meaningful, satisfying lives with a debilitating disease.

When she was first diagnosed with ALS, Chen was heartbroken and depressed. She isolated herself from her loved ones. But talking with another ALS patient at her monthly support group helped Chen start accepting her diagnosis and reach out for help.

Accepting your condition and asking your physicians about your options opens up a world of resources and support, Cheu said.

Taking Charge of Your Health Care

Cheu stressed the importance of taking charge of your health care with these three steps: Stop, look and listen. When you’re first diagnosed, stop, “and just sit down, and take some deep breaths.”

“Look at your disease, and learn everything you can about it, [such as] how it can affect you.” Think of it as learning a new language. If you were traveling to France, and wanted to make the most of your trip, you’d learn some French, he said.

Finally, “listen to your advisors,” or your health care team. Your doctors advise you on what to do, but you ultimately make your own decision on how to proceed, he said.

Taking charge of your health also includes: engaging in healthy behaviors, coping with your emotions and creating calm every day. For instance, you can meditate, journal or spend time with loved ones.

Focusing on Today

“Every person is unique, and has unique concerns that day in that moment,” Cheu said. That’s why he asks his patients to focus on today and consider: “What do you think is the most important thing to achieve today?”

Having a Hero

In addition to Ein-shei Chen, Cheu features other chronically ill individuals in Living Well With Chronic Illness. “Everyone needs a hero,” he said. Pick a hero who inspires you to keep going, someone who’s overcome major hurdles but is living life to the fullest.

Overcoming Loneliness

Loneliness is a common issue for chronically ill patients, Cheu said. After you’re diagnosed, the people in your life might stop calling and inviting you to social events. You also might distance yourself from others. The first step in overcoming loneliness is to recognize that it’s part of chronic illness, he said.

Next, in his book, Cheu encourages readers to “create peaceful and meaningful solitude.” As he explains, “Happiness starts within, and the best relationships happen when you are at peace with yourself regardless of your present condition or circumstances.” Choose activities you find restorative and that bring you joy, such as praying, spending time outdoors, reading or playing music.

Cheu also suggests considering how you’d like to improve your relationships. Would you like to enhance your current connections or make new friends? Would you like to hang out with people who share your religious beliefs or individuals who have the same illness? Then make a list of specific ways you’ll approach these relationships. Cheu also underscored volunteering and having face-to-face interactions.

Cultivating Spirituality

In his book, Cheu defines spirituality as “a way of thinking and living that uses the positive aspects of human thinking, feelings, and behavior to achieve meaning and purpose in life.” He suggests exploring your personal values and making a commitment to live them. Consider how you’re “going to live out this life, today and every day.”

Cultivating spirituality also includes regularly checking in with yourself and asking whether your current life reflects your values, Cheu writes. He also notes the importance of gratitude, and showing your appreciation for your caregivers.

Having a chronic illness can be devastating and make you feel incredibly helpless. While you have little control over your diagnosis, you can take charge of your responses and reactions. A chronic illness doesn’t have to stop you from leading a fulfilling life.

Living with chronic pain is something nobody should ever face in this lifetime. But often, we simply don’t have a choice.

Much like our new blogger, Tracy Rydzy, MSW, LSW, who is hosting this new blog, Living with Chronic Pain:

“I was working as a licensed social worker when an emergency spinal surgery 2 years ago changed my life and my career. I live with chronic pain and, as a result, I have taken my social work and writing skills, and made them into this blog. This blog is a humorous, informative, no-holds barred honest look at life with chronic pain, depression and disability.”

Please give a warm Psych Central welcome to Tracy over on her new blog, Living with Chronic Pain today!

However, according to Dana Becker, Ph.D, author of the thought-provoking book One Nation Under Stress: The Trouble with Stress As An Idea, by focusing on how each person can manage stress, we’re obscuring the bigger picture and issues: the social, political and economic problems that spark and perpetuate our stress in the first place.

Today’s articles and rhetoric on stress imply that if we fix ourselves, we’ll fix everything. Instead of stress-reducing tips empowering us, according to Becker, “we’re being sold a bill of goods.” We’re buying into an illusion that “blames the victim.”

“The advice is targeted to help us achieve a sense of control in situations that aren’t really controllable except through some kind of economic, political or social level.” In other words, “having control over how well we eat isn’t the same as changing workplace policies.”

Instead of talking about poor workplace policies, spotty daycare and other hurdles for single parents or dual-career households, we’re talking about stress, said Becker, a psychotherapist and professor of social work at Bryn Mawr College. Instead of fixing the problem of a single parent with three kids having to work ‘til 8:30 p.m. every night, we’re talking about taking a bubble bath, she said.

Becker doesn’t dismiss the importance of self-care or healthy habits. She views this as a “both and.” “Nobody is saying that it’s a bad thing to take care of ourselves. [But] a lot of these problems won’t be solved unless we engage in a national discussion.”

History of Stress

So how did the concept of stress come to be? The term “stress” was used as early as 1914 by Harvard physiologist Walter Cannon. But his concept was different than ours today. As Becker notes in One Nation Under Stress, “Cannon described stress in terms of heat, hunger, oxygen deprivation and other phenomena that can cause predictable physiological responses.”

He concluded that in response to fear and fury, our bodies released adrenalin and our heartbeat and blood sugar increased. But our bodies would always return to “homeostasis,” or keep “on an even course.”  Remnants of this theory do live on today. According to Becker in her book:

“…it is generally agreed that, after Cannon, all stress theories were based at least in part on his ideas about homeostasis. Cannon’s work lives on in the popular idea that there is an ongoing battle between our out-of-date physiology and the demands of modern life. We make biological ‘adjustments’ that are no longer functional: we react to an angry boss the way our Stone Age counterparts reacted to a saber-tooth tiger, but we can’t run away…”

It was Czech-born endocrinologist Hans Selye who popularized the concept of stress. At first, Selye used the term “stress” much like Cannon did. But by 1950, Becker writes, “he was describing stress as a ‘response to a condition evoked by stressors.’” In his book The Stress of Life, which Selye penned for the public, he refers to stress as “the rate of wear and tear caused by life.” He also made the connection between stress and disease.

Selye was a master marketer of stress. According to Becker in her book, “A tireless promoter of the stress concept, Selye sold and resold it over the years in popular and professional venues – in his best-selling books The Story of the Adaptation Syndrome and The Stress of Life, in talks to doctors’ groups in Canada and the United States, and at meetings of the American Psychological Association.

But Selye was so good that while the public accepted stress as a prominent concept, his specific theories got lost. In fact, “…the ‘truth’ of the stress concept and the American embrace of it did not come about through scientific agreement or through medical cures for ‘stress-related’ diseases. It was stress’s popularity that made it ‘true,’” Becker writes.

Collective Movements

While it’s the American way to believe we can fix anything on our own, some problems require collective action, Becker said. Take discrimination, for instance. The only reason the brave behavior of Rosa Parks “worked is because there was a movement already afoot,” Becker said.  If a movement didn’t exist, her individual protest would’ve likely been an isolated one.

Today, there are many collective movements that aim to effect change. Becker mentioned a website called MomsRising, a place where moms can connect and pressure their representatives to make changes at the policy level.

Ultimately, Becker believes we’re asking the wrong questions about “stress.” Rather than solely asking how we can alleviate or reduce our own stress, we should be asking how our society – at the policy level – can address the bigger picture. The problems at the root of our stress are rarely individual issues; they’re social ones.