Stress

Stress

Everyone experiences stress from time to time. Stress disorders however are of a different magnitude. These occur as a result of profound trauma such as encountering or witnessing a death or experiencing serious injury. People with stress disorders exhibit intense fear helplessness or horror. Acute stress disorder occurs soon after the traumatic event and lasts for a month or less. Post-traumatic stress disorder (PTSD) may begin within a few days of an event or may have delayed onset—sometimes as long as 30 to 40 years—and continues for more than three months.

Signs and Symptoms

A stress disorder is often accompanied by the following signs and symptoms.

Flashbacks dreams and intrusive thoughts
Avoidance of anything that prompts recollection of the trauma
Inability to recall aspects of the traumatic event
Detachment a decrease in emotional responsiveness
A sense that one's future will be cut short
Impulsiveness risk-taking
Hopelessness
Overreactions such as increased arousal and startled response
Problems functioning normally in work and social settings

What Causes It?

Stress conditions are caused by the combination of a traumatic event and a strong reaction to it. Such traumas include war rape inappropriate sexual experience illness bereavement or natural disaster.

Who's Most At Risk?

People with the following conditions or characteristics are at a higher-than-average risk for developing a stress disorder.

Women are at greater risk than men
Older people and children
People with the following personality traits: neurotic extroverted poor self-confidence past history of psychiatric problems
Genetic predisposition
Guilt or shame
Lack of social support or financial security
Early separation from parents childhood neglect
Alcoholic parents
Poverty

What to Expect at Your Provider's Office

If you are experiencing symptoms associated with stress disorder you should see your health care provider. He or she can help make a diagnosis and guide you in determining which treatment or combination of therapies will work best for you.

Your provider will do a physical examination noting if you appear pale tired or disoriented. Diagnostic procedures may include a psychiatric exam and psychological testing hypnosis in cases of amnesia and an electroencephalogram (EEG) to rule out brain damage or diagnose sleep disorder. Imaging techniques can also rule out brain damage.

Treatment Options

Prevention

Crisis intervention can help prevent post-traumatic stress disorder from developing.

Treatment Plan

While symptoms associated with acute stress usually automatically decrease with time chronic stress requires a longer and more complex treatment plan. Crisis intervention may provide support acceptance and education. Psychotherapy can help people master their fears and overcome avoidance behaviors.

Drug Therapies

Your provider may prescribe the following medications for symptom relief (although none has been approved by the Food and Drug Administration for this use):

Benzodiazepines—drugs used as minor tranquilizers and hypnotics
Antidepressants to reduce anxiety and impulsiveness
Sedating antidepressants to relieve insomnia

Complementary and Alternative Therapies

A comprehensive treatment plan for stress disorders may include a range of complementary and alternative therapies.

Nutrition

Following these nutritional tips may reduce symptoms.

Avoid refined foods such as sugar and baked goods as well as inflammatory foods such as caffeine alcohol dairy and animal products.
Increase foods that nourish the nervous system such as whole grains fresh vegetables and foods rich in essential fatty acids such as nuts seeds and cold-water fish.

Potentially beneficial nutrient supplements include the following.

Digestive enzymes including betaine HCL to support proper digestive function
B-complex (50 to 100 mg a day) calcium (1 000 mg a day) and magnesium (400 mg a day) which may be depleted by stress

Herbs

The following herbal remedies may provide relief from symptoms: a combination of equal parts of passionflower (Passiflora incarnata) lemon balm (Melissa officinalis) and oatstraw (Avena sativa) with one to three of the following herbs.

With anxiety: kava kava (Piper methysticum) motherwort (Leonurus cardiaca)
With insomnia: valerian (Valeriana officinalis) skullcap (Scutellaria laterifolia)
With depression: St. John's wort (Hypericum perforatum) wood betony (Stachys betonica)
With digestive upset: wild yam (Dioscorea villosa) chamomile (Matricaria recutita)
With exhaustion: bladderwrack (Fucus vesiculosus) gotu kola (Centella asiatica)

Siberian ginseng (Eleuthrococcus senticosus) inhibits the alarm phase of stress. It is best taken four to six months as a fluid extract (1:1) 1/2 to 1 tsp. two to three times per day. Take before 3 pm.

Herbs are generally available as dried extracts (pills capsules or tablets) teas or tinctures (alcohol extraction unless otherwise noted). Dose for teas is 1 heaping tsp./cup water steeped for 10 minutes (roots need 20 minutes).

Homeopathy

An experienced homeopath can prescribe a regimen for treating stress disorder that is designed especially for you. Some of the most common acute remedies are listed below.

Aconite for panic with heart palpitations shortness of breath
Arsenicum for anxiety with restlessness
Phosphorous for free-floating anxiety and foreboding

Acute dose is three to five pellets of 12X to 30C every one to four hours until symptoms are relieved.

Prognosis/Possible Complications

People with stress disorder are at greater risk of developing other mood or anxiety disorders or experiencing substance abuse. They are predisposed to conditions such as heart disease insomnia and gastrointestinal illness. Suicide is more common among people with stress disorder.

Following Up

Patients are treated on an outpatient basis until symptoms have subsided. In cases where there is a concern about self-abuse or suicide the patient will be referred for treatment on an inpatient basis.

Supporting Research

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington DC: American Psychiatric Association; 1994.

Blumenthal M ed. The Complete German Commission E Monographs. Boston Mass: Integrative Medicine Communications; 1998: 422 425 431 462.

Braunwald E ed. Heart Disease: A Text Book of Cardiovascular Medicine. 5th ed. Philadelphia Pa: W.B. Saunders; 1997.

Dambro MR. Griffith's 5-Minute Clinical Consult. 1999 ed. Baltimore Md: Lippincott Williams & Wilkins Inc.; 1999.

Fauci AS Braunwald E Isselbacher KJ et al eds. Harrison's Principles of Internal Medicine. 14th ed. New York NY: McGraw-Hill; 1998.

Kaplan HW ed. Comprehensive Textbook of Psychiatry. 6th ed. Baltimore Md: Williams & Wilkins; 1995.

Morrison R. Desktop Guide to Keynotes and Confirmatory Symptoms. Albany Calif: Hahnemann Clinic Publishing; 1993:4 40 292 293.

Murray MT. The Healing Power of Herbs. Rocklin Calif: Prima Publishing; 1991:54-57.

Rakel RE ed. Conn's Current Therapy. 50th ed. Philadelphia Pa: W.B. Saunders; 1998.

Rosen P ed. Emergency Medicine: Concepts and Clinical Management. 4th ed. St. Louis Mo: Mosby-Year Book; 1998.

Sabiston DC ed. Textbook of Surgery. 15th ed. Philadelphia Pa: W.B. Saunders; 1998.

Yamada T ed. Textbook of Gastroenterology. 2nd ed. Philadelphia Pa: Lippincott-Raven Publishers; 1995.

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application use or misuse of any of the information contained herein including any injury and/or damage to any person or property as a matter of product liability negligence or otherwise. No warranty expressed or implied is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor pharmacist nurse or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage precautions warnings interactions and contraindications before administering any drug herb or supplement discussed herein.