1. What are the most common causes of stress? What are the early signs of stress?

Stress can be caused by virtually any situation where someone feels that the demands of a situation exceed their resources and ability to meet those demands. On a physiological level, the body's stress response is triggered whenever there's a perceived threat - physical or emotional, which creates a cascade of biological changes in the body to prepare the body to fight or run. We have a wonderful mechanism here, but with today's demands, many of us experience triggered stress responses multiple times per day and fail to return to a calm state of being. This can lead to a host of symptoms, from headaches and gastrointestinal issues to increased blood pressure, feelings of anxiety or depression, or even skin conditions. If not properly managed, stress can lead to more severe health issues, but these are some of the many early warning signs people experience when they're under too much stress. A good rule of thumb; if you think you might be under too much stress, you probably are! Learning proper stress management is important for everyone.

2. What causes stress in children and teens? And how can it be treated?

Children and teens these days live with a tremendous amount of potential stressors. Schedules are busier. The stakes are higher and competition more fierce academically. Social pressures and bullying are on the rise, especially with the relatively recent advent of cyber- bullying. It's estimated that five to 20 percent of children and adolescents are living with some type of psychological issue, treated or untreated.  

Many of these stressors can be better managed with more parental support and involvement, which is crucial. In fact, parental involvement is correlated with better outcomes virtually across the board when it comes it issues kids deal with, so rest assured that you make a powerful difference in your children's lives throughout their childhood and teenage years. In addition to helping your kids handle the stressors in their lives, teaching your children effective stress management techniques during childhood can provide them important skills that they can use throughout their lives. If techniques like meditation, breathing exercises, visualization techniques, yoga, and physical exercise don't effectively manage the stress, it's a good idea to talk to your doctor or another professional to see what other options can be explored.

3. How does being a caregiver or having a family member with a chronic disease affect family stress?

Being a caregiver can bring intense amounts of stress. Not only are the demands high - providing large amounts of physical and emotional support for another person in addition to meeting all of the other responsibilities of career, family and daily living, but the caregiver's life often becomes so consumed with meeting these needs that the caregiver isn't able to meet her own needs - sleep and down time may be inadequate, for example. I say 'her' because, though men can be caregivers, women are much more often the caregivers of the family. She may also feel guilt for some of her feelings, or even for being healthy when a loved one isn't, and this can cause more stress. When caregivers aren't able to meet their own basic physical and emotional needs, they can become quite stressed, and this stress can be felt by every member of the family. Other family members may also become stressed as family resources (time, money, energy) are stretched. Not having a sense of control in the situation can also impact things, tripling the stress experienced by the caregiver. If you are a caregiver, it's crucial that you prioritize your own needs as well; it's okay to ask for help in doing that.

4. How do women tend to react to stress? Is there a link to other illnesses?

Women face many negative health effects from stress ranging from relatively mild conditions like menstrual upsets to more serious conditions like heart disease, high blood pressure, migraine, depression, anxiety disorders, and digestive problems. Women also face many more daily stressors related to children, family and household responsibilities. Women do more housework (even when both parents work), put in more hours of childcare and often face very stressful jobs, as well.

Women also tend to respond to stress in different ways than men. We tend to take the edge off with emotional eating more often, which can lead to poor body image and related feelings of shame and disappointment in self, which can lead to more stress. Too much emotional eating can also lead to unhealthy weight gain, which is linked to other health risks.  We more often take responsibility for the wellbeing of everyone around us, which can lead to more feelings of self-blame when things go wrong for others. Women are also at greater risks of experiencing depression and anxiety disorders as a result of stress. That's the bad news. The good news is that when women are experiencing stress, they are more likely to reach out to others and either offer additional support or in other ways connect. This adds to women's ability to cope with stress, which is much needed in the context of today's high-stress lifestyles.

5. How does stress affect a person's health and wellbeing? How does stress affect the immune system?

Stress can affect health and wellness in many, many different ways.Virtually all diseases and conditions can be traced back, in varying degrees, to stress as a partial cause or as a mitigating factor. A major reason behind this is that stress can put a damper on immune functioning; it can minimize the body's ability to fight disease. When we experience chronic stress - the kind of stress that comes with a high-tension job, a conflict-ridden marriage or being a caretaker for someone with high needs, for example - our body's fight-or-flight response becomes triggered, and stays triggered for long periods of time. The body's stress response wasn't intended to do this, and it can have a host of negative effects on health, and the immune system takes a major hit. Another way that stress can affect immunity is that when we're living a high-stress lifestyle, we often don't take care of ourselves in ways that build immunity. For example, when we're too busy, we may be stressed as a result, but we also may not sleep enough, eat healthy meals, or factor in restorative 'down time' with friends and family. This can all impact our health and immunity toward disease.

6. What are some major strategies that are effective in managing stress?

There are two main strategies for coping: problem-based coping and emotion-based coping. When we focus on minimizing problems, we reduce the stress in our lives by cutting down on our stressors - eliminating some of the things in our lives that cause us stress. This is a great strategy when possible, but it's not possible (or even beneficial) to eliminate all stress - we need some stress (called 'eustress') to keep us feeling vital and alive. Emotion-focused coping, by contrast, is a means of managing our internal response to stress; we change our perceptions of stress and our responses to it, and experience less of it in the process. Some forms of emotion-based coping include changing negative self-talk, prayer, journaling, affirmations, and finding the humor in a stressful situation. Emotion-based coping is a wonderful way to minimize stress in that we don't need to eliminate the stress in order to manage it - this type of coping allows us to better manage whatever comes. Ideally, both types of coping should be used, and they can often be used in conjunction with one another.

7. What kind of professional help do people use to manage stress?

Sometimes stress gets to be too much to handle without help. In cases like that, it's important to find support from outside resources.

That can be as simple as talking to a good friend. Especially for women, the support we find from good friends - a kind ear, a helping hand, a feeling of validation that a good friend can offer - can go a long way toward helping manage stress. Sometimes people go to life coaches or wellness coaches for a higher level of help that includes more information, deeper digging, more targeted support, greater accountability and structure in finding balance and managing stress.

Other times a therapist is the more appropriate answer with cognitive behavioral therapy, support with pharmaceutical options and other therapeutic techniques. A doctor can work in conjunction with a therapist by giving referrals, prescribing anti-depressant and anti- anxiety medication, and being part of a combined approach that involves both therapy and medication. The thing to remember is that there is help out there, so if you feel overwhelmed by stress and feel you need help managing it, reach out for this help.