Stress: APA’s 2009 Survey

In early November 2009, the American Psychological Association released the results of their 2009 Stress in America Survey. The executive summary is an excellent way to review the results of the survey in 20 pages. The survey was conducted by Harris Interactive and included 1,568 adults aged 18 and older who reside in the United States. The report also includes the results of a YouthQuery survey conducted among 1,206 youths aged 8-17 years of age. Those who provide mental health services to either or both adults and children should take a look at the outcome of this survey. The data are distressing and worrisome to those of us with interest in the effects of stress on our physical health.

According to the survey, parents think their own stress does not affect their children and that their children are not stessed. It appears that parents do not see the worries and stress-related symptoms of their children accurately; and while three-quarters of young people say they can talk to their parents about things they worry about, they also indicate that worry is a real problem for them. Either they are not telling their parents about their stress or worry, or their parents are not hearing them when they communicate. As a result, children may not be getting the family support they need to manage stress. Parents also seem to underestimate the severity of the stress teens and tweens experience.

42% of adults indicate that their stress has increased in 2009. This is 7% fewer than those reporting an increase in stress during 2008 (49%) but is still almost half of the adults surveyed. While it is somewhat comforting to know that only 42% of adults said that their stress has increased in the past year, it is difficult to tell from this report whether the 49% who reported an increase last year are now experiencing less stress or whether it is merely the same as in 2008. The summary indicates that “this could be a precursor to serious health consequesces related to chronic stress.”

While 44% indicate they exercise or walk to manage their stress, 49% indicate they rely on sedentary means of managing stress. 43% reported eating too much or eating unhealthy foods because of stress. Only 4% indicate that they see a mental health professional to deal with stress.

Money, work and the economy are still the most important sources of stress for adults.

Two-thirds of U.S. adults have been told by a health care provider that they have chronic health condition(s) and 70% have received recommendations for lifestyle and behavior changes….exercise more (48%), lose weight (38%) and eat healthier (36%). Few were offered or received support to make these changes; half did not even get an explanation for the recommendation. Women seem to be bearing the brunt of the stress…or are more likely to report it. They are also more likely to report physical symptoms along with the stress.

The potential physical effects of stress has long been studied by mental health and medical professionals. Back in 1967 Holmes and Rahe developed their Life Changes questionnaire also known at the Social Readjustment Rating Scale. This simple questionnaire has been used in a multitude of studies and scores correlated with the occurrence of serious physical illness within the next year. Let’s hope that those who become ill following these two years of significant stress will have access to the health care services they need.

A 2008 study detailed a physiological explanation, and an article in Gizmag does a nice, brief discussion, of how stress affects the immune system. Under stress, the body produces cortisol to facilitate the “fight or flight” response. Under chronic stress, there is an overabundance of cortisol, so the body remains on alert long after that is necessary and the immune system is affected. The mechanism at work seems to be the shortening of chromosomal end caps called telomeres which produce telomerase, an enzyme that keeps immune cells “young”. Cortisol diminishes the production of telomerase thus shortening the healthy life of protective T lymphocytes.

Of course, there is a perfect opportunity for development of a drug to reduce cortisol or increase telomerase. As specialists in behavioral change, I would think it incumbent upon mental health professionals to be doing more education about stress management rather than waiting for yet another drug to make us healthy. There are certainly online resources to facilitate such education. If only 4% of adults indicate that they consult with a mental health professional to help them manage stress, it would appear that the opportunities in this area are wide open.

What does your organization do to help your clients and your community better manage stress? Do you believe there are ways that behavioral health providers might more effectively attract the severely stressed into treatment? Should the practice of psychotherapy also include community education in stress inoculation techniques? How do you manage your own stress?

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