Book: Resilience – How We Find New Strength at Times of Stress

Book Title:

Resilience – How We Find New Strength at Times of Stress.

Author(s): Fredric Flach (MD).

Year: 2020.

Edition: First (1st).

Publisher: Hatherleigh Press.

Type(s): Paperback.

Synopsis:

Make stress your ally in the pursuit of happiness and personal fulfillment.

There’s no escaping stress. It appears on our doorstep uninvited in the shattering forms of death, divorce, or job loss. Stress even comes in the pleasant experiences of promotion, marriage, or a long-held wish fulfilled.

So why do some people come out of a crisis feeling better than ever, and others never seem to bounce back?

You will discover:

  • How to develop the 14 traits that will make you more resilient.
  • Why “falling apart” is often the smartest step to take on the road to resilience.
  • When the five-step plan for creative problem solving can help.
  • What essential steps you can take to strengthen your body’s resilience.
  • How to redefine your problem and restructure your pain to create a life you can handle, a life you can learn from and enjoy!

Drawing on more than thirty years of case studies from his own psychiatric practice, Dr. Frederic Flach reveals the remarkable antidote to the destructive qualities of stress – physical, mental, and emotional resilience.

Book: Relaxation and Stress Reduction Workbook

Book Title:

Relaxation and Stress Reduction Workbook.

Author(s): Matthew McKay (PhD).

Year: 2019.

Edition: Seventh (7th).

Publisher: New Harbinger.

Type(s): Paperback and Kindle.

Synopsis:

The Relaxation and Stress Reduction Workbook broke new ground when it was first published in 1980, detailing easy, step-by-step techniques for calming the body and mind in an increasingly overstimulated world. Now in its seventh edition, this fully revised and updated workbook-highly regarded by therapists and their clients-offers the latest stress reduction techniques to combat the effects of stress and integrate healthy relaxation habits into every aspect of daily life.

This new edition also includes powerful self-compassion practices, fully updated chapters on the most effective tools for coping with anxiety, fear, and panic-such as worry delay and diffusion, two techniques grounded in acceptance and commitment therapy (ACT)-as well as a new section focused on body scan.

In the workbook, you will explore your own stress triggers and symptoms, and learn how to create a personal action plan for stress reduction. Each chapter features a different method for relaxation, explains why the method works, and provides on-the-spot exercises you can do when you feel stressed out. The result is a comprehensive yet accessible workbook that will help you to curb stress and cultivate a more peaceful life.

What is Adjustment Disorder?

Introduction

Adjustment disorder (AjD) is a maladaptive response to a psychosocial stressor that occurs when an individual has significant difficulty adjusting to or coping with a stressful psychosocial event. The maladaptive response usually involves otherwise normal emotional and behavioural reactions that manifest more intensely than usual (taking into account contextual and cultural factors), causing marked distress, preoccupation with the stressor and its consequences, and functional impairment.

Diagnosis of AjD is quite common; there is an estimated incidence of 5-21% among psychiatric consultation services for adults. Adult women are diagnosed twice as often as are adult men. Among children and adolescents, girls and boys are equally likely to receive this diagnosis. AjD was introduced into the Diagnostic and Statistical Manual of Mental Disorders in 1980. Prior to that, it was called “transient situational disturbance.”

Signs and Symptoms

Some emotional signs of AjD are:

  • Sadness;
  • Hopelessness;
  • Lack of enjoyment;
  • Crying spells;
  • Nervousness;
  • Anxiety;
  • Desperation;
  • Feeling overwhelmed and thoughts of suicide; and
  • Performing poorly in school/work etc.

Common characteristics of AjD include:

  • Mild depressive symptoms;
  • Anxiety symptoms; and
  • Traumatic stress symptoms, or
  • A combination of the three.

According to the DSM-5, there are six types of AjD, which are characterised by the following predominant symptoms: depressed mood, anxiety, mixed depression and anxiety, disturbance of conduct, mixed disturbance of emotions and conduct, and unspecified. However, the criteria for these symptoms are not specified in greater detail. AjD may be acute or chronic, depending on whether it lasts more or less than six months. According to the DSM-5, if the AjD lasts less than six months, then it may be considered acute. If it lasts more than six months, it may be considered chronic. Moreover, the symptoms cannot last longer than six months after the stressor(s), or its consequences, have terminated. However, the stress-related disturbance does not only exist as an exacerbation of a pre-existing mental disorder.

Unlike major depression, the disorder is caused by an outside stressor and generally resolves once the individual is able to adapt to the situation. The condition is different from anxiety disorder, which lacks the presence of a stressor, or post-traumatic stress disorder and acute stress disorder, which usually are associated with a more intense stressor.

Suicidal behaviour is prominent among people with AjD of all ages, and up to one-fifth of adolescent suicide victims may have an adjustment disorder. Bronish and Hecht (1989) found that 70% of a series of patients with AjD attempted suicide immediately before their index admission and they remitted faster than a comparison group with major depression. Asnis et al. (1993) found that AjD patients report persistent ideation or suicide attempts less frequently than those diagnosed with major depression. According to a study on 82 AjD patients at a clinic, Bolu et al. (2012) found that 22 (26.8%) of these patients were admitted due to suicide attempt, consistent with previous findings. In addition, it was found that 15 of these 22 patients chose suicide methods that involved high chances of being saved. Pelkonen et al. (2005) states statistically that the stressors are of one-half related to parental issues and one-third in peer issues.

One hypothesis about AjD is that it may represent a sub-threshold clinical syndrome.

Risk Factors

Those exposed to repeated trauma are at greater risk, even if that trauma is in the distant past. Age can be a factor due to young children having fewer coping resources; children are also less likely to assess the consequences of a potential stressor.

A stressor is generally an event of a serious, unusual nature that an individual or group of individuals experience. The stressors that cause adjustment disorders may be grossly traumatic or relatively minor, like loss of a girlfriend/boyfriend, a poor report card, or moving to a new neighbourhood. It is thought that the more chronic or recurrent the stressor, the more likely it is to produce a disorder. The objective nature of the stressor is of secondary importance. Stressors’ most crucial link to their pathogenic potential is their perception by the patient as stressful. The presence of a causal stressor is essential before a diagnosis of adjustment disorder can be made.

There are certain stressors that are more common in different age groups:

  • Adulthood:
    • Marital conflict.
    • Financial conflict.
    • Health issues with oneself, partner or dependent children.
    • Personal tragedy such as death or personal loss.
    • Loss of job or unstable employment conditions e.g. corporate takeover or redundancy.
  • Adolescence and childhood:
    • Family conflict or parental separation.
    • School problems or changing schools.
    • Sexuality issues.
    • Death, illness or trauma in the family.

In a study conducted from 1990 to 1994 on 89 psychiatric outpatient adolescents, 25% had attempted suicide in which 37.5% had misused alcohol, 87.5% displayed aggressive behaviour, 12.5% had learning difficulties, and 87.5% had anxiety symptoms.

Diagnosis

DSM-5 Classification

The basis of the diagnosis is the presence of a precipitating stressor and a clinical evaluation of the possibility of symptom resolution on removal of the stressor due to the limitations in the criteria for diagnosing AjD. In addition, the diagnosis of AjD is less clear when patients are exposed to stressors long-term, because this type of exposure is associated with AjD and major depressive disorder (MDD) and generalised anxiety disorder (GAD).

Some signs and criteria used to establish a diagnosis are important. First, the symptoms must clearly follow a stressor. The symptoms should be more severe than would be expected. There should not appear to be other underlying disorders. The symptoms that are present are not part of a normal grieving for the death of family member or other loved one.

Adjustment disorders have the ability to be self-limiting. Within five years of when they are originally diagnosed, approximately 20-50% of the sufferers go on to be diagnosed with psychiatric disorders that are more serious.

ICD-11 Classification

International Statistical Classification of Diseases and Related Health Problems (ICD), assigns codes to classify diseases, symptoms, complaints, social behaviours, injuries, and such medical-related findings.

ICD-11 classifies Adjustment disorder (6B43) under “Disorders specifically associated with stress”.

Treatment

There has been little systematic research regarding the best way to manage individuals with an adjustment disorder. Because natural recovery is the norm, it has been argued that there is no need to intervene unless levels of risk or distress are high. However, for some individuals treatment may be beneficial. AjD sufferers with depressive or anxiety symptoms may benefit from treatments usually used for depressive or anxiety disorders. One study found that AjD sufferers received similar interventions to those with other psychiatric diagnoses, including psychological therapy and medication.

In addition to professional help, parents and caregivers can help their children with their difficulty adjusting by:

  • Offering encouragement to talk about their emotions;
  • Offering support and understanding;
  • Reassuring the child that their reactions are normal;
  • Involving the child’s teachers to check on their progress in school;
  • Letting the child make simple decisions at home, such as what to eat for dinner or what show to watch on TV; and/or
  • Having the child engage in a hobby or activity they enjoy.

Criticism

Like many of the items in the DSM, adjustment disorder receives criticism from a minority of the professional community as well as those in semi-related professions outside the health-care field. First, there has been criticism of its classification. It has been criticised for its lack of specificity of symptoms, behavioural parameters, and close links with environmental factors. Relatively little research has been done on this condition.

An editorial in the British Journal of Psychiatry described adjustment disorder as being so “vague and all-encompassing… as to be useless,” but it has been retained in the DSM-5 because of the belief that it serves a useful clinical purpose for clinicians seeking a temporary, mild, non-stigmatising label, particularly for patients who need a diagnosis for insurance coverage of therapy.

In the US military there has been concern about its diagnosis in active duty military personnel.

References

Asnis, G.M., Friedman, T.A., Sanderson, W.C., Kaplan, M.L., van Praag, H.M. & Harkavy-Friedman, J.M. (1993) Suicidal Behavior in Adult Psychiatric Outpatients, I: Description and Prevalence. American Journal of Psychiatry. 150(1), pp.108-112. doi:10.1176/ajp.150.1.108.

Bolu, A., Doruk, A., Ak, M., Özdemir, B. & Özgen, F. (2012) Suicidal Behavior in Adjustment Disorder Patients. Dusunen Adam. 25(1), pp.58-62.

Bronish, T. & Hecht, H. (1989) Validity of Adjustment Disorder, Comparison with Major Depression. Journal of Affective Disorders. 17, pp.229-236.

Pelkonen, M., Marttunen, M., Henriksson, M. & Lönnqvist, J. (2005) Suicidality in Adjustment Disorder: Clinical Characteristics of Adolescent Outpatients. European Child & Adolescent Psychiatry. 14(3), pp.174-180. doi:10.1007/s00787-005-0457-8.

Book: Mindfulness Workbook for Stress Relief

Book Title:

Mindfulness Workbook for Stress Relief: Reduce Stress through Meditation, Non-Judgement, Mind-Body Awareness, and Self-Inquiry.

Author(s): April Snow (LMFT).

Year: 2020.

Edition: First (1st).

Publisher: Rockridge Press.

Type(s): Kindle.

Synopsis:

Mindfulness is a powerful and proven method for reducing stress and its negative health effects. The Mindfulness Workbook for Stress Relief shows you how to relieve tension and find calm using soothing, restorative techniques like meditation, non-judgement, self-inquiry, and mind-body awareness.

Featuring helpful exercises and simple meditations, this hands-on stress management workbook delivers a wide variety of effective mindfulness tools that you can add to your self-care toolbox like breath awareness, body scans, mindful walking, and more.

The Mindfulness Workbook for Stress Relief includes:

  • Practical & actionable: This book has a beginner-friendly focus that covers a spectrum of everyday situations and science-based solutions.
  • Evidence-based approach: Explore engaging mindfulness-based exercises that are proven to help relieve stress, anxiety, chronic pain, and sleep issues.
  • Situational success: Learn how to address stress triggers in many areas of daily life like relationships, at work, and beyond.

Take a deep breath and begin your practice today with this evidence-based mindfulness workbook.

Aromatherapy & Mental Health

Research Paper Title

The effects of Lavender and Chamomile essential oil inhalation aromatherapy on depression, anxiety and stress in older community-dwelling people: A randomised controlled trial.

Background

Considering the prevalence of mental health problems in older adults, this study aims to investigate the effect of inhalation aromatherapy using lavender and chamomile essential oils on depression, anxiety, and stress of community-dwelling older people.

Methods

A three-armed, parallel, randomised, and controlled trial design was used in this study. 183 participants were enrolled and randomly assigned to three groups (n = 61): the lavender, chamomile, and control groups. The participants in the experimental groups inhaled three drops of 1.5% lavender and chamomile essential oils for 30 nights. The participants in the control group inhaled only distilled water in a similar fashion. Data were collected using the Depression, Anxiety, and Stress-Scale (DASS) at baseline, immediately after the intervention, and one month after the intervention. Chi-square, Fisher’s exact, one-way ANOVA, and repeated measures ANOVA were used for data analysis.

Results

Statistically significant improvement occurred in depression, anxiety, and stress levels immediately and one month after the intervention in lavender and chamomile groups compared to the control group (p < 0.01).

Conclusions

Inhalation aromatherapy with both lavender and chamomile essential oils helped decrease depression, anxiety, and stress levels in community-dwelling older adults.

Reference

Ebrahimi, H., Mardani, A., Basirinezhad, M.H., Hamidzadeh, A. & Eskandari, F. (2021) The effects of Lavender and Chamomile essential oil inhalation aromatherapy on depression, anxiety and stress in older community-dwelling people: A randomized controlled trial. Explore (New York, N.Y.). doi: 10.1016/j.explore.2020.12.012. Online ahead of print.

Deployment-Related Stress & Support Needs

Research Paper Title

“This is not your Life…and it becomes your Life”: A Qualitative Exploration of Deployment-related Stress and Support needs in National Guard and Reserve spouses who are Mothers of Young Children.

Background

The adverse effects of deployment-related stress (DRS) on military service members, spouses, and children are well documented.

Findings from a recent Consensus Report on Military Families by the National Academies of Science, Engineering, and Medicine (2019) underscore the priority of gaining a more comprehensive understanding of the diversity of today’s military families and their needs and well-being.

While social support is generally regarded as helpful during times of stress, it has not been studied extensively in National Guard/Reserve spouses who are parents of young children.

Methods

This qualitative study of 30 women examines the unique ways in which DRS affects women who are National Guard/Reserve spouses and mothers of young children, as well as the processes through which they encountered support to manage these stressors.

Salient themes spanned experiences involving deployment cycle phases of separation and reintegration and included both anticipated and unanticipated changes in family-related division of labour, dynamics, and communication patterns.

These were complicated by geographic, social, and cultural isolation and misguided efforts to support spouses initiated by civilians.

Conclusions

Women managed these stressors primarily through seeking, acquiring, and repurposing existing sources of informal social support for themselves and formal supports for their children, with varying degrees of success.

Reference

Ross, A.M., DeVoe, E.R., Steketee, G., Spencer, R. & Richter, M. (2020) “This is not your Life…and it becomes your Life”: A Qualitative Exploration of Deployment-related Stress and Support needs in National Guard and Reserve spouses who are Mothers of Young Children. Family Process. doi: 10.1111/famp.12622. Online ahead of print.

Book: The ABCS of Coping with Anxiety

Book Title:

The ABCS of Coping with Anxiety: Using CBT to Manage Stress and Anxiety.

Author(s): James Cowart (PhD).

Year: 2017.

Edition: First (1st).

Publisher: Crown House Publishing.

Type(s): Paperback and Kindle.

Synopsis:

In ‘The ABCS of Coping with Anxiety: Using CBT to Manage Stress and Anxiety’, James Cowart offers a concise collection of tried-and-tested strategies from cognitive behavioural therapy (CBT) and makes them accessible to people who are learning to cope with their anxiety on a day-to-day basis. ‘The ABCS of Coping with Anxiety’ has been placed highly commended in the health and social care category in the 2018 British Medical Association Medical Book Awards.

Anxiety is a normal part of our human nature. For spurring you to make decisions or perform, it can actually be helpful. However, an unchecked pattern of intrusive negative thoughts can escalate the severity and persistence of the level of anxiety experienced over time. As this worsens, it is not uncommon to feel an increasing lack of control ultimately leading to a chain of self-defeating behaviors that may negatively affect all aspects of your daily life. Yet, while it is not possible to directly control our emotions (or what others think or do), it is possible to learn and apply coping skills that can help you face feared situations rather than escape or avoid them.

James Cowart s aim in ‘The ABCS of Coping with Anxiety’ is to share a toolbox of CBT techniques garnered over 40 years clinical practice that will enable you to manage your anxiety on a sustainable path toward taking back some of that control. These self-help strategies focus on developing key coping skills designed to reduce fear and anxiety, and are complemented by a user-friendly, step-by-step program of practical exercises that can be personalized to meet each individual s unique needs.

Informed by his extensive experience and therapeutic knowledge, and with real-life case studies to guide you along your own journey, James s easy-to-remember ABCS approach is as transformative as it is simple:

  • A is for accepting the thoughts and feelings you can and can not control.
  • B is for breathing slowly and naturally to relieve and relax muscle tension.
  • C is for countering any unrealistic or catastrophic thoughts with truth and logic.
  • S is for staying with it so you can face your fears and anxieties until they are reduced.

Each step is explored in detail in the first four chapters, and further discussion is also dedicated to using the ABCS with different types of anxiety (including social anxiety, specific phobias, panic attacks and obsessive compulsive disorder (OCD)) and coping with related depression, anger and impulsivity. Punctuated with research-informed insight and instruction throughout, The ABCS of Coping with Anxiety’ offers hope, relief and reassurance in helping you master your anxiety and work toward greater independence.

Suitable for those living with anxiety and for the health professionals including psychiatrists, psychologists, social workers and counselors working with them.

Book: Anxiety – Overcome It and Live Without Fear

Book Title:

Anxiety – Overcome It and Live Without Fear.

Author(s): Sonali Gupta.

Year: 2020.

Edition: First (1st).

Publisher: HarperCollins.

Type(s): Paperback and Kindle.

Synopsis:

Do you know the difference between anxiety and stress? What can you do when you have a panic attack? How do you know when it is time to get help?

Anxiety is a mental health crisis that has gripped over three crore Indians. In Anxiety: Overcome It and Live without Fear, clinical psychologist Sonali Gupta delves into the condition, using case studies to identify how anxiety can be triggered at work, in relationships, and by social media. Gupta shares a unique glimpse into this mental health condition in India, especially among Gen Z and millennials.

Recommending strategies and techniques for anxiety-prone readers, this book will help you confront your fears and take control of your life.

Book: The Stress Survival Guide for Teens

Book Title:

The Stress Survival Guide for Teens: CBT Skills to Worry Less, Develop Grit, and Live Your Best Life (The Instant Help Solutions Series).

Author(s): Jeffrey Bernstein, PhD.

Year: 2019.

Edition: First (1st), Illustrated Edition.

Publisher: Instant Help.

Type(s): Paperback and Kindle.

Synopsis:

Is stress getting the best of you? Do you ever feel overwhelmed, like your life is zooming by? This practical, proven-effective, and easy-to-use survival guide has your back!

School pressure, BFF drama, body changes, social media, dating – is it any wonder you are feeling stressed? You are not alone. Many teens today find themselves worried, anxious, and stressed out. But there are ways you can take control of your stress before it interferes with your life. This go-to “survival guide” will show you how to deal with stress so you can get back to the things that make you happy.

With this fun and easy guide, you will learn how cognitive behavioral therapy (CBT) can help you challenge negative thoughts and replace them with more helpful, flexible ways of seeing life’s challenges. You will also discover how important it is to slow down and notice the things that are really going well in your life! Finally, you will learn to figure out what is really important to you, and how you can use your values to build resilience against stress and future setbacks.

Life is full of stress, but that does not mean you have to be. With this book, you will learn to quiet your negative inner voice and focus on your strengths, so you can conquer any challenge you might face, achieve your goals, and live your very best life.

Book: The Handbook of Stress

Book Title:

The Handbook of Stress – Neuropsychological Effects on the Brain.

Author(s): Cheryl D. Conrad (Editor).

Year: 2011.

Edition: First (1st).

Publisher: Wiley-Blackwell.

Type(s): Hardcover and Kindle.

Synopsis:

The Handbook of Stress: Neuropsychological Effects on the Brain is an authoritative guide to the effects of stress on brain health, with a collection of articles that reflect the most recent findings in the field.

  • Presents cutting edge findings on the effects of stress on brain health.
  • Examines stress influences on brain plasticity across the lifespan, including links to anxiety, PTSD, and clinical depression.
  • Features contributions by internationally recognised experts in the field of brain health.
  • Serves as an essential reference guide for scholars and advanced students.