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.

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 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.

Book: The Instinct to Heal

Book Title:

The Instinct to Heal – Curing Depression, Anxiety and Stress Without Drugs and Without Talk Therapy.

Author(s): David Servan-Schreiber.

Year: 2004.

Edition: First (1ed).

Publisher: Rodale Books.

Type(s): Hardcover, Paperback and Kindle.

Synopsis:

Millions of Americans try drugs or talk therapy to relieve depression and anxiety, but recent scientific studies prove certain alternative treatments can work as well or better-often bringing on a cure.

In the extraordinary international bestseller The Instinct to Heal, award-winning psychiatrist and neuroscientist David Servan-Schreiber, M.D., Ph.D., presents seven natural approaches, each with proven results, that together form a treatment plan that builds on the body’s relationship to the brain, yielding faster, more dramatic, and permanent changes. People who want to leave suffering behind now can live joyful, happy lives.

Book: Mental Health: A New Understanding

Book Title:

Time Special Edition: Mental Health: A New Understanding.

Author(s): The Editors of TIME.

Year: 2018.

Edition: First (1st).

Publisher: Time.

Type(s): Magazine and Kindle.

Synopsis:

People at all stages of life experience mental illness, including anxiety and depression.

There has never been a better understanding of how the right support, lifestyle and approach can begin to crack the code and lead toward better health.

Now, in a new Special Edition, Mental Health: A New Understanding, the editors of TIME take a look at the vast world of mental health from understanding the causes and symptoms of mental disorders to feeling better, including the power of exercise, why your pets are good for your mental health, and the benefits of pharmaceutical aides, therapy and other ways to alleviate pain.

There is also guidance on how to help a friend or loved one who is suffering from mental illness and understanding life as an addict.

Additionally, they look at suicide, depression amongst college-age children and why the loneliness epidemic should be taken very seriously.

Mental Health is an excellent primer on understanding our own minds.

Book: The Science of Stress

Book Title:

Time Special Edition: The Science of Stress.

Author(s): The Editors of TIME.

Year: 2019.

Edition: First (1st).

Publisher: Time.

Type(s): Magazine and Kindle.

Synopsis:

Stress is a modern mental bogeyman, keeping nearly half of Americans up at night. It also takes a profound physical toll.

Research has found it linked to higher risks of heart attacks, strokes and many major chronic conditions.

Yet, many Americans say they do not do anything to meaningfully combat stress.

This special edition can help. First, you will examine the sources of your stress, including just how smartphones and other digital distractions rewire the brain for stress. Then, consider what you can do to increase calm and improve your health.

Learn about the science-backed research that shows that self-care and relaxation can help alleviate stress in real and measurable ways.

Find the latest proven ways to dampen the stress response, including mindfulness techniques, exercise, walking in nature and even washing the dishes. Get valuable tips on how to relax fast, in any situation. Or, if that’s just not possible, let this special edition make the case for embracing stress and teach you how to harness it to make yourself stronger, more positive and more resilient.

Stress is a powerful response to an increasingly challenging world. Let this special edition help you make sure you are in control of it!

Book: 8 Keys to Stress Management

Book Title:

8 Keys to Stress Management.

Author(s): Elizabeth Anne Scott.

Year: 2013.

Edition: First Edition (1st).

Publisher: W.W. Norton Company.

Type(s): Paperback, Audiobook, and Kindle.

Synopsis:

According to many measures, people today are dealing with stressors that are greater in number and severity than in the past several decades, and this stress is taking a toll on our collective wellness.

The book outlines strategies to identifying stressors, offers techniques in reversing the response, and discusses the effects of stress.