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Understanding and Managing Stress

It could be a traffic jam, or a busy airport. It could be at school or on the job. Wherever your look, you can see signs of stress and tension. Stress is everywhere in our society, and there’s a lot of evidence that it affects our health.

Stress and Spinal Cord Injury
Many people believe that having a spinal cord injury must be extremely stressful. While no one knows this for sure, some recent research is helping us find answers to this question.

One group that was studied was made up of almost 200 British spinal cord injury (SCI) survivors between the ages of 34 and 74 and injured more than 20 years. They were followed for six years, and the stress they reported was compared with their medical diagnoses, their other health problems, their levels of physical and emotional function, and their involvement in their communities.

It’s NOT How Disabled You Are!
It seems that what wasn’t found is at least as important as what was found: The severity of the spinal cord injury was not at all a factor in how much stress people felt. No matter how you measured the severity of the disability – by how much paralysis the person had, by how physically dependent they were, or by how much help they needed – it did not predict how much stress a given SCI survivor might have. Another stress study involving younger SCI survivors, done at the Baylor College of Medicine in Texas found the same thing: there was no connection between severity of the disability and the amount of stress.

Stress and Your Health
What was related to stress? Not much: not heart disease, not ulcers, not cancer; not even such common SCI problems as pressure sores or shoulder pain. Among the British people studied, those with the most stress did complain of more fatigue. Some of them also had more stomach pain and nausea. Over time, those who had higher stress also seemed to use more alcohol. These were the only health issues that seemed to have any relationship to stress.

Does this mean that SCI survivors don’t have to worry about stress-related health problems? No. What it likely means is that the SCI group studied was too small, and the time period was too short for these serious but slowly developing stress-related problems to show up.

Stress and Coping
On the other hand, this same research showed that stress in spinal cord injury does play a role in psychological adjustment and happiness. The British SCI survivors who had more stress thought that their quality of life was lower than those who had little stress. They were more dissatisfied with their lives and they had more physical and emotional symptoms of depression too. When studied again three years later, they still had stress, and they were still unhappy and depressed. The stress study done in Texas with spinal cord injuries also found that life dissatisfaction and depression symptoms were related to high stress.

What’s the Point?
All of these findings seem to tell us the same thing: If you have stress now, look into stress management and other ways to get a handle on it!

How Do SCI Survivors Stack UP?
How does the stress reported by SCI survivors compare with that of nondisabled people? The only way we have to make comparisons is by looking at the work of other researchers who used the same stress test we did. Here’s what we found out:

  • In one study of Americans without disabilities, their stress scores were about the same as the British SCI survivors.
  • The Texan SCI survivors, however, had more stress than the British SCI survivors did. This could be because the Texans were younger and weren’t injured as long.
  • College students had more stress than the SCI survivors.
  • The wives who cared for the British SCI survivors themselves had more stress.

Unfortunately, until there’s research that directly compares SCI survivors and nondisabled people, we won’t know for sure how you stack up, but you can safely assume that:

  • newly injured people may have more stress
  • their stress should decrease over time
  • no one should tell you that because you’ve got a spinal cord injury you ought to have more stress! Since we know that the severity of your injury isn’t a factor in stress, it may be that just having a spinal cord injury isn’t a key factor either

Getting on Top of Your Stress
Whether you’re spinal cord injured or not, we know that too much stress is not good. These are possible signs of stress:

headache dry mouth teeth grinding
trouble sleeping irritability moodiness
forgetfulness sadness depression
lack of creativity dissatisfaction tension
anger tight shoulders & neck muscles feeling too "hyper" or out of control
increased smoking more alcohol or drug use

There’s a good chance that your spinal cord injury is not, in itself, the cause of your stress. However, there is an equally good chance that problems related to your SCI are contributing to your stress. Think about what’s going on in your life. Some of the things causing stress you can change; others you can’t. Focusing on the things that you can’t change only creates more stress, so work on those things that you think you might be able to do something about. Try to solve the problem that’s creating the stress.

Exercise is great. An aerobic workout, stretching, or weight lifting can really help you feel better. Stretching exercises for your neck, shoulders and back might also "hit the spot."

Relaxation is also helpful. Special relaxation activities, called "progressive relaxation" are good. "Thinking your way through" relaxing, focusing on slow, deep breathing or guided imagery might help. Don’t forget about the stress-reducing effects of just listening to quiet music, reading, or going to a movie, too. Better yet, take a trip and get away. There’s nothing wrong with taking some time to do something for yourself that totally takes your mind off of the source of your stress.

Finally, let go of things. You don’t have to be a "superquad" or a "superpara" every minute of every day. Your house doesn’t need to be spotlessly clean. You don’t need to read every magazine that comes in the mail. You don’t need to accept every invitation you receive, or agree to volunteer for every thing that comes along. Set more realistic goals and find easier ways to do things. As the commercial says, "Just say NO!"

If these solutions don’t work, and you find your stress getting worse, you might want to consider getting some outside help. This can include counseling or a stress management workshop. It can mean hiring a house cleaner. Maybe sign up for a yoga class, or take a course that targets your stress directly. Is your problem with communication and bottled up feelings? Then, consider communications classes or an assertiveness training workshop.

Here are some organizations, found in most communities, that are possible resources:

  • parks departments and recreation centers
  • the YMCA, the YWCA
  • your local health department, or a mental health program
  • mental health professionals, like psychologists, psychiatrists, and social workers
  • your church and its leaders
  • college or university counseling centers, social work departments, even their health and physical education departments

Regardless of what you do, remember: You can change the cause of the stress. You can change what you do about it, or you can change how you feel about it. However, no matter what you do, you have to do something if you want your stress levels to be less!

This is part of a library of educational brochures developed by Craig Hospital with a federal grant titled, "Marketing Health Promotion, Wellness, and Risk Information for Spinal Cord Injury Survivors in the Community. The opinions expressed here are not necessarily those of the funding agency, the National Institute on Disability and Rehabilitation Research of the US Department of Education.

For a hard copy of this brochure, click on your selection above and hit the "print" button on your browser. If you'd like to ask for one directly from Craig Hospital, you can contact us by telephone at 303-789-8202, or you can e-mail us at HealthResources@craighospital.org.