How Much Stress Is Too Much?
Could you run for 10 miles? Could you pick up a 100-pound stone? Most people, without embarrassment, would answer “no.” People know how much is too much, how much might hurt them. What if we ask the same questions about emotional stress?
To be clear, I do not mean trauma such as young people dying suddenly or being victim of violent accidents or assaults. “Stress” in this sense are normal life events which are difficult to cope with. How much of this is too much? Once we surpass whatever our limits are we begin suffering stress-related symptoms or outright mental disorders. Can we, as with the 100-pound stone, know what is too much before we become overwhelmed?
The answer is yes, if we begin to assess stress and its effects on us. Trauma has been the topic of much writing, and rightly so. Many people suffer silently from trauma that is unspoken or ignored. Part of the point of labeling something as trauma is that it is not part of normal life. Stress, however, is part and parcel of ordinary living. We live in an era of a national opioid crisis, frequent suicides, and mental illness, which seems to spread like wildfire. Instead of waiting for the feeling that we (or a loved one) are in crisis, can we look for ways to step in before these difficult outcomes?
Over my many years in psychiatric practice, it’s become clear to me that we do not have a commonsense way of gauging when any one of us would likely be overwhelmed. So, I’ve devised a simple system for people to use to examine their lives and see if they are at risk of being overwhelmed. This has nothing to do with mental illness. The system is for everyday life. But first I want to be clear about what we are looking for.
What is Being Overwhelmed and Why is it Important?
Let’s begin with a definition. What exactly is being overwhelmed? It is when the things you must cope with exceed your abilities to do so. This is very straightforward on the surface but digging down can get more complicated.
Being overwhelmed may be a warning sign of a bigger problem but is also a problem just by itself. When overwhelmed, we do not think as clearly, tend to be more emotional and of course, do not feel well. Often, many of us do not realize we are overwhelmed until after we have bitten someone’s head off or have had great difficulty getting through some small demand. Others may withdraw and stay alone in their room away, while some may turn to substances to blunt their feelings.
Most people judge your emotional state by how you appear or how you function in your everyday role. The problem is that many of us can look fine and do our jobs while feeling emotionally overwhelmed. So, in order to find out, we must ask. And to ask we must know when it is necessary to do so.
We all know examples of this, such as the loss of a loved one or a frightening event. But there are many times when we find ourselves emotionally inundated and are not sure what pushed us over the edge.
Can We Predict When We Might Become Overwhelmed?
For years I have used a metaphor to convey to my patients why they suddenly find themselves feeling so unsettled. I define four essential constituents of mental well-being and compare them to the poles of a tent. The four are:
Health. This need not be perfect, but allows you to function without pain, significant disability or the imminent threat of either. A severe or terminal illness is frequently the problem, but chronic disease is a common cause that is often overlooked.
People. These are folks who care about you and share parts of your life—friends, family or whoever fits the bill.
A home. A place that is safe, comfortable and you have at least in part, a claim to. Your room may be enough. Home is a launching pad for building a life. It is a basecamp and a refuge for which there is no substitute.
A way to survive. In our culture, this means money. We do not hunt and gather, nor sow and reap. We get money to buy what we need and take care of ourselves and our loved ones. Our jobs, dependence on a partner, or a pension all do the job. In each case, we get the money we need.
If any one of these is suddenly absent or disturbed, you will of course be stressed. The important point is this: if more than one is absent or disturbed, you will be overwhelmed. To think of the tent; one pole suddenly not working causes problems. Two poles mean you no longer have a tent. Now you are exposed to the elements, no longer protected.
To bring home the point, imagine yourself with any two of these four compromised in your own life. Perhaps you are having marital problems and your work hours are suddenly cut. Or you are trying to cope with an illness, and you discover your insurance has not covered an expensive piece of your care. Or perhaps you are in between jobs, and you will miss yet another rent or mortgage payment. Or lastly, you have been quite sick and now, a few weeks into the problem, the flow of visitors dries up.
These problems and countless others are exhaustingly common and occur right under our noses, even if you are the person in question. The reason they are missed is because most of the issues are considered normal life problems and people are thought to generally plod through them. But our psyches need a sense that life is still basically under some control, and we will not end up powerless and alone. This is the need for four poles (or at least three).
More About the Four Poles
We all have more sophisticated psychological needs than suggested by the four poles. Things such as close relationships and a sense of meaning in life are the two most important. The four poles do not replace these. Rather, they are the foundation upon which such things are built. They are the basis of our inner sense of stability and safety in an unpredictable world. The use of this metaphor has helped me communicate to my patients the excessive weight of stress they are carrying without knowing it.
Rather than severe trauma, it is often common life events that pull the poles out from our safe tents. Divorce, illness, and unemployment are unfortunately common and clear examples. Anyone who has been through these knows how easily one dimension such as money or health, reaches out and wrenches away friends, funds or even our homes.
If we incorporated the tent metaphor into our thinking a few things would be suddenly obvious. For example, all cancer patients need—or need at least the offer of—psychological care as part of their treatment. In addition, homelessness is not just another social problem. It undermines the psychological health needed to solve the homelessness itself, so is self-perpetuating. Lastly, some people may need more attention, even if just from family and friends, than they usually receive. These include women who have had recent miscarriages, people without advanced training who lose their jobs, and anyone caring for a chronically sick relative.
The ability to predict when things are just too much is just as important in our psychological lives as in our physical ones. We know how far is too far to run, how much is too much to lift. It is time we know how much is too much to cope with.