Diagnosis and Associated Issues Stress and Anxiety
For a person who has had psychosis, experiencing too much stress increases the possibility of a relapse. Increased stress can also make existing psychotic symptoms worse.
Defining Stress and Anxiety
Stress can be defined as the difference between the demands a person perceives are being made on them and how many adequate resources they believe they have to meet those demands.
Anxiety may be defined as the perception of a threat. The threat may be to a person's physical body, ego, job, relationships or anything else. When a person concludes that something or someone is a threat, their body usually reacts quite quickly.
In both definitions the key word is perception - that is, how a person evaluates the situation and their ability to cope with it. In response to seeing something as a threat (anxiety) or a challenge (stress) the body reacts. This is something we all experience. It makes sense to be psyched up physically when getting ready to play a tough sport or run away from a wild animal. Unfortunately, the body is not designed to maintain this reaction for a long time. When people get over-stimulated (i.e. from the ongoing perception that something is a threat or a challenge that may be too big to successfully meet) it can create some problems. So, stress and anxiety are basically responses of the mind and body.
What Causes Stress and Anxiety?
It isn't really correct to say that any specific event or situation will make someone stressed. That is because people are all different in how they look at situations. For example, one person may become afraid when seeing a dog but the next person is happy to meet a new dog. So, it isn't the dog that is making the first person anxious and the other happy, they have different reactions because they see the dog differently.
If a person goes home and tries to watch TV but is worrying about their job and believes they are going to get fired, what is the cause of the anxiety? Is it the job? What the boss said? It is likely that the person sees the loss of the job as a threat to finances, self-esteem, etc. In this situation the person may be sitting in front of the TV relaxing at home but is very stressed and anxious because of the thoughts about the job. There are many situations that people see as threatening or challenging, but the point is that it is not necessarily the situations that disturb them; it is the way they view those situations.
Some examples of stressful situations are:
- Many life events that result in change (for example moving to a different city or changing jobs). Even positive life event changes can generate stress.
- Work and/or school can create stress by presenting challenges, difficult tasks and deadlines. Conflicts with friends, family or coworkers. Ongoing concerns about money and housing.
- People's own thoughts can create stress - for example, by setting impossibly high standards for oneself or worrying excessively about things.
- Daily hassles, such as getting stuck in traffic, missing the bus, or misplacing keys.
So stress and anxiety usually result from a combination of factors: an event in the world; a perception that a situation is challenging or even threatening; a perception that the person either has or does not have enough resources to effectively deal with the situation; and physiological responses that prepare the body to react to the challenges.
When Normal Becomes Abnormal
Although stress and anxiety are common experiences, they can escalate to become problems. Research has shown that chronic (ongoing) stress can increase the risk of developing depression and other mental and physical health problems.
Over time, stress and anxiety can develop into particular mental disorders. Anxiety disorders such as Phobias, Panic Disorder, Social Anxiety Disorder and Generalized Anxiety Disorder are associated with significant distress to the individual and may NOT simply be accounted for by the psychotic disorder. They should be diagnosed and treated by a qualified mental health professional.