a little stress assessment

Stress will kill you.  Google it.  You'll see. And before it kills you, it will make you extremely miserable.

I think we can all handle short seasons (like a week) of high-octane go-go-go.  But we can't do it all day every day without doing serious damage to ourselves.  Even if we're doing things we LIKE, and we never get any rest, we're doing damage.

My own experience with stress, anxiety, depression, and burnout has motivated me to sort out how to live within the limits of my own human body, with the balance of work and play and rest that God designed me for.

Here's how I've learned to assess my own stress levels:

  • How am I sleeping?  If I'm waking up in the middle of the night, and having trouble going back to sleep, I'm overly stressed.  That's the most common type of insomnia.  Nightmares or repetitive thematic dreams are a tip-off, too.
  • How am I eating?  If I've lost my appetite, I'm buzzed up on adrenaline and stressed.
  • Am I getting regular exercise that makes me sweat?  Without it, I'm stressed.
  • How are my moods?  If I'm irritable and everybody else on the road is an idiot, I'm stressed.
  • Is there any white space in my calendar?  No?  I'm stressed.
  • Do I feel trapped and without choices?  I'm stressed.
  • Does my daily routine feel manageable?  If I can't make headway and I'm overwhelmed, I'm stressed.
  • Do I know what the next fun thing is?  And is it happening this week?  If not, I'm stressed.
  • Do I have close friends/family who know everything about me and support me?  If I'm hiding things emotionally, I'm stressed.

And here are the questions I ask to try to keep life in a reasonable place:

  • Do I want to do this?  For years, I couldn't answer this question honestly.  I thought I wanted to.  My sleep, eating, moods, etc., told a different story--one I didn't want to hear.
  • How many things on my schedule are "have-to's" as opposed to "want-to's"?
  • If I'm overwhelmed by "have-to's", why am I doing these things?
  • Why am I afraid to stop doing things I know are hurting me?
  • Do I believe that God won't love me if I quit?
  • Am I trying to make other people (parents, friends, colleagues) admire me?
  • Am I living beyond my means financially, so I have to keep running like a lunatic just to pay the bills?
  • What do my close friends honestly think about the pace I'm keeping?  Have I even asked for their help?

I'm going to link you up here with Tommy Nelson, pastor of Denton Bible Church, speaking at Dallas Theological Seminary about his own experience with stress and depression.  30 minutes that can change your life.  Here you go.


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Doing the same thing over and over, and expecting a different result. I'm not sure who first defined insanity in those terms, but wow.  That shoe fits.

Mental health issues like depression and anxiety don't just fall out of the sky and hit us in the head one day.  They develop over time.  Usually, many factors are involved.  It's complicated.  When I'm trying to understand a client's story, the medical model helps me a lot.

The medical model says that mental health problems result from a combination of biological, psychological, and social factors.  A perfect storm of biological susceptibility, psychological stress, and social stress.

Biological susceptibility might include:  a family history of depression, anxiety, etc; an illness like thyroid disease; adrenaline stress or exhaustion; sleep deprivation.  Our brain is integrally connected to the rest of our body.  (That's what your neck is for, right?)  The things that impact our body will impact our brain, and that means they will impact our mood and mental health.

Psychological stressors tend to be things in the past:  trauma; stress; life transitions; an abuse history; family history of alcoholism, workaholism, ministryaholism, or whatever ism your family of origin happens to have.  I would include spiritual issues here.  All the lies and false beliefs that keep us stuck and despairing.

Social stress lives in the present:  marital discord; economic distress; problems in the workplace; conflict with family or friends.

All those things overlap and impact each other.  Think of those overlapping circles in a venn diagram.  (I was trying to put one on here but it didn't work so I'm going to rely on the power of your imagination for the graphics today.)

And here is where I think I often become the bearer of bad tidings.

If you want to get better, you will have to make change.

You might need to take medication.

You might need to take a good, hard look at things in the past that are painful.

You might need to make some tough changes in the present.

But here is what I know for sure.  If you keep doing the same thing over and over, expect the same results.  Expect the insanity to continue.  And realize that you're making that choice.

Maybe that sounds harsh, but I work with people who are really, really in trouble.  Kids who want to die.  Women in abusive relationships.  The problems are real.  And the solutions require courage and hard work and life-long change.

Anything less than that reality, is just somebody trying to sell you something.  And I think that the vendor is the Enemy of your soul.  So caveat emptor, everybody.

Here's an old story that's floated around for a while.  I found it printed in Encouragement, Barnabas International, July 1993.

Autobiography in Five Short Chapters

Portia Nelson

Chapter 1

I walk down the street.  There is a deep hole in the sidewalk.  I fall in.  I am lost and helpless.  It isn’t my fault but it takes forever to find a way out.

Chapter 2

I walk down the same street.  There is a deep hole in the sidewalk.  I pretend I don’t see it.  I fall in again.  I can’t believe I am in the same place, but it isn’t my fault.  It still takes a long time to get out.

Chapter 3

I walk down the same street.  There is a big hole in the sidewalk.  I see it is there.  I still fall in…it’s a habit.  My eyes are open and I know where I am.  It is my fault.  I get out immediately.

Chapter 4

I walk down the same street.  There is a deep hole in the sidewalk.  I walk around it.

Chapter 5

I walk down another street.

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Being sick makes you feel bad

Being sick makes you feel bad.  We're in the middle of flu season, so we all know this. But sometimes being sick makes you feel really, really bad.  Like clinically-depressed bad or panic-attack bad.

Here's a little problem.  Depression and anxiety symptoms that arise from medical problems feel exactly the same as depression and anxiety that come from psychological stress or trauma.  Sometimes we take such a psychological approach to anxiety and depression that we forget to look at possible medical problems.

Here's a list of medical issues that can make people feel anxious or depressed:

  • Adrenal disease
  • Anemia
  • Brain injury
  • Caffeine
  • Caffeine withdrawal
  • Cancer, especially pancreatic cancer
  • Chronic Fatigue Syndrome
  • Hearing loss, often associated with social isolation
  • Infections or post-infection states
  • Low blood sugar
  • Migraines
  • Mineral imbalances
  • Mitral Valve Prolapse
  • Thyroid disease
  • Vitamin deficiencies (especially thiamine, vitamin B-12, niacin)
  • Medications such as birth control pills, weight loss pills, blood pressure medications, Accutane

Source:  Healing Anxiety and Depression, Daniel G. Amen, M.D.

So there you go, a little bit of anxiety and depression info to file away.  I hope you never actually need it.

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Alone or attached?

"An alone self is a bad self."  I read that somewhere several years ago, and it's kind of like one of the first things God said about human beings:  "It is not good for man to be alone." In psychology, attachment theory talks about what happens to human beings who have been alone, with inadequate love and attention, as infants.  Back in the early 1900's, theorists began observing three distinct categories of behavior in young children who were exposed to new situations.  These "attachment styles" correlated to the attention, or lack of it, that the children experienced from their parents or primary caregivers.

Here is what researchers observed:

  • When secure children got into a strange situation, they were able to explore, return to their parent if they needed to, then explore again.  If they got fussy, they could be comforted easily by their parent.  If the parent left the room, the child was upset, but when the parent returned, the child went to the parent immediately for comfort.
  • Anxious-resistant children tended to be quite upset by new situations.  They were clingy, whiny, and difficult to comfort.  They wanted comfort but they also seemed to be resistant to receiving that comfort.
  • Avoidant children appeared to be less upset by new situations, and they didn't seem to mind being left by their parent.  But when the parent returned, they would avoid contact by doing something like playing with toys.  Researchers believed that these children had tried for comfort, experienced the fact that they would not receive it, and had given up.

To a baby, caring attention means way more than a clean diaper and some mashed banana.  It means that somebody will attend to what I need and make sure that I am OK.  It's calming, it's comforting to know I'll be taken care of; it means I can get out, explore the world, and have some brain space left for something besides my basic needs.  Babies don't understand words; they understand our actions toward them.

Of course, other researchers have gone on to study how childhood attachment patterns affect us as adults.  Last year, a friend of mine passed on a book called How We Love:  Discover Your Love Style, Enhance Your Marriage by Milan and Kay Yerkovich.  The authors ask probing questions to evaluate your own attachment style as an adult, like:

  • Did you learn about trust and respect?
  • Were you allowed to have your feelings?
  • Were you allowed to be a kid?
  • Do you know how to wait?
  • Can you say no?
  • Can you ask for help?
  • Can you say you're sorry?

The point of this kind of self-examination is not to make you feel like a bad, hopeless person unfit for human relationships.  The point is that, since we are grown-ups now, we have the capacity to recognize our own maladaptive patterns and do something about them.  And before we can change, we have to recognize that what we're doing that doesn't work.  The truth sets you free.   After it scares you half to death first.

Which is why it sometimes helps to talk about this stuff with somebody while you're working through it.

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Write this down

"God made me fast.  And when I run, I feel His pleasure."  Eric Liddell (whose life story was recorded in Chariots of Fire) I am not a runner.  Things jiggle and leak and hurt when I run.  Therefore I have determined that running is not good for me, and I need to restrict myself to a brisk walk.  But I love that quote.  It's made me ask things like:

God, what did you make me?  I know I'm not fast, but I think there's something that I'm supposed to do, and in so doing, feel Your pleasure.

It hasn't always been easy for me to identify "what God made me."

Areas of incompetence are easy to mark off the list--for me, anything to do with numbers, money, or linear thinking ranges from apathy to painful to epic failure.  I can remember my poor dad trying to teach me my 9 times tables.  I was in the 8th grade.  When I was in college, a math professor told me I had a bad attitude about math.  I said, "Yes, I know."  Whatever that math gene is, I think it just got left out.  God clearly did not make me that way.

Another category of "not really me" is learned skills:  things I can be good at, but they aren't my natural gifts.  Lots of times learned skills are what we do on the job.  I have spent a lot of time doing those kinds of things because they are useful and practical, and we need to eat and have a relatively clean house.  I can learn to do those things with great skill, but they will make me tired.  And that is a sure sign that this is not really what God made me, either.

Then there is this magical category of things I could do all day and still feel energized.  For example, I never need a vacation from making things pretty.   I love to have a heart-to-heart with a good friend.  And I can sit here writing at this computer all day in my jammies, happy as a clam.  It took me a long time to realize this, but things like that are my natural gifts.  This is what God made me.  The happiness and energy I feel when I'm doing those things is His reflected pleasure.

The following journal prompts are not originally mine.  I wrote them down from the reality TV show, Starting Over, several years ago.  (God works in mysterious ways, even through reality TV.)  I've used them myself and find them helpful in reconnecting with what I like, what speaks to me, what brings me joy, where my life is in this present moment, and where I would like it to be.  If you answer the questions and consider "why"--it can be a great exercise in considering what God made you.

  • My favorite color is:
  • My favorite food is:
  • My favorite song:
  • My most valued possession:
  • My greatest strength:
  • My greatest weakness:
  • My greatest fear:
  • My best skill:
  • My biggest mistake:
  • My greatest accomplishment:
  • The experience that brings me greatest joy:
  • The thing I am least fond of doing:
  • The most fun thing I can think of to do is:
  • If I were to die today, what is the one thing everyone who knows me would say about me?
  • What would I want them to say?
  • Why wouldn't they say what I hope?
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You might be a little codependent if...

  • You say "yes" when you want to say "no."
  • You do more than your fair share of the work.
  • You're disappointed or angry with all the slackers around you.
  • You are surrounded by needy and demanding people who never really seem to appreciate you like they should.
  • You feel pressured, over-committed, stressed, rushed, undervalued, and used.
  • You are last on the list.  And you just thought:  "Wait a minute.  I'm allowed to be on the list?  Isn't that selfish?"
  • You're hoping somebody will notice you and make you feel better.
  • You think that saying "no" makes you a mean, bad, unspiritual person.
  • You suspect that people who say "no" to you are not especially nice and maybe not too spiritual, either.
  • You feel sad or angry because nobody seems to do as much for you as you do for them.
  • You feel anxious and guilty over other people's feelings, actions, wants, needs, and well-being.
  • You can't say what you really think or feel, because that would hurt the other person's feelings or make them mad.
  • You walk on eggshells.
  • You don't really know how to have fun.  And if you do have accidentally have fun, you feel guilty.
  • You worry about what everybody thought about you after you leave a meeting or party.
  • You aren't quite sure how you feel.  But it's not mad, sad, or scared, that's for sure.  Those feelings are bad.
  • You let other people hurt you.  Again and again and again.  You call this forgiveness.
  • You lie to protect other people.  You lie to protect yourself.  You lie to yourself to protect yourself.
  • You're terrified of the truth.  You can't even name it in your own mind.
  • You come to a point where you just can't deal with the pain any more.
  • You get really angry, intolerant, distant, and shut down, because that's the only way to be safe.

The term "codependent" was coined in alcohol and drug treatment programs to talk about the maladaptive behaviors of friends and family members who supported and enabled the addict to remain addicted.  Now we recognize that you don't necessarily need a drug addict or alcoholic in the equation to have codependent behaviors.

For me, the bottom line with codependency is a pattern of confusion over what is mine and what is yours.  Responsibility and consequences are all out of whack.  When I'm being codependent, I'm helping you when you ought to be helping yourself.  Helping makes you happy with me right now, but ends up making a mess in the long term.

Books and books and books have been written about codependency and how to get out of it.  Boundaries by Cloud and Townsend is a great place to start.  The Search for Significance by Robert McGee digs into the deeper spiritual issues that keep us wrapped up in other people's junk.  If you want to get all crazy and read a feminist author, Harriet Goldhor Lerner has a great book called The Dance of Anger that pretty much blew my mind the first time I read it.

I have three tips that have helped me in my own recovery.

Number One:  A Practical Tip

Practice on the people who don't matter.  (I hear you out there howling already, but bear with me.)  There are people who really, really matter in our lives.  Our parents.  Our children.  Our in-laws.  And if we're codependent, we are probably going to be in it up to our necks with these people.  The patterns have been in place for years, and change is difficult with them.

For some of us, being able to identify the fact that we don't like something, and to tell the person we don't like it, and to ask for what we want, and to allow the other person to have their emotions about it--that is ENORMOUS.  We have had absolutely no experience in this, and we need to practice, practice, practice.  And it can help to practice in the small, everyday exchanges that aren't quite so emotionally charged as family interactions.

If you live in America, you can start practicing on the fast food industry.  Send back the cold fries, my recovering-codependent friends!  Never eat a wilted salad again!  No espresso shots in the chai tea!  In the huge scheme of your life, what that server thinks of you just DOES NOT MATTER.  You need never see them again.  So take the opportunity to identify what you don't like, and ask for what you do like.  This is not about being mean and ugly and selfish, it's about being honest and assertive in baby steps so that we can experience the fact that the universe will not implode when we ask for what we want, and maybe someday take a similar baby step in a relationship that really matters.

Number Two:  An Emotional Tip

Do the right thing and learn to live with a little guilt.  When you start changing care-taking patterns, you will probably feel guilty and worried about what the server at McDonald's thought of your Christian witness when you refused the cold fries.  That's OK.  (Unless you cussed her out, which is not OK.  I said assertive, not aggressive.)  Don't let your emotions control you.  You just do the right thing, and eventually your emotions will get used to it.  It really helps at this point to have a couple of close friends (or a counselor) who can help you figure out the right thing, and press on through the guilt and fear.  When you're feeling confused and upset, talk it out before you take any action.  Make sure you're doing the right thing and not the guilty, fearful thing.

Number Three:  A Spiritual Tip

God is in charge of the universe, and it his His job, not mine.   I am not responsible for the health and happiness of every person I meet, even if they tell me that I am.  If I'm running around like a crazy person, feeling all heavy-laden, then it's likely I've taken over trying to run the universe again.  Jesus offers rest for my soul, but He won't force it on me.

A few years ago, I was sitting in front of a pastor, weeping, and saying, "When will it ever be enough?"  And this man said to me, "It is enough already."  The reason it's enough already is because Jesus has done everything that needs to be done.  His love is enough for me, and His love is enough for you.

We can walk together in that, trusting that God cares for us.

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Cleaning the fridge

Years ago my friend Pam told me that life is like a refrigerator, and you are issued a certain number of Tupperware containers for all the emotional leftovers that come your way.  Most of us keep putting stuff in there, until eventually you realize you're out of real Tupperware, you've used up all the ghetto Tupperware like leftover margarine tubs, and in fact you're having a hard time getting the door shut anymore.  Anytime the door gets opened a crack, it's ugly and scary and everyone falls back ten feet, blanching and gagging.  You can't begin to think what might make it better, so you keep the door shut and hope you might happen to have that special self-cleaning fridge, the kind that magically devours the leftovers with no effort at all on your part.  Unlike any other known to man. And maybe you do, lucky you.  But if you're like the rest of us, not so much.  And one day, you might find yourself desperate enough to want it clean, no matter what it takes to get it that way.

And that desperate place is a very, very good place to be.  If you're in that place, stop and be glad.  Desperation will motivate you like nothing else.  It will make you willing to throw away things you have held onto with both your two hands, convinced that your very life depends on that rotten, moldy piece of resentment from 1977.  But when you're desperate enough, you might find yourself ready to let it go and let God redeem.  Which means you will end up with a fresh, new start.

I know this for sure, because that's what God has done for me.

So a few years after Pam first told me about the fridge, I told her I felt like the fridge was clean now.  And she asked me, how did you clean the fridge? And I didn't have a good answer at the time.  I was a little bit like the man who said, "I was blind, and now I see."  It was clean, I was grateful, and that's all I knew.

But I've thought about that a lot as time has gone on, and I think I can see some of the things that were helpful.

Getting the gunk out

When you clean an actual refrigerator, the first thing you have to do is get everything out onto the counter and get rid of whatever looks like a science experiment gone bad.   To me, this is the worst part of the process, the very reason I don't clean my actual fridge much.  It's hard and no fun and I hate it.  The truth is, I will only truly clean it if something really awful gets spilled.  (Or if I have advance notice that a particularly intimidating person is coming over, and might look in my fridge.)  Otherwise, I just wipe the fronts of the shelves when I remember.  It's always bad in the back.

I think cleaning the emotional fridge is like that, too.  Wiping down the front of the shelves will only do it for so long.  Eventually, you've got to get all the way to the back.  Generally, in the process, it looks like you're making an even bigger mess than you had before.  This is OK.  It really is.  Even if it feels absolutely terrifying.  Hang in there.

Getting changed

I think there's a huge temptation to try to put everything back the way it was--jam it back in there and slam the door again.  But if you're really desperate, you'll know this is not what you really want--no matter how tempting.  I remember a few months into that process in my own life, someone asked me when I was going to be back to normal.  I said, "Never, I hope."  I wasn't going through all that grief just to find myself in that mess again, not if I could help it.

Everybody's "stuff" is their own, but I read books about depression and anxiety and codependency and boundaries, because that's what I was dealing with.  For us, The patterns of our marriage were a huge part of the mess, so we worked hard on those and created something new and different that we love today.

One of the most basic changes I've made, is to deal with what's wrong, as soon as I know about it.  No more of the hoping it's going away on its own.  One of my first symptoms is waking up in the middle of the night.  I might not have a conscious thought that's anxious, but I know that if I start waking up in the middle of the night, I am anxious about something, and I need to figure it out.  Now.  And I know I am a verbal processor, so I need to talk to somebody.

Getting help

So, for me, getting help is part of being changed.  In the pre-cleaning years, when I wasn't desperate enough yet, I wanted to go to therapy.  But...it just wasn't bad enough.  So I didn't go.  And there were so many things I was afraid to say to anybody.  I'm sure I would have been a very frustrating client to some poor therapist.  I had a weird kind of magical thinking going on that went something like this:  "If I don't say it, it's not true."   I wouldn't even write the truth down in my own journal, that's how bad it was.  Nobody knew the real me, not even me.

It's absolutely imperative for me to have two or three close friends of the "say anything" variety, and my husband has to be the first one on the list.  I so value having people who really know me and will tell me what they think.  I even listen to their advice sometimes.  More than I used to.

So.  Messes and change and emotional honesty are hard work, no doubt about it.  But remain calm and keep cleaning.

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Marriage: Horsemen, Principles, and Living Longer

Need a good reason to work on your marriage?  Try this on for size:  "People who stay married live four years longer than people who don't."  That's way better than a Stairmaster, says John Gottman, who has spent twenty years researching marriage. Gottman has studied so many couples--following their relationships for decades--that he can tell within 5 minutes, with 91% accuracy, if a couple will divorce.  He calls negative interactions like criticism, contempt, defensiveness and stonewalling "The Four Horsemen of the Apocalypse," signaling that the end is near.

Not only does he know what signals divorce, but he also knows what makes couples satisfied and successful in marriage.  So when he writes a book called The Seven Principles for Making Marriage Work--and includes a bunch of quizzes and exercises to boot--it seems to me that all of us married people ought to read it and at least consider what the man says.

Gottman's book is not about behavioral technique.  He doesn't really care if you have differences of opinion--even ones that get pretty loud.  He doesn't care if you say the right thing in the right way.  He claims (based on his research) that what really matters are things like deep friendship and admiration for one another, a true caring connection, mutual honor and respect.  With those things, you can live through differences and not be too worried about getting every little thing just right.  And his ideas are directed at being deeply satisfied in marriage, not just staying together in boredom or misery.  This is about growing a marriage that's full of life and nourishment.

Here is Gottman's advice for a marriage that works, and works well:

  • Enhance your love maps
  • Nurture your fondness and admiration
  • Turn toward each other instead of away
  • Let your partner influence you
  • Solve your solvable problems
  • Overcome gridlock
  • Create shared meaning

He's got specific ideas for simple, proactive interactions that provide maximum benefit to marriages--things we can all do in just a few minutes a day.

To see how he fleshes out his advice, buy the book--and enjoy those four extra years of life!

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Bad enough yet?

One of the things I've been asked is, "Do I really need help?  Is it bad enough yet?"  My personal rule of thumb on this is:  if you're asking the question, it's time to get help.  If you know something is wrong, go ahead and start treating it.  Don't wait for it to get worse.  We know that makes sense with physical ailments, and it works for emotional issues too. Here are some specific things to watch for:

  • General functioning:  am I able to do what I need to do?  Or am I having trouble accomplishing my normal routine?  Have I lost interest in things I usually enjoy?  Do I feel tired, worn out, overwhelmed?
  • Social functioning:  do I have enjoyable, open relationships with family and friends?  Or am I experiencing a lot of conflict at home, at school, or at work?  Am I isolating myself, or feeling like others don't care about me?  Do I have lots of things I want to tell someone, but feel I have no one to talk to?
  • Sleep:  am I sleeping too much or too little?  Having trouble falling asleep?  Waking up in the night?  Do I feel rested in the morning, or sluggish and exhausted?
  • Mood:  am I feeling sad and empty?  Crying a lot?  Or feeling angry and frustrated, and lashing out at others?  Do I feel guilty and worthless a lot?
  • Food:  am I eating more than normal?  Or experiencing a loss of appetite?
  • Thoughts:  am I having trouble concentrating?  Am I indecisive?  Or am I having racing or intrusive thoughts?  Are there things I just can't stop thinking about, no matter what?  Does it seem like I'm thinking in circles?
  • Behavior:  is my behavior normal and healthy for me?  Or am I acting in ways that are unusual and unhealthy?  (Ask a trusted friend or family member if you can't tell.)  Are there behaviors I wish I could stop, but can't?

Experiencing a couple of these things over a period of two weeks or more is cause for concern.

If you have thoughts of death or suicide, please call for help immediately.  The US National Suicide Hotline is free and available 24 hours a day, 7 days a week.  1-800-784-2433.

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