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How to Stop the Stress: Delaware Health


Laurie Bick knows stress.

Her previous job as communications director for the Delaware Republican Committee is enough to suggest the Newark-area resident doesn’t avoid high-pressure situations. She recently became public relations director at Wilmington University, but prior to that, she sweated through a period of unemployment and unsatisfying part-time jobs. Being unemployed in this economy is frightening and terribly stressful.

“I guess you could say I was at the height of my career in corporate business communications when I relocated from Pennsylvania to Delaware in 2005 for a position at DuPont,” says Bick. “When that ended 14 months later, I mistakenly thought I could take my time in finding another full-time position. I redoubled my efforts in actively looking for work, but I couldn’t get around the fact that I was still new to Delaware and had few business contacts. My mother came to live with me in October 2005, so I became the breadwinner of my household and became responsible for her care.”

Bick says she carries “a lot of my stress in my neck, shoulders and lower back” from a hectic schedule. I employ a couple of techniques. I do meditation at least once a day, and I practice tai chi on a daily basis, which is a martial art in addition to being what many have described as ‘meditation in motion,’” she says.

Bick takes inspiration from her late mother, who discovered yoga in her fifties. Bick says her regimen makes a big difference, citing research and clinical studies that show the practice can amount to the equivalent of getting an extra six hours of sleep.

Dr. Michael N. Marcus, medical director of the Christiana Care Outpatient Psychiatric Practice in Wilmington, says alternative practices, like the ones described by Bick, are useful in combating stress.

Marcus says human beings are built to take on a great deal of stress, but need to recognize the signs and take action.

“The first step to managing stress is to recognize it,” says Dr. Heather Raff, of Cardiovascular Associates of Southern Delaware in Lewes. “Once a person realizes that he is affected negatively by stress, he can then look for the potential source. The key is trying to eliminate or reduce the source.”

Raff says symptoms can include fatigue, palpitations, chest pains, headaches or an upset stomach. Other signs of prolonged stress can include aggression, depression, reduced concentration and loss of self-esteem.

Marcus says one way to cope with work-related pressure is to set free time for lunch or a walk and not focus as much on news of the day.

“It’s a matter of what you can handle,” he says of exposure to the around-the-clock news cycle and constant communication from social media and other sources.

Bick says other technology can help. “My saving grace is having a smartphone loaded with the right apps,” she says. “My Droid enables me to respond to emails, access my calendar, and periodically check in to all of my preferred social channels via a social dashboard app.”

Getting away from the phone is also necessary. “I never lose sight of the fact that smartphones do come equipped with a working on-off button,” Bick says.

One popular stress reliever is alcohol, but Marcus says drinking can backfire and have an effect that is the opposite of what is  intended.

Kris Bronson, a psychologist who has a practice  in North Wilmington, says humans deal with two different types of stress: acute and ongoing. Acute stress is a traumatic event. As painful as that can be, “We handle that pretty well,” Bronson says.

More troublesome is ongoing stress.

As the term suggests, stress that comes from caring for someone on a long-term basis or working in a high pressure environment can lead to long-term effects, says Bronson, who along with psychiatric social worker Sharon Cooper holds seminars that touch on stress and other issues.

Bronson says it is important for those under constant stress from a job or spending time as a caregiver to find ways to take time off, even if it is for an evening or a few hours.

Early this year, the American Psychological Association issued its annual Stress in America report. Its authors believe stress remains a major public health issue.

“America has a choice,” says psychologist Norman B. Anderson, the association’s executive vice president. “We can continue down a well-worn path where stress significantly impacts our physical and mental health, causes undue suffering and drives up health care costs.

“Or we can get serious about this major public health issue and provide better access to behavioral health care services to help people more effectively manage their stress and manage chronic disease.”

The annual report, based on a poll of nearly 1,200 people, indicates the average level of stress is down slightly from a year earlier. At the same time, many of those surveyed reported higher levels of stress in 2011.

Feeling the most stress are caregivers helping elderly family members, as well as people suffering from chronic diseases such as obesity or depression, the report indicates.

Bronson agrees that lack of access to behavioral health services is a problem, especially in rural areas, but adds that discussion of stress and discussion of findings of the report raise awareness of the challenges and the steps that can be taken.

Even for those not suffering from a chronic disease, stress is a serious matter when work and family pressures can collide.

It is not hard to find a Delawarean who has wondered whether stress contributed to a friend’s heart attack or stroke.

Bronson says the pressures of keeping a job, losing a job, managing finances or working overtime can result in added stress.

Raff says she has seen patients who have been affected by the economy and now deal with heightened cardiac risk factors.

“However, I have also seen patients have physiologic stress reactions to positive stress as well, like planning a wedding. The bottom line is that stress affects people in personal ways,” the Lewes cardiologist says.

One change from the past that can have wide-ranging effects is the higher percentage of male breadwinners out of work and spending more time at home.

Males, according to Bronson, can end up in the unfamiliar situation of doing more family jobs, such as fixing meals and doing housework.

The spouse often works to pick up the slack by taking on more overtime or another part-time job.

Bronson says the loss of income can dramatically change the lives of college-age children who depend on the support of their parents, or drain college funds of younger offspring.

The pressures can also affect family nutrition, according to a study led by Katherine Bauer, an assistant professor of public health and researcher at Temple University’s Center for Obesity Research and Education.

The study of households in the Minneapolis-St. Paul area of Minnesota covered a large percentage of families from lower-income households. Only 14 percent of those surveyed earned a family income of more than $75,000.

Stress levels from work-family pressures were also measured. Not surprisingly, the study gained national attention and spawned a flurry of articles, perhaps causing more stress for harried parents.

“We really don’t want this to be another topic that working parents feel guilty about,” says Bauer. “So many parents are striving to do their best, working hard at their jobs and raising their children. Even a meal as simple as a sandwich and some cut up fruit and vegetables will do.”

Parents can also prepare large batches of healthy dishes that can be reheated and served on busy nights. That can lessen the temptation to grab more fatty carry-out food on the way home, although healthier options are beginning to pop up at grocery stores and some restaurants.

Researchers, meanwhile, continue to discern whether certain foods can help in stress management.

Last March, food giant Nestle had potentially good news with the release of a small study indicating that moderate amounts of dark chocolate could bring a calming influence. Scientists at the company’s research center in Switzerland discovered that the chemical compounds in dark chocolate may improve the disposition of people who experience higher levels of stress.

Study participants who recorded higher levels of stress at the beginning of the study experienced a reduction in the chemical reactions in their bodies associated with stress.

The results showed the level of stress-related hormones fell among all participants, including those who were not identified as being under stress at the beginning of the study.

One place that can be stressful for patients and families is a hospital or outpatient center. That was one of the reasons that Bayhealth, in central and southern Delaware, became affiliated with Planetree, a patient-centered care system.

The affiliation, in place since 2005, has made a difference in efforts to cut the level of stress that naturally occurs in a hospital setting, according to Marianne Foard and Donna Henderson, who head the program at Bayhealth.

According to Foard, the approach includes everything from aromatherapy (the smell of fresh-baked cookies is one feature) to the use of a therapy dog.

Planetree’s philosophy is visible in the recently completed expansion and renovation at Dover’s Kent General Hospital, with soothing colors and amenities replacing past tendencies toward sterile decor. Staffers make sure that natural light is used wherever possible. Small waterfalls around the hospital campus provide another soothing feature.

Foard says Planetree principles are used system-wide, and include Bayhealth’s  outpatient care centers. In addition to Kent General, Bayhealth operates Milford Memorial Hospital.

To the south, Beebe Medical Center in Lewes operates Integrative Health to aid patients. The unit offers a number of services aimed at reducing stress for those battling illness or facing surgery.

“Studies have shown that managing stress is an essential part of both the prevention and healing process,” says Cheyenne Luzader, coordinator for Integrative Health. “We emphasize patient education and self responsibility. Our patients learn about the relationship between their stress levels and illness by learning to recognize, assess and manage their stress factors. Then they learn techniques to help them cope with stress.”

She adds that in addition to learning about a host of alternative medicine options, patients “are encouraged to re-energize relationships with others, with nature and with their spiritual foundations.”

Raff agrees that the key in any situation  is to seek a support network for help—family, friends, spiritual leaders, psychologists or psychiatrists.

“Stress-relief activities can be different depending on the person,” says Raff. Some find relief in exercising and some find relief in meditation or yoga. Others may turn to knitting, reading or being with family.”

Bick says the techniques she uses to combat stress continue to make a big difference.

“It means that I’m giving my mind and body a mental vacation—a way of letting go—as I focus on one, all-encompassing task at hand. I am stronger, more resilient and calm. I feel centered. What’s more, it takes a lot to take me off center, so that the minor calamities of any given day are less likely to stress me out in the first place.”