Dr. Bethany Lo Presti (NorthShore) - 11:59 AM:
Hello! And welcome to our chat today about managing stress. I'm ready to answer any questions!

Kathryn (Moderator) - 12:00 PM:
Our stress chat is now open - you can submit questions at any time during this chat.

  Luis (Vernon Hills, IL) - 12:01 PM:
When I get stressed, I feel like my nerves hurt and I get severe headaches. Is there anything I can try to reduce the pains?

Dr. Bethany Lo Presti (NorthShore) - 12:02 PM:
when our reaction to stress takes the form of a physical ailment (like a headache), I recommend first checking with a primary care physician to make sure there is nothing else going on. It's not uncommon for stress to cause headaches. I recommend some deep breathing exercises and a gentle stretching routine such as yoga

  Kate (IL) - 12:02 PM:
Can anxiety have physical symptoms other than panic attacks? How else can it appear?

Dr. Bethany Lo Presti (NorthShore) - 12:06 PM:
Some people experience what we refer to as "partial panic," which is just a symptom or small group of symptoms, rather than a full panic attack. For example, someone may ONLY have stomach upset, or difficulty concentrating when they are stressed. There are MANY symptoms of anxiety--too many to list here. Most of them have an adaptive function if we were in a life threatening situation, but when they are caused by an overactive anxiety response, it doesn't feel adaptive at all. The symptoms are very uncomfortable! Working with a cognitive behavioral therapist to better understand your specific symptoms can help greatly. Let me know if I can help further!

  Betty - 12:07 PM:
When I start stressing about bills at home and having fights with my husband, I automatically turn to biting my nails and playing with my hair, which has lead to hair loss. Is there any advice on how to stop this habit or occupy myself?

Dr. Bethany Lo Presti (NorthShore) - 12:11 PM:
This is quite common--and you might even notice that you are engaged in these habits before you even NOTICE that you are doing them! There is a specific type of therapy called Habit Reversal Therapy that can help to "unlearn" these habits. It is a very straightforward process and it does not take a lot of sessions to see results. It involves slowing down the process so that we notice when we are engaged in the habitual behaviors (it sounds like you are already aware of your "triggers," which is great), and substituting NEW responses rather than the old habits. A word of encouragement--our brains have a cool feature known as "plasticity," which means our brains can change. This means that anything we learn, we can un-learn. This comes in quite handy with these types of habits and maladaptive behaviors that we want to change. I hope this helps!

  Scott - 12:12 PM:
Sometimes I get so stressed about various issues (family, work, the world) that I my thoughts can be overtaken and it's hard to focus and sometimes sleep. What are some ways I can relax and create a long term resolution moving forward? Some of my friends have been prescribed Xanax for related issues. What are your thoughts on this?

Dr. Bethany Lo Presti (NorthShore) - 12:18 PM:
While Xanax and related medications can be effective for reducing stress, I prefer more natural remedies for relaxation wherever possible. Some tips that can help-- slow down--easier said than done, I realize, but our world is moving faster and faster with the number of demands we have and the number of portals for information we have at our fingertips. Try to take a break from all of this stimulation--especially as you wind down at the end of your day. Mindfulness meditation can help with this. There are guided meditations available, and you can learn how to incorporate mindfulness into your life through our mindfulness group lead by Dr. Farra at our Evanston office. There are also apps like "headspace" that can help you learn mindfulness meditation. Lowering lights and turning off all screens at least 2 hours before bed can lead to more restful sleep and better focus the next day.

  Rachel - 12:19 PM:
Can you offer some tips for dealing with stress caused by parenting a high energy child? I feel like my partner and I get even more stressed (I'm sure our child is too) trying to deal with things everyday.

Dr. Bethany Lo Presti (NorthShore) - 12:23 PM:
Oh, that's a great question! I don't know many children who are NOT high-energy ;-) It sounds simple, but can be very effective to delegate responsibility for your child. If we stay focused on everything our high energy children are doing throughout the day, we will most likely feel our anxiety creeping up. If you and your partner can work out a plan where you each get some alone time every day, i would highly recommend it. It can be scheduled--for example, I need my husband to take over every morning for the first 20 minutes or so after I wake up so that I can get my day started peacefully. It can also be helpful to have a sort of "code" where you can quickly ask your partner for a sort of parents "time out" when you are feeling overwhelmed. getting regular help so that you and your partner can have some alone time every week is also essential. it's surprising how little time it takes (as long as it's regular and dependable)to make a significant difference in your stress levels!

  Bob - 12:28 PM:
What techniques do you recommend for handling/resolving anxiety and stress when you are in the middle of the stressful situation (i.e. at work or in front of your children)?

Dr. Bethany Lo Presti (NorthShore) - 12:31 PM:
Great question! We hear a lot of great recommendations for reducing stress that just aren't practical for helping us "in the moment." My number one recommendation when we are in a stressful situation is to engage in deep, diaphragmatic breathing. This sends a signal to the parasympathetic branch of your nervous system (the part of our brains responsible for calming us down) that you are ready for it to start working. This may sound simple, but taking control of your breathing is an essential piece of taking control of your stress. There are therapists at all of our locations who can help you with some deep breathing techniques if you need more direction with this.

  Katherine (Chicago, IL) - 12:32 PM:
Hello, I graduated from respiratory school in May. I am trying to control my nervousness/stress prior to taking a test. Anything that I can do or take prior to taking an exam? My thoughts are continuously running just thinking about my boards. Thank you in advance.

Dr. Bethany Lo Presti (NorthShore) - 12:35 PM:
Congrats! Yes, exams can be very stressful! I would recommend a combination of breath work to calm the physiological reactions you're having in these moments (see previous answer for more info) as well as some cognitive restructuring. Usually, in these situations, it's our scary negative thoughts that get the best of us (the "what ifs" and "I HAVE to pass this exam"). By working with a cognitive behavioral therapist, even for just a few sessions, you can learn to quiet those thoughts and replace them with more adaptive thoughts. Best of luck!

  Nancy (Wilmette, IL) - 12:36 PM:
I had a therapist tell me my body is in constant fight-or-flight response, since when I try to relax I feel as if my body physically hurts. It's as if it is not able to relax. What are things I can do to help my body get out of fright-or-flight?

Dr. Bethany Lo Presti (NorthShore) - 12:38 PM:
There is a process of re-training our bodies when we are in "fight or flight" mode that is quite effective. It involves working with a therapist to better understand the reactions that are occurring in our body so that they are not so scary, and then addressing some of the ways that we try to avoid having these symptoms. Quite often, the more we try to avoid feeling anxious, the more we actually FEEL anxious. Learning that the bodily reactions to stress are normal and adaptive, and then learning to experience them without fear, is the key to getting your body out of that constant state of alarm. There are some great individual therapists as well as classes available at our outpatient locations to help with this if needed!

  Jessica (IL) - 12:39 PM:
What tips do you recommend for social anxiety? I'm very outgoing but it seems at parties, I get very nervous and stressed. Even if I know a few people, I become too afraid to get up and talk to more friends.

Dr. Bethany Lo Presti (NorthShore) - 12:44 PM:
The first recommendation is to approach, rather than avoid, these situations. Behaviorally, we tend to want to avoid anything that makes us uncomfortable. We can do this in obvious ways, like avoiding going to parties altogether, but also in more subtle ways, like playing with our cell phones, drinking or using medication to avoid feeling anxious, or not making eye contact with others. Learning to engage in social situations without these types of avoidance actually makes it easier over time! Additionally, working on addressing some of the negative thoughts that might be present in social situations really helps too. This is usually best done with the help of a CBT therapist and may be easier than you think!

  Kathy (Munster, IN) - 12:44 PM:
I have not been myself for over a year. I've been dealing with job stresses and the loss of a family member, and I'm always tired. What are the options for potential professionals to see to seek counsel?

Dr. Bethany Lo Presti (NorthShore) - 12:45 PM:
I'm very sorry to hear this. Sometimes life really does get tough! I'm glad that you're considering reaching out for help. The best option for getting help here at NorthShore is to call our main number and request an initial evaluation appointment, where someone can help you identify and decide on the best route for treatment. The number to call is 847-425-6400. Best of luck to you!

  Andy - 12:46 PM:
My wife and I both work and we have three kids going in a million different directions and it can lead to a lot of stress, including on the weekends when you're supposed to be relaxing! Any tips for managing family stress and trying to keep everyone even-keeled while still getting everything done you need to get done?

Dr. Bethany Lo Presti (NorthShore) - 12:51 PM:
This is a great question, and a common problem in our fast-paced world! My recommendation is to first sit down with your wife (and possibly with a therapist, for additional direction) to analyze your weekly schedule. Identify areas where you could simplify. Once the schedule starts rolling for most families for the week, it's hard to stop and see what we could be doing differently to reserve that precious time to relax. Stepping back to make a plan can really help. This may mean simplifying the schedule by reducing activities, pre-planning family meals, or even getting additional help. Many families find that a little strategy goes a long way in improving this situation. All the best to you and your family!

  Sarah - 12:52 PM:
My husband and family don't seem to really relate or understand the daily stress or anxiety that I feel. When I try to talk about it with my husband, he sometimes thinks I am being sensitive, and need to "let it go" or "get over it", when that's very hard to do. What are some tips on helping my husband understand that stress is a real problem?

Dr. Bethany Lo Presti (NorthShore) - 1:00 PM:
We all have different "set points" for stress, and this can be due to our genetics, past experiences, current stress load, and coping strategies. It can be so hard for a family when one person doesn't seem to understand the other's reaction to stress. First, know that it is not unusual to be more sensitive to stress or to stressful situations than others. I think the most important first step for you is to seek some help in better managing and reducing your own stress. If it were as easy as just "getting over it," you probably would have done it a long time ago! For most people, it's necessary to seek the help of a therapist who can then also help to facilitate a conversation with the most important people in our lives. This helps them to understand what you are going through, and perhaps more importantly, how to open up a way of communicating that is more helpful to you. There are well-trained therapists in all of our outpatient practices who can help you with this!

Kathryn (Moderator) - 1:00 PM:
This will be the end of our chat - thank you for your questions. We will work to address unanswered questions at a later time. For more information on managing stress, or to speak to a specialist like Dr. Lo Presti, contact NorthShore's Department of Psychiatry & Behavioral Sciences.

Dr. Bethany Lo Presti (NorthShore) - 1:18 PM:
Thanks to all for the great questions today! Please do not hesitate to reach out if I can be of more help. All the best to you!