What kind of help is available for chronic stress? I have suffered from this all my adult life, with no respite, for 45 years.

Answered by: Gregory Sullivan

Chronic stress comes in many forms – related to work, finances, living situation, relationships, and more – but chronic stress has the common theme of being ongoing, difficult to resolve, and negatively impacting the brain and body.

Some external stressors are controllable, and making life changes that reduce such stressors helps. Other forms of stress are, or in some instances at least appear to be, uncontrollable. The brain and body are designed well to deal with short term or “acute” stress, with the body systems that respond to stressors quickly returning to regular functioning, thus re-establishing physiological “homeostasis”. But chronic stress takes its toll when the systems well-designed for acute response are repeatedly or chronically activated.

Neuroscientists have termed the negative effects of chronic stress on the body as “allostatic load”. It is now more widely recognized that horrific stressors can lead to disorders such as posttraumatic stress disorder (PTSD). But chronic stress is also associated with clinical depression, chronic fatigue syndrome, pain syndromes such as fibromyalgia and migraine headaches, Gulf War syndrome, irritable bowel syndrome and more.

Such disorders are responsive to various treatments, both psychotherapeutic and pharmacologic. Often treatment in the form of psychotherapies may be helpful in identifying what stressors may be more controllable and making life changes that reduce or moderate the stressors. It is always important to remember that the brain is the master controller of interpretation of what is stressful, thus providing opportunities for reconceptualization and reappraisals to be potential internal mediators for reducing chronic stress, thereby mitigating its negative impact.

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Gregory Sullivan, M.D.
Member, Institutional Review Board 

Gregory M. Sullivan, M.D. is an Assistant Professor of Clinical Psychiatry in the Department of Psychiatry at Columbia University. His areas of expertise include the diagnosis, treatment, and neurobiology of anxiety and mood disorders.

Dr. Sullivan received his undergraduate degree from the University of California, Berkeley, and in 1992 he received his medical doctorate from the College of Physicians & Surgeons at Columbia University. He remained at Columbia for residency training in psychiatry, completed a two-year NIH-sponsored research fellowship in anxiety and affective disorders,...
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