Adoptee Rage! This blog is written exclusively for the 38% of Abused and Neglected Adopted Children. The U.S. HHSA Identifies #1 Risk: Maltreatment, Child Abuse and Risk for Death In Adopted children. Childhood domination, Coping compensation. Research in Adoption Psychology, Developmental Trauma"The Adoption Paradox". By Rainstorm Red-Smith
About Adoptee Rage
Statistics Identify large populations of Adoptees in prisons, mental hospitals and committed suicide.
Fifty years of scientific studies on child adoption resulting in psychological harm to the child and
poor outcomes for a child's future.
Medical and psychological attempts to heal the broken bonds of adoption, promote reunions of biological parents and adult children. The other half of attempting to repair a severed Identity is counselling therapy to rebuild the self.
ADOPTEE RAGE! "Adopted Children Learn What they Live" __________________________________________ Adoptee Site:Secret Sons and daughters Exceptionally Great Adoptee Writing!!! LINK:secretsonsanddaughters.org
ADOPTED CHILDREN LEARN WHAT THEY LIVE
If adopted children live with parents who are called their “real” parents, they learn that they came from “unreal” parents and that they’re rooted in something unreal, untrue, and unworthy of acknowledgement.
If adopted children live with labels like “chosen” or “lucky,” they learn that they were first unchosen and unlucky.
If adopted children live love defined by “your first mother loved you so much that they gave you up for adoption,” they learn that real love means being given away and to fear being given away every time they are told how much they are loved.
If adopted children live as “the answer to their parent’s prayers,” they learn that their sole purpose in life is to make others happy or risk a second abandonment if they don’t.
If adopted children live “Forever Family,” they learn that they’re like an adopted puppy or kitten, something to be acquired.
If adopted children live that finding first family is wrong, they learn that their deep need to know about their origins is wrong as well, and despair, sometimes waiting until it’s too late to find their truths.
If adopted children live with secret adoptions and no access to their original birth certificates, health histories, and heritages, they learn that they are not valued for who they were and question if they’re as worthless as the paper their amended birth certificates are printed on.
If adopted children live that adoption is only a blessing, they learn that their feelings of loss are invalid, and there must be something wrong with them for feeling that way.
If adopted children live that their trauma is real and their sadness over it is normal, they learn that their feelings are important and appropriate too.
If adopted children live with the opportunity to grieve, they learn they can survive and even thrive after loss.
If adopted children live with validated feelings, they learn that others genuinely care and value them.
If adopted children live with knowledge of their original identities, they can live authentically as themselves and not have to pretend to be someone else to be loved.
If adopted children live within an honest familial and societal system, they learn that they are more than a baby to be acquired and trust that they are valued just as they are.
By Joanne C. Currao born Tracey Elisabeth McCullough
ADOPTEE RAGE! Growing Up As the Family's "Adopted Shame" __________________________________________ I am the adopted family's shame. Being constantly reminded of my shameful nature, that is inevitable by being born illegitimate to a socially designated slut. Only the socially unacceptable, loose and morally corrupt woman would become pregnant and abandon her illegitimate bastard child to the state. I grew up knowing and being constantly reminded that not only was my mother a sinner, unacceptable as a person, but her offspring was also the epitome or poster child for Christian sin. Born from sin, living as sin and the only good that could redeem my sinful nature was the "savior" in the form of the legitimate married Christian woman that could transform my innate evil nature, bastardness and illegitimate nature into acceptable Christian follower. But this was not the case, I was not redeemed in the eyes of society or in the eyes of the church congregation or local community. I was an outsider in a cohesive community, and the adoptive mother's constant reminders that I was an outsider to the adoptive family. I was reprimanded before I spoke, acted or thought about any action. I was punished to remind me that my place was stationed far below the social status of one of the community's favorite, financial contributing, upstanding town families. The shame I carry has grown heavy over my life, but as an innocent child I needed to be reminded frequently. The permanent hand print on my face was proof of my training to be silent, to be unseen and not herd. Never to talk without first being addressed by my adoptive parent. I was expected to be silent, submissive and lady-like. Although I never received instruction of what "lady like" meant, It was just another word that I would be struck in the face for failing to do it, failing to be lady-like, over and over again slapped in the face. Some behaviors become more of a habit, like smoking. As my adoptive mother would slap me in the face for any and no reason, like a physical tic, she would strike me in the face for what she thought was a disapproving look especially while she was driving the car and we were both facing forward. I was always told that I should be ashamed of myself, and I did truly feel ashamed and always do feel ashamed of myself, as mother has told me to be. My adoptive mother has instilled in me the shame I am entitled to feel and the state of shame I feel then and now is real and believed as true. My shameful self, my shameful state, my personal shame I feel inside and the shame I see in myself is all true and valid. As my adoptive mother has worked so hard to instill in me the importance of me knowing that I should feel shame about my existence, my nature and my future self that I should always know and feel that I am a shamed of myself. My adoptive mother has stressed the importance of my learning from her words, "do as I say, not as I do" and I will always submit to her domination and control as my shameful nature is corrupt and I can never trust my shameful nature. I should always be ashamed of myself and never forget my shame. I was always told that my place in the world is the adopted child in the family and without her social status I am nothing in the world. Without my adoptive mother's acknowledgement or acceptance, I do not exist. I must always remember that I do not exist without the favor of the adoptive family that allows me to exist in the world as their shame.
I recently attended a social gathering with friends, family, strangers and a bunch of cute kids. As the day ended and goodbyes were shared, I over heard a six-year-old quietly ask her mother for something. Suddenly, in front of the crowd, the mother exploded and yelled hysterically at the child. The little girl was silenced with tears streaming down her cheeks. It looked like a familiar scene for mother and daughter. The crowd silenced too, but quickly acted like nothing happened. This example of shaming and humiliating a child can have long term devastating effects. Will this little girl grow up to respect her mother?
“ Wherever I look, I see signs of the commandment to honor one’s parents and nowhere of a commandment that calls for the respect of a child.” Children respect those who respect them. The above quote comes from my colleague, Alice Miller, who passed in 2010. Her deeply thoughtful and profound work continues to inspire. She’s considered the most articulate child advocate in the world.
Adult children raised by narcissistic parents frequently tell similar childhood stories of shame and humiliation. Often these shaming acts take place in front of other people. Treating children badly and without respect is not the golden rule for parenting, but why do we see this so often?
Just today, a friend shared a similar story. Her brother frequently shames his children. When the family gets together, he loudly announces the wrong doings of his children, with no insight to the damage it does. The children stand listening with eyes cast downward. Is it any wonder that young people in these situations grow into adults with self-doubt, depression and anxiety?
Shaming and humiliating children is emotionally abusive. It is not ok to smack children
physically or with words. Young people deserve and are entitled to reach out, attach and bond with their caretakers. It is an expectation that the parent will provide safety, protection, acceptance, understanding and empathy. When this does happen, children grow up knowing their worth and demanding respect from others and themselves.
When children are emotionally or psychologically abused, they grow up feeling unloved, unwanted, and fearful. Normal development is interrupted and it sends the wounded child into exile. This is when negative internal messages are developed and why we have so many adults today feeling “not good enough.”
As children become adults, they parent themselves in the same manner they were parented. Messages internalized from childhood are now ingrained in the adult. Those messages play like repeating endless tapes. “How could you be so stupid?” “ You can’t do anything right.” “ This is why no-one likes you.”
Shaming and humiliation causes fear in children. This fear does not go away when they grow up. It becomes a barrier for a healthy emotional life and is difficult to eradicate. If these same children become parents, the possibility also exists that the fear and negativity can be unwittingly passed through the generations.
Our goal in recovery is to stop the legacy of distorted love. As Seneca (Roman philosopher, author, politician, 4 B.C.E. to C.E. 65) says, “ Fear and love cannot live together…Blows are used to correct brute beasts.”
When we talk about disrespectful children, we must look at parenting. Solid parenting shows children respect and empathy. When a parent truly gives respect to a child, they receive it back. When this becomes the norm for the household, we see young people
grow up with a loving value system that makes a difference in the world. However, when children are shamed, humiliated and then silenced, it represses the harm that may re-surface later in life. If this happens, it can be in the form of self-destruction or cruelty to others.
Make the commitment to never shame a child. Treat children like you want to be treated. If you were raised by narcissistic parents, your own recovery work truly makes the difference. I salute you for the earnest efforts to stop the legacy of distorted love. The children of the world need YOU!
ADOPTEE RAGE! The Persistent State of Anxiety In Adopted Child __________________________________________ The large population of Adopted Children present to the world of psychology and psychiatry the adopted child's constant and consistent feelings of anxiety, shame and humiliation that is directly related to the facts of being an adopted child. Compared to the similar age group population of biological offspring the adopted child population is chronically over represented in psychotherapy care, inpatient resident of psychiatric hospitalizations. The psychological professionals and mental health organizations have a serious familiarity, knowledge and patient-doctor professional relationships with regard to the over represented population of adopted children and adult adoptees in contact with mental health care. The tragedy lies with the adopted children and adult adoptees without access to such mental health assistance due to the adoptive family's adoption problem denial, ignorance of adoption issues and lack of financial resources for adopted children and adult adoptees to receive mental health assistance. That is a legitimate need for persons that were forced adopted without their consent in childhood, which is an on-going life-long process to make sense of the resulting adoption psychological trauma inflicted on innocent children.
Anxiety In-Depth Report
Fear and stress reactions are essential for human survival. They enable people to pursue important goals and to respond appropriately to danger. In a healthy individual, the stress response (fight, fright, or flight) is provoked by a genuine threat or challenge and is used as a spur for appropriate action.
An anxiety disorder, however, involves an excessive or inappropriate state of arousal characterized by feelings of apprehension, uncertainty, or fear. The word is derived from the Latin, angere , which means to choke or strangle. The anxiety response is often not triggered by a real threat. Nevertheless it can still paralyze the individual into inaction or withdrawal. An anxiety disorder persists, while an appropriate response to a threat resolves, once the threat is removed.
Anxiety disorders are classified according to the severity and duration of their symptoms and specific behavioral characteristics. Categories include:
Generalized anxiety disorder (GAD)
Obsessive-compulsive disorder (OCD)
Post-traumatic stress disorder (PTSD)
Separation anxiety disorder (which is almost always seen in children)
GAD and panic disorder are the most common. Anxiety disorders are usually caused by a combination of psychological, physical, and genetic factors, and treatment is, in general, very effective.
GENERALIZED ANXIETY DISORDER
Generalized anxiety disorder (GAD) is the most common anxiety disorder. It affects about 5% of Americans over the course of their lifetimes. It is characterized by:
A more-or-less constant state of worry and anxiety, which is out of proportion to the level of actual stress or threat in one's life.
This state occurs on most days for more than 6 months despite the lack of an obvious or specific stressor. (It worsens with stress, however.)
It is very difficult to control worry. For a clear diagnosis of GAD, the specific worries should be differentiated from those that would define other anxiety disorders, such as fear of panic attacks or appearing in public. Moreover, they are not obsessive such as those that occur with obsessive-compulsive disorder.
Patients with GAD may experience physical symptoms (such as gastrointestinal complaints) in addition to, or even in place of, mental worries. (This latter case may be more common among people from non-Western cultures.)
People with GAD tend to be unsure of themselves, overly perfectionist, and conforming.
Given these conditions, a diagnosis of GAD is confirmed if three or more of the following symptoms are present (only one for children) on most days for 6 months:
Being on edge or very restless
Having difficulty with concentration
Having muscle tension
Experiencing disturbed sleep
Symptoms can cause significant distress and impair normal functioning. To be classified as GAD, they should not be due to a medical condition, another mood disorder, or psychosis. GAD rarely occurs by itself. It typically occurs along with another type of anxiety disorder, depression, or substance abuse.
Panic disorder is characterized by periodic attacks of anxiety or terror (panic attacks). Panic attacks usually last 15 - 30 minutes, although residual effects can persist much longer. The frequency and severity of acute states of anxiety determine the diagnosis. (Panic attacks can occur in nearly every anxiety disorder, not just panic disorder. In other anxiety disorders, however, there is always a cue or specific trigger for the attack.) A diagnosis of panic disorder is made under the following conditions:
A person experiences at least two recurrent, unexpected panic attacks.
For at least a month following the attacks, the person fears that another will occur.
Symptoms of a Panic Attack. During a panic attack a person feels intense fear or discomfort with at least four or more of the following symptoms:
Rapid heart beat
Shortness of breath
A choking feeling or a feeling of being smothered
Feelings of unreality
Either hot flashes or chills
A fear of dying
A fear of going insane
Women may be more likely than men to experience shortness of breath, nausea, and feelings of being smothered. More men than women have sweating and abdominal pain. Panic attacks that include only one or two symptoms, such as dizziness and heart pounding, are known as limited-symptom attacks . These may be either residual symptoms after a major panic attack or precursors to full-blown attacks.
Frequency of Panic Attacks. Frequency of attacks can vary widely. Some people have frequent attacks (for example, every week) that occur for months; others may have clusters of daily attacks followed by weeks or months of remission.
Triggers of Panic Attacks. Panic attacks may occur spontaneously or in response to a particular situation. Recalling or re-experiencing even harmless circumstances surrounding an original attack may trigger subsequent panic attacks.
Phobias, manifested by overwhelming and irrational fears, are common. In most cases, people can avoid or at least endure phobic situations, but in some cases, as with agoraphobia, the anxiety associated with the feared object or situation can be incapacitating.
Agoraphobia. Agoraphobia is described as fear of being in public places or open areas. (The term is derived from the Greek word agora, meaning outdoor marketplace.) In its severest form, agoraphobia is characterized by a paralyzing terror of being in places or situations from which the patient feels there is neither escape nor accessible help in case of an attack. Consequently, people with agoraphobia confine themselves to places in which they feel safe, usually at home. The patient with agoraphobia often makes complicated plans in order to avoid confronting feared situations and places.
Social Phobia. Social phobia, also known as social anxiety disorder, is the fear of being publicly scrutinized and humiliated and is manifested by extreme shyness and discomfort in social settings. This phobia often leads people to avoid social situations and is not due to a physical or mental problem (such as stuttering, acne, or personality disorders). Social phobia has been termed "the neglected anxiety disorder" because it is often not properly diagnosed.
The associated symptoms vary in intensity, ranging from mild and tolerable anxiety to a full-blown panic attack. (Unlike a panic attack, however, social phobia is always directly related to a social situation.) Symptoms include sweating, shortness of breath, pounding heart, dry mouth, and tremor.
The disorder may be further categorized as generalized or specific social phobia:
Generalized social phobia is the fear of being humiliated in front of other people during nearly all social situations. People with this subtype are the most socially impaired and also the most likely to seek treatment.
Specific social phobia usually involves a phobic response to a specific event. Performance anxiety ("stage fright") is the most common specific social phobia and occurs when a person must perform in public. These patients usually feel comfortable in informal social situations.
Children with social anxiety develop symptoms in settings that include their peers, not just adults, and these symptoms may include tantrums, blushing, or not being able to speak to unfamiliar people. These children are often able to have normal social relationships with familiar people, however.
Specific Phobias. Specific phobias (formerly simple phobias) are an irrational fear of specific objects or situations. Specific phobias are among the most common medical disorders. Most cases are mild and not significant enough to require treatment.
The most common phobias are fear of animals (usually spiders, snakes, or mice), flying ( pterygophobia ), heights ( acrophobia ), water, injections, public transportation, confined spaces ( claustrophobia ), dentists (odontiatophobia ), storms, tunnels, and bridges.
When confronting the object or situation, the phobic person experiences panicky feelings, sweating, avoidance behavior, difficulty breathing, and a rapid heartbeat. Most phobic adults are aware of the irrationality of their fear, and many endure intense anxiety rather than disclose their disorder.
Obsessive-compulsive disorder (OCD) is time-consuming, distressing, and can disrupt normal functioning. Much research suggests that a critical feature in this disorder is an overinflated sense of responsibility, in which the patient's thoughts center around possible dangers and an urgent need to do something about them.
Obsessions are recurrent or persistent mental images, thoughts, or ideas. The obsessive thoughts or images can range from mundane worries about whether one has locked a door to bizarre and frightening fantasies of behaving violently toward a loved one.
Compulsive behaviors are repetitive, rigid, and self-directed routines that are intended to prevent the manifestation of an associated obsession. Such compulsive acts might include repetitive checking for locked doors or unlit stove burners or calls to loved ones at frequent intervals to be sure they are safe. Some people are compelled to wash their hands every few minutes or to spend inordinate amounts of time cleaning their surroundings in order to subdue the fear of contagion.
Over half of patients with OCD have obsessive thoughts without the ritualistic compulsive behavior. Although individuals recognize that the obsessive thoughts and ritualized behavior patterns are senseless and excessive, they cannot stop them in spite of strenuous efforts to ignore or suppress the thoughts or actions. OCD often accompanies depression or other anxiety disorders. Some patients find that their symptoms subside over time, while others experience a worsening of symptoms.
Symptoms in children may be mistaken for behavioral problems (taking too long to do homework because of perfectionism, refusing to perform a chore because of fear of germs). Children do not usually recognize that their obsessions or compulsions are excessive.
Associated Obsessive Disorders. Certain other disorders that may be part of, or strongly associated with, the OCD spectrum include:
Body dysmorphic disorder (BDD). In BDD, people are obsessed with the belief that they are ugly, or part of their body is abnormally shaped.
Hypochondriasis. People who have hypochondiasis have an excessive fear of having a serious disease.
Anorexia nervosa. OCD frequently accompanies this eating disorder, where the compulsive behavior focuses on food restriction and thinness.
Trichotillomania. People with trichotillomania continually pull their hair, leaving bald patches.
Tourette syndrome. Symptoms of Tourette syndrome include jerky movements, tics, and uncontrollably uttering obscene words.
Obsessive-Compulsive Personality. OCD should not be confused with obsessive-compulsive personality , which defines certain character traits (being a perfectionist, excessively conscientious, morally rigid, or preoccupied with rules and order). These traits do not necessarily occur in people with obsessive-compulsivedisorder .
POST-TRAUMATIC STRESS DISORDER
Post-traumatic stress disorder (PTSD) is a severe, persistent emotional reaction to a traumatic event that severely impairs one’s life. It is classified as an anxiety disorder because of its symptoms. Not every traumatic event leads to PTSD, however. There are two criteria that must be present to qualify for a diagnosis of PTSD:
The patient must have directly experienced, witnessed, or learned of a life-threatening or seriously injurious event.
The patients' response is intense fear, helplessness, or horror. Children may behave with agitation or with disorganized behavior.
Triggering Events. PTSD is triggered by violent or traumatic events that are usually outside the normal range of human experience. War is a prime example. There is some evidence that events most likely to trigger PTSD are those that involve deliberate and destructive behavior (murder, rape) and those that are prolonged or physically challenging. Such events include, but are not limited to, experiencing or witnessing sexual assaults, accidents, military combat, natural disasters (such as earthquakes), or unexpected deaths of loved ones. PTSD may also occur in people who have serious illness and receive aggressive treatments or who have close family members or friends with such conditions.
Symptoms of PTSD. There are three basic sets of symptoms associated with PTSD. They may begin immediately after the event or can develop up to a year afterward:
Re-experiencing. In such cases, patients persistently re-experience the trauma in at least one of the following ways: in recurrent images, thoughts, flashbacks, dreams, or feelings of distress at situations that remind them of the traumatic event. Children may engage in play, in which traumatic events are enacted repeatedly.
Avoidance. Patients may avoid reminders of the event, such as thoughts, people, or any other factors that trigger recollection. They tend to have an emotional numbness, a sense of being in a daze or of losing contact with their own identity or even external reality. They may be unable to remember important aspects of the event.
Increased Arousal. This includes symptoms of anxiety or heightened awareness of danger (sleeplessness, irritability, being easily startled, or becoming overly vigilant to unknown dangers).
To further qualify for a diagnosis of PTSD, patients must have at least one symptom in the re-experiencing category, three avoidance symptoms, and two arousal symptoms. Symptoms are chronic (3 months or more). Symptoms should also not be associated with alcohol, medications, or drugs and should not be intensifications of a pre-existing psychological disorder.
Acute Stress Disorder. In a syndrome called acute stress disorder, symptoms of PTSD occur within 2 days to 4 weeks after the traumatic event. Most people with acute stress disorder go on to develop PTSD.
Long-Term Outlook. The long-term impact of a traumatic event is uncertain. PTSD may cause physical changes in the brain, and in some cases the disorder can last a lifetime.
SEPARATION ANXIETY DISORDER
Separation anxiety disorder almost always occurs in children. It is suspected in children who are excessively anxious about separation from important family members or from home. For a diagnosis of separation anxiety disorder, the child should also exhibit at least three of the following symptoms for at least 4 weeks:
Extreme distress from either anticipating or actually being away from home or being separated from a parent or other loved one
Extreme worry about losing or about possible harm befalling a loved one
Intense worry about getting lost, being kidnapped, or otherwise separated from loved ones
Frequent refusal to go to school or to sleep away from home
Physical symptoms such as headache, stomach ache, or even vomiting, when faced with separation from loved ones
Separation anxiety often disappears as the child grows older, but if not addressed, it may lead to panic disorder, agoraphobia, or combinations of anxiety disorders.
The Body's Response
The best way to envision the effect of acute stress is to imagine yourself in a primitive situation, such as being chased by a bear.
THE BRAIN'S RESPONSE TO ACUTE STRESS
In response to seeing the bear, a part of the brain called the hypothalamic-pituitary-adrenal (HPA) system is activated.
Release of Steroid Hormones and the Stress Hormone Cortisol. The HPA systems trigger the production and release of steroid hormones ( glucocorticoids ), including the primary stress hormone cortisol . Cortisol is very important in organizing systems throughout the body (including the heart, lungs, circulation, metabolism, immune systems, and skin) to deal quickly with the bear.
Release of Catecholamines. The HPA system also releases certain neurotransmitters (chemical messengers) called catecholamines , particularly those known as dopamine , norepinephrine , and epinephrine (also called adrenaline).
Catecholamines activate an area inside the brain called the amygdala , which appears to trigger an emotional response to a stressful event. In the case of the bear, this emotion is most likely fear.
Release of Neuropeptide S . The brain releases neuropeptide S, a small protein that modulates stress by decreasing sleep and increasing alertness and a sense of anxiety. This gives the person a sense of urgency to run away from the bear.
Effects on Long- and Short-Term Memory. During the stressful event, catecholamines also suppress activity in areas at the front of the brain concerned with short-term memory, concentration, inhibition, and rational thought. This sequence of mental events allows a person to react quickly, either to fight the bear or to flee from it. It also interferes with the ability to handle difficult social or intellectual tasks and behaviors during that time.
At the same time, neurotransmitters signal the hippocampus (a nearby area in the brain) to store the emotionally loaded experience in long-term memory. In primitive times, this brain action would have been essential for survival, because long-lasting memories of dangerous stimuli (such as the large bear) would be critical for avoiding such threats in the future.
Research also finds that during times of stress, nerve cells in the brain interpret chemical signals incorrectly. Instead of switching "off," these nerve cells perceive the signals as telling them to switch "on." It's as though the brain's "brakes" fail in response to stress.
RESPONSE BY THE HEART, LUNGS, AND CIRCULATION TO ACUTE STRESS
The stress response also affects the heart, lungs, and circulation:
As the bear comes closer, the heart rate and blood pressure increase instantaneously.
Breathing becomes rapid, and the lungs take in more oxygen.
The spleen discharges red and white blood cells, allowing the blood to transport more oxygen throughout the body. Blood flow may actually increase 300 - 400%, priming the muscles, lungs, and brain for added demands.
THE IMMUNE SYSTEM'S RESPONSE TO ACUTE STRESS
The effect of the confrontation with the bear on the immune system is similar to mobilizing a defensive line of soldiers to potentially critical areas. The steroid hormones reduce activity in parts of the immune system, so that specific infection fighters (including important white blood cells) or other immune molecules can be repositioned. These immune-boosting troops are sent to the body's front lines where injury or infection is most likely to occur, such as the skin and the lymph nodes.
THE ACUTE RESPONSE IN THE MOUTH AND THROAT
As the bear gets closer, fluids are diverted from nonessential locations, including the mouth. This causes dryness and difficulty talking. In addition, stress can cause spasms of the throat muscles, making it difficult to swallow.
THE SKIN'S RESPONSE TO ACUTE STRESS
The stress effect moves blood flow away from the skin to support the heart and muscle tissues. This also reduces blood loss in the event that the bear causes a wound. The physical effect is cool, clammy, sweaty skin. The scalp also tightens so that the hair seems to stand up.
METABOLIC RESPONSE TO ACUTE STRESS
Stress shuts down digestive activity, a nonessential body function during short-term periods of hard physical work or crisis.
THE RELAXATION RESPONSE: THE RESOLUTION OF ACUTE STRESS
Once the threat has passed and the effect has not been harmful (for example, the bear has not wounded the human), the stress hormones return to normal. This is known as the relaxation response. In turn, the body's systems also return to normal.
In prehistoric times, the physical changes in response to stress were an essential adaptation for meeting natural threats. Even in the modern world, the stress response can be an asset for raising levels of performance during critical events, such as a sports activity, an important meeting, or in situations where there is actual danger or a crisis.
If stress becomes persistent and low-level, however, all parts of the body's stress apparatus (the brain, heart, lungs, blood vessels, and muscles) become chronically over-activated or under-activated. Such chronic stress may produce physical or psychological damage over time. Acute stress can also be harmful in certain situations, particularly in individuals with pre-existing heart conditions.
PSYCHOLOGICAL EFFECTS OF STRESS
Studies suggest that the inability to adapt to stress is associated with the onset of depression or anxiety.
Some evidence suggests that the repeated release of stress hormones produces hyperactivity in the hypothalamic-pituitary-adrenal (HPA) system, and disrupts normal levels of serotonin, the brain chemical that is critical for feelings of well-being. Some people appear to be more at risk for an overactive HPA system under stress, including those with personality traits that cause perfectionism. On a more obvious level, stress reduces quality of life by affecting feelings of pleasure and accomplishment. In addition, relationships are often threatened in times of stress.
The full impact of mental stress on heart disease is just coming to light, but the underlying mechanisms are not always clear. Stress can influence the activity of the heart when it activates the automatic part of the nervous system that affects many organs, including the heart. Such actions and others could negatively affect the heart in several ways:
Sudden stress increases the pumping action and rate of the heart, while at the same time causing the arteries to constrict (narrow). This restricts blood flow to the heart.
The emotional effects of stress alter the heart rhythms, which could pose a risk for serious arrhythmias (rhythm abnormalities) in people with existing heart rhythm disturbances.
Stress causes the blood to become stickier (possibly in preparation for potential injury).
Stress appears to impair the clearance of fat molecules in the body.
Stress that leads to depression appears to be associated with increased intima-medial thickness, a measure of the arteries that signifies worsening blood vessel disease.
Stress causes the body to release inflammatory markers into the bloodstream. These markers may worsen heart disease or increase the risk of a heart attack or stroke.
Studies have reported an association between stress and high blood pressure, which may be more pronounced in men than in women. According to some evidence, people who regularly experience sudden spikes in blood pressure (caused by mental stress) may, over time, develop injuries to the inner lining of their blood vessels.
Evidence is still needed to confirm any clear-cut relationship between stress and heart disease. However, research has linked stress to heart disease in men, particularly in work situations where they lack control. The association between stress and heart problems in women is weaker, and there is some evidence that the ways in which women cope with stress may be more heart-protective.
A condition called stress cardiomyopathy (or Takotsubo cardiomyopathy) is widely recognized. In this disease, intense emotional or physical stress causes severe but reversible heart dysfunction. The patient experiences chest pain, and EKGs and echocardiograms indicate a heart attack, but further tests show no underlying obstructive coronary artery disease.
Psychological stress is also recognized as a possible cause of acute coronary syndrome (ACS), a collection of symptoms that indicate a heart attack or approaching heart attack. High levels of psychological stress are associated with harmful changes to the blood. Research suggests that stress has the potential to trigger ACS, particularly in patients with heart disease. Studies also suggest that the risk is greatest immediately after the stressful incident, rather than during it .
Stress Reduction and Heart Disease. Studies suggest that treatments that reduce psychological distress improve the long-term outlook in people with heart disease, including after a heart attack. Evidence indicates that stress management programs may significantly reduce the risk of heart attacks in people with heart disease. Specific stress management techniques may help some heart problems but not others. For example, acupuncture in one study helped people with heart failure but had no effect on blood pressure. Relaxation methods, on the other hand, may help people with high blood pressure.
In some people, prolonged or frequent mental stress causes an exaggerated increase in blood pressure, a risk factor for stroke.
EFFECT ON THE IMMUNE SYSTEM
Chronic stress affects the immune system in complicated ways, and may have various results.
Susceptibility to Infections. Chronic stress may have an effect on the immune system's response to infections. Several studies claim that people who are under chronic stress have low white blood cell counts and are more vulnerable to colds. Once a person catches a cold or flu, stress can make symptoms worse. People who carry the herpes virus may be more susceptible to viral activation after they are exposed to stress.
Inflammatory Response. Some evidence suggests that chronic stress triggers an over-production of certain immune factors called cytokines. Such findings may partly explain the association between chronic stress and numerous diseases, including heart disease and asthma.
A relationship between excess stress and cancer has not been proven. However, there may be a connection between stress and cancer survival. One study suggested that cancer patients who were separated from their spouses had lower survival rates than married cancer patients. Although stress reduction techniques have no effect on survival rates, studies show that they are very helpful in improving a cancer patient's quality of life.
The brain and intestines are closely related, and are controlled by many of the same hormones and parts of the nervous system. Indeed, some research suggests that the gut itself has features of a primitive brain. It is not surprising then that prolonged stress can disrupt the digestive system, irritating the large intestine and causing diarrhea, constipation, cramping, and bloating. Excessive production of digestive acids in the stomach may cause a painful burning.
Irritable Bowel Syndrome. Irritable bowel syndrome (or spastic colon) is strongly related to stress. With this condition, the large intestine becomes irritated, and its muscular contractions are spastic rather than smooth and wave-like. The abdomen is bloated, and the patient experiences cramping and alternating periods of constipation and diarrhea. Sleep disturbances due to stress can make irritable bowel syndrome even worse.
Peptic Ulcers. It is now well established that most peptic ulcers are caused by H. pylori bacteria or the use of nonsteroidal anti-inflammatory (NSAID) medications (such as aspirin and ibuprofen). Nevertheless, studies still suggest that stress may predispose a person with H. pylori to ulcers.
Inflammatory Bowel Disease. Although stress is not a cause of inflammatory bowel disease (Crohn's disease or ulcerative colitis), there are reports of an association between stress and symptom flare-ups.
EATING AND STRESS
Stress can have varying effects on eating problems and weight.
Weight Gain. Often stress is related to weight gain and obesity. Many people develop cravings for salt, fat, and sugar to counteract tension. As a result, they gain weight. Weight gain can occur even with a healthy diet, however, in some people who are exposed to stress. In addition, the weight gained is often abdominal fat, which increases the risk of diabetes and heart problems.
The release of cortisol, a major stress hormone, appears to boost abdominal fat and may be the primary connection between stress and weight gain. Cortisol is a glucocorticoid. These hormones, along with insulin, appear to be responsible for stress-related food cravings. Evidence suggests that hormonally induced cravings for "comfort foods" may have a biological benefit for managing stress. Eating comfort foods appears to reduce the negative hormonal and behavioral changes associated with stress, which might lessen the impact of stress on an individual. Carbohydrates in particular may increase levels of tryptophan and large neutral amino acids. This leads to more production of the chemical messenger serotonin, which might improve mood and performance under stress.
There may be a "reward-based stress eating" model. In this theory, stress and tasty, high-calorie foods cause the brain to make chemicals called endogenous opioids. These neurotransmitters help protect against the harmful effects of stress by slowing activity of a brain process called the hypothalamic-pituitary-adrenal (HPA) axis, thus weakening the stress response. Repeated stimulation of the reward pathways through stress-induced HPA stimulation, eating tasty food, or both, may lead to changes in the brain that cause compulsive overeating.
Research finds that overeating may be triggered by different stressors in men and women. Women tend to put on extra pounds when dealing with financial and work problems, as well as strained family relationships. Men gain more weight from lack of decision authority at work and difficulty in learning new skills on the job.
Eating Disorders . Chronically elevated levels of stress chemicals have been observed in patients with anorexia and bulimia. Some studies, however, have not found any strong link between stress and eating disorders. More research is needed to determine whether changes in stress hormones are a cause or a result of eating disorders.
Stress can exacerbate existing diabetes by impairing the patient's ability to manage the disease effectively.
Researchers are attempting to find the relationship between pain and emotion, but the area is complicated by many factors, including the effects of different personality types, fear of pain, and stress itself. Evidence suggests that chronic pain may impair the action of neutrophils, thereby weakening the immune response.
Muscular and Joint Pain. Stress may intensify chronic pain caused by arthritis and other conditions. Psychological distress also plays a significant role in the severity of back pain. Some studies have clearly associated job dissatisfaction and depression to back problems, although it is still unclear whether stress is a direct cause of the back pain.
Headaches. Tension-type headaches are highly associated with stress and stressful events. Sometimes the headache does not start until long after the stressful event has ended. Additionally, stress can contribute to the development of headaches or cause headaches to occur more frequently.
Some research suggests that people who experience tension-type headaches may have some biological predisposition for translating stress into muscle contractions. Among the wide range of possible migraine triggers is emotional stress (although the headaches often erupt after the stress has eased).
The tensions of unresolved stress frequently cause insomnia, which prevents stressed people from sleeping or causes them to awaken in the middle of the night or early morning. This appears to be due to the fact that stress causes physiological arousal during non-rapid eye movement sleep.
SEXUAL AND REPRODUCTIVE DYSFUNCTION
Sexual Function. Stress can reduce sexual desire and cause women to be unable to achieve orgasm. The stress response leads to a drop in androgen (male hormone) levels, sometimes contributing to temporary erectile dysfunction in men.
Premenstrual Syndrome. Some studies indicate that the stress response in women with premenstrual syndrome may be more intense than in those without the syndrome.
Fertility. Chronic stress may affect fertility. Stress hormones have an impact on the hypothalamus, which produces reproductive hormones. This effect may lead to changes in a woman's menstrual cycle, as well as a reduction in a man's sperm count. Stress can also reduce sex drive.
Effects on Pregnancy. Old wives' tales about a pregnant woman's emotions affecting her baby may have some credence. Stress may cause physiological alterations, such as increased adrenal hormone levels or resistance in the arteries, which may interfere with normal blood flow to the placenta. Maternal stress during pregnancy has been linked to a higher risk for miscarriage, lower birth weight, and an increased incidence of premature births. Some evidence also suggests that an expectant mother's stress can even influence the way in which her baby's brain and nervous system will react to stressful events. One study found a higher rate of crying and low attention in infants of mothers who had been stressed during pregnancy.
Menopause . A drop in estrogen levels during perimenopause and menopause may be responsible for changes in mood precipitated by stress.
MEMORY, CONCENTRATION, AND LEARNING
Stress affects the brain, particularly memory, but the effects vary widely depending on whether the stress is acute or chronic.
Effect of Acute Stress on Memory and Concentration. Studies indicate that the immediate effect of acute stress impairs short-term memory, particularly verbal memory. On the plus side, high levels of stress hormones during short-term stress have been associated with enhanced memory storage, improved working memory, and greater concentration on immediate events. The difference in effect may be due to how cortisol impacts glucocorticoid receptors in the hippocampus and prefrontal cortex.
Effect of Chronic Stress on Memory. If stress becomes chronic, sufferers often lose concentration at work and home, and they may become inefficient and accident-prone. In children, the physiologic responses to chronic stress can interfere with learning. Studies have connected long-term exposure to excess amounts of the stress hormone, cortisol to a shrinking of the hippocampus, the brain's memory center. It is not yet known whether this shrinking is reversible.
Skin Disorders. Stress may worsen numerous skin conditions, including hives, psoriasis, acne, and rosacea, and it is one of the most common causes of eczema. Unexplained itching may also be caused by stress. Evidence suggests that experiencing the stress of a traumatic event (parental divorce or separation, or a severe disease in a family member) before age 2 increases the risk of developing eczema.
Unexplained Hair Loss (Alopecia Areata). Alopecia areata is hair loss that occurs in localized (individual) patches. The cause is unknown, but stress is suspected as a player in this condition. For example, hair loss often occurs during periods of intense stress, such as when people are in mourning.
Teeth and Gums. Stress has now been implicated in increasing the risk for periodontal disease, which can cause tooth loss and has been linked to heart disease.
People who are under chronic stress often turn to alcohol or tobacco for relief. Stress compounds the damage these self-destructive habits cause under ordinary circumstances. Many people also resort to unhealthy eating habits, smoking, or passive activities, such as watching television when they are stressed.
Alcohol affects receptors in the brain that reduce stress. Lack of nicotine increases stress in smokers, which creates a cycle of dependency on smoking.
The cycle is self-perpetuating: a sedentary routine, an unhealthy diet, alcohol abuse, and smoking all promote heart disease. They also interfere with sleep patterns, and lead to increased rather than reduced tension levels. Drinking four or five cups of coffee, for example, can cause changes in blood pressure and stress hormone levels similar to those produced by chronic stress. Animal fats, simple sugars, and salt are known contributors to health problems.
Conditions With Similar Symptoms
The physical symptoms of anxiety disorders mirror many symptoms of stress, including:
A fast heart rate
Rapid, shallow breathing
Increased muscle tension
Anxiety is an emotional disorder, however, and is characterized by feelings of apprehension, uncertainty, fear, or panic. Unlike stress, the triggers for anxiety are not necessarily or even usually associated with specific stressful or threatening conditions. Some individuals with anxiety disorders have numerous physical complaints, such as headaches, gastrointestinal disturbances, dizziness, and chest pain. Severe cases of anxiety disorders are debilitating, interfering with a person's career, family, and social life.
Depression can be a disabling condition, and, like anxiety disorders, it may sometimes be linked to chronic stress. Individuals with a high level of work-related stress are more than twice as likely to experience a major depressive episode, compared with people who are under less stress. Evidence also suggests that certain people may be genetically susceptible to depression after they experience stressful life events.
Depression shares some of the symptoms of stress, including changes in appetite, sleep patterns, and concentration. Serious depression, however, is distinguished from stress by feelings of sadness, hopelessness, loss of interest in life, and, sometimes, thoughts of suicide. Acute depression is also accompanied by significant changes in the patient's functioning. The person may need professional therapy to determine whether depression is caused by stress, or if it is the primary problem.
POST-TRAUMATIC STRESS DISORDER SYMPTOMS
Post-traumatic stress disorder (PTSD) is a reaction to a very traumatic event, and it is actually classified as an anxiety disorder. The event that brings on PTSD is usually outside the norm of human experience, such as intense combat or sexual assault. The patient struggles to forget the traumatic event and frequently develops emotional numbness and event-related amnesia. Often, however, there is a mental flashback, and the patient re-experiences the painful circumstance in the form of dreams and disturbing thoughts and memories. These thoughts and dreams resemble or recall the trauma. Other symptoms may include a lack of pleasure in previously enjoyed activities, hopelessness, irritability, mood swings, sleep problems, inability to concentrate, and an excessive startle-response to noise.
The standard approach to treating most anxiety disorders is a combination of talk therapy, such as cognitive-behavioral therapy (CBT), and an antidepressant medication. A selective serotonin reuptake inhibitor (SSRI) is typically the first choice, with the serotonin-norepinephrine reuptake inhibitor (SNRI) venlafaxine (Effexor) being an alternative. If patients do not respond to these drugs, tricyclic antidepressants may be helpful. Benzodiazepines may be recommended for patients who are not helped by antidepressants or who need help rapidly (antidepressants take several weeks to be effective). A healthy lifestyle that includes exercise, adequate rest, and good nutrition can also help to reduce the impact of anxiety.
Irresolvable grief: What the professionals knew but didn’t tell single parents (“unwed” mothers) and grandparents-to-be
“A grief reaction unique to the relinquishing mother was identified. Although this reaction consists of features characteristic of the normal grief reaction, these features persist and often lead to chronic, unresolved grief. CONCLUSIONS: The relinquishing mother is at risk for long-term physical, psychologic, and social repercussions. Although interventions have been proposed, little is known about their effectiveness in preventing or alleviating these repercussions.” Journal of Obstetric, Gynecological and Neonatal Nursing, 1999 Jul-Aug; 28(4):395-400 “Postadoptive Reactions of the Relinquishing Mother: a Review”
“In sum, society sees to it that by action or by implication, a woman who is having a child out of wedlock will come away from the experience with an inferior sense of herself as a mother, whether she keeps her baby or relinquishes him for adoption. This downgrading of the maternal image, can do serious injury to the later maternal functioning of the woman whose perception of herself as a mother is thus impaired.” HELPING UNMARRIED MOTHERS, Rose Bernstein, 1971, [Permission given this author by the Child Welfare League of America and the National Association of Social Workers to use portions that originally appeared in "Child Welfare and Social Work".]
“The decisions unmarried mothers have to make are among the difficult ones. These decisions have to be made under conditions of restricted maneuverability and abnormal pressures – pressures of time and emotion that do not allow for testing, exploring, and other procedures that are ordinarily considered essential to sound decision-making.” HELPING UNMARRIED MOTHERS, Rose Bernstein, 1971, [Permission given this author by the Child Welfare League of America and the National Association of Social Workers to use portions that originally appeared in "Child Welfare and Social Work".]
“Existing evidence suggests that the experience of relinquishment renders a woman at high risk of psychological (and possibly physical) disability. Moreover very recent research indicates that actual disability or vulnerability may not diminish even decades after the event. ….Taken overall, the evidence suggests that over half of these women are suffering from severe and disabling grief reactions which are not resolved over the passage of time and which manifest predominantly as depression and psychosomatic illness. ” — PSYCHOLOGICAL DISABILITY IN WOMEN WHO RELINQUISH A BABY FOR ADOPTION, Dr. John T. Condon (Medical Journal of Australia) Vol. 144 Feb 3, 1986 (Department of Psychiatry, Flinders Medical Centre, Bedford Park, SA 5042, Consultant Psychiatrist)
” A grief reaction unique to the relinquishing mother was identified. Although this reaction consists of features characteristic of the normal grief reaction, these features persist and often lead to chronic, unresolved grief. Conclusions: The relinquishing mother is at risk for long-term physical, psychological, and social repercussions…. Although interventions have been proposed, little is known about their effectiveness in preventing or alleviating these repercussions.” — “Postadoptive Reactions of the Relinquishing Mother: A Review.” By Holli Ann Askren, MSN, CNM, Kathleen C. Bloom, PhD, CNM. In the Journal of Obstetric, Gynecological and Neonatal Nursing, 1999 Jul-Aug; 28(4)
“Relinquishing mothers have more grief symptoms than women who have lost a child to death, including more denial; despair, atypical responses; and disturbances in sleep, appetite, and vigor.” Askren, H., & Bloom, K. (1999) Post-adoptive reactions of the relinquishing mother: A review. Journal of Obstetric, Gynecological and Neonatal Nursing, 1999 Jul-Aug; 28(4)
“Results shown in Table 3 demonstrate that mothers relinquishing a child for adoption tend towards more grief symptoms than bereaved parents … .” … “Table 3, comparing natural mothers in both open and closed adoptions with bereaved parents, shows that natural mothers suffer more denial, atypical responses, despair, anger, depersonalization, sleep disturbance, somaticizing, physical symptoms, dependency, vigor.” Blanton, T.L., & Deschner, J. (1990). Biological mother’s grief: The postadoptive experience in open versus confidential adoption. Child Welfare Journal, 69(6),
“Bowlby (1980) proposed 4 phases of the grief process. The first phase is characterized by numbing and detachment where a person experiences emotional and psychological shock, which causes a dulling of feelings and cognitive disbelief.” , De Simone, M. (1994). Unresolved grief in women who have relinquished an infant for adoption. Doctoral dissertation, New York University School of Social Work, New York, N.Y