Disclaimer. This web site is for research and educational purposes only. The information given in this site is not intended to replace a therapeutic practitioner relationship.
By stress I mean discomfort – either physically, mentally, socially or spiritually. The word 'discomfort' does not necessarily mean something mild. You can have severe discomfort too. We could call severe discomfort by other words, of course, like pain or agony.
If it does not cause you discomfort then it is not stress according to the definition I am using.
If you have CFS or FMS then you have stress as a result of your illness. However, in my opinion, stress itself can actually lead to CFS or FMS. It does this by dropping the body's energy levels below the 'burnout threshold'. If you would like to listen to a half hour MP3 talk on burnout and managing energy, click here.
Below this threshold, your body does not have the right amount of energy that it needs to perform basic functions, especially those that are particularly energy dependent like brain function, muscle function, digestion, keeping warm and immune function. So symptoms result in these parts of your system: poor concentration, mood disturbance, sore and tired muscles, irritable digestion, feeling too cold, becoming sensitive to foods, chemicals and smells.
Most of this web site is concerned with finding and treating causes of physical stress, so on this page I am going to discuss mental, social and spiritual matters.
The Mind and Stress
Mental stress is usually the result of worrying. Common things to worry about are relationships, finances and health. Relationships means social life. So there is an overlap between mental and social stress. Health problems obviously can include more than CFS and FMS. For example, having cancer, diabetes or heart disease may cause worry. So, what can you do about these worries? First off, it is good to acknowledge what you are worrying about. Get it out of your subconscious and admit, “Okay, I am worrying about this thing”. Then you need to formulate some kind of plan to deal with the issue. Write it down if you need to. What your plan is will vary a lot and will depend on the problem and your personal situation. It may include getting advise, making changes in your routine, work or home life, praying, taking time out, having a vacation, starting a savings plan and so on. Once you have at least a preliminary plan or even just a time set aside to work on a plan, you can move on and make a list of things that are personal stress relievers for you. This might include various types of exercise, listening to music, socialising, spiritual activities, reading, going for a drive, doing your favourite hobby, gardening, etc.
Exercise is particularly important in managing mental stress. To listen to an MP3 talk on exercise and its benefits, click here. I usually only initially recommend gentle, relaxing exercises and slow resistance exercise in my patients with CFS and fibromyalgia. These type of exercises can be very stress relieving. Faster, aerobic type exercise I have found to often result in aggravating the conditions, at least initially. The role of graded exercise therapy (GET) and also cognitive behaviour therapy (CBT, described below) in patients with CFS/ME and Fibromyaliga is quite controversial. See for example:
Wiltshire, CE, et. al. Rethinking the treatment of chronic fatigue syndrome - a reanalysis and evaluation of findings from a recent major trial of graded exercise and CBT, BMC Psychol., 2018, 6:6. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5863477/)
I have found GET to be particularly applicable to patients who are less than about 25 years of age. For older patients it can be problematic, especially if too much aerobic exercise is used. In commencing GET, it is most helpful to engage the services of an exercise physiologist experienced in treating patients with CFS.
What about past traumatic events in our lives? One approach is to reframe our beliefs about traumatic events. This is one of the aims of Cognitive Behaviour Therapy (CBT). It is not traumatic events themselves that cause stress disorders but our beliefs about those events. Can you reframe the way that you look at the traumatic events in your life in order to reduce their negative impact or even change them to a positive influence? CBT probably works best in younger sufferers of CFS (Werker CL et al, Clinical Practice: Chronic fatigue syndrome, Eur J Pediatr. 2013 Oct)
Stress relievers need to be scheduled into your daily and weekly routines. There are some good self-help books when it comes to mental health. There are some bad ones too. Ones that I believe are good include, “Telling Myself the Truth” by W. Bacchus and “Depression, The Way Out” by N. Nedley. If you would like to listen to a half hour talk on the causes of depression that I did, click here.
Most patients that Dr. Bird sees have two parallel lines of health challenges, one physical and the other psychological. They both need appropriate recognition and therapy. Dr. Bird focuses primarily on the physical aspects of chronic fatigue and related conditions. For ladies seeking a counsellor who is familiar with CFS-related issues as well as the treatment of anxiety, grief and disability-related depression I would recommend checking out Lorna Bird's (my wife's) services here: Yes to Health
Lorna specialises in a scientifically validated Cognitive Behaviour Therapy approach and offers very affordable rates. She does not provide Medicare Rebates.
For those seeking a psychologist, I would suggest Peter Webb who works at NIIM
Social Life and Stress
The greatest gift is freedom of choice. Without the ability to choose there is no capacity to love. But choice brings risk. Most people choose to get emotionally close to other people. In doing so, they take a risk. In addition, since we don't choose to be born we are all automatically exposed to the risks of close relationships since we all have a mother and a father. The risk in close emotional relationships is that you will be rejected, misused or betrayed. Just as there is an overlap between mental and social health, so there is an overlap between social health and spiritual health. Guilt, loss of meaning, lack of identity, fear of death and bitterness all have a spiritual dimension. And these things can all be connected to relationship problems. What can be done to relieve social stress? Dealing with social and spiritual stress is important. We will discuss spiritual matters later. There are three things that are socially challenging to do but which are vital to the relief of social stress: Forgiveness, saying sorry and telling someone else in a loving way that they have a problem. I admit that these three things can be hard to do, especially in the right spirit. Here are some tips that might help:
If you believe in God or Jesus, pray for help.
If you think that you should say sorry then you probably should.
Beware of the excuse of just blaming someone else.
If you are not sure if you should say sorry, remember that it is good to go through life with a few too many sorries than not enough.
When apologising, don't add an excuse. Don't say, “I am sorry, but....”. Just keep it simple.
Remember that forgiveness and trust are different.
You can forgive someone without trusting them.
Human forgiveness means letting go of negative baggage associated with a hurt.
Remember to forgive yourself.
In order to trust someone again, they need to sincerely apologise.
You can forgive someone and still lay civil charges in order to provide protection for yourself and others and also at times in order to help the offender.
Forgiveness is a choice. It is not dependent on the size or type of offense.
Forgiveness does not mean completely forgetting an offense. But it does mean not focusing on it and dwelling upon it.
In order to tell someone that they have a problem, you need to first feel a genuine love and concern for them.
When seeking to help someone with a problem or to say sorry or to forgive it is usually best to use face to face communication or the telephone. Otherwise misunderstandings more easily occur. Also, written messages can more easily be used against you if the relationship remains or turns 'toxic'.
Choose the right time and place. For example, going for a walk with someone might make it easier to discuss hard things.
Privacy is important.
Beware of gossip.
When it comes to social health it is important to have identity and value in your life. We get identity and value from association with what I call identity structures. Identity structures include things like family, employment or training, local community, God, nationality, clubs and hobbies or other groups of people that you 'belong' to. Most of these identity structures can be taken from you by people's choices or by calamity. You can lose your job, family, community, hobby, nationality. Refugees know all about this kind of thing. The one identity structure that cannot really be taken from you except by your own choice is God – our Heavenly Father. So faith can be a real help when it comes to social health and security. Usually in a calamity other identity structures remain apart from God. So, check out all the ones that are left and use them to help know that you are valuable and that you have identity. Also, you might want to join some community where you can find identity. But beware of unhealthy identity structures like cults and drug-dealing gangs. By the way, there is identity and value in just being human. Humans are special. You only have to read the first chapter of the book of Genesis to realise this.
If you would like help in achieving some goals in relation to stress management you could contact my wife, Lorna, who is a certified health coach who loves helping people to achieve realistic health and lifestyle goals. Email contact: firstname.lastname@example.org
In 2013 I did a talk with a Chinese friend of mine which we called “Meditation, Science and Religion”. This five part DVD series is available from www.steps.org.au. The audio files in MP3 for the presentations can be listened to or downloaded here: A History of Meditation (51 min., 49 MB). Stress and Meditation (43 min., 62 MB). Scientific Studies on Meditation (50 min., 72 MB). When I was studying for these talks on meditation, science and religion I came across a lot of scientific studies showing how beneficial having faith was when it comes to health and coping with stress. I discuss some of these benefits in this series. At home I have a 1169 page book called "Handbook of Religion and Health" (Koenig et al. 2012) which enumerates study after study that demonstrates the positive effect of faith on physical and mental health. One of the most important faith benefits that I believe in is the Sabbath. This means taking a break from the worries and cares of secular life and work on each seventh day of the week. To me, this principle is so important, so radically stimulating and so connected with destiny that I wrote a whole book on it (click here if you want to read a pdf version). All I will say here is, Don't underestimate the Sabbath issue. I predict that in the near future that the Sabbath issue will become very prominent. Already in Europe and the USA there are loud calls for the setting aside of the first day of the week as a government mandated rest day for “family and faith”
Images and content © D. Bird 2017