If you have OCD, you likely know that stress is major trigger of OCD symptoms. In addition, as the anxiety caused by stress often causes people to use poor coping strategies such as avoidance, stress can often get in the way of treatment for OCD. As such, it is vital to understand what stress is and how to cope with it. Let’s explore stress and how to best manage it.
What Is Stress?
Although we have all experienced stress at one time or another, it can be difficult to put our finger on exactly what stress is. Indeed, stress is often thought about from three different perspectives: an event, a reaction or a transaction.
Stress as an Event
Sometimes stress is thought of as an event, in which case the event is called a stressor. Examples of stressors include getting divorced, being laid off or being diagnosed with a serious illness. Daily hassles such as getting a parking ticket or forgetting to pick up milk on the way home can also be thought of as stressors.
In general, the more long-standing, uncontrollable, unpredictable and ambiguous you perceive a stressor to be, the more negative its impact will be on your well-being. People with OCD often report experiencing an increase in the number or severity of stressors just prior to their symptoms becoming worse.
Stress as a Reaction
Stress can also be thought of as our reaction to an event. The classic stress response is the “flight or flight” reaction in which your body activates a number of physical and behavioral defense mechanisms to deal with an impending threat. This includes the release of specific hormones, activation of stress-sensitive brain regions, an increase in heart rate and blood pressure, and a decrease in appetite and sexual activity. All of these changes are designed to keep us alive in the face of danger.
Importantly, it is often these physical and psychological symptoms that we are detecting when we say that we feel stressed out. Although the flight or flight reaction is helpful in the short-term, it puts a strain on the systems of the body and can contribute to a variety of physical and mental illnesses including cardiovascular disease, diabetes, depression and anxiety disorders including OCD if it goes on for too long.
Stress as a Transaction
Another way we can think of stress is as state that results from a transaction between you and your environment. In this model of stress, your environment is constantly making demands on you such as getting to work on time, paying monthly bills, resolving conflicts with friends or co-workers or parenting children. In turn, you are able to bring a number of resources to bear such as time, money, knowledge, skill, social support to meet the demands placed on you by the environment.
According to this model, if you believe that you do not have the resources you need to deal with the demands placed on you, you feel stress. A nice feature of this model of stress is that it accounts for why different people react differently when faced with the same challenges -- not everybody sees the demands of the environment the same way, and likewise, not everyone sees their capacity to deal with stress in the same way. As such, you can end up having as many different reactions to potentially stressful conditions as you do people.
Good Coping Strategies are Essential
According to the transactional model of stress, the perception of our ability to cope with the demands of the environment is the key to whether we will experience stress or not. Again, if we feel we have the resources to meet the demands of the environment, we should not feel stress. As such, many types of therapy for OCD focus on developing coping strategies that help people feel like they have more control over events in their environment –- the thinking is that the more control people have, the less stress they feel and the less severe their OCD symptoms become.
In general, most psychotherapies emphasize so-called problem-focused coping. Specifically, coping strategies that get to the root of the problem are often far more effective in reducing stress than those that seek to simply manage the emotional distress caused by a situation.
Lazarus, R.S., & Folkman, S. "Stress, Appraisal and Coping" 1984: 173-177.