Bipolar4LifeSupport

Stress is a normal and unavoidable part of life — but too much stress can affect your emotional and physical wellbeing. According to APA’s 2015 Stress in America survey¹, average stress levels today are slightly higher than they were in 2014. On a scale of 1 to 10 where 10 is “a great deal of stress” and one is “little or no stress,” American adults rated their stress level at a 5.1 today, up from 4.9 in 2014. But worrisomely, a significantly greater percentage of adults reported experiencing a stress level of 8 or higher on the 10-point scale. Twenty-four percent of American adults reported this extreme level of stress in 2015, up from 18 percent the previous year.

Emotional support is an important protective factor for dealing with life’s difficulties. The 2015 survey found the average stress level for those with emotional support was 5.0 out of 10, compared to 6.3 for those without such support.

Loneliness has been associated with a wide variety of health problems including high blood pressure, diminished immunity, cardiovascular disease and cognitive decline.² In fact, low levels of social support have even been linked to increased risk of death from cardiovascular disease, infectious diseases and cancer.³

The good news is that there are ways to seek out such support, and to nurture your supportive relationships.

The benefits of social support

As important as social support is, many Americans don’t feel they have access to this valuable resource. When asked if there is someone they can ask for emotional support, such as talking over problems or helping make difficult decisions, 70 percent said yes. However, more than half (55 percent) also said they could have used at least a little more emotional support.

In fact, experts say, almost all of us benefit from social and emotional support. And though it may seem counterintuitive, having strong social support can actually make you more able to cope with problems on your own, by improving your self-esteem and sense of autonomy.

You don’t need a huge network of friends and family to benefit from social support, however. Some people find camaraderie among just a handful of people, be they co-workers, neighbors or friends from their church or religious institution, for instance.

Yet social skills don’t always come naturally. Some people have trouble making social connections. Many others lose established connections due to life changes such as retirement, relocation or the death of a loved one. In any case, it’s possible to forge new connections to reap the benefits of a healthy support network.

Grow your support network

Cast a wide net.  When it comes to your social supports, one size doesn’t fit all. You may not have someone you can confide in about everything  — and that’s okay. Maybe you have a colleague you can talk to about problems at work, and a neighbor who lends an ear when you have difficulties with your kids. Look to different relationships for different kinds of support. But remember to look to people you can trust and count on, to avoid disappointing, negative interactions that can make you feel worse.

Be proactive.  Often people expect others to reach out to them, and then feel rejected when people don’t go out of their way to do so. To get the most out of your social relationships, you have to make an effort. Make time for friends and family. Reach out to lend a hand or just say hello. If you’re there for others, they’ll be more likely to be there for you. And in fact, when it comes to longevity, research suggests that providing social support to friends and family may be even more important than receiving it.⁴

Take advantage of technology.  It’s nice to sit down with a friend face-to-face, but it isn’t always possible. Luckily, technology makes it easier than ever before to stay connected with loved ones far away. Write an email, send a text message or make a date for a video chat. Don’t rely too heavily on digital connections, however. Some research suggests that face-to-face interactions are most beneficial.

Follow your interests.  Do you like to hike, sing, make jewelry, play tennis, get involved in local politics? You’re more likely to connect with people who like the things you like. Join a club, sign up for a class or take on a volunteer position that will allow you to meet others who share your interests. Don’t be discouraged if you don’t make friends overnight. Try to enjoy the experience as you get to know others over time.

Seek out peer support.  If you’re dealing with a specific stressful situation  —  such as caring for a family member or dealing with a chronic illness  —  you may not find the support you need from your current network. Consider joining a support group to meet others who are dealing with similar challenges.

Improve your social skills.  If you feel awkward in social situations and just don’t know what to say, try asking simple questions about the other person to get the ball rolling. If you’re shy, it can be less intimidating to get to know others over shared activities — such as a bike ride or a knitting class — rather than just hanging out and talking. If you feel particularly anxious in social situations, consider talking to a therapist with experience in social anxiety and social-skills training.

Ask for help. If you lack a strong support network and aren’t sure where to start, there are resources you can turn to. Places of worship, senior and community centers, local libraries, refugee and immigrant groups, neighborhood health clinics and local branches of national organizations such as Catholic Charities or the YMCA/YWCA may be able to help you identify services, support groups and other programs in your community.

Seek professional help

If you’re feeling stressed and don’t have anyone to rely on, psychologists can help. As experts in human behavior, psychologists can help you develop strategies to manage stress and improve your social skills. Use the APA’s  Psychologist Locator Service  to find a psychologist in your area. You can also visit www.mentalhealth.gov, a website of the U.S. Department of Health & Human Services that offers resources in English and Spanish.

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Whenever there is a disaster of any magnitude, psychologists often are mobilized to help.

To an outside observer, it would be difficult to tell the psychologist apart from the other volunteers.

Psychologists may be providing a variety of important support services, such as directing people to food and shelter, but they also offer crucial emotional support after a disaster.

Because psychologists are uniquely trained in helping people cope with stress and strong emotions, they are able to help disaster survivors, volunteers and disaster relief operation workers understand their emotions, such as anger, distress and grief.

Although psychologists do not offer therapy at disaster sites, they can help people build upon their own internal strengths to begin the process of recovering from the disaster. Psychologists help those in disastrous circumstances to build their skills of resilience to move from feeling hopeless to having a more long-term, realistic perspective. This process can include taking small steps toward concrete goals and connecting with others as they learn to cope with a disaster’s logistical and emotional challenges.

As psychologists offer this support, they may:

• Listen to people’s concerns on a variety of issues including their homes, missing family members and pets.
• Help people to manage their temporary living conditions and to acclimate to shelters located possibly far from their home state and in different environments.
• Provide information about available resources for current needs (clothing, medical care, etc.); help to facilitate those connections.
• Advocate for the needs of particular individuals or families as they navigate the systems that have been established to provide aid.
• Help individuals to strengthen their resilience skills by making connections with family and friends; accepting that change is going to be an ongoing experience; maintaining a hopeful outlook; and helping people to develop their own personal recovery plans.
• Listen to parents’ concerns about how their children will recover from the disaster and manage potential challenges ahead (e.g. new living arrangements, new schools, etc.).
• Help problem-solve conflicts among shelter residents; among family members; and among volunteers and staff.
• Help people to manage other life disasters that might be happening at the same time (e.g. death or illness of a relative not related to the current event).
• Educate people that it is normal for disaster survivors to have an array of common reactions. Some of these include: fears, memories, nightmares, irritable and/or withdrawn emotions, and confusion.
• Assure people that it is possible to recover from disaster and to build fulfilling and satisfying lives.
• In working with children: notice and support positive coping strategies; help children to reestablish connections with others; help children to find ways to help others; help families reestablish familiar routines and structures; remind children and families of the importance of taking breaks from recovery efforts and promote healthy self-care.
• Provide information on how and where to seek longer-term assistance.

Related Information

• APA’s Disaster Response Network
• Disasters
• Trauma

Disasters such as hurricanes, earthquakes, transportation accidents or wildfires are typically unexpected, sudden and overwhelming. For many people, there are no outwardly visible signs of physical injury, but there can be nonetheless an emotional toll. It is common for people who have experienced disaster to have strong emotional reactions. Understanding responses to distressing events can help you cope effectively with your feelings, thoughts and behaviors, and help you along the path to recovery.

What are common reactions and responses to disaster?

Following disaster, people frequently feel stunned, disoriented or unable to integrate distressing information. Once these initial reactions subside, people can experience a variety of thoughts and behaviors. Common responses can be:

• Intense or unpredictable feelings. You may be anxious, nervous, overwhelmed or grief-stricken. You may also feel more irritable or moody than usual.
• Changes to thoughts and behavior patterns. You might have repeated and vivid memories of the event. These memories may occur for no apparent reason and may lead to physical reactions such as rapid heartbeat or sweating. It may be difficult to concentrate or make decisions. Sleep and eating patterns also can be disrupted — some people may overeat and oversleep, while others experience a loss of sleep and loss of appetite.
• Sensitivity to environmental factors. Sirens, loud noises, burning smells or other environmental sensations may stimulate memories of the disaster creating heightened anxiety. These “triggers” may be accompanied by fears that the stressful event will be repeated.
• Strained interpersonal relationships. Increased conflict, such as more frequent disagreements with family members and coworkers, can occur. You might also become withdrawn, isolated or disengaged from your usual social activities.
• Stress-related physical symptoms. Headaches, nausea and chest pain may occur and could require medical attention. Preexisting medical conditions could be affected by disaster-related stress.

How do I cope?

Fortunately, research shows that most people are resilient and over time are able to bounce back from tragedy. It is common for people to experience stress in the immediate aftermath, but within a few months most people are able to resume functioning as they did prior to the disaster. It is important to remember that resilience and recovery are the norm, not prolonged distress.

There are a number of steps you can take to build emotional well-being and gain a sense of control following a disaster, including the following:

• Give yourself time to adjust. Anticipate that this will be a difficult time in your life. Allow yourself to mourn the losses you have experienced and try to be patient with changes in your emotional state.
• Ask for support from people who care about you and who will listen and empathize with your situation. Social support is a key component to disaster recovery. Family and friends can be an important resource. You can find support and common ground from those who’ve also survived the disaster. You may also want to reach out to others not involved who may be able to provide greater support and objectivity.
• Communicate your experience. Express what you are feeling in whatever ways feel comfortable to you — such as talking with family or close friends, keeping a diary or engaging in a creative activity (e.g., drawing, molding clay, etc.).
• Find a local support group led by appropriately trained and experienced professionals. Support groups are frequently available for survivors. Group discussion can help you realize that you are not alone in your reactions and emotions. Support group meetings can be especially helpful for people with limited personal support systems.
• Engage in healthy behaviors to enhance your ability to cope with excessive stress. Eat well-balanced meals and get plenty of rest. If you experience ongoing difficulties with sleep, you may be able to find some relief through relaxation techniques. Avoid alcohol and drugs because they can be a numbing diversion that could detract from as well as delay active coping and moving forward from the disaster.
• Establish or reestablish routines. This can include eating meals at regular times, sleeping and waking on a regular cycle, or following an exercise program. Build in some positive routines to have something to look forward to during these distressing times, like pursuing a hobby, walking through an attractive park or neighborhood, or reading a good book.
• Avoid making major life decisions. Switching careers or jobs and other important decisions tend to be highly stressful in their own right and even harder to take on when you’re recovering from a disaster.

In addition to these recommendations, APA’s Road to Resilience brochure describes steps that you can take to build resilience — the process of adapting well in the face of adversity, trauma, tragedy, threats or significant sources of stress.

When should I seek professional help?

If you notice persistent feelings of distress or hopelessness and you feel like you are barely able to get through your daily responsibilities and activities, consult with a licensed mental health professional such as a psychologist. Psychologists are trained to help people address emotional reactions to disaster such as disbelief, stress, anxiety and grief and make a plan for moving forward. To find a psychologist in your area, visit APA’s Psychologist Locator.

Thanks to psychologists Kevin Rowell, PhD, and Rebecca Thomley, PsyD, for their assistance with this article.

Revised August 2013

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