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How To Cope With Stress

U.S. Army Major Stephen Beckwith (2nd-R) and Captain Reis Ritz (R) arrive to speak with the media about helping with the casualties after U.S. Army Major Nidal Malik Hasan went on a shooting rampage at Fort Hood on November 6, 2009 in Killeen, Texas.
Joe Raedle
U.S. Army Major Stephen Beckwith (2nd-R) and Captain Reis Ritz (R) arrive to speak with the media about helping with the casualties after U.S. Army Major Nidal Malik Hasan went on a shooting rampage at Fort Hood on November 6, 2009 in Killeen, Texas.
How To Cope With Stress
We'll look at the results of a new study on stress by the American Psychological Association and how people are dealing with it.

MAUREEN CAVANAUGH (Host): I'm Maureen Cavanaugh, and you're listening to These Days on KPBS. The actual motive behind the shooting rampage at Ft. Hood last week is still unclear. Unless the prime suspect recovers and decides to tell us his reasons, we may never know. But right after the shooting, the airwaves were filled with experts and former military officers talking about stress. They spoke about the stress of multiple deployments and new programs to help military families deal with stress. So as it turns out, just days ago the American Psychological Association released a new survey documenting that the majority of Americans, not only those in the military, deal with significant levels of stress and the survey also documents there are physical and emotional consequences to that stress. Joining me to talk about the survey called “Stress In America” are my guests Dr. Annette Conway. She is a local psychologist, a member of the San Diego Psychological Association and serving as the chair of the Public Education and Media Committee. Dr. Conway, welcome to These Days.

DR. ANNETTE CONWAY (Psychologist): Thank you, Maureen.

CAVANAUGH: And Dr. Stephen Sobel, San Diego-based psychiatrist who specializes in stress in teenagers and adults. Dr. Sobel, welcome.

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DR. STEPHEN SOBEL (Psychiatrist): Thanks. It’s a pleasure to be joining you this morning.

CAVANAUGH: And we want to invite our listeners to join the conversation. Have you dealt with symptoms caused by the stress in your life? How would you describe your level of stress and how are you dealing with it? Give us a call with your questions and comments. Our number is 1-888-895-5727, that’s 1-888-895-KPBS. You know, when I watched that coverage last week, I was really surprised that so much of the expert commentary around the Ft. Hood shootings seemed to revolve around the issue of stress. And I wonder, Dr. Conway, how often does stress erupt in violence?

DR. CONWAY: Well, it’s usually cumulative. What happens is that it’s often times not known, maybe someone has not sough professional help and it’s been cumulative. They’ve not had an outlet to discuss some deep-lying issues that they have, and then it comes out in a violent motive.

CAVANAUGH: And I’m wondering for the purposes of our discussion, if we can just start off by clarifying. We use the word stress so often but how do psychologists and psychiatrists define stress, Dr. Conway? What is it?

DR. CONWAY: Well, you have to first look at the difference between good stress and bad stress. Stress can affect our entire body. And good stress is a motivator. It gives you that boost to help you get you through an exam or meet a deadline. But bad stress, especially that stress that is felt consistently over a prolonged period of time can have a negative effect on your body. It can increase the heart rate, muscle tension, blood pressure, cause anxiety, fatigue, and even hormonal changes.

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CAVANAUGH: And, Dr. Sobel, I wonder, the stress that we talk about, does that actually stem from our fight or flight reaction? A very deep, ancient part of our brains?

DR. SOBEL: There’s a part of the brain, Maureen, called the amygdala. It’s a deep part of the brain, the center of the brain and it’s the site of fear. And what happens is if you – if someone becomes stressed, in other words, someone experiences some significant stressor in his or her life, there’s a fear response, and it’s the amygdale that fires. In fact, if – when they take rats and they destroy the amygdala, these rats no longer hide in the corner when a cat comes out, they’re looking for some cats to beat up. And so what happens is that when there is a stress in someone’s life, the person reacts by their amygdala firing. And that amygdala is tied into all the different brain centers including the brain centers that result in what we call the fight or flight response or some people add freeze, so they call it a ‘fight, flight or freeze’…

CAVANAUGH: Freeze, right.

DR. SOBEL: …response.

CAVANAUGH: That’s interesting. And, Dr. Conway, you told us a little bit about how the body deals with stress, the higher blood pressure, the respiratory – respiration can go up. Does stress just dissipate? Does it just go away or do you have to do something to make it go away?

DR. CONWAY: Well, you have to learn to manage it. You have to learn to find ways that you can find individual methods for managing your stress. In the survey, most people used exercise, walking and listening to music, as a means of managing their stress. Nationally, however, many Americans still rely on sedentary activities and unhealthy behaviors to manage their stress.

CAVANAUGH: And that would be sort of just watching television or even maybe taking a drink or something like that.

DR. CONWAY: Exactly. 36% of Americans nationally watch television two or more hours a day and 33% play videogames as a means of managing their stress.

CAVANAUGH: We are talking about a – really about a new survey that came out from the American Psychological Association called “Stress in America.” I’m speaking with Dr. Annette Conway and Dr. Stephen Sobel, and we are asking for your calls and you to join the conversation to tell us a little bit about your stress and what makes you stressed and how you manage it. The number is 1-888-895-5727. Dr. Sobel, one of the biggest parts of this survey was the affect of stress on children and teenagers and I know that’s your – that’s one of your specialties. Tell us a little about that because I don’t think a lot of people recognize that kids are so stressed.

DR. SOBEL: That was one of the most striking parts of this survey to me. It’s the recognition that we, as parents, and I have an 18-year-old daughter, that we, as parents, do a much poorer job of recognizing the amount of stress that our children have and in some ways it’s ironic because I’m sure you remember, I’m sure Dr. Conway remembers, and our listeners remember, when we were kids, when we were teenagers, it’s a stressful time. Everyone laughs and talks about how middle school and high school is so stressful for children and for teens. But parents aren’t doing as good a job of recognizing it as they need to do, as the survey showed.

CAVANAUGH: Yes, and do we know whether or not young people today have more stress than people in previous generations or are we just documenting it a little bit more?

DR. SOBEL: Well, life has certainly gotten a lot more complicated…

CAVANAUGH: Yeah, that’s…

DR. SOBEL: …than it used to be. Plus, we’re doing a better job, I hope, as a profession and as a country and as a society, recognizing the effects that different stressors are having on children and teenagers these days.

CAVANAUGH: And the survey finds that many parents are in denial about the stress their children are trying to handle. Dr. Sobel, in your practice do you find that to be true?

DR. SOBEL: Absolutely true. Absolutely true. Sometimes parents are astonished at the level of difficulties that their children are having. We have suicides that occur every year all over the country. And, sad to say, many times parents aren’t aware of the level of the stress their kids are experiencing.

CAVANAUGH: And Dr. Conway, why is that? Is it because we just assume that kids are resilient and they’re going through some tough times when they’re teenagers? Why isn’t this recognized as a real concern?

DR. CONWAY: Well, I think it’s because parents are juggling a lot. You have the household responsibilities and the financial responsibilities and then especially if it’s a dual career family, then both the mother and father are working and the children are, you know, left to be cared by, you know, daycare, a nanny or themselves.

CAVANAUGH: Let’s take a call. We are inviting your calls, 1-888-895-5727. And Scott is calling from San Diego. Good morning, Scott, and welcome to These Days.

SCOTT (Caller, San Diego): Well, thank you and thank you for the topic. It’s interesting, my agency, Mental Health America of San Diego County, just did a forum with about 60 HR directors and one of the topics obviously is stress in the workplace. And our partners from Barney & Barney presented, and they looked at the typical things that you might see, incidents like absenteeism, disciplinary action, and they saw really no change. And so they thought, wow, this is very interesting because we would expect to see a spike in these areas and they looked at their employee assistance program and saw a 300% increase in…

CAVANAUGH: Wow.

SCOTT: …the nation. And so, really, it talks about what an employer can do during these tough economic times to support the employee and their families. And so really, as a prevention measure, to have an employee assistance program in place—and we saw it in that example—where employees utilized it and then we saw the back end not having impact in the workplace. So we thought that was a really positive example on a prevention tool.

CAVANAUGH: Scott, thank you for that and I do want to talk more later in the program about what the recession may be doing to our stress levels as well. But getting back to the report that really just came out days ago, American Psychological Association’s “Stress in America,” this study, Dr. Conway, find – uses a figure of 75% of adults dealing with significant stress over the past year. Tell us a little bit more about that statistic because that’s really pretty amazing.

DR. CONWAY: Yes. Well, in general, when you look at the stress levels of American – that Americans have reported over the past 3 years, the numbers are still high. The top poll – the top three stressors seem to be money, work and the economy. In 19 – 2008, more people reportedly – reported that they felt extremely stressed but that seems to have tapered off but still they say, yeah, 75% of Americans still feel levels of stress that are on the high range.

CAVANAUGH: And does it – So is that consistent with previous findings? Or is that more?

DR. CONWAY: That remains about the same. You know, last year there was a spike in the stress levels because if you remember last fall, it was a very unusual moment in time in that you had the banking crisis…

CAVANAUGH: Yes, right.

DR. CONWAY: …and the stock market plummeting. But, pretty much, stress levels have remained the same.

CAVANAUGH: So, Dr. Sobel, that’s either good news or bad news considering that we’re not really getting anywhere in trying to manage this stress.

DR. SOBEL: No, we’re not doing as well as we should be. Hey, it’s important to recognize that there are what I describe as two different types of stressor anxiety. There’s the background anxiety that we all experience whether it be an increase in anxiety in October in San Diego because of our experience with fires, or whether it be the anxiety that’s caused by the fact that the economy is making a slow recovery and unemployment remains so high. And so everyone has this background anxiety that affects us and affects us all more or less the same. But superimposed upon that is every individual’s unique experience, what I call the situational anxiety, and it’s the combination of background anxiety and situational anxiety that we experience as stress, that we experience as anxiety. And when that level gets to a certain point, and that point varies as a result of a number of different factors, genetic factors, psychological factors, coping strategy factors, but when that level gets to a certain point, people start to complain of being highly stressed and that’s what gets picked up in a survey like this…

CAVANAUGH: Right.

DR. SOBEL: …where your last caller was talking about, when that anxiety is just too high and really impacts someone’s quality of life.

CAVANAUGH: And I’m wondering, Dr. Conway, do people in your practice, just anecdotally, are you hearing more about the recession and problems with money?

DR. CONWAY: Oh, absolutely. Absolutely. That seems to be the number one topic that my clients talk about. And it’s – you know, they – they say that, you know, they don’t see any change in the future and a lot of it creates hopelessness, which turns, obviously, into depression. And then I’m man – you know, helping them manage their depression.

CAVANAUGH: And, Dr. Sobel, I imagine that that kind of a stress affects the entire family including the children.

DR. SOBEL: Oh, absolutely.

CAVANAUGH: Umm-hmm.

DR. SOBEL: Absolutely. One of the other things that the survey pointed out is that children are stressed by their parents being stressed, which makes perfect sense when you think about it. But surprisingly enough, parents don’t fully recognize that.

CAVANAUGH: Right, because they think they’re keeping it from the kids but the kids are picking it up anyway. Okay, we have to take a short break and when we return, we will continue our conversation about the new APA survey called “Stress in America,” and we’ll be taking your calls, 1-888-895-5727. You’re listening to These Days on KPBS.

CAVANAUGH: Welcome back. I'm Maureen Cavanaugh, and you're listening to These Days on KPBS. The subject is stress. A new American Psychological Association report, “Stress in America,” finds just about 75% of us dealing with significant levels of stress in the last year, and also surprising numbers for the amount of children and teenagers who are having to cope with stress. My guests are Dr. Annette Conway, she is a local psychologist and a member of the San Diego Psychological Association, please excuse me, and serving as the chair of the Public Education and Media Committee. And Dr. Stephen Sobel is a San Diego psychiatrist, specializes in stress in teenagers and adults. And we are taking your calls at 1-888-895-5727. There are a lot of people who want to join the conversation right now but I want to get in one fast quick question to you both before we go to the phones. And because this report has an outline of a lot of the ways that people are seeing stress affect their lives in terms of the symptoms that they’re experiencing, Dr. Conway, I see that there are a lot of people definitely losing sleep over the amount of stress in their lives.

DR. CONWAY: Umm-hmm. Yes, I think that’s one of the symptoms of being stressed, in addition to fatigue, in addition to not being able to concentrate, being, you know, muscle tension, and I think insomnia is probably, especially with women, and hormonal changes, that seems to be the number one – one of the more significant factors.

CAVANAUGH: And, Dr. Sobel, I wonder what are the symptoms that usually bring people into your office?

DR. SOBEL: It’s usually a result of some behavioral problem, some life circumstance problem and, of course, it varies whether it’s an adolescent or whether it’s an adult. For a teenager, usually it’s something precipitated by some problems in school, failing a test, doing – having difficulty studying, fighting with mom and dad about doing homework, or there’s a behavior change. Teenagers becoming more irritable, more isolated, distancing from friends, or parents are starting to become concerned about perhaps some self medication, some alcohol abuse, some drug use, to try to decrease the amount of stress that the teen is experiencing. For – And so the teenager usually comes in as a result of a parent pushing, though it’d be nice if – and especially excellent when teenagers come to their parents and say, hey, I need some help.

CAVANAUGH: Right.

DR. SOBEL: For adults, we see similar things. People are less bothered by the symptoms, it appears, in my experience, than by the consequences. I’m too tired to go to work.

CAVANAUGH: Right.

DR. SOBEL: I’m too tired to take care of all the chores and problems I have, those sorts of things.

CAVANAUGH: Thank you. We’re taking your calls at 1-888-895-5727. And let’s hear from Jim in Carlsbad. Good morning, Jim, and welcome to These Days.

JIM (Caller, Carlsbad): Morning. You know, it’s an interesting phenomena. I have a wife who’s really a wonderful, wonderful parent and I say that in all honesty because I probably would be a lot more lax. We’ve had an adopted daughter since birth. She’s turning 17 and one of the things that I think makes her stress level low and makes her really, you know, really a cheerful kid who doesn’t have a lot of these pressures is the boundaries that have been set up mostly by my wife. And the analogy I was taught – we actually went to a parenting class back when she was like three at Montessori, and the boundary thing was described to us as, you know, if you’re driving across the Golden Gate Bridge you probably, most people, unless you’re phobic, probably don’t have a problem with driving across a bridge, yet imagine what it would be like driving across that bridge if they took down the guardrails.

CAVANAUGH: Right, exactly, with no rules things go haywire.

DR. SOBEL: Umm-hmm.

CAVANAUGH: Jim, thank you for that call. What do you – I’m going to get your reaction, Dr. Sobel, what do you think about that? The kind of thing, discipline reduces stress in teenagers?

DR. SOBEL: Well, I think it’s a little bit different than the point that he was making. Well, depending, of course, how one defines discipline.

CAVANAUGH: Umm-hmm.

DR. SOBEL: I think the caller’s pointing out something very interesting and that is the void issue, v-o-i-d. And that is that when a stress occurs and we don’t know what’s going to happen, am I going to drive safely across that Golden Gate Bridge, for example, a void exists and the brain does not like a void. And so when a void exists, the brain fills in that void and it tends to fill it in in catastrophic ways. It makes sense if you’re a caveman and you hear a noise outside and you don’t know whether it’s the wind or a sabertooth tiger. You’re better off assuming it’s a sabertooth tiger.

CAVANAUGH: Umm-hmm.

DR. SOBEL: Because if you assume it’s the wind and it’s not, you’re eaten. And so what happens is we tend to fill in these voids and we tend to fill them in with catastrophic, black and white type thinking and that, needless to say, creates tremendous amounts of anxiety. So being aware that that’s what we’re trying to do, we’re trying to make predictions about the future and we realize they’re just predictions, is one way to decrease the amount of anxiety that someone experiences.

CAVANAUGH: I understand. Let’s go to the phones. Michael is calling from South Bay. Good morning, Michael. Welcome to These Days.

MICHAEL (Caller, South Bay): Hello, and thank you for taking my call.

CAVANAUGH: You’re welcome.

MICHAEL: One of the things that I was noticing was that the wages that congress authorizes as far as minimum wage is concerned is very slow to rise but, in fact, they actually vote to raise their own wages more frequently. I feel that if the wages that were increased for congress directly affected wage increases for the rest of Americans, there wouldn’t be such a financial stress on households.

CAVANAUGH: Well, I appreciate that, Michael. I’m sure a lot of people feel the same way. But I’m wondering, Dr. Conway, to get back to the whole issue of money and how much money people are making and how much money people are taking into their homes, when people come in and that’s their major area of stress, do you send them to a financial advisor? I mean, what do you tell them to do?

DR. CONWAY: No, I think we probably look at their money situation realistically. One thing that I do is I weigh the pros and cons of, you know, of decision making, saying, you know, what can we do to change your situation. Let’s look at some rational solutions and then you write it down and you also weigh the pros and cons and you look at it in a more rational way. And I think that people, if they can look at it more rationally with using a psychologist or a psychiatrist as an objective support system for them, I think that they seem to decrease their anxiety level.

CAVANAUGH: I see, because they’re doing something about it.

DR. CONWAY: Yes, they are. They are, and they know they have that support system.

CAVANAUGH: Let’s take a call from Ed in Lakeside. Good morning, Ed, and welcome to These Days.

ED (Caller, Lakeside): Good morning. An interesting topic and as an old-timer, I’m in my eighties, I’d like to call attention to a book that was written 15 years ago that has a lot to do with stress and that is it’s Juliette Schor’s book, “The Overworked American.” And that is not the only book. Over a period of years there’s also “Nickeled and Dimed: And Not Making It in America (sic).” All we have to do is focus on what is called the productivity index—I think that’s the term—where in America that’s the one thing that’s going up and up and up. And that means that the individual worker is putting out more work. That means, in turn, people working like flipping hamburgers, sometimes I stand back and marvel at how busy they are. They’re working, working, working to keep that job. And, of course, it’s a role model and that sort of thing.

CAVANAUGH: Right.

ED: That’s my contribution.

CAVANAUGH: Well, Ed, thank you for calling. That’s interesting to note – to certainly note that this has not been a short term problem in America. We’ve been dealing with this for a long time. Dr. Sobel, one of the things that’s in this survey, “Stress in America,” is the idea that if people go to their regular medical doctor with symptoms of stress, that sometimes they don’t get exactly the kind of treatment they need. Can you tell us a little bit about that?

DR. SOBEL: Yeah, that was one of the disturbing things to me as a physician in the survey. What they found were that about 48% of people that were told you need to make some changes, you have some medical problems—hypertension, elevated cholesterol or the like—were given an explanation for why the doctor was recommending it. 35% were given specific recommendations or techniques about how to make the changes. Only about 5 to 10% were actually referred to another healthcare professional, I would assume by that they were talking about a mental healthcare professional, and only 48% stated that the physician ever followed up on it. So I know physicians are overwhelmed and overworked and have limited time as a result of a variety of factors to interact with patients but if the physician is not doing a good enough job of explaining the problem and giving specific recommendations of how to deal with it then following up on it, it’s not going to bode well that the patient is going to make the changes necessary.

CAVANAUGH: Is this an indication, Dr. Sobel, that perhaps stress related symptoms and illnesses are not taken as seriously as they should be?

DR. SOBEL: I think that that is very, very clear. I think that’s an – at a – on one level, it’s at a national level. The coverage that a patient has for mental health treatments pales in comparison to the treatment that he or she has for general medical problems. And that creates financial barriers that prevent patients from getting the kind of treatment that they would like to get.

CAVANAUGH: Let’s take another call. Michael is calling from PB. Good morning, Michael. Welcome to These Days.

MICHAEL (Caller, Pacific Beach): Hi.

CAVANAUGH: Hi.

MICHAEL: I wanted to ask if there’s groups of people in our society and also in foreign countries that have significantly less stress and how it is that they are achieving that if they do?

CAVANAUGH: That’s a good question. Anyone want to take that? Dr. Conway, Dr. Sobel? Do we have any statistics on that?

DR. CONWAY: No research on that.

CAVANAUGH: I’m sorry, Michael, we’ll have to find out. That’s a fascinating question, to find out if maybe groups of meditators or Zen practitioners have significantly less stress than the rest of us. Let’s hear from Clayton in Hillcrest. Good morning, Clayton. Welcome to These Days.

CLAYTON (Caller, Hillcrest): Morning, Maureen, how’re you doing?

CAVANAUGH: I’m doing great, how are you?

CLAYTON: I hear your stress is down.

CAVANAUGH: I – I’m managing it well this morning.

CLAYTON: My point is for actually both of your guests this morning. I am prior active service military and one thing I always noticed while in service was that a lot of people feel that going to see a social worker or a mental health professional of any kind could greatly jeopardize their chances for promotion, and now that I’m out I see it on both sides of the field, that people are scared because they’re – they think it’s a sign of weakness or jeopardizing their health to go see someone to get help.

CAVANAUGH: Interesting question. Thank you for that, Clayton. And I want to ask you, Dr. Conway, is that – is it – well, first let’s take it in the military and then take it in just ordinary civilian life. Is seeking help for a psychological problem related to stress looked down upon even today?

DR. CONWAY: I’m not too sure about the military but, in general, yes, mental health help is stigmatized and a lot of people do not seek mental help because they think that they’re going to be labeled as crazy or that they are going to affect their employment or it’s going to affect some other part of their life that, you know, it would…

CAVANAUGH: It would help – it would hurt…

DR. CONWAY: Yes, exactly.

CAVANAUGH: …their job applications…

DR. CONWAY: Absolutely.

CAVANAUGH: …or something like that. But all of this is all confidential information, right?

DR. CONWAY: Absolutely. Yeah. When you seek mental health services, it is a confidential relationship and it is private and it’s just between the psychologist or psychiatrist and the patient. And whatever happens in that room stays in that room unless the person, the patient, says that they’re going to harm themselves or harm somebody else.

CAVANAUGH: Dr. Sobel, I’ve heard that in the military—we’ve done a lot of shows on this—that in the military there is a – there has been, in the past, a stigma but the military is working very hard on welcoming people to take part in the mental health services and beefing up their mental health services…

DR. SOBEL: Umm-hmm.

CAVANAUGH: …for both enlisted personnel and their families. I wonder, do you deal with any people either in the military or former military?

DR. SOBEL: I have an office in San Diego and I also have an office in Carlsbad…

CAVANAUGH: Umm-hmm.

DR. SOBEL: …and I see a large number of family members, spouses, children, and occasionally active military who come to see me for treatment and the caller’s point is correct. There’s tremendous stigma. The active duty who come to see – active duty military who come to see me often are very anxious about coming in and talking about their anxiety for fear of the consequences, if someone should ever find out, of their career. One of the things that’s coming out as a result of this horrific tragedy at Ft. Hood is the military simply does not have enough mental health services. The number of individuals in the military who are experiencing significant problems as a result of stress is staggering, and the military simply does not have enough mental health personnel to solve that entire problem. One thing I read in Time magazine about a year ago is that some of the people from the soldiers going into Afghanistan are actually being given Prozac in order to try to treat or prevent the development of post traumatic stress disorder. So it’s a recognized problem but it’s definitely not getting, at least in my opinion, the help that it needs, the attention that it needs.

CAVANAUGH: Let’s take another call. Vicky is calling from Poway. Good morning, Vicky, and welcome to These Days.

VICKY (Caller, Poway): Good morning. Thank you so much for taking my call.

CAVANAUGH: You’re welcome.

VICKY: My comment is that I feel like we live in a very competitive society and that I have – I am the mother of two children, they’re seven and three. And among the other moms, I feel like we’re always racing our children to see who is, you know, the best in their skills or how can we help them to achieve better skills for the future? So I feel like we are overloading the children with extracurricular activities and we’re not allowing them to have enough free time just to play and just be kids.

CAVANAUGH: Well, thank you for that Vicky, and I’m going to toss that to you, Dr. Sobel. Do you agree with Vicky?

DR. SOBEL: I do but the survey was interesting. The survey says that even though Vicky and I think that’s the case, that’s not what the kids say. The kids are mostly stressed out about school performance, about what life will be like after school, getting into college, and things like that, and they’re stressed about their financial situation. They’re much less stressed about how many activities they’re going to do and are much less stressed about their relationships with their parents. I think what happens is that we tend to assume that our kids are stressed by the same things that we’re stressed about and so when we’re driving our kids from one activity to the next, we’re anxious but they’re not.

CAVANAUGH: Dr. Conway, what are some of the things that you tell your patients on how to reduce or manage their stress level?

DR. CONWAY: Well, I think especially with children, it’s important to be open and honest with your kids. You know, like Dr. Sobel was saying, the survey findings are showing that the kids are picking up on the pressures of the parents, which are the pressure at school and family finance. You know, parents think that they’re protecting their kids by not discussing issues like finances and the economy or other difficult subjects but it’s actually better to talk to your kids and help them understand the situation, reassure them that they will be okay even if the family needs to make some changes.

CAVANAUGH: And, Dr. Sobel, the things that people are doing listed in this survey, walking, meditating, that kind of thing, is that going to help you manage your stress?

DR. SOBEL: Absolutely, it’s going to help. Exercise is important. Finding ways to burn off the excess energy that you’re getting as a result of stress, avoiding certain things. The most common, quote, medication, unquote, for anxiety and stress is alcohol.

CAVANAUGH: Yes.

DR. SOBEL: So people try to drink to decrease their stress levels and all that does is add to your stress levels because of the consequences of the alcohol or the drug use. Or when people are not sleeping because of anxiety, they’re tired the next day, what do they do? They start drinking a lot of coffee…

CAVANAUGH: Right.

DR. SOBEL: …which all – and all that does is to add to the stress. And I also wanted to highlight one comment, if I may, that Dr. Conway made that I think is really important for listeners to hear and that is, when you’re talking to your kids about the stresses the family experiences, which is a frightening thing for parents to talk about, the thing I think is important to highlight is that the kids don’t need to know all the details. They don’t want to know all the details. What they want to know is that you have a strategy that you’re going to put into place and it’s going to be okay. And that you trust them enough to let them know what’s going on and to reassure them it’s going to be okay.

CAVANAUGH: We could talk about this for another couple of hours but we have to end it now. I want to thank my guests so much, Dr. Stephen Sobel and Dr. Annette Conway, thank you both for talking to us and giving us your wisdom.

DR. SOBEL: Thank you very much.

DR. CONWAY: Thank you.

CAVANAUGH: And I want to let everyone know, the callers who called, I want to thank them, the people we couldn’t get to. Please do post your comments at KPBS.org/TheseDays. Now coming up, we’ll speak with a local poet and National Book Club Award nominee, Ray Armentrout. That’s next here on KPBS.