5 Pitfalls When Talking With Your Doctor About Stress

Chronic stress is often described as the cost of daily living in a world where you are juggling the responsibilities and obligations of work, caregiving, and running a household. It differs from acute stress, e.g., being verbally attacked by a stranger on the street, which requires our body to prepare to defend itself and go into “fight or flight” mode. And it differs from distress, e.g., thorny problems such as going through a divorce, dealing with an injury, or having financial problems that are hard to distract oneself from. Chronic stress lies in an uneasy no-man’s land between acute stress and distress. The positioning of chronic stress in this no-man’s land makes it the type of stress we tend to ignore or push down. But left uncontrolled, chronic stress affects your physical health. Indeed, it’s not uncommon for stress to show up in our medical complaints, with some data estimating that 60–80% of visits to a primary care provider may have a stress-related component.

Here Are 5 Common Pitfalls That Arise When Talking With Your Doctor About Your Stress

1. Even though stress is common, it is also an elusive condition and we currently have no clear-cut way to diagnose it. A thorough, stress-oriented, face-to-face medical visit remains the gold-standard way to diagnose stress and its effects. Stress is also a diagnosis of exclusion — meaning a clinician cannot assume someone’s daily headaches, insomnia, or difficulty concentrating is due to stress without taking a full history, doing a physical exam, and having some baseline lab data to inform their diagnosis.

2. Even when stress is accurately diagnosed, another problem is encountered. Many frontline clinicians don’t have a lot of time to listen to their patients. This is not their fault and there are plenty of healthcare professionals who are mad about this situation. Unfortunately, the way modern healthcare is practiced means providers are often kept busy with too many other things, and quality time listening to patients gets sacrificed in the process. But without listening to your unique story, any stress management advice you are given will probably be ineffective.

3. One side effect of not having sufficient time to listen is that healthcare providers can be too quick to pull out the prescription pad and write a prescription for an antidepressant to help with stress when that is not what is indicated.

4. Even if your primary care provider does offer you appropriate stress management counseling (typically, information intended to help patients reduce stress through exercise, biofeedback, yoga, etc.), it’s rare that you are asked about real-world barriers like lack of resources, social support, or excessive caregiving responsibilities that stop you from doing what you know you should do to manage your stress.

5. If you are lucky to have a practitioner who is afforded time to listen and attentive to helping you implement a stress management strategy, there is often a glaring omission in conversations about stress: and that’s the role systemic inequality and social injustice plays in stressing us out as individuals. Many times these conversations are avoided because healthcare professionals are simply not trained to have them.