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Tuesday, March 24, 2015

The stress of money

APA’s latest Stress in America survey found that 72 percent of Americans reported feeling stressed about money at least some time in the prior month. In this episode, psychologist and researcher Linda Gallo, PhD, talks about how stress from finances and other sources can affect your health.
About the expert: Linda Gallo, PhD
Linda Gallo, PhDLinda Gallo, PhD, received her doctorate in clinical/health psychology from the University of Utah in 1998. After completing a postdoctoral fellowship in cardiovascular behavioral medicine at the University of Pittsburgh, she joined the faculty at San Diego State University in 2001. She is currently an associate professor of psychology, an adjunct associate professor in the Graduate School of Public Health and a co-director of the Institute for Behavioral and Community Health Studies.
Her research focuses on how stress and health are linked and the differences in how people from different ethnicities and socioeconomic backgrounds are affected by stress and other psychological conditions. She has published more than 60 peer-reviewed articles, books and book chapters
Audrey Hamilton: Money is a top cause of stress for many Americans. That's according to the latest Stress in America survey conducted by the American Psychological Association. Stress can negatively affect health and even contribute to chronic health problems such as diabetes and heart disease. In this episode, we talk with psychologist and researcher Linda Gallo about managing stress and how it affects people from different economic and ethnic backgrounds. I'm Audrey Hamilton and this is “Speaking of Psychology.”
Linda Gallo is a professor of psychology at San Diego State University. She is also co-director of the Institute for Behavioral and Community Health Studies, which promotes research aimed at making behavioral science applicable to medicine and health care. Dr. Gallo has extensively studied how stress and other psychological problems can lead to increased risk of chronic disease and she has helped develop a number of psychological interventions aimed at lowering disease risk in lower income populations. Thank you for joining us, Dr. Gallo.
Linda Gallo: Thank you very much for having me.
Audrey Hamilton: I think there are many people who are aware that stress can negatively affect our health, but what are some side effects of stress that people may not expect? You know, what sort of diseases can be aggravated or even caused by stress?
Linda Gallo: Well, humans are actually equipped to deal with stress and stress can be beneficial, at least initially, because it allows us to avoid danger and face challenges. But, stress becomes unhealthy when it is unrelenting and people do not experience opportunities to recover. So, in these cases stress can lead to physical problems, things like headaches and stomach aches and also mental health issues, such as anxiety, trouble sleeping.
And then over time, the toll of stress on the body accumulates and can contribute to chronic physical conditions, such as heart disease, diabetes and other illnesses.
And in addition, some conditions can be made worse by stress. For example, stress can exacerbate auto immune conditions like rheumatoid arthritis. And yeah, something else that people may not be aware of is that chronic stress can also affect our immune system in a way that makes us more vulnerable to acute viral illnesses like colds and the flu. But, it should more likely to get sick with those conditions than those under stress as well.
Audrey Hamilton: What's the difference between good stress and bad stress?
Linda Gallo: I think that bad stress is the kind that makes us distressed or upset. When those feelings continue over time, you know, that can be particularly detrimental to the body. Sometimes stress prepares us to face a challenge. And if we have the resources to meet that challenge, then it can be a positive thing but that sort of incites us to prepare and get ready for things like an important event or a meeting or things like that.
In those cases, it is OK. It is really the situations that are uncontrollable or that causes a lot of distress that end up being the most unhealthy for us.
Audrey Hamilton: Now APA's 2015 Stress in America survey tells us that money continues to be a top source of stress for Americans from all economic backgrounds. Now however, in this last survey, lower income households reported higher overall stress levels than those living in higher income households. Can you explain why we're seeing such a stress gap between lower and higher income families?
Linda Gallo: So, there are a number of factors that contribute to higher levels of stress in people with lower incomes. First, as we know from the Stress in America survey, financial stress is a very common cause of stress overall and it's more likely to occur if people have lower incomes. But, people with lower incomes may also experience exposure to stress across many other domains in their lives. They may work in jobs that are stressful because they are demanding but don't allow a lot of control or their work environment may be unhealthy. For example, they could have a lot of noise or exposure to toxins in their work environment. And they may also be exposed to more stressful community environments – community environments that have less green space, more traffic, crowding or even violence.
And then, the other component is that in addition to increased exposure to stress people with lower incomes often have fewer resources to cope with stresses that they face. So, this includes both tangible resources like health insurance, a savings account, a reliable source of transportation and also psychosocial resources such as a source of social support, in that sense of control over one's life and destiny. So those can cause stress to escalate and continue to create an unhealthy cycle.
Audrey Hamilton: And you mention this. How important is family and social support when it comes to managing stress?
Linda Gallo: So I think we all recognize that family can be both a critical source of support and well-being and also a source of stress for many people. And people with cohesive and supportive families tend to live healthier lifestyles and have better health than those who have less supportive families. But when there are problems in the family relationships or when a family member is having difficulties, this can be an important source of stress.
And in addition, as we were just saying, we know that having good social support, having someone to talk about problems with, people who can provide help or guidance is very important to health. And that support can come from family members or friends and also from other sources like formal support groups or religious organizations. Overall, social support is an important resource for coping with stress and it's also more generally important for maintaining good health and well-being.
Audrey Hamilton: Is this something that comes up pretty frequently in your research – looking at these factors that contribute to how people manage stress?
Linda Gallo: Absolutely. Yes and the point that I raised initially about family being both an important source of support and stress – this is something that people mention all of the time that they ask me what is the most relevant stressors or resources in your life – family comes up sort of in both of those questions.
Audrey Hamilton: Right. I can imagine. Both sides of the coin with that one.
Linda Gallo: Exactly.
Audrey Hamilton: Your research focuses on people from different ethnic backgrounds as well. Can you talk a little about what, if any, differences you found and how various ethnic groups experience and manage psychosocial health problems?
Linda Gallo: Well, a person's cultural background can influence the experience and expression of emotions in psychosocial health problems and also how they go about seeking help, the types of coping styles they have and how much stigma they may attach to having a mental health problem. In some cultural contexts it may be more socially acceptable to report physical health problems than mental health problems. So sometimes people from ethnic minority groups might report things like physical symptoms, such as stomach aches, headaches or pain when they're experiencing a lot of stress or depression. All of us have those symptoms arise when stress is high, but sometimes those might be the ones that are primarily reported in certain cultural groups.
And unfortunately, we know that psychosocial health problems are undertreated in general, but this is especially the case in diverse groups. Racial and ethnic disparities in mental health treatment are very well documented in the United States and ethnic minorities are also more likely to seek help for behavioral health problems in primary care settings and less likely to seek some in outpatient mental health care settings. So, it may be that the trend toward integrated care models where behavioral and physical health care are integrated but within the same context is a potential avenue to reduce disparities and improve care for diverse groups.
Audrey Hamilton: You think this is mainly related to stigma issues or just a lack of feeling of effectiveness?
Linda Gallo: Yes, I think there's a number of issues going on. So one of the stigma attached with having mental health problems – one is kind of preferences about what's most comfortable to talk about and the words people like to use to explain how they're feeling.
And in terms of healthcare seeking, part of it is stigma, there's a lot of access issues. Having access to good care and culturally appropriate access to care can be a challenge for many people. So there's a lot of different barriers that could interfere with help seeking, particularly for ethnically diverse groups.
Audrey Hamilton: So what would you recommend people do if they think their stress levels are out of control and you know, you can talk about this from different groups. I mean, we're talking about lower income or different ethnic backgrounds or just people who may be more apt to go out and get care, but what are some of the recommendations from psychologists as to what they can do to get their stress under control?
Linda Gallo: Well, if someone does feel overwhelmed by stress, they can definitely seek help from a psychologist or another mental health provider. In addition, they can stay in touch with people who can provide social support. So they can ask for help from family and friends or a community or religious organization. So whatever setting is most comfortable for them to seek support. And that's something obviously that anyone can do and as I was mentioning earlier, social support can be important in maintaining health at all times, not just when we're under stress.
And we also know that regular exercise is an excellent means of reducing or coping with stress. There's a lot of research showing that engaging in moderate activity for about 30 minutes a day can improve mood and, of course, we know that has many physical benefits as well. And walking can be ideal for a lot of people because it doesn't require any special equipment or gym memberships and it can be done with a friend of family member as well, which can also create social support or someone can join a walking group in their neighborhood. Things like that.
And since stress can really get in the way of activities like these, it's important to set aside time regularly for healthy and relaxing behaviors because I think, as we all know, we know it's good for us, we know it's healthy, but when stress arises often we let go of the behaviors that could help us deal with it most effectively.
Audrey Hamilton: Well Dr. Gallo, thank you so much for joining us. Appreciate you taking the time.
Linda Gallo: Thank you very much. It was a pleasure to talk with you, Audrey.
Audrey Hamilton: Find more tips on how to manage stress and read the complete Stress in America report on our website. With the American Psychological Association's “Speaking of Psychology” I'm Audrey Hamilton.

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