International Stress Awareness Week – Expert Interview

Death. Moving. Separation or Divorce. Job Loss. Long-term Illness.

Considering the top stressors in life, it is hard to fathom that stress can ever be a good thing. But a certain amount of stress actually helps us get things done, compete, perform, and stay safe. For example, being nervous before a track meet or a job interview is good stress—the kind that makes you do your best. And the time you outran your neighbor’s pitbull? Good stress, too.

But when stress becomes chronic, as it can from a traumatic event or when life challenges are ongoing, this is when the danger arises.

While studies have shown that short-term stress boosts the immune system, chronic stress has the opposite effect, suppressing the immune system and placing us at risk for a host of physical and psychological disorders.

International Stress Awareness Week, hosted by the International Stress Management Association (UK), is November 7-11, 2022. To mark this event and shed light on this ever more important concern, Dr. Josh Briley generously lent his time to speak with us about the function of stress in our lives, treatment for stress disorders, and preventive measures to stay healthy in the midst of what life brings our way.

Meet the Expert: Josh Briley, PhD

Dr. Josh Briley is a licensed psychologist. He earned his doctorate in 2003 from the University of North Texas and worked in direct patient care until 2019.

In addition to operating a private practice, Dr. Briley spent many years working with veterans through the US Bureau of Veteran Affairs and inmates through the Federal Bureau of Prisons.

Dr. Briley is now the clinical education director for Electromedical Products International (EPI), a company that manufactures and distributes Alpha-Stim devices to treat anxiety, insomnia, depression, and pain. He is a fellow of the American Institute of Stress (AIS) and a member of the organization’s Daily Life and Workplace Stress Board.

Interview with Dr. Josh Briley

The following interview from 2022 has been lightly edited for length and clarity.

[] Would you like to talk about your work with the AIS and how you got involved with the organization?

[Dr. Josh Briley] Yes, the American Institute of Stress is committed to helping to educate people on the different types of stress, different stress management techniques, and researching stress.

The company I work for, Electromedical Products International Inc., is affiliated with AIS. So that’s how I got involved. I wrote a couple of articles. They’ve got quarterly magazines that are available for free on their website for anybody who would like to read them. And then with my credentials, I became a fellow with the organization, and now I sit on one of their boards.

[] Could you talk a little bit about the difference between healthy levels of stress and unhealthy levels of stress?

[Dr. Josh Briley] That’s actually a really good question because these days, most people don’t realize that there is such a thing as a healthy level of stress.

Without some level of stress, we don’t perform at our best. Like the butterflies you would get before taking a test, or if you’re an athlete, the anxiety you get before a performance. That releases adrenaline and gets your body ready to perform, and actually enhances your performance.

So you need stress to a certain level. It becomes unhealthy when the stress rises to a point that is actually detrimental to your performance. Your body can’t handle the amount of stress that you have, and so instead of enhancing your ability to perform, it actually inhibits it.

We see this in first responders—somebody who’s trained to know how to handle crisis situations—and the stress actually helps them. But if the stress feels too much to where they enter what we call the “red zone,” then they feel overwhelmed by the stress, and they may freeze up, or they may not make 100 percent the right decision.

There is a very definite level, and it’s a little bit different for everybody, depending on the stress management techniques, coping skills, and all that, but there definitely is a point where the stress stops being productive, and it starts becoming detrimental.

[] What are the signs that a person is experiencing an unhealthy stress level? 

[Dr. Josh Briley] Some indications that the stress is becoming unhealthy is when it begins to negatively impact your daily functioning. If you’re not able to relax, it is usually an early sign of stress.

For healthy stress, you have the stress response to the situation, and when the situation is over, you’re able to kind of relax, regroup, and then get ready for the stressful situation because there’s always something that’s coming at us. With an unhealthy level of stress, you stay keyed up, so you’re not able to relax naturally.

You may start to use substances to help calm down—alcohol or some other substance. You may find that you’re having difficulty sleeping. Either you can’t fall asleep or you can’t stay asleep because your mind is always racing. You’re always worrying about the next—what’s gonna happen or how you will get everything done.

Your appetite can be affected, and also, you may find that you’re sleeping too much. People can have either reaction, or they can have both. Some days they can’t sleep, and then some days, they sleep too much as a way to try to avoid the stressor.

And the same thing with appetite. Sometimes when you feel stressed, you don’t have an appetite at all. And then sometimes there’s emotional eating, where you can’t stop eating. Both of those can be a sign of unhealthy levels of stress.

If you find that you’re either withdrawing from friends and family, or every time you’re around someone, you just seem to be obsessed with talking about your problems and your issues…

Don’t get me wrong: it’s healthy, to an extent, to get your frustrations out, but if that’s all you’re doing, constantly, that’s a sign that you’re overstressed.

[] So when people are under an unhealthy level of stress for a prolonged period of time, a stress disorder can develop from there, is that correct? 

[Dr. Josh Briley] Yes. A stress disorder can come from one of two ways. One, you are just chronically under too much stress, and so you develop the stress disorder, or it could be one big overwhelming stressor that could contribute to an acute stress disorder.

Basically, a stress disorder can occur anytime our natural ability to cope with stress is significantly diminished and we just can’t cope anymore. Stress disorders develop from either situation, so chronically feeling overwhelmed and unable to handle what’s going on or having a lot of stressors going on for a long time. Or one big stressor, like I just had a friend who had a car wreck. Something like that could develop into an acute stress disorder.

[] When you say “acute stress disorder,” is that a general category? 

[Dr. Josh Briley] With the latest diagnostic manual for mental health, there is a category called “trauma and stress-related disorders.” It’s where post-traumatic stress disorder has been placed.

Acute stress disorder is what we call the set of symptoms—that difficulty coping within the first 30 days of the development of the disorder. Once it gets beyond 30 days, then it becomes post-traumatic stress disorder. Other stress disorders are what we call “adjustment disorders.” Those can be with depression, with anxiety, or with a mix of depression and anxiety. There’s a whole category of them now.

For example, if there’s some big change that happens, and it could be a good change—maybe you get married and move in with your new spouse—but that’s always an adjustment, and if that adjustment is not healthy, it’s overwhelmingly stressful, then you can be diagnosed with an adjustment disorder. And that adjustment disorder can be predominantly with depression, predominantly with anxiety, or with both.

Post-traumatic stress disorder does often have anxiety, depression, and sleep disorders—all of that bundled in as part of the diagnosis.

[] What treatment options exist for stress disorders?

[Dr. Josh Briley] There’s a wide range of things you can do. When I’m working with somebody, I find it always helpful to help them understand what’s going on. So we do an evaluation, and you don’t have to see a professional for this. You can look at your own life and figure out what’s going on. There are assessments available that you can take to kind of figure out how you respond to stress or what kinds of things trigger stress. The AIS website has a couple of different stress assessments that you can take that would give you this information. In fact, even our president recently took one just to see how it was, and he was surprised at the results; what he always thought was one of his strengths, one of the good things about him, actually turned out to be a stress response.

Having worked with the man for a while, I was not at all surprised. Don’t get me wrong. I love the man to death—Dr. Kirsch is amazing. He’s the president of AIS. He’s also the man who invented alpha-stim, the device that my company makes. He’s an absolutely amazing man, and he’s got a huge passion to help people live their best life. And so that’s why he and I clicked because I share the same passion: helping people, not just giving them a bandaid.

But again, you can’t fix a problem if you don’t understand it, so you need to examine what’s going on….

Then, just like anything else, you have to find appropriate ways to respond. If you can’t calm down, naturally, for example, then you need to start practicing ways to calm down—meditation, relaxation exercise, yoga—something to bring you in the moment, and let your nervous system, and your body calm down.

And again, here, AIS has podcasts every week that can give you some techniques. These magazines that we publish, Contentment and Combat Stress, have articles on how to cope with these stressors. We just did one that focused on movement at Contentment magazine was all about using movement to help cope with stress. And we’re about to publish one on different technologies you can use to help with stress. There are apps you can use to help. There’s books you can read. The alpha-stim is a great way to balance your nervous system and help you feel calm and relaxed.

And then, if those are working, find someone to talk to. Find a therapist or a clergy member that you trust. Sometimes you just need that outside perspective to help you see things clearly. I’ve seen that numerous times when we get overwhelmed and stressed out, we get tunnel vision when we don’t see the forest for trees. Sometimes all it takes is somebody you trust going, “Look at it from this angle” or “Try this.” And it may seem like an obvious solution to them, but you couldn’t see it because of that tunnel vision.

For me, medication is always the last resort, but if you have developed a stress disorder, talk to your doctor. See if some medications, at least for the short term, can be helpful. The way I like to use medications when I’m working with somebody, I can’t prescribe, so I have to refer them to their prescriber, but I like them for the short term.

Get your emotions stabilized, get you sleeping well, and get it to where your emotions aren’t all over the map, and then we can work on the root of the problem and help you find better ways to cope with things. Then, down the road, you can hopefully come off your medications.

[] Are there preventative measures you advise people to take, knowing that life is stressful, that people can then employ during times of acute stress? 

[Dr. Josh Briley] Absolutely. The initial skills and techniques I talked about for how to treat a stress disorder can also be preventative. What I like to point out is just like any other skill, you have to practice it to become proficient at it. So get in the habit of doing self-care.

Everybody has different things that relax them. Most meditation apps drive me absolutely nuts. They cause me more stress. But I use them heavily with patients because they work for most people. Going for a run is incredibly relaxing for me, or it is when I’m in shape, anyway.

Exercise is a great stress reliever. Stress builds up energy in your body, and exercise is a good, productive way to use that energy, so that it’s not just sitting there and causing the muscle tension, stomach problems, and racing thoughts. A ten-minute walk, a five-minute walk, a few times a day. Taking a break. Going to get a drink of water and taking a few deep breaths on the way can be a great way to increase your ability to cope with stress.

And to the best of your ability, make sure you’re sleeping well at night, and make sure your diet is appropriate. Unfortunately, most Americans eat stuff that is not good for us. Fast food, Fried [foods], all that stuff. It doesn’t feed our bodies. It doesn’t help cleanse our bodies from toxins. it doesn’t help our bodies function at their peak level, whereas if you make a few tweaks to your diet to where you’re eating healthier, your body is able to handle a lot more, and you’ll actually find you sleep better.

[] It’s really interesting. As a society, we tend to associate eating well with our physical health, less so with our mental health.

[Dr. Josh Briley] Right, but it is absolutely important for your mental health. If you have a cold, most of the time, you feel very depressed because the two are connected. When you feel anxious and worked up, your stomach gets flutters and your muscles get tight. It’s all connected, and so if you’re only doing one without the other, you’re not taking care of all of you.

[] Is there anything else you’d like to add that I haven’t asked that you feel would be important for readers to know?

[Dr. Josh Briley] Taking small steps is key to self-care and building stress resilience. Too many times, we make a decision, “Okay, I’m gonna take care of myself. I’m going to meditate.” And you try to meditate for 30 minutes, and you give up after two because you don’t have the skills. Or you say, “I’m going to work out.” So you go hit the gym for a full hour, and then you can’t move for the rest of the day.

That actually causes more stress, trying to go overboard, so start slowly. Look at your life. What can you more easily change? Make those changes and let yourself build on those as you go. And add new things to it as you go. It’s a longer process, but it works.

[] I love that. I think that’s really helpful in a culture that has this kind of “Go big or go home” attitude.

[Dr. Josh Briley] Right. American culture is “more is better,” and it’s almost never that more is better.

Resources for International Stress Awareness Week

The American Institute of Stress (AIS): AIS is a non-profit corporation that offers a host of publications, tools, and resources to educate the public on stress, stress management, self-care, and mental wellness. The online learning center has a variety of free products, including video lectures, classes, essays, articles, and interviews.

Sources of Stress by Generation: This AIS webpage ranks the top sources of stress for Gen Z, Millennials, and Gen X versus Baby Boomers and older adults.

International Stress Management Association (ISMA UK): ISMA has been hosting International Stress Awareness Week since 2018. They also provide a certificate course in stress management and a coaching program, in addition to member benefits like discounts on health insurance, monthly master classes, and professional peer networking opportunities.

International Stress Awareness Week: Find out more about how ISMA UK is promoting this event and how to get involved.

Cevia Yellin By Cevia Yellin
Cevia Yellin is a freelance writer based in Eugene, Oregon. She studied English and French literature as an undergraduate. After serving two years as an AmeriCorps volunteer, she earned her master of arts in teaching English to speakers of other languages. Cevia’s travels and experiences working with students of diverse linguistic and cultural backgrounds have contributed to her interest in the forces that shape identity. She grew up on the edge of Philadelphia, where her mom still lives in her childhood home.