Recognizing the Signs When You're Under Too Much Stress

It might seem unusual to pose the question of how to know when you're under too much stress. After all, many people instantly recognize the symptoms and frequently complain about feeling frazzled.

However, as a licensed NYC psychotherapist with over 25 years of experience, I often see clients who are completely unaware of how severe their stress levels have become.

Chronic stress often hides behind a mask of daily busyness until our bodies force us to stop and rest

Why Don't People Realize They are Experiencing Chronic Stress?

People who have endured acute stress or developmental trauma during childhood often do not recognize when their adult stress levels are too high. Because they became accustomed to a baseline of survival and chaos early in life, an elevated stress response feels entirely "normal" to them.

They don't recognize it as an unhealthy or dangerous state. However, enduring acute stress on a long-term basis can have severe negative medical and psychological consequences. Chronic stress has a way of quietly creeping up on you, gradually wearing down your nervous system without you even realizing it.

The Physical Warning Signs of High Stress Levels

One of the most effective ways to identify an unhealthy level of chronic stress is to observe your somatic responses. When you are emotionally overwhelmed, your body will often send out warning signals before your mind consciously registers the anxiety.

• Sleep and Energy Disruptions: Experiencing persistent insomnia, frequent nightmares, feeling tired most of the time, and experiencing low energy even after resting.
• Tension and Physical Pain: Chronic muscle tension, shoulder and back pain, muscle spasms, a clenched jaw, and grinding your teeth at night (bruxism).
• Gastrointestinal and Cardiovascular Distress: An upset stomach, nausea, constipation, diarrhea, or flares of Irritable Bowel Syndrome (IBS). You may also notice a rapid heartbeat, high blood pressure, difficulty breathing, or chest pain.
• Nervous Habits: Fidgeting, pacing back and forth, nail-biting, dry mouth, difficulty swallowing, or cold, sweaty hands and feet.

• Changes in Intimacy: A noticeably low libido and sudden problems with sexual performance.

The Psychological and Emotional Symptoms of Overwhelm

When stress exhausts your cognitive and emotional reserves, it fundamentally alters how you think, feel, and interact with the world around you.

• Mood Dysregulation: Feeling persistently agitated, frustrated, moody, losing your temper easily, and snapping at loved ones.
• Cognitive Fatigue: Experiencing racing thoughts, persistent worrying, being exceptionally forgetful, and having severe problems focusing on daily tasks.
• Social Isolation: Finding it difficult to relax or quiet the mind, isolating and avoiding others, and feeling less pleasure in socializing or engaging in hobbies you once loved.
• Emotional Vulnerability: Feeling easily overwhelmed, hopeless, helpless, pessimistic, or experiencing a dip into low self-esteem and depression.
• Maladaptive Coping: Relying on or abusing alcohol or drugs to artificially numb the nervous system.

Note: Many of these physical and psychological signs can also involve underlying medical conditions. When in doubt, it is essential to check with your primary care medical doctor to rule out organic causes.

Holistic Lifestyle Changes for Sustainable Stress Management

If you are recognizing these warning signs in your own life, there are proactive lifestyle modifications you can implement immediately to regulate your nervous system.

To explore specific self-care and mindfulness tools, you can read my comprehensive guides on Stress Management: Taking Time For Self Care and Managing Your Stress: Workplace Burnout. 

Dedicating time to Self Reflection and Basic Mindfulness can help you reconnect with your body's signals before they turn into chronic pain.

When you feel an acute spike in anxiety, utilizing somatic techniques like Square Breathing can instantly soothe your nervous system. 

Additionally, examining the Mind-Body Connection: Can Yoga Improve Your Mood?.  

Also, using therapeutic tools like Journal Writing to Relieve Stress and Anxiety are proven strategies to release trapped emotional tension.

When to Seek Professional Psychotherapy in NYC

A certain amount of healthy stress is a natural part of living. However, if your medical doctor has ruled out underlying physical issues and you have tried making healthy lifestyle adjustments but still feel entirely consumed by overwhelm, you could benefit deeply from professional clinical support.

A skilled mental health professional can help you uncover the root causes of your stress response. If you are ready to explore your options, you can read my advice on The Benefits of Attending Psychotherapy and How to Choose a Psychotherapist. 

Embracing specialized therapeutic support can make all the difference in restoring your peace of mind and overall quality of life.

About Josephine Ferraro, LCSW

 I am a licensed New York City psychotherapist, hypnotherapist, and specialist in EMDR, AEDP, IFS, Emotionally Focused Therapy for Couples and Somatic Experiencing. 

With over 25 years of experience, I help individual adults and couples get to the root of chronic stress, anxiety, and trauma to restore long-term well-being.

I offer a complimentary 15 phone call before setting up an appointment.

Connect With Me:

• Website: Josephine Ferraro, LCSW - NYC Psychotherapist
• Phone: 📞 9177422624 (Tap to Call)
• Email: ✉️  josephineferraro@iCloud.com
• Location: Greenwich Village, New York 10011

Tips on How to Improve Your Sleep

Good sleep is essential to your health, mental health and overall well being.  

How to Improve Your Sleep

Generally, adults need 7-9 hours of sleep per night.  If you're getting less than that, you might have insomnia.

What is Insomnia?

Insomnia is a sleep-wake disorder which has three primary symptoms:

• Problems Falling Asleep (Onset Insomnia): An inability to fall asleep within 20-30 minutes

Problems Falling and Staying Asleep

• Problems Staying Asleep (Middle Insomnia): Frequent waking up in the middle of the night after sleep onset, which is more than 20-30 minutes, and difficulty falling back asleep after middle of the night awakening

• Early Morning Wakefulness (Late Insomnia): Waking up 30 minutes or more before the desired wake up time and before 6.5 hours of sleep. This often involves an inability to fall back to sleep.

A medical doctor will usually give a diagnosis of insomnia if a patient experiences sleep problems for three nights or more over a period of three months and no other condition is causing the sleep problem.  

There are also two different types of insomnia: 

• Short term insomnia: Lasting at least one month but less than three months

• Chronic insomnia: 
• Persistent insomnia: Lasting three months or longer
• Recurrent insomnia: Two or more episodes within a year

Common Causes of Insomnia

There can be many cases of insomnia, including:

• Anxiety
• Stress (see my article: Are You Experiencing Chronic Stress?)
• Depression
  
• Uncomfortable sleeping conditions (bed, temperature, light)
• Noise
• Drug use
• Alcohol use
• Caffeine
• Nicotine
• Irregular work shifts

Helpful Tips to Overcome Sleep Problems

See your medical doctor to get a diagnosis and rule out any other medical issues that could be causing a sleep problem.

There are also other things you can do on your own (always check with your medical doctor first before):

• Exercise: Daily physical activity at an appropriate level for you can release endorphins, which is good for your overall health and can help to improve your sleep.

Tips to Overcome Sleep Problems

• Practice Sleep Hygiene: Good sleep hygiene habits can help with insomnia, including:

• Wake up and go to sleep at the same time, even on weekends

• Make sure the room where you sleep is quiet, dark, relaxing and at a comfortable temperature

• Remove electronic devices from the bedroom, including the TV, smart phone, computer and other electronic devices

• Limit Napping: If you tend to nap during the day, limit it to 30 minutes or less and don't nap later in the afternoon.
• 
  
• Use Your Bed Only For Sleep and Sex: Don't do work while you're in bed. You want your bed to be associated only with sleep and sex. 

• Eat a Healthy Diet: Eat nutritious meals. Avoid alcohol close to bedtime and limit caffeine

Get Help in Therapy

If you doctor has ruled out medical causes and attributes your sleep problem to psychological issues, like anxiety, depression, unresolved trauma or other psychological issues, seek help from a licensed mental health professional.

Get Help in Therapy

Once medical issues have been ruled out, a skilled psychotherapist can help you to determine the underlying issues that are creating sleep problems and help you to work through these issues.

So, rather than struggling on your own, seek help from your medical doctor and, if the problem is related to mental health issues, seek help from a licensed psychotherapist.

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing and Sex Therapist.

I have helped many individual adults and couples to overcome mental health issues (see my article: What is a Trauma Therapist?).

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Self Help Tips For Coping With Anxiety

Experiencing occasional anxiety is common.  At any given time at least 30% of people experience anxiety.  In this article, I'm focusing on self help tips you can use for anxiety relief (see my articles:  What is the Difference Between Fear and Anxiety? , Coping with Anticipatory Anxiety and Tips to Cope With Chronic Worrying).

Coping With Anxiety

Common Symptoms of Anxiety

Let's start by defining some of the symptoms of anxiety:

• Feeling nervous, restless or tense
• Having a sense of impending danger, panic or doom
• Having problems concentrating on anything other than your present worry
• Wanting to avoid anything that triggers your worry
• Having an increased heart rate
• Having problems sleeping (either falling or staying asleep)
• Trembling
• Sweating
• Breathing rapidly (hyperventilation)
• Having gastrointestinal (GI) problems

Common Forms of Anxiety

Here are some common forms of anxiety:

• Generalized Anxiety

• Panic Attacks (see my article: Tips on Coping With Panic Attacks)

• Posttraumatic Stress Disorder (see my article: Reacting to the Present Based on Your Past and Experiential Therapy, Like EMDR, Can Achieve Emotional Breakthroughs)

• Social Anxiety (see my article: Overcoming Social Anxiety)

• Adult Separation Anxiety (see my article: Overcoming Adult Separation Anxiety)

• Agoraphobia

• Phobias (see my article:What Are Phobias?)

Self Help Tips For Coping With Anxiety

If you experience occasional anxiety, which isn't causing significant problems in your life, here are some self help tips.

• Start Your Day With a Sense of Well Being: How you start your day can set the tone for the rest of your day and make a big difference in how you feel (see my article: Tips For Starting Your Morning With a Sense of Well Being and The Power of Creating Personal Rituals).

• Keep Physically Active: Whether you walk, dance, work out at the gym or engage in other healthy physical activity, keeping physical can be a powerful stress reliever.  Develop a physical routine for yourself that takes into account your ability to be active in a healthy way.  Consult with your doctor before making any significant changes to your physical activity.

• Use Stress Management and Relaxation Techniques: Meditation, visualization, yoga and other forms of stress management can help reduce anxiety (see my articles: Stress Management: Finding Moments of Peace and Relaxation,  Stress Management and Self Care, Mindfulness Meditation, Safe Place Meditation and Creating Quiet Times For Yourself).

• Remember to Breathe: When you're anxious, you might breathe in a shallow way, which can increase anxiety.  So you could benefit from being aware of your breathing and using relaxing breathing techniques (see my article: Square Breathing).

• Make Sleep a Priority: Most people need 7-8 hours of sleep per night (see my articles: Tips For Better Sleep and Conquering Your Nightmares).

• Spend Time in Nature: Spending time in green places can help relieve stress and anxiety (see my article: Walking in Nature Can Improve Your Mood).

• Eat a Balanced Diet: A balanced diet incorporates fruits, vegetables, whole grains and proteins.  Always consult with your doctor before changing your diet.

• Reduce or Avoid Alcohol: The stimulative effect of alcohol can increase anxiety, so be aware of how much you're drinking (see my articles: Overcoming the Temptation to Use "Liquid Courage" to Cope With Social Situations).

• Avoid Recreational Drugs: Certain recreational drugs can increase anxiety, including cannabis.  

• Cut Back or Eliminate Caffeinated Beverages: Caffeine can make anxiety worse, so be aware of your caffeine intake and take steps to either reduce or eliminate caffeinated beverages.

• Quit Smoking: Nicotine can make anxiety worse so take steps to stop smoking (see my article: Becoming a Successful Nonsmoker)

• Keep a Journal: Keeping a personal journal can help you to become aware of what's causing you anxiety and what helps to reduce your anxiety (see my article: Journal Writing Can Reduce Stress and Anxiety).

• Identify Your Triggers: Along with keeping a journal, being able to identify your triggers can help you to deal with your anxiety (see my article: Coping With Triggers).

• Get Emotional Support: Instead of isolating, stay social and get emotional support from trusted friends, family and a significant other (see my article: Overcoming Your Discomfort With Asking For Emotional Support).

When Self Help Isn't Enough

The suggestions above can help to reduce anxiety, but when you're experiencing persistent anxiety self help might not be enough.  

In my next article, I'll discuss how psychotherapy can help you to overcome anxiety (see my article: Getting Help in Therapy For Anxiety).

Getting Help in Therapy

Anxiety can reduce the quality of your life and overall sense of well-being.

If anxiety is a persistent problem, seek help from a licensed mental health professional.

Getting help in psychotherapy for your anxiety can improve the quality of life for you and for your loved ones who might be affected by your anxiety, so don't hesitate to seek help (see my article: Your Anxiety or Depression Could Be Having a Negative Impact on Your Loved Ones).

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT and Somatic Experiencing therapist.

I work with individual adults and couples.

I have helped many clients to overcome persistent anxiety.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Common Nightmares During the COVID-19 Global Pandemic

Have you been having nightmares lately? If so, you're not alone. Pandemic nightmares have been common during this COVID-19 pandemic.  Regardless of age, sex, gender, sexual orientation, or nationality, many people have been having pandemic nightmares, which is the subject of this article (see my articles: How to Overcome Anxiety Dreams).

Common Nightmares During the COVID-19 Global Pandemic

These nightmares are so common that Robert Bosnak, a Jungian analyst in Santa Barbara California, has been offering a free online workshop on Friday nights at 6 PM (PST) during the pandemic called the Spooky Dreams Cafe where he uses Embodied Imagination, a method of dreamwork which he developed, to help some people on the Zoom call with these nightmares (see my article: Dream Incubation: Planting Seeds).

Many people, who lived through the crisis of the 9/11 World Trade Center attack, have reported in therapy that they're having similar nightmares during this time to the ones they had in 2001 and beyond (see my article: Tips For Getting Better Sleep).

Common Themes in Pandemic Nightmares
There are certain themes that are common in these COVID-related nightmares, including (but not limited to):

• Anxiety-related events or circumstances in the dream
• Places, which were once known and familiar, suddenly looking and feeling unfamiliar in the nightmare
• A need to escape or run
• Feeling trapped, helpless and/or lost
• A regression to an earlier age (e.g., an adult dreaming that they're a child again)
• Losing someone or something
• Phones and other gadgets malfunctioning
• Other sudden and inexplicable changes 

Typical Nightmares During the COVID-19 Global Pandemic
The following dreams are typical of the type of dreams people have been having during this COVID-19 crisis (as told to me by friends and used with permission):

Dream 1:
I'm in a classroom, which is taking place in my apartment. The instructor, whom I like, is taking things out of my dresser drawer to show the class. These items include a silk scarf I haven't seen in many years.  At one point, he breaks apart the wooden dresser drawer, and I'm fascinated by this (it seems like a deconstruction of some sort). Then, I notice that there's a similar dresser in the room that remains in tact.  I leave the room to go to the rest room, and when I come back, my laptop is gone. Somehow, I know that the instructor gave it away to one of my classmates, and I'm annoyed that he did this without my permission. I look around for it, but I can't find it. I see a male friend, who is sitting in a far off corner of the room. Then, suddenly, the scene changes: I'm walking around in an area of my neighborhood, not far from my home, where I've been many times before. I know that this place is familiar to me, but it looks and feels eerily unfamiliar.  I know I need to get back to class, but I don't know which way to go because I'm lost.  Then, I see a cab and get in it.  There's a couple, who are on their way home from the airport, who are already in the cab.  I don't know where to tell the cab driver to go because I'm lost, but I'm relieved to be in the cab.  The cab stops because the couple have arrived outside their home. I get out too because I realize it's useless to be in the cab if I don't know where I'm going.  The couple tell me that I have to pay thousands of dollars to them for the short distance that I went with them, and I get angry and tell them that I won't pay.  I know that my male friend is back in the class, he has his car and he would come get me if I call him, but I don't know where I am, so I can't tell him. The scene changes: I'm sitting at an outdoor bar with this same friend and our classmates.  We're all dressed up. I suddenly realize that I forgot that he's much taller than me.  I tell my friend about what just happened (that I was lost) and he's surprised and laughs. I'm feeling much better.  The outdoor bar is up on a bridge that overlooks people's homes down below. These people have shallow outdoor pools in front of their homes.  I tell my friend that we could do that too (we could each have outdoor pools).  Then, as I'm gazing out at the water from the bridge, I tell my friend, "Let's pretend that we're on the Arno Bridge in Florence" and he agrees.

Dream 2:
I'm a child of 7 or 8 years old. My mother tells me that we have to escape from where we're living to move back to the US.  Only a few close relatives know because it's a secret.  My mother doesn't want her husband, my stepfather, to know that we're running away because he's abusive and we're escaping from him.  I grab whatever I can quickly because we have to get to the airport fast, and I kiss my relatives goodbye.  I don't have time to say goodbye to a male friend, who has been good to me (I'm older in this part of the dream).  So, I try to text him to tell him that I had to leave due to an emergency, but my phone won't work. I know he's going to be hurt that I left suddenly without an explanation, and I feel terrible about this. Then, my mother, brother and I run to the airport to get on a rescue flight that's been arranged for us by the US government to bring us back to the states. Somehow, I get separated from my mother and brother (I'm a young child again in this part of the dream). I don't know which way to go. I'm scared and I call out to my mother, but I don't see her anywhere. Nothing looks or feels familiar, even though I know I've been to this area many times before. I see other people who are also running and I ask them the way to the airport because I'm lost.  They point the way and I run all the way to the airport. Once I get there, I realize I don't have a plane ticket. I call out to my mother again saying that I don't have a plane ticket.  Even though she's still nowhere to be found, a reassuring male voice tells me over the airport public address system that I don't need a plane ticket because this is a special government rescue flight for my family to escape. When I get to security, I realize that I'm not wearing a face mask so I'm not going to be allowed on the flight. I see everyone else around me wearing a face mask, and I look around to see if there's somewhere I can buy as mask (I'm older again in this part of the dream). Then, I realize that I do have a mask, but I've been wearing it on my chin, so I pull it over to cover my nose and mouth.  When I arrive at the gate, I still don't see my mother or brother, but I feel a little calmer because I know I'm going to make the flight and I'll escape from this place.  Somehow, I see the long document that my mother had to fill out to get approval from the government for this rescue flight. I feel badly that I didn't know before about the abuse that my mother endured at the hands of my stepfather.  While I'm waiting for the flight at the gate, I try to text my male friend again. I desperately want to reach him so he won't feel abandoned by me, but my phone still doesn't work. I feel sad that he's going to feel sad and abandoned.

A Word About These Nightmares
I'm going to deconstruct these nightmares and discuss how to work with nightmares in my next article but, for now, suffice it to say that both of these dreams have many typical features of anxiety dreams and, specifically, many elements typical of current pandemic nightmares (outlined above at the beginning of this article).

Getting Help in Therapy
Nightmares during times of crisis are often a way for the unconscious mind to work through difficult emotions and reconsolidate traumatic memories.

In addition, these nightmares sometimes reveal underlying unresolved trauma (see my article: Before and After Psychological Trauma).

If you've been having nightmares during this global pandemic, you're not alone.

An experienced psychotherapist, who helps clients during times of crisis and who works with dreams, can help you to understand and heal from nightmares.

Rather than suffering on your own, take the first step by calling a licensed psychotherapist for help.  Being able to work through your fears and nightmares can provide you with relief and allow you to feel more empowered.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR, AEDP, EFT and Somatic Experiencing therapist (see my article: The Therapeutic Benefits of Integrative Therapy).

I work with individual adults and couples.

One of my specialties is helping clients to overcome unresolved trauma.

During the global pandemic, like most psychotherapists, I'm providing online therapy, which is also known as teletherapy and telehealth (see my article: The Advantages of Online Therapy When You Can't See Your Therapist in Person).

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.