Seminar on Living Abroad and Stress Management

April 25, 2004

 

Japanese Americans’ Care Fund invited Dr. Jun Shigemura to give a seminar on managing stress related to living abroad on Sunday April 25, 2004.  Twenty-three people attended the seminar that took place in a conference room at Fred M. Packard Center where the Care Fund’s office is located.  Dr. Shigemura is a faculty staff at the Department of Psychiatry, National Defense Medical College and currently is a visiting researcher in the Department of Psychiatry at Uniformed Services University of the Health Sciences in Bethesda, MD.  His PowerPoint presentation defined and gave examples of what is “stress”, what happens when we have too much stress, what kinds of stress we have from living abroad, and how to deal with stress.  Please find below a brief summary of his presentation.

 

  1. Why do we need special care while living abroad?

 

We cannot completely avoid having stress wherever we live.  However, if you live in the United States, away from your family, friends, and culture, it is almost natural to have stress.  When you are in need of counseling in the United States, it may be difficult to express your feelings and subtle cultural differences in English.  Furthermore, there is a limited number of Japanese-speaking mental health specialists in the Washington Metropolitan area.  Therefore, it is imperative to manage and reduce your stress level on your own.

 

  1. What is “stress”?

 

We use “stress” casually in our daily life, but not many people know what “stress” actually is.  We tend to think that if our stress level is low, we are healthier.  However, neither too much nor too little stress is good.  In fact, an appropriate level of stress is needed for having a productive and healthy life.  Moreover, happy events such as a marriage, the birth of a child, and relocation can cause stress.

 

3.  What happens when you have too much stress? (general)

 

We need a certain level of stress to function well, but too much stress can cause mental and physical problems (Table 1).  When we try to self medicate with alcohol, tobacco, or drugs, we can become dysfunctional.  Moreover, too much stress can lead to mental disorders such as depression as well as to serious strains on marital or family relationships.  Once mental disorders are developed, it becomes difficult to self-manage and requires interventions from mental health professionals.

 

Table 1.  Stress-Related Symptoms

 

Fatigue (both physical and mental)

Diminished interests in pleasure

Diminished feeling of satisfaction

Loss of productivity

Inability to solve problems

Diminished ability to concentrate

 

Feeling anxious

Irritable mood

Feeling down

Isolation from others

Being cynical

Being suspicious

Paranoid

 

  1. What happens when children have too much stress?

 

Stress is not limited to adults.  Children can also accumulate too much stress.  However, children may not be able to express their feelings in words and as a result, symptoms can often manifest themselves in physical illness and behavioral changes (Table 2).  They may try to reduce their anxiety by clinging to parents and regressing to babyish behaviors.

 

Table 2.  Stress-Related Symptoms for Children

 

Mood Change

·        Irritable mood

·        Easy to get angry

·        Low level of energy

·        Excessive energy

Physical Symptoms

·        Stomachache, diarrhea

·        Insomnia

·        Headache

·        Frequent need to go to toilet

·        Bed-wetting

Behavioral Change

·        Diminished ability to concentrate and pay attention

·        Lower grades

·        Refusal to go to school

·        Risky behaviors

·        Regression (clinging to parents, babyish expressions, etc.)

 

  1. Traumatic Stress

 

When you are exposed to an extreme traumatic stressor, you may suffer from posttraumatic stress disorder (PTSD).  Traumatic events include natural disasters (earthquakes, typhoon, etc.), crimes, accidents, wars, and terrorist attacks.  Closer to home, domestic violence, child abuse, death of loved ones, and serious illness such as cancer can also constitute traumatic stressors.  Even if you do not directly experience trauma, you may suffer from PTSD by witnessing or learning about others’ traumatic experience.  Providing support and understanding towards  PTSD sufferers can help them recover, while a small criticism can deepen their wounds caused by trauma. 

 

  1. Stress Stemming from Living in the United States

 

Stress from living in the United States can start even before you leave Japan.  The level of stress depends on the purpose of your move, your motivation, and the stability of your living conditions.  You may become anxious if you cannot get enough information in preparation for your move.

 

Once you move to the United States, you will face both qualitative and quantitative differences at work, at home, or at school. For example, in American work places, you may encounter colleagues of different nationalities and work style, but language barriers and cultural differences may hinder communications. 

 

Your relationship with your family and friends may change as well.  If you move to the United States to accompany your spouse, you may have to resign from your job or change your job.  Stress may be caused by problems related to health, child care, and education as American systems are very different from Japanese systems.  Your relationship with friends in the Japanese community can be tricky because the community is small. 

 

  1. How to Manage Stress

 

The first step in stress management is ‘to recognize that it is normal to feel stressed when living in the United States’.  The second step is to find out what is causing the stress, and finally, to manage the stress and find solutions.  Simply put, managing stress means asking yourself, “Can I reduce my stress level?”  If the answer is YES, you should take measures to reduce your stress level.  If the answer is NO, you need to accept the reality.

 

There are three basic measures to reduce your stress; (1) time management, (2) relaxation, and (3) exercise.

 

(1)   Time Management

It is impossible to carry out 100% of what we want to do.  Therefore, it is essential to prioritize and begin with the highest priority.  You can achieve more by limiting the number of activities.  By prioritizing you can generate more time for relaxation and exercise.

(2)   Relaxation

The key to relaxation is whether you can enjoy and find time to relax.  If you enjoy relaxing, it does not matter whether you do it alone or with others, indoors or outdoors.

(3)   Exercise

Physical exercise is different from relaxation because exercise can relax not only your mind but also your body.  As in the case of relaxation, it does not matter what type of exercise as long as you enjoy it.

 

Ideally, you should be able to reduce your stress level by taking the above measures.  If it turns out to be difficult, ask for help from your family members, friends, or colleagues.  If you still cannot manage your stress, please ask for professional help before it is too late.  In the Washington Metropolitan area, the number of Japanese-speaking mental health professionals is very limited, and only a few are locally licensed.  Therefore, I am trying to form an informal, volunteer-based network of professionals.  The purpose of the network is: 1) to facilitate referrals, and 2) to identify volunteers in assisting the community in case of  traumatic events.  I hope these activities will be helpful to the community’s psychological well-being.