FARAI CHIDEYA, host:
From NPR News, this is Notes & Notes. I'm Farai Chideya.
We've been bringing you a series of reports on how the economy is transforming American life. Today our focus is on mental and physical health. In a moment, we'll talk about how it affects public health. But first, a look at our ability to cope with emotions about money and the economy. Stephanie Smith is a psychologist who works with the American Psychological Association. Dr. Smith, welcome.
Dr. STEPHANIE SMITH (Clinical Psychologist): Thanks so much for having me.
CHIDEYA: So when people are stressed out about money, how does it affect them emotionally and psychologically?
Dr. SMITH: Well, I think the stress can have a lot of impacts. It can certainly affect folks' mood. People can notice that their mood is down, that they're sadder or more preoccupied than they typically are. It can also cause a lot of anxiety or stress, so folks can be irritable, notice some physical symptoms, stomachaches, headaches, all sorts of different symptoms of anxiety due to the economic situation.
CHIDEYA: So I'm looking at the results of something called the 2008 Stress in America Survey. That must be quite something to work on. And it said that the amount of - you know, the percentage of people who are stressed about money has gone up. But it was already significant to begin with. So is money just generally just one of those things that Americans worry about?
Dr. SMITH: Absolutely. I think even in the best of times, it's something that we all deal with day to day. You just can't get away from money. We have to use it all of the time. So it's always going to be a source of stress. But given the current financial crisis, clearly, that all of our stress level has just shot through the roof. And interestingly, that study that you've been talking about was completed before the financial collapse of the last two months. So presumably, our stress levels are even higher now than they were when that study came out.
CHIDEYA: So what kind of symptoms do you see in your office as people come in?
Dr. SMITH: Well, I'm seeing a lot of different kinds of symptoms. I certainly see the stress and anxiety around the financial situation affecting people's relationships with the ones close to them, their spouses, their children, their families, their friends even. It can cause a lot of strain, particularly if we're not on the same page financially as some of the other folks close to us. Clearly, a lot of people are losing their jobs or are in fear of losing their jobs. They're not going to be getting their bonuses or raises. They're not getting overtime. So that's causing a lot of stress in the workplace as well. And unfortunately, often a lot of us bring that workplace stress home. So it really permeates almost every area of our lives.
CHIDEYA: If you - let's break it down bit by bit. If you find yourself in a tight spot, either whether it's very clear that you're in a tight spot like you're losing your home, or whether it's just anxiety, but you find yourself feeling a little out of control, what's your first step?
Dr. SMITH: The first step is focus on what you can control. Like you said, sometimes life feels out of control. But in fact, there are almost always things that we can control in our lives, whether it's what we spend on holiday gifts. If we're going out to dinner, you know, we can decide expensive restaurant, not-so expensive restaurant or not to go out at all. And then there are lot of things that we can control outside of money as well. So, how are going to spend our free time? How much effort and energy are we going to put in into the relationships of those close to us? So really focusing on - recognizing and focusing on the things that we can control.
CHIDEYA: If you find yourself in a position where you feel completely rundown, could that be related to the emotional stress of dealing with these issues?
Dr. SMITH: Absolutely. Stress is exhausting, as is depression. Anxiety and depression really tax all the parts of our body physically, mentally. It affects everything. So if we're experiencing a large amount of stress about finances or really about anything, it can absolutely wear us down. We can feel tired, we can start getting colds more frequently, our appetite might change, we might gain weight, we might lose weight. It can really affect every system of the body.
CHIDEYA: Now, if you find yourself in that position, gaining weight or losing weight, finding yourself wanting to sleep more or not being able to sleep, is this something where you say, I can go to my general physician and go and get this dealt with, or do you really have to look for someone who's more trained in emotional issues like a psychologist or a psychiatrist?
Dr. SMITH: Well, of course, I'm a big fan of psychologists. I think that really the main point is, if you're feeling those things you just listed, if you notice a change in mood and a change in behavior, to get help somewhere. If you're more comfortable with your primary physician, then by all means, go to them. If you're comfortable seeking out the help of a psychologist, then I think that's an excellent option as well. I think it's also important for people to realize that just because you seek the help of a psychologist doesn't mean you're going to be on the couch forever. Gone are the days of, you know, three times a week therapy for ten years and, you know, it's the equivalent of sending a child to school in terms of financial commitment. It's not that way anymore. You can see a psychologist once, twice, three times, reassess priorities, come up with some very real coping strategies and be on your way.
CHIDEYA: As a psychologist, you do not prescribe psychiatric medications, is that correct?
Dr. SMITH: That's correct.
CHIDEYA: So how often do you think - I mean, I don't know if there's a way to quantify it or just in general, how open should people be to the idea of taking medication even for a short term if they really have reached a point where they're dealing with a lot of job-related stress or economy-related stress?
Dr. SMITH: Well, you know, I think that's a personal decision. Some people have some really strong ideas about medication and, you know, that's OK. I think the main thing, like I said before, is to get help somewhere. Whether that's from a psychologist, who can give you some really concrete behavioral and stress management strategies to deal with the financial crisis or any problems that you're having, whether you choose to deal with it that way, or choose to deal with by going to a psychiatrist or a general practitioner who can prescribe some medication. You know, like I say, I think the main issue is that people get help somewhere. I think the research is pretty clear that when people are experiencing true anxiety or depressive disorders that the combination of medication and psychotherapy or counseling, both of those things together are the most effective.
CHIDEYA: Overall, before we let you go, what do you think is a good thing for people to be aware of if so far, you know, they're rolling with the punches, dealing with the anxiety, what's the number one thing to remember if you haven't gotten to the breaking point, but you, you know, you're still concerned about the trends that you see around you?
Dr. SMITH: I think the number one thing is, don't abandon your healthy stress management strategies. We all have good coping skills that we use on a daily basis, whether it's exercise or yoga or walking, or talking to a friend, or going to religious services, or watching our favorite soap opera. We all have some good strategies. Don't leave those behind in these tough times.
CHIDEYA: All right. Stephanie, thank you so much.
Dr. SMITH: Thank you.
CHIDEYA: That was Stephanie Smith, a licensed clinical psychologist. She's also the public education coordinator in Colorado for the American Psychological Association. And she joined us from Post Modern Studios in Denver, Colorado.
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