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Podcast #19: Stress and Anxiety

Updated: Mar 29




What's something everybody today has in common? Lots, and lots, and lots of stress and anxiety. Plus, having an invisible disability can bring an extra load of craziness. Check out this blog to see how this applies to you.....



Definition and Benefits

Stress and anxiety are with us everyday. Even as you read this, you are probably very familiar with these concepts. But, what exactly do they mean? The Zcenter Team (2022) define it best: "Stress is caused by an external trigger while anxiety is the persistence of worries. Stress and anxiety are normal responses from the body to danger. The cause of stress is in response to a recognized threat. Anxiety may not always have an identifiable trigger. While stress is short-term, anxiety is a long-term experience. Sometimes stress can turn into anxiety. Stress is the body’s reaction to a threat. Anxiety is the body’s response to stress."

Stress, and it's related sister anxiety, are as common today as the air we breathe. However, they can often have hidden--and not so hidden--influences on our daily life. The folks at the American Psychological Association (2024) explain that: "Stress is a normal reaction to everyday pressures, but can become unhealthy when it upsets your day-to-day functioning. Stress involves changes affecting nearly every system of the body, influencing how people feel and behave.By causing mind–body changes, stress contributes directly to psychological and physiological disorder and disease and affects mental and physical health, reducing quality of life."

I'm sure we have all seen these ramifications in ourselves or those around us. So, common sense tells us that reducing stress and anxiety can be incredibly beneficial. For instance, you will sleep better every night, be in a better mood, promote a healthy weight, and generally get along better with everyone around you (U. S. Department of Health and Human Services, 2024). These benefits can also translate to your job, as you will have: fewer work-related injuries, less illness and lost time; take less sick days and absences; better work productivity; and more job satisfaction (Better Health Channel, 2024). Reducing stress at home definitely promotes healthier relationships, better communication, and gives you a safe place to un-wind, where you can love and be loved by others in your life (CITATIONS!!) Who wouldn't want that? The bad news is that stress and anxiety are all around us. The good news is that you can always do something about it.



Connections with LD and Dyslexia

    One of the first things I noticed when I started my research on adults with LD back in the 1980s was the huge amount of stress and anxiety that these folks faced everyday (ADD CITATIONS!!). Not only did they look stressed out, but they talked continually about many other negative aspects related to stress, such as: fatigue, anger, frustration, work-related problems, personal relationship issues, and lots--and lots--of physical and mental health problems. All of this craziness just seemed to go hand-in-hand with getting that first LD diagnosis, and then living with it for the rest of your life.

    In those days, we were just barely understanding what learning disabilities were, much less how to cope with them on a long-term basis. In fact, since the 1970's, the vast majority of time and energy used with folks with LD or dyslexia is still spent focusing on academic achievement, like achieving grade level in elementary or high school or getting a great GPA in college. Nonetheless, the ugly fact remains--living with invisible disabilities like LD or dyslexia takes a huge toil on your life. And of equal importance, this negativity starts when you are a very young child and continues to snowball throughout your life. For example, researchers have recently explored the relationship between stress and LD. They discovered that " . . . hormonal, (epi)genetic, and neurobiological mechanisms [chronic stressors] might underlie . . . the onset of LDs. We then found that stress factors combined with feelings of inferiority, low self-esteem, and peer victimization could potentially further aggravate academic failures in children with LDs" (Burenkova, Oksana, Naumova, & Grigorenko, 2021).

This supports one of the trends that used to break my heart when I talked to adults about their invisible disability. I constantly observed how they just accepted it as "normal" to live with such high levels of chaos and craziness. I would ask them about their LD and they would respond with "It's all because I can't read" or " I really don't write as well as other people". It was clear that they didn't understand that the real price to pay living with an invisible disorder isn't just reading or writing--it's the quality of your life. This is especially true when you are an adult.

For instance, did you know that research tells us that folks with LD "are twice as likely to struggle with mental health issues, such as anxiety and depression, as the general public" (CITATION)? One of the ramifications of such high levels of stress and anxiety can be seen in excessive fear of failure (U. S. Department of Education, 2024). Another side effect, which no ever talks about, is that folks with LD can be at higher risk for self-harm and suicide (Weinreich, Haberstroh, Schulte-Korne, & Moil, 2023). A third disturbing aspect is the high incidence of depression and LD (Harkav-Friedman, 2024). Perhaps, the relationship between stress and anxiety is best described by Hallberg (2022), an adult with LD herself, when she says, "My learning disabilities and anxiety have always gone hand-in-hand . . ." She graphically explores her fears and panic attacks in the article below. Also, check out another article on children and anxiety and learning disabilities.




Scenarios



Scenario A

Ben has always hated taking tests. Ever since he can remember, he would tense up and start to sweat when the teacher called on him in class. Before he was diagnosed with dyslexia in the third grade, he would dread when the teacher would ask him to read in class. All of the other kids could read with fluency and accuracy, but Ben would struggle just trying to make sense of the symbols on the page. His oral reading was so bad that the other students would snigger when he stumbled over a word or lost his place. Tutoring didn't help much and his anxiety soon generalized to test taking as well.

Timed tests scared him to death, as he kept making mistakes and couldn't remember or process the necessary information fast enough. The annual state assessments given to the whole school became a nightmare for him. He often cut class or stayed home sick when they were administered. As much as Ben hated school, he loved playing sports--especially football. He was part of a winning team that brought home 3 state championships in a row. As a result, Ben was always a popular guy with a busy social life. Also, despite his poor grades, he is currently being recruited by 3 different colleges for a football scholarship. But, how can Ben go to college when he can't pass tests? Just thinking about that makes Ben sweat even more.



Scenario B:

Javier's life revolves around his job in Hotel Management. He started with the company as an intern in high school and worked his way up through his attention to detail, creativity, long hours, and winning personality. Everybody liked Javier and everyone wanted to work with him. His generosity and sense of humor often hid his secret--due to his learning disabilities and ADD, he had to work twice as hard as everyone else just to be part of the team. All of that effort and concentration didn't leave any time for the rest of his life, but who cares? As part of a very large, bi-lingual family who moved a lot, he is used to be alone and independent. This job, and this company, have become his extended family by giving him a great salary with lots of benefits, support to go to college, and opportunities to travel the world. Now, he is competing for a promotion to be General Manager of the South American branch. This would be the crowning achievement of his career. So, why is he so stressed out all of the time? Javier is used to pressure, deadlines, and dealing with difficult people. But recently, he's been having anxiety that comes out of nowhere and is almost a full blown panic attack. He's so proud of his success at work, why won't his body and mind cooperate now--just when he needs it?

Scenario C

Joanie is often the shyest person in the room. As the only sister of four, very active brothers who were much bigger than her, she usually didn't talk or interact with others in her family. She often felt that she and her mother were tiny people surrounded by lots of large, noisy men. It also didn't help that her severe dyslexia kept her from communicating well, as she would often struggle to find the right words or say the wrong thing at the wrong time. So, she just kept to herself and slipped into the background, both at home and at school.

All of that got worse one night when one of her brothers brought George, a drinking buddy, home from a party. Joanie's parents were away at a golf tournament and her other brothers were on a camping trip. After Joanie's brother passed out, she was raped repeatedly by George who threatened to beat her up if she told anyone. When George came to their house, he continued to threaten her to keep her silence. So, Joanie never told anyone about her traumatic experience. Instead, she just got quieter and withdrew even more. At one point, she was so depressed that she considered suicide. When she finally left home, she rarely dated and continued to be skittish, fearful, and anxious. She also developed such a bad case of Chronic Fatigue Syndrome that she dropped out of college, where she had been on the Dean's List for two straight years. Joanie feels alone and stuck in a nightmare that will never end. She wants to move forward into a better life, but just doesn't know how to do it.



Tips/Tricks for Stress and Anxiety

I think it's important to start this section with a caveat. Unlike the other blogs and podcasts in this series, stress and anxiety are different animals that should be treated in a slightly different way. For instance, many of the tips given below can be done by anyone with little training whenever they wish. However, sometimes the stress and anxiety have been with you for so long, and are so much of your everyday life, that you may need to move to another level. I have always been a proponent of people not being forced into counseling before they are ready for it. But, I also strongly believe that there are times when being guided by professionals is the only logical choice.

This view is supported by others who work with folks both with and without disabilities. For example, Mannarino (2024) says, "If you feel paralyzed by stress, can’t control your emotions, depression interferes with your ability to function, . . . it may be time to seek professional care". Folks from the Cleveland Clinic (2024) agree: "Don’t stay 'frozen' or feeling like you’re holding your breath waiting for your feelings to be over. If you are stuck in a rut and can’t get yourself out, seek professional help". Being stuck in an emotional rut that just gets deeper and deeper is no way to live. Try the tips below--but if you're still having problems, think about other options such as counseling online or in your local community. Also, check out these articles for more information:





Tip #1: Test Anxiety

I think that most people are intimidated by tests. Whether it's written, essay, or oral, it can often be scary and stressful to have to remember everything that you studied the night before the exam. Even pop quizzes can sometimes make your heart pound faster. In fact, researchers have found that text anxiety can be seen in 10 to 40 percent of all students (Healthline, 2023).

But for folks with invisible disabilities, test-taking is just one big ordeal after another. In fact, some students with LD or dyslexia become so paralyzed by stress that they develop intense test anxiety. This is a much more serious condition than just being nervous before an occasional exam. It can include such symptoms as: extreme sweating; nausea, vomiting, or diarrhea; stomach pain; rapid heartbeat; shortness of breath; headaches or becoming faint and lightheaded (Healthline, 2023). These physical symptoms go hand-in-hand with emotions and cognitive behaviors like: helplessness, disappointment, fear, worry about past poor performances or consequences of failure, and intense feelings of being inadequate. Such negative thoughts can also be accompanied by having your mind go blank, panic, racing thoughts, lack of concentration or procrastination. (University of North Carolina, 2024). For some students with invisible disabilities, test anxiety can be so paralyzing that their parents request that an IEP or 504 plan be written just to address this condition (CITATIONS).

Nevertheless, whether your test anxiety is about specific tests or becomes more pervasive, there are still lots of things you can do right now. For instance, try these beginning techniques : a) Take a few deep breaths, while relaxing each muscle one at a time; b) Read each question slowly, more than once if needed; c) Before you answer, be sure you completely understand what the question is asking; d) Focus on one question at a time; and e) Make sure that you focus only on that question before you move on to the next one (Healthline, 2023).

Another set of valuable ideas stresses as much pre-preparation as possible. While your go-to plan may be to ignore the pain and put off studying until the last minute, tips from the educators as Brain Balance (2024) can really make a difference. For example, give yourself a consistent plan to study (e.g., same time, same place, study schedule, start by highlighting notes or using flashcards for review, set a timer for study breaks, etc.). Practice important tests ahead of time by making up sample exam questions or orally reviewing critical material with a partner. Be sure to make your practice test as long or as short as the actual exam, so you'll know how much time you'll need the day of the test. Find yourself a cheerleader who will support you and encourage you during the rough times. Also, make sure you get plenty of sleep the night before. If you find that your anxiety level still keeps you from performing the best you can, think about practicing some relaxation techniques that you find either online or from a professional. Of equal importance, ask for and get approval ahead of time to use any necessary accommodations (i.e., extra time, oral exam, scribe to record answers, distraction free rooms, screen reading technology, etc.)

All of these tips were just what Ben in Scenario A, needed. While he had dreaded tests for years, he never thought that that the fear would have such a direct impact on his life. Previously, Ben spent all of his time and energy surviving public school. His grades were never that great, but he had plenty of friends to party with, plus playing football made up for everything else. Now, he's facing a whole new set of issues. Everyone keeps telling him that he has to go to college and he's so lucky to be actively recruited by so many schools. While all that sounds great, what his friends and family don't understand is that the ordeal of academics and test taking will go on for four more years. They don't seem to get that it won't be just football--he'll have a scholarship and GPA to keep up as well. Ben gets frantic just thinking about all of it.

Then, something great happened during one of his visits to a prospective college campus. Alex, a Coach from a school in Ohio, grilled him about his high school grades. Ben felt so comfortable with Alex that he confessed about his dyslexia and test anxiety. Alex reassured him that they had lots of support for Ben if he chose his college. Not only would his books, tuition, housing, and meals be paid every semester, but he would have individual tutoring for each of his courses. In addition, the Disability Office would make sure that he got all of the accommodations that he needed for every test. As soon as Ben made his decision, the Disability Office would contact him right away to start the ball rolling. That's all Ben needed to hear. When he started as a Freshman the following Fall, he immediately got extra time for tests and screen technology to read the Multiple choice items to him. That, and all of the extra tutoring, helped Ben keep a 3.0 in most of his classes. Now, he's almost ready to graduate from college. Not to mention, he's been talking to a scout from the NFL. While his test anxiety never went away, he really feels he can deal with it now.

If you're like Ben and have test anxiety that keeps you from showing your true academic potential to others, check out the articles below.




Tip #2: Stress and Promotions

It's always been ironic to me that the bulk of transition curricula for students with disabilities focuses on getting that first job. Yet, few educators or job coaches stress how critical it is to keep the job once you're hired. And, to my knowledge, no one ever talks about how to move ahead with that job if you want to continue on your career path.

This trend seems crazy to me, as research has found that 63% of employees in the United States were promoted in the last two years. In addition when asked, 79.5% of employees knew what they had to do to get promoted within their company. Also, one third of employees were actively looking for a new job "in the last 6 months due to lack of career growth" (Noori, 2023).

Clearly, adults with LD or dyslexia need more guidance than just creating an on-line resume. To be successful, they have to learn how to think long-term, because the older they get the more important that becomes. This process is not just fulfilling an IEP goal, this IS adult life in all of its challenges and complexity. Consequently, I believe that getting promoted is a topic that definitely needs more attention for folks with invisible disabilities.

So, what do you need to know to get that promotion? As I did a deep dive into this topic, I found two different sets of Tips for folks with LD and dyslexia. The first group laid out lots of ideas about promotion for adults in general. The second group addressed specific concerns about the promotion of employees with disabilities, especially in terms of discrimination.

Let's start with a few, generalized Tips about getting promoted. Some, as those suggested by Reynolds (2023), just seem like common sense. She recommends that you: a) be a model employee, b) be a problem-solver, c) have a "can-do" attitude, and d) make your boss look good. The Editorial Team at Indeed (2024) add that you should try to be valuable to your company to get noticed as an irreplaceable employee. You should proactively ask for feedback or guidance from your supervisor and demonstrate your leadership skills whenever possible. It's critical to have a strong work ethic and be a positive force in the workplace. You should also observe your colleagues who have been promoted already, as well as keep yourself motivated to reach your final goal.

This picture changes slightly if you have an invisible disability. Unlike your peers without disabilities, you are covered on the job by two sets of important laws: The Americans with Disabilities Act and Title VII of the Civil Rights Act of 1964 (Shegarian and Associates, 2016; The Foster Law, 2020). This is an important distinction, as children and adolescents in the United States are only covered by IDEA or Section 504 in public school settings. Given IDEA, students automatically have access to many, free resources, so the responsibility to use this support falls on educators, families, or administrators. However, when you become an adult--especially an adult employee--you are totally on your own. Your only resource is you and the ADA or Title VII. Remember: your employer, peers, or supervisor are not there to advocate for you. You must do that for yourself. To further complicate matters, if you have not chosen to self-disclose your invisible disability, you have no foundation to advocate for protection under the laws. As a result, this quickly becomes a hazy maze full of challenges and complications (Brown & Lantham, 2024). However, one over-riding theme emerges: While lots of options, issues, and conflicts surround self-advocacy and promotion, only you can make the personal decision to move forward. Is it worth it or not? It's up to you.

Javier is an excellent example of that. As described in Scenario B, he has worked for the same corporation successfully for many years. His job in Hotel Management has become his life, as most of his time and energy is spent compensating for his LD and ADHD. Javier has given everything to his company and now he hopes that all of that will pay off. He's done everything just like the generalized Tips suggested for promotion. For example, he's a model employee who is a positive problem-solver with a great work ethic. He seeks leadership roles whenever he can, from starting a department soft-ball team to staying late on weekends to help his supervisor solve a crisis. He also gets advice from a mentor, Bill, who has been promoted 3 times in the last four years. Bill has strongly urged Javier to apply for the Manager's position in South America. Not only would his new duties involve a substantial pay increase, benefits, and extensive travel, but he could move permanently to Brazil; living in Rio has always been his dream destination. That's the up-side. The down-side is that the competition is fierce, with four other people applying for the same position; all who are amazingly qualified.

If that's not complicated enough, these scary episodes of panic and extreme anxiety just seem to come out of nowhere. For instance, Javier will be sitting in a weekly staff meeting and, all of a sudden, he will start sweating profusely, with a rapid heartbeat, dizziness and shortness of breath. Sometimes, it can get even worse with abdominal cramping, nausea, and even chest pain. One time during a client lunch, Javier swore that he was having a heart attack. After the paramedics were called, he was told to see his physician right away. His doctor diagnosed it as a panic attack and urged Javier to see a therapist for more help. But, that's the last thing he planned to do--he's not crazy, he's just really worried about his work. Besides, what if word got out that he was seeing a shrink? There goes the promotion.

What Javier doesn't understand is that the roots of his anxiety and panic may be due to his LD and ADHD. Professionals have consistently said that there are clear connections between LD, Dyslexia, and ADHD and extreme anxiety. As the folks at the International Dyslexia Association (2020) explain: "All people, young and old, can experience overwhelming stress and exhibit signs of anxiety, but. . . adults with dyslexia are particularly vulnerable. That’s because many individuals do not fully understand the nature of their learning disability, and as a result, tend to blame themselves for their own difficulties. Years of self-doubt and self recrimination may erode a person’s self-esteem, making them less able to tolerate the challenges of school, work, or social interactions". Such extreme emotions can trigger a full-blown anxiety attack (CITATIONS). The relationship between anxiety and ADHD is even more pronounced. Did you know that: "Approximately 25 to 40 percent of adults with ADHD also have an anxiety disorder" (Hallowell, 2019)? He goes on to say, "[ADHD] can bring on anxiety disorders, including phobias, generalized anxiety disorder (GAD), panic attacks, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and more". For someone like Javier, who is everyday in a high stress, high stakes workplace, but has never acknowledged or even understood his invisible disabilities, you have a recipe for disaster.

So, what should Javier do before he loses the promotion? The first step, perhaps the hardest, is to acknowledge that he is extremely anxious and needs to do something different. For a workaholic as ambitious, competitive, and impatient as Javier, that's a huge deal. Second, he needs to break his wall of silence and shame and talk to someone--anyone; a close friend, a relative, or perhaps a professional. If he's too embarrassed to talk to somebody, even journaling will be a big help to see patterns and understand the situation better. Hallowell (2019) has some great Tips Javier can use right away: a) Don't spend your time and energy worrying alone. Saying your worry aloud takes away it's power and de-escalates the anxiety; b) Get the facts about the situation. Anxiety is fed by a lack of or wrong information. Not knowing the truth can just make the worry more paralyzing; and c) As soon as you feel your anxiety rising, make a plan. That will make you feel less vulnerable and more in control. If your plan doesn't work right away, revise it and try again. This still breaks the vicious circle of stress, anxiety, shame, and worry. And, of most importance, learn as much about LD, Dyslexia, and ADHD as you can.

Javier got so desperate after a third panic attack in a week that he decided to try the Tips above. He was too ashamed to talk to anyone, so he started journaling and looking online for resources. He finally broke down and called his brother, who laughed and said, "Jay, you've always been an intense, super ambitious guy--get help already! Call me when you need me." The more Javier journaled, the more he realized that this promotion had become the center of his life. Maybe, it was time to take a deep breath and think about what he already had accomplished. Was the job in Rio really worth his life? He also found out a shocking fact about the promotion; it was to close down hotels in South America not expand them. Did Javier see himself as the bad guy laying off hundreds of employees? So, Javier decided to make a new plan. He started sending out resumes to small, boutique hotels in Brazil that were looking for a person to make them grow. Eventually, he was hired by a group in Rio who wanted a fresh approach. He's happily worked there for 5 years now, but with a new perspective. He also educated himself about the complex relationship between ADHD and anxiety. Plus, going to the beach everyday helps a lot!

If you're like Javier and facing the challenges of getting promoted, try some of the Tips above. Or, if you are experiencing severe worry and stress, check out the information below. It can really help alleviate the anxiety.....






Tip #3: Healing from Sexual Abuse

I have to be honest and confess that I wasn't sure whether to tackle this topic or not. In my four decades as a Transition Specialist and Special Educator, I never, ever, heard anyone talk about people with LD or dyslexia who had been sexually assaulted by others. This seemed to be the elephant in the living room that was never discussed. But as I wrote this Blog about stress and anxiety, it seemed natural to look at this topic as a potential stressor for many adults with disabilities. Unfortunately, the little research available seems to bear me out. For instance, did you know that "Women with a disability are at greater risk of experiencing rape than women without a disability. An estimated 2 in 5 (39%) female victims of rape had a disability at the time of the rape " (CDC, 2020). As the CDC explains, these numbers are probably underestimated, because many people choose not to report these incidents. Other statistics, while few and far between, underscore the same trend. The folks at CAP20 (2021) explain that: ". . . having multiple disabilities can increase a person’s risk of rape and sexual assault, and children with mental health or intellectual disabilities are almost five times more likely than their non-disabled peers to experience sexual abuse". Moreover, less than a hand-full of studies exist on the incidence of sexual abuse and rape on adults with learning disabilities or dyslexia. They, too, allude to the same trends (ADHD Evidence Project, 2023; Dyslexia Octopus, 2021; Helton, Gochez-Kerr, & Gruber, 2018; Little,2018; Rabinowitz Educational Center, 2024). Clearly, Joanie in Scenario C is not alone.

Having said all that, I believe that it is entirely beyond the scope of this blog to give any advice in this area. Sexual abuse, whether it happens to people either with or without disabilities, is a very serious matter with potentially profound legal and personal implications. If this is true for you, I would strongly encourage you to recognize any issues you are facing and seek professional help as soon as possible. Trained counselors in this area can literally change your life. See the articles below for more information:





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References


Transition Connection

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