What is stress?

Excess stress can manifest itself in a variety of emotional, behavioral, and even physical symptoms, and the symptoms of stress vary enormously among different individuals.

Stress is a normal part of life that can either help us learn and grow or can cause us significant problems. Stress releases powerful neurochemicals and hormones that prepare us for action (to fight or flee). If we don’t take action, the stress response can create or worsen health problems. Prolonged, uninterrupted, unexpected, and unmanageable stresses are the most damaging. Stress can be managed by seeking support from loved ones, regular exercise, meditation, or other relaxation techniques, structured timeouts, and learning new coping strategies to create predictability in our lives.

What causes stress?

Picture of some of the areas of the body that are affected by stress

Stress is a fact of nature in which forces from the inside or outside world affect the individual, either one’s emotional or physical well-being, or both. The individual responds to stress in ways that affect the individual, as well as their environment. Due to the overabundance of stress in our modern lives, we usually think of stress as a negative experience, but from a biological point of view, stress can be a neutral, negative, or positive experience.

In general, stress is related to both external and internal factors. External factors include the

physical environment,
your job, your relationships with others,
your home, and
all the situations, challenges, difficulties, and expectations you’re confronted with on a daily basis.

Internal factors determine your body’s ability to respond to, and deal with, the external stress-inducing factors. Internal factors which influence your ability to handle stress include your

nutritional status,
overall health and fitness levels,
emotional well-being, and
the amount of sleep and rest you get.

Stress has driven evolutionary change (the development and natural selection of species over time). Thus, the species that adapted best to the causes of stress (stressors) have survived and evolved into the plant and animal kingdoms we now observe.

Man is the most adaptive creature on the planet because of the evolution of the human brain, especially the part called the neo-cortex. This adaptability is largely due to the changes and stressors that we have faced and mastered. Therefore, we, unlike other animals, can live in any climate or ecosystem, at various altitudes, and avoid the danger of predators. Moreover, we have learned to live in the air, under the sea, and even in space, where no living creatures have ever survived. So then, what is so bad about stress?

Excess stress can manifest itself in a variety of emotional, behavioral, and even physical symptoms, and the symptoms of stress vary enormously among different individuals.

Common somatic (physical) symptoms often reported by those experiencing excess stress include

sleep disturbances or changes in sleeping habits (insomnia or sleeping too much),
muscle tension,
muscle aches,
headache, gastrointestinal problems, and
fatigue.

Symptoms of many preexisting medical conditions can also worsen during times of stress. Emotional and behavioral symptoms that can accompany excess stress include

nervousness,
anxiety,
changes in eating habits including overeating or undereating (leading to weight gain or loss),
loss of enthusiasm or energy, and
mood changes, like irritability and depression.

Of course, none of these signs or symptoms means for certain that there is an elevated stress level since all of these symptoms can be caused by other medical and/or psychological conditions.

It is also known that people under stress have a greater tendency to engage in unhealthy behaviors, such as excessive use or abuse of alcohol and drugs, cigarette smoking, and making poor exercise and nutritional choices, than their less-stressed counterparts. These unhealthy behaviors can further increase the severity of symptoms related to stress, often leading to a “vicious cycle” of symptoms and unhealthy behaviors.

The experience of stress is highly individualized. What constitutes overwhelming stress for one person may not be perceived as stress by another. Likewise, the symptoms and signs of poorly managed stress will be different for each person.

Who is most vulnerable to stress? What are the risk factors for stress?

Stress comes in many forms and affects people of all ages and all walks of life. No external standards can be applied to predict stress levels in individuals — one need not have a traditionally stressful job to experience workplace stress, just as a parent of one child may experience more parenting stress than a parent of several children. The degree of stress in our lives is highly dependent upon individual factors such as our

physical health,
the quality of our interpersonal relationships,
the number of commitments and responsibilities we carry,
the degree of others’ dependence upon us,
expectations of us,
the amount of support we receive from others, and
the number of changes or traumatic events that have recently occurred in our lives.

However, it is possible to make some generalizations. People with adequate or strong social support networks report less stress and overall improved mental health in comparison to those without adequate social support. People who are poorly nourished, who get inadequate sleep, or who are physically unwell also have a reduced capacity to handle pressures and stresses of everyday life and may report higher stress levels. Some stressors are particularly associated with certain age groups or life stages. Children, teens, the newly married, working parents, single parents, and seniors are examples of the groups who often face common stressors related to life transitions.

A key aspect of a healthy adaptational response to stress is the time course. Responses must be initiated rapidly, maintained for a proper amount of time, and then turned off to ensure an optimal result. An over-response to stress or the failure to shut off a stress response can have negative biological and mental-health consequences for an individual. Healthy human responses to stress involve three components:

The brain handles (mediates) the immediate response. This response signals the adrenal medulla to release epinephrine and norepinephrine.
The hypothalamus (a central area in the brain) and the pituitary gland initiate (trigger) the slower maintenance response by signaling the adrenal cortex to release cortisol and other hormones.
Many neural (nerve) circuits are involved in the behavioral response. This response increases arousal (alertness, heightened awareness), focuses attention, inhibits feeding and reproductive behavior, reduces pain perception, and redirects behavior.

The combined results of these three components of the stress response maintain the internal balance (homeostasis) and optimize energy production and utilization. They also gear up the organism for a quick reaction through the sympathetic nervous system (SNS). The SNS operates by increasing the heart rate, increasing blood pressure, redirecting blood flow to the heart, muscles, and brain and away from the gastrointestinal tract, and releasing fuel (glucose and fatty acids) to help fight or flee the danger.

How does the body respond to stress?

While the complete story is not fully known, scientists understand much about how the response to stress works. The two main systems involved are the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic nervous system (SNS). (These systems are described later.) Triggered (activated) primarily by an area in the brain stem (lowest part of brain) called the locus coeruleus, the SNS results in the secretion of epinephrine and norepinephrine. The following are the five most important concepts to remember about these two systems:

They are governed by a feedback loop to regulate their response. (In a feedback loop, increased amounts of a substance—for example, a hormone—inhibit the release of more of that substance, while decreased amounts of the substance stimulate the release of more of that substance.)
They interact with each other.
They influence other brain systems and functions.
Genetic (inherited) variability affects the responses of both systems. (That is, depending on their genes, different people can respond differently to similar stresses.)
Prolonged or overwhelming responses of these systems can be harmful to an individual.

The HPA axis is a grouping of responses to stress by the brain and the pituitary and adrenal glands. First, the hypothalamus (a central part of the brain) releases a compound called corticotrophin releasing factor (CRF), which was discovered in 1981. The CRF then travels to the pituitary gland, where it triggers the release of a hormone, adrenocorticotrophic hormone (ACTH). ACTH is released into the bloodstream and causes the cortex of the adrenal gland to release the stress hormones, particularly cortisol, which is a corticosteroid hormone. Cortisol increases the availability of the body’s fuel supply (carbohydrate, fat, and glucose), which is needed to respond to stress. However, if cortisol levels remain elevated for too long, then muscle breaks down, there is a decreased inflammatory response, and suppression of the immune (defense) system occurs.

Corticosteroids in measured doses are used to treat many illnesses that are characterized by inflammation or an overactive immune system, such as asthma and inflammatory bowel disease. For the same reason, they are used to help reduce the chances that our body will immunologically reject a transplanted organ. Corticosteroids also can cause fluid retention and high blood pressure. Therefore, it is critical that the response to corticosteroids be carefully controlled (modulated). This control usually is accomplished by a feedback mechanism in which increased cortisol levels feeding back to the hypothalamus and pituitary turn off production of ACTH. In addition, extremely high levels of cortisol can cause mental changes, including depression and psychosis, which disappear when the levels return to normal.

What is the role of the locus coeruleus in stress?

The locus coeruleus has many connections to other parts of the brain, particularly areas that bring in and process sensory information (information from sight, hearing, smell, taste, and touch). The locus coeruleus secretes norepinephrine and stimulates other brain centers to do the same. It is like the pacemaker (meaning it controls the tempo) of the brain. Thus, it increases arousal (heightened awareness, alertness) and vigilance (watchfulness, carefulness) and adjusts (modulates) the action of the autonomic nervous system, which includes the SNS.

The autonomic nervous system regulates blood flow, heart rate, blood pressure, and breathing (respiration). It can also temporarily shut down the gastrointestinal (GI) and sexual systems until the crisis or stressful event is over. These initial reactions, to get our blood flowing, heart pumping, and muscles energized, occur very quickly and automatically.

How do the connections in the brain work in stress?

The HPA axis and the locus coeruleus systems are linked through the hypothalamus and an area of the brain known as the limbic system. The limbic system is the control area for emotion and the processing area for memory. These linkages are critical. For example, if you see the bushes rustling, your locus coeruleus immediately gets the stress response rolling. However, when you see that it is not a mountain lion but a golden retriever in the bushes, your memory of the tameness of the dog will turn off the stress response. Similarly, if a person is nervous before a public-speaking engagement and the first minute or two goes well, this happy feeling will turn down the activity of the locus coeruleus. These internal adjustments are why experienced public speakers often start off with a joke. It’s as much to calm themselves (if the joke goes well) as it is to entertain you.

The connections also include the endogenous (within the body) opiate (opium-like) system and the reward (dopamine) system. Thereby, during stress, pain is reduced and an extremely happy feeling (euphoria) may result. These connections partially account for “runner’s high” and have a great deal to do with why we like roller coasters and scary movies.

Here’s how the connections work. The limbic system performs an emotional analysis and memory review of the information provided by the senses. Then, the multiplicity of connections allows us to determine whether the current stress is

one that has been mastered in the past and successfully adapted to,
not a threat at all, or
a clear and present danger.

All of this internal activity must occur in milliseconds, and it does.

What do we know about using (activating) and overusing our internal systems that respond to stress?

Animal and human research has taught us much about our internal stress systems. When laboratory animals are exposed to a prolonged stress (usually food deprivation, mild electrical stimulation of the foot, or handling), they develop a stress syndrome. This syndrome consists of high blood pressure (hypertension), loss of appetite, weight loss, muscle wasting, gastrointestinal ulcers, loss of reproductive function, suppression of the immune system, and depression. Researchers also noticed that stress of long duration (chronic stress) sensitizes the stress system (makes it more responsive to stress). That is, the system then overresponds to new stressors. They further noticed that the administration of certain drugs, such as amphetamines or cocaine, could also sensitize the stress response. Moreover, constant stress increases the self-administration of drugs in laboratory animals. So, a vicious cycle is induced. The more stress there is, the more mice seek the drugs, and the more the sensitivity (increased responsiveness) to stress is increased!

Early separation from the mother has also been seen as another potent stressor in animals. Such separation has been linked to increased levels of the stress hormones that cause the stress syndrome, which includes depression. Studies in humans are under way to evaluate how maternal stress, even early in the pregnancy, can affect the developing fetus.

Why might maternal stress affect the fetus? The answer is the communication of the blood circulations of the mother and the fetus. From the mother’s blood, the fetus gets both the good (for example, nutrients and oxygen) and the bad. The bad components of the blood can include alcohol, nicotine, illicit drugs, some prescription medications, and stress chemicals such as cortisol and norepinephrine.

These animal and human studies seem to indicate that excessive stress leads to depression. In other words, chronic stress in the mother’s womb (in utero) or early deprivation (separation from the mother) might even predispose a person to developing the psychiatric syndrome of clinical depression in later life. Furthermore, other experiments show that the administration of stress hormones can actually decrease brain connections and even the number of brain cells in crucial areas, such as the limbic system. This loss of brain connections and cells then can lead to further maladaptive (inadequate adjustment) responses to stress.

What’s more, some particular kinds of stress seem to be even more detrimental than other types. That is, some types of stress can actually lead to diseases. For example, stresses that are unpredictable and uncontrollable seem to be the greatest culprits. On the other hand, stresses with which we can cope and master are not necessarily bad. In fact, we can learn from these stresses, predict their recurrence, and develop action plans to reduce or avoid them in the future. In this way, some stresses can actually trigger new personality growth and biologically induced adaptive (healthy adjustment) changes. Indeed, much of psychotherapy is empirically (guided by practical experience rather than theory) based upon this concept.

There is now evidence that points to abnormal stress responses as causing or contributing to various diseases or conditions. These include anxiety disorders, depression, and substance abuse. Stress can affect virtually any organ system, being associated with conditions as diverse as skin rashes or hives, high blood pressure, cardiovascular disease, certain gastrointestinal diseases, some cancers, and even the process of aging itself. Stress also seems to increase the frequency and severity of migraine headaches, episodes of asthma, and fluctuations of blood sugar in people with diabetes. There also is scientific evidence showing that people experiencing psychological stress are more prone to developing colds and other infections than their less-stressed peers. Overwhelming psychological stress (also called trauma) can cause both temporary (transient) and long-lasting (chronic) symptoms of a serious psychiatric illness called posttraumatic stress disorder (PTSD).

Uncontrollable, unpredictable, and constant stress has far-reaching consequences on our physical and mental health. Stress can begin in the womb and recur throughout life. One of the potential pathological (abnormal) consequences of stress is a learned helplessness that leads to the hopelessness and helplessness of clinical depression, but in addition, many illnesses, such as chronic anxiety states, high blood pressure, heart disease, and addictive disorders, to name a few, also seem to be influenced by chronic or overwhelming stress.

Nature, however, has provided us with efficient processes (mechanisms) to cope with stressors through the HPA axis and the locus coeruleus/sympathetic nervous system. Furthermore, research has shown us the biological processes that explain what we all intuitively know is true—which is, that too much stress, particularly when we cannot predict it or control its recurrence, is harmful to our health.

What can people do for stress management? What are home remedies to combat stress symptoms?

If we think about the causes of stress, the nature of the stress response, and the negative effects of some types of stress (prolonged, unexpected, or unmanageable stress), several healthy management strategies and home remedies to combat the effects of stress become clear.

Exercise: An important step in stress management and treatment of stress-related symptoms is exercise. Since the stress response prepares us to fight or flee, our bodies are primed for action. Unfortunately, however, we usually handle our stresses while sitting at our desk, standing at the watercooler, or behind the wheel stuck in traffic. Exercise on a regular basis helps to turn down the production of stress hormones and associated neurochemicals. Thus, exercise can help avoid the damage to our health that prolonged stress can cause. In fact, studies have found that exercise is a potent antidepressant, anxiolytic (combats anxiety), and sleeping aid for many people.
Meditation: For centuries in Eastern religious traditions, the benefits of meditation and other relaxation techniques have been well known. Now, Western medicine and psychology have rediscovered that particular wisdom, translated it into simple nonspiritual methods, and scientifically verified its effectiveness. Thus, one or two 20-30 minute meditation sessions a day can have lasting beneficial effects on health. Indeed, advanced meditators can even significantly control their blood pressure and heart rate as well.
Avoid drugs and alcohol: Elimination of drug abuse (both illegal drugs and prescription medications have the potential for abuse) and no more than moderate alcohol use are important for the successful management of stress. We know that people, when stressed, seek these outlets, but we also know that many of these substances sensitize (make even more responsive) the stress response. As a result, small problems produce big surges of stress chemicals. What’s more, these attempts with drugs and alcohol to mask stress often prevent the person from facing the problem directly. Consequently, they are not able to develop effective ways to cope with or eliminate the stress.
Medications: In fact, even prescription drugs for treatment of anxiety, such as diazepam, lorazepam, clonazepam, or alprazolam, can be counterproductive in the same way. Therefore, these medications should only be used cautiously under the strict guidance of a physician. If, however, stress produces a full-blown psychiatric problem, like posttraumatic stress disorder (PTSD), clinical depression, or anxiety disorders, then psychotropic medications, particularly the selective serotonin reuptake inhibitors (SSRIs), are extremely useful. Examples of SSRIs include sertraline, paroxetine, fluoxetine, citalopram, and escitalopram.
Take breaks: We know that chronic or uninterrupted stress is very harmful. It is important, therefore, to take breaks and decompress. Take a lunch break and don’t talk about work. Take a walk instead of a coffee break. Use weekends to relax, and don’t schedule so many events that Monday morning will seem like a relief. Learn to recognize and respond to your stress signals. Take regular vacations or even long weekends or mental-health days at regular intervals.
Create predictability and structure: Create predictability in one’s work and home life as much as possible. Structure and routine in one’s life can’t prevent the unexpected from happening. However, they can provide a comfortable framework from which to respond to the unexpected. Think ahead and try to anticipate the varieties of possibilities, good and bad, that may become realities at work or home. Generate scenarios and response plans. One might find that the “unexpected” really doesn’t always come out of the blue. With this kind of preparation, it’s possible to turn stress into a positive force to work for growth and change.
Get counseling: For those who may need help dealing with stress, stress-management counseling in the form of individual or group therapy is offered by various mental-health-care providers. Stress counseling and group discussion therapy have proven to reduce stress symptoms and improve overall health and attitude.

Stress Management Techniques

What is stress?

Physical and chemical factors that can cause stress include trauma, infections, toxins, illnesses, and injuries of any sort.

Stress may be considered as any physical, chemical, or emotional factor that causes bodily or mental unrest and that may be a factor in causing disease.

Physical and chemical factors that can cause stress include trauma, infections, toxins, illnesses, and injuries of any sort.
Emotional causes of stress and tension are numerous and varied.

While many people associate the term stress with psychological stress, scientists and physicians use this term to denote any force that impairs the stability and balance of bodily functions.

If stress disrupts body balance and function, then is all stress bad? Not necessarily. A mild degree of stress and tension can sometimes be beneficial.

For example, feeling mildly stressed when carrying out a project or assignment often compels us to do a good job, focus better, and work energetically.
Likewise, exercising can produce a temporary stress on some body functions, but its health benefits are indisputable. It is only when stress is overwhelming, or poorly managed, that its negative effects appear.

An important goal for those under stress is the management of life stresses. Elimination of stress is unrealistic, since stress is a part of normal life. It’s impossible to completely eliminate stress, and it would not be advisable to do so. Instead, we can learn relaxation techniques and other methods to manage stress so that we have control over our stress and its effects on our physical and mental health.

Who is most susceptible to stress?

The degree of stress in our lives is highly dependent upon individual factors such as our physical health, the quality of our interpersonal relationships, financial issue, and more.

Stress comes in all forms and affects people of all ages and all walks of life. No external standards can be applied to predict stress levels in individuals — one need not have a traditionally stressful job to experience workplace stress, just as a parent of one child may experience more stress related to parenting than a parent of several children.
The degree of stress in our lives is highly dependent upon individual factors such as our physical health, the quality of our interpersonal relationships, the number of commitments and responsibilities we carry, the degree of others’ dependence upon and expectations of us, the amount of support we receive from others, and the number of changes or traumatic events that have recently occurred in our lives.
However, certain factors can enhance our susceptibility to stress or act to reduce its severity.
People with strong social support networks (consisting of family, friends, religious organizations, or other social groups) report less stress and overall improved mental health in comparison to those without these social contacts.
People who are poorly nourished, who get inadequate sleep, or who are physically unwell also have reduced capabilities to handle the pressures and stresses of everyday life and may report higher stress levels.
Some stressors are particularly associated with certain age groups or life stages. Children, teens, college students, working parents, and seniors are examples of the groups who often face common stressors related to life transitions.
People who are providing care for the elderly or infirm loved ones may also experience a great deal of stress as caregivers. Having a loved one or family member who is under a great deal of stress often increases our own stress levels as well.

What are the symptoms and effects of excess stress or “out-of-control” stress?

Manifestations of excess or poorly managed stress can be extremely varied.
While many people report that stress induces headaches, sleep disturbances, feelings of anxiety or tension, anger, or concentration problems, others may complain of depression, lack of interest in food, increased appetite, or any number of other symptoms.
In severe situations, one can experience overwhelming stress to the point of so-called “burnout,” with loss of interest in normal activities.
Scientific studies have shown that psychological stress may worsen the symptoms of almost every known medical condition.
Examples of conditions in which stress may worsen the intensity of symptoms include
- cardiovascular diseases,
- asthma,
- multiple sclerosis,
- chronic pain,
- acne,
- fibromyalgia, and
- depression.
While stress alone is not a cause of cardiovascular disease nor high blood pressure, it may actually worsen the progression of these diseases in many people.
Stress also has effects on the immune system. While some studies show that acute short-term stresses may actually be able to boost the body’s immune response, chronic (long-term) stress has the effect of “wearing down” the immune system, leading to an increased susceptibility to colds and other infections. Scientific studies have also shown that stress can decrease the immune response to vaccinations and prolong wound healing.

In general, stress is related to both external and internal factors. External factors include your physical environment, your job, relationships with others, your home, and all the situations, challenges, difficulties, and expectations you’re confronted with on a daily basis.

Internal factors determine your body’s ability to respond to and deal with, the external stress-inducing factors. Internal factors that influence your ability to handle stress include your nutritional status, overall health and fitness levels, emotional well-being, your ability to control stress through relaxation techniques or other strategies, and the amount of sleep and rest you get.

Managing stress, therefore, can involve learning tips to change the external factors which confront you or the internal factors which strengthen your ability to deal with what comes your way. Five main techniques that can help to relieve stress are:

Exercise
Relaxation and Meditation techniques
Time manage
Organizational skills
Support systems

How can exercise help manage stress?

Exercise can also aid in relaxation and improve sleep.

Exercise can be a key, central method to compensate for stressors.
Physical exercise not only promotes overall fitness, but it helps you to manage emotional stress and tension as well.
Exercise can also aid in relaxation and improve sleep.
For one thing, exercise can emotionally remove one temporarily from a stressful environment or situation.
Being fit and healthy also increases your ability to deal with stress as it arises.

Relaxation techniques and meditation

One goal of yoga is to restore balance and harmony to the body and emotions through numerous postural and breathing exercises.

There are many ways to use structured relaxation techniques to help control stress and improve your physical and mental well-being. While some types of meditation and relaxation therapies are best learned in a class, it’s also possible to learn meditation techniques on your own. There are hundreds of different types of relaxation methods ranging from audio CDs to group martial arts and fitness classes.

The following are only examples of the types of structured programs available that can increase our capacity for relaxation:

Autogenic training: Developed in the early 20th century, this technique is based upon passive concentration and awareness of body sensations. Through repetition of so-called autogenic “formulas”, one focuses upon different sensations, such as warmth or heaviness, in different regions of the body. Autogenic training has been used by physicians as a part of therapy for many conditions. Popular in Europe (where it is even covered by some insurance plans), this method is currently gaining acceptance in the United States. No particular physical skills or exercises are involved; however, people desiring to learn this technique must be prepared to invest time and patience. Since this technique is slightly more complex than some relaxation methods, a course is generally the best way to learn the method.
Biofeedback: Biofeedback is one method of learning to achieve relaxation, control stress responses, or modify the body’s reactions through the use of monitoring equipment that provides information from the body which would normally not be available. This method is based upon the principle first advanced in the early 1960s that the autonomic nervous system (the part we don’t consciously use) is trainable. For example, instruments can be used to measure heart rate, blood pressure, brain activity, stomach acidity, muscle tension, or other parameters while people experiment with postural changes, breathing techniques, or thinking patterns. By receiving this feedback, one can learn to identify the processes that achieve the desired result, such as a reduction in heart rate and blood pressure. Biofeedback is used by many practitioners for a variety of psychological and physical conditions. Because the technique involves the use of measuring devices, it can only be performed by a professional.
Imagery: Imagery, sometimes referred to as guided imagery, is the use of pleasant or relaxing images to calm the mind and body. By controlling breathing and visualizing a soothing image, a state of deep relaxation can occur. This method can be learned by anyone and is relatively easy to try out.
Meditation techniques: Ranging from practices associated with specific religions or beliefs to methods focusing purely on physical relaxation, meditation is one of the most popular techniques to achieve physical and mental relaxation. There are thousands of different types of meditation, and many can be learned on your own. The meditative state is one in which there is a deep centering and focusing upon the core of one’s being; there is a quieting of the mind, emotions, and body. The meditative state can be achieved through structured (as in a daily practice of a routine) or unstructured (for example, while being alone outdoors) activities. While teachers of meditative arts are readily available, some techniques can be learned through books or online tutorials.
- A form of meditation popularized for several decades is transcendental meditation (TM). TM has the goal of achieving transcendental consciousness (the simplest form of awareness). It is practiced for 15-20 minutes in the mornings and evenings and is relatively easy to learn. Numerous classes and teaching materials are available for beginners.
- Another variant of a meditation technique has gained popularity in the U.S. since its description in the 1970s by Harvard physician Herbert Benson. This technique involves the generation of the so-called relaxation response through the repetition of a word or phrase while quietly seated, 10-20 minutes per day. Designed to evoke the opposite bodily reaction to the stress response (or “fight or flight” reaction), this method carries no religious or spiritual overtones. Its value has been documented in the reduction of blood pressure and other bodily stress responses. Like other forms of meditation, it can be learned on one’s own, but time and practice are required to elicit the desired relaxation state.
Progressive muscle relaxation: Progressive muscle relaxation is a method developed in the 1930s in which muscle groups are tightened and then relaxed in succession. This method is based upon the idea that mental relaxation will be a natural outcome of physical relaxation. Although muscle activity is involved, this technique requires no special skills or conditioning, and it can be learned by almost anyone. Progressive muscle relaxation is generally practiced for 10-20 minutes a day. As with the relaxation response, practice and patience are required for maximum benefits.
Qigong: The martial art qigong is an ancient Chinese health-care system that combines physical training (such as isometrics, isotonic, and aerobic conditioning) with Eastern philosophy and relaxation techniques. There are many different kinds of qigong, including medical qigong. Some forms are practiced while standing, sitting, or lying down; others involve structured movements or massage. Over 70 million Chinese practice some form of qigong daily. Qigong has been used for centuries in China for the treatment of a variety of medical conditions. Learning qigong involves time, commitment, patience, and determination, and learning from a master or group is advisable. Since this technique involves physical exertion, check with your doctor before beginning, particularly if you have a chronic medical condition or are over 40 years old.
Tai chi: Like qigong, tai chi is a Chinese martial art. It has been termed a kind of “meditation in motion” and is characterized by soft, flowing movements that stress precision and force. Also known as tai chi chuan, this method is thousands of years old. As with qigong, training from a master is necessary to learn the art of tai chi. Again, since motion and force are required, check with your doctor before beginning training.

Yoga: There are many forms of yoga, an ancient Indian form of exercise based upon the premise that the body and breathing are connected with the mind. The practice of yoga is thought to be over 5,000 years old. One goal of yoga is to restore balance and harmony to the body and emotions through numerous postural and breathing exercises. Yoga, which means “joining” or “union” in Sanskrit, has been called the “search for the soul” and the “union between the individual and the divine.” Among the benefits of yoga are increased flexibility and capability for relaxation. No special level of conditioning is required; yoga can be learned by nearly anyone. Classes, books, and videos are widely available. Those with special or chronic physical conditions will want to get clearance from their doctor before beginning.

Good time management skills are critical for effective stress control. In particular, learning to prioritize tasks and avoid over commitment are critical measures to make sure that you’re not overscheduled. Always using a calendar or planner and checking it faithfully before committing to anything is one way to develop time management skills. You can also learn to identify time wasting tasks by keeping a diary for a few days and noticing where you may be losing time.

For example, productivity experts recommend setting aside a specific time (or multiple times) each day to check and respond to email and messages rather than being a continual slave to incoming information. Banishing procrastination is another time management skill that can be learned or perfected.

If your physical surroundings (office, desk, kitchen, closet, car) are well organized, you won’t be faced with the stress of misplaced objects and clutter. Make it a habit to periodically clean out and sort through the messes of paperwork and clutter that accumulate over time.

Support systems

People with strong social support systems experience fewer physical and emotional symptoms of stress than their less-connected counterparts. Loved ones, friends, business associates, neighbors, and even pets are all part of our social networks. Cultivating and developing a social support network is healthy for both body and mind.

How can I get help with stress management?

If you feel you can’t cope with or manage stress on your own or you are faced with unbearable stress, remember that there are resources to help.

Check in with your doctor. Stress can take its toll on your body, increasing your susceptibility to infections and worsening the symptoms of practically any chronic condition. Stress alone can also be a cause of numerous physical symptoms. Your physician will be able to assess the effects that stress may be having on your physical functioning and can recommend ways to combat these negative influences. Remember to be honest about the extent of stress you are experiencing. In severe cases of short-term life stress, your doctor can talk with you about the possibility of medications to help alleviate the short-term symptoms. He or she can also suggest relaxation techniques and provide advice on stress-reduction strategies that are most appropriate for you. Your doctor is also an excellent referral source should you decide to seek a counselor or therapist.
Consider counseling. Stress-management counseling is offered by various types of mental-health professionals. Stress counseling and group-discussion therapy have proven benefits in reduction of stress symptoms and improvement in overall health and attitude. Counseling doesn’t have to be a long-term commitment, but some people will benefit from a series of stress-counseling sessions from a qualified therapist. He/she can help you identify the problem areas in your life and work on strategies to control your most stressful moments or situations. The very act of talking to an impartial and supportive observer can also be a great way to unleash tension and worry.
Spend time with those you love. Countless studies show that people with a balanced, happy social support structure (consisting of friends, family, loved ones, or even pets) experience fewer stress-related symptoms and are better stress managers than people without social support. Your loved ones are also in an excellent position to observe your lifestyle and offer suggestions and help when you need it.
Take a course. Many relaxation programs, meditation techniques, and methods for emotional and physical relaxation are actually learned processes that can be acquired most quickly through a class or course with a competent instructor. An added benefit is that you will meet others with similar goals and interests.

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