CONDITIONS

What Is Stress Management

Stress management is the use of various techniques that may help manage or control your levels of stress, particularly chronic stress. Certain techniques of stress management can be learned and done individually, while others may require the help of a professional, such as a doctor, therapist, social worker, counselor, or an alternative medicine practitioner. Many people also find support for stress management in groups and group activities. 

Learning how to manage stress, especially chronic stress, is becoming an issue among many employers. Schools are also starting to teach stress management to their students, in order to improve rising rates of academic stress.

What Causes Stress Management

What causes stress can differ considerably from person to person. Something that may not bother you may cause severe stress to someone else, and the other way around. Stresses can be individual, or they can be several small things adding up to one big stressor. There are also routine stresses and traumatic stresses, acute (short-term) and chronic (long-term) stresses, all of which affect people in different ways. Stresses aren’t always necessarily caused by a “bad” situation, they can be caused by seemingly happy events or events that you’ve chosen, such as marriage, moving, graduation, promotions, becoming a parent, and retirement. 

When you experience stress, your body releases hormones that are meant to help you cope. These hormones, including cortisol, trigger your fight-or-flight response. These hormones are supposed to protect you by pushing you to react to the stress that you’re facing. Your body reacts to the hormones by tensing your muscles and increasing your heart rate or pulse, making you ready and alert, to react. Stress becomes a problem, however, when the stress reactions don’t resolve once the danger or perception of danger has been removed, and the feeling of over-alertness doesn’t go away. 

Acute stress or short-term stresses start and stop suddenly. An acute stress can range from narrowly missing being hit by a car while you’re crossing the street or having a fight with someone you love. The stresses trigger the hormone release but the sensation should go away once you have overcome the stress. 

Chronic stress is caused by situations that affect you over a longer period, such as financial issues, stressful situations at work, or relationship difficulties. The hormones may be released but because the stress doesn’t go away completely, your body doesn’t know how to cope with that constant feeling of anxiety or worry. 

Here are just a few examples of other situations that can cause significant stress: 

  • Death of a loved one
  • Divorce
  • Illness or injury
  • Being a caregiver for frail or ill relative or chronically ill child
  • Moving
  • Buying or selling a home
  • Hazardous event like fire, flood, natural disaster, or car crash
  • Finances
  • Job
  • Pregnancy
  • Becoming a parent
  • Job change
  • School
  • Exposure to excessive noise or other stimulation 

Stressful situations, particularly traumatic events, may lead to a more severe problem called post-traumatic stress disorder (PTSD). With PTSD, you may re-experience the event, have nightmares, or experience flashbacks. You may find yourself thinking of the event for no reason. Avoidance of anything that may trigger ideas or thoughts of the event can add to the stressful feelings.

Risk Factors For Stress Management

Stressful events occur to everyone—and can be from those that may be happy (such as a wedding) and those that can have serious consequences (such as financial difficulties). But stress doesn’t cause the same reactions in everyone. We all know some people who are happy and enjoy life, no matter what life throws at them, but we may also know someone who feels paralyzed when they are faced with something that we may feel wouldn’t bother us. 

People who at higher risk of reacting badly to stresses include those who: 

  • Have had stressful childhood experiences, such as trauma or abuse
  • Are older
  • Are caregivers of family members
  • Are chronically ill
  • Live in big cities
  • Are divorced or widowed
  • Are alone, with little or no support system 

Stress seems to affect more women than men, as it does people with certain personality traits, such as those who are quick to anger.

Diagnosing Stress Management

Once you have decided to see a doctor about your stress and stress management, you will likely be given an exam to rule out any physical problems and along with your medical history, you might be asked about: 

  • Your symptoms and personal history
  • How long you have had the symptoms
  • What events or situations trigger your stress

You may also be given a screening test, questionnaire, or psychological evaluation.

Symptoms of Stress Management

The symptoms of stress are as different between people as are the causes. Some people show stress symptoms physically, while others psychologically. These are the most common symptoms of stress: 

  • Depression
  • Difficulty concentrating
  • Difficulty relaxing
  • Difficulty with decision making
  • Increasing use of alcohol, nicotine, or drugs
  • Irritability
  • Jumpiness
  • Lack of confidence
  • Sleep disturbances 

Physical symptoms of stress can include:

  • Abdominal cramping
  • Changes in appetite
  • Decreased sexual function
  • Diarrhea
  • Fatigue
  • Headaches
  • Muscle tension and pain
  • Obesity or unintentional weight loss
  • Shortness of breath or difficulty breathing 

Unmanaged stress may also worsen or lead to certain types of physical illnesses or conditions, such as: 

  • Asthma
  • Autoimmune disorders, like fibromyalgia
  • Diabetes (type 2)
  • Heart disease
  • Hypertension or high blood pressure

Prognosis

Everyone has some stress in his or her life. How well they deal with it can directly affect the prognosis or outcome. Good stress management after a traumatic event can help reduce the risk of developing post-traumatic stress disorder, and stress management overall helps reduce the risk of stress causing or worsening physical ailments.

Screening

If you feel you may need stress management, your doctor has screening tests and questionnaires that may help determine your state of mind.

Prevention

We can’t avoid all stresses, but by taking some preventative action, we can try to limit our exposure to stresses and our reactions to the stresses when they do occur. These include actions such as: 

  • Exercising
  • Avoiding stimulants (like caffeine and nicotine) and sedatives (like alcohol)
  • Doing things you enjoy (hobbies, going out with friends, etc.)
  • Eating well
  • Saying “no” to things and events that will stress you, when feasible (also called assertive communication)
  • Managing your time
  • Delegating tasks, when possible
  • Asking for help

Techniques for Stress Management

Successful stress management techniques vary considerably between different people. While some may respond well to traditional methods of talking things out or distractions, other people need medication or to be proactive and have techniques ready and waiting to be used if they’re needed. As well, many people find that they need a combination of techniques, as some may work in some situations but not in others. The important thing to keep in mind is that it may take practice for some techniques to work for your and you may have to do some trial-and-error too, to find which ones work best. Here are some suggestions: 

Lifestyle changes. Making changes in every day life activities can make a difference in how your body reacts to stress. These include:

  • Exercise
    • Walking
    • Going to the gym
    • Joining a team sport
    • Swimming
    • Dancing
    • Yoga
    • Tai Chi
  • Eating a healthy diet
  • Connecting with loved ones
  • Quitting smoking
  • Stopping or reducing alcohol consumption
  • Getting adequate amount of sleep
  • Getting enough alone time
  • Getting out of the house and socializing
  • Taking up a hobby 

Counseling. Seeing a counselor or therapist may also be helpful. Cognitive behavior therapy (CBT) is a type of therapy that helps people perceive what is causing their stress and how they react to it. 

Medications. Several medications for anxiety have proven to help some people with severe stress, but many doctors feel it shouldn’t be a first-line treatment, that medications should be tried if counseling is not effective, for example. Also, it’s important to understand that not everyone responds in the same way to anti-anxiety medications, so it may take trying a few different types before you find one that is effective for you. Examples of anti-anxiety medications that may help with stress management include: 

Antidepressants. Examples of antidepressants used to treat anxiety disorders include:

  • Citalopram
  • Escitalopram
  • Fluoxetine
  • Paroxetine
  • Sertraline
  • Venlafaxine
  • duloxetine
  • Amitriptyline,
  • Imipramine
  • Nortriptyline 

Benzodiazepines. This class of medication works more quickly, and is usually used for relieving acute anxiety. They can become habit-forming, so they should be used with caution.

  • Alprazolam
  • Clonazepam
  • Diazepam
  • Lorazepam 

Other types of medications that may be used that fall into the following classes:

  • MAO inhibitors
  • Anticonvulsants
  • Beta blockers 

Support groups. Joining a support group, particularly if your stress is coming from being a caregiver or from a health condition or illness.

 

Complementary and Alternative Treatment

Relaxation techniques not only encourage a clearing of the mind (distraction), they can have a physical effect on the your body as well, such as lowering your heart rate and blood pressure, and relaxing your muscles that may have tensed up. 

  • Mindfulness. This is a technique that encourages people to be in the moment, to identify what is happening at that time, to take their mind off stress-related issues. Mindfulness works best when it’s been practiced and learned during non-stressful times, so it can be called on when needed.
  • Meditation. Like mindfulness, meditation encourages the mind to move away from stressful issues. Like mindfulness, meditation is best when learned and practiced during non-stressful times. There are many ways to learn meditation, with therapists, mobile apps, videos, books, and audio.
  • Guided imagery. With guided imagery, you are encouraged to bring your mind elsewhere, to imagine a place you want to be. Again, like mindfulness and meditation, this should be learned and practiced during a non-stressful time in order to be effective during stressful periods.
  • Deep breathing exercises. Taking the time to do deep breathing exercises helps relax both the body and mind. This can be done during the stressful situation or after. It can also be practiced when there are no stresses, which encourages your body to respond to deep breathing exercises when you need them.
  • Muscle relaxation techniques. As with deep breathing exercises, working on actively relaxing your muscles distracts your mind and encourages body relaxation. This can be done during a stressful situation, but should be practiced when you aren’t feeling stressed, so you can understand how your body feels during relaxation.
  • Yoga. Listed above as a form of exercise, yoga also encourages relaxation.
  • Acupuncture. To perform acupuncture, the practitioner inserts fine needles into specific parts of the body that are believed to conduct energy. This allows for the body’s energy to flow, promoting relaxation and healing.
  • Massage. Swedish massage, the lightest of massages, encourages relaxation as the massage therapist works to relax your muscles. It is believed that massage can help decrease cortisol levels in the body.
  • Aromatherapy. Many people report a calming sensation with the scent of lavender. Other natural oils that may help relax you include:
    • Bergamot
    • Cedarwood
    • Chamomile
    • Geranium
    • German frankincense
    • Jasmine
    • Marjoram
    • Roman frankincense
    • Vanilla 

Herbal and natural supplements. A number of supplements can be helpful to those who suffer from stress—but be sure to speak with your doctor first to see what is right for you. If you take prescription medicines, check with your pharmacist to be sure that the supplements you want to try don’t interact with your medicines, either prescription or over-the-counter.

  • Valerian. According to University of Maryland Medical Center, valerian may be helpful for some people in managing stress. However, it should be used with caution and not used with standard sedatives as it could intensify the effects.
  • Kava. Commonly used to reduce anxiety and stress, the medical center issued a warning regarding kava as it has been found to be related to liver failure in some people. Check with your doctor to see what is right for you.

When To Contact A Doctor

Sometimes you can’t manage your stress on your own and you need help. If you have any of the following signs, speak with your doctor about what you might do to manage your stress: 

  • You are becoming physically ill or have physical symptoms
  • Your anxiety is preventing you from participating in daily activities
  • You think about suicide 

If you have suicidal thoughts or actions, seek help immediately. Go to the emergency room or a walk-in clinic, call your doctor, or call the National Suicide Prevention Lifeline at 800-273-8255

Questions For A Doctor

  • Could there be something physical causing my symptoms?
  • Should I see a mental health practitioner or therapist?
  • What can I do to manage my symptoms now?
  • What treatments are available to me?
  • What side effects might these drugs have? (If you are prescribed medicines)
  • How long will I need treatment?
  • Who can I call/where do I go in case of emergency?
  • How can I reduce the risk of more bad reactions to stress?