Reduce Stress

  

Healthy Diet. A healthy lifestyle is an essential companion to any stress-reduction program. General health and stress resistance can be enhanced by a regular exercise, a diet rich in a variety of whole grains, vegetables, and fruits, and by avoiding excessive alcohol, caffeine, and tobacco.

Exercise. Exercise in combination with stress management techniques is extremely important for many reasons:

·        Exercise is an effective distraction from stressful events.  

·        Employees who follow an active lifestyle need fewer sick and disability days than sedentary workers.  

·        And most importantly, stress itself poses significantly less danger to overall health in the physically active individual.

 

The heart and circulation are able to work harder for longer stretches of time, and the muscles, ligaments, bones, and joints become stronger and more flexible.

Usually, a varied exercise regime is more interesting, and thus easier to stick to. Start slowly. Strenuous exercise in people who are not used to it can be very dangerous and any exercise program should be discussed with a physician. In addition, half of all people who begin a vigorous training regime drop out within a year. The key is to find activities that are exciting, challenging, and satisfying. The following are some suggestions:

·        Sign up for aerobics classes at a gym. 
·        Brisk walking is an excellent aerobic exercise that is free and available to nearly anyone. Even short brisk walks can relieve bouts of stress.  

·        Swimming is an ideal exercise for many people including pregnant women, individuals with musculoskeletal problems, and those who suffer exercise-induced asthma.  

·        Yoga or Tai Chi can be very effective, combining many of the benefits of breathing, muscle relaxation, and meditation while toning and stretching the muscles. The benefits of yoga may be considerable. Numerous studies have found it beneficial for many conditions in which stress is an important factor, such as anxiety, headaches, high blood pressure, and asthma. It also elevates mood and improves concentration and ability to focus.

As in other areas of stress management, making a plan and executing it successfully develops feelings of mastery and control, which are very beneficial in and of themselves. Start small. Just 10 minutes of exercise three times a week can build a good base for novices. Gradually build up the length of these every-other-day sessions to 30 minutes or more.

 

 

Cognitive-behavioral methods are the most effective ways to reduce stress. They include identifying sources of stress, restructuring priorities, changing one's response to stress, and finding methods for managing and reducing stress. This approach my be particularly helpful when the source of stress is chronic pain or other chronic diseases.

Identifying Sources of Stress. It is useful to start the process of stress reduction with a diary that keeps an informal inventory of daily events and activities. While this exercise might itself seem stress producing (and yet one more chore), it need not be done in painstaking detail. A few words accompanying a time and date will usually be enough to serve as reminders of significant events or activities.

·        The first step is to note activities that put a strain on energy and time, trigger anger or anxiety, or precipitate a negative physical response (eg, a sour stomach or headache).  

·        Also note positive experiences, such as those that are mentally or physically refreshing or produce a sense of accomplishment.  

·        After a week or two, try to identify two or three events or activities that have been significantly upsetting or overwhelming.

 

Questioning the Sources of Stress. Individuals should then ask themselves the following questions:

·        Do these stressful activities meet their own goals or someone else's?  

·        Have they taken on tasks that they can reasonably accomplish?  

·        Which tasks are in their control and which ones aren't?

 

Restructuring Priorities: Adding Stress Reducing Activities. The next step is to attempt to shift the balance from stress-producing to stress-reducing activities. Eliminating stress is rarely practical or feasible, but there are many ways to reduce its impact. One study indicated, in fact, that adding daily pleasant events has more positive effects on the immune system than reducing stressful or negative ones. In most cases, small daily decisions for improvement accumulate and reconstruct a stressed existence into a pleasant and productive one.

Consider as many relief options as possible. Examples include the following:

·        Take long weekends or, ideally, vacations.  

·        If the source of stress is in the home, plan times away, even if it is only an hour or two a week.  

·        Replace unnecessary time-consuming chores with pleasurable or interesting activities.  

·        Make time for recreation. (This is as essential as paying bills or shopping for groceries.)

 

Discuss Feelings. The concept of communication and "letting your feelings out" has been so excessively promoted and parodied that it has nearly lost its value as good psychologic advice. Nevertheless, feelings of anger or frustration that are not expressed in an acceptable way may lead to hostility, a sense of helplessness, and depression.

Expressing feelings does not mean venting frustration on waiters and subordinates, boring friends with emotional minutia, or wallowing in self-pity. In fact, because blood pressure may spike when certain chronically hostile individuals become angry, some therapists strongly advise that just talking, not simply venting anger, is the best approach, especially for these people.

The primary goal is to explain and assert one's needs to a trusted individual in as positive a way as possible. Direct communication may not even be necessary. Writing in a journal, writing a poem, or composing a letter that is never mailed may be sufficient.

Expressing one's feelings solves only half of the communication puzzle. Learning to listen, empathize, and respond to others with understanding is just as important for maintaining the strong relationships necessary for emotional fulfillment and reduced stress.

Keep Perspective and Look for the Positive. Reversing negative ideas and learning to focus on positive outcomes helps reduce tension and achieve goals. The following steps using an example of a person who is alarmed at the prospect of giving a speech may be useful:

·        First, identify the worst possible outcomes (forgetting the speech, stumbling over words, humiliation, audience contempt).  

·        Rate the likelihood of these bad outcomes happening (probably very low or that speaker wouldn't have been selected in the first place).  

·        Envision a favorable result (a well-rounded, articulate presentation with rewarding applause).  

·        Develop a specific plan to achieve the positive outcome (preparing in front of a mirror, using a video camera or tape recorder, relaxation exercises).  

·        Try to recall previous situations that initially seemed negative but ended well.

 

Use Humor. Research has shown that humor is a very effective mechanism for coping with acute stress. Keeping a sense of humor during difficult situations is a common recommendation from stress management experts. Laughter not only releases the tension of pent-up feelings and helps keep perspective, but it appears to have actual physical effects that reduce stress hormone levels. It is not uncommon for people to recall laughing intensely even during tragic events, such as the death of a loved one, and to remember this laughter as helping them to endure the emotional pain.

 

 

Many institutions within the current culture, while paying lip service to stress reduction, put intense pressure on individuals to behave in ways that promote tension. Some experts argue that employers should be held responsible for taking measures to prevent stress from work overload and should provide help to deal with work-related stress. Treating stress has a number of benefits, not only for the individual but also for the employer. In one study, for example, in which a company set up a two-year stress management educational program, the savings to the company in workmen's compensations costs were nearly $150,000, compared to the cost of the program which was only $150 per participant for a total of $6,000. A study in Japan indicated that the most popular approaches for reducing stress in the work place were educational and consultation programs for each individual worker. Stress prevention methods that only involved management were inadequate.

In general, however, few workplaces offer stress management programs, and it is usually up to the employee to find their own ways to reduce stress. Here are some suggestions:

·        Seek out someone in the Human Resources department or a sympathetic manager and communicate concerns about job stress. Work with them in a non-confrontational way to improve working conditions, letting them know that productivity can be improved if some of the pressure is off.  

·        Establish or reinforce a network of friends at work and at home.  

·        Restructure priorities and eliminate unnecessary tasks.  

·        Learn to focus on positive outcomes.  

·        If the job is unendurable, plan and execute a career change. Send out resumes or work on transfers within the company.  

·        If this isn't possible, be sure to schedule daily pleasant activities and physical exercise during free time.

It may be helpful to keep in mind that the bosses are also victimized by the same stressful conditions they are imposing.

 

 

Studies of people who remain happy and healthy despite many life stresses conclude that most have very good networks of social support. One study indicated that support even from strangers reduced blood pressure surges in people undergoing a stressful event. Many studies suggest that having a pet helps reduce medical problems aggravated by stress, including heart disease and high blood pressure.

 

 

Since stress is here to stay, everyone needs to develop methods for invoking the relaxation response, the natural unwinding of the stress response. Relaxation lowers blood pressure, respiration, and pulse rates, releases muscle tension, and eases emotional strains. This response is highly individualized, but there are certain approaches that seem to work. Combinations are probably best. For example, in a study of children and adolescents with adjustment disorder and depression, a combination of yoga, a brief massage, and progressive muscle relaxation effectively reduced both feelings of anxiety and stress hormone levels. No one should expect a total resolution of stress from these approaches, but if done regularly, these programs can be very effective. [See Table.]

 

Relaxation Methods	Specific Procedure
Deep Breathing Exercises. During stress, breathing becomes shallow and rapid. Taking a deep breath is an automatic and effective technique for winding down. Deep breathing exercises consciously intensify this natural physiologic reaction and can be very useful during a stressful situation, or for maintaining a relaxed state during the day.	·         Inhale through the nose slowly and deeply to the count of ten.   ·         Make sure that the stomach and abdomen expand but the chest does not raise up.   ·         Exhale through the nose, slowly and completely, also to the count of ten.   ·         To help quiet the mind, concentrate fully on breathing and counting through each cycle.   ·         Repeat five to ten times and make a habit of doing the exercise several times each day, even when not feeling stressed.
Muscle Relaxation. Muscle relaxation techniques, often combined with deep breathing, are simple to learn and very useful for getting to sleep. In the beginning it is useful to have a friend or partner check for tension by lifting an arm and dropping it; the arm should fall freely. Practice makes the exercise much more effective and produces relaxation much more rapidly.	·         • After lying down in a comfortable position without crossing the limbs, concentrate on each part of the body.   ·         Maintain a slow, deep breathing pattern throughout this exercise.   ·         Tense each muscle as tightly as possible for a count of five to ten and then release it completely.   ·         Experience the muscle as totally relaxed and lead-heavy.   ·         Begin with the top of the head and progress downward to focus on all the muscles in the body.   ·         Be sure to include the forehead, ears, eyes, mouth, neck, shoulders, arms and hands, fingers, chest, belly, thighs, calves, and feet.   ·         Once the external review is complete, imagine tensing and releasing internal muscles.
Meditation.Meditation, used for many years in Eastern cultures, is now widely accepted in this country as a relaxation technique. The goal of all meditative procedures, both religious and therapeutic, is to quiet the mind (essentially, to relax thought). With practice, meditation reduces stress hormone levels and elevates mood. The practiced meditator can achieve a reduction in heart rate, blood pressure, adrenaline levels, and skin temperature while meditating. Some recommend meditating for no longer than 20 minutes in the morning after awakening and then again in early evening before dinner. Even once a day is helpful. (One should probably not meditate before going to bed: some people who meditate before sleep wake up in the middle of the night alert and unable to return to sleep.) New practitioners should understand that it can be difficult to quiet the mind, and should not be discouraged by lack of immediate results. A number of techniques are available. A few are discussed here.	Mindfulness Meditation. Mindfulness is a common practice that focuses on breathing. It employs the basic technique used in other forms of meditation. ·         Sit upright with the spine straight, either cross-legged or sitting on a firm chair with both feet on the floor, uncrossed.   ·         With the eyes closed or gently looking a few feet ahead, observe the exhalation of the breath.   ·         As the mind wanders, one simply notes it as a fact and returns to the "out" breath. It may be helpful to imagine one's thoughts as clouds dissipating away. Transcendental Meditation (TM). TM uses a mantra (a word that has a specific chanting sound but no meaning). The meditator repeats the word silently letting thoughts come and go. In one study, TM was as effective as exercise in elevating mood. Mini-Meditation. The method involves heightening awareness of the immediate surrounding environment. Choose a routine activity when alone. For example: ·         While washing dishes concentrate on the feel of the water and dishes.   ·         Allow the mind to wander to any immediate sensory experience (sounds outside the window, smells from the stove, colors in the room).   ·         If the mind begins to think about the past or future, abstractions or worries, redirect it gently back.   ·         This redirection of brain activity from your thoughts and worries to your senses disrupts the stress response and prompts relaxation. It also helps promote an emotional and sensual appreciation of simple pleasures already present in a person's life.
Biofeedback	·         • During biofeedback, electric leads are taped to a subject's head.   ·         The person is encouraged to relax using methods such as those described above.   ·         Brain waves are measured and an audible signal is emitted when alpha waves are detected, a frequency which coincides with a state of deep relaxation.   ·         By repeating the process, subjects associate the sound with the relaxed state and learn to achieve relaxation by themselves.
Massage Therapy. Massage therapy appears to slow down the heart and relax the body. Rather than causing drowsiness, however, massage actually increases alertness. A number of massage therapies are available and some are listed here.	Swedish massage uses muscle manipulation. It is the standard massage technique and is widely available. Shiatsu applies intense pressure to parts of the body. It can be painful, but people report deep relaxation afterward. Reflexology manipulates acupuncture points in the hands and feet.