Stress Management

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What is STRESS:

Stress is defined as the body’s reaction to any change that requires us to respond or to make an adjustment. We experience these changes on a daily basis. Stress is a daily phenomenon. It is normal to have stress. 

Stress becomes a problem when we have too many stress-causing factors and do not use any stress-managing strategies. In these situations, stress can become chronic and can lead to many problems related to physical and mental health.

Causes of Stress:

Factors that cause stress are called stressors. In the presence of stressors, our body releases stress hormones—adrenaline and cortisol. These stress hormones cause our body to react in response.

Physical Environment: When our physical environment fails to meet our physical needs, it can lead to stress. For example, if our neighbourhood is too noisy, if there is no access to clean water, if levels of air pollution are too high, if the temperatures are too cold or too hot, it can all be a cause for stress. A risk of health hazards can also cause stress.

Social Environment: We all engage with our social environment in different ways—through family interactions, by socializing with our friends, acquaintances and colleagues and when participating in other groups, committees and social or political organizations. If we sense a lack of belonging in these social interactions, then it leads to stress. Problems in our relationships with other people can be a big cause for stress.

Physiological stressors: Factors that put strain on our body are called physiological stressors. Illness, injury and chronic pain can cause stress.

Emotional Problems: Individuals who experience emotional problems like sadness, anxiety, depression or loneliness are at a higher risk of experiencing stress. Stress in itself can be an emotional problem as well, so this can create a vicious cycle in which stress causes emotional imbalance and emotional problems cause stress.

Psycho-spiritual stressors: These are the stress factors that put a crisis on our moral or spiritual values and beliefs. We might find our work to be misaligned with our values. We might find ourselves not fitting well within our relationships. When we don’t find fulfillment in the meaning or purpose of life, or are unable to fulfill our needs of self-actualization, it could be a cause for stress. 

Self-image: Our self-image is determined by how we feel about ourselves and what we think others feel about us. If we feel that we are not being able prove ourselves in a positive, strong image, it can lead to stress. We can experience this cause of stress both in our personal as well as professional lives. Sometimes, people feel the constant need to maintain a certain status and when they are unable to do so due to external or internal factors, we can accumulate stress.

Life events: Sometimes certain life events that are beyond our control can cause us stress. The cause for stress is not always a negative reason. These can also be positive events like getting married, getting a promotion or buying a house. 

These can be sudden, small impact events like a car breaking down, not being able to find a babysitter, an unfinished assignment, hosting guests etc. Sometimes these can be big-impact events like the loss of a loved one, getting a life-changing medical diagnosis for yourself or someone you love, etc.

Developmental History: Individuals exposed to intense or chronic stress factors during their developmental years are at a higher risk for problems due to accumulated stress. The stress factors could have been experienced in many forms during childhood or adolescence. Abuse, maltreatment, trauma, family conflict, lack of emotional support, neglect, exposure to war or terrorism—can be some of the many stressors that can affect an individual’s stress level even after growing up.

Uncertainty: When people are insecure about their personal, financial or professional situation—and sometimes even the political situation around them—it can be stressful. Individuals in this situation might feel a lack of control or they might be fearful about the unpredictability of the situation.

Lack of coping resources: Coping skills play a central role in how effectively an individual can respond to stressors. People who do not have access to coping skills or coping resources can have a high level of stress. 

Types of Stress:

Stress can manifest or show its symptoms in our body in many different ways. Based on the way it manifests, stress can be of the following types:

Cognitive stress: Tense thoughts, anxiety in the mind, fear about what might happen, worrying about everything

Emotional stress: Easily irritable, restless, unable to relax, sad or depressed, feeling of tension

Physical or Physiological stress: Tightness in the body or muscles, grinding teeth, sweating, headaches, nausea, fatigue, awareness of heart beat, upset stomach, constipation, shakiness, feeling of fainting

Behavioural stress: Strained face and expressions, clenched fists, eating too much or too little, sleeping too much or too little, losing interest in activities, difficulty staying still, partying too much, withdrawing from others, 

Levels of stress:

There are three levels of stress in increasing order:

1. Acute Stress:

It happens in reaction to a certain situation. It usually lasts for a short period. It is characterized by the following symptoms:

-  rapid heart rate for the duration of stress

-  rapid blood pressure for the duration of stress

-  tension headache

-  stomach acidity

-  tense muscles (jaw, back, neck)

Examples: Almost being hit by a car on the road, being called upon to answer a question, emotional reaction to someone’s comment

2. Episodic Acute Stress:

When acute stress happens in frequent episodes over time, it is known as episodic acute stress. All the symptoms of acute stress start to appear as soon as we are experience a stressor. When this happens frequently and repeatedly, individuals might start to show fatigue, digestive problems, recurring headaches and sleep disturbances.

Examples: Multiple disasters in a short period of time, repeated presence of stressors that cause acute stress

3. Chronic Stress

When episodes of acute stress continue to happen more intensely and more frequently, it might seem as if the individual is constantly stressed. This is called chronic stress. The individual seems to live with acute stress on a daily basis. Chronic stress can lead to many psychological and medical problems. Its symptoms can be diverse and might include severe temper issues, diabetes, depression and even suicidal feelings. It requires treatment and attention.

Examples: long-term poverty, repeated abuse, consistently poor working conditions, unhappy relationship

Consequences of stress:

Stress that continues without relief is called distress. Distress can have many negative effects on our well-being:

1.  Stress leads to diseases. Heart problems, diabetes, elevated blood pressure, chest pain, sexual problems, headaches and many abdominal problems are linked to stress.

2.  Stress is linked to some leading causes of death. Many fatal conditions like cancer, lung problems, heart problems, liver cirrhosis, accidents and suicide are linked to stress.

3.  Stress can cause mental illnesses. Stress can lead to anxiety, depression and panic attacks.

4.  Stress can be physically uncomfortable. Headaches, pain, stomach issues and bodily tensions arising due to stress can be a cause of constant discomfort.

5.  Stress affects our behaviour. Stress can lead to social withdrawal, nervousness, fidgeting, anger issues and changes in eating and sleeping behaviours.

6.  Stress decreases efficiency. As a result of stress, you might avoid tasks, neglect your responsibilities, have difficulty concentrating and experience memory issues. This can decrease your efficiency in personal and professional tasks.

7.  Stress strains relationships. When you are under stress, you are unable to interact effectively with others, could demonstrate poor communication skills and lack of attention. This makes it hard for your relationships to function smoothly.

8.  Stress can lead to substance use problems. Long-term stress increases the risk of getting involved in compulsive substance use.

9.  Stress can cause problems in marital or intimate relationships. Stress can cause sexual problems, fertility problems and difficulty in conceiving in addition to the inability in being able to resolve issues amicably.

10. Stress decreases happiness in daily life. Physical and mental issues resulting from stress will prevent you from fully engaging in enjoyable experiences. Even if you are physically able to participate, you might not find happiness in doing so.

Stress is a commonly occurring event in all our lives. However, it is important to deal with it effectively and in a timely manner.

How to Know When You Have Stress:

You can deal with stress only when you know that you are experiencing stress or have stressors in your life. If you notice the following changes in yourself, then it could indicate that you are experiencing stress:

-  Changes in thinking patterns:

Constantly worried, concentration problems, forgetfulness, negative thoughts, difficulty making decisions, feeling unsure or confused, 

-  Changes in emotional behaviour:

Feeling sad, depressed, or hopeless, mood swings, irritability, feeling overwhelmed, low self-esteem, anxiety, nervousness, unable to relax, easily frustrated

-  Changes in the body:

Frequent headaches, dizziness, faint feelings, tightness in muscles, body aches or pains, stomach problems, chest pain, rapid heartbeat, lowered immune system, frequent colds and infections, ringing in the ear, fatigue, cold and sweaty palms, change in appetite, sexual difficulties, weight gain or loss

-  Changes in behaviour:

Neglecting responsibilities, withdrawing from social situations, fidgeting, pacing, foot-tapping, grinding teeth, difficulty sleeping, clenched jaw, increased use of caffeine, alcohol, cigarettes or drugs

Strategies to deal with stress:

Problem-focused strategies: 

Problem focused coping strategies focus on dealing with the cause of the problem. When we use these strategies, we follow a problem-solving process in which we try to identify the actual problem that needs to be fixed, instead of changing other things in the environment. We try to go deeper into the problem in order to gain more information that could be helpful in solving the problem. 

Problem-focused strategies aim to cut out or change the source of the stress. Some of these strategies might include:

-  Analyzing the problem

-  Taking control of the situation (for example, talking to the person involved in the stress-causing situation; actively working to eliminate or reduce the cause; actively learning new skills or strategies that might help)

-  Evaluating the pros and cons 

-  Active planning

Problem-focused strategies are usually quite effective as they address the source of the problem. Sometimes these strategies might be hard to use if the source of the problem is beyond one’s control. 

Emotion-focused strategies:

Emotion focused coping strategies focus on managing the emotions that build up in the presence of stress. Instead of targeting the problem, these strategies target the emotional symptoms of stress. These strategies are helpful when the source of stress is outside the person’s control. 

Emotion-focused strategies help to release emotions, manage feelings and facilitate relaxation. Some of these strategies might include:

-  Disclosure, that is expressing thoughts, feelings and emotions by talking to someone, or by writing

-  Thinking about the positives of the situation (for example, thinking about the ‘good’ things in your life, instead of thinking about the problems)

-  Relaxation techniques (for example, mindfulness, meditation, yoga, stretching, listening to calming music, drinking calming tea etc.)

-  Cognitive reframing, or consciously changing the way you look at the situation to help see new perspectives or find novel solutions (for example, examining your thoughts, challenging your thoughts and replacing your thoughts with other thoughts)

-  Comfort therapies (for example, eating comfort food, shopping, dressing up etc.)

-  Distraction (for example, keeping yourself busy in things that keep your mind off the problem)

Emotion-focused coping strategies can sometimes be ineffective since they do not address the cause of the problem. They might provide immediate but temporary relief. This is why these strategies can be suitable for temporary problems when the source is outside of our control (e.g., an upcoming exam, a surgical procedure etc.)

However, a person should not be using only emotion-focused strategies, especially for repeated or long-term stress. Those problems should be addressed by using problem-focused strategies.

Proactive strategies

Proactive coping strategies are used to prevent the stress from happening in the first place. Individuals who use proactive strategies are able to create conditions that are non-conducive to stress. By using proactive strategies, we can also develop the capability and strength to deal with stressors if they appear.

Some proactive strategies could include:

-  Identifying potential stressors (for example, thinking about what challenges could occur when starting a new task and preparing accordingly)

-  Future-oriented coping, that is anticipating future stressors that could occur and acting in advance to reduce their impact

-  Accumulating resources that would be helpful in dealing with stress if and when it happens

-  Self-regulation, that is thinking about, and working on developing behaviours, competencies and skills that are required to deal with stress

-  Daily practice of mental strengthening, that is, using coping strategies regularly that help to harmonize the body and mind to bring peace, clarity, compassion and courage into your daily life.

Social support strategies:

Social support strategies rely on the support of other people in order to provide relief from stress. A person’s social network might include sources of support, including family, friends, partners, spouses, counsellors or even organizations. Social support can be provided in the following ways:

-  Emotional support: When someone’s positive presence and warm, nurturing support helps a person to feel calm, valued and loved

-  Tangible support: When someone provides specific resources (e.g., money in a financially stressful situation) or services (e.g., babysitting) in order to help relieve the stress of an individual

-  Informational support: When someone is able to offer guidance, information, counselling, advice or suggestions to alleviate the stress of a person

-  Companionship support: When someone is able to reduce the stress of an individual by being present, by offering company, by engaging the person in social conversation and activities, and by instilling a sense of belonging

Avoidance strategies:

It is an unhealthy response in reaction to stress. Avoidance coping continues to maintain or increase the stressor in the individual’s life. It can sometimes give short-term relief and therefore could seem to be a coping strategy. However, avoidance strategies are maladaptive. They do not create conditions for the reduction of stress. These strategies are dysfunctional and non-productive.

This is how a person might demonstrate avoidance strategies when under stress:

-  Denial: A person experiencing stress might not admit that he or she is actually experiencing stress. If this happens, then the person is in denial. The tension continues to accumulate, while the person thinks or declares that he or she is fine.

-  Mental disengagement: When we disengage our mind from the problem caused by the stressor, we might trick ourselves into being calm when actually we are not. People might do this through daydreaming, sleeping or by self-distraction.

-  Dissociation: Sometimes, people might compartmentalize their emotions, thoughts and memories. This prevents them from seeing the overall picture. They are unable to relate to a changed context.

-  Escape: To deal with their stress, some people withdraw from friends or family. They do not engage with anyone and often just spend time alone.

-  Numbing: Some people just numb themselves from real life in order to avoid facing the stressful situation. These behaviours might include substance use including excessive alcohol consumption or doing drugs.

Use of avoidance strategies can be harmful for a person’s mental and emotional well-being in the long term. If maladaptive strategies like the above are used frequently, then a person becomes habitual of using them. These strategies might seem to reduce stress in the immediate moment, but can cause dependence and other problems in the future, while continuing to maintain the stress and its causes.

Tips for stress management:

1.  Learn to be assertive. Practice and learn the skills of assertive communication in order to avoid stress-accumulation. Say ‘no’ to things when you are experiencing an over-burdening of the body or mind.

2.  Maintain a gratitude journal. When you write about the things you are thankful for, it helps you see the positive side of things and sometimes opens up your perspective to new solutions.

3.  Exercise. Regular workout is very effective for relaxing the body and the mind. It improves your mood. While gentle walks and simple exercises are good too, a 40-minute brisk workout can have especially positive effects.

4.  Healthy diet. Eating a well-balanced diet helps to keep the body’s internal system balanced. It can have a positive effect on your body and mind. Do not skip meals. Ensure to have a wide variety of healthy foods to ensure you stay nourished.

5.  Mindful breathing. Focussing our attention on our breath can take off the pressure from our mind. It also helps us become mindful of our body and can make life peaceful and clearer.

6.  Muscle relaxation. Tense muscles can be relaxed through various means including stretching, yoga, getting a massage, hot bath or shower and even a good night’s sleep.

7.  Time management. Learning to organize your time can be helpful in organizing your life, reducing some of the stress and helping you to identify how much work you can handle. It also increases your efficiency, gives you a positive sense of achievement and helps you feel good about yourself.

8.  Take a break. Give your body and mind a break from the routine activities that are stressing you down. You can try something structured, like meditation, yoga or tai chi, or just something relaxing like reading, listening to music, taking walks in the nature, watching a movie or engaging in a hobby.

9.  Socialize for support. Sometimes talking to trusted others can help to reduce your stress and can also give you some new suggestions. You can talk to some family members, good friends, a counsellor or a therapist. You can also seek spiritual support from someone at your place or worship or a spiritual organization.

10.  Laugh a lot. It helps to release tension. Participate in jokes, watch a comedy show or a funny movie. Don’t hesitate to laugh out loud.

11. Be easy on yourself. Do not expect too much of yourself. Be gentle. Appreciate yourself for who you are and the things you can do.

12. Don’t suppress your emotions. Do not try to control your emotions all the time. If you feel sad, just notice that you are feeling sad. It is okay to experience different emotions.

13. Tackle your problems in manageable amounts. Focus on one problem, or one aspect of your problem at one time. Do not get overwhelmed by trying to deal with many things together.

14. Remember you are not alone. Problems affect everyone. Other people have likely experienced similar problems. Do not hesitate to ask for help if required.