Stress Management

What Is Stress?
Dr. Hans Selye, the father of stress theory, defined stress as "the nonspecific response of the body to any demand made upon it." The "demand" can be a threat, a challenge or any kind of change which requires the body to adapt. The response is automatic, immediate. Stress can be good (called "eustress") when it helps us perform better, or it can be bad ("distress") when it causes upset or makes us sick.

What Does the Stress Reaction Consist of?
The stress reaction results from an outpouring of adrenaline, a stimulant hormone, into the blood stream. This, with other stress hormones, produces a number of changes in the body which are intended to be protective. The result often is called "the fight-or-flight response" because it provides the strength and energy to either fight or run away from danger. The changes include an increase in heart rate and blood pressure (to get more blood to the muscles, brain and heart), faster breathing (to take in more oxygen), tensing of muscles (preparation for action), increased mental alertness and sensitivity of sense organs (to assess the situation and act quickly), increased blood flow to the brain, heart and muscles (the organs that are most important in dealing with danger) and less blood to the skin, digestive tract, kidneys and liver (where it is least needed in times of crisis). In addition, there is an increase in blood sugar, fats and cholesterol (for extra energy) and a rise in platelets and blood clotting factors (to prevent hemorrhage in case of injury).

What Are Common Symptoms of Stress?
Manifestations of stress are numerous and varied but they generally fall into four categories (this is only a partial list of most common symptoms):

Physical: fatigue, headache, insomnia, muscle aches/stiffness (especially neck, shoulders and low back), heart palpitations, chest pains, abdominal cramps, nausea, trembling, cold extremities, flushing or sweating and frequent colds. Mental: decrease in concentration and memory, indecisiveness, mind racing or going blank, confusion, loss of sense of humor. Emotional: anxiety, nervousness, depression, anger, frustration, worry, fear, irritability, impatience, short temper. Behavioral: pacing, fidgeting, nervous habits (nail-biting, foot-tapping), increased eating, smoking, drinking, crying, yelling, swearing, blaming and even throwing things or hitting.

What Are the Causes of Stress?
Dr. Selye called the causes of stress "stressors" or "triggers." There are two kinds of stressors: external and internal.

External stressors include:

• Physical environment: noise, bright lights, heat, confined spaces.
• Social: rudeness, bossiness or aggressiveness on the part of someone else.
• Organizational: rules, regulations, "red tape," deadlines.
• Major life events: death of a relative, lost job, promotion, new baby.
• Daily hassles: commuting, misplacing keys, mechanical breakdowns.

Internal stressors include:

Lifestyle choices: caffeine, not enough sleep, overloaded schedule. Negative self-talk: pessimistic thinking, self-criticism, over-analyzing. Mind traps: unrealistic expectations, taking things personally, all-or-nothing thinking, exaggerating, rigid thinking. Stressful personality traits: Type A, perfectionist, workaholic, pleaser.

It is important to note that most of the stress that most of us have is actually self-generated. This is a paradox because so many people think of external stressors when they are upset (it is the weather, the boss, the children, the spouse, the stock market). Recognizing that we create most of our own upsets, however, is an important first step to dealing with them.

What Are Some Ways to Master Stress?
The following are some categories that can be helpful in mastering stress:

Change lifestyle habits. Decrease caffeine (coffee, tea, colas, chocolate). Well-balanced diet. Decrease consumption of junk food. Eat slowly. Regular exercise (at least 30 minutes, three times per week). Adequate sleep (figure out what you need, then get it). Leisure time (do something for yourself everyday). Relaxation exercises (e.g., meditation, self-hypnosis).

Change stressful situations.

• Time and money management.
• Assertiveness.
• Problem-solving.
• Possibly leaving a job or a relationship.

Change your thinking. Look at things more positively. See problems as opportunities. Refute negative thoughts. Keep a sense of humor.

Diversion and distraction. Take a time-out (anything from a short walk to a vacation) to get away from the things that are bothering you. This will not resolve the problem, but it gives you a break and a chance for your stress levels to decrease. Then, you can return to deal with issues feeling more rested and in a better frame of mind.

[Prepared by Dr. David B. Posen Lifestyle Counselor and Psychotherapist, and Author of "Always Change a Losing Game" Oakville, Ontario. May be copied and distributed to patients]
Internet Mental Health (www.mentalhealth.com) copyright © 1995-1998 by Phillip W. Long, M.D.

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