01. Effective Ways to Manage and Reduce Stress

Mother and son reading By Dr. Terry Rabinowitz

Did you ever think of stress as a good thing?  Probably not, but intermittent small quantities of stress can be beneficial.  Stress is that feeling of bodily or mental tension that is related to environmental factors that disrupt our usual equilibrium.  On an everyday basis, stress motivates us to get things done: think about the bills you need to pay to avoid a bad credit rating, the test you have to pass to keep your grades up, or the talk you have to prepare for your colleagues at work. 

Some common stressors include frustration, a feeling that comes from interference with one's ability to attain a desired goal or satisfaction; conflict, a feeling of uncertainty or a need to make a choice; and time or emotional pressure.  It’s when stress gets out of hand that trouble can occur - too much of a good thing may be bad for you.

Excess stress may show up as mental and emotional symptoms including poor concentration, memory problems, anxiety, hostility, and aggression.  In addition, behavioral symptoms such as excessive drinking, drug abuse, or overeating may be consequences of too much stress.  Finally, erratic breathing, muscle tension, aches and pains, or dry mouth may be some physical manifestations of stress that has gotten out of control. 

Personality style may play a role in how we respond to stressful situations.  Negativity and pessimism are related to poorer health in general while hardiness may be protective against stressful effects and includes three key characteristics; the 3 Cs:  Commitment - a tendency to be fully involved in whatever one is doing, to be fully engaged, and to give each activity one’s best effort; Challenge - an openness and willingness to view new situations as opportunities for growth rather than as threats to the status quo; and Control - a belief or sense that the outcomes of one’s actions are contingent on what one does, not on what the environment dictates, and that one can influence one’s environment.

Chronic stress can wreak havoc on our bodies by causing us to constantly be in the "fight-or-flight" mode.  When this occurs, perceived threats (i.e., stressors) cause a part of our brain, the hypothalamus, to set off a kind of chemical "alarm."  This triggers our adrenal glands - tiny structures that sit atop our kidneys - to release several hormones including adrenaline and cortisol that lead to a number of physiologic and emotional changes including increased heart rate, elevated blood pressure, altered immune system functioning, suppressed digestive and reproductive system activity, and depression.

How can we minimize stress in our lives?

These are some inexpensive and safe ways to combat stress including:

  • Relaxation Training.  This may be the most effective technique for reducing the effects of chronic stress and comprises many different techniques including progressive muscle relaxation training, hypnosis, and mindfulness meditation.
  • Diaphragmatic Breathing, also known as "cleansing breath," is the easiest and simplest technique to master:  In essence, it involves taking in a deep breath through your nose using your diaphragm rather than the muscles around your ribs - like trying to pull the air in through your nose deep down into your abdomen rather than into your lungs - holding your breath, and then exhaling slowly through your mouth with pursed lips.
  • Guided Imagery
    • Close your eyes
    • Take easy breaths
    • Go to a happy place in your thoughts
    • Imagine nice sights, sounds, and smells

Keep in mind that not all stress can be managed with these simple strategies.  In these cases, stress and associated depression may require medications to restore one’s equilibrium.

All of us will face stress at some time in our lives and some stressful situations will be unavoidable.  It makes good sense to know some ways we can effectively deal with this ubiquitous condition.  Taking appropriate steps will help us to contain stress or to treat stress at its earliest stages, leading to a better quality of life.  

Terry Rabinowitz, MD, DDS, is Professor in the Departments of Psychiatry and Family Medicine at the University of Vermont College of Medicine and Director, Psychiatry Consultation and Telemedicine Services at Fletcher Allen.