Everyone tends to become overwhelmed and stressed out at times.  Although stress can be beneficial when it gives us the boost we need to get through situations like work deadlines or exams, extreme stress has adverse health consequences that may affect many of our body systems.


When stress is severe (real or perceived), our body launches what physicians refer to as the fight-or-flight response.  This was first described by Dr. Walter Cannon nearly 100 years ago.  During this response, hormones (mainly adrenalin and cortisol) and brain impulses create an explosive reaction that are intended to be lifesaving.  These include, rapid heart rate, elevated blood pressure, sweats (a coolant), amplified senses, and increased blood flow to muscles and mobilization of fuel in the form of sugar and fats that are stored in the body for emergencies.  It is as if the body has called out the National Guard to defend it from whatever emergency the body is threatened with. Adrenaline and cortisol are intended to prepare you for action. However, chronic stress can result in an increased risk for heart attacks (high cholesterol), strokes (high blood pressure), diabetes (high sugars), heart rhythm problems, cancer and increased risk for infection (suppressed immune system) and premature death.  As a result, stress is the fourth pillar in Lifestyle medicine and carries equal weight as diet, exercise and sleep.


We view stress as being either situational or physiological.  Situational Stress happens to us all at some point in our lives and usually involves problems, or combination of problems with relationships, money or work.  We will outline strategies to help manage these stressors below.  Physiological Stress however, is a more difficult problem that is much less under our control and often goes undetected.  Types of physiological stress include sleep apnea and sleep deprivation, chronic pain, post-surgical complications, chronic infections, and more severe problems such as chronic heart problems and cancer.  Obviously, treatments for situational stress and physiological stress are different.  In both cases, treatment is directed towards resiliency, but physical stress requires a more cause specific approach often involving multiple tests.


Tips for managing situational stress:

Managing your stress takes some practice, but it is possible.  Some helpful tips to help you remain calm and relaxed include:

  1. Regular Physical Exercise: Studies have shown over and over that regular physical exercise works just as well or better than any medication used to manage stress.  Any exercise is better than none, but cardio exercise that increases your heart rate seems to work the best.  When you feel particularly stressed, take a quick, brisk walk.  Exercising 150 minutes per week stimulates both your cardiovascular system and the production of calming brain neurotransmitters called endorphins, thereby helping with both physical and mental health.
  2. Relaxation techniques: If you can slow down your mind and body long enough to realize that you are not in mortal danger, you will remain calm.  One way to do this is by breathing deeply.  Another straightforward technique is to focus on a word or phrase that has significance to you.  Repeat this word or phrase if you find yourself becoming tense.  Relaxation lowers your pulse, respiration, and blood pressure.  When you combine different techniques such as deep breathing, muscle relaxation, meditation and yoga, you can significantly lower your stress levels.  You can also elevate your mood and improve your ability to focus.
  3. Change your attitude to stress: Instead of thinking of stress as overwhelming, look at it as a challenge, because you are not likely to avoid it altogether.  Reversing negative attitudes can help to reduce tension.  For instance, your stress may be triggered by a problem that you think is impossible to solve.  Try writing down your question and come up with as many solutions as possible.  Write down the pros and cons of each one.  Once you have settled on a possible solution, note all steps you need to take to put it into action.  This process helps you to get out of a negative, panic-stricken state of mind and puts the rational part of your brain back in control.
  4. Learn How to say No: A common cause of stress is having too little time to accomplish what you need to do.  Many times, you create your stress because you can’t say no.  You take on additional responsibilities even when you know you don’t have time for them.  It is sometimes hard to say no for fear of conflict or rejection.  Try to understand why you find it difficult to say no.  You must know and accept your limits.  Also, learn how to phrase your no in ways that let people down gently.
  5. Keep a stress diary: Keeping a stress diary can help you learn how to manage your stress because you will become more aware of situations that cause it. Perhaps you could even give each situation a rating on a scale of one to ten.  Use the diary to try to understand what triggers your stress and identify activities you can modify or eliminate.  Think of ways you could handle stressful situations differently and coping techniques you could use.
  6. Reduce caffeine, alcohol and refined sugar consumption: Try to reduce your use of stimulants such as caffeine and alcohol as they will amplify your stress level. People tend to use alcohol to alleviate stress but using unhealthy coping mechanisms like drinking or drugs just replaces one problem for another.  Try to drink more water and replace caffeinated drinks with herbal teas.  Refined sugars are well-known for giving your body a temporary boost, which then causes an energy crash that leaves you feeling tired and irritable.  A healthy, nutritious and well-balanced diet can go a long way towards helping you cope with stress.
  7. Talk to others: When you express your feelings to others, it can help to reduce your stress levels.  When you feel stressed, take a break and call a friend or close family member.  A reassuring voice that makes you feel nurtured and understood will help you keep your problems in perspective.  If you do not feel like talking to other people, then give yourself a little pep talk.  Talking to yourself is not a sign of craziness!  However, negative self-talk is damaging.  Tell yourself that you can deal with the situation and that everything will turn out fine. Research seems to suggest that every thought and emotion can release chemicals into our bodies that impact function, both good and bad.
  8. Make it a priority to do something you enjoy: Some people enjoy perusing hobbies like music, art or gardening.  Others find enjoyment in activities that are more solitary like meditation or walking.  Do something like listening to relaxing music or pulling a few weeds, which might enable you to return to the stressful situation with a different perspective and a renewed state of mind.
  9. Smile and laugh: Laughter goes a long way to reducing stress because it too releases endorphins and decreases excess levels of stress hormones.  It can trick your nervous system into making you feel happy.  A smile or a laugh can immediately help to relieve the tension both in your face and body.
  10. Sleep well:  Stress can affect your ability to sleep, but lack of sleep is also a fundamental cause of stress.  It is a vicious cycle that is hard to break.  Try turning off the TV earlier, dimming the lights and giving yourself time to unwind and relax before going to bed.  Getting enough sleep is essential for your mind and body.  If you are feeling exhausted, it may cause you to think irrationally, and this only increases your stress.


Chronic stress, whether from life situations, or a physiological response to some hidden noxious physical problem wears us down and coping becomes a challenge.  During these times we are looking for easy ways to get through the day which may include unhealthy fast foods, numbing alcohol or drugs, less exercise, and poor decisions related to work and relationships.