“I promise you nothing is as chaotic as it seems. Nothing is worth diminishing your health. Nothing is worth poisoning yourself into stress, anxiety, and fear.” - Steve Maraboli
What is stress?
The most fitting definition of stress I have found is the following:
stress is “a (perceived) substantial imbalance between demand and response capability, under conditions where failure to meet demand has important (perceived) consequences [1]."
This definition can be applied to most of life’s social stresses. For example, the electric company requires you to pay your bill (demand), but you may not have enough money (response capability), so your electricity might get shut off (consequence). Or, your boss wants you to finish a project before a deadline (demand), but you're not sure if you will have enough time to do it (response capability), and you might get reprimanded at your job if you fail (consequence).
Notice the word ‘perceived’ is added. That is because the imbalance between demand and response may or may not actually exist. Maybe your rich uncle decides to help you and pay that electric bill. Maybe your boss will be understanding if you can’t finish a project by the deadline. However, the psychological and physiological response to stress that someone endures is the same, whether it’s real or perceived.
The effects of stress.
Everyone recognizes the immediate effects of stress. The fight-or-flight response of increased heart rate, increased breathing, and tensed muscles. This is a normal response of the body’s sympathetic nervous system and is designed to help you deal with an immediate threat by getting your body primed for dealing with (fighting) or running away from (fleeing) a dangerous situation.
Once the immediate stress is gone, the body returns to its normal state. Problems arise when we encounter these stresses routinely and the body never gets a chance to return to normal. This state of chronic stress can exacerbate, and in some instances cause serious health conditions.
Stress has been known to affect the following biological systems:
Immune system – in the form of increased susceptibility to infections [2].
Gastrointestinal system – ulcers, colitis, irritable bowel syndrome, acid reflux [3].
Reproductive system – pregnancy failure (implantation, miscarriage) [4].
Cardiovascular system – coronary artery disease, stroke [5-6].
Musculoskeletal – impaired wound healing [7].
Cognitively, stress can be a risk factor for depressive and anxiety disorders [8-9], and also impairs memory [10-11].
How dangerous is stress?
All-cause mortality (the risk of dying from anything) goes up if you have a major depressive disorder or clinically significant anxiety. However, for the stress of everyday life that does not reach a clinical threshold per se, the risk is less clear. The results are mixed. Some studies say stress is a risk factor, some say it makes no difference, and some even say it’s inversely related. Meaning that having a certain amount of stress is good for us [12]. The latter would imply a different definition of stress than what we are using, which often leads to conflicting results in the studies.
Ways to reduce stress.
Following is a list of ideas to help reduce stress [13].
Get a massage [14].
Listen to your favorite music.
Meditate for 10 minutes. Of special interest are transcendental mediation techniques. [15-16].
Participate in regular exercise that you enjoy doing. Shoot for 30 minutes, most days of the week [17].
Perform gentle static stretches for 10 minutes. Yoga and Tai Chi are also good options.
Play with your pet. If you don’t have one, get one [18].
Prepare for upcoming stressful situations.
Take a long walk.
Take a stress management course or get a book on stress management.
Take a warm bath. Add essential oils, Epsom salt, or both. Make sure to follow manufacturers’ recommendations.
Take up a relaxing hobby.
Talk to a friend and unload your problems [19].
Watch a comedy or read a funny book, and laugh [20].
Try Progressive Muscular Relaxation [21]
1. Lie down in a comfortable spot. Your surroundings should be mostly quiet, and mostly dark. Whatever you find peaceful.
2. Tighten up your toes and feet. Keep them tightened for about 5-10 seconds, and then relax. Do not tighten up any other parts of your body.
3. Next, tighten up the muscles of your calves for 5-10 seconds, and then relax. Again, do not tighten up any other muscles.
4. Continue this sequence by separately tightening up the thigh muscles, glutes, stomach, hands, upper arms, neck, and face. You can change the body parts and sequence to whatever you prefer.
5. After you have tensed each separate body part, tighten up the entire body all at once for 5-
10 seconds, without holding your breath.
6. Relax and lie still for the next 5-10 minutes, relaxing your thoughts.
Try Diaphragmatic Breathing [22]
Take a deep breath in…
Did your chest puff out and your shoulders rise? They probably did, and they are not supposed to. Somewhere along the way, we as adults forgot how to breathe.
The muscles that puff out your chest and cause your shoulders to rise are the secondary muscles of respiration and are only supposed to be active during heavier physical activities. The primary muscle of respiration is the diaphragm, a thin muscle that separates the chest from the abdomen. When you breathe in, the diaphragm contracts and flattens, pushing your belly out. When you exhale, the diaphragm relaxes and the air is pushed out of your lungs.
Simply put, under normal circumstances, you should be breathing with your belly, not your chest and shoulders. Most infants and young children do this naturally, as they have not yet been exposed to chronic stress, prolonged sitting, and postural imbalances that lead to dysfunctional breathing.
To perform diaphragmatic breathing, do the following:
Lie down in a comfortable spot. Your surroundings should be mostly quiet, and mostly dark. Whatever you find peaceful.
Place one hand on your chest and one hand on your belly.
Take a deep breath through your nose. Your belly should rise, and your chest should move very little.
Exhale through the mouth. Exhalation should take about twice as long as inspiration (4 seconds in through the nose, 8 seconds out through the mouth). How much air you can take in with a breath is determined by how much air you can exhale on the previous breath. So focus on pushing out as much air as you can before you take your next breath in.
Spend about 5 minutes, twice per day practicing this technique. Whenever you get some free time or if you find yourself stressed out.
Seek a professional
Stress can be intertwined with disorders such as anxiety and depression, but they are not the same thing. Some examples of red flags that should prompt you to get medical attention are the following:
inability to cope with stresses,
difficulty sleeping,
disordered eating patterns, and/or thoughts of hurting yourself or others.
That’s not an exhaustive list. Depression and anxiety should be examined, diagnosed, and treated by an appropriate mental health professional.
A helpful self-assessment screening tools can be found here:
When in doubt, go see a doctor.
Glossary
Perceived: to notice or become aware of (something)
Psychological: of or relating to the mind
Physiological: the ways that living things or any of their parts function
Susceptibility: the state of being easily affected, influenced, or harmed by something
Cognitively: of, relating to, or involving conscious mental activities (such as thinking, understanding, learning, and remembering.
Works Cited
1. Kasl, Stanislav V. “Stress and Health.” Annual Review of Public Health, vol. 5, no. 1, May 1984, pp. 319–341, 10.1146/annurev.pu.05.050184.001535. Accessed 26 Mar. 2020.
2. Miloyan, Beyon, et al. “Anxiety Disorders and All-Cause Mortality: Systematic Review and Meta-Analysis.” Social Psychiatry and Psychiatric Epidemiology, vol. 51, no. 11, 14 Sept. 2016, pp. 1467–1475, 10.1007/s00127-016-1284-6. Accessed 30 Oct. 2019.
3. Rakesh, Dr, et al. “Stress and the Gastrointestinal Tract.” Journal of Gastroenterology and Hepatology, vol. 20, 2005, pp. 332–339, 10.1111/j.1400-1746.2004.03508.x. Accessed 2 Aug. 2021.
4. Nakamura, Katrina, et al. “Stress and Reproductive Failure: Past Notions, Present Insights and Future Directions.” Journal of Assisted Reproduction and Genetics, vol. 25, no. 2-3, 15 Feb. 2008, pp. 47–62, 10.1007/s10815-008-9206-5. Accessed 2 Aug. 2021.
5. Fioranelli, Massimo, et al. “Stress and Inflammation in Coronary Artery Disease: A Review Psychoneuroendocrineimmunology-Based.” Frontiers in Immunology, vol. 9, 6 Sept. 2018, 10.3389/fimmu.2018.02031. Accessed 2 Aug. 2021
6. Kivimäki, Mika, et al. Contribution of Stress to the Aetiology and Prognosis of Cardiovascular Disease. , 2017.
7. Walburn, Jessica, et al. “Psychological Stress and Wound Healing in Humans: A Systematic Review and Meta-Analysis.” Journal of Psychosomatic Research, vol. 67, no. 3, Sept. 2009, pp. 253–271, 10.1016/j.jpsychores.2009.04.002. Accessed 2 Aug. 2021.
8. MELCHIOR, MARIA, et al. “Work Stress Precipitates Depression and Anxiety in Young, Working Women and Men.” Psychological Medicine, vol. 37, no. 8, 4 Apr. 2007, pp. 1119–1129, www.ncbi.nlm.nih.gov/pmc/articles/PMC2062493/, 10.1017/s0033291707000414.
9. Stein, Murray B, and Thomas Steckler. Behavioral Neurobiology of Anxiety and Its Treatment. Berlin Springer Berlin, 2013.
10. Sandi, Carmen. “Stress and Cognition.” Wiley Interdisciplinary Reviews. Cognitive Science, vol. 4, no. 3, 2013, pp. 245–261, www.ncbi.nlm.nih.gov/pubmed/26304203, 10.1002/wcs.1222. Accessed 8 Sept. 2019.
11. Scott, Stacey B., et al. “The Effects of Stress on Cognitive Aging, Physiology and Emotion (ESCAPE) Project.” BMC Psychiatry, vol. 15, no. 1, 3 July 2015, 10.1186/s12888-015-0497-7.
12. Stewart-Brown, S. “Emotional Wellbeing and Its Relation to Health.” BMJ, vol. 317, no. 7173, 12 Dec. 1998, pp. 1608–1609, www.ncbi.nlm.nih.gov/pmc/articles/PMC1114432/, 10.1136/bmj.317.7173.1608. Accessed 24 Sept. 2019.
13. n.d. Exercise Pro. BioEx Systems Inc.
14. Field, Tiffany, et al. “Massage Therapy Reduces Anxiety and Enhances Eeg Pattern of Alertness and Math Computations.” International Journal of Neuroscience, vol. 86, no. 3-4, Jan. 1996, pp. 197–205, 10.3109/00207459608986710. Accessed 20 Feb. 2020.
15. Goyal, M, et al. “Meditation Programs for Psychological Stress and Well-Being: A Systematic Review and Meta-Analysis.” Deutsche Zeitschrift Für Akupunktur, vol. 57, no. 3, 2014, pp. 26–27, www.sciencedirect.com/science/article/pii/S0415641214008492, 10.1016/j.dza.2014.07.007.
16. Miller, John, et al. “Three-Year Follow-up and Clinical Implications of a Mindfulness Meditation-Based Stress Reduction Intervention in the Treatment of Anxiety Disorders.” International Journal of Yoga Therapy, vol. 8, no. 1, 1 Jan. 1998, pp. 45–53, 10.17761/ijyt.8.1.f5654n6515513127. Accessed 2 Oct. 2020
17. Salmon, Peter. “Effects of Physical Exercise on Anxiety, Depression, and Sensitivity to Stress.” Clinical Psychology Review, vol. 21, no. 1, Feb. 2001, pp. 33–61, www.sciencedirect.com/science/article/pii/S027273589900032X, 10.1016/s0272-7358(99)00032-x.
18. Allen, Karen, et al. “Pet Ownership, but Not ACE Inhibitor Therapy, Blunts Home Blood Pressure Responses to Mental Stress.” Hypertension, vol. 38, no. 4, Oct. 2001, pp. 815–820, 10.1161/hyp.38.4.815. Accessed 26 Mar. 2019
19. Ditzen, Beate, et al. “Effects of Different Kinds of Couple Interaction on Cortisol and Heart Rate Responses to Stress in Women.” Psychoneuroendocrinology, vol. 32, no. 5, June 2007, pp. 565–574, 10.1016/j.psyneuen.2007.03.011. Accessed 2 Aug. 2021
20. Bennett, Mary Payne, and Cecile Lengacher. “Humor and Laughter May Influence Health: III. Laughter and Health Outcomes.” Evidence-Based Complementary and Alternative Medicine, vol. 5, no. 1, 2008, pp. 37–40, 10.1093/ecam/nem041.
21. Bahrami-Eyvanekey, Zeinab, et al. “Comparison of the Effects of Guided Imagery and Progressive Muscle Relaxation on Quality of Life of Patients Undergoing the Coronary Artery Bypass Graft Surgery: A Randomized Clinical Trial.” Iranian Journal of Nursing Research, vol. 12, no. 3, 10 Aug. 2017, pp. 7–15, 10.21859/ijnr-12032. Accessed 18 Oct. 2019.
22. Varvogli, Liza, et al. HEALTH SCIENCE JOURNAL ® VOLUME 5, ISSUE 2 (2011) Stress Management Techniques: Evidence-Based Procedures That Reduce Stress and Promote Health.
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