Chronic stress, how bad is it really?



The stress response of the body is somewhat like an aeroplane readying for take-off. Virtually all systems (e.g., the heart and blood vessels, the immune system, the lungs, the digestive system, the sensory organs, and brain) are modified to meet the perceived danger (if a plane doesn’t get enough speed/power it doesn’t take off). And under ordinary circumstances, a take-off will not harm the plane, nor will stress harm you! But what would happen after take off if the plane kept going at full power? It's likely the engines would malfunction, maybe even have a catastrophic failure (break apart)! The fact is that engines are not designed to run at full power continuously, and neither are we. Yet in this modern and primitive world, we live in, people are being stressed without there being a real life-threatening danger present, at least most of the time. Our ancestors experienced real life-threatening danger almost daily, predators, toxic foods, poisons etc. Although we do not face that kind of danger, a 30 or 40 mortgage can seem equally daunting. A new star employee can threaten that promotion we've been working for. A takeover of our company may mean redundancies! And so it goes, threats don't have to be life-threatening any longer, they just have to feel that way to us. Worse than that, these perceived dangers don't even have to be real; even being a figment of our imagination will do it!

So, there never has been a greater need to understand why we get stressed and even more important than that; what we can do to combat it! But can we combat it? Yes, we can, effective stress management is key and with practice is highly achievable. Even better than that is the fact that once YOU effectively manage stress, you will open yourself up to a side of yourself that you never even knew existed! That's right, you may not become a superhero but you will definitely open up the hidden power that lays deep within all of us. The human brain has hidden resources that can help all of us, much more than we ever thought possible! Just look at the Guinness Book of Records to see what humans are capable of? We really are an incredible species and are capable of some remarkable feats. Better than that we have compassion and although not in the G B R, there are some incredibly loving and compassionate people out there. People whose courage and selflessness surpasses human normality and the world is a  better place for them having been in it. Such power and passion lay within You too!

That said, we first must learn to manage stress and fear. The recent killing of an American journalist, James Foley, highlights how much danger people like him face every day, they don't do it for the money, they do it because they believe it is the right thing to do. Do they suffer stress, of course, they do and for the most part it is real and appropriate because they are often in real danger, but it's how they handle life after the danger passes that allow them to do it again! When you handle stress effectively, experience it when it's appropriate and don't when it's not, then you get to live life in all its beauty!

Stressors come at us thick and fast and learning how to deal with them is paramount. Below is a list of the ways stress affects us all and it is by no means a complete list; but it's fairly comprehensive and to that end, I hope you find it both of interest and useful.

External and Internal Stressors: - People can experience either external or internal stressors.

External stressors: include adverse physical conditions (such as pain, extreme weather, hot or cold temperatures) or stressful psychological environments (such as poor working conditions or abusive relationships, divorce, loss of a loved one, moving home, redundancy etc.). Humans, like animals, can experience external stressors.

Internal stressors: can also be physical (infections, inflammation) or psychological. An example of an internal psychological stressor is intense worry about a harmful event that may or may not occur. As far as anyone can tell, internal psychological stressors are rare or absent in most animals except humans.

Acute or Chronic Stress

Stressors can also be defined as short-term (acute) or long-term (chronic).

Acute Stress

Acute stress is the reaction to an immediate threat, commonly known as the fight or flight response. The threat can be any situation that is experienced, real or unreal, even subconsciously, as a danger.

Common acute stressors include:

  • noise,
  • crowding,
  • isolation,
  • hunger,
  • fear
  • extreme heat or cold
  • danger,
  • infection,
  • and Imagining (real or unreal) a threat or remembering a dangerous event.
  • Trauma - Natural or man-made disasters
  • Cumulative Trauma - series of small, sometimes almost insignificant, trauma's, that have a very significant effect on life

Under most circumstances, once the acute threat has passed, the response becomes inactivated and levels of stress hormones return to normal, a condition called the relaxation response.

Chronic Stress

Frequently, however, modern life poses on-going stressful situations that are not short-lived and the urge to act (to fight or to flee) must be suppressed. Stress, then, becomes chronic. Common chronic stressors include:

  • on-going highly pressured work,
  • long-term relationship problems,
  • loneliness,
  • psychological trauma, whether diagnosed or not
  • identified or unidentified illness, self or others
  • depression and/or anxiety disorders
  • lack of security
  • Persistent financial worries.
  • The aftereffect of Natural or man-made disasters/catastrophes - which, if not treated, can lead to PTSD (Post Traumatic Stress Disorder)

What Is The Effect Of Acute Stress?

The best way to envision the effect of acute stress is to imagine oneself in a primitive situation, such as being chased by a bear.

The Brain's Response to Acute Stress: The response to seeing the bear, is that a part of the brain function called the Hypothalamic - Pituitary - Adrenal Axis (HPA axis) is activated. 

Release of Hormones: The HPA Axis (Hypothalamus, Pituitary Gland & Adrenal Gland) triggers the production and release of corticotrophin-releasing hormones (CRH) in the Hypothalamus to the Pituitary Gland, Which releases ACTH (Adrenocorticotrophin Hormone) into the system from the Pituitary Gland to the Adrenal Glands, which then releases stress hormones into our system. The stress hormones, Cortisol and Epinephrine (Adrenaline) are very important in marshalling systems throughout the body (including the heart, lungs, circulation, metabolism, immune systems, and skin) to deal quickly with the bear. Although cortisol, alone, lowers the effectiveness of the immune system. It also affects the function of the frontal lobes of the brain. Adrenaline, among other things, affects the hippocampus, the memory part of the brain; small wonder highly stressed people forget things!

Neurotransmitters: signal the amygdala and hippocampus to store the emotionally loaded experience in long-term memory. In primitive times, this combination of responses would have been essential for survival, when long-lasting memories of dangerous stimuli (i.e., the large bear) would be critical for avoiding such threats in the future. And despite the effect of adrenaline on the hippocampus, memories of survival matters seem to take precedence.

During a stressful event: Hormones also suppress activity in areas at the front of the brain concerned with short-term or working memory, concentration, inhibition, and rational thought. This sequence of mental events allows a person to react quickly to the bear, either to fight or to flee from it. (It also hinders the ability to handle complex social or intellectual tasks and behaviours.)

Response by the Heart, Lungs, and Circulation to Acute Stress: As the bear comes closer, the heart rate and blood pressure increase instantaneously. Breathing becomes rapid and the lungs take in more oxygen. Blood flow may actually increase 300% to 400%, priming the muscles, lungs, and brain for added demands. The spleen discharges red and white blood cells, allowing the blood to transport more oxygen.

The Immune System's Response to Acute Stress: The effect on the immune system from confrontation with the bear is similar to marshalling a defensive line of soldiers to potentially critical areas. The steroid hormones dampen parts of the immune system so that infection fighters (including important white blood cells) or other immune molecules can be redistributed. These immune-boosting troops are sent to the body's front lines where injury or infection is most likely, such as the skin, the bone marrow, and the lymph nodes.

The Acute Response in the Mouth and Throat: As the bear gets closer, fluids are diverted from nonessential locations, including the mouth. This causes dryness and difficulty in talking. In addition, stress can cause spasms of the throat muscles, making it difficult to swallow.

The Skin's Response to Acute Stress: The stress effect diverts blood flow away from the skin to support the heart and muscle tissues. (This also reduces blood loss in the event that the bear catches up.) The physical effect is a cool, clammy, sweaty skin. The scalp also tightens so that the hair seems to stand up.

Metabolic Response to Acute Stress: Stress shuts down digestive activity, a nonessential body function during short-term periods of physical exertion or crisis. And a major reason highly stressed people also suffer from digestive problems.

The Relaxation Response: The Resolution of Acute Stress. Once the threat has passed and the effect has not been harmful (i.e., the bear has not eaten or seriously wounded you), body systems return to normal; that is, in normally stressed people. However, in the case of chronically stressed people, the system often malfunctions, it doesn't reset properly and we become hyper-vigilant . . . . it takes very little to set us off again!

What Are The Negative Effects Of Stress: In prehistoric times, the physical changes in response to stress were an essential adaptation for meeting natural threats. Even in the modern world, the stress response can be an asset for raising levels of performance during critical events such as a sports activity, an important meeting, or in situations of actual danger or crisis. If stress becomes persistent and low-level, however, all parts of the body's stress apparatus (the brain, heart, lungs, vessels, and muscles) become chronically over or under activated. This may produce physical or psychological damage over time. Acute stress can also be harmful in certain situations.

Stress-related conditions that are most likely to produce negative physical effects include:

The accumulation of persistent stressful situations, particularly those that a person cannot easily control (for example, high-pressured work plus an unhappy relationship). Persistent stress following a severe acute response to a traumatic event (such as an automobile accident). An inefficient or insufficient relaxation response. Acute stress in people with serious illness, such as heart disease, or the time between diagnoses and treatment. Or the ongoing financial burden associated with illness; yourself or a loved one

Psychological Effects of Stress: Studies suggest that the inability to adapt to stress is associated with the onset of depression or anxiety. Some evidence suggests that repeated release of the stress hormones produces hyperactivity in the hypothalamus-pituitary-adrenal axis (HPA Axis) and disrupts normal levels of serotonin, the nerve chemical that is critical for feelings of well-being.

Heart Disease: Mental stress is as major a trigger for angina as is physical stress. Incidents of acute stress have been associated with a higher risk for serious cardiac events, such as heart rhythm abnormalities and heart attacks, and even death from such events in people with heart disease.

Sudden stress increases the pumping action and rate of the heart and causes the arteries to constrict, thereby, for certain people, posing a risk for blocking blood flow to the heart.

Stressful events: May cause men and women who have relatively low levels of the neurotransmitter serotonin (and therefore a higher risk for depression or anger) to produce more of certain immune system proteins (called cytokines), which in high amounts cause inflammation and damage to cells, including, possibly, heart cells.

Recent evidence confirms the association between stress and hypertension (high blood pressure). People who regularly experience sudden increases in blood pressure caused by mental stress may, over time, develop injuries in the inner lining of their blood vessels.

Strokes: One survey revealed that men who had a more intense response to stressful situations, such as waiting in line or problems at work, were more likely to have strokes than those who did not report such distress.

Susceptibility to Infections: Chronic stress appears to blunt the immune response and increase the risk of infections and may even impair a person's response to immunisations.

Cancer: Current evidence does not support the idea that stress causes cancer. Nevertheless, some animal studies suggest that a lack of control over stress (not simply stress itself) had negative effects on immune function and contributed to tumour growth.

Gastrointestinal Problems: The brain and the intestine are strongly related and mediated by many of the same hormones and nervous system. (Indeed, some research suggests that the gut itself has features of a primitive brain.) It is not surprising then that prolonged stress can disrupt the digestive system, irritating the large intestine and causing diarrhoea, constipation, cramping, and bloating. Excessive production of digestive acids in the stomach may cause painful burning.

Irritable Bowel Syndrome: Irritable bowel syndrome (or spastic colon) is strongly related to stress.

Peptic Ulcers: It is now well established that most peptic ulcers are either caused by the H. pylori bacteria or by the use of nonsteroidal anti-inflammatory (NSAID) medications (such as aspirin and ibuprofen). Nevertheless, studies still suggest that stress may predispose someone to ulcers or sustain existing ulcers.

Eating Problems: Stress can have varying effects on eating problems and weight.

Weight Gain: Often stress is related to weight gain and obesity. Many people develop cravings for salt, fat, and sugar to counteract tension and, thus, gain weight. Weight gain can occur even with a healthy diet in some people exposed to stress. And the weight gained is often abdominal fat, a predictor of diabetes and heart problems.

Weight Loss: Some people suffer a loss of appetite and lose weight. In rare cases, stress may trigger hyperactivity of the thyroid gland, stimulating appetite but causing the body to burn up calories at a faster than normal rate.

Eating Disorders: Anorexia nervosa and bulimia nervosa are eating disorders that are highly associated with adjustment problems in response to stress and emotional issues.

Diabetes: Chronic stress has been associated with the development of insulin resistance, a condition in which the body is unable to use insulin effectively to regulate glucose (blood sugar). Insulin-resistance is a primary factor in diabetes. Stress can also exacerbate existing diabetes by impairing the patient's ability to manage the disease effectively.

Sleep Disturbances, the tensions of unresolved stress frequently cause insomnia, generally keeping the stressed person awake or causing an awakening in the middle of the night or early morning.

Sexual and Reproductive Dysfunction Sexual Function: Stress can lead to diminished sexual desire and an inability to achieve orgasm in women. The stress response can also cause temporary impotence in men.

Premenstrual Syndrome: Some studies indicate that the stress response in women with premenstrual syndrome may be more intense than in those without the syndrome.

Memory, Concentration and Learning: Stress has significant effects on the brain, particularly on memory, concentration and our ability to learn new things. People suffering from negative stress may become inefficient and accident-prone. It also affects our ability reason things out logically or makes good decisions; this is generally associated with altered blood flow in the pre-frontal cortex (our thinking brain). Some memory loss may occur naturally with age; however, stress may play an even more important role, because of the effect of stress hormones within the hippocampus, other than simply ageing, in this process.

Who is at risk for chronic stress or stress-related diseases?

General factors that Increase susceptibility: At some point in their lives virtually everyone will experience stressful events or situations that overwhelm their natural coping mechanisms. In one poll, 89% of respondents indicated that they had experienced serious stress in their lives. Many factors influence susceptibility to stress.

Conditions that Influence the Effects of Stress: People respond to stress differently, and depending on different factors, such as:

Early nurturing: Abusive behaviour (verbal, physical, sexual or mental) towards children may cause long-term abnormalities in the hypothalamic-pituitary-Adrenal system (HPA Axis), which regulates stress.

Personality traits: Certain people have personality traits that cause them to over-respond to stressful events.

Genetic factors: Some people have genetic factors that affect stress, such as having a more or less efficient relaxation response. One 2001 study found a genetic abnormality in serotonin regulation that was associated with a heightened reactivity of the heart rates and blood pressure in response to stress. (Serotonin is a monoamine, neurotransmitter, brain chemical involved with feelings of well being.)

Immune Regulated Diseases: Certain diseases that are associated with immune abnormalities (such as rheumatoid arthritis or eczema) may actually impair a person's response to stress.

The Length and Quality of Stressors: Naturally, the longer the duration and the intensity of the stressors, the more likely it will be that the body’s ability to function normally will be reduced and make one more susceptible to illness and or disease.

Individuals at Higher Risk: Studies indicate that the following people are more vulnerable to the effects of stress than others: Children and younger adults, the elderly and single men. No one is immune to stress, however, and it may simply go unnoticed in the very young and old.

Women in general: Women, in general, may be at higher risk than men from stress-related chest pain, although men's hearts may be more vulnerable to adverse effects from long-term stress, such as from their jobs or dysfunctional relationships etc.

Working mothers: Working mothers, regardless of whether they are married or single, face higher stress levels and possible adverse health effects, most likely because they bear a greater and more diffuse work load than men or other women. This has been observed in women in Europe and the US. Such stress may also have a domino and harmful effect on their children.

Less-educated individuals: Those with lower educational achievement or a generally lower than average IQ, seem to be at more risk of exposure to negative stress. Whether this is because of the lack of education or low IQ is not quite clear. It may be that people in these groups generally have not developed good or effective coping strategies.

Divorced or widowed individuals: A number of studies indicate that unmarried people (including those divorced or widowed) generally do not live as long as their married contemporaries.

The unemployed & isolated individuals: Long term unemployed and people who are targets of racial, sexual or gender discrimination (including those physically or mentally challenged).

People who are abused, physically. verbally, sexually or mentally: and those without health insurance or where the prospect of timely healthcare is a problem. People who live in cities (or large urban areas) are all subjected to increased levels of negative stressors. Of course, there are always exceptions within any aspect of the human condition.

Effects in Childhood: Animal studies report that rats that have been exposed to maternal grooming (i.e., positive physical affection by the mother) have lower stress hormone levels in adulthood. Depressed or aggressive mothers are particularly powerful sources of stress in children, even more so than with poverty or overcrowding. Children are frequent victims of stress because they are often unable to communicate their feelings accurately or their responses to events over which they have no control. Adolescent boys and girls experience equal amounts of stress, but the source and effects may differ.

Girls tend to become stressed from interpersonal situations, and stress is more likely to lead to depression in girls than in boys.

For boys, one study suggested events such as changing schools or poor grades are the most important sources of stress. Another indicated, however, that the probability of childhood behavioural difficulties in a boy is increased with the number and type of stressors encountered in the home.

Stress in the Elderly: As people age, the ability to achieve a relaxation response after a stressful event becomes more difficult. Ageing may simply wear out the systems in the brain that respond to stress so that they become inefficient. The elderly, too, are very often exposed to major stressors such as medical problems, the loss of a spouse and friends, a change in a living situation, and financial worries.

Caregivers: caregivers of family members. Studies show that caregivers of physically or mentally disabled family members are at risk for chronic stress. Spouses caring for a disabled partner are particularly vulnerable to a range of stress-related health threats including influenza, depression, heart disease, and even poorer survival rates.

Caring for a spouse with even minor disabilities can induce severe stress. (Intervention programs that are aimed at helping the caregiver approach the situation positively can be very helpful at reducing stress and helping the caregiver maintain a positive attitude.)

Wives experience significantly greater stress from caregiving than husbands, and, according to a 2000 study, tend to feel more negative about their husbands than caregiving husbands feel about their wives.

Specific risk factors that put caregivers at higher risk for severe stress or stress-related illnesses include the following:

  • Having a low income.
  • Living alone with the patient.
  • Helping a highly dependent patient.
  • Having a difficult relationship with the patient.

Health Professional Caregivers: Caregiving among health professionals is also a high-risk factor for stress. One 2000 study, for example, found that nurses with low job control, high job demands, and low work-related social support experienced very dramatic health declines, both physically and emotionally.

Angry Personalities People who are less emotionally stable or have high anxiety levels tend to experience specific events as more stressful than others.

Some experts describe an exaggerated negative response to stress as "catastrophising" the event turning it into a catastrophe. An overly angry or hostile response to stressful situations may be dangerous to the heart, but studies are mixed. Studies in 1998 and 2000 have reported an association among women between anger, irritability, and hostility and narrowing of the arteries, a major risk factor for heart disease.

The 1998 study reported that being self-conscious in public and suppressing anger was also associated with this risk. A 1999 study further reported a link in older women between long term anger and the development of abnormal obesity (the so-called apple shape), an important risk factor for heart diseases.

Lack of Social Network: The lack of an established network of family and friends predisposes one to stress disorders and stress-related health problems, including heart disease and infections.

And, a 2000 study reported that older people who maintain active relationships with their adult children are buffered against the adverse health effects of chronic stress-inducing situations, such as low income or lower social class. One study suggested this may be because people who live alone are unable to discuss negative feelings and so relieve their stress.

Work Risk Factors: According to one survey, up to 40% of European and American workers describe their jobs as very stressful. Job-related stress is particularly likely to become chronic because it is such a large part of daily life. And, stress, in turn, reduces a worker's effectiveness by impairing concentration, causing sleeplessness, and increasing the risk of illness, back problems, accidents, and lost time. Work stress can lead to harassment or even violence while on the job.

At its most extreme, stress that places such a burden on the heart and circulation may be fatal. The Japanese even have a word for sudden death due to overwork, karoshi. In fact, a number of studies are now suggesting that job-related stress is as great a threat to health as smoking or not exercising.

Among the intense stressors at work are the following:

  • Having no participation in decisions that affect one's responsibilities.
  • Unrelenting and unreasonable demands for performance.
  • Lack of effective communication and conflict-resolution methods among workers and employers.
  • Lack of job security.
  • Long hours.
  • Lack of proper break times
  • Excessive time spent away from home and family.
  • Office politics and conflicts between workers.
  • Wages not commensurate with levels of responsibility.
  • Peer isolation or social exclusion
  • Bullying, in its many forms

An Absent or Inadequate Relaxation Response: In some people, stress hormones remain elevated instead of returning to normal levels. This may occur in highly competitive athletes or people with a history of depression

What Other Conditions Have The Same Symptoms As Stress?

Anxiety Disorders: The physical symptoms of anxiety disorders mirror many of those of stress, including a fast heart rate; rapid, shallow breathing; and increased muscle tension. Anxiety is an emotional disorder, however, and is characterized by feelings of apprehension, uncertainty, fear, or panic. Unlike stress, the triggers for anxiety are not necessarily or even usually associated with specific stressful or threatening conditions. Some individuals with anxiety disorders have numerous physical complaints, such as headaches, gastrointestinal disturbances, dizziness, and chest pain. Severe cases of anxiety disorders are debilitating and interfere with career, family, and social spheres.

Depression: Depression can be a disabling condition, and, like anxiety disorders, may result from untreated chronic stress. Depression also mimics some of the symptoms of stress, including changes in appetite, sleep patterns, and concentration. Serious depression, however, is distinguished from stress by feelings of sadness, hopelessness, loss of interest in life, and, sometimes, thoughts of suicide. Acute depression is also accompanied by significant changes in the patient's functioning. Professional therapy may be needed in order to determine if depression is caused by stress or if it is the primary problem.

Post-Traumatic Stress Disorder Symptoms: Post-traumatic stress disorder (PTSD) is a reaction to a very traumatic event, it is actually classified as an anxiety disorder. The event that precipitates PTSD is usually outside the norm of human experiences, such as intense combat or sexual assault. The patient struggles to forget the traumatic event and develop emotional numbness and event-related amnesia.

Often, there is are mental flashbacks, and the patient re-experiences the painful circumstance in the form of intrusive dreams and disturbing thoughts and memories, which resemble or recall the trauma. Other symptoms may include lack of pleasure in formerly enjoyed activities, hopelessness, irritability, mood swings, sleep problems, inability to concentrate, and an excessive startle-response to noise.

What Are The General Guidelines For Reducing Stress: Perhaps the best general approach for treating stress can be found in the elegant passage by Reinhold Niebuhr, "Grant me the courage to change the things I can change, the serenity to accept the things I can't change, and the wisdom to know the difference."  The process of learning to control stress is life-long, and will not only contribute to better health but a greater ability to succeed in one's own agenda.

When to Seek Professional Help for Stress: Stress can be a factor in a variety of physical and emotional illnesses, which should be professionally treated. Many stress symptoms are mild and can be managed by over the counter medications (e.g., aspirin, acetaminophen, or ibuprofen for a tension headache and antacids and anti-diarrhoea medications or laxatives for mild stomach distress). A physician should be consulted, however, for physical symptoms that are out of the ordinary, particularly those which progress in severity or awaken one at night. A mental health professional, Hypnotherapist or Psychotherapist should be consulted for unmanageable acute stress or for severe anxiety or depression. Often short-term therapy, especially Hypnotherapy, can resolve stress-related emotional problems.

Considerations for choosing a strategy for reducing stress: In choosing specific strategies for treating stress, several factors should be considered.

First, there is, in a general sense, no single method that is uniformly successful: although some, such as hypnotherapy and CBT (Cognitive Behavioural Therapy) is associated with a higher than usual success rate. Sometimes, a combination of approaches, medication and therapy, can be more effective.

Second, what works for one person does not necessarily work for someone else.

Third, stress can be positive as well as negative. Appropriate and controllable stress provides interest and excitement and motivates the individual to greater achievement, while a lack of stress may lead to boredom and depression.

Finally: stress may play a part in making people vulnerable to illness. A physician or psychologist should be consulted if there are any indications of accompanying medical or psychological conditions, such as cardiac symptoms, significant pain, anxiety, or depression.

Overcoming obstacles to treatment: Often people succeed in relieving stress for the short-term but resort to previous ways of stressful thinking and behaving because of outside pressure or entrenched beliefs or habits. Hypnotherapy, Psychotherapy, CBT and EFT are particularly helpful in this respect

One major obstacle to reducing stress is the strong biological urge to fight or flight itself. The very idea of relaxation can feel threatening because it is perceived as letting down one's guard. For example, an over-demanding boss may put a subordinate into a psychological state of fighting-readiness, even though there is no safe opportunity for the subordinate to fight back, or even express anger. Stress builds up, but the worker has the illusion, even subconsciously, that the stress itself is providing safety or preparedness, so does nothing to correct the condition.

Many people are afraid of being perceived as selfish if they engage in stress-reducing activities that benefit only themselves. The truth is that self-sacrifice may be inappropriate and even damaging if the person making the sacrifice is unhappy, angry, or physically unwell.

Many people believe that certain emotional responses to stress, such as anger, are innate and unchangeable features of personality. Research has shown, however, that with hypnotherapy and or cognitive behavioural therapy (CBT), individuals can be taught to change their emotional reactions to stressful events.

It is essential to remember that reducing stress and staying relaxed clears the mind, so it can initiate appropriate actions to get rid of the stress-ridden conditions.

Stress reduction and effects on health: It should be strongly noted that treating stress cannot cure medical problems, but it can allow the body to function more normally in fighting illness and disease. Any stress management program is not a substitute for standard medical treatments, but it can be a very important component in a medical regimen. Some studies have reported the following:

A 2001 study reported that treatments that reduce psychological distress after a heart attack appeared to improve the long-term outlook. Some evidence exists that stress management programs may reduce the risk of heart events (e.g., heart attack) by up to 75% in people with heart disease. One study found that stress management programs are more effective than exercise in reducing heart risks (although exercise is also protective).

A 2001 study reported that stress management techniques along with methods for coping with anger were associated with lower blood pressure. 

In one 2001 study, patients with chronic daily tension headache who were given tricyclics reported greater improvement after a month than those who were taught stress management techniques. The combination of the two approaches worked even better. And at six months, stress management was as effective as the antidepressants in improving headaches.

What Are Some Specific Stress Reduction Methods?

Healthy Lifestyle:

A healthy diet and a healthy lifestyle is an essential companion to any stress-reduction program. General health and stress resistance can be enhanced by regular exercise, a diet rich in a variety of whole grains, vegetables, and fruits, and by avoiding excessive alcohol (within 14 units for women and 21 units for men per week), caffeine, and tobacco completely.

The old adage, we are what we eat is certainly true. The brain transmutes nutrients into vital neurotransmitters/hormones; when we eat the right nutrients the brain works well when the brain works well, so do we!

Exercise: Exercise in combination with stress management techniques is extremely important for many reasons:

Exercise is an effective distraction from stressful events.

Employees who follow an active lifestyle need fewer sick days than sedentary workers. And most importantly, stress itself poses significantly less danger to overall health in the physically active individual. The heart and circulation are able to work harder for longer stretches of time, and the muscles, ligaments, bones, and joints become stronger and more flexible.

Usually, a varied exercise regime is more interesting, and thus easier to stick to. Start slowly. Strenuous exercise in people who are not used to it can be very dangerous and any exercise program should be discussed with a physician. In addition, half of all people who begin a vigorous training regime drop out within a year. The key is to find activities that are exciting, challenging, and satisfying. The following are some suggestions:

However, always, seek the advice of your GP or other medical professional first!

Signing up for aerobics and cardiovascular classes at a gym can be an excellent starting point.

Brisk walking is an excellent aerobic exercise that is free and available to nearly anyone. Even short brisk walks can relieve bouts of stress.

Swimming is an ideal exercise for many people including pregnant women, individuals with musculoskeletal problems, and those who suffer exercise-induced asthma.

Yoga, Pilates or Tai Chi can be very effective, combining many of the benefits of breathing, muscle relaxation, and meditation while toning and stretching the muscles. The benefits of these three disciplines may be considerable.

Numerous studies have found it beneficial for many conditions in which stress is an important factor, such as anxiety, headaches, high blood pressure, and asthma. It also elevates mood and improves concentration and ability to focus.

As in other areas of stress management, making a plan and executing it successfully, develops feelings of mastery and control, which are very beneficial in and of themselves. Start small. Just 10 minutes of exercise three times a week can build a good base for novices. Gradually build up the length of these every-other-day sessions to 30 minutes or more.

Hypno-therapeutic Techniques: are amongst the most effective ways to reduce stress. They include identifying sources of stress, restructuring priorities, changing one's response to stress, and finding methods for managing and reducing stress. This approach may be particularly helpful when the source of stress is chronic pain or other chronic diseases.

EFT, Emotional Freedom Techniques are an extremely efficient way for people to resolve emotional issues, which may or may not be stress-related. It is a method of tapping meridian points throughout the body which redistribute and realigning our energy system. It works by detaching thought (trigger) from emotion. Once a thought no longer accesses the trigger the emotion is not fired.

Diaphragmatic Breathing:  is one of the most effective and life-sustaining exercises we can do; whether we are stressed or not; but particularly is we are stressed. Breathing itself is the life source for all humans and this particular technique can actually dupe the brain into a state of relaxation; thereby abating the stress response.

Identifying Sources of Stress. It is useful to start the process of stress reduction with a diary that keeps an informal inventory of daily events and activities. While this exercise might itself seem stress-producing (and yet one more chore), it need not be done in painstaking detail. A few words accompanying time and date will usually be enough to serve as reminders of significant events or activities.

The first step is to note activities that put a strain on energy and time, trigger anger or anxiety, or precipitate a negative physical response (e.g., a sour stomach or a headache).

Also note positive experiences, such as those that are mentally or physically refreshing or produce a sense of accomplishment.

After a week or two, try to identify two or three events or activities that have been significantly upsetting or overwhelming.

Questioning the Sources of Stress:  Individuals should then ask themselves the following questions:

Do these stressful activities meet my own goals or someone else's?

Have I taken on tasks that I can reasonably accomplish?

Which tasks are in my control and which ones are not?

What is my daily level of happiness?

Restructuring Priorities: Adding Stress Reducing Activities. The next step is to attempt to shift the balance from stress-producing to stress-reducing activities.

Eliminating stress is neither possible or desirable, but there are many ways to reduce its impact. One study indicated, in fact, that adding daily pleasant events has more positive effects on the immune system than reducing stressful or negative ones. In most cases, small daily decisions for improvement accumulate and reconstruct a stressed existence into a pleasant and productive one. Also, daily exposure to humour or fun can be positive in enhancing our condition (human) or helping to reduce stress. The more upbeat and relaxed we are the more resilient we become too stressful situations!                                                                

Consider as many relief options as possible. Examples include the following:

Take long weekends or, ideally, vacations.

  • If the source of stress is in the home, plan times away, even if it is only an hour or two a week.
  • Replace unnecessary time-consuming chores with pleasurable or interesting activities.
  • Make time for recreation. (this is as essential as paying bills or shopping for groceries.)
  • Give yourself permission to take time out.
  • Develop effective exit strategies when in stressful situations.
  • Make a list of people who promote or exacerbate your stress; and try to minimise contact or, if possible, avoid them altogether!
  • Start writing a list of your goals and work towards them, this gives purpose to your life.

Reward yourself for achieving certain tasks; moving towards pleasure is extremely stimulating (and stress-reducing) experience. Also, moving away from pain, or displeasure is equally stress-reducing. However, motivation tends to drop once you are out of the unpleasant/painful situation and is therefore often not as sustainable as towards pleasure strategies.

Discuss Feelings: I can’t overestimate how poor communication affects stress levels. If you find it difficult to communicate your feelings, make an appointment to seek help from; a therapist, a life coach or mentor, friends or even a stranger may be possible sources to investigate. You could even take a course on effective communication?

Expressing feelings: does not mean venting anger (or its counterpart, frustration) on waiters, subordinates and loved ones, or boring friends with emotional minutiae, or wallowing in self-pity. In fact, because blood pressure may be dangerously elevated when certain chronically ill or hostile individuals become angry, I advise that just talking and not venting anger may be the better approach for these people.

The primary goal: Is to understand and explain your needs –which are not being met - to a trusted individual, in the most positive way possible. Direct communication may, sometimes, not even be necessary, e.g. writing in a journal, writing a poem, or composing a letter that is never posted, especially one that allows the writer to express and/or release their emotions effectively, e.g. anger, frustration, anxiety etc. may be sufficient.

Expressing one's feelings: Is also a two-way street. Learning to listen and hear, empathise, and respond to others with understanding is just as important for maintaining the strong relationships necessary for good emotional health and reduced stress.

Try to keep things in perspective: Don’t make a big deal out of a little deal - look for the positive. Reframing negative ideas and learning to focus on positive outcomes helps reduce tension and achieve goals. I know, you might say, that’s easy for you to say. I’m not saying it is easy, but it is possible. And wouldn’t you be willing to explore the possibility if it could relieve the pain of stress?

The following steps: May help to reduce stress, using an example of a person who is terrified at the prospect of giving a speech may be useful:

First, identify the worst possible outcomes (forgetting the speech, stumbling over words, humiliation, and adverse audience reaction, feeling rejected by your peers).

Rate how high the prospect of these bad outcomes happening actually is.

Imagine, in your mind's eye, a favourable result - a well-rounded, articulate, presentation with rewarding applause – a good audience reaction.

Develop a specific plan to achieve the positive outcome (preparing in front of a mirror, using a video camera or tape recorder, get effective feedback from a friend, mentor or coach, try relaxation exercises and know your subject well).

Try to recall previous situations that initially seemed negative but ended well.

Use Humour. Research has shown that humour is a very effective mechanism for coping with acute stress, releasing the body's happy drugs etc. into the system. Keeping a sense of humour during difficult situations is a common recommendation from stress management experts. Laughter not only releases the tension of pent-up feelings and helps keep perspective, but it appears to have actual physical effects that reduce stress hormone levels. It is not uncommon for people to recall laughing intensely even during tragic events, such as the death of a loved one, and to remember this laughter as helping them to endure the emotional pain.

Relaxation Techniques: Since the causal factors that cause stress is here to stay, finding ways to invoke the relaxation response, the natural unwinding of the stress response, is essential for wellbeing.

Relaxation lowers blood pressure, respiration, and pulse rates release muscle tension and ease emotional strains. This response is highly individualised, but there are certain approaches that seem to work. Combinations are probably best.

For example, in a study of children and adolescents with adjustment disorder, a hypnotically induced progressive muscle relaxation technique effectively reduces both feelings of anxiety and stress hormone levels. One could expect a partial or total resolution of stress from this approach, but only if done regularly. Using this method can be very effective if it becomes a part of your normal daily routine.

And, as already stated, diaphragmatic breathing. This simple technique can have a beneficial effect on stress psychologically and physiologically.

Psychologically: when we are stressed our breathing becomes quick and shallower than normal. When we breathe deeper and slower, it has the effect of tricking the body’s defence system; almost eluding that the danger has passed.

Physiologically: The brain uses more than 20% of our oxygen intake, so when we take a deeper breath, more oxygen goes to serve our brain. The more oxygenated our brain becomes, the better the functionality. The more positive thought we can add to the process, the quicker we can, possibly, resolve the stressful situation!

Stress is very much a vital part of normal living and is necessary for our survival. However, negative stress is what we need to manage! Normal, positive stress, actually enhances our function, it makes us quicker, sharper, stronger but negative stress depletes our normal function and over time leads to illness and disease!

Whilst we cannot control external/internal events or people who, perceptually, cause us to have stress, we can very much control our response to it and it is this aspect that we use in stress management.


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