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Stress

Dealing With Stress

Last updated on:
24/04/2012

Contributing Author: Guy Slowik FRCS

Here are some of the best ways to manage stress.

The TARP method. This technique has been proven effective for many. A tarp is a protective cover thrown over something - a car or boat, for example - to protect it from the elements. Likewise, the TARP method offers a form of protection, too - protection against the distressing and sometimes harmful effects of stress.

The TARP method teaches simple techniques that can be used any time, anywhere, to control your response to stressful situations. It consists of four steps:

In addition to the TARP method, other activities and methods also can help manage stress.

"Tune in"

Tuning in is important, because if you don't tackle your stress early, it can interfere with your sense of well being and your health almost before you know it. And the effects of stress often get worse as time goes on.

Whenever you notice yourself feeling the beginnings of stress - for example, when you feel irritable, tense, distracted, or fatigued - scan yourself for signs of stress.

How-To Information:

Follow these four steps to scan yourself for signs of stress:

1. Scan yourself for physical signs of stress, starting with your head and working down. For example:

  • Do you have muscle tension?
  • Do you have sweaty palms?
  • Do you have rapid breathing or rapid pulse?

2. Scan your behavior for signs of stress. For example:

  • Are you pacing or fidgeting?
  • Is your voice too tense, too loud or too quiet?

3. Scan your emotions, remembering some feelings that may be in the background. For example:

  • Do you feel nervous, moody, depressed?
  • Do you feel frustrated?
  • Do you feel lonely?

4. Scan your thoughts and thinking patterns. For example:

  • Are your thoughts always turning to your worries?
  • Are you having trouble with concentration or memory?

Learning to spot signs of stress instantly can take practice. But if you make a point of scanning your body, behavior, feelings, and thoughts regularly, it will get easier.

Nice To Know:

Some people may find that a single sign will always tip them off that they are under stress. For example, they may notice that they always start to sweat, or tap a foot, or talk fast. Other people may have a "menu" of warning signs, any one of which could alert them to the beginning of stress.

"Analyze"

Once you know how to "tune in" to your signs of stress, you will be better able to analyze the situations that are stressful to you. These "stressors," as they are called, could be either external or internal.

External stressors are things and events outside your body that can make you feel threatened or out of control. For example:

  • Physical irritants like noise, pollution, heat, or humidity
  • Work demands or conditions
  • Frightening events, like narrowly escaping a traffic accident
  • Social or family demands, changes, or problems

Internal stressors result from one's own attitudes and thinking patterns. For example:

  • Do you always talk to yourself with words like "should, must, and ought?"
  • Do you feel like a failure if you are late, or if things don't go as planned?
  • Do you have "me last" syndrome, feeling you have to look after everyone else's needs before you think of your own?
  • Do you feel worthless unless everyone likes you all the time?
  • Are you guilty of "awful-izing," which means always expecting the worst? For example, if family members are late, do you often imagine they are injured or dead?

Need To Know:

Sometimes, your body itself can cause stress. For example, it is stressful to have to live with constant backache or other nagging sources of pain. Or, if you are not sleeping well (perhaps because of stress), you may be more stressed than ever the next day because you are so tired.

How-To Information:

A stress diary can be helpful in the analyzing stage. For one week, write down all the stressors you can identify. Don't leave anything out. Here's an example:

Monday

7:30 am

mad at Jimmy, too slow getting off to school

8:00 am

traffic jam; thinking about mistake I made yesterday in Peterson proposal

8:30 am

too much work; John keeps on giving me more

9:30 am

worried about cost of fixing car

10:05 am

tense about making the phone call to Jimmy's school

10:20 am

terrible noise from street-repair crew; headache

When you have about a week's worth of diary entries, study them. See which of them are caused by external events (for example, other people making you late) and which are mostly caused by your own way of thinking or feeling (for example, you are worried about something that may never happen).

In some cases, you may find that stress is caused by a combination of internal and external factors. For example, you might be worried about the cost of fixing the car, and make it worse by blaming yourself for not earning more money.

Sometimes, just by keeping a stress diary you will be able to see solutions to problems that have been bothering you. For example:

  • If the commute is a major source of stress, try a different way of getting to work.
  • If you are worried about your future at work, discuss this with your supervisor; you may find your worries are groundless.
  • If you are always rushed, you may be able to work out better ways to manage your time.
  • If your children are upsetting you at a certain time of day, have a family conference and agree on a different way of doing things.

Unfortunately, we often cannot simply remove the cause of our stress. But we can change the way we deal with it, both in the short term (as "first-aid") and in the long term (developing a stress-resistant lifestyle).

"Respond"

"Responding" in the days of early man meant fighting the source of stress or running away from it. Your body will still produce a physical "alarm response" that pumps stress hormones through your body, tensing your muscles and speeding up your heart. This "alarm response" in most cases doesn't do us any good - and it can be harmful.

You can learn to turn off the alarm response and regain control. You can learn to respond calmly, and deal actively and positively with your stress, whether it is caused by outside or internal factors.

Four useful techniques for responding calmly are:

1. Time out. A brief time out is the simplest possible approach to stress:

  • Stop the activity (or the conversation) that was causing you stress.
  • If you can move away, go to another room, or go for a short walk.
  • If you can't move away, count to 10 silently before you speak again.

2. Breathing. You can often tell if people are under stress because of the way they are breathing. For example, customs officers have noticed that smugglers are the people taking fast, shallow breaths. If you learn to control your breathing, it will help you regain control over the effects of stress.

  • Watch babies breathing; their abdomens expand when they breathe in.
  • Watch a tense adult breathing; there may be no movement of the abdomen. All the work is being done by the chest.

Abdominal breathing can be very soothing, because it slows you down. It is also efficient, bringing a good supply of oxygen to your brain. Prepare for stressful times by practicing your breathing now:

  • Check your breathing pattern by putting one hand on your chest and one hand on your stomach. If your lower hand moves and your top hand does not, you are doing abdominal breathing. But if your top hand moves and your bottom one does not, you are doing chest breathing.
  • To do abdominal breathing, get your stomach relax. Breathe in deeply, then breathe all the air out. Let your lungs fill with air again naturally, while your stomach expands.
  • Practice this "belly breathing" whenever you have spare time (for example, while you are driving).
  • Whenever you are stressed, worried, or tense, use your breathing to help calm yourself down. Take a deep breath and quietly let it go out completely, then let your abdomen expand as the air comes back into your lungs. Keep noticing your abdominal breathing for another few breaths.

For a variation on this breathing technique, try "10-to-one countdown" breathing:

  • Start with abdominal breathing, letting all the breath out and then allowing your abdomen to expand as your lungs fill up again.
  • When you breathe out again, say "10," letting go of tension as if it is being carried out of your body with the air.
  • Next time you breathe out, say "nine," and so on, all the way down to "one."
  • When you get to "one," start again.
  • Each time you breathe out, tell yourself you are letting go of tension.
  • Many people repeat this sequence slowly for a period of 15 to 20 minutes. They find that with each new countdown, they reach a deeper level of relaxation.

When we are under stress, we often feel things are happening too fast. Another technique, called slow-down breathing, can help you get settled down and in control. It starts with abdominal breathing, and uses cue words to help you focus and clear your mind. Examples of cue words are:

  • As you breathe in, silently say "calm"
  • As you breathe out, silently say "smiling"
  • As you breathe in, say "present"
  • As you breathe out, say "now"

Practice breathing techniques for five or 10 minutes until you get the feel of it, then again several times a day for a few moments. Then it will be instantly ready to use as a "mini-tranquilizer" whenever you notice yourself starting to feel tense or out of control.

3. Progressive muscle relaxation. This technique will help you get rid of the muscle tension that is a major sign of uncontrolled stress, and which can lead to headaches, back pain, and muscle pulls. It is based on the principle that muscles go to a deeper level of relaxation after they have been tensed.

  • Lie on the floor or on a firm bed, or sit in a chair that has good head support.
  • Close your eyes and breathe deeply two or three times.
  • Next, tighten up the muscles of different parts of your body in turn; keep them tight while you count silently to five; then let go and imagine the tension going out as you relax and smooth the muscles.
  • Start with your face. Squint your eyes, tighten your teeth and jaw, and wrinkle your forehead. Feel the tension while you count silently to five, and then let go of it. Feel the warmth of relaxation coming to your face.
  • Next, pull your shoulders up until they nearly touch your ears. Feel the tension while you count silently to five. Then let go.
  • Now progress through the rest of your body, tightening muscles while you count slowly to five, then letting the tension go. Start with your stomach and chest muscles, then your lower abdomen, buttocks, and thighs. Finish with your lower legs, curling up your toes and tightening calf muscles to feel the tension in your foot, ankle, calves, and knee.
  • When you have finished, notice the tension and release in all your muscles. Breathe deeply a few times, and feel relaxed, refreshed, and comfortable.

4. Thought-stopping. This is a good technique for dealing with stress that comes from your own negative feelings. When you notice negative thoughts, just say "stop!" to yourself. It may sound too simple to be effective - but it works, even though you may have to repeat the word several times until the negative thoughts are interrupted.

Sometimes, using mental images can help you stop the negative thoughts:

  • Imagine that the negative thoughts are coming from a tape recorder, and that you can push the "stop" button or turn down the volume to zero.
  • Imagine sticky paper that catches your negative thoughts as they fly about.
  • Imagine a "stop" sign that blocks your negative thoughts.
  • Imagine a box that your negative thoughts get trapped in.
  • Imagine you are driving through a car wash that washes the thoughts away.

Need To Know:

And the secret is...

The secret to making these four "respond" techniques work is to practice them several times a week, until you feel comfortable. Then use them. And don't give up on them too soon. All too often, people will only try something a couple of times and give up after a few days. It may take a while before you are getting the full benefit of these techniques.

"Prevent"

There are simple things you can do to help your body and mind withstand stress. These will help you improve your immune system, your energy level, your self-esteem, and your sense of well-being.

1. Relaxation. Relaxing regularly will help prevent stress.

  • Set aside just 15 minutes every day, whether you are feeling stressed or not.
  • Go through whatever relaxation procedures work best for you. Techniques such as yoga and stretching can be effective, as can progressive muscle relaxation.

2. Regular exercise. If you know people who run, swim, or bicycle regularly, you may notice that they have less stress than others. When your body is in first-class condition, your mind and emotions will also benefit. Regular exercise is one excellent way to "stress-proof" yourself, or at reduce the bad effects of stress.

Exercise can make you look better, sleep better, concentrate better, and withstand disease better. It will also improve your mood and make you feel better about yourself. The best exercise for stress-proofing is aerobic activity, which uses your whole body. This includes jogging, bicycling, brisk walking, cross-country skiing, aerobic dancing, swimming, rowing, skating, and stair-stepping.

  • If you are not used to exercise, start with walking. Walk briskly for about 20 minutes, three times a week.
  • As you get in shape, take longer walks, or switch to a more vigorous form of activity.
  • If you don't have access to a lake, mountain, or country road to row, ski, or bike on, substitute on machines at home or in a gym. But whenever you can, get out into nature. The quietness and change of scene will help your stress levels.

Need To Know:

Some exercise safety tips:

  • If you are over age 35 and not used to vigorous exercise, check with a doctor before you start, or stick to walking.
  • Begin every exercise session slowly (including walks), and don't speed up until your muscles are warm.
  • Don't race. Take the talk test. If you don't have enough spare breath to hold a conversation, slow down.
  • At the end of your exercise session, walk around slowly for a while to cool down.

3. Eating right. You will be much better able to withstand stress if your body feels good, and it can't feel good if you don't feed it properly.

  • Make sure you have three good meals a day, with plenty of fruit, vegetables, and filling food like bread, rice, or noodles.
  • If you get hungry between meals, plan for a nutritious snack like fruit, yogurt, or a bagel. If you take a snack to work with you, you won't be tempted by junk food.

Eating well will give you a sense of control that can help to reduce your stress levels, as well as making you feel good physically.

4. Chemicals: alcohol and drugs. People may be tempted to take a drink or drugs to deal with stress. It doesn't help. Alcohol may seem to calm you down, but it only masks the symptoms of stress for a while. Excessive alcohol (and drugs) will give you a rebound; you are likely to feel more stressed than ever when the effects wear off.

One or two drinks a day, such as a glass of wine or beer with dinner, usually won't harm you. If you are regularly drinking much more than that, cut down - and if that is hard to do, get some help.

5. Tobacco. People often say that a cigarette "calms their nerves," but tobacco is really a stimulant. If you are afraid that quitting would cause you too much stress, talk to your doctor about prescribing a nicotine patch or gum to help ease the difficulty of withdrawal. Patches or gum work best if you also join a quit-smoking group or use a good self-help program that helps you learn to be a nonsmoker. In the long run, you will become a calmer person if you stop smoking.

For more information about how to stop smoking, go to Smoking: How To Stop.

6. Caffeine. People have different reactions to caffeine, and most people can take two or three cups of coffee or tea a day without trouble. But you might try cutting down your caffeine intake, to see if you are less jumpy. (If you get a headache for a few days, don't worry; that's a normal withdrawal symptom, and it will go away within a week.)

 
 

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From Andrew Maynard - Chair of the University of Michigan Department of Environmental Health Sciences, with help from David Faulkner - 2013 Master of Public Health graduate.