When stress becomes unmanageable, try these evidence-based tools to tackle it in healthy ways.
Stressful experiences are a normal part of life, and the stress response is a survival mechanism that primes us to respond to threats. Some stress is positive: Imagine standing in front of a crowd to give a speech and hitting it out of the park. Stressful? Certainly. But also challenging and satisfying.
But when a stressor is negative and can’t be fought off or avoided — such as layoffs at work or a loved one’s medical crisis — or when the experience of stress becomes chronic, our biological responses to stress can impair our physical and mental health.
Fortunately, there are many evidence-based tools to help combat the negative effects of stress in healthy ways. They recommend that you:
- Try to eliminate the stressors: Whether or not you experience an intolerable level of psychological stress depends on the intensity of the situation and also the person experiencing it. How you perceive and think about a stressor can also make a big impact on how you respond. It’s not always possible to escape a stressful situation or avoid a problem, but you can try to reduce the stress you are feeling. Evaluate whether you can change the situation that is causing you stress, perhaps by dropping some responsibility, relaxing your standards or asking for help.
- Cultivate social support: Strong social support can improve resilience to stress.1 Reach out strategically. Some friends or family members may be good at listening and sympathizing. Others might excel at practical help, like bringing over a home-cooked meal or covering an hour of child care. Giving support can also increase positive emotions and decrease negative emotions.2 Just make sure your relationships stay in balance. A friend who requires support but never gives it may increase your stress level.
- Seek good nutrition: When confronted with a stressor, the central nervous system releases adrenaline and cortisol, which affects the digestive tract among other physiological changes. Acute stress can kill the appetite, but the release of the hormone cortisol during chronic stress can cause fat and sugar cravings. Research also suggests that high cortisol combined with high sugar consumption may prompt the deposition of fat around our internal organs3 — visceral fat that is associated with cardiovascular and metabolic diseases. A diet high in a variety of nutrients can both protect health and provide more physical energy to deal with challenges. No need to go vegan or swear off cookies —just aim to consume a rainbow of fruits and vegetables as part of your daily diet. Avoid using substances such as alcohol to dampen the stress response since substances do not solve the root of the problem and can have serious health effects.
- Relax your muscles: Because stress causes muscles to tense, being stressed out can create tension headaches, backaches and general fatigue. Combat stress and these symptoms with stretches, massage or warm baths. Or try progressive muscle relaxation, a method that has been shown to reduce anxiety and improve overall mental health.4 To practice progressive muscle relaxation, get in a comfortable position and choose a muscle group, like your lower leg muscles (most practitioners recommend starting with the lower body and working your way up). Inhale and contract the muscles for five to 10 seconds, then exhale and release the muscles suddenly. Relax for 10 or more seconds and then move on to the next muscle group. Another option is passive progressive muscle relaxation. This technique is similar to progressive muscle relaxation but skips the tensing step. Instead, simply picture each muscle group one at a time and focus on relaxing that portion of the body.
- Meditate: A strong body of research shows that mindful meditation can reduce psychological stress and anxiety — even short-term mindfulness meditation programs work.5 To get started, set aside five minutes in a quiet place to sit and breathe. Focus on the present moment; if stray thoughts intrude, acknowledge them and then let them go. Don’t judge yourself for any mental wavering. Gently refocus and bring the attention back to the present moment.
- Protect your sleep: Daytime stress affects nighttime sleep.6 Making matters worse, losing shuteye can affect both cognition and mood. How to sleep better? Try to have a consistent sleep routine that allows time to wind down before lights out. Meditation and relaxation can help with insomnia.7 Also, avoid caffeine and alcohol in the late afternoon and evening. Put down your screens, as blue light can suppress the sleepy hormone melatonin (and checking social media may ramp up your emotions.) Finally, move your body during the day: A large body of research suggests that physical activity can improve sleep, especially for middle-aged and older adults.8
- Get physical: Brisk movement can not only improve sleep, it can directly combat stress. In one study, working adults who participated in moderate physical activity had half the perceived stress as working adults who did not participate.9 Physical activity may also cancel out some of the negative effects of stress, including the impact of stress on the immune system.10 Adding physical activity needn’t be expensive or complex: A brisk 30-minute walk or a dance session in the living room can do the trick.
- Take a moment in nature: Studies conducted in multiple countries have found that green space improves mood.11 Even nature videos can speed the recovery from stress compared with videos of urban scenes.12 Taking a moment to notice nature — even in the form of a bustling city park — can refocus and calm your mind.
- Keep your pleasurable activities: When life gets overwhelming, people often drop their leisure activities first. But cutting yourself off from pleasure can be counterproductive. Even when time is tight, look for opportunities to do something for yourself, whether that means reading a novel, singing along to your favorite tunes or streaming your favorite comedy on Netflix. Humor and laughter can benefit both mental and physical health.13
- Reframe your thinking: One of the most research-supported treatments for stress and anxiety is cognitive behavioral therapy, or CBT. At the root of this therapy approach is the understanding that our thoughts influence our emotions, which in turn influences our behaviors. Reframing your thoughts around a stressor can help manage your emotions, reducing feelings of stress.14 Some tips: If you feel yourself spiraling into imagining worst-case scenarios, stop and put your mind elsewhere. Set realistic expectations for yourself. Strive for acceptance of situations outside of your control.
- Seek help: If you feel overwhelmed and self-help isn’t helping, look for a psychologist or other mental health provider who can help you learn how to manage your stress effectively. He or she can help you identify situations or behaviors that contribute to your stress and then develop an action plan to change the stressors, change your environment and change your responses.
Acute versus chronic stressThe experience of stress can be either acute or chronic. Acute stress usually occurs in response to a short-term stressor, like a car accident or an argument with your spouse. Acute stress can be very distressing, but it passes quickly and typically responds well to coping techniques like calming breathing or brisk physical activity.
Chronic stress occurs when stressors don’t let up. The roots of chronic stress can vary widely, from situations people can control or avoid (such as having a toxic friendship) to difficulties that are hard to escape (poverty, racism or other discrimination). Because people respond differently to stressful circumstances, a situation that one person might find tolerable can become a source of chronic stress for another.
Chronic stress can damage both mental and physical health. Being chronically stressed may leave you feeling fatigued, sap your ability to concentrate and cause headaches and digestive difficulties. People prone to irritable bowel syndrome often find that their symptoms spike with psychological stress.15 Though acute stress can heighten certain immune responses, the wear-and-tear of chronic stress is bad for the immune system.16 Chronic stress can also affect cardiac health, with multiple studies finding a link between chronic stress and the development of coronary artery disease.17
The American Psychological Association gratefully acknowledges the assistance of Beverly Thorn, PhD, in developing this fact sheet.
ReferencesOzbay, F., Johnson, D. C., Dimoulas, E., Morgan, C. A., Charney, D., & Southwick, S. (2007). Social support and resilience to stress: from neurobiology to clinical practice Psychiatry (Edgmont (Pa.: Township)), 4(5), 35–40.Nelson, S. K., Layous, K., Cole, S. W., & Lyubomirsky, S. (2016). Do unto others or treat yourself? The effects of prosocial and self-focused behavior on psychological flourishing. Emotion, 16(6), 850-861. http://dx.doi.org/10.1037/emo0000178Gyllenhammer, L. E., Weigensberg, M. J., Spruijt-Metz, D., Allayee, H., Goran, M. I., & Davis, J. N. (2014). Modifying influence of dietary sugar in the relationship between cortisol and visceral adipose tissue in minority youth. Obesity (Silver Spring, Md.), 22(2), 474–481. doi:10.1002/oby.20594.Gaylord, C., Orme-Johnson, D., & Travis, F. (1989). The Effects of the Transcendental Mediation Technique and Progressive Muscle Relaxation on Eeg Coherence, Stress Reactivity, and Mental Health in Black Adults. International Journal of Neuroscience, 46(1-2), 77–86. doi: 10.3109/00207458908991618.Goyal M, Singh S, Sibinga EMS, et al (2014). Meditation Programs for Psychological Stress and Well-being: A Systematic Review and Meta-analysis. JAMA Intern Med.174(3):357–368. doi:10.1001/jamainternmed.2013.13018Åkerstedt, T., Kecklund, G., & Axelsson, J. (2007). Impaired sleep after bedtime stress and worries. Biological Psychology, 76(3), 170–173. doi: 10.1016/j.biopsycho.2007.07.010.Black, D. S., O’Reilly, G. A., Olmstead, R., Breen, E. C., & Irwin, M. R. (2015). Mindfulness meditation and improvement in sleep quality and daytime impairment among older adults with sleep disturbances: a randomized clinical trial. JAMA internal medicine, 175(4), 494–501. doi:10.1001/jamainternmed.2014.8081Dolezal, B. A., Neufeld, E. V., Boland, D. M., Martin, J. L., & Cooper, C. B. (2017). Interrelationship between Sleep and Exercise: A Systematic Review Advances in preventive medicine, 2017, 1364387. doi:10.1155/2017/1364387Aldana, S. G., Sutton, L. D., Jacobson, B. H., & Quirk, M. G. (1996). Relationships between Leisure Time Physical Activity and Perceived Stress. Perceptual and Motor Skills, 82(1), 315–321. doi: 10.2466/pms.1922.214.171.1245Fleshner, F. (2005). Physical Activity and Stress Resistance: Sympathetic Nervous System Adaptations Prevent Stress-Induced Immunosuppression. Exercise and Sport Sciences Reviews, 33(3), 120–126. doi: 10.1097/00003677-200507000-00004Kondo, M., Fluehr, J., Mckeon, T., & Branas, C. (2018). Urban Green Space and Its Impact on Human Health. International Journal of Environmental Research and Public Health, 15(3), 445. doi: 10.3390/ijerph15030445Ulrich, R.S., Simons, R.F., et al (1991). Stress recovery during exposure to natural and urban environments. Journal of Environmental Psychology. 11(3), 201-230. doi: 11016/S0272-4944(05)80184-7Savage, B.M., Lujan, H.L., Thipparthi, R.R & DiCarlo, S.E. (2017). Humor, laughter, learning and health! A brief review. 41(3), 341-347. doi: 1152/advan.00030.2017Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses. Cognitive therapy and research, 36(5), 427–440. doi:10.1007/s10608-012-9476-1Qin, H.-Y. (2014). Impact of psychological stress on irritable bowel syndrome. World Journal of Gastroenterology, 20(39), 14126. doi: 10.3748/wjg.v20.i39.14126Segerstrom, S. C., & Miller, G. E. (2004). Psychological stress and the human immune system: a meta-analytic study of 30 years of inquiry. Psychological bulletin, 130(4), 601–630. doi:10.1037/0033-2909.130.4.601Strike, P. C., & Steptoe, A. (2004). Psychosocial factors in the development of coronary artery disease. Progress in Cardiovascular Diseases, 46(4), 337–347. doi: 10.1016/j.pcad.2003.09.001