By Nancy Montgomery CONSUMER HEALTH INTERACTIVEBelow: • What is stress? • How does stress affect you? • Are you juggling too much? • Pinpoint your stress • Take a deep breath • What to do next

Stress is a necessary part of life. It stimulates our creativity, impels us toward our goals, and spices up our existence. As Pema Chödrön, a Buddhist nun, says in her book When Things Fall Apart, "The essence of life is that it is challenging.… To be fully alive, fully human, and completely awake is to be continually thrown out of the nest." What is stress? Stress is anything that knocks your body out of physiological balance. There are positive kinds of stress -- like the kind that helps you focus and pumps you up before a big game or a major presentation. And then there's bad stress -- the kind that eats away at you and robs you of your health and energy. Stress helped our ancestors survive. When they encountered danger, their bodies released stress hormones that created a "fight or flight" response. Among other bodily changes, they experienced an increase in heart rate and breathing, sending more blood and oxygen to the large muscles to equip them to do battle or head for the hills. Today our bodies undergo the same physiological changes under stress that our ancestors' did. The difference is that we can't rid ourselves of the resulting stress hormones by simply fighting our enemy or racing for shelter. If stress continues without relief, over time those same stress hormones that protected our ancestors eventually harm our health. Chronic stress keeps your immune system from functioning properly, making you more likely to get sick. It can also increase your levels of cortisol -- a hormone that stimulates your appetite and can cause you to gain weight. High levels of cortisol can increase your blood pressure, theoretically making you more susceptible to a stroke or heart attack. Stress can also contribute to depression and aggravate skin conditions and ailments like asthma; there is also a fair amount of data that "type A" personalities have a higher risk of cardiovascular disease. How does stress affect you? It is possible to experience stress without being aware of it. For instance, you might not think your workday is particularly stressful until you notice that your neck and shoulder muscles are knotted up and you have indigestion. Stop for a minute and think about how stressed your life is overall. Now look over the following lists of possible stress symptoms and check any you've experienced within the past month. Physical symptoms • Headaches |
• Stiff neck, tense shoulders |
• Trouble sleeping |
• Frequent tiredness |
• Increased sweating |
• Back pain |
• Irregular heart rate |
• Frequent colds or flu |
• Digestive problems |
• Skin problems |
• Sexual dysfunction |
• Changes in appetite |
• Teeth grinding |
Emotional symptoms • Constant anxiety |
• Impatience |
• Depression |
• Irritability |
• Anger or hostility |
• A feeling of helplessness |
• Frequent sense of discouragement without cause |
• Mood swings |
Changes in thinking • Poor concentration |
• Forgetfulness |
• Obsessive negative thoughts |
• Speech problems |
• Hard time learning new things |
Behavioral changes • Eating too much or too little |
• Being accident prone |
• Smoking or drinking too much, using recreational drugs |
• Reckless driving |
• Poor communication |
• Showing extreme anger |
Relationship changes • Isolation |
• Intolerance |
• Resentment |
• Lashing out |
• Fewer contacts with friends |
Look back on the items you've checked. Are you more stressed or less stressed than you thought before? Are you juggling too much? Before you can begin to manage the stress in your life, you need to get a clear picture of what's causing it.. The term "stressor" is used to describe any situation or event that causes you stress.. Sometimes stress comes from being overwhelmed by all the responsibilities you have to juggle. Here's an exercise to help you get a feel for how much you're trying to handle and what your stressors are. Click here to print out The Juggler diagram in PDF format. Imagine that the figure in the diagram is you. In each of the balls over the figure's head, write in one responsibility you currently have. If you need to add more balls, draw them in. In the balls at the bottom of the page, write in anything you've let drop, either on purpose or because you just didn't have time to get to it. It might be something like a regular report you're always late with, or a workout at the gym that you can't seem to fit into your schedule. Once you're done, take a look at the balls you're currently juggling. Do they seem like too much of a load? Do they seem about right? Now look at the balls on the ground. Did you drop them on purpose or because you didn't have any choice? Look at each ball in the air and on the ground one by one. Consider each one: • Is it something you want to keep juggling, or can you let it drop? |
• If you need to keep that ball in the air, can you do it easily, or do you have to let another ball drop to be able to keep the first one up? |
• Are there any balls on the ground that you want to put up in the air? |
• Is there anything you can do to make that easier to accomplish? |
Look at the juggler exercise as way to examine -- and if necessary rebalance -- the load you're carrying. We’ll talk more in future lessons about ways to reduce stress even if you can't reduce the number of balls you're juggling. Pinpoint your stress When you look at your daily routine, some sources of stress may be immediately obvious. Maybe it's getting the kids off to school or a noisy coworker. But you may feel stress several times a day and not even notice, because you're caught up in what you're doing or you're simply used to feeling that way. By writing down your stressors as they occur, you'll get a better idea of where your problems lie. Over the next week, use the Stress Diary to log every time you feel stressed. Note the date and time and briefly describe the stressor. Rate the degree of stress you felt on a scale of 1 to 10, with 10 being the most stress imaginable. Briefly note in the last column how you felt and what -- if anything -- you did. For instance, your diary might include an entry like this: Date/Time | Stressor | Severity | Location/Activity | What I did/felt | Thursday 1/12, noon | Team lunch; boss not happy with progress of project | 7 | Cafe, meeting | Stomach tied in knots, couldn't eat, went back to the office with a headache | Monday | Traffic | 8 | Highway, near crash | Cursed at other drivers |
In the next class we'll talk about how to get a handle on these stressors. Take a deep breath You'll learn more techniques for dealing with stress in future classes, but in the meantime, here's a deep-breathing exercise to try the next time you feel stressed. Inhale through your nose, taking in as much air as you can. Expand your lower abdomen as you inhale, instead of lifting your shoulders. Exhale slowly through your mouth with your lips pursed as if whistling. Continue to exhale until you feel every bit of air is gone from your lungs. Repeat three to five times. What to do next Before the next class, do the following: • Review the symptoms of stress and check all that apply to you. |
• Rate your overall stress level. |
• Practice the deep breathing exercise to relax. |
Future classes: -- Nancy Montgomery is a senior editor at Consumer Health Interactive.
References Stress Management. Personal Action Guide. The StayWell Company. 1999
Tubesing, Nancy Loving and Donald A Tubesing, Editors. Structured Exercises in Stress Management Vol 1. Whole Person Press. 1983.
Stress: Why you have it and how it hurts your health. MayoClinic.com. December 22, 2005. http://www.mayoclinic.com/health/stress/SR00001
Signs and symptoms of stress: Prompt recognition is crucial. MayoClinic.com. http://www.mayoclinic.com/health/stress-symptoms/SR00008_D
Reviewed by Michael Potter, MD, an attending physician and associate clinical professor at the University of California, San Francisco. He is board-certified in family practice.
First published March 23, 2006
Last updated May 14, 2008
Copyright © 2006 Consumer Health Interactive
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