How can we manage stress?

If we think about the causes of stress, the nature of the stress response, and the negative effects of some types of stress (prolonged, unexpected, or unmanageable stress), several healthy management strategies become clear. A first step in stress management is exercise. You see, since the stress response prepares us to fight or flee, our bodies are primed for action. Unfortunately, however, we usually handle our stresses while sitting at our desk, standing at the watercooler, or behind the wheel stuck in traffic. Exercise on a regular basis helps to turn down the production of stress hormones and neurochemicals. Thus, exercise can help avoid the damage to our health that prolonged stress can cause. In fact, studies have found that exercise is a potent antidepressant, anxiolytic (combats anxiety), and sleeping aid for many people.

For centuries in Eastern religious traditions, the benefits of meditation and other relaxation techniques have been well known. Now, Western medicine and psychology have rediscovered that particular wisdom, translated it into simple nonspiritual methods and scientifically verified its effectiveness. Thus, one or two 20-30 minute meditation sessions a day can have lasting beneficial effects on health. Indeed, advanced meditators can even significantly control their blood pressure and heart rate as well.

Elimination of drug use and no more than moderate alcohol use are important for the successful management of stress. We know that people, when stressed, seek these outlets, but we also know that many of these substances sensitize (make even more responsive) the stress response. As a result, small problems produce big surges of stress chemicals. What's more, these attempts with drugs and alcohol to mask stress often prevent the person from facing the problem directly. Consequently, they are not able to develop effective ways to cope with or eliminate the stress.

In fact, even prescription drugs for anxiety, such as diazepam (Valium), lorazepam (Ativan), or alprazolam (Xanax), can be counterproductive in the same way. Therefore, these medications should only be used cautiously under the strict guidance of a physician. If, however, stress produces a full-blown psychiatric problem, like posttraumatic stress disorder (PTSD), clinical depression, or anxiety disorders, then psychotropic medications, particularly the selective serotonin reuptake inhibitors (SSRIs), are extremely useful. Examples of SSRIs include sertraline (Zoloft), paroxetine (Paxil), or fluoxetine (Prozac).

We know that chronic or uninterrupted stress is very harmful. It is important, therefore, to take breaks and decompress. Take a lunch break and don't talk about work. Take a walk instead of a coffee break. Use weekends to relax, and don't schedule so many events that Monday morning will seem like a relief. Learn your stress signals. Take regular vacations or even long weekends or mental-health days at intervals that you have learned are right for you.

Create predictability in your work and home life as much as possible. Structure and routine in your life can't prevent the unexpected from happening. However, they can provide a comfortable framework from which to respond to the unexpected. Think ahead and try to anticipate the varieties of possibilities, good and bad, that may become realities at work or home. Generate scenarios and response plans. You may find that the "unexpected" really doesn't always come out of the blue. With this kind of preparation, you can turn stress into a positive force to work for your growth and change.

For those who may need help dealing with stress, stress-management counseling in the form of individual or group therapy is offered by various mental-health-care providers. Stress counseling and group discussion therapy have proven to reduce stress symptoms and improve overall health and attitude.