How do you handle stress? What was the most stressful event in your life?

How did you handle it? The night before your final exam, your father has a heart-attack and is admitted to a hospital, what do you do?

Stress is what you feel when you have to handle more than you are used to. When you are stressed, your body responds as though you are in danger. It makes hormones that speed up your heart, make you breathe faster, and give you a burst of energy. This is called the fight-or-flight stress response. Some stress is normal and even useful. Stress can help if you need to work hard or react quickly. For example, it can help you win a race or finish an important job on time. But if stress happens too often or lasts too long, it can have bad effects. It can be linked to headaches, an upset stomach, back pain, and trouble sleeping. It can weaken your immune system, making it harder to fight off disease. If you already have a health problem, stress may make it worse. It can make you moody, tense, or depressed. Your relationships may suffer, and you may not do well at work or school. What can you do about stress? The good news is that you can learn ways to manage stress. To get stress under control:

Find out what is causing stress in your life. Look for ways to reduce the amount of stress in your life. Learn healthy ways to relieve stress or reduce its harmful effects.

How do you measure your stress level? Sometimes it is clear where stress is coming from. You can count on stress during a major life change such as the death of a loved one, getting married, or having a baby. But other times it may not be so clear why you feel stressed. It's important to figure out what causes stress for you. Everyone feels and responds to stress differently. Keeping a stress journal may help. Get a notebook, and write down when something makes you feel stressed. Then write how you reacted and what you did to deal with the stress. Keeping a stress journal can help you find out what is causing your stress and how much stress you feel. Then you can take steps to reduce the stress or handle it better. To find out how stressed you are right now, use this Interactive Tool: What Is Your Stress Level?

How can you avoid stress? Stress is a fact of life for most people. You may not be able to get rid of stress, but you can look for ways to lower it.

You might try some of these ideas:

Learn better ways to manage your time. You may get more done with less stress if you make a schedule. Think about which things are most important, and do those first. Find better ways to cope. Look at how you have been dealing with stress. Be honest about what works and what does not. Think about other things that might work better. Take good care of yourself. Get plenty of rest. Eat well. Don't smoke. Limit how much alcohol you drink. Try out new ways of thinking. When you find yourself starting to worry, try to stop the thoughts. Work on letting go of things you cannot change. Learn to say "no." Speak up. Not being able to talk about your needs and concerns creates stress and can make negative feelings worse. Assertive communication can help you express how you feel in a thoughtful, tactful way. Ask for help. People who have a strong network of family and friends manage stress better.

tress Management - Causes of Stress

A lot of things can cause stress. You may feel stress when you go on a job interview, take a test, or run a race. These kinds of short-term stress are normal. Long-term (chronic) stress is caused by stressful situations or events that last over a long period of time, like problems at work or conflicts in your family. Over time, chronic stress can lead to severe health problems. Personal problems that can cause stress include:
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Your health, especially if you have a chronic illness such as heart disease, diabetes, or arthritis. Emotional problems, such as anger you can't express, depression, grief, guilt, or low self-esteem. Your relationships, such as having problems with your relationships or feeling a lack of friendships or support in your life. Major life changes, such as dealing with the death of a parent or spouse, losing your job, getting married, or moving to a new city. Stress in your family, such as having a child, teen, or other family member who is under stress, or being a caregiver to a family member who is elderly or who has health problems. For more information, see the topic Quick Tips: Reducing the Stress of Caregiving. Conflicts with your beliefs and values. For example, you may value family life, but you may not be able to spend as much time with your family as you want.

Social and job issues that can cause stress include:

Your surroundings. Living in an area where overcrowding, crime, pollution, or noise is a problem can create chronic stress. Your job. Being unhappy with your work or finding your job too demanding can lead to chronic stress. Learn how to manage job stress. Your social situation. Being poor, feeling lonely, or facing discrimination based on your race, gender, age, or sexual orientation can add stress to your life.

Post-traumatic stress You may need help dealing with stress if you have faced a life-threatening or traumatic event such as rape, a natural disaster, or war. These events can cause acute stress disorder or posttraumatic stress disorder (PTSD). For more information, see the topic Post-Traumatic Stress Disorder.

Stress Management - Measuring Stress

Feeling stress is a fact of life for most people. But it affects everyone differently. What causes stress for you may not be stressful for someone else. That's because how you view a situation affects how much stress it causes you. Only you can figure out whether you have too much stress in your life. Ask yourself these questions to find out what is causing your stress: What job, family, or personal stress do I have? Stress can be caused by an ongoing personal situation such as:

Problems in your family or with a relationship. Caring for a family member who is elderly, has chronic health problems, or is disabled. Caregiving is a major source of stress. For more information, see the topic Quick Tips: Reducing the Stress of Caregiving. Your job. Dealing with a family member who is under stress.

Have I had any recent major life changes? Life changes such as getting married, moving to a new city, or losing a job can all be stressful. You can't always control these things, but you can control how you respond to them. To find out your current stress level based on recent changes in your life, try this Interactive Tool: What Is Your Stress Level?

Do my beliefs cause me stress? Some people feel stress because their beliefs conflict with the way they are living their life. Examine your beliefs to find out if you have this kind of conflict in your life. How am I coping with stress? Your lifestyle choices can prevent your body from recovering from stress. For example, as you sleep, your body recovers from the stresses of the day. If you're not getting enough sleep or your sleep is often interrupted, you lose the chance to recover from stress. The way you act and behave can also be a sign of stress. Some people who face a lot of stress react by smoking, drinking too much alcohol, eating poorly, or not exercising. The health risks posed by these habits are made even worse by stress. Your body feels stress-related wear and tear in two ways: the stress itself and the unhealthy ways you respond to it. Use this coping strategies evaluation form (What is a PDF document?) to help you find out how you cope with stress. You can also try this Interactive Tool: How Well Do You Bounce Back? It measures your ability to deal with life's challenges.

Managing Job Stress - Overview

Job stress comes in different forms and affects your mind and body in different ways. Small things can make you feel stressed, such as a copy machine that never seems to work when you need it or phones that won't quit ringing. Major stress comes from having too much or not enough work or doing work that doesn't satisfy you. Conflicts with your boss, coworkers, or customers are other major causes of stress. It's normal to have some stress. Stress releases hormones that speed up your heart, make you breathe faster, and give you a burst of energy. Stress can be useful when you need to focus on or finish a big project. But too much stress or being under stress for too long isn't good for you. Constant stress can make you more likely to get sick more often. It can also lead to long-term health problems such as heart disease, high blood pressure, back problems, and depression. Look for these signs of job stress:

Headaches Trouble sleeping Problems concentrating Short temper Upset stomach Job dissatisfaction and low morale

What Causes Job Stress? Most of the time, it's the major sources of stress that lead to job burnout and health problems. Job stress can affect your home life too. Here are some common sources of major job stress, with examples of each:

Lack of control. Feeling as if you have no control over your work or job duties is the biggest cause of job stress. People who feel like they have no control at work are most likely to get stress-related illnesses. Here's an example: o Shelly is responsible for putting together a report that her boss must deliver at a 4 p.m. meeting. She's been waiting all day for the notes and numbers she needs. Shelly finally gets the notes from her boss at 3:15 and rushes to prepare the report and charts and to make copies in time. She gets it done, but she feels mad and resentful. This is the third time this week that this has happened. Increased responsibility. Taking on extra duties in your job is stressful. You can get more stressed if you have too much work to do and you can't say no to new tasks. o John volunteers for every new project, because he heard that's the best way to get promoted. But the tasks are starting to pile up, and he's feeling overwhelmed. He knows he can't really manage one more thing. But this morning, John's boss asked him to take on another project, and John agreed. Now he's more worried than ever about getting everything done. Job satisfaction and performance. Do you take pride in your job? If your job isn't meaningful, you may find it stressful. Are you worried about doing well at work? Feeling insecure about job performance is a major source of stress for many people. o Raoul has worked in his new job for 8 months. He thinks he is doing well. But his boss doesn't say much, so Raoul isn't sure. He wonders if he's on the right track, but he's afraid to ask. Uncertainty about work roles. Being unsure about your duties, how your job might be changing, or the goals of your department or company can lead to stress. If you report to more than one boss, juggling the demands of different managers can also be stressful. o Rosa's old manager was promoted. Now Rosa is working for someone new. She's heard that the new boss plans to "shake things up" in her department. The new boss just hired Emily, whose job seems to be the same as Rosa's. Rosa worries about what this means for her. Poor communication. Tension on the job often comes from poor communication. Being unable to talk about your needs, concerns, and frustrations can create stress. o A new job with more responsibility and better pay just opened up in Jill's department. Jill knows she can do this job. And she's been with the company longer than anyone else on her team. She waits for her manager to ask if she is interested. But after several weeks, a coworker is promoted to the new job. Jill feels hurt and angry, but she doesn't say anything. Lack of support. Lack of support from your boss or coworkers makes it harder to solve other problems at work that are causing stress for you. o Jeff works in a busy office answering customer complaint calls all day. It would be easier to handle all the calls if he could at least trade tips with his coworkers. But everyone else is busy too. His coworkers never make it out of their cubicles during the day, even to let off a little steam.

Poor working conditions. Unpleasant or dangerous physical conditions, such as crowding, noise, or ergonomic problems, can cause stress. o Sonya is exposed to constant noise at work. She wears earplugs, but at the end of her shift her ears are ringing. She often comes home with a headache.

Stress Management - Effects of Stress

Stress causes changes in your body. It also affects your emotions. How stress affects the body Common symptoms of stress include:

A fast heartbeat. A headache. A stiff neck and/or tight shoulders. Back pain. Fast breathing. Sweating, and sweaty palms. An upset stomach, nausea, or diarrhea.

Over time, stress can affect your:1

Immune system. Constant stress can make you more likely to get sick more often. And if you have a chronic illness such as AIDS, stress can make your symptoms worse. Heart. Stress is linked to high blood pressure, abnormal heartbeat (arrhythmia), blood clots, and hardening of the arteries (atherosclerosis). It's also linked to coronary artery disease, heart attack, and heart failure. Muscles. Constant tension from stress can lead to neck, shoulder, and low back pain. Stress may make rheumatoid arthritis worse. Stomach. If you have stomach problems, such as gastroesophageal reflux disease (GERD), peptic ulcer disease, irritable bowel syndrome, or ulcerative colitis, stress can make your symptoms worse. Reproductive organs. Stress is linked to low fertility, erection problems, problems during pregnancy, and painful menstrual periods. Lungs. Stress can make symptoms of asthma and chronic obstructive pulmonary disease (COPD) worse. Skin. Skin problems such as acne and psoriasis are made worse by stress.

How stress affects your thoughts and emotions You might notice signs of stress in the way you think, act, and feel. You may:

Feel cranky and unable to deal with even small problems. Feel frustrated, lose your temper more often, and yell at others for no reason.

Feel jumpy or tired all the time. Find it hard to focus on tasks. Worry too much about small things. Feel that you are missing out on things because you can't act quickly. Imagine that bad things are happening or about to happen.

How stress affects you depends on many things, such as:

Your personality. What you have learned from your family about responding to stress. How you think about and handle stress. See: Positive thinking: Stopping unwanted thoughts.

Your coping strategies Your social support.

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The type of stress matters Stress can affect you both instantly (acute stress) and over time (chronic stress). Acute (short-term) stress is the body's instant response to any situation that seems demanding or dangerous. Your stress level depends on how intense the stress is, how long it lasts, and how you cope with the situation. Most of the time, your body recovers quickly from acute stress. But stress can cause problems if it happens too often or if your body doesn't have a chance to recover. In people with heart problems, acute stress can trigger an abnormal heartbeat (arrhythmia) or even a heart attack. Chronic (long-term) stress is caused by stressful situations or events that last over a long period of time. This could include having a difficult job or dealing with a chronic disease. If you already have a health problem, stress can make it worse.

Stress in Children and Teens - Topic Overview

Children and teens notice and react to stress in their family and also experience their own stress. It is important to recognize stress in children and teens and help them with healthy coping strategies. The strategies they learn often stay with them into adulthood. Generally, anything that may cause children fear and anxiety can cause stress. This can include being away from home, starting a new school or moving to a new location, being separated from parents or caregivers, worrying about school and getting along with others, worrying about their changing bodies, and worrying about the future.

The following are some common signs of stress in different age groups.
Signs of stress in children and teens

Preschool and toddlers

Elementary-age children

Preteens and teens

Anger Anxiety Eating and sleeping problems, including nightmares Fear of being alone Irritability Regressing to infant behaviors Trembling with fright Uncontrollable crying Withdrawal

Being distrustful Complaining of headaches or stomachaches Feeling unloved Having no appetite Having trouble sleeping Needing to urinate frequently Not caring about school or friendship Acting withdrawn Worrying about the future

Anger Disillusionment Distrust of the world Low self-esteem Stomachaches and headaches Rebellion

Helping with stress Adults can help children and teens with stress in many ways. Two important ways are creating a low-stress environment and helping them develop positive coping skills. The following can help develop a low-stress environment:

Acknowledge your child's feelings. Develop trust and let your child know that mistakes are learning experiences. Be supportive and praise your child. Show care, warmth, and love. Hug your child often. Have clear expectations without being overly rigid; emphasize cooperation over competition. Do not over-schedule your child into too many activities. Find ways to have your children contribute to the family. Build on the strengths of the family. Be aware of what your child wants (not just what you want).

It is important to help children develop positive coping skills, as these skills are often carried into adult life. You can help by:

Providing a good example. Keep calm and control your anger. Think through plans to decrease stress and share them with the family.

Encouraging rational thinking. Be sure your children think about consequences of their actions. Help them understand what is fantasy and what is reality. For example, a child's behavior did not cause a divorce, or they are not failures because they were not picked first for something. Providing them with some control. Allow your children to make choices within your family framework. For example, allow them to arrange their room, choose family activities, and help make family decisions. Talking openly. When appropriate, talk about your stressful day. Encourage them to talk about what is bothering them. Finding a physical activity and/or hobby that they enjoy and encouraging them to participate. Encouraging them to eat healthy foods and emphasizing the importance of a healthy lifestyle. Learning and teaching your children relaxation skills.

Interactive Tool: How Well Do You Bounce Back? - What does this tool measure?
Click here to find out how resilient you are .

This tool measures your resiliency-your ability to bounce back from stressful situations. People who are resilient recover quickly from disruptive change, illness, or misfortune without being overwhelmed or acting in destructive ways. The tool calculates your score based on the statements you choose. The calculation is based on those personality factors-such as flexibility, self-confidence, creativity, and ability to learn from experience-that make people more resilient.

Stress Management - Ways to Relieve Stress

The best way to manage your stress is to learn healthy coping strategies. You can start practicing these tips right away. Try one or two until you find a few that work for you. Practice these techniques until they become habits you turn to when you feel stress. You can also use this coping strategies form (What is a PDF document?) to see how you respond to stress. Stress-relief techniques focus on relaxing your mind and your body. Ways to relax your mind

Write. It may help to write about things that are bothering you. Write for 10 to 15 minutes a day about stressful events and how they made you feel. Or think about starting a stress journal. This helps you find out what is causing your stress and how much stress you feel. After you know, you can find better ways to cope.

Let your feelings out. Talk, laugh, cry, and express anger when you need to. Talking with friends, family, a counselor, or a member of the clergy about your feelings is a healthy way to relieve stress. Do something you enjoy. This can be: o A hobby, such as gardening. o A creative activity, such as writing, crafts, or art. o Playing with and caring for pets. o Volunteer work. You may feel that you're too busy to do these things. But making time to do something you enjoy can help you relax. It might also help you get more done in other areas of your life.

Focus on the present. Meditation and guided imagery are two ways to focus and relax your mind. o Meditate. When you meditate, you focus your attention on things that are happening right now. Paying attention to your breathing is one way to focus. For more information, see: Stress management: Doing meditation.
o

Use guided imagery.With guided imagery, you imagine yourself in any setting that helps you feel calm and relaxed. You can use audiotapes, books, or a teacher to guide you. To learn more, see: Stress management: Doing guided imagery to relax.

Ways to relax your body

Exercise. Regular exercise is one of the best ways to manage stress. Walking is a great way to get started. Even everyday activities such as housecleaning or yard work can reduce stress. Stretching can also relieve muscle tension. For more information about becoming more active, see the topic Fitness. Try techniques to relax. Breathing exercises, muscle relaxation, and yoga can help relieve stress. o Breathing exercises. These include roll breathing, a type of deep breathing. For more information, see: Stress management: Breathing exercises for relaxation.
o

Progressive muscle relaxation. This technique reduces muscle tension. You do it by relaxing separate groups of muscles one by one. To learn more, see: Stress management: Doing progressive muscle relaxation.

Yoga, tai chi, and qi gong. These techniques combine exercise and meditation. You may need some training at first to learn them. Books and videos are also helpful. You can do all of these techniques at home. For more information on yoga, see:

Quick Tips: Reducing the Stress of Caregiving - Get started

Caring for a family member who has a disability or a chronic illness can be rewarding. But it's also demanding. One of the keys to being a successful caregiver is to manage stress by seeking support and taking care of yourself. Think about the kinds of caregiving tasks or situations that trigger stress for you. Then you can focus on one or two things you can do that will help the most to reduce stress. Here are some ideas:
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Get support

Ask family members for help. Include them in caregiving decisions. Share the tasks. Make a list of weekly tasks, and share that list with your family. Ask for help with shopping, housecleaning, and errands. You don't have to do all the work on your own. Stay involved. Make time for social activities and friends, even if it's only a phone call or coffee during the week. Join a caregiver support group. Meeting other caregivers helps you know you're not alone. And it gives you a chance to talk about your worries and concerns with others who understand. Find respite care. Respite services provide someone who can stay with your family member while you get away for a few hours or days. Time away can help you manage your stress. Look up caregiver resources in your community. Hospitals, churches, and other groups may provide transportation or other services that support caregiving tasks. You can reduce stress by planning ahead so you know who to call when you need extra help.

Take care of yourself

Put your own health first. Be sure to schedule and go to your medical checkups. Eat a healthy diet, and get enough sleep. Taking care of yourself will help you deal with stressful situations. Get regular exercise. Even a 10-minute walk can relieve stress.

Take a breath. Try stress reduction techniques like deep breathing and meditation. Take a break. Its important to take time off from caregiving once in a while. Spend some time doing things you enjoy or on things in your own life that need attention.

What to think about Depression is common among caregivers. It's emotionally draining to care for a loved one whose health is getting worse. Don't dismiss your feelings as "just stress." If you're having trouble coping with your feelings, it may help to talk with a counselor. If you have symptoms of depression, such as a lack of interest in things you enjoy, a lack of energy, or trouble sleeping, talk with your doctor.

Quick Tips: Reducing Holiday Stress - Get started

The holidays can be a joyful time, offering a chance to reconnect with friends and family. But they can also be stressful. You may feel pressure to buy and give gifts. Maybe you are worried about money. The holidays can also be hectic. There never seems to be enough time to get things done. Think about the kinds of events that trigger stress for you during the holidays. Then you can focus on one or two things you can do that will help the most to reduce stress. Here are some ideas:
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Preparing for the holidays

Know your spending limit. Lack of money is one of the biggest causes of stress during the holiday season. This year, set a budget, and don't spend more than you've planned. It's okay to tell your child that a certain toy costs too much. Don't buy gifts that you'll spend the rest of the year trying to pay off. Give something personal. You can show love and caring with any gift that is meaningful and personal. It doesn't have to cost a lot. Or use words instead of an expensive gift to let people know how important they are to you. Make a phone call or write a note and share your feelings. Get organized. Make lists or use an appointment book to keep track of tasks to do and events to attend.

Share the tasks. You don't have to do everything yourself. Share your "to do" list with others. Spend time with friends and family while you share tasks like decorating, wrapping gifts, and preparing the holiday meal. Learn to say no. It's okay to say "no" to events that aren't important to you. This will give you more time to say "yes" to events that you do want to attend. Be realistic. Try not to put pressure on yourself to create the perfect holiday for your family. Focus instead on the traditions that make holidays special for you. And remember that just because it's a holiday, family problems don't go away. If you have a hard time being around your relatives, it's okay to set limits on your time at events and visits.

During the holidays You may not be able to avoid stressful situations during the holidays. But you can plan to respond to them in a healthy way.

Take breaks from group activities. Pay attention to your own needs and feelings. Spend a little time by yourself if you can. Meditate, or do some relaxation breathing. Go for a short walk. Keep a regular sleep, meal, and exercise schedule. Limit your alcohol. Taking care of yourself will help you deal with stressful situations during the holidays. Get support if you need it. Holidays can sometimes trigger depression. They can be especially hard if you are already dealing with the death of a loved one or the breakup of a relationship. You may feel embarrassed to ask for help, or you may think that you'll get over "the blues" on your own. But most people need treatment to get better. Talk with your doctor about counseling and medicine for depression.

Stress Management - Ways to Avoid Stress

Stress is a part of life, and you can't always avoid it. But you can try to avoid situations that can cause it, and you can control how you respond to it. The first step is knowing your own coping strategies. Try using a stress journal to record stressful events, your response to them, and how you coped. After you know what is causing your stress, try making some changes in your life that will help you avoid stressful situations. Here are a few ideas: Manage your time Time management is a way to find the time for more of the things you want and need to do. It helps you decide which things are urgent and which can wait. Managing your time can make your life easier, less stressful, and more meaningful. For more information, see:
Stress management: Managing your time.

Look at your lifestyle

The choices you make about the way you live affect your stress level. Your lifestyle may not cause stress on its own, but it can prevent your body from recovering from it. Try to:

Find a balance between personal, work, and family needs. This isn't easy. Start by looking at how you spend your time. Maybe there are things that you don't need to do at all. Finding a balance can be especially hard during the holidays. For help, see: o Quick Tips: Reducing Holiday Stress. Have a sense of purpose in life. Many people find meaning through connections with family, friends, jobs, or volunteer work. Get enough sleep.Your body recovers from the stresses of the day while you are sleeping. For more information, see: Insomnia: Improving your sleep.

Adopt healthy habits. Eat a healthy diet, limit how much alcohol you drink, and don't smoke. Staying healthy is your best defense against stress. Exercise. Even moderate exercise, such as taking a daily walk, can reduce stress.

Get support Support in your life from family, friends, and your community has a big impact on how you experience stress. Having support in your life can help you stay healthy. Support means having the love, trust, and advice of others. But support can also be something more concrete, like time or money. It can be hard to ask for help. But doing so doesn't mean you're weak. If you're feeling stressed, you can look for support from:

Family and friends. Coworkers, or people you know through hobbies or other interests. A professional counselor. (See tips for finding a counselor or therapist.) People you know from church, or a member of the clergy. Employee assistance programs at work, or stress management classes. Support groups. These can be very helpful if your stress is caused by a special situation. Maybe you are a caregiver for someone who is elderly or has a chronic illness. For more help, see:

Problem Solving to Manage Stress - Topic Overview

Problem solving helps you overcome complex stressful events. Identify all aspects of a stressful event, including behavior, thoughts, and feelings. For example, if you have just been laid off from your job, you need to identify:

Behaviors, such as the need to look for another job, earn money for your family, and make other adjustments in your life.

Negative thoughts, such as "I'll never get another job." Negative feelings, such as anger and depression. How your body responds, such as fatigue or difficulty sleeping.

You can then find coping strategies, such as talking with others about your feelings of anger or depression. Brainstorm by:

Thinking of as many solutions as you can, even if they seem very difficult to accomplish. Not criticizing any solution. Combining solutions.

Evaluate your alternatives and choose the best one. When rating your solutions, take into account the:

Likelihood of being able to carry it out and succeed. Cost in time and energy. Effect of the solution on other people.