Stress Management


         Stress:  that ever-present, life-span shortening, ulcer-inducing, pull-out your-hair condition that is part and parcel of our modern lives.  If there is one issue that I talk about with every client, this is it.  Stress has an immediate impact on our well-being and is therefore one of the most vitally important things to learn to manage as well as we possibly can.  This article will help you to learn more about what stress is and how to work towards minimizing its negative impact on our lives and our health.


What is Stress?


         Stress can be a difficult concept to grasp because we tend to overuse the term.  Stress can refer to almost any difficult emotion.  When we apply a term to nearly everything, it basically starts to mean nothing.  We know that stress is uncomfortable, bad, unhealthy, and something we should try to minimize, but what does it actually refer to?

First, often when we use the term “stress,” what we are actually referring to is distress.  Stress manifests itself in a few different forms and some of these are actually healthful and helpful.  Distress is the form that is unhealthful, especially when it is long-term and unremitting.  To simplify, I will use the term “stress” when referring to distress.  According to Kottler & Chen in their textbook on stress titled Stress Management and Prevention: Applications to Daily Life, stress is “a psychological and physiological reaction to a real or perceived threat that requires some action or resolution.”  Let’s break down that definition:

  • Psychological reaction – this refers to the changes in our thinking that occur when we are stressed. Our thoughts may become rapid (racing thoughts), worried (attempting to identify possible negative events by wondering “what if…”), jumbled (for an explanation of this, see the “physiological reaction” section), or fixated (being able to think only about what is stressing us out).
  • Physiological reaction – our bodies have a primitive response to stress that is generally labeled as our fight or flight response. This is a series of changes within our body that prepares us to flee or fight off a predator.  If a lion were to walk into your office,   this response would be effective in enabling you to escape or fight off this threat.  However, (unless you work in a zoo) you are highly unlikely to encounter this type of threat on a day-to-day basis.  Your body does not differentiate between the threat of a hungry predator and a looming deadline/overdue bill/household chore (insert your own specific stress trigger here).  Your body and brain are prepared to physically fight off these stress triggers as if they were a lion regarding you as lunch.  Your body undergoes numerous changes that may be uncomfortable and unhealthy, but are adaptive in terms of helping you either put up a fight or flee as quickly possible.  Your brain also undergoes changes that prioritize quick judgments and decisions and de-emphasize more rational thoughts that require more time and effort (hence our thoughts seeming jumbled).  I highly recommend the excellent book Why Zebras Don’t Get Ulcers by Robert Sapolsky which thoroughly explains the stress response while being both informative and funny.  Or you can watch a very crude 3 minute YouTube video that summarizes this work and features its author here.
  • Real or perceived threat – As was just mentioned, your body does not differentiate between threats whether they be a real and present predator or something that we perceive as threatening. It is this factor that makes anxious worry so destructive.  As we ponder the “what if’s,” our body is responding as if those awful thing were really happening.
  • Requires some action or resolution – This tends to be an area that causes many of our problems with stress management. We may go through the first part of the cycle by identifying the threat (real or perceived) and then responding to the threat but we never do anything to close the loop.  We may do something to distract ourselves, the stress may pass, we may even blow off some steam.  However, we need to proactively do something to address the threat that started off this cycle in the first place (more on that in just a bit).

So now that we have a basic understanding of what stress is, let’s explore a bit further the ways in which we may actually manage it.

Inputs and Outputs


         I typically describe stress management by having people imagine a glass container (such as a pitcher).  Imagine that water is being poured into it (this is the incoming stressors) and water being poured out (this is what we are doing to relieve stress, also called coping skills).  If more is being poured in than poured out, the container will overflow.   When this happens, we will feel overwhelmed and very likely irritable.

We will come back to this idea of inputs and outputs (stressors and coping skills) as we talk about how to go about managing stress.  Before moving on to that discussion, one important dynamic bears highlighting.  It is a major trend common to almost all of us that when inputs (or stressors) increase, we tend to decrease outputs.  At times when we have multiple deadlines, a serious illness falls upon a loved one, our kids get into trouble at school, or any other such stressor our efforts at caring for ourselves dramatically decrease.  We say to ourselves something along the lines of: “I just don’t have time to look after myself.  I will get back to it once things settle down a bit.”  Thus, our inputs and outputs look like the following graph:


If you take away only one thing from this article, please let it be that this is the area that will give you the most benefit in managing your stress.  At times when your stress level goes up, so too does your need to initiate coping skills, thus looking more like this:


Using this technique will enable you to persevere through challenging times and not succumb to feeling overwhelmed or overly stressed out.

Signs of Imbalance


When there are more stressors than stress relievers happening in our life, there can be a myriad of negative effects.  Some of these include:

  • Our sleep may be impaired, as with:
    • difficulty falling asleep (also called primary insomnia and may be a sign of anxiety)
    • staying asleep (also called maintenance insomnia and may be a sign of depression)
    • feeling like we are not getting restful sleep
  • Physical Effects
    • Tension – typically in the neck or shoulders
    • Stomach upset – heartburn, indigestion, basically feeling like this:
  • Anxiety
    • Feeling keyed up or on edge
    • Experiencing panic attacks
    • Having worried thoughts
  • Short-tempered
  • More emotional than usual

The difficult thing about stress management is that sometimes we may not even be consciously aware of being stressed.  If someone were to ask us if we are stressed we might even deny it.  Typically, this is because we are maintaining a high baseline level of stress in our life.  If we constantly run at 90% of our stress capacity but only identify being “stressed” if we reach 100%, it is easy to see how we might deny being stressed while actually we are consistently functioning at a high stress level.  You will recall that earlier we recognized that our stress response (fight or flight) is not designed to run long term and begins to have negative effects when it does.  Ideally, the stress response is turned on when we need it to face an urgent, imminent threat and then it turns off once we have successfully confronted that issue.



Managing Stress


         There are basically two (nonexclusive) approaches to managing your stress: decreasing inputs and increasing outputs.

In terms of decreasing inputs, this involves taking an inventory of the things that are creating stress in your life.  You can take out a sheet of paper and try to list all of these things.  Think of tasks like:

  • Household responsibilities such as chores, caring for children, etc.
  • Community responsibilities such as volunteering, boy/girl scouts, PTA/school involvement, board meetings, etc.
  • Social commitments such as commitments to help friends, attending functions that you perhaps would prefer not to, relationship stresses, etc.
  • Career issues such as job dissatisfaction, interpersonal issues, stressful projects, commuting, etc.


Once you have created as thorough a list as possible, assign a numerical value to each item with 1 being minimally stressful and 5 being extremely stressful.  Tally up your total number.  Now, I recommend that you aim to decrease this number by 10%.  You can accomplish this by tackling a small number of highly rated items or a large number of lowly rated items or some combination thereof.  You may have to get creative in order to figure out how to address these issues.  Can you hire someone to take some of the household responsibilities (like a house cleaner or a landscaper) or delegate some of those responsibilities to other members of the household?  Can you disengage from certain duties within the community or attend fewer functions?  Can you work on saying “no” to requests for help, even if it would be difficult to do so?  Can you work out a telecommuting schedule to address commuting?  Can you look for a different job or delegate certain job responsibilities?

Undertaking these changes is not likely to be overtly easy, so do not get discouraged by encountering resistance (either from others or from yourself).  Your stress level is telling you that you cannot continue to operate as you have been and therefore you need to address these changes or risk having some negative health consequences.  This is not meant to add pressure on you or to make you feel bad about your situation; it is meant to serve as a wake-up call to draw attention to an area of need.  Stress is serious and, as a society, we have a tendency to ignore it by dismissing it as an inevitable part of our lives.  To some degree, this is true, but not if your stress level has risen to that of distress.

In terms of how to increase stress outputs, the key is to turn to things that you find relaxing, rewarding, fun, or supportive.  You should also assess the balance between escape activities – things that allow us to disconnect and be passive recipients, and active enterprises – things that require our active participation in order to receive the benefit.  We typically engage in many escape activities but may not have as many active enterprises.  If this is the case for you, consider incorporating more things in the active mode.  See the graph below for some ideas of things that fall into each of these categories.

Escape Active
Relaxing Taking a bath

Reading a book

Watching TV/movies



Deep breathing

Rewarding Watching children play


Reading to children


Completing tasks that

have been put off

Learning a new hobby

Fun Reading

Watching TV/movies

Attending sports event




Playing recreational



Supportive Go out with friends Attend a support group


The important thing is that you tailor your approach to incorporate those things that are meaningful to you.  Some of these items could become “inputs” to stress if the reward you gain from them is not more significant than the stress of committing to them.  These would be the things that I suggest you cut.  Ideally, you will gain maximum reward with minimal added stress from the events that you are choosing.  The overall objective here is for you to become more purposeful in selecting the events to which you are committing your time.

In Closing…

Stress is an omnipresent and serious issue.  It may be easy to dismiss stress by thinking “everyone has it,” or “I deal with this all the time” but we must recognize that there are significant costs attributable to stress.  In fact, sources show that “job stress is estimated to cost American companies more than $300 billion a year in health costs, absenteeism and poor performance.”  ( Research/centers/CPH-NEW/stress-at-work/financial-costs.aspx)  While this demonstrates the economic impact of stress to corporations, take a moment to consider the personal burden of being worn-out, stressed-out, sick, tired, and overwhelmed.  It makes sense for us to do everything in our power to confront this and minimize the amount and impact of stress in our day-to-day lives.  While the quote from 1978’s Animal House of “fat, drunk, and stupid is no way to go through life, son” ( typically garners a chuckle, I would tweak this to read “stressed, tired, and overwhelmed is no way to go through life.”

Please accept the challenge of making efforts today to decrease the inputs and increase the outputs of stress.  Every effort made in this area will reap benefits in both the short and long term.

Learning points

         At this point, you should have a clear understanding of the following:

  • What is stress?
  • The purpose of the stress response within our bodies
  • The “fight or flight” response
  • The meaning of inputs and outputs of stress
  • What to do when inputs increase?
  • How to balance inputs and outputs
  • What types of outputs exist?


Good luck and take care of yourself.


Edited by: Shirley Sachs

Written March 11, 2016


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