Stress is part of life, and it affects everyone at one time or another. And to be clear, stress is not all bad. A certain amount of stress energizes people, improving performance and efficiency. It’s only when stress builds too high that problems can develop.

So much for generalities. The sort of stress you encounter, how you perceive it, and how you react to it depend on individual factors, such as:

§                    Whether you are male or female

§                    How old you are

§                    Whether you are caring for an elderly or sick relative

§                    Your employment situation

All of these factors affect stress—and how best to respond to it—in different ways.

How gender affects stress

The physiology of the stress response is similar for everyone. But some researchers believe that there are distinct differences in the way women and men experience and respond to stress.

Community surveys taken in many countries find women consistently report greater distress than men do. A study of roughly 1,100 American adults that appeared in The Journal of Personality and Social Psychologyfound that women were more likely than men to experience ongoing stress and feel that their lives were out of their control.

Why the disparity? There are probably several reasons for it.

Social responsibilities add up for women

Some researchers believe that the social responsibilities typically handled by women — including child care, care of older relatives, and housework — expose them to more abundant opportunities for distress. These responsibilities constitute the “second shift” for women who work outside the home.

This additional burden can lay the groundwork for long-term health problems, as was demonstrated in a large study of nurses. The women in the study charged with caring for a disabled or chronically ill spouse for nine or more hours a week were at increased risk of having a heart attack or other manifestation of coronary artery disease over a four-year period.

Financial pressure takes a toll on men

Men more often report financial stress than women do, which makes sense since men are traditionally expected to be breadwinners.

Men and women react differently to stress

A study asked 166 married couples to keep a daily diary tracking 21 common stressors, such as arguments and overloads at home and work, for six weeks. Here’s what it found:

§                    Wives proved 5% more likely than husbands to report days marked by “any distress” and 19% more likely to experience “high-distress” days.

§                    The women did not typically carry feelings of “high distress” from one day to the next, but did report facing a greater overall number of stressful situations.

§                    Certain demands affected men or women more. Men reacted more strongly to an argument with a child, financial woes, or work overload, for example, while women were more distressed by arguments with a spouse, transportation difficulties, or family demands.

Some interesting preliminary research suggests women and men tend to cope with stressful situations differently, too. A team of psychologists published a study in Psychological Review suggesting that women are less likely to fight or flee when faced with stressors. Instead, they are likely to “tend-and-befriend.” “Tending” is nurturing behavior designed to protect and relieve distress. “Befriending,” which may support tending, refers to seeking and maintaining social connections.

Biology explains some differences

Sex hormones and the pituitary hormone oxytocin are partly responsible for gender differences in the response to stress, and suggest that the “tend-and-befriend” behavior may have held evolutionary advantages for women.

§                    Effects of hormones. Oxytocin dampens anxiety and induces relaxation. Its effects are enhanced by female sex hormones and diminished by male sex hormones. When under stress, both men and women release epinephrine and cortisol; men also release testosterone, which tends to increase hostility and aggression.

§                    Evolutionary behavior. The impulse to fight or flee in the face of danger could have disastrous consequences for women, who tend to be smaller than men and may be pregnant or caring for small children. It is intriguing to speculate on whether “tend-and-befriend” could have positive consequences for women. After all, social connections are key to reducing the damaging effects of stress.

Age and stress

Age affects stress for several reasons. Often these factors interact to increase stress.

Aging brings new stressors

Major life events and physical problems can cause stress as people age. These include:

§                    The death of a spouse

§                    Accidents

§                    Ailments such as arthritis that cause pain and disability

§                    Life-threatening illnesses such as heart disease and cancer

§                    Unpleasant side effects from medications and other treatments

§                    Sleep disturbances.

In addition, a dwindling interest in exercise — tied, perhaps, to arthritis or compromised vision, hearing, and balance as you grow older — can make you more of a shut-in than you would like to be. This can set off a cycle of declining physical abilities and increasing frailty.

Is that stressful? Just ask anyone who worries that a walk outside might end in broken bones or finds it difficult to do simple tasks around the house. People do adapt to changing abilities, it’s true, but the road to that point may not be smooth.

Older people have unique social pressures

Each generation has its own social pressures and cultural constraints. Consider the following:

§                    Inhibition. Many older people were raised in environments where emotional displays were frowned upon.

§                    Conflict avoidance. Many older women never learned how to state needs directly or handle uncomfortable conflicts before they become a source of stress

§                    Career limitations. In addition, many older women never had abundant opportunities for work outside the home, which can offer a creative, productive outlet.

§                    Spiritual sustenance. On the other hand, many do take comfort from religion, which may have an effect on health and longevity.

Biological factors also change with time

Some preliminary evidence suggests that disturbances in the hypothalamic-pituitary-adrenal (HPA) axis, which controls the stress response, compound certain health problems that are common among older people, such as cardiovascular disease and stroke.

Aging and long-term stress both appear to trigger HPA disturbances in some people. In addition, constant exposure to certain stress hormones, such as cortisol, can harm nerve cells in the hippocampus, potentially affecting learning and memory processing.

Change is possible at any age

Once you identify key sources of stress in your life, odds are good that you can overcome them. It’s possible to prevent or at least combat physical decline and some age-related ailments through exercise, good nutrition, appropriate medications, and stress-control techniques.

Caregiving and stress

Caring for others fulfills a basic social contract in ways that can draw generations and individuals closer to one another. Certainly, caring for an elderly parent or ailing spouse is a worthy, often satisfying pursuit.

But it isn’t easy. If you’re a caregiver, you may often wrestle with stress as well as exhaustion, anger, guilt, grief, and other difficult emotions.

More often than not, caregivers are women. The task is especially hard on women in the so-called sandwich generation, who are simultaneously caring for children and older parents, quite possibly while working outside the home, too.

Stress Management

HOW TO REDUCE, PREVENT, AND COPE WITH STRESS

It may seem that there’s nothing you can do about your stress level. The bills aren’t going to stop coming, there will never be more hours in the day for all your errands, and your career or family responsibilities will always be demanding. But you have a lot more control than you might think. In fact, the simple realization that you’re in control of your life is the foundation of stress management.

Managing stress is all about taking charge: taking charge of your thoughts, your emotions, your schedule, your environment, and the way you deal with problems. The ultimate goal is a balanced life, with time for work, relationships, relaxation, and fun – plus the resilience to hold up under pressure and meet challenges head on.

Identify the sources of stress in your life

Look at how you currently cope with stress

Think about the ways you currently manage and cope with stress in your life. Your stress journal can help you identify them. Are your coping strategies healthy or unhealthy, helpful or unproductive? Unfortunately, many people cope with stress in ways that compound the problem.

Unhealthy ways of coping with stress

These coping strategies may temporarily reduce stress, but they cause more damage in the long run:

§                    Smoking §                    Drinking too much §                    Overeating or undereating §                    Zoning out for hours in front of the TV or computer §                    Withdrawing from friends, family, and activities

§                    Using pills or drugs to relax §                    Sleeping too much §                    Procrastinating §                    Filling up every minute of the day to avoid facing problems §                    Taking out your stress on others (lashing out, angry outbursts, physical violence)

Stress management starts with identifying the sources of stress in your life. This isn’t as easy as it sounds. Your true sources of stress aren’t always obvious, and it’s all too easy to overlook your own stress-inducing thoughts, feelings, and behaviors. Sure, you may know that you’re constantly worried about work deadlines. But maybe it’s your procrastination, rather than the actual job demands, that leads to deadline stress.

To identify your true sources of stress, look closely at your habits, attitude, and excuses:

§                    Do you explain away stress as temporary (“I just have a million things going on right now”) even though you can’t remember the last time you took a breather?

§                    Do you define stress as an integral part of your work or home life (“Things are always crazy around here”) or as a part of your personality (“I have a lot of nervous energy, that’s all”).

§                    Do you blame your stress on other people or outside events, or view it as entirely normal and unexceptional?

Until you accept responsibility for the role you play in creating or maintaining it, your stress level will remain outside your control.

Learning healthier ways to manage stress

If your methods of coping with stress aren’t contributing to your greater emotional and physical health, it’s time to find healthier ones. There are many healthy ways to manage and cope with stress, but they all require change. You can either change the situation or change your reaction. When deciding which option to choose, it’s helpful to think of the four As: avoid, alter, adapt, or accept.

Since everyone has a unique response to stress, there is no “one size fits all” solution to managing it. No single method works for everyone or in every situation, so experiment with different techniques and strategies. Focus on what makes you feel calm and in control.

Dealing with Stressful Situations: The Four A’s

Change the situation: §                       Avoid the stressor. §                       Alter the stressor.

Change your reaction: §                       Adapt to the stressor. §                       Accept the stressor.

Stress management strategy #1: Avoid unnecessary stress

Not all stress can be avoided, and it’s not healthy to avoid a situation that needs to be addressed. You may be surprised, however, by the number of stressors in your life that you can eliminate.

§                    Learn how to say “no” – Know your limits and stick to them. Whether in your personal or professional life, refuse to accept added responsibilities when you’re close to reaching them. Taking on more than you can handle is a surefire recipe for stress.

§                    Avoid people who stress you out – If someone consistently causes stress in your life and you can’t turn the relationship around, limit the amount of time you spend with that person or end the relationship entirely.

§                    Take control of your environment – If the evening news makes you anxious, turn the TV off. If traffic’s got you tense, take a longer but less-traveled route. If going to the market is an unpleasant chore, do your grocery shopping online.

§                    Avoid hot-button topics – If you get upset over religion or politics, cross them off your conversation list. If you repeatedly argue about the same subject with the same people, stop bringing it up or excuse yourself when it’s the topic of discussion.

§                    Pare down your to-do list – Analyze your schedule, responsibilities, and daily tasks. If you’ve got too much on your plate, distinguish between the “shoulds” and the “musts.” Drop tasks that aren’t truly necessary to the bottom of the list or eliminate them entirely.

Stress management strategy #2: Alter the situation

If you can’t avoid a stressful situation, try to alter it. Figure out what you can do to change things so the problem doesn’t present itself in the future. Often, this involves changing the way you communicate and operate in your daily life.

§                    Express your feelings instead of bottling them up. If something or someone is bothering you, communicate your concerns in an open and respectful way. If you don’t voice your feelings, resentment will build and the situation will likely remain the same.

§                    Be willing to compromise. When you ask someone to change their behavior, be willing to do the same. If you both are willing to bend at least a little, you’ll have a good chance of finding a happy middle ground.

§                    Be more assertive. Don’t take a backseat in your own life. Deal with problems head on, doing your best to anticipate and prevent them. If you’ve got an exam to study for and your chatty roommate just got home, say up front that you only have five minutes to talk.

§                    Manage your time better. Poor time management can cause a lot of stress. When you’re stretched too thin and running behind, it’s hard to stay calm and focused. But if you plan ahead and make sure you don’t overextend yourself, you can alter the amount of stress you’re under.

Stress management strategy #3: Adapt to the stressor

If you can’t change the stressor, change yourself. You can adapt to stressful situations and regain your sense of control by changing your expectations and attitude.

§                    Reframe problems. Try to view stressful situations from a more positive perspective. Rather than fuming about a traffic jam, look at it as an opportunity to pause and regroup, listen to your favorite radio station, or enjoy some alone time.

§                    Look at the big picture. Take perspective of the stressful situation. Ask yourself how important it will be in the long run. Will it matter in a month? A year? Is it really worth getting upset over? If the answer is no, focus your time and energy elsewhere.

§                    Adjust your standards. Perfectionism is a major source of avoidable stress. Stop setting yourself up for failure by demanding perfection. Set reasonable standards for yourself and others, and learn to be okay with “good enough.”

§                    Focus on the positive. When stress is getting you down, take a moment to reflect on all the things you appreciate in your life, including your own positive qualities and gifts. This simple strategy can help you keep things in perspective.

Adjusting Your Attitude

How you think can have a profound effect on your emotional and physical well-being. Each time you think a negative thought about yourself, your body reacts as if it were in the throes of a tension-filled situation. If you see good things about yourself, you are more likely to feel good; the reverse is also true. Eliminate words such as "always," "never," "should," and "must." These are telltale marks of self-defeating thoughts.

Stress management strategy #4: Accept the things you can’t change

Some sources of stress are unavoidable. You can’t prevent or change stressors such as the death of a loved one, a serious illness, or a national recession. In such cases, the best way to cope with stress is to accept things as they are. Acceptance may be difficult, but in the long run, it’s easier than railing against a situation you can’t change.

§                    Don’t try to control the uncontrollable. Many things in life are beyond our control— particularly the behavior of other people. Rather than stressing out over them, focus on the things you can control such as the way you choose to react to problems.

§                    Look for the upside. As the saying goes, “What doesn’t kill us makes us stronger.” When facing major challenges, try to look at them as opportunities for personal growth. If your own poor choices contributed to a stressful situation, reflect on them and learn from your mistakes.

§                    Share your feelings. Talk to a trusted friend or make an appointment with a therapist. Expressing what you’re going through can be very cathartic, even if there’s nothing you can do to alter the stressful situation.

§                    Learn to forgive. Accept the fact that we live in an imperfect world and that people make mistakes. Let go of anger and resentments. Free yourself from negative energy by forgiving and moving on.

Stress management strategy #5: Make time for fun and relaxation

Beyond a take-charge approach and a positive attitude, you can reduce stress in your life by nurturing yourself. If you regularly make time for fun and relaxation, you’ll be in a better place to handle life’s stressors when they inevitably come.

Healthy ways to relax and recharge

§                       Go for a walk. §                       Spend time in nature. §                       Call a good friend. §                       Sweat out tension with a good workout. §                       Write in your journal. §                       Take a long bath. §                       Light scented candles.

§                       Savor a warm cup of coffee or tea. §                       Play with a pet. §                       Work in your garden. §                       Get a massage. §                       Curl up with a good book. §                       Listen to music. §                       Watch a comedy.

Don’t get so caught up in the hustle and bustle of life that you forget to take care of your own needs. Nurturing yourself is a necessity, not a luxury.

§                    Set aside relaxation time. Include rest and relaxation in your daily schedule. Don’t allow other obligations to encroach. This is your time to take a break from all responsibilities and recharge your batteries.

§                    Connect with others. Spend time with positive people who enhance your life. A strong support system will buffer you from the negative effects of stress.

§                    Do something you enjoy every day. Make time for leisure activities that bring you joy, whether it be stargazing, playing the piano, or working on your bike.

§                    Keep your sense of humor. This includes the ability to laugh at yourself. The act of laughing helps your body fight stress in a number of ways.

Stress management strategy #6: Adopt a healthy lifestyle

You can increase your resistance to stress by strengthening your physical health.

§                    Exercise regularly. Physical activity plays a key role in reducing and preventing the effects of stress. Make time for at least 30 minutes of exercise, three times per week. Nothing beats aerobic exercise for releasing pent-up stress and tension.

§                    Eat a healthy diet. Well-nourished bodies are better prepared to cope with stress, so be mindful of what you eat. Start your day right with breakfast, and keep your energy up and your mind clear with balanced, nutritious meals throughout the day.

§                    Reduce caffeine and sugar. The temporary "highs" caffeine and sugar provide often end in with a crash in mood and energy. By reducing the amount of coffee, soft drinks, chocolate, and sugar snacks in your diet, you’ll feel more relaxed and you’ll sleep better.

§                    Avoid alcohol, cigarettes, and drugs. Self-medicating with alcohol or drugs may provide an easy escape from stress, but the relief is only temporary. Don’t avoid or mask the issue at hand; deal with problems head on and with a clear mind.

§                    Get enough sleep. Adequate sleep fuels your mind, as well as your body. Feeling tired will increase your stress because it may cause you to think irrationally.

Cultivating Mindfulness to Reduce Stress and Anxiety

Mindfulness is the practice of purposely focusing your attention on the present moment — and accepting it without judgment. Mindfulness is now being examined scientifically and has been found to be a key element in happiness.

Ancient roots, modern applications

The cultivation of mindfulness has roots in Buddhism, but most religions include some type of prayer or meditation technique that helps shift your thoughts away from your usual preoccupations toward an appreciation of the moment and a larger perspective on life.

Professor emeritus Jon Kabat-Zinn, founder and former director of the Stress Reduction Clinic at the University of Massachusetts Medical Center, helped to bring the practice of mindfulness meditation into mainstream medicine and demonstrated that practicing mindfulness can bring improvements in both physical and psychological symptoms as well as positive changes in health attitudes and behaviors.

Mindfulness improves well being

§                    Increasing your capacity for mindfulness supports many attitudes that contribute to a satisfied life.

§                    Being mindful makes it easier to savor the pleasures in life as they occur, helps you become fully engaged in activities, and creates a greater capacity to deal with adverse events.

§                    By focusing on the here and now, many people who practice mindfulness find that they are less likely to get caught up in worries about the future or regrets over the past, are less preoccupied with concerns about success and self-esteem, and are better able to form deep connections with others.

Mindfulness improves physical health

If greater well-being isn’t enough of an incentive, scientists have discovered the benefits of mindfulness techniques help improve physical health in a number of ways. Mindfulness can:

§                    help relieve stress

§                    treat heart disease

§                    lower blood pressure

§                    reduce chronic pain

§                    improve sleep

§                    alleviate gastrointestinal difficulties.

Mindfulness improves mental health

In recent years, psychotherapists have turned to mindfulness meditation as an important element in the treatment of a number of problems, including:

§                    depression

§                    substance abuse

§                    eating disorders

§                    couples’ conflicts

§                    anxiety disorders

§                    obsessive-compulsive disorder.

Some experts believe that mindfulness works, in part, by helping people to accept their experiences — including painful emotions — rather than react to them with aversion and avoidance.

It’s become increasingly common for mindfulness meditation to be combined with psychotherapy, especially cognitive behavioral therapy. This development makes good sense, since both meditation and cognitive behavioral therapy share the common goal of helping people gain perspective on irrational, maladaptive, and self-defeating thoughts.

Mindfulness Techniques
There is more than one way to practice mindfulness, but the goal of any mindfulness technique is to achieve a state of alert, focused relaxation by deliberately paying attention to thoughts and sensations without judgment. This allows the mind to refocus on the present moment. All mindfulness techniques are a form of meditation.
Basic mindfulness meditation	Sit quietly and focus on your natural breathing or on a word or “mantra” that you repeat silently. Allow thoughts to come and go without judgment and return to your focus on breath or mantra.
Body sensations	Notice subtle body sensations such as an itch or tingling without judgment and let them pass. Notice each part of your body in succession from head to toe.
Sensory	Notice sights, sounds, smells, tastes, and touches. Name them “sight,” “sound,” “smell,” “taste,” or “touch” without judgment and let them go.
Emotions	Allow emotions to be present without judgment. Practice a steady and relaxed naming of emotions: “joy,” “anger,” “frustration.” Accept the presence of the emotions without judgment and let them go.
Urge surfing	Cope with cravings (for addictive substances or behaviors) and allow them to pass. Notice how your body feels as the craving enters. Replace the wish for the craving to go away with the certain knowledge that it will subside.

Meditation and other practices that foster mindfulness

Mindfulness can be cultivated through mindfulness meditation, a systematic method of focusing your attention.

You can learn to meditate on your own, following instructions in books or on tape. However, you may benefit from the support of an instructor or group to answer questions and help you stay motivated. Look for someone using meditation in a way compatible with your beliefs and goals.

If you have a medical condition, you may prefer a medically oriented program that incorporates meditation. Ask your physician or hospital about local groups. Insurance companies increasingly cover the cost of meditation instruction.

Getting started on your own

Some types of meditation primarily involve concentration — repeating a phrase or focusing on the sensation of breathing, allowing the parade of thoughts that inevitably arise to come and go. Concentration meditation techniques, as well as other activities such as tai chi or yoga, can induce the well-known relaxation response, which is very valuable in reducing the body’s response to stress.

Mindfulness meditation builds upon concentration practices. Here’s how it works:

§                    Go with the flow. In mindfulness meditation, once you establish concentration, you observe the flow of inner thoughts, emotions, and bodily sensations without judging them as good or bad.

§                    Pay attention. You also notice external sensations such as sounds, sights, and touch that make up your moment-to-moment experience. The challenge is not to latch onto a particular idea, emotion, or sensation, or to get caught in thinking about the past or the future. Instead you watch what comes and goes in your mind, and discover which mental habits produce a feeling of well-being or suffering.

§                    Stay with it. At times, this process may not seem relaxing at all, but over time it provides a key to greater happiness and self-awareness as you become comfortable with a wider and wider range of your experiences.

Practice acceptance

Above all, mindfulness practice involves accepting whatever arises in your awareness at each moment. It involves being kind and forgiving toward yourself.

Some tips to keep in mind:

§                    Gently redirect. If your mind wanders into planning, daydream, or criticism, notice where it has gone and gently redirect it to sensations in the present.

§                    Try and try again. If you miss your intended meditation session, you simply start again.

By practicing accepting your experience during meditation, it becomes easier to accept whatever comes your way during the rest of your day.

Cultivate mindfulness informally

In addition to formal meditation, you can also cultivate mindfulness informally by focusing your attention on your moment-to-moment sensations during everyday activities. This is done by single-tasking — doing one thing at a time and giving it your full attention. As you floss your teeth, pet the dog, or eat an apple, slow down the process and be fully present as it unfolds and involves all of your senses.

Exercises to try on your own

If mindfulness meditation appeals to you, going to a class or listening to a meditation tape can be a good way to start. In the meantime, here are two mindfulness exercises you can try on your own.

Practicing mindfulness meditation

This exercise teaches basic mindfulness meditation.

1.               Sit on a straight-backed chair or cross-legged on the floor.

2.               Focus on an aspect of your breathing, such as the sensations of air flowing into your nostrils and out of your mouth, or your belly rising and falling as you inhale and exhale.

3.               Once you’ve narrowed your concentration in this way, begin to widen your focus. Become aware of sounds, sensations, and your ideas.

4.               Embrace and consider each thought or sensation without judging it good or bad. If your mind starts to race, return your focus to your breathing. Then expand your awareness again.

Invest in yourself

The effects of mindfulness meditation tend to be dose-related — the more you do, the more effect it usually has. Most people find that it takes at least 20 minutes for the mind to begin to settle, so this is a reasonable way to start. If you’re ready for a more serious commitment, Jon Kabat-Zinn recommends 45 minutes of meditation at least six days a week. But you can get started by practicing the techniques described here for shorter periods.

Learning to stay in the present

A less formal approach to mindfulness can also help you to stay in the present and fully participate in your life. You can choose any task or moment to practice informal mindfulness, whether you are eating, showering, walking, touching a partner, or playing with a child or grandchild. Attending to these points will help:

§                    Start by bringing your attention to the sensations in your body.

§                    Breathe in through your nose, allowing the air downward into your lower belly. Let your abdomen expand fully.

§                    Now breathe out through your mouth.

§                    Notice the sensations of each inhalation and exhalation.

§                    Proceed with the task at hand slowly and with full deliberation.

§                    Engage your senses fully. Notice each sight, touch, and sound so that you savor every sensation.

When you notice that your mind has wandered from the task at hand, gently bring your attention back to the sensations of the moment.