What is stress?

Stress is a response of the body to a variety of internal and external stimuli. External triggers may include a job change, move to a new city, marriage, death of a loved one, or an illness in the family. (Happy as well as sad events can create stress.) Internal stimuli may include physical or mental discomfort. Personality traits, such as a need to strive for perfection or to please others, can also cause stress.

Stress can produce either negative or positive reactions. For instance, you may strive for perfection because you feel inadequate, and the constant pressure you put on yourself may ultimately work against you. On the other hand, you may experience pressure positively and become highly motivated and productive, thus achieving more than you would under normal circumstances.

Why is stress harmful?

Whether positive or negative, stress produces physical reactions. The body releases hormones and chemicals that accelerate the function of the heart, lungs, muscles, and other organs. This response may be protective, such as enabling you to escape from a careening car. When you feel safe again, these bodily reactions usually disappear. However, if you are stressed for long periods of time, these hormones will continue to be released and to stimulate your body. Eventually, this mind-body communication produces wear and tear.

What life events increase stress?

The following examples of life changes are taken from the Holmes-Rahe Scale stress assessment test. The most stressful events (for most of the people tested) are highest on the list.

• Death of a close family member or friend
• Unfaithful spouse
• Major financial difficulties
• Loss of employment
• Marital separation or divorce
• Pregnancy
• Lawsuit
• Serious illness in the family
• Major personal illness
• Important exam
• Change in work conditions
• Move to another city

How does my body tell me if I am overstressed?

When your body is overstimulated for an extended period of time, it may warn you with some of the following signals of distress:

• Tension
• Racing heart
• Irritability
• Insomnia
• Neck or low back pain
• Fatigue
• Headaches
• Stomach upset
• Constipation or diarrhea
• Appetite increase or decrease
• Increased substance use (such as cigarettes, alcohol, caffeine, drugs)
• Other signs and symptoms of stress

These signs indicate that you need to examine your lifestyle and pressing concerns. Prolonged stress may interfere with your enjoyment of life and lead to physical or emotional illness. Illnesses related to (but not necessarily caused by) stress include ulcers, irritable bowel syndrome, high blood pressure, migraine headaches, and neck or low back pain.

If these warning signs of stress-related illnesses persist, talk with your physician. You may also find some relief by using some of the common coping strategies listed below.

How can I assess my stress level?

Many people are not aware that subtle emotional and behavioral changes are occurring as a result of stress. The following self-quiz may alert you to signs of stress in your life.

• Do you find it hard to relax and have fun?
• Are you easily irritated?
• Do you find it hard to sleep at night?
• Do you feel overburdened by responsibility?
• Do you experience physical signs of stress (such as a nervous stomach)?
• Have you lost interest in relationships or sex?
• Are you unable to perform your job adequately?
• Have you noticed an increased desire to smoke or drink?

If you answered yes to four out of the eight questions, you may want to use some of the following strategies to help deal with excess stress.

Common coping strategies

• Active physical exercise. Regular exercise can help reduce muscle tension and promote a sense of well-being. The physical tension built up by worrying may also be relieved. (Massage can also produce this effect).
• Limit-setting at work and on extracurricular activities. Saying "no" to excessive demands by your employer and on your free time can minimize stress.
• Family, friends, social groups. Loving "support systems" also help when dealing with stressful events.
• Vacations or "playtime." It is important to plan "mini-breaks" (or longer vacations) to allow your body to rest during peak stress periods.
• Hobbies. Finding an interest on which to focus your attention and energy will often offset the effects of stress.
• Religion. Meditation or prayer may have a relaxing effect on your body.
• Counseling. Talking with a counselor can be helpful in identifying problems that trigger stress and in breaking patterns of negative stimulation that produce stress.
• Relaxation techniques. Workshops in stress management and tension relaxation teach effective methods for managing stress.
• Exercises to alleviate stress.