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Stress and Coping Back to Course Index

Stress and Coping




Stress is the pressure and tension a person feels when faced with a new, unpleasant, or threatening situation.  Stress is very much a part of life.  It affects everyone at some time or another.  A certain amount of stress can be good in that it moves us to meet life’s challenges.  However, too much stress can cause both physical and emotional damage.


Even in the womb, it has been shown through research that too much imgresstress can cause problems.  If a mother is very anxious or stressed while she’s pregnant, there’s reduced blood flow to the baby through the uterine arteries, the main source of blood and nutrition for the baby.  This could cause the baby to grow more slowly and set up a secondary stress response in the fetus (Glover, Vivette, Discovery Health, Discovery Communication Inc., 2001). Secondly, if a mother has high levels of cortisol, the main stress hormone, so does the fetus.  It seems that enough cortisol crosses the placenta from the mother to the fetus to actually affect fetal levels.  So if the mother is stressed, her cortisol goes up, and so does the cortisol level in the fetus.   This, in turn, could well affect the brain’s development and the baby’s future stress responses. (Glover, Vivette, Discovery Health, Discovery Communication Inc., 2001).


Stress is an automatic reaction to a demand or danger; at its most basic, stress is a survival mechanism.  The muscles tense, and the heart rate and breathing speed up.  A rush of adrenaline gives an individual the strength and energy to deal with the situation or run.  This reaction is often called the “fight or flight” response.    This cascade of responses is perfectly suited to fighting or fleeing from physical danger.  However, one of the detrimental problems of stress is if we remain in a stressed state, the adrenaline continues.  This overload is unhealthy.    Today’s stressors such as traffic, work pressures, and family obligations are of a different variety, and the responses that worked so skillfully when confronting a brief physical attack can fail when the stresses are emotional and continuous.


The body’s response to stress begins in the brain.  When we perceive danger, the senses send a message to the cortex that, in turn, processes the message and sends the information to the amygdala.  The amygdala activates the hypothalamus, located at the brain’s base.  This stimulates the center of the adrenal gland to release adrenaline.  Adrenaline raises blood sugar, increases heart rate, and boosts the amount of energy a person has available to his/her muscles.  While this is occurring, the pituitary gland stimulates the outside of the adrenal gland, called the adrenal cortex, to release a second key stress hormone, cortisol.  Cortisol acts to maintain high levels of both blood pressure and blood sugar. 


images-2Stressors are not themselves bad or good; their effects on you can cause problems.  The response caused by stress can have short-term benefits. However, scientists are concerned with the hormone’s long-term effects on our health.  Research shows that extended exposure to cortisol weakens bones, causes nerve cells in the brain to degenerate or perhaps even die, and compromises the immune system, making us more vulnerable to infection. 


Extended Exposure to Stress Can Contribute to:


High Blood Pressure


Skin Problems

Weight gain or loss


Back Pain and Muscle Tensionimages


Digestive Disorders

Heart Disease


Allergies and Sinus Infections

Sore throats and Colds


Menstrual Irregularity

Damage to Relationships


Beyond the damage done by illness brought on by stress, living with chronic pain, such as back pain, may make an individual feel frustrated and alone.  Missing work due to frequent illnesses can also bring added anxiety.  If a client has untreated health problems, it is best for them to see their health care provider right away. 


How much stress is too much?  There is no easy answer to this question.  Stress affects people differently.  What’s stressful to one person may be “no big deal” to another.  Perceptions may play an important role in this distinction.  Personality is believed to be a significant factor in how we perceive stress.  If you think of a “Type A” personality, you see a rushed, ambitious, “on-the-go” person.  These traits can bring on additional stress.  On the contrary, a “Type B” personality has a more “laid back” approach.  They are more flexible and adaptable and possibly more able to put things into perspective.


Beyond personality, which is a gift of social, biological, psychological, and behavioral factors, studies also show that men and women handle stress differently.  This difference, according to some scientists, is attributed to estrogen.  This estrogen and perhaps women, unlike men, tend to have a stronger social support network to which they turn during times of stress, help explain why women, in general, seem to be better able to cope with stress than men.


Type A

If you regularly exhibit a number of the following behaviors:


–   I accentuate keywords when there’s no reason to do so.

–   I hurry the speech of others by saying, “yes, yes, uh-huh, yes.”

–   I think or do more than one thing simultaneously.

–   I feel guilty when relaxing.

–   I don’t notice the decorations in an office or the outfit a friend was wearing.

–   I move, walk and eat rapidly.

–   I pride myself on working best under pressure.

–   I schedule myself for more and more in less and less time.

–   I rarely schedule “down” time.

–   I am competitive.

– I frequently talk with my hands.


Type B:

If you regularly exhibit a number of the following behaviors:


–  I accept delays and let others do things at their own pace.

–  I can relax without guilt.

–  I can work without agitation.

–  If time does not permit, I can easily allow some tasks to remain

     uncompleted until I can get to them.



Even people with the most adaptable personalities can experience the effects of long-term stress if they lack a sense of control over aspects of their daily lives.  Scientists studying stress in the workplace have found that those who perceive that they have the least control over their working environment suffer from the highest levels of stress-related illnesses.


How do you cope with the stress in your lives for those of you in the giving professions?  There are a variety of ways, some more effective than others, to cope with stress.  Some coping strategies may actually be as harmful as the stress they are supposed to deal with.  Dr. George S. Everly, Jr. created the following stress assessment.  This scale is an educational tool, not a clinical instrument.  Therefore, its purpose is to inform you of ways in which you can effectively and healthfully cope with the stress in your life while, at the same time, through a point system, giving you some indication of the relative desirability of the coping strategies you are currently using.


Simply follow the instructions given for each of the 14 items below.  When you have completed all of the items, total your points and place that score in the box provided.


___ 1.  Give yourself 10 points if you feel that you have a supportive family around you.

___ 2.  Give yourself 10 points if you actively pursue a hobby.

___ 3.  Give yourself 10 points if you belong to some social or activity group that meets at least once a month (other than your family).

___4.  Give yourself 15 points if you are within five pounds of your “ideal” body weight, considering your height and bone structure.

___ 5.  Give yourself 15 points if you practice some form of “deep

relaxation” at least three times a week.  Deep relaxation exercises include meditation, imagery, yoga, etc.

___ 6.  Give yourself 5 points each time you exercise thirty minutes or longer during an average week.

___ 7.  Give yourself 5 points for each nutritionally balanced and wholesome meal you consume during the course of an average day.

___ 8.  Give yourself 5 points if you do something that you really enjoy

            which is “just for you” during the course of an average week.

___ 9.  Give yourself 10 points if you have someplace at work or in your home that you can go in order to relax and/or be by yourself.

___10.  Give yourself 10 points if you practice time management techniques in your daily life.

___11.  Subtract 10 points for each pack of cigarettes you smoke during the course of an average day.

___ 12.  Subtract 5 points for each evening during the course of an average week that you take any form of medication or chemical substance, including alcohol, to help you sleep.

___ 13.  Subtract 10 points for each day during the course of an average week that you consume any form of medication or chemical substance, including alcohol, to help you calm down or relax.

___ 14.  Subtract 5 points for each day during the course of an average week that you bring work home:  work that was meant to be done at your place of employment.


Now calculate your total score.  A “perfect” score would be 115 points or greater.  If you scored in the 50-60 range, you probably have an adequate collection of coping strategies for the most common sources of stress.  However, you should keep in mind that the higher your score, the greater your ability to cope with stress in an effective and healthful manner. (This stress assessment test was created by Dr. George S. Everly, Jr., University of Maryland.)


Part of the resilience and/or resistance to stress is related to a person’s coping skills, and part is related to the number and type of stressors in their lives.



Symptoms of Stress:

Physical Symptoms:             Psychological Symptoms:


 Headaches                                                  Restlessness

 Upset stomach                                             Anger

 Fatigue                                                        Impatience

 Backache                                                     Depression

 Diarrhea                                                       Forgetfulness

 Sweating                                                     Feeling unwanted

 Changes in menstruation                            Feeling unloved

 Fever blisters                                               Moodiness

 Acne                                                            Denial of Symptoms


Behaviors:                             Substance Use:


Grinding Teeth                                         Alcohol

Stuttering                                                 Drugs

Tapping feet or fingers                             Food

Isolating self


Neglecting appearance

Arguing with friends or family

Avoiding responsibility

Crying easily

Overeating or under eating

Snapping at others

Withdrawing from family and friends


Identifying triggers can be the first step to reducing stress.  Keeping a journal can help an individual identify what is causing them stress and how the stress affects them.  A journal can also act as an outlet for emotion and frustration.  This method can also reduce stress in that it can help in the decision-making process as an individual explores the pros and cons of a situation.  The individual may discover solutions to a problem they had not previously thought of. 



Some of the sample questions to get a journal started include:


How did you feel today?


What upset you today?images-3


Did you laugh today?


Are you facing any major decisions today?


Are you feeling anxious or frustrated?  Why?



Once an individual can identify what is causing the stress, they can attack the source. 



“I don’t know what is wrong with me lately!  I lose my temper so easily.  I wake up in an o.k. mood but struggle to get to work on time.  I have been late three times this month.  The traffic is so bad.  My son has immediate demands by the time I get home, but I have so much to do.  I would love to be in the mood to play with him, but it takes me so long to get home; by the time we eat dinner and get ready for the next day, it is past his bedtime, and I am exhausted.  I just yell at him to go to bed.  It is always the traffic that gets me worked up.  This shift is killing me.  It puts me right in the middle of rush hour.  I don’t know how everybody else can stand it.  It takes me over an hour to go the distance it should only take to drive about 25 minutes any other time of the day.”


After a meeting with Rudy’s boss, a shift change was made that put him out of rush hour traffic.  Although he and his family are having to adjust to a new schedule, the time they have together is much more relaxed. 


It is often impossible to change what is causing an individual stress.  One of the most prevalent causes of stress is worrying about things we have no control over.  To manage stress, an individual must learn to accept things that they cannot change.  If an individual does not have control over the stressor, the next course of action is to exert control over the response caused by the trigger.  An individual can learn to defuse stress and deal with it more adaptively.  Some of the techniques available to help with learning to defuse stress include thought stopping, systematic relaxation, deep breathing, meditation, and visualization.


Thought Stopping:

Whether a person is conscious of it or not, they talk to themselves silently every day.  This mental conversation is called self-talk.  This self-talk helps determine how we will respond to a situation.  If the thoughts are negative and criticizing, we respond poorly.  A person can reduce stress by learning to identify, challenge, and change negative messages.  Thought stopping involves being aware of the negative self-talk and when a negative thought enters the mind, internally say “stop!” and replace it with a new, more positive statement.  An example is “I will never get this project done…Stop!  I am making progress and will continue to work towards my goal”.


Systematic Relaxation:

This technique can help a person relax the major muscle groups in the body. 

1.  Begin getting in as comfortable a position as possible.

2.  Begin with the facial muscles.  Frown hard for 5-10 seconds and then relax all of the muscles.

3.  Then move to the eyes and forehead, tightening the muscles for 5-10 seconds and then relax the muscles.

4.  Move to the neck and jaw, repeating the process.

5.  Continue through the shoulders, arms, chest, legs, etc. until all the body has been tensed and relaxed.




This is a process of focusing on a single word or object to clear your mind.  This can often require practice. 

1.  Sit or lie in a comfortable position.

2.  Close your eyes and concentrate on a calming word or object.

3.  As other words or thoughts enter your mind, just allow them to pass and remain focused on the calming word or object.

4.  Gradually, you’ll begin to feel more and more relaxed.

(Stress Management Self Care Handbook, 1999)



Deep Breathing:

This is one of the easiest ways to relieve tension.  This exercise brings needed oxygen to all of the muscles.

1.  Lie on the back with a pillow under the head.  Bend the knees and, if possible, place a pillow under them. 

2.  Put one hand on the stomach below the rib cage.

3.  Slowly breathe in through your nose.  The stomach should rise.

4.  Exhale slowly through the mouth.

5.  Repeat several times.



Your imagination is a great resource for reducing stress.  This technique utilizes your imagination to help you escape to gain some perspective to better handle the situation. 

Close your eyes and imagine yourself in a place you enjoy-a mountain meadow, a pleasant garden, a cabin by the lake, a sunny beach, or your own backyard.  Picture yourself relaxing there.  Enjoy the feel of the sun, the fresh breeze, the soft grass, or the sand underneath you.  Enjoy the sounds, the wind in the trees, the surf, and birds.  Become aware of the fragrances.  Try to experience all of your senses in the fantasy-sight, sound, touch, taste, and smell.  Focus on the scene for typically 5 to 10 minutes, then gradually return to your other activities.


In addition to changing the reaction to stressors, there are often ways to make us more resilient to stress.  If an individual can learn to manage their time more effectively by getting up early, minimizing interruptions, requesting help, getting organized, and planning ahead, they can avoid many stressful situations.  When feeling the stress creeping in, sometimes simply walking around the building can help.  Physical activity is a great way of reducing stress.  Exercise has an overall relaxing effect.  Getting enough sleep is also important in ensuring the body is prepared to handle day-to-day crises. 


Stress can lead to an entirely different set of health risks if you seek relief through smoking, drinking, drug use, or poor nutrition.  There is no one solution for handling stress, but one of the most important factors is not to become a victim of circumstances.  Whether or not a person has control over the stressors, they can control how the stress affects them.


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