Stress Management Part Two: Going to the Well

2016 December 13
by Dr. Steve Sarche

Part one of this two part article on how to manage stress can be summed up quickly.   When you are stressed, do not avoid dealing with it, but handle it directly.  It is important to keep stress in your direct consciousness and make a daily goal to check in on how your stress is and what to do to manage it.  The bonus is that the best techniques to manage stress are also the most effective ways to achieve wellness.

The World Health Organization has defined wellness as “an active process of becoming aware of and making choices toward a more successful existence.”

There are five pillars of wellness that are ancient and powerful in managing stress.   In summary, they are:

  1. Exercise
  2. Mindfulness
  3. Sleep
  4. Social connectedness
  5. Nutrition

Exercise comes in many forms.  Taking a brisk walk is very good for decreasing stress.   A thirty minute brisk walk 5-6 days per week will make a person feel less stressed.  Another approach is cardiovascular exercise.  Sustained exercise that elevates the heart rate is associated with helping manage mild to moderate depression and anxiety.   For best results you should exercise at least 2 days per week with a goal of over 180 total minutes total per week.  This can be achieved doing anything from gardening to dancing.

I recommend consulting with an expert for ideas on how you can customize your workout and make it something that is enjoyable and that you look forward to.  Of course, consult your primary care doctor if there are any health concerns about exercising.

Stress tends to cause us to think about or perceive the past, present and future in exaggerated and negative ways.  Mindfulness is a skill that helps to block or stop those intrusive thoughts.  Mindfulness means maintaining a present or moment to moment awareness and acceptance of thoughts, feelings, bodily sensations, and external surroundings.

Mindfulness in wellness is generally achieved through meditation.   There are several apps you can download that help coach you on how to do that.  One that I have personally used is “stopbreathethink.org“.   It is best to take some time to look at a few and pick one that suits you best.  Stress management through mindfulness requires about 10 minutes per day every day.   That is not a lot of time and there is a huge potential pay back for that.

Good sleep is crucial in well-being and managing stress.  Most experts agree that avoiding caffeine after noon will help in improving sleep.  Even if you don’t notice any direct effects on sleep due to caffeine usage, it is thought that regular use of caffeine can result in long-term lower or slower energy production by cells. Caffeine also stimulants fight or flight like responses in the body. That can make the load of stress feel even worse.

Next, use relaxation techniques at bedtime.  This includes deep breathing and light stretching or yoga.  Mindfulness is another effective technique.

Turn off electronics around an hour before bed, or engage in low-stimulus dimly backlit activity on them. This is helpful in improving time to fall asleep.   Don’t watch or read news as bed time approaches.

Avoid napping after 1pm.   A 15 to 20 minute nap around the lunch hour can be helpful for energy and cognitive tasks, but anything more will generally make it harder to fall asleep at night.

Make a goal to go to bed around the same time every night and to get up at about the same time every morning.   Best to time that so that you will get approximately 8 hours of sleep per night.   Some people do not need that much, but most of us do.  In addition, make those sleep/wake times match natural circadian rhythms.  This means that going to bed around 10 to 11pm is best for most of us.

Finally, if you lay down and are wide awake after 20 minutes, get up and get out of bed.  It is best to read a boring or low stimulus item with dim light and go back to bed the minute you feel tired.  Most people will feel tired after about 5-10 minutes.  I used to use school text books for this.

If there is a medical issue that interferes with sleep, such as chronic pain, depression or sleep apnea, you will need to see a provider to treat the condition.

Social connectedness is basically the act of reaching out to a friend or family member each day.  Sometimes stress causes us to isolate or feel isolated and then that causes stress to increase.  Social connectedness is directly associated with people reporting a higher quality of life. The outreach can be through text, email, phone call, or meeting up.

Stress can affect one’s diet or nutrition in a negative way.  It can cause a person to do harmful things that make stress worse.   It is common to use food for comfort.  Unfortunately, most of the time that comfort eating comes in the form of processed foods such as fast food, or sugary food.  People under stress are also prone to over eat.

People who log what they eat tend to do better overall in terms of making healthy decisions regarding their diet.  “My Fitness Pal” is an example of an app that can help with that.  It has been shown that eating fresh and healthy food such as vegetables can decrease stress hormones while diets high in sugar, caffeine, alcohol and processed food can irritate the nervous system.

Additionally, I suggest that under stress, you should completely avoid drugs and alcohol.  While certain drugs, especially alcohol and marijuana can help decrease stress in the immediate present, regular usage is associated with worsening wellness and sense of well-being over the long-term.  Daily use may lead to depression and anxiety as well.

None of these stress management techniques are complicated and that is the beauty of stress management.  The solutions are simple and easy to execute.  The hard part is getting in the daily habit of doing that.

In 2015, Dr. Saundra Jain and others published a study called “WILD 5 Wellness: impact of a five-pronged Wellness Program on Mood”.  In it, they showed that participants who did attend to the 5 stress management components improved certain wellness measures by 44% over the course of a month.   That is huge.

The key to their success was to engage in each component daily and log that progress.   Part of why this program for self-directed wellness is so effective is that even if one of the five components doesn’t work well for a person, it is likely the other four will.

We will each respond to the individual components differently, but put together, they are effective.  Dr. Jain and colleagues were also able to show that wellness can be achieved in a self-directed way.   Hold yourself accountable, put reminders on your calendar and use a chart to encourage adherence.

Some people’s stress leads to a condition of anxiety.   These techniques will still be helpful but you should seek professional help if the stress is too overwhelming and it not effective or is too difficult to regularly engage in self-directed wellness.

Stress is exhausting.  It can be a drain on our wellness and sense of well-being.   Challenge yourself to keep your reserves full.  Keep going to the well.

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