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Healthy for life: Stress management

So, you’re stressed out at work and in life. Here’s how to find the calm you’ve always wanted.

  1. What is stress?
  2. What is the difference between stress and anxiety?
  3. What are the signs of chronic stress?
  4. What are the risks of not treating stress?
  5. What are some daily activities that help you manage your stress?
  6. When is it time to seek professional help for stress and anxiety?
  7. What are common treatments for stress and anxiety?
  8. Can stress be a good thing?
  9. What types of insurance provide coverage for mental health services?

Have you woken up on a Monday morning recently and wondered why you even got out of bed? You’re already stressed and anxious about the coming day, and it hasn’t even started yet. There always seems to be a reason to be stressed out or have anxiety: work, your home life, the neighbor complaining about your dog.

But stress and anxiety don’t have to rule your life — or even ruin your Monday morning. Here’s what you may need to know about stress and anxiety, and how to manage them.

What is stress?

Stress is how you react to challenging or difficult situations. When you’re faced with a stressful situation, your body releases hormones, such as adrenaline, that give you the energy you need to react. It also fires up the amygdala, the part of your brain that specializes in fight-or-flight responses. Your breathing quickens, your muscles tense up, your heart pounds, and you start sweating. It gets you ready for action.

“It’s so interesting from a biological standpoint, because these stress responses we have, they’ve evolved for a reason. They’re functional,” says Jeremy Jamieson, Ph.D. He’s an associate professor of psychology who studies stress at the University of Rochester.

Indeed, the fight-or-flight response is helpful when you’re driving and a car pulls out in front of you, and you need to react in an instant. It’s much less helpful when you’re stuck in traffic on the way to work.

Acute stress is normal and goes away quickly, often within minutes. Chronic stress lasts for weeks or months — or even longer — because what is stressing you out doesn’t go away. Left uncontrolled, chronic stress can lead to serious health problems, such as high blood pressure, heart disease and diabetes, among others.

As Jamieson notes, most stressors in modern life are social by nature. Stressful situations such as getting stuck in traffic aren’t going to hurt you physically, but your reaction to them over time can.

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What is the difference between stress and anxiety?

People sometimes use the words “stress” and “anxiety” interchangeably, but anxiety is different. It’s a feeling of dread, fear or uneasiness. You can experience anxiety before something happens, after something has happened, or even in the absence of something happening. In other words, anxiety generates internally, while stress is generally caused by external events.

Much like stress, anxiety is a normal part of life. But some people develop anxiety disorders. In fact, anxiety disorders are the most common of all mental health disorders.

There’s a broad range of anxiety disorders. The most common are:

  • Phobias (fear of heights, spiders, public speaking, etc.)
  • Panic disorders (which show up as panic attacks, or a sudden episode of intense fear)
  • Generalized anxiety disorder (meaning you experience long-lasting and excessive worry and anxiety)
  • Social anxiety disorder (an intense, persistent fear of being watched and judged by others)

Left untreated, anxiety disorders can interfere with your ability to live your daily life.

What are the signs of chronic stress?

Everyone reacts to chronic stress differently. Common signs can include:

  • Back pain (Muscle tension or pain)
  • Eating too much (or not enough)
  • Forgetfulness
  • Getting angry easily
  • Headaches
  • Insomnia
  • Lack of energy and focus
  • Lack of interest in activities you once enjoyed
  • Misusing drugs and/or alcohol
  • Upset stomach

What are the risks of not treating stress?

As noted above, over time, your body’s normal reaction to stressors can increase your risk of developing a range of other chronic conditions:

Heart disease: Stress increases the hormone cortisol in the body, which is linked to high blood pressure, cholesterol and triglycerides. Chronic stress can affect your heart indirectly, too. It can lead you to lose sleep, exercise less and make unhealthy food choices (which can lead to obesity), all of which can put you at a greater risk of developing heart disease.

Diabetes: If you’re stressed out all the time, it can mess with the balance of blood sugar levels in your body. Insulin, a hormone that helps regulate your body’s blood sugar levels, decreases when you’re stressed out, while levels of the hormones glucagon and epinephrine (adrenaline) increase, with more glucose (sugar) released from your liver.

At the same time, levels of growth hormone and cortisol (which regulates your response to stress) increase, causing your muscle and fat to be less sensitive to insulin. As a result, more glucose is available in your bloodstream. And if you have type 2 diabetes, stress can cause your blood sugar level to rise and become more difficult to regulate.

Dementia/Alzheimer’s disease: Those higher hormone levels can also harm your brain function. Specifically, they can make it more difficult to process your thoughts and remember things. This puts you at a higher risk of cognitive decline and developing brain-related diseases such as Alzheimer’s.

What are some daily activities that help you manage your stress?

“We’re not at the mercy of stress,” says Jamieson. “We’re active agents in how we construct our stress response.” Here are some things you can do to respond more appropriately to stress:

  • Identify your stressors. Figure out where your stress is coming from, which may not always be obvious. For example, are you stressed because of a work challenge or because problems at home are keeping you from focusing at work? You may find it helpful to keep a journal.
  • Identify your stress reactions. Does stress make your back hurt? Do you snap at your kids? Or overeat? Learn how you act when you’re under stress.
  • Avoid stressful situations when you can. For example, if the morning commute stresses you out, you might leave home earlier to avoid the rush, try taking public transportation or exploring work-from-home options.
  • Get organized. When you’re feeling overwhelmed, it can be hard to figure out what to do next. Organizing your desk or making a to-do list can help you focus.
  • Take care of your body. Get enough sleep (7 to 9 hours is right for most adults), exercise for at least 30 minutes on most days, and follow a healthy diet. Some studies have shown that foods rich in B vitamins can help relieve stress; those include dark leafy greens, bananas, avocados, fish and chicken.
  • Avoid unhelpful stress responses. Stress-eating, smoking, and misusing alcohol and drugs may seem to help in the moment, but they can make your situation worse. Instead, think about taking up a stress-relieving activity such as yoga, meditation or joining that gym down the street. Regular exercise can be a great stress reliever, as can just taking time to breathe and collect your thoughts.

    If you find that stress is causing you to overeat, your doctor may be able to refer you to a dietitian/nutritionist. They can help you figure out ways to eat less and still be full, by eating foods that taste great but just happen to be healthier.

And if you’re abusing alcohol and/or drugs, your doctor can put you in touch with a substance abuse specialist, psychologist or psychiatrist, all of whom can help you work through those issues (see below for more information).

  • Do something you enjoy every day. Lose yourself in a book, take up a new hobby or meet a friend for coffee.
  • Learn how to relax. Calm your body and mind with deep breathing, meditation, yoga or tai chi.

A mental health professional can help treat anxiety and depression, sleep issues and more, all from the comfort of your own home. To add this coverage, explore Mental Health Complete Plus.

When is it time to seek professional help for stress and anxiety?

If everything you’re trying to reduce your stress levels isn’t working and your symptoms are lingering for 2 weeks or longer, you may want to seek professional help from a doctor, psychologist or psychiatrist, who can help treat your symptoms and prescribe you medication to help manage those symptoms better.

If you’re thinking about harming yourself or attempting suicide, you’ll want to seek help immediately. Ways to do this include:

  • Calling 911
  • Calling the National Suicide Prevention Lifeline at 988 or visiting 988lifeline.org
  • Contacting the Crisis Text Line by texting HOME to 741741 or visiting crisistextline.org

All 3 options are available 24/7.

If you aren’t sure where to start, talk with your doctor. Discuss the symptoms you’re having and anything you’re doing to make them go away. You may find it helpful to bring a friend or relative along to take notes or to give more information to your doctor.

What are common treatments for stress and anxiety?

While there are some common ways to treat chronic stress and anxiety disorders, there’s no one way that’s better than the others. Your doctor may also need to try more than one treatment before you start feeling better.

A common starting point is psychotherapy, which is sometimes called talk therapy. This is where you work with a trained mental health professional, such as a clinical psychologist (a nonmedical doctor), either in an individual or group setting, and talk through your stress. You and the mental health professional will work on ways to decrease stress, deal with it and get past it.

They may also suggest cognitive behavioral therapy, which teaches you different ways of viewing and reacting to stressors, and/or exposure therapy, where you engage with your stressors in a controlled way.

Another type of therapy is mindfulness-based stress reduction (MBSR), which teaches you techniques to better deal with stress. Studies have shown that MBSR helps people reduce stress and negative thoughts and feelings.

For anxiety disorders, you may also need to see a psychiatrist — a medical doctor who specializes in mental health conditions. A psychiatrist might prescribe medication, sometimes along with talk therapy. (In some states, psychologists can also prescribe medication.)

Depending on your situation, your psychiatrist might prescribe:

  • An antidepressant, which helps treat clinical depression
  • An antianxiety medication, which helps reduce the symptoms of anxiety

Check with your doctor before starting or stopping these medications.

Can stress be a good thing?

Although most of us would like to live stress-free lives, Jamieson says stress can be harnessed in positive and powerful ways. “Athletes and musicians are sort of the go-to examples of situations where stress can be functional and helpful,” he says. Instead of avoiding stressful situations, they lean into them — whether that means making a late-game free throw or playing a difficult piano solo.

Jamieson has collaborated on research that shows the value of 2 ways of thinking: believing that doing hard things is positive and believing that the body’s stress responses can fuel performance.

When people adopt both ways of thinking, he says, “they engage with difficult things, but then the positive mindset about the stress sustains them through that engagement. That process can be really helpful for people who otherwise get immobilized by stress.”

What types of insurance provide coverage for mental health services?

Many types of health insurance provide some coverage for mental health services. In fact, Affordable Care Act (ACA) plans are required to do so. Among the essential services spelled out in the ACA are mental health and substance use disorder services.

Plus, all state Medicaid programs provide some mental health coverage. Some also cover substance use disorder services.

It’s important to check the specifics of your plan. The details will be outlined in the plan’s summary of benefits, which should be available on the carrier’s website.

A mental health professional can help treat anxiety and depression, relationship conflicts and more. Explore Mental Health Complete Plus for your virtual care options, or call 1-844-211-7730.

The article above is provided as general information only. It is not intended to diagnose or recommend treatment of any illness, disease or condition. You should consult a qualified medical professional if you have questions or need more information.

Sources:

988 Suicide & Crisis Lifeline. “988 Suicide & Crisis Lifeline.” Retrieved from https://988lifeline.org/ Accessed April 11, 2024

American Psychiatric Association. “What are anxiety disorders?” June 2023. Retrieved from https://www.psychiatry.org/patients-families/anxiety-disorders/what-are-anxiety-disorders

Brown University. “Mindfulness-based stress reduction.” Retrieved from https://professional.brown.edu/executive/mindfulness/mindfulness-based-stress-reduction Accessed April 11, 2024

Centers for Disease Control and Prevention. “Diabetes and mental health.” May 15, 2023. Retrieved from https://www.cdc.gov/diabetes/managing/mental-health.html

Center for Medicaid & CHIP Services. “Mental health and substance use disorder action plan.” July 2023. Retrieved from https://www.medicaid.gov/media/160191

Crisis Text Line. “In a crisis?” Retrieved from https://www.crisistextline.org/ Accessed April 11, 2024

Harvard Medical School. “Understanding the stress response.” April 3, 2024. Retrieved from https://www.health.harvard.edu/staying-healthy/understanding-the-stress-response

HealthCare.gov. “What Marketplace health insurance plans cover.” Retrieved from https://www.healthcare.gov/coverage/what-marketplace-plans-cover/ Accessed April 11, 2024

JAMA Network Open. “Association of stress with cognitive function among older black and white U.S. adults.” March 2023. Retrieved from https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2802090

Mayo Clinic. “Stress management.” August 10, 2023. Retrieved from https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress-symptoms/art-20050987

MedlinePlus. “Anxiety.” October 17, 2023. Retrieved from https://medlineplus.gov/anxiety.html

MedlinePlus. “Learn to manage stress.” November 6, 2022. Retrieved from https://medlineplus.gov/ency/article/001942.htm

MedlinePlus. “Relaxation techniques for stress.” August 11, 2022. Retrieved from https://medlineplus.gov/ency/patientinstructions/000874.htm

National Institute of Mental Health. “Anxiety disorders.” April 2024. Retrieved from https://www.nimh.nih.gov/health/topics/anxiety-disorders

National Institute of Mental Health. “I’m so stressed out! Fact sheet.” Retrieved from https://www.nimh.nih.gov/health/publications/so-stressed-out-fact-sheet Accessed April 11, 2024

Substance Abuse and Mental Health Services Administration. “Anxiety disorders.” April 24, 2023. Retrieved from https://www.samhsa.gov/mental-health/anxiety-disorders

University of California, San Francisco. “Blood sugar and stress.” Retrieved from https://dtc.ucsf.edu/types-of-diabetes/type2/understanding-type-2-diabetes/how-the-body-processes-sugar/blood-sugar-stress/ Accessed April 11, 2024

University of Minnesota. “11 ways too much stress can impact your health.” January 12, 2023. Retrieved from https://ccaps.umn.edu/story/11-ways-too-much-stress-can-impact-your-health

University of Rochester Medical Center. “Stress can increase your risk for heart disease.” Retrieved from https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=1&ContentID=2171 Accessed April 11, 2024

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