Learn to manage stress

  • Information
    • We all feel stress at one time or another. It's a normal and healthy reaction to change or a challenge. But stress that goes on for more than a few weeks can affect your health. Keep stress from making you sick by learning healthy ways to manage it.


      The first step in managing stress is recognizing it in your life. Everyone feels stress in a different way. You may get angry or irritable, lose sleep, or have headaches or stomach upset. What are your signs of stress? Once you know what signals to look for, you can start to manage it.

      Also identify the situations that cause you stress. These are called stressors. Your stressors could be family, work, relationships, money, or health problems. Once you understand where your stress is coming from, you can come up with ways to deal with your stressors.


      When you feel stressed, you may fall back on unhealthy behaviors to help you relax. These may include:

      • Eating too much
      • Smoking cigarettes
      • Drinking alcohol or using drugs
      • Sleeping too much or not sleeping enough

      These behaviors may help you feel better at first, but they may hurt you more than they help. Instead, use the tips below to find healthy ways to reduce your stress.


      There are many healthy ways to manage stress. Try a few and see which ones work best for you.

      • Recognize the things you can't change. Accepting that you can't change certain things allows you to let go and not get upset. For instance, you cannot change the fact that you have to drive during rush hour. But you can look for ways to relax during your commute, such as listening to a podcast or book.
      • Avoid stressful situations. When you can, remove yourself from the source of stress. For example, if your family squabbles during the holidays, give yourself a breather and go out for a walk or drive.
      • Get exercise. Getting physical activity every day is one of the easiest -- and best -- ways to cope with stress. When you exercise, your brain releases chemicals that make you feel good. It can also help you release built-up energy or frustration. Find something you enjoy -- whether it is walking, cycling, softball, swimming, or dancing -- and do it for at least 30 minutes on most days.
      • Change your outlook. Try to develop a more positive attitude toward challenges. You can do this by replacing negative thoughts with more positive ones. For example, rather than thinking, "Why does everything always go wrong?" change this thought to, "I can find a way to get through this." It may seem hard or silly at first, but with practice you may find it helps turn your outlook around.
      • Do something you enjoy. When stress has you down, do something you enjoy to help pick you up. It could be as simple as reading a good book, listening to music, watching a favorite movie, or having dinner with a friend. Or, take up a new hobby or class. Whatever you choose, try to do at least one thing a day that's just for you.
      • Learn new ways to relax. Practicing relaxation techniques is a great way to handle daily stress. Relaxation techniques help slow your heart rate and lower your blood pressure. There are many types, from deep breathing and meditation to yoga and tai chi. Take a class, or try learning from books, videos, or online sources.
      • Connect with loved ones. Do not let stress get in the way of being social. Spending time with family and friends can help you feel better and forget about your stress. Confiding in a friend may also help you work out your problems.
      • Get enough sleep. Getting a good night's sleep can help you think more clearly and have more energy. This will make it easier to handle any problems that crop up. Aim for about 7 to 9 hours each night.
      • Eat a healthy diet. Eating healthy foods helps fuel your body and mind. Skip the high-sugar snack foods and load up on vegetables, fruits, whole grains, low-fat or nonfat dairy, and lean proteins.
      • Learn to say no. If your stress comes from taking on too much at home or work, learn to set limits. Ask others for help when you need it.


      If you can't manage stress on your own, you may want to talk with your health care provider. Or consider seeing a therapist or counselor who can help you find other ways to deal with your stress. Depending on the cause of your stress, you also may find it helps to join a support group.

      Test Your Anxiety IQ

      1. If you feel anxious all the time for no reason, you should think about talking with your health care provider.

        1. A. True
        2. B. False

        The correct answer is true. Excessive worry may be a sign of an anxiety disorder. You may have an anxiety disorder if you can't control your worry about everyday problems such as work, relationships, money, or health. Talk with your doctor, if worry interferes with your job, home life, or activities you enjoy.

      2. Anxiety can also cause physical symptoms.

        1. A. True
        2. B. False

        The correct answer is true. Along with constant worry, your muscles may feel tense, or you may headaches and stomach problems such as nausea and diarrhea. Your doctor may do tests to see whether other medical problems could be causing these symptoms.

      3. A panic attack can cause:

        1. A. Sudden feelings of intense fear
        2. B. Sweating, chills, or hot flashes
        3. C. Trembling or shaking
        4. D. Chest pain or discomfort
        5. E. Fear of dying or losing control
        6. F. All of the above

        The correct answer is all of the above. Panic attacks are sudden bouts of terror that peak within 20 minutes. They can be so intense that you live in fear of the next one, and you may avoid things you think may trigger another attack. This can cause you to change how you live your life, so it's best to get help soon.

      4. A panic attack may seem like a heart attack.

        1. A. True
        2. B. False

        The correct answer is true. A panic attack can cause chest pain, a racing heart, and shortness of breath. Many people with this condition first seek treatment in the emergency room, because the panic attack feels like a heart attack.

      5. Post-traumatic stress disorder (PTSD) is a type of anxiety disorder.

        1. A. True
        2. B. False

        The correct answer is true. Post-traumatic stress disorder is a type of anxiety disorder. It can occur after you've experienced a traumatic event involving injury or death. It can cause repeated nightmares, feelings of detachment, flashbacks, and feeling hyper aware of your surroundings, along with other anxiety symptoms.

      6. PTSD only happens to war veterans.

        1. A. True
        2. B. False

        The correct answer is false. While it does occur in some vets, PTSD can occur in anyone who has experienced trauma. PTSD changes the body's response to stress. No one knows why some people develop PTSD and others don't. See your doctor right away if you think you have PTSD. Early treatment has the best chance of success.

      7. PTSD may occur after:

        1. A. A natural disaster
        2. B. An assault
        3. C. Domestic abuse
        4. D. War
        5. E. Rape
        6. F. All of the above

        The correct answer is all of the above. Most people will feel some anxiety right after these types of events. With PTSD, symptoms continue for at least 30 days. But don't wait to seek help. Call your doctor right away if you feel out of control, feel like hurting yourself or others, or have other symptoms of PTSD such as those in question 5.

      8. Feeling driven to do the same action over and over to relieve anxiety may be a sign of:

        1. A. Post-traumatic stress disorder
        2. B. Generalized anxiety disorder
        3. C. Social phobia
        4. D. Panic disorder
        5. E. Obsessive-compulsive disorder
        6. F. All of the above

        The correct answer is obsessive-compulsive disorder (OCD). People with OCD have unwanted and repeated thoughts or behaviors. This may include counting constantly or washing your hands over and over. Treatment can help, so tell your doctor if your symptoms interfere with daily life, work, or relationships.

      9. Social phobia is just another term for shyness.

        1. A. True
        2. B. False

        The correct answer is false. People with social phobia have an intense fear of being judged. They may avoid going to parties, meeting new people, or speaking in public. They can worry for days or weeks about an upcoming event. This fear may interfere with ordinary activities and can make it hard to make and keep friends.

      10. Antidepressants can help treat anxiety disorders.

        1. A. True
        2. B. False

        The correct answer is true. Antidepressants can help treat many types of anxiety problems. Other medicines also may help. Your doctor can determine which treatment is best for you.

      11. Medicine is the only effective treatment for anxiety disorders.

        1. A. True
        2. B. False

        The correct answer is false. A type of talk therapy called cognitive-behavioral therapy can help you change thoughts or behaviors that cause anxiety. You may also learn new ways to react to symptoms of anxiety. Support groups may be helpful for some types of anxiety. Exercise, rest, and eating healthy can also help you feel better.

  • References
    • Ahmed SM, Lemkau JP, Hershberger PJ. Psychosocial influences on health. In: Rakel RE, ed. Textbook of Family Medicine. 8th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 3. Stress: How to cope better with life's challenges. Accessed April 17, 2014.

      Larzelere MM, Jones GN. Stress and health. Prim Care. 2008;35:839-56. PMID: 18928833

      National Center for Complementary and Alternative Medicine. 5 Things to know about relaxation techniques for stress. January 2013. Accessed April 17, 2014.

      National Institute of Mental Health. Fact sheet on stress. Available at: Accessed April 17, 2014.

      US Department of Health and Human Services: Stress and your health fact sheet. July 2012. Accessed April 17, 2014.