By Natasha Persaud
How can I relieve my stress?
If you can get away from the stressful situation, so it's no longer a problem, do it. That's the top priority, says Esther Sternberg, M.D., chief of the Section on Neuroendocrine Immunology and Behavior at the National Institute of Mental Health (NIMH) and director of the NIMH's Integrative Neural Immune Program.
If you can't get away from the stressor—you can't change your job, you're a caregiver for someone with a serious chronic illness—then taking these steps may help:
Exercise. Research shows that physical activity greatly improves the brain's stress response circuits, so that you cope better. "The brain chemicals serotonin and dopamine, which are involved in positive mood states, are boosted with exercise," says Dr. Sternberg.
Physical activity decreases fatigue, gives you energy and guards against disease by protecting your immune system, helping you maintain a healthy weight and raising your good cholesterol levels.
You don't need an intense workout to reap benefits: Even 30 minutes of walking or gentle swimming can help. Also try yoga and tai chi for relaxation.
Pace yourself. If you're working 24/7, you need to retrain yourself to take breaks. Take an hour for lunch or get away for a few minutes to go offline: Listen to music, take a bubble bath, call a friend or do something else that you enjoy.
Reframe your thinking. Chronic stress can lead to a downward spiral of anger, anxiety and frustration. When you sense that your emotions are being revved up, take deep breaths and try to think about the situation in a calm, analytic way to minimize the effects on your body and brain. For example, say to yourself, "This traffic jam is annoying, but it'll be over in a matter of minutes; it's not worth fretting about."
Seek social support. Enlist family members, friends and members of your community to help you take a break. Ask a friend to take you shopping or out to dinner, or to take care of your sick loved one for a few hours while you get a massage.
Meditate or pray. Research on nuns and priests shows that prayer lowers the brain's stress response patterns and activates more positive emotional centers. There's also some evidence that meditation facilitates the effect of medication to heal.
Go on vacation. When you're stressed, you need to "shut down and reboot," notes Dr. Sternberg. "Many times caregivers say they can't take time off, but I say that you must—it's that essential to your well-being. In Europe, doctors can actually prescribe a spa treatment to someone with burnout."
Why is it often necessary to see a health-care professional for help treating chronic stress?
"Not all stress is the same," Dr. Sternberg says. "There are different causes and individuals react in different ways." A person with marital stress, for example, might benefit from counseling from a psychologist; a caregiver might see a social worker for help structuring medical care for their loved one, so it's not such a burden; someone with a medical condition that has been triggered by stress would benefit from seeing a medical doctor. Many people need a team of health-care professionals to manage their condition. Treatment will depend on your particular needs.
You wouldn't feel guilty about taking your car to the repair shop if the motor was burning out. It's the same concept with your health. If you're experiencing anxiety, having trouble functioning to your normal level or getting sick frequently, then you need to see a health-care professional.
First, see your primary-care physician, who can assess your condition and refer you for further evaluation, if needed. If your doctor thinks that you have a mood disorder, you may be referred to a mental health professional (psychiatrist, psychologist or social worker) for psychotherapy, cognitive behavior therapy and/or medication. During therapy, you learn to reframe your thinking about the situation that's upsetting to you and disconnect the emotional response. If your doctor suspects you have an associated medical condition or an underlying illness, you might be referred to a medical specialist.
The goal of any treatment is restoration of the communication system between your brain and your immune system, whether through pharmacological agents, psychotherapy or other techniques.
"Just as it probably took you 50 tries to learn to ride a bicycle as a child, it takes a lot of practice to get your mind and body back into balance," Dr. Sternberg says. Taking care of yourself and learning to cope using lifestyle strategies and seeing health-care professionals trained in stress management can help bring restoration.