anxiety and stress management essay

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How to Relax in Stressful Situations: A Smart Stress Reduction System

Yekta said can.

1 Computer Engineering Department, Bogazici University, 34342 Istanbul, Turkey; [email protected] (N.C.); [email protected] (D.E.); rt.ude.nuob@yosre (C.E.)

Heather Iles-Smith

2 Leeds Teaching Hospitals NHS Trust/University of Leeds, Leeds LS1 3EX, UK; [email protected]

Niaz Chalabianloo

Javier fernández-Álvarez.

3 General Psychology and Communication Psychology, Catholic University of Milan, 20123 Milan, Italy; [email protected] (J.F.-Á.); [email protected] (C.R.); [email protected] (G.R.)

Claudia Repetto

Giuseppe riva.

Stress is an inescapable element of the modern age. Instances of untreated stress may lead to a reduction in the individual’s health, well-being and socio-economic situation. Stress management application development for wearable smart devices is a growing market. The use of wearable smart devices and biofeedback for individualized real-life stress reduction interventions has received less attention. By using our unobtrusive automatic stress detection system for use with consumer-grade smart bands, we first detected stress levels. When a high stress level is detected, our system suggests the most appropriate relaxation method by analyzing the physical activity-based contextual information. In more restricted contexts, physical activity is lower and mobile relaxation methods might be more appropriate, whereas in free contexts traditional methods might be useful. We further compared traditional and mobile relaxation methods by using our stress level detection system during an eight day EU project training event involving 15 early stage researchers (mean age 28; gender 9 Male, 6 Female). Participants’ daily stress levels were monitored and a range of traditional and mobile stress management techniques was applied. On day eight, participants were exposed to a ‘stressful’ event by being required to give an oral presentation. Insights about the success of both traditional and mobile relaxation methods by using the physiological signals and collected self-reports were provided.

1. Introduction

Stress constitutes a complex process that is activated by a physical or mental threat to the individuals’ homeostasis, comprising a set of diverse psychological, physiological and behavioral responses [ 1 ]. Although it is usually considered a negative response, stress actually constitutes a key process for ensuring our survival. However, when a stress response is repeatedly triggered in the absence of a challenging stimulus, or if there is constant exposure to challenging situations, stress can become harmful. Evidence suggests that, in either of these two contexts, stress is a persistent factor for the development of psycho-pathological conditions [ 2 , 3 ].

When faced with stressful events, people make autonomic and controlled efforts to reduce the negative impact and maximize the positive impact that every specific situation may provoke. Generally, this process is denominated as emotion regulation, formally defined as the process by which individuals can influence what emotions they have, when they have them and how they experience and express those emotions [ 4 ]. It has been suggested that the term emotion regulation can be understood as a broad tag that comprises the regulation of all responses that are emotionally charged, from basic emotions to complex mood states as well as regulation of everyday life [ 5 ].

Failure to address triggers of stress has been shown to lead to chronic stress, anxiety and depression, and attributed to serious physical health conditions such as cardiovascular disease [ 6 ]. The World Health Organization concluded that psychological stress is one of the most significant health problems in the 21st-century and is a growing problem [ 7 ]. There are various interventions to minimize stress based on individual preferences and requirements. Stress management techniques including ancient practices such as Tai Chi [ 8 ] and yoga [ 9 ] as well as other physical activities [ 10 ] are often cited as being helpful in combating stress. Likewise traditional meditation, mindfulness [ 11 ] and cognitive behavioural therapy (CBT) [ 12 ] all have established benefits. These techniques are not applicable in office or social environments, or during most daily routines. Therefore, a smart device based stress management application may be of benefit. Recently, smartphone applications such as Calm, Pause, Heartmath and Sway have been developed for indoor environments. However, these applications are not individualized nor do they include biofeedback and studies that validate their effects are limited [ 13 ].

In this study, we used the stress level detection scheme using physiological signals and added a physical activity based context analyzer. When the user experiences a high stress level, the system suggests appropriate stress reduction methods (traditional or mobile). We further compare the effects of traditional and mobile stress alleviation methods on physiological data of 15 international Ph.D. students (participants) during eight days of training. In addition, 1440 h of physiological signals from Empatica E4 smart bands were collected in this training event. Stress management techniques based on the emotion regulation model of James Gross [ 4 ] were applied to reduce participant stress levels. To the best of our knowledge, this work is the first one suggesting appropriate stress reduction methods based on contextual information and comparing both traditional and mobile stress management interventions in the real-life environment using a commercial smart-band based automatic stress level detection system that eliminates motion artifacts. Using such a system is essential because these offline stress level detection algorithms could be used in real-time biofeedback apps.

Application of our stress level detection algorithm, in a real world context, could allow individuals to receive feedback regarding high stress levels along with recommendations for relaxation methods. Additional continued monitoring may also enable the individual to better understand the effectiveness of any stress reduction methods. However, for our stress detection algorithm to be applied in daily life, the smart device should be unobtrusive (i.e., should not be comprised of cables, electrodes, boards). Our system works on smart-bands which are perfect examples of this type of unobtrusive wearable device.

This paper describes emotion regulation in the context of stress management and how yoga and mindfulness can be used for regulating emotions ( Section 2 ). Methods of detecting stress and analyzing context based on physical activity are described ( Section 3 ) and data are presented related to our method for stress level detection with the use of smart-bands ( Section 4 ). Experimental results and discussion are also presented ( Section 5 ) and we present the conclusions and future works of the study ( Section 6 ).

The major research contributions of this study are the following:

• Developing a physical activity based context analyzer and relaxation method suggestion system
• Comparison of stress reduction methods (mobile mindfulness, traditional mindfulness and yoga) and their effectiveness in the context of stress management with the use of an unobtrusive smartwatch based stress level detection system
• Application of James Gross’s prominent emotion regulation model in the context of stress management and measuring the physiological component with smart bands.

2. Background

2.1. emotion regulation in the context of stress management.

Stress is a normal part of daily life. However, its effects often vary across individuals and despite similar circumstances, some people do not feel under strain while others may be severely affected. Multiple reasons exist for these differences between individuals, including how people perceive reality and how they respond to the numerous stimuli to which they are exposed. When a person believes that a certain situation surpasses their available coping mechanisms, it is referred to as perceived stress. Thus, perceived stress varies from person to person depending on the value that an individual gives to a situation and their self-recognition of the resources to deal with it.

Numerous psychological scientists have investigated perceived stress. Individuals who display a mismatch between contextual demands and perceived resources constantly (rather than during a specific moment in time) are referred to as experiencing chronic stress. Chronic stress has not only been shown to be very relevant in people’s well-being and quality of life, but also important in the appearance and maintenance of several physical and mental diseases [ 14 ].

As a consequence, mounting research has focused on the mechanisms that people implement in order to alleviate the physical and cognitive burden associated with that perceived stress. Coping styles, stress management techniques, self-regulation, or emotion regulation techniques are different labels that define the way people implement certain behavioral, cognitive, or emotional strategies to maintain allosteric load [ 15 ]. In other words, every living organism needs to vary among plasticity and stability in order to survive. Human beings are not the exception to the rule and the complex system that applies to every single person and the necessity of reaching a constant level of regulation permits the individuals to pursue their goals.

Specifically, emotion regulation has been defined as the study of “the processes by which we influence which emotions we have when we have them, and how we experience and express them” [ 4 ]. A large body of evidence has shown that there are very different consequences depending on the effectiveness people achieve to regulate their emotions. Naturally, both at an implicit or explicit level, people regulate emotions in order to maintain those allosteric levels previously mentioned. Therefore, when there are specific stressors that demand a particular cognitive or physical response, the emotional reactivity may be stronger and the need for a proper regulation more relevant. Indeed, emotion regulation has shown to be a transdiagnostic factor that is present at a wide range of mental disorders. In other words, the way people initiate, implement and monitor their emotional processes, in order to reach more desirable states, has a significant impact on the stress levels. Some emotion regulation (ER) strategies have shown to be correlated with mental health issues. Among these strategies, cognitive reappraisal, problem-solving, or acceptance shall be mentioned as strategies that are negatively correlated with psychopathology, while rumination, experiential avoidance, or suppression are positively correlated with psychopathology [ 16 ]. In this regard, hinging on the different ER strategies deployed, ER can constitute a protective factor to face stress responses that all individuals experience after minor or major stressors [ 17 ]. Additionally, an adaptive regulation of emotions, by managing stress, may also be beneficial for clinical populations, such as people suffering from affective disorders [ 18 , 19 ].

Therefore, from whole psychotherapeutic treatments to single self-applied applications, studies in the literature have focused on how people can better regulate their emotions and manage their stress levels. Among many other techniques, cognitive behavioral therapy, autogenic training, biofeedback, breathing exercises, relaxation techniques, guided imagery, mindfulness, yoga, or Tai-Chi, are some of the stress management interventions that have received attention from researchers [ 20 , 21 ].

2.2. Yoga and Mindfulness: As Tools for Emotion Regulation

2.2.1. yoga.

Yoga is an ancient Eastern practice that developed more than 2000 years ago. Although its original creator and source are uncertain, the earliest written word ‘Yoga Sutra’ describes the philosophy of yoga focussing on growing spirituality, regulating emotions and thoughts. Initially, the focus was on awareness of breathing and breathing exercises ‘pranayama’ to calm the mind and body, ultimately reaching a higher state of consciousness.

As yoga evolved, physical movement in the form of postures was included and integrated with yogic breathing ‘prana’ and elements of relaxation. The underlying purpose is to create physical flexibility, reduce pain and unpleasant stimuli and reduce negative thoughts and emotions to calm the mind and body, thereby improving well-being. In the healthcare literature, the benefits are reported to be far-reaching both for mental and physical health conditions such as anxiety, depression, cardiovascular disease, cancer and respiratory symptoms. It is also reported to reduce muscular-skeletal problems and physical symptoms through increasing the awareness of the physical body.

Yoga has become a global phenomenon and is widely practiced in many different forms. Generally, all types of yoga include some elements of relaxation. Additionally, some forms include mainly pranayama and others are more physical in nature. One such practice is vinyasa flow which involves using the inhale and exhale of the breathing pattern to move through a variety of yoga postures; this leads to the movement becoming meditative. The practice often includes pranayama followed by standing postures linked together with a movement called vinyasa, (similar to a sun salutation) which helps to keep the body moving and increases fitness, flexibility and helps maintain linkage with the breath. The practice also often includes a range of seated postures, an inversion (such as headstand or shoulder stand) and final relaxation ‘savasana’.

2.2.2. Mindfulness

Mindfulness involves being more present at the moment by acknowledging the here and now, often referred to as ‘being present’ rather than focussing on the past or future [ 8 ]. Being present may include being aware of our surroundings and the environment, or of what we are eating and drinking and physical sensations such as the sun or wind on our skin.

Acknowledging the thoughts and body are also aspects of mindfulness. Each day humans experience thousands of thoughts, the majority being of no consequence. In some instances, these thoughts are repetitive and negative in nature which can lead to increased stress and the related unpleasant physical symptoms such as feeling anxious, nausea and tension headaches. Being mindful includes an awareness of our thinking and whether we are caught up with our thoughts rather than being aware of the moment. Additionally, on a daily basis, awareness of the physical body may be minimal; being mindful includes increasing this awareness through becoming more connected with the sensations in the body. This might include experiencing the legs moving when walking, or feeling the ground under the feet or the natural way of the body whilst standing.

Mindfulness has been shown to be of benefit to physical and mental health. It is currently recommended by the National Institute for Clinical Excellence [ 22 ] as adjunctive therapy to Cognitive Behavioural Therapy (CBT) for the prevention of relapse depression.

However, it may be challenging for some individuals to do this with a multitude of distractions around them and, therefore, they may choose to identify a particular time and place when and where they can sit in a comfortable position to start to become aware of their breathing and bodily sensations.

2.2.3. Mobile Mindfulness Inspired By Tai-Chi—Pause

Tai-Chi is an internal Chinese martial art practiced for both its defense training, its health benefits and meditation. There is good evidence of benefits for depression, cardiac and stroke rehabilitation and dementia [ 23 ]. The term Tai-Chi refers to a philosophy of the forces of yin and yang, related to the moves. An iPhone application Pause inspired by Tai-Chi is used for guided mindfulness which draws upon the principles of mindfulness meditation to trigger the body’s rest and digest response, quickly restoring attention [ 24 ].

3. Related Work

Researchers have created the ability to detect stress in laboratory environments with medical-grade devices [ 25 , 26 , 27 , 28 ]; smartwatches and smart bands started to be used for stress level detection studies [ 29 , 30 , 31 ]. These devices provide high comfort and rich functionality for the users, but their stress detection accuracies are lower than medical-grade devices due to low signal quality and difficulty obtaining data in intense physical activity. If data are collected for long periods, researchers have shown that their detection performance improves [ 32 ]. During movement periods, the signal can be lost (gap in the data) or artifacts might be generated. Stress level detection accuracies for 2-classes by using these devices are around 70% [ 29 , 30 , 33 , 34 ].

After detecting the stress level of individuals, researchers should recover from the stressed state to the baseline state. To the best of our knowledge, there are very few studies that combine automatic stress detection (using physiological data) with recommended appropriate stress management techniques. Ahani et al. [ 35 ] examined the physiological effect of mindfulness. They used the Biosemi device which acquires electroencephalogram (EEG) and respiration signals. They successfully distinguished control (non-meditative state) and meditation states with machine learning algorithms. Karydis et al. [ 36 ] identified the post-meditation perceptual states by using a wearable EEG measurement device (Muse headband). Mason et al. [ 37 ] examined the effect of yoga on physiological signals. They used PortaPres Digital Plethtsmograph for measuring blood pressure and respiration signals. They also showed the positive effect of yoga by using these signals. A further study validated the positive effect of yoga with physiological signals; researchers monitored breathing and heart rate pulse with a piezoelectric belt and a pulse sensor [ 21 ]. They demonstrated the effectiveness of different yogic breathing patterns to help participants relax. There are also several studies showing the effectiveness of mobile mindfulness apps by using physiological signals [ 20 , 38 , 39 ]. Svetlov et al. [ 20 ] monitored the heart rate variability (HRV), electrodermal activity (EDA), Salivary alpha-amylase (sAA) and EEG values. In other studies, EEG and respiration signals were also used for validating the effect of mobile mindfulness apps [ 38 , 39 ]. When the literature is examined, it could be observed that the effect of ancient relaxation methods and mobile mindfulness methods are examined separately in different studies. Ancient methods generally require out of office environments that are not suitable for most of the population, since, in the modern age, people started to spend more time in office-like environments. On the other hand, some smartphone applications such as Pause, HeartMath and Calm do not require extra hardware or equipment and be applicable in office environments. Hence, an ideal solution depends on the context of individuals. A system that monitors stress levels, analyzes the context of individuals and suggests an appropriate relaxation method in the case of high stress will benefit society. Furthermore, mobile methods along with the ancient techniques should be applied in stressful real-life events and their effectiveness should be compared by investigating physiological signals. When the literature is examined, there is not any study comparing the performance of these methods in real-life events (see Table 1 ). Another important finding is that these methods should be compared with unobtrusive wearable devices so that they could be used for a biofeedback system in daily lives. Individuals may be reluctant to use a system with cables, electrodes and boards in their daily life. Therefore, a comparison of different states with such systems could not be used in daily life. There is clearly a need for a suggestion and comparison of ancient and mobile meditation methods by using algorithms that could run on unobtrusive devices. An ideal system should detect high stress levels, suggest relaxation methods and control whether users are doing these exercises right or not with unobtrusive devices. Our algorithm is suitable to be embedded in such daily life applicable systems that use physiological signals such as skin temperature (ST), HRV, EDA and accelerometer (ACC). In this paper, we present the findings of our pilot study that tested the use of our algorithm during general daily activities, stress reduction activities and a stressful event.

Comparison of our work with the studies applying different types of meditation techniques for stress management in the literature.

4. Methodology

4.1. unobtrusive stress detection system with smart bands.

Our stress detection system developed in [ 32 ] allows users to be aware of their stress levels during their daily activities without creating any interruption or restriction. The only requirement to use this system is the need to wear a smart band. Participants in this study wore the Empatica E4 smart band on their non-dominant hand. The smart band provides Blood Volume Pressure, ST, EDA, IBI (Interbeat Interval) and 3D Acceleration. The data are stored in the memory of the device. Then, the artifacts of physiological signals were detected and handled. The features were extracted from the sensory signals and fed to the machine learning algorithm for prediction. In order to use this system, pre-trained machine learning models are required. For training the models, feature vectors and collected class labels were used.

4.1.1. EDA Preprocessing Artifact Detection and Removal Methods

The body sweats when emotional arousal and stress are experienced and, therefore, skin conductance increases [ 40 ]. This makes EDA a promising candidate for stress level detection. Intense physical activity and temperature changes contaminate the SC (Skin Conductance) signal. Therefore, affected segments (artifacts) should be filtered out from the original signal. In order to detect the artifacts in the SC signal, we used an EDA toolkit [ 41 ] which is 95% accurate on the detection of the artifacts. While developing this tool, technicians labeled the artifacts manually. They trained a machine learning model by using the labels. In addition to the SC signal, 3D acceleration and ST signals were also used for artifact detection. We removed the parts that this tool detected as artifacts from our signals. We further added batch processing and segmentation to this tool by using custom software built-in Python 2.7.

4.1.2. EDA Feature Extraction Methods

After the artifact removal phase, features were extracted from the EDA signal. This signal has two components phasic and tonic; features from both components were extracted (see Table 2 ). The cvxEDA tool [ 42 ] was used for the decomposition of the signal into these components. This tool uses convex optimization to estimate the Autonomic Nervous System (ANS) activity that is based on Bayesian statistics.

EDA features and their definitions.

Tonic Component Features

The tonic component in the EDA signal represents the long-term slow changes. This component is also known as the skin conductance level. It could be regarded as the indicator of general psychophysiological activation [ 43 ].

Phasic Component Features

The phasic component represents faster (event-related ) differences in the SC signal. The Peaks of phasic SC component as a reaction to a stimulus is also called Skin Conductance Response [ 43 ]. After we decompose the phasic component from the EDA signal, peak related features were extracted.

4.1.3. Heart Activity Preprocessing (Artifact Detection and Removal) and Feature Extraction Methods

Heart activity (or, more specifically, HRV) reacts to changes in the autonomic nervous system (ANS) caused by stress [ 44 ] and it is, therefore, one of the most commonly used physiological signal for stress detection [ 40 ]. However, vigorous movement of subjects and improperly worn devices may contaminate the HRV signal collected from smartwatches and smart bands. In order to address this issue, we developed an artifact handling tool in MATLAB programming language [ 45 ] that has batch processing capability. First, the data were divided into 2 min long segments with 50% overlapping. Two-minute segments were selected because it is reported that the time interval for stress stimulation and recovery processes is around a few minutes [ 46 ]. The artifact detection percentage rule (also employed in Kubios [ 47 ]) was applied after the segmentation phase. In this rule, each data point was compared with the local average around it. When the difference was more than a predetermined threshold percentage, (20% is commonly selected in the literature [ 48 ]), the data point was labeled as an artifact. In our system, we deleted the inter-beat intervals detected as the artifacts and interpolated these points with the cubic spline interpolation technique which was used in the Kubios software [ 47 ]. The time-domain features of HRV are calculated. In order to calculate the frequency domain features, we interpolated the RR intervals to 4 Hz. Then, we applied the Fast Fourier Transform (FFT). These time and frequency domain features (see Table 3 ) were selected because these are the most discriminative ones in the literature [ 30 , 49 , 50 ].

HRV features and their definitions [ 32 ].

4.1.4. Accelerometer Feature Extraction Methods

Research has shown that movements of the human body and postures can indeed be employed as a means to detect signs of different emotional states. The dynamics of body movement were investigated by Castellano et al. who used multimodal data to identify human affective behaviors. Specific movement metrics, such as the amount of movement, intensity and fluidity, were used to help deduct emotions, and it was found that the amount of movement was a major factor in distinguishing different types of emotions [ 51 ]. Melzer et al. investigated whether movements comprised of collections of Laban movement components could be recognized as expressing basic emotions [ 52 ]. The results of their study confirm that, even when the subject has no intention of expressing emotions, particular movements can assist in the perception of bodily expressions of emotions. Accelerometer sensors may be used to detect these movements and different types of affect. The accelerometer sensor data are used for two different purposes in our system. Firstly, we extracted features from the accelerometer sensor, for detecting stress levels. We also selected the features to be used as described in Table 4 [ 53 ] and, as mentioned above, this sensor was also employed to clean the EDA signal in the EDAExplorer Tool [ 41 ].

ACC features and their definitions.

4.1.5. Skin Temperature

A skin temperature signal is used for the artifact detection phase of the EDA signal in the EDAExplorer Tool [ 41 ]. After we divide our data into segments, different modalities were merged into one feature vector. The heart activity signal started with a delay (to calculate heartbeats per minute at the start) and all signals were then synchronized. We included start and end timestamps for each segment, and each modality was merged with a custom Python script.

4.1.6. Machine Learning Classifier Algorithms

The Weka machine learning toolkit [ 54 ] is used for identifying stress levels. The Weka toolkit has several preprocessing features before classification. Our data set was not balanced when the number of instances belonging to each class was considered. We solved this issue by removing samples from the majority class. We selected random undersampling because it is the most commonly applied method [ 55 ]. In this way, we prevented classifiers from biasing towards the class with more instances. In this study, we employed five different machine learning classification algorithms to recognize different stress levels: MultiLayer Perceptron (MLP), Random Forest (RF) (with 100 trees), K-nearest neighbors (kNN) ( n = 1–4), Linear discriminant analysis (LDA), Principal component analysis (PCA) and support vector machine (SVM) with a radial basis function. These algorithms were selected because they were the most commonly applied and successful classifiers for detecting stress levels [ 30 , 48 ]. In addition, 10-fold stratified cross-validation was then applied and hyperparameters of the machine learning algorithms were fine-tuned with grid search. The best performing models have been reported.

4.1.7. Dimensionality Reduction

We applied correlation-based feature selection (CBFS) technique which is available in the Weka machine learning package for combined signal [ 56 ]. The CBFS method removes the features that are less correlated with the output class. For every model, we selected the ten most important features. This method is applied for MLP, RF, kNN and LDA. In order to create an SVM based model, we applied PCA based dimensionality reduction where the covered variance is selected as 0.95 (the default setting).

4.1.8. Insights from the Feature Selection Process

The CBFS method computes the correlation of features with the ground truth label of the stress level. Insights about the contribution of the features to the stress detection performance can be obtained from Figure 1 and Figure 2 . Three of the best features (over 0.15 correlation) are frequency domain features. These features are high, low and very-low frequency components of the HRV signal (see Figure 1 ). When we examine the EDA features, peaks per 100 s feature are the most important and distinctive feature by far. Since the EDA signal is distorted under the influence of the stimuli, the number of peaks and valleys increases. Lastly, when the acceleration signal is investigated, the most discriminative feature is mean acceleration in the z -axis (see Figure 2 b). This could be due to the nature of hand and body gestures which are caused by stressed situations.

Top-ranking features selected for the HRV signal.

Top-ranking features selected for the EDA and ACC signals.

4.2. Relaxation Method Suggestion by Analyzing the Physical Activity-Based Context

Context is a broad term that could contain different types of information such as calendars, activity type, location and activity intensity. Physical activity intensity could be used to infer contextual information. In more restricted environments such as office, classrooms, public transportation and physical activity intensity could be low, whereas, in outdoor environments, physical activity intensity could increase. Therefore, an appropriate relaxation method will change according to the context of individuals.

For calculating physical activity intensity, we used the EDAExplorer tool [ 41 ]. The stillness metric is used for this purpose. It is the percentage of periods in which the person is still or motionless. Total acceleration must be less than a threshold (default is 0.1 [ 41 ]) for 95 percent of a minute in order for this minute to count as still [ 41 ]. Then, the ratio of still minutes in a session can be calculated. For the ratio of still minutes in a session, we labeled sessions below 20% as still, above 20% as active and suggested relaxation method accordingly (see Figure 3 ).

The whole system diagram is depicted. When a high stress level is experienced, by analyzing the physical activity based context, the system suggests the most appropriate reduction method.

4.3. Description of the Data Collection Procedure

The proposed stress level monitoring mechanism, for real-life settings, was evaluated during an eight day Marie Skłodowska-Curie Innovative Training Network (ITN) training event in Istanbul, Turkey, for the AffecTech project. AffecTech is a program funded by Horizon 2020 (H2020) framework established by the European Commission. The AffecTech project is an international collaborative research network involving 15 PhD students (early stage researchers (ESR)) with the aim of developing low-cost effective wearable technologies for individuals who experience affective disorders (for example, depression, anxiety and bipolar disorder).

The eight-day training event included workshops, lectures and training with clearly defined tasks and activities to ensure that the ESR had developed the required skills, knowledge and values outline prior to the training event. At the end of the eight-day training, ESRs were required to deliver a presentation about their PhD work to two evaluators from the European Union where they received feedback about their progress (see Figure 4 for raw physiological signals at the start of the presentation). For studying the effects of emotion regulation on stress, yoga, guided mindfulness and mobile-based mindfulness, sessions were held by a certified instructor.

Sample data belong to a presentation session. The increase in EDA, ST and IBI could be observed when the subject started the presentation.

During the training, physiological and questionnaire data were collected from the 16 ESR participants (9 men, mean age 28); 15 ESRs and one of the AffecTech project academics, all of whom gave informed consent to participate in the study. Participants were from different countries with diverse nationalities (two from Iran, two from Spain, two from Italy, one from Argentina, one from Pakistan, one from China, one from Switzerland, one from Belarus, one from France, one from England, one from Barbados, one from Turkey and one from Bulgaria). Due to the fault of one of the Empatica E4 devices, it was not possible to include data from one participant. The remaining 15 participants completed all stages of the study successfully.

During the eight days of training and presentations, psychophysiological data were collected from 16 participants during the training event from Empatica E4 smart band while they are awake. For studying the effects of emotion regulation on stress, yoga, guided mindfulness and mobile-based mindfulness sessions were held by a certified instructor. The timeline of the event is shown in Figure 5 .

Time-line depicting eight days of the training event. Presentations, relaxations and lectures are highlighted.

4.3.1. Physiological Stress Data

The psychophysiological signal data were collected using the Empatica E4 smart band whilst participants were awake throughout the eight days of the AffecTech training. Physiological data included IBI, EDA, ACC (Accelerometer) and ST and stored in different csv files. In addition, 27.39% of the data are obtained from free times (free day and after training until subjects slept 5:00 p.m.–10:00 p.m.), 43.83% of the data comes from lectures in the training, 11.41% is the presentation session and relax sessions consist of 17.35% of the data. As mentioned previously, we randomly undersampled (most commonly applied method [ 55 ] ) the data to overcome the class imbalance problem. The participants’ blood pressure (BP) was also recorded using CE(0123) Harvard Medical Devices Ltd. automated sphygmomanometer prior to and after each stress reduction event (yoga and mindfulness), in order to demonstrate whether the participants stress levels were modified. On each occasion that the participants’ BP was recorded, the mean of three recordings was used as the final BP. A reduction in the participants’ blood pressure and/or pulse rate may be seen, which demonstrates a reduction in stress level.

4.3.2. Ethics

The procedure used in this study was approved by the Institutional Review Board for Research with Human Subjects of Boğaziçi University with the approval number 2018/16. Prior to data acquisition, each participant received a consent form describing the experimental procedure and its benefits and implications to both the society and the subject. The procedure was also explained verbally to the subject. All of the data are stored anonymously.

4.3.3. Questionnaire Self-Report Stress Data

A session-based self-report questionnaire comprised of six questions based on the Nasa Task Load Index (NASA-TLX) [ 57 ]. The frustration scale was specifically used to measure perceived stress levels [ 32 ]. We asked the following question to the participants for each session:

How irritated, stressed and annoyed versus content, relaxed and complacent did you feel during the task?

Questionnaires were completed daily (at the end of the day) and, after each presentation, lecture and stress reduction event (such as yoga and mindfulness).

4.3.4. Stress Management Scheme Using Yoga and Mindfulness

During the eight day training, it is assumed that the participants’ stress levels are likely to have increased day by day because they were required to give a presentation (perceived as a stressful event) reporting their PhD progress to the EU project evaluators at the end of the training.

Underpinned by James Gross’s Emotion Regulation model (see Figure 6 ) [ 4 ], we modified the situation to help the participants to reduce their thoughts of the end of the training presentation. To help participants manage their stress levels, we applied Yoga and mindfulness sessions on two separate days (day three and day four, respectively). These sessions lasted approximately 1 h and, throughout the sessions, participants wore an Empatica E4 smartband. In addition to the physiological signals coming from the Smartbands, participants’ blood pressure values were also recorded before and after the yoga and mindfulness sessions.

Application of James Gross’s Emotion Regulation model [ 4 ] in the context of stress management.

5. Experimental Results and Discussion

5.1. statistical data analysis, 5.1.1. validation of different perceived stress levels by using the self-reports.

In order to validate that the participants experienced different perceived stress levels in different contexts (lecture, relaxation, presentation), we used the Frustration item (see Section 4.5) from the NASA-TLX [ 57 ]. The distribution of answers is demonstrated in Figure 7 . Our aim is to show that the perceived stress levels (obtained from self-report answers) differ in relaxation sessions considerably when compared to the presentation session (high stress). To this end, we applied the t -test (in R programming language) to the perceived stress self-report answers of yoga versus presentation, mindfulness versus presentation and pause (mobile mindfulness) versus presentation session pairs. The paired t -test is used to evaluate the separability of each session. The degree of freedom is 15. We applied the variance test to each session tuple; we could not identify equal variance in any of the session tuples. Thus, we selected the variance as unequal. We used 99.5% confidence intervals. The t -test results’ ( p -values and test statistics) are provided in Table 5 . For all tuples, the null hypothesis stating that the perceived stress of the relaxation method is not less than the presentation session is rejected. The perceived stress levels of participants for all meditation sessions are observed to be significantly lower than the presentation session (high stress).

Visual representation of the frustration scores collected in different types of sessions.

T -test results for session tuple comparison of perceived stress levels using self-reports.

5.1.2. Before and After Physiological Measurements for Evaluating Performance of Yoga and Mindfulness with Blood Pressure

In this section, we compared the effect of stress management tools such as yoga and mindfulness on blood pressure. It is expected that blood pressure sensors will be part of unobtrusive wrist-worn wearable sensors soon. We plan to integrate a blood pressure (BP) module to our system when they are available. Therefore, by using the measurements of a medical-grade blood pressure monitor, we provided insights about how stress reaction affects BP. We further applied and tested the prominent emotion regulation model of James Gross by analyzing these measurements in the context of stress management. We measured the diastolic and systolic BP and pulse using a medical-grade blood pressure monitor before and after the yoga and mindfulness sessions. In order to ensure that the participants were relaxed and that an accurate BP was recorded, BP was measured three times with the mean as the recorded result. A one-sample t -test was applied to the difference between mean values. The results are shown in Table 6 .

The difference between the mean diastolic blood pressure, the mean systolic blood pressure and the mean pulse, before and after sessions of guided mindfulness and guided yoga. (* p < 0.05).

Mindfulness decreased the systolic BP, –1.13% (ns), increased diastolic BP, +1.75% ( p < 0.05) and decreased the pulse –5.75% ( p < 0.05). Medicine knows that systolic blood pressure (the top number or highest blood pressure when the heart is squeezing and pushing the blood around the body) is more important than diastolic blood pressure (the bottom number or lowest blood pressure between heartbeats) because it gives the best idea of the risk of having a stroke or heart attack. In this view, the significant reduction of systolic BP after mindfulness is an important result.

Moreover, the difference between systolic and diastolic BP is called pulse pressure. For example, 120 systolic minus 60 diastolic equals a pulse pressure of 60. It is also known that a pulse pressure greater than 60 can be a predictor of heart attacks or other cardiovascular diseases, while a low pulse pressure (less than 40) may indicate poor heart function. In our study, pulse pressure was lower after mindfulness (we had both a significant reduction in systolic BP and an increase in diastolic BP), but its value was higher than 40 (42.69 mean difference before the mindfulness and 40.48 mean difference after the mindfulness), suggesting that this result can also be considered clinically positive.

During yoga, there was a decrease in systolic BP by −5.81% ( p < 0.05), diastolic BP by −1.93% (ns) and increase in pulse +8.06% ( p < 0.05). Yoga appears to be more effective than mindfulness at decreasing systolic and diastolic blood pressure, although mindfulness seems to be more effective than yoga for decreasing the pulse due to the activity involved in yoga.

5.2. Physiological Stress Level Detection with Wearables by Using Context Labels as the Class Label

We tested our system by using the known context labels of sessions as the class label. We used Lecture (mild stress), Yoga and Mindfulness (relax) and Presentation in front of the board of juries (high stress) as class labels by examining perceived stress self-report answers in Figure 6 . We investigated the success of relaxation methods, different modalities and finding the presenter.

5.2.1. Effect of Different Physiological Signals on Stress Detection

We evaluated the effect of using the interbeat-interval, the skin conductance and the accelerometer signals separately and in a combined manner on two and three class classification performance. These classes are mild stress, high stress and relax states from mindfulness and yoga sessions. The results are shown in Table 7 , Table 8 and Table 9 . For the three-class classification problem, we achieved a maximum accuracy of 72% by using MLP on only HRV features and 86.61% with only accelerometer features using the Random Forest classifier and 85.36% accuracy combination of all features with LDA classifier (see Table 7 ). The difficulty in this classification task is a similar physiological reaction to relax and mild stress situations. However, since the main focus of our study is to discriminate high stress from other classes to offer relaxation techniques in this state, it did not affect our system performance. We also investigated high-mild stress and high stress-relax 2-class classification performance. For the discrimination of high and mild stress, HRV outperformed other signals with 98% accuracy using MLP (see Table 8 ). In the high stress-relax 2-class problem, only HRV features with RF achieved a maximum accuracy of 86%, whereas ACC features with MLP achieved a maximum of 94% accuracy. In this problem, the combination of all signals with RF achieved 92% accuracy which is the best among all classifiers (see Table 9 ). For all models, EDA did not perform well. This might be caused by the loose contact with EDA electrodes in the strap due to loosely worn smartbands.

Effect of different modalities and their combination on the system performance. Note that the number of classes is fixed at 3 (high stress, mild stress and relax).

Effect of different modalities and their combination on the system performance. Note that the number of classes is fixed at 2 (high stress and mild stress).

Effect of different modalities and their combination on the system performance. Note that the number of classes is fixed at 2 (high stress and relax).

5.2.2. Effectiveness of Yoga, Mindfulness and Mobile Mindfulness (Pause)

We applied three different relaxation methods to manage stress levels of individuals. In order to measure the effectiveness of each method, we examined how easily these physiological signals in the relaxation sessions can be separated from high stress presentations. If it can be separated from high stress levels with higher classification performance, it could be inferred that they are more successful at reducing stress. As seen in Table 10 and Table 11 , mobile mindfulness has lower success in reducing stress levels. Yoga has the highest classification performance with both HR and EDA signals.

The classification accuracy of the relaxation sessions using stress management methods and stressful sessions using EDA.

The classification accuracy of the relaxation sessions using stress management methods and stressful sessions using HRV.

6. Conclusions

In this study, by using our automatic stress detection system with the use of Empatica-E4 smart-bands, we detected stress levels and suggested appropriate relaxation methods (i.e., traditional or mobile) when high stress levels are experienced. Our stress detection framework is unobtrusive, comfortable and suitable for use in daily life and our relaxation method suggestion system makes its decisions based on the physical activity-related context of a user. To test our system, we collected eight days of data from 16 individuals participating in an EU research project training event. Individuals were exposed to varied stressful and relaxation events (1) training and lectures (mild stress), (2) yoga, mindfulness and mobile mindfulness (PAUSE) (relax) and (3) were required to give a moderated presentation (high stress). The participants were from different countries with diverse cultures.

In addition, 1440 h of mobile data (12 h in a day) were collected during this eight-day event from each participant measuring their stress levels. Data were collected during the training sessions, relaxation events and the moderated presentation and during their free time for 12 h in a day, demonstrating that our study monitored daily life stress. EDA and HR signals were collected to detect physiological stress and a combination of different modalities increased stress detection, performance and provided the most discriminative features. We first applied James Gross ER model in the context of stress management and measured the blood pressure during the ER cycle. When the known context was used as the label for stress level detection system, we achieved 98% accuracy for 2-class and 85% accuracy for 3-class. Most of the studies in the literature only detect stress levels of individuals. The participants’ stress levels were managed with yoga, mindfulness and a mobile mindfulness application while monitoring their stress levels. We investigated the success of each stress management technique by the separability of physiological signals from high-stress sessions. We demonstrated that yoga and traditional mindfulness performed slightly better than the mobile mindfulness application. Furthermore, this study is not without limitations. In order to generalize the conclusions, more experiments based on larger sample groups should be conducted. As future work, we plan to develop personalized perceived stress models by using self-reports and test our system in the wild. Furthermore, attitudes in the psychological field constitute a topic of utmost relevance, which always play an instrumental role in the determination of human behavior [ 58 ]. We plan to design a new experiment which accounts for the attitudes of participants towards relaxation methods and their effects on the performance of stress recognition systems.

Acknowledgments

We would like to show our gratitude to the Affectech Project for providing us the opportunity for the data collection in the training event and funding the research.

Author Contributions

Y.S.C. is the main editor of this work and made major contributions in data collection, analysis and manuscript writing. H.I.-S. made valuable contributions in both data collection and manuscript writing. She was the yoga and mindfulness instructor in the event and contributed the related sections regarding traditional and mobile methods. She also led the blood pressure measurement efforts before and after relaxation methods. D.E. and N.C. contributed equally to this work in design, implementation, data analysis and writing the manuscript. J.F.-Á., C.R. and G.R. contributed the experiment design and provided valuable insights into both emotion regulation theory. They also contributed to the related sections in the manuscript. C.E. provided invaluable feedback and technical guidance to interpret the design and the detail of the field study. He also performed comprehensive critical editing to increase the overall quality of the manuscript. All authors have read and agreed to the published version of the manuscript.

This work has been supported by AffecTech: Personal Technologies for Affective Health, Innovative Training Network funded by the H2020 People Programme under Marie Skłodowska-Curie Grant Agreement No. 722022. This work is supported by the Turkish Directorate of Strategy and Budget under the TAM Project number DPT2007K120610.

Conflicts of Interest

The authors declare no conflict of interest.

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How to Manage Your Anxiety

• Charlotte Lieberman

We can all be more compassionate with ourselves.

We all feel anxiety at times. It becomes problematic when it feels unmanageable, which means different things for different people.

• The key to managing anxiety is learning to identify it, understand it, and respond to it with self-compassion.
• Mindfulness techniques like breath work, meditation, and yoga can reduce anxiety and improve cognition.
• Routines help reduce general feelings of anxiety and are often effective antidotes for those with more serious mental health disorders.
• If your anxiety is holding you back, simply imagining success, and encouraging yourself as you would a friend, has also been correlated with motivation and the achievement of goals.

Where your work meets your life. See more from Ascend here .

When I was nine, I was diagnosed with anxiety disorder by my first-ever therapist. My parents dragged me into treatment after repeatedly catching me cleaning their bathroom. I didn’t mind, but I was confused. I didn’t see anything wrong with what I was doing: organizing their medicine cabinet by color and size, throwing out expired antibiotics and sticky bottles of cough syrup. My favorite part was wiping down the sink with warm water, feeling my worries wash away with stubble and soap scum. Cleaning gave me the sense that I could find inner order among the outer chaos — our cramped New York apartment, murmurs of my parents’ struggling marriage, the growing pains of adolescence.

• CL Charlotte Lieberman is a writer, marketing consultant, and certified life coach/hypnotist. You can find her work in The New York Times , The Harvard Business Review , Marie Claire , and elsewhere. Follow her on Twitter @clieberwoman.

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Essay on Stress Management

500 words essay on stress management.

Stress is a very complex phenomenon that we can define in several ways. However, if you put them together, it is basically the wear and tear of daily life. Stress management refers to a wide spectrum of techniques and psychotherapies for controlling a person’s stress level, especially chronic stress . If there is effective stress management, we can help one another break the hold of stress on our lives. The essay on stress management will throw light on the very same thing.

Identifying the Source of Stress

The first step of stress management is identifying the source of stress in your life. It is not as easy as that but it is essential. The true source of stress may not always be evident as we tend to overlook our own stress-inducing thoughts and feelings.

For instance, you might constantly worry about meeting your deadline. But, in reality, maybe your procrastination is what leads to this stress than the actual deadline. In order to identify the source of stress, we must look closely within ourselves.

If you explain away stress as temporary, then it may be a problem. Like if you yourself don’t take a breather from time to time, what is the point? On the other hand, is stress an integral part of your work and you acknowledging it like that?

If you make it a part of your personality, like you label things as crazy or nervous energy, you need to look further. Most importantly, do you blame the stress on people around you or the events surrounding you?

It is essential to take responsibility for the role one plays in creating or maintaining stress. Your stress will remain outside your control if you do not do it.

Strategies for Stress Management

It is obvious that we cannot avoid all kinds of stress but there are many stressors in your life which you can definitely eliminate. It is important to learn how to say no and stick to them.  Try to avoid people who stress you out.

Further, if you cannot avoid a stressful situation, try altering it. Express your feelings don’t bottle them up and manage your time better. Moreover, you can also adapt to the stressor if you can’t change it.

Reframe problems and look at the big picture. Similarly, adjust your standards and focus on the positive side. Never try to control the uncontrollable. Most importantly, make time for having fun and relaxing.

Spend some time with nature, go for a walk or call a friend, whatever pleases you.  You can also try working out, listening to music and more. As long as it makes you happy, never give up.

Get the huge list of more than 500 Essay Topics and Ideas

Conclusion of the Essay on Stress Management

All in all, we can control our stress levels with relaxation techniques that evoke the relaxation response of our body. It is the state of restfulness that is the opposite of the stress response. Thus, when you practice these techniques regularly, you can build your resilience and heal yourself.

FAQ of Essay on Stress Management

Question 1: What is the importance of stress management?

Answer 1: Stress management is very efficient as it helps in breaking the hold which stress has on our lives. Moreover, you can also become happy, healthy and more productive because of it. The ultimate goal should be to live a balanced life and have the resilience to hold up under pressure.

Question 2: Give some stress management techniques.

Answer 2: There are many stress management techniques through which one can reduce stress in their lives. One can change their situation or their reaction to it. We can try by altering the situation. If not, we can change our attitudes towards it. Remember, accept things that you cannot change.

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An Overview of Stress Management

Elizabeth Scott, PhD is an author, workshop leader, educator, and award-winning blogger on stress management, positive psychology, relationships, and emotional wellbeing.

Carly Snyder, MD is a reproductive and perinatal psychiatrist who combines traditional psychiatry with integrative medicine-based treatments.

Stress Management

Stress management is the range of techniques, strategies, and therapies designed to help people control their stress. This can include lowering acute stress, but it is often aimed at lowering chronic stress to improve health, happiness, and overall well-being. Stress management strategies may include:

• Deep breathing
• Eating a healthy diet
• Getting enough sleep
• Guided visualization
• Hobbies and leisure activities
• Mindfulness
• Positive thinking
• Progressive muscle relaxation
• Psychotherapy
• Social support

We all experience stress in our lives. Because many health problems are caused or influenced by stress, it's essential to understand how stress affects your body and learn effective stress management techniques to make stress work for you rather than against you.

What Is Stress?

Stress is your body’s response to changes in your life. Because life involves constant change—ranging from everyday, routine changes like commuting from home to work to adapting to major life changes like marriage, divorce, or death of a loved one—there is no avoiding stress.  

Your goal shouldn't be to eliminate all stress but to eliminate unnecessary stress and effectively manage the rest. There are some common causes of stress that many people experience, but each person is different.

Stress can come from many sources, which are known as " stressors ." Because our experience of what is considered "stressful" is created by our unique perceptions of what we encounter in life (based on our own mix of personality traits, available resources, and habitual thought patterns), a situation may be perceived as "stressful" by one person and merely "challenging" by someone else.

Simply put, one person's stress trigger may not register as stressful to someone else. That said, certain situations tend to cause more stress in most people and can increase the risk of burnout .

For example, when we find ourselves in situations where there are high demands on us but we little control and few choices, we are likely to experience stress. We might also feel stress when we don't feel equipped; where we may be harshly judged by others; and where consequences for failure are steep or unpredictable.

Many people are stressed by their jobs , relationships , financial issues , and health problems, as well as more mundane things like clutter or busy schedules . Learning skills to cope with these stressors can help reduce your experience of stress.  

Press Play for Advice On Dealing With Money Issues

Hosted by therapist Amy Morin, LCSW, this episode of The Verywell Mind Podcast shares what to do when financial stress is impacting your mental health. Click below to listen now.

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Just as stress is perceived differently by each of us, stress affects us all in ways that are unique to us. One person may experience headaches, while another may find stomach upset is a common reaction, and a third may experience any of a number of other symptoms.

While we all react to stress in our own ways, there is a long list of commonly experienced effects of stress that range from mild to life-threatening. Stress can affect immunity, which can impact virtually all areas of health. Stress can affect mood in many ways as well. Creating a stress management plan is often one part of a plan for overall wellness.

If you find yourself experiencing physical symptoms you think may be related to stress, talk to your doctor to be sure you are doing what you can to safeguard your health. Symptoms that may be exacerbated by stress are not "all in your head" and need to be taken seriously.

Stress can be effectively managed in many different ways. The best stress management plans usually include a mix of stress relievers that address stress physically and psychologically and help to develop resilience and coping skills.

7 Highly Effective Stress Relievers

Use quick stress relievers.

Some stress relief techniques can work in just a few minutes to calm the body's stress response. These techniques offer a "quick fix" that helps you feel calmer at the moment, and this can help in several ways.

When your stress response is not triggered, you may approach problems more thoughtfully and proactively. You may be less likely to lash out at others out of frustration, which can keep your relationships healthier. Nipping your stress response in the bud can also keep you from experiencing chronic stress.

Quick stress relievers like breathing exercises, for example, may not build your resilience to future stress or minimize the stressors that you face. But they can help calm the body's physiology once the stress response is triggered.  

Develop Stress-Relieving Habits

Some techniques are less convenient to use when you are in the middle of a stressful situation. But if you practice them regularly, they can help you manage stress in general by being less reactive to it and more able to reverse your stress response quickly and easily.

Long-term healthy habits, like exercise or regular meditation , can help to promote resilience toward stressors if you make them a regular part of your life.   Communication skills and other lifestyle skills can be helpful in managing stressors and changing how we feel from "overwhelmed" to "challenged" or even "stimulated."

Eliminate Stressors When You Can

You may not be able to completely eliminate stress from your life or even the biggest stressors, but there are areas where you can minimize it and get it to a manageable level.

Any stress that you can cut out can minimize your overall stress load. For example, ending even one toxic relationship can help you more effectively deal with other stress you experience because you may feel less overwhelmed.  

Discovering a wide variety of stress management techniques, and then choosing a mix that fits your needs, can be a key strategy for effective stress relief.

Stress FAQs

There are a number of common questions that you might ask about stress and stress management.

Is All Stress Harmful to Health?

There are several different types of stress , and not all are harmful. Eustress , for example, is a positive form of stress. But chronic stress has been linked to many serious health issues and is the type of negative stress most often mentioned in the news.   While we want to manage or eliminate negative stress, we also want to keep positive forms of stress in our lives to help us remain vital and alive.

However, if we experience too much stress in our lives, even "good" stress can contribute to excessive stress levels, which can lead to feeling overwhelmed or having your stress response triggered for too long. This is why it is still important to learn to relax your body and mind periodically and cut down on unnecessary stress whenever possible.

How Can I Tell When I’m Too Stressed?

Stress affects us all in different ways, not all of which are negative. In fact, the stress of an exciting life can actually serve as a good motivator and keep things interesting. When stress levels get too intense, however, there are some stress symptoms that many people experience.

For example, headaches, irritability, and "fuzzy thinking" can all be symptoms that you’re under too much stress.   While not everybody who’s under stress will experience these specific symptoms, many will.

If you find that you don't realize how stressed you are until you are overwhelmed, it's important to learn to notice your body's subtle cues and your own behavior, almost like an outside observer might. To notice how your body is reacting to stress, you can try this body scan meditation (it helps relax at the same time).

What Can I Do When I Feel Overwhelmed?

We all feel overwhelmed from time to time; that’s normal. While it’s virtually impossible to eliminate times when events conspire and the body’s stress response is triggered, there are ways that you can quickly reverse your body’s reaction to stress, buffering the damage to your health and keeping your thinking clear, so you can more effectively deal with what’s going on in the moment.

Is There a Way to Be Less Affected by Stress?

By practicing regular stress management techniques, you can eliminate some of the stress you feel and make yourself more resilient in the face of stress in the future. There are several things you can try, ranging from a morning walk to an evening journaling practice to just making more time for friends. The trick is to find something that fits with your lifestyle and personality, so it’s easier to stick with.

National Institute of Mental Health. 5 Things You Should Know About Stress .

Ma X, Yue ZQ, Gong ZQ, et al. The effect of diaphragmatic breathing on attention, negative affect and stress in healthy adults .  Front Psychol . 2017;8:874. doi:10.3389/fpsyg.2017.00874

National Center for Complementary and Integrative Medicine. Mind and Body Approaches for Stress: What the Science Says . 2020.

Bota PG, Miropolskiy E, Nguyen V. Stop caretaking the borderline or narcissist: How to end the drama and get on with life .  Ment Illn . 2017;9(1):6985. doi:10.4081/mi.2017.6985

Lehrer PM, Woolfolk RL, Sime WE. Principles and Practice of Stress Management . 3rd edition. New York: The Guilford Press; 2007.

By Elizabeth Scott, PhD Elizabeth Scott, PhD is an author, workshop leader, educator, and award-winning blogger on stress management, positive psychology, relationships, and emotional wellbeing.

7 Ideas for Managing Stress and Anxiety

Effective ways to manage your response to these challenging times..

Posted September 9, 2021 | Reviewed by Vanessa Lancaster

• What Is Anxiety?
• Find a therapist to overcome anxiety
• 62% of Americans feel more anxious than in the previous year, which is double that of similar polls during the last three years.
• Slow, controlled breathing, meditation, scheduled worry time, and exercise can help manage stress and anxiety.
• Positive self-talk, activities that promote the flow state, and social engagement are effective stress management tools.

There is no end to suggestions published in print or online for managing or reducing stresses and the anxiety that may come with them, especially with Covid, political, climate, and money issues that affect so many. A poll in 2020 showed that 62% of Americans feel more anxious than they did at that time in the previous year, marking a substantial increase of about double that of similar polls in the previous three years, in which the number ranged from 32% to 39%.

Below is a summary of suggestions for managing stress and anxiety. (This is not medical advice, and it comes with no guarantees. For anxiety, sleep problems, depression , and other responses to stress, it would be good to see a primary care doctor to rule out any medical factors and see a licensed mental health professional if such problems are more prominent.)

Slow, controlled breathing. It can help quiet the nervous system . This is a method with a neuroscience background. During a slowed-down exhalation, the neural network that helps to rest and digest—the parasympathetic system, which includes nerve fibers in the vagus nerve —tends to oppose and reduce the emergency responses of fight, flight, or freeze controlled by the sympathetic nervous system and transmitted by norepinephrine and epinephrine. This calming method has been taught to first responders and military personnel facing threatening situations,

Meditation . Meditating is so popular that it needs no introduction. Combining it with slow, controlled breathing can be even better in some types of yoga. Lowering anxiety, muscle tension, and blood pressure are some of the physical and mental benefits that researchers have reported.

Scheduled worry-time. One recommendation is to use a notebook to write down topics for worrying as they arise, rather than dwelling on them. Then, schedule a time to think about them, say from 5:00 to 5:15, for example, and think of ways to deal with them as much as possible, especially about acting on things you can control.

Positive self-talk . People may think unnecessarily about worst-case scenarios, even catastrophes that are unlikely to happen. Analyzing them rationally and telling yourself about a more constructive response can help. This rethinking or re-framing can be part of the cognitive-behavioral approach to psychotherapy . Sports provide examples of mental resilience even during temporary failures: it has been pointed out that even a home run hero in baseball can strike out most of the times at-bat.

Physical exercise. People who work out or even take brisk walks 2-5 times a week often say they feel calmer, as much as after an anti-anxiety pill. High-intensity interval training, with short effortful exercises separated by rest periods, is another approach, especially for those with less patience.

Flow-promoting activity. It could be controlling a flight simulator, planting garden bulbs, painting a picture, or photographing birds. These activities take concentration and physical engagement, doing things step-by-step outside of work-related, home management , or routine tasks. The "flow-state" promoted by such activities was first described in a 1975 book by psychologist Mihály Csíkszentmihályi, an engaging writer with a name challenging to pronounce.

Social engagement . Talking or doing things with friends or family can be good buffers against everyday stresses. That’s one reason small communities can be resilient. All the more so when there is an opportunity of volunteering to help others.

To be sure, the crises of Covid, climate change , and political turmoil are real; these suggestions for lifestyle changes are no substitutes for community actions to address viruses, wildfires, hurricanes, or toxic politicians. In the meantime, these are some types of coping skills and activities that can be sources of help.

But wait! There are more. We can add two more approaches to managing stress and the anxiety that may result:

• Medication if needed . It is typically prescribed by a qualified health care professional, usually an M.D. psychiatrist or primary care provider.
• Limiting media . Whether news, social media , or emails, you have a right to limit it to what you need to know and when. Some suggest avoiding it first thing in the morning.

More details about these and other methods can be found in The Anxiety and Phobia Workbook , a user-friendly handbook by Edmund Bourne on diagnosis and treatment. As he points out, some anxiety is normal, several different types of anxiety disorders can be diagnosed, and anxiety is only one of the possible reactions to stress. We hope the ideas outlined here can be a helpful introduction.

Robert A. Lavine, PhD is a clinical psychologist, GWU School of Medicine Adjunct Assoc. Professor, writer for The Atlantic , and author of How the Brain Connects to Cognitive & Behavioral Change .

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Essay about Anxiety and Stress

Essay about anxiety and stress

A lot of people suffer from anxiety but never know how to deal with it. It can be the most discouraging and tiring feeling in the world, however, there are many ways you can beat your nerves down until they become nothing more than a clumsy memory.

What is anxiety?

Anxiety is so common that we all have either suffered through or had friends who did at some point. I am one to always say that having an anxious moment sucks because it’s just not fun when those feelings take over – yet even though being overwhelmed by them feels like defeat doesn’t mean anything will come out of this battle for us psychologically speaking as long as enough action has been taken against these distressing thoughts before they get any worse!

The most common form of this problem comes in the shape of panic attacks, where humans feel their heart and breathing rate increase for no apparent reason. It can be so maddening that it leaves us feeling discouraged, helpless, or tiring with nothing to look forward to but another attack coming on like waves crashing against our shoreline; only to leave destruction behind when they recede back out into the ocean once more.

However, there are ways we as human beings can fight these debilitating effects by seeking medical attention from professionals who have dealt with anxiety before such as psychologists or psychiatrists alike because not everyone wants medication constantly flowing through them all day long just waiting around until you’re finally

Difference between anxiety and stress

Anxiety is the feeling of being worried and tense. Stress is a mental or emotional strain on an individual. Anxiety and stress are two different things, but they can be related to one another. Many people experience anxiety because of their everyday stresses at work, school, or home life. It’s important to know the difference between anxiety and stress so that you can get help if you need it!

Stress is a powerful force. Under its pressure, people are prone to mental and physical ailments including irritability, anger, fatigue, muscle pain and digestive troubles as well as problems sleeping. The experience of stress can be much more intense than that experienced by those who have anxiety; according to some psychologists the worries associated with anxiety cannot dissipate even when there’s no immediate reason for them in particular circumstances – they persist indefinitely or until something changes their course.

Anxiety Symptoms

Watch out! anxiety symptoms include excessive worry, restlessness, and keyed-up feelings. The anxiety has many other side effects such as difficulty concentrating or mind going blank, irritability, muscle tension, and sleep disturbance (difficulty falling asleep).

These are only a few of the multitude of unpleasant things that happen when you experience an anxiety attack. I consulted my primary care physician who suggested some ways to help alleviate these problems by getting a watch so we can keep track of time in order for me not to lose focus on anything else happening around me at any given moment because sometimes our bodies just need us to relax more than usual if it’s been continuously stressed from something like work or school.

Social anxiety

There are different types of anxiety panic disorder, social anxiety disorder, agoraphobia, etc. the most common one is social anxiety.

Social anxiety disorder is a condition where people feel uncomfortable in social settings. They worry that others will judge them, ridicule or embarrass them if they make mistakes and this can lead to feelings of shame, inadequacy, and depression.

The brain plays tricks on you when it comes to anything involving other humans; either making the situation seem worse than reality or overselling your own strengths so as not look vulnerable which only leads to more stress because now there are false impressions being made out there about us by our own minds!

Anxiety Causes

It is estimated that about 15% of the world’s population suffers from anxiety. It can manifest in many different ways, and for some people, it can be debilitating. Anxiety disorders can be triggered by a number of factors. These may include genetics, environmental stress, poverty, childhood trauma, or drug withdrawal, and misuse among others.

Living with anxiety

Many people living with anxiety do not know how to handle it. The first thing you should do is talk to your doctor, explain your symptoms, and figure out what type of treatment may be best for you. There are many different types of treatments available so it is important to find one that works for you specifically. Here are a few popular treatments: therapy, medication, relaxation techniques like meditation or yoga, exercise (which has been shown in studies to reduce both physical and mental stress). The doctor will identify that what kind of anxiety are you suffering from.

Living with anxiety can be difficult. The good news is that there are many resources available to help you learn more about this condition and find ways to reduce your symptoms. If you have a loved one who suffers from anxiety, it may also be helpful for them if you understand what they’re going through so that you can better support them during their journey back to health.

Here are some simple tips to avoid anxiety and stress.

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• Diseases & Conditions
• Anxiety disorders

You may start by seeing your primary care provider to find out if your anxiety could be related to your physical health. He or she can check for signs of an underlying medical condition that may need treatment.

However, you may need to see a mental health specialist if you have severe anxiety. A psychiatrist is a medical doctor who specializes in diagnosing and treating mental health conditions. A psychologist and certain other mental health professionals can diagnose anxiety and provide counseling (psychotherapy).

To help diagnose an anxiety disorder, your mental health provider may:

• Give you a psychological evaluation. This involves discussing your thoughts, feelings and behavior to help pinpoint a diagnosis and check for related complications. Anxiety disorders often occur along with other mental health problems — such as depression or substance misuse — which can make diagnosis more challenging.
• Compare your symptoms to the criteria in the DSM-5. Many doctors use the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, to diagnose an anxiety disorder.
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Our caring team of Mayo Clinic experts can help you with your anxiety disorders-related health concerns Start Here

The two main treatments for anxiety disorders are psychotherapy and medications. You may benefit most from a combination of the two. It may take some trial and error to discover which treatments work best for you.

• Psychotherapy

Also known as talk therapy or psychological counseling, psychotherapy involves working with a therapist to reduce your anxiety symptoms. It can be an effective treatment for anxiety.

Cognitive behavioral therapy (CBT) is the most effective form of psychotherapy for anxiety disorders. Generally a short-term treatment, CBT focuses on teaching you specific skills to improve your symptoms and gradually return to the activities you've avoided because of anxiety.

CBT includes exposure therapy, in which you gradually encounter the object or situation that triggers your anxiety so you build confidence that you can manage the situation and anxiety symptoms.

Medications

Several types of medications are used to help relieve symptoms, depending on the type of anxiety disorder you have and whether you also have other mental or physical health issues. For example:

• Certain antidepressants are also used to treat anxiety disorders.
• An anti-anxiety medication called buspirone may be prescribed.
• In limited circumstances, your doctor may prescribe other types of medications, such as sedatives, also called benzodiazepines, or beta blockers. These medications are for short-term relief of anxiety symptoms and are not intended to be used long term.

Talk with your doctor about benefits, risks and possible side effects of medications.

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Lifestyle and home remedies

While most people with anxiety disorders need psychotherapy or medications to get anxiety under control, lifestyle changes also can make a difference. Here's what you can do:

• Keep physically active. Develop a routine so that you're physically active most days of the week. Exercise is a powerful stress reducer. It may improve your mood and help you stay healthy. Start out slowly and gradually increase the amount and intensity of your activities.
• Avoid alcohol and recreational drugs. These substances can cause or worsen anxiety. If you can't quit on your own, see your doctor or find a support group to help you.
• Quit smoking and cut back or quit drinking caffeinated beverages. Both nicotine and caffeine can worsen anxiety.
• Use stress management and relaxation techniques. Visualization techniques, meditation and yoga are examples of relaxation techniques that can ease anxiety.
• Make sleep a priority. Do what you can to make sure you're getting enough sleep to feel rested. If you aren't sleeping well, see your doctor.
• Eat healthy. Healthy eating — such as focusing on vegetables, fruits, whole grains and fish — may be linked to reduced anxiety, but more research is needed.

Alternative medicine

Several herbal remedies have been studied as a treatment for anxiety, but more research is needed to understand the risks and benefits. Herbal and dietary supplements aren't monitored by the Food and Drug Administration (FDA) the same way medications are. You can't always be certain of what you're getting and whether it's safe. Some of these supplements can interfere with prescription medications or cause dangerous interactions.

Before taking herbal remedies or dietary supplements, talk to your doctor to make sure they're safe for you and won't interact with any medications you take.

Coping and support

To cope with an anxiety disorder, here's what you can do:

• Learn about your disorder. Talk to your doctor or mental health provider. Find out what might be causing your specific condition and what treatments might be best for you. Involve your family and friends and ask for their support.
• Stick to your treatment plan. Take medications as directed. Keep therapy appointments and complete any assignments your therapist may give you. Consistency can make a big difference, especially when it comes to taking your medication.
• Take action. Learn what triggers your anxiety or causes you stress. Practice the strategies you developed with your mental health provider so you're ready to deal with anxious feelings in these situations.
• Keep a journal. Keeping track of your personal life can help you and your mental health provider identify what's causing you stress and what seems to help you feel better.
• Join an anxiety support group. Remember that you aren't alone. Support groups offer compassion, understanding and shared experiences. The National Alliance on Mental Illness and the Anxiety and Depression Association of America provide information on finding support.
• Learn time management techniques. You can reduce anxiety by learning how to carefully manage your time and energy.
• Socialize. Don't let worries isolate you from loved ones or activities.
• Break the cycle. When you feel anxious, take a brisk walk or delve into a hobby to refocus your mind away from your worries.

Preparing for your appointment

You may start by seeing your primary care provider. He or she may refer you to a mental health professional.

What you can do

Before your appointment, make a list of:

• Your anxiety symptoms. Note when they occur, whether anything seems to make them better or worse, and how much they affect your day-to-day activities and interactions.
• What causes you stress. Include any major life changes or stressful events you've dealt with recently. Also note any traumatic experiences you've had in the past or as a child.
• Any family history of mental health problems. Note if your parents, grandparents, siblings or children have struggled with any mental health problems.
• Any other health problems you have. Include both physical conditions and mental health issues.
• All medications you're taking. Include any medications, vitamins, herbs or other supplements, and the doses.
• Questions to ask your doctor to make the most of your appointment.

Some basic questions to ask your doctor include:

• What's the most likely cause of my anxiety?
• Are there other possible situations, psychological issues or physical health problems that could be causing or worsening my anxiety?
• Do I need any tests?
• Should I see a psychiatrist, psychologist or other mental health provider?
• What type of therapy might help me?
• Would medication help? If so, is there a generic alternative to the medicine you're prescribing?
• In addition to treatment, are there any steps I can take at home that might help?
• Do you have any educational materials that I can have? What websites do you recommend?

Don't hesitate to ask other questions during your appointment.

What to expect from your doctor

Your doctor will likely ask you several questions, such as:

• What are your symptoms, and how severe are they? How do they impact your ability to function?
• Have you ever had a panic attack?
• Do you avoid certain things or situations because they make you anxious?
• Have your feelings of anxiety been occasional or continuous?
• When did you first begin noticing your feelings of anxiety?
• Does anything in particular seem to trigger your anxiety or make it worse?
• What, if anything, seems to improve your feelings of anxiety?
• What traumatic experiences have you had recently or in the past?
• What, if any, physical or mental health conditions do you have?
• Do you take any prescription drugs?
• Do you regularly drink alcohol or use recreational drugs?
• Do you have any blood relatives who have anxiety or other mental health conditions, such as depression?

Preparing and anticipating questions will help you make the most of your time.

• Anxiety disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://dsm.psychiatryonline.org. Accessed Feb. 26, 2018.
• Anxiety disorders. National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml. Accessed Feb. 26, 2018.
• Brown A. Allscripts EPSi. Mayo Clinic, Rochester, Minn. March 5, 2018.
• Anxiety disorders. National Alliance on Mental Illness. https://www.nami.org/Learn-More/Mental-Health-Conditions/Anxiety-Disorders/Overview. Accessed Feb. 25, 2018.
• Help with anxiety disorders. American Psychiatric Association. https://www.psychiatry.org/patients-families/anxiety-disorders/what-are-anxiety-disorders. Accessed Feb. 28, 2018.
• Reinhold JA, et al. Pharmacological treatment for generalized anxiety disorder in adults: An update. Expert Opinion in Pharmacotherapy. 2015;16:1669.
• Bandelow B, et al. Efficacy of treatments for anxiety disorders: A meta-analysis. International Clinical Psychopharmacology. 2015;30:183.
• Find support. National Alliance on Mental Illness. https://www.nami.org/Find-Support. Accessed Feb. 26, 2018.
• Bazzan AJ, et al. Current evidence regarding the management of mood and anxiety disorders using complementary and alternative medicine. Expert Review of Neurotherapeutics. 2014;14:411.
• Natural medicines in the clinical management of anxiety. Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed Feb. 26, 2018.
• Sarris J, et al. Plant-based medicines for anxiety disorders, Part 2: A review of clinical studies with supporting preclinical evidence. CNS Drugs. 2013;27:301.
• Bystritsky A. Complementary and alternative treatments for anxiety symptoms and disorders: Herbs and medications. https://www.uptodate.com/contents/search. Accessed Feb. 26, 2018.
• Bystritsky A. Pharmacotherapy for generalized anxiety disorder in adults. https://www.uptodate.com/contents/search. Accessed Feb. 26, 2018.
• Sawchuk CN (expert opinion). Mayo Clinic, Rochester, Minn. March 21, 2018.

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What is stress management?

• Identify the causes
• Replace unhealthy coping strategies
• Practice the 4 As

Avoid unnecessary stress

Alter the situation, adapt to the stressor.

• Accept the things you can't change

Move more during your day

• Time management
• Reach out and connect

Make time for fun and relaxation

Maintain balance with a healthy lifestyle.

• Reducing stress in the moment

Stress Management Techniques & Strategies to Deal with Stress

While it may seem like there’s nothing you can do about stress in your life, there are healthy steps you can take to destress and regain control.

It may seem like there’s nothing you can do about stress—no way to avoid it and no way to de-stress completely when it hits. The bills won’t stop coming, there will never be more hours in the day, and your work and family responsibilities will always be demanding. But the truth is, you have a lot more control over stress than you may think. In fact, the simple realization that you’re in control of your life is the foundation of stress management.

Managing stress is all about taking charge: of your thoughts, emotions, schedule, environment, and the way you deal with problems. The ultimate goal is a balanced life, with time for work, relationships, relaxation, and fun—plus the ability to hold up under pressure and meet challenges head on.

Stress management involves using various techniques and coping strategies to improve the way you react to stressful things in your life and build resilience . But it’s not one-size-fits-all. That’s why it’s important to experiment and find out what works best for you. Whether you’re looking to reduce your overall stress levels, avoid unnecessary stressors in your life, or deal with stress in the moment, the following stress management techniques and strategies can help.

Why does stress management matter?

If you’re living with high levels of stress, you’re putting your entire well-being at risk. Stress wreaks havoc on your emotional equilibrium, as well as your overall physical and mental health. It narrows your ability to think clearly, function effectively, and enjoy life.

Identify the causes of stress in your life

Stress management starts with identifying the sources of stress in your life. This isn’t as straightforward as it sounds. While it’s easy to identify major stressors such as changing jobs, moving, or going through a divorce, pinpointing the sources of chronic stress can be more complicated.

It’s all too easy to overlook how your own thoughts, feelings, and behaviors contribute to your everyday stress levels. Sure, you may know that you’re constantly worried about work deadlines, but maybe it’s your procrastination, rather than the actual job demands, that is causing the stress.

To identify what’s really stressing you out, look closely at your habits, attitude, and excuses:

• Do you explain away stress as temporary (“I just have a million things going on right now”) even though you can’t remember the last time you took a breather?
• Do you define stress as an integral part of your work or home life (“Things are always crazy around here”) or as a part of your personality (“I have a lot of nervous energy, that’s all”)?
• Do you blame your stress on other people or outside events, or view it as entirely normal and unexceptional?

Until you accept responsibility for the role you play in creating or maintaining it, your stress level will remain outside your control.

Keep a stress journal

A stress journal can help you identify the regular stressors in your life and the way you deal with them. Each time you feel stressed, make a note of it in your journal or use a stress tracker on your phone. As you keep a daily log, you will begin to see patterns and common themes. Write down:

• What caused your stress (make a guess if you’re unsure).
• How you felt, both physically and emotionally.
• How you acted in response.
• What you did to make yourself feel better.

Replace unhealthy coping strategies with healthy ones

Think about the ways you currently manage and cope with stress in your life. Your stress journal can help you identify them. Are your coping strategies healthy or unhealthy? Many of us cope with stress in ways that make us feel better temporarily—but compound the problem in the long run.

Unhealthy ways of dealing with stress

• Using alcohol or drugs to relax .
• Bingeing on junk or comfort food.
• Zoning out for hours on your phone or TV.
• Withdrawing from friends, family, and social activities.
• Sleeping too much.
• Filling up every minute of the day to avoid facing problems.
• Taking out your stress on others
• Procrastinating.

If your methods of coping with stress aren’t contributing to your greater emotional and physical health, it’s time to find healthier ones. No single method works for everyone or in every situation, so experiment with different stress management techniques and strategies. Focus on what makes you feel calm and in control.

Practice the 4 As of stress management

There are many healthy ways to reduce stress or cope with its effects, but they all require change. You can either change the situation or change your reaction. When deciding which option to choose, it’s helpful to think of the four As: avoid , alter , accept , or adapt .

Not all stress can be avoided, and it’s not healthy to avoid a situation that needs to be addressed. But you may be surprised by the number of stressors in your life that you can eliminate.

Learn how to say “no.” Know your limits and stick to them. Whether in your personal or professional life, taking on more than you can handle is a surefire recipe for stress.

Avoid people who stress you out. If someone consistently causes stress in your life, limit the amount of time you spend with that person, or end the relationship.

Take control of your environment. If the evening news makes you anxious, turn off the TV. If traffic makes you tense, take a longer but less-traveled route. If going to the market is an unpleasant chore, do your grocery shopping online.

Avoid hot-button topics . If you get upset over religion or politics, cross them off your conversation list. If you repeatedly argue about the same subject with the same people, stop bringing it up or excuse yourself when it’s the topic of discussion.

Pare down your to-do list. Analyze your schedule, responsibilities, and daily tasks. If you’ve got too much on your plate, distinguish between the “shoulds” and the “musts.” Drop tasks that aren’t truly necessary to the bottom of the list or eliminate them entirely.

If you can’t avoid a stressful situation, try to alter it. Often, this involves changing the way you communicate and operate in your daily life.

Express your feelings instead of bottling them up. If something or someone is bothering you, communicate your concerns in an open and respectful way. If you don’t voice your feelings, resentment will build and the stress will increase.

Be willing to compromise. When you ask someone to change their behavior, be willing to do the same. If you both are willing to bend at least a little, you’ll have a good chance of finding a happy middle ground.

Be more assertive.  Don’t take a backseat in your own life. Deal with problems head on, doing your best to anticipate and prevent them. If you’ve got an exam to study for and your chatty roommate just got home, say up front that you only have five minutes to talk.

Find balance. All work and no play is a recipe for burnout. Try to find a balance between work and family life, social activities and solitary pursuits, daily responsibilities and downtime.

If you can’t change the stressor, change yourself. You can adapt to stressful situations and regain your sense of control by changing your expectations and attitude.

Reframe problems. Try to view stressful situations from a more positive perspective. Rather than fuming about a traffic jam, look at it as an opportunity to pause and regroup, listen to your favorite radio station, or enjoy some alone time.

Look at the big picture. Take perspective of the stressful situation. Ask yourself how important it will be in the long run. Will it matter in a month? A year? Is it really worth getting upset over? If the answer is no, focus your time and energy elsewhere.

Adjust your standards. Perfectionism is a major source of avoidable stress. Stop setting yourself up for failure by demanding perfection. Set reasonable standards for yourself and others, and learn to be okay with “good enough.”

Practice gratitude. When stress is getting you down, take a moment to reflect on all the things you appreciate in your life , including your own positive qualities and gifts. This simple strategy can help you keep things in perspective.

Accept the things you can’t change

Some sources of stress are unavoidable. You can’t prevent or change stressors such as the death of a loved one, a serious illness, or a national recession. In such cases, the best way to cope with stress is to accept things as they are. Acceptance may be difficult, but in the long run, it’s easier than railing against a situation you can’t change.

Don’t try to control the uncontrollable. Many things in life are beyond our control, particularly the behavior of other people. Rather than stressing out over them, focus on the things you can control such as the way you choose to react to problems.

Look for the upside. When facing major challenges, try to look at them as opportunities for personal growth. If your own poor choices contributed to a stressful situation, reflect on them and learn from your mistakes.

Learn to forgive. Accept the fact that we live in an imperfect world and that people make mistakes. Let go of anger and resentments. Free yourself from negative energy by forgiving and moving on.

Share your feelings. Expressing what you’re going through can be very cathartic, even if there’s nothing you can do to alter the stressful situation. Talk to a trusted friend or make an appointment with a therapist.

Speak to a Licensed Therapist

BetterHelp is an online therapy service that matches you to licensed, accredited therapists who can help with depression, anxiety, relationships, and more. Take the assessment and get matched with a therapist in as little as 48 hours.

When you’re stressed, the last thing you probably feel like doing is getting up and exercising. But physical activity is a huge stress reliever—and you don’t have to be an athlete or spend hours in a gym to experience the benefits. Exercise releases endorphins that make you feel good, and it can also serve as a valuable distraction from your daily worries.

While you’ll get the most benefit from regularly exercising for 30 minutes or more, it’s okay to build up your fitness level gradually. Even very small activities can add up over the course of a day. The first step is to get yourself up and moving. Here are some easy ways to incorporate exercise into your daily schedule:

• Put on some music and dance around.
• Take your dog for a walk .
• Walk or cycle to the grocery store.
• Use the stairs at home or work rather than an elevator.
• Park your car in the farthest spot in the lot and walk the rest of the way.
• Pair up with an exercise partner and encourage each other as you work out.
• Play ping-pong or an activity-based video game with your kids.

Using mindful rhythmic exercise to manage stress

While just about any form of physical activity can help burn away tension and stress, rhythmic activities are especially effective. Good choices include walking, running, swimming, dancing, cycling, tai chi, and aerobics. But whatever you choose, make sure it’s something you enjoy so you’re more likely to stick with it.

While you’re exercising, make a conscious effort to pay attention to your body and the physical (and sometimes emotional) sensations you experience as you’re moving. Focus on coordinating your breathing with your movements, for example, or notice how the air or sunlight feels on your skin. Adding this mindfulness element will help you break out of the cycle of negative thoughts that often accompanies overwhelming stress.

Learn to manage your time better

Poor time management can cause a lot of stress. When you’re stretched too thin and running behind, it’s hard to stay calm and focused. Plus, you’ll be tempted to avoid or cut back on all the healthy things you should be doing to keep stress in check, like socializing and getting enough sleep. The good news: there are things you can do to achieve a healthier work-life balance.

Don’t over-commit yourself. Avoid scheduling things back-to-back or trying to fit too much into one day. All too often, we underestimate how long things will take.

Prioritize tasks. Make a list of tasks you have to do, and tackle them in order of importance. Do the high-priority items first. If you have something particularly unpleasant or stressful to do, get it over with early. The rest of your day will be more pleasant as a result.

Break projects into small steps. If a large project seems overwhelming, make a step-by-step plan. Focus on one manageable step at a time, rather than taking on everything at once.

Delegate responsibility. You don’t have to do it all yourself, whether at home, school, or on the job. If other people can take care of the task, why not let them? Let go of the desire to control or oversee every little step. You’ll be letting go of unnecessary stress in the process.

Reach out and connect to people who make you feel good

There is nothing more calming than spending quality time with another human being who makes you feel safe and understood. In fact, face-to-face interaction triggers a cascade of hormones that counteracts the body’s defensive “fight-or-flight” response. It’s nature’s natural stress reliever (as an added bonus, it also helps stave off depression and anxiety). So make it a point to connect regularly—and in person—with family and friends.

[Read: Social Support for Stress Relief]

Keep in mind that the people you talk to don’t have to be able to fix your stress. They simply need to be good listeners. And try not to let worries about looking weak or being a burden keep you from opening up. The people who care about you will be flattered by your trust. It will only strengthen your bond.

Of course, you may not always have someone close by to lean on when you feel overwhelmed by stress, but by building and maintaining a network of close friends you can improve your resiliency to life’s stressors.

Tips for building relationships

• Reach out to a colleague at work.
• Help someone else by volunteering .
• Have lunch or coffee with a friend.
• Ask a loved one to check in with you regularly.
• Call or email an old friend.
• Go for a walk with a workout buddy.
• Schedule a weekly dinner date.
• Meet new people by taking a class or joining a club.
• Confide in a clergy member, teacher, or sports coach.
• Join a support group—either in-person or via on online therapy platform .

Beyond a take-charge approach and a positive attitude, you can reduce stress in your life by carving out “me” time. Don’t get so caught up in the hustle and bustle of life that you forget to take care of your own needs. Nurturing yourself is a necessity, not a luxury. If you regularly make time for fun and relaxation, you’ll be in a better place to handle life’s stressors.

Set aside leisure time. Include rest and relaxation in your daily schedule. Don’t allow other obligations to encroach. This is your time to take a break from all responsibilities and recharge your batteries.

Do something you enjoy every day. Make time for leisure activities that bring you joy, whether it be stargazing, playing the piano, or working on your bike.

Keep your sense of humor. This includes the ability to laugh at yourself. The act of laughing helps your body fight stress in a number of ways.

Take up a relaxation practice. Relaxation techniques such as yoga, meditation, and deep breathing activate the body’s relaxation response , a state of restfulness that is the opposite of the fight or flight or mobilization stress response. As you learn and practice these techniques, your stress levels will decrease and your mind and body will become calm and centered.

In addition to regular exercise, there are other healthy lifestyle choices that can increase your resistance to stress.

Eat a healthy diet . Well-nourished bodies are better prepared to cope with stress, so be mindful of what you eat. Start your day right with breakfast, and keep your energy up and your mind clear with balanced, nutritious meals throughout the day.

Reduce caffeine and sugar. The temporary “highs” caffeine and sugar provide often end with a crash in mood and energy. By reducing the amount of coffee, soft drinks, chocolate, and sugar snacks in your diet , you’ll feel more relaxed and you’ll sleep better.

Avoid alcohol, cigarettes, and drugs. Self-medicating with alcohol or drugs may provide an easy escape from stress, but the relief is only temporary. Don’t avoid or mask the issue at hand; deal with problems head on and with a clear mind.

Get enough sleep. Adequate sleep fuels your mind, as well as your body. Feeling tired will increase your stress because it may cause you to think irrationally.

Tips for reducing stress in the moment

When you’re frazzled by your morning commute, stuck in a stressful meeting at work, or fried from another argument with your spouse, you need a way to manage your stress levels right now . That’s where quick stress relief comes in.

The fastest way to reduce stress is by taking a deep breath and using your senses—what you see, hear, taste, and touch—or through a soothing movement. By viewing a favorite photo, smelling a specific scent, listening to a favorite piece of music, tasting a piece of gum, or hugging a pet, for example, you can quickly relax and focus yourself.

[Read: Quick Stress Relief]

Of course, not everyone responds to each sensory experience in the same way. The key to quick stress relief is to experiment and discover the unique sensory experiences that work best for you.

More Information

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• Tolerating Distress - Workbook and information sheets to help you manage feelings of distress. (Centre for Clinical Interventions)
• How To Relax (Video) - Video to help you ease stress. (Mind)
• Trauma- and Stressor-Related Disorders. (2013). In Diagnostic and Statistical Manual of Mental Disorders . American Psychiatric Association. Link
• Can, Yekta Said, Heather Iles-Smith, Niaz Chalabianloo, Deniz Ekiz, Javier Fernández-Álvarez, Claudia Repetto, Giuseppe Riva, and Cem Ersoy. “How to Relax in Stressful Situations: A Smart Stress Reduction System.” Healthcare 8, no. 2 (April 16, 2020): 100. Link
• Norelli, Samantha K., Ashley Long, and Jeffrey M. Krepps. “Relaxation Techniques.” In StatPearls . Treasure Island (FL): StatPearls Publishing, 2021. Link
• Toussaint, Loren, Quang Anh Nguyen, Claire Roettger, Kiara Dixon, Martin Offenbächer, Niko Kohls, Jameson Hirsch, and Fuschia Sirois. “Effectiveness of Progressive Muscle Relaxation, Deep Breathing, and Guided Imagery in Promoting Psychological and Physiological States of Relaxation.” Evidence-Based Complementary and Alternative Medicine 2021 (July 3, 2021): e5924040. Link
• Unger, Cynthia A, David Busse, and Ilona S Yim. “The Effect of Guided Relaxation on Cortisol and Affect: Stress Reactivity as a Moderator.” Journal of Health Psychology 22, no. 1 (January 1, 2017): 29–38. Link
• Singh, Karuna. “Nutrient and Stress Management.” Journal of Nutrition & Food Sciences 6, no. 4 (2016). Link
• Katsarou, Alexia L., Marios M. Vryonis, Athanassios D. Protogerou, Evangelos C. Alexopoulos, Apostolos Achimastos, Dimitrios Papadogiannis, George P. Chrousos, and Christina Darviri. “Stress Management and Dietary Counseling in Hypertensive Patients: A Pilot Study of Additional Effect.” Primary Health Care Research & Development 15, no. 1 (January 2014): 38–45. Link
• Errisuriz, Vanessa L., Keryn E. Pasch, and Cheryl L. Perry. “Perceived Stress and Dietary Choices: The Moderating Role of Stress Management.” Eating Behaviors 22 (August 1, 2016): 211–16. Link
• Choi, Dong-Woo, Sung-Youn Chun, Sang Ah Lee, Kyu-Tae Han, and Eun-Cheol Park. “Association between Sleep Duration and Perceived Stress: Salaried Worker in Circumstances of High Workload.” International Journal of Environmental Research and Public Health 15, no. 4 (April 2018): 796. Link
• Blaxton, Jessica M., Cindy S. Bergeman, Brenda R. Whitehead, Marcia E. Braun, and Jessic D. Payne. “Relationships Among Nightly Sleep Quality, Daily Stress, and Daily Affect.” The Journals of Gerontology: Series B 72, no. 3 (May 1, 2017): 363–72. Link
• Saleh, Dalia, Nathalie Camart, Fouad Sbeira, and Lucia Romo. “Can We Learn to Manage Stress? A Randomized Controlled Trial Carried out on University Students.” PLOS ONE 13, no. 9 (September 5, 2018): e0200997. Link
• Loprinzi, Paul D., and Emily Frith. “Protective and Therapeutic Effects of Exercise on Stress-Induced Memory Impairment.” The Journal of Physiological Sciences: JPS 69, no. 1 (January 2019): 1–12. Link
• Salmon, P. “Effects of Physical Exercise on Anxiety, Depression, and Sensitivity to Stress: A Unifying Theory.” Clinical Psychology Review 21, no. 1 (February 2001): 33–61. Link

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Coping with Stress

Many of us are facing challenges that can be stressful and overwhelming. Learning to cope with stress in a healthy way will help you, the people you care about, and those around you become more resilient.

Stress can cause the following:

• Feelings of fear, anger, sadness, worry, numbness, or frustration.
• Changes in appetite, energy, desires, and interests.
• Trouble concentrating and making decisions.
• Nightmares or problems sleeping.
• Physical reactions, such as headaches, body pains, stomach problems, or skin rashes.
• Worsening of chronic health problems and mental health conditions.
• Increased use of  alcohol , illegal drugs (like heroin , cocaine , or methamphetamine ), and misuse of prescription drugs (like opioids).
• Healthy Ways to Cope with Stress
• If you or someone you know is struggling or in crisis, help is available. Call or text 988 or chat 988lifeline.org
• Disaster Distress Helpline : CALL or TEXT 1-800-985-5990 (press 2 for Spanish)

Here are some ways you can manage stress, anxiety, grief, or worry:

• Take breaks from news stories, including those on social media. It’s good to be informed, but constant information about negative events can be upsetting. Consider limiting news to just a couple times a day and disconnecting from phone, TV, and computer screens for a while.
• Eat healthy. Have fruits and vegetables, lean protein, whole grains, and low-fat or no-fat dairy. Limit foods with unhealthy fats, salt, and added sugars. See Healthy Eating Tips .
• Get enough sleep.  Go to bed and wake up at the same time each day to help you sleep better . Adults need 7 or more hours per night.
• Move more and sit less. Every little bit of physical activity helps. Start small and build up to 2 ½ hours a week. You can break it into smaller amounts such as 20 to 30 minutes a day.
• Limit alcohol  intake. Choose not to drink, or drink in moderation on days you drink alcohol. Moderation means having 2 drinks or less a day for men or 1 drink or less for women. Find out more at Drink Less, Be Your Best .
• Avoid using illegal drugs or prescription drugs in ways other than prescribed. Don’t take someone else’s prescription. Substance use treatment is available, and recovery starts with asking for help.
• Avoid smoking , vaping, and the use of other tobacco products. People can and do quit smoking for good.
• Continue with regular health appointments, tests, screenings, and vaccinations.
• Take deep breaths, stretch, or meditate .
• Try to do some other activities you enjoy.
• Talk with people you trust about your concerns and how you are feeling.
• Connect with your community-based or faith-based organizations.

For Everyone

• How Right Now — Finding What Helps
• Coping with a Disaster or Traumatic Event
• Suicide Prevention
• I’m So Stressed Out! Fact Sheet (NIMH)
• Mindfulness Coach – PTSD: National Center for PTSD (va.gov)

For Families and Children

• Helping Children Cope with Emergencies
• Adolescent Mental Health
• Tools for Supporting Emotional Wellbeing in Children and Youth

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Recent developments in stress and anxiety research

• Published: 01 September 2021
• Volume 128 , pages 1265–1267, ( 2021 )

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• Urs M. Nater 1 , 2  

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Stress and anxiety are virtually omnipresent in today´s society, pervading almost all aspects of our daily lives. While each and every one of us experiences “stress” and/or “anxiety” at least to some extent at times, the phenomena themselves are far from being completely understood. In stress research, scientists are particularly grappling with the conceptual issue of how to define stress, also with regard to delimiting stress from anxiety or negative affectivity in general. Interestingly, there is no unified theory of stress, despite many attempts at defining stress and its characteristics. Consequently, the available literature relies on a variety of different theoretical approaches, though the theories of Lazarus and Folkman ( 1984 ) or McEwen ( 1998 ) are relatively pervasive in the literature. One key issue in conceptualizing stress is that research has not always differentiated between the perception of a stimulus or a situation as a stressor and the subsequent biobehavioral response (often called the “stress response”). This is important, since, for example, psychological factors such as uncontrollability and social evaluation, i.e. factors that may influence how an individual perceives a potentially stressful stimulus or situation, have been identified as characteristics that elicit particularly powerful physiological stressful responses (Dickerson and Kemeny 2004 ). At the core of the physiological stress response is a complex physiological system, which is located in both the central nervous system (CNS) and the body´s periphery. The complexity of this system necessitates a multi-dimensional assessment approach involving variables that adequately reflect all relevant components. It is also important to consider that the experience of stress and its psychobiological correlates do not occur in a vacuum, but are being shaped by numerous contextual factors (e.g. societal and cultural context, work and leisure time, family and dyadic systems, environmental variables, physical fitness, nutritional status, etc.) and dispositional factors (e.g. genetics, personality, resilience, regulatory capacities, self-efficacy, etc.). Thus, a theoretical framework needs to incorporate these factors. In sum, as stress is considered a multi-faceted and inherently multi-dimensional construct, its conceptualization and operationalization needs to reflect this (Nater 2018 ).

The goal of the World Association for Stress Related and Anxiety Disorders (WASAD) is to promote and make available basic and clinical research on stress-related and anxiety disorders. Coinciding with WASAD’s 3rd International Congress held in September 2021 in Vienna, Austria, this journal publishes a Special Issue encompassing state-of-the art research in the field of stress and anxiety. This special issue collects answers to a number of important questions that need to be addressed in current and future research. Among the most relevant issues are (1) the multi-dimensional assessment that arises as a consequence of a multi-faceted consideration of stress and anxiety, with a particular focus on doing so under ecologically valid conditions. Skoluda et al. 2021 (in this issue) argue that hair as an important source of the stress hormone cortisol should not only be taken as a complementary stress biomarker by research staff, but that lay persons could be also trained to collect hair at the study participants’ homes, thus increasing the ecological validity of studies incorporating this important measure; (2) the incongruence between psychological and biological facets of stress and anxiety that has been observed both in laboratory and field research (Campbell and Ehlert 2012 ). Interestingly, there are behavioral constructs that do show relatively high congruence. As shown in the paper of Vatheuer et al. ( 2021 ), gaze behavior while exposed to an acute social stressor correlates with salivary cortisol, thus indicating common underlying mechanisms; (3) the complex dynamics of stress-related measures that may extend over shorter (seconds to minutes), medium (hours and diurnal/circadian fluctuations), and longer (months, seasonal) time periods. In particular, momentary assessment studies are highly qualified to examine short to medium term fluctuations and interactions. In their study employing such a design, Stoffel and colleagues (Stoffel et al. 2021 ) show ecologically valid evidence for direct attenuating effects of social interactions on psychobiological stress. Using an experimental approach, on the other hand, Denk et al. ( 2021 ) examined the phenomenon of physiological synchrony between study participants; they found both cortisol and alpha-amylase physiological synchrony in participants who were in the same group while being exposed to a stressor. Importantly, these processes also unfold over time in relation to other biological systems; al’Absi and colleagues showed in their study (al’Absi et al. 2021 ) the critical role of the endogenous opioid system and its relation to stress-related analgesia; (4) the influence of contextual and dispositional factors on the biological stress response in various target samples (e.g., humans, animals, minorities, children, employees, etc.) both under controlled laboratory conditions and in everyday life environments. In this issue, Sattler and colleagues show evidence that contextual information may only matter to a certain extent, as in their study (Sattler et al. 2021 ), the biological response to a gay-specific social stressor was equally pronounced as the one to a general social stressor in gay men. Genetic information is probably the most widely researched dispositional factor; Kuhn et al. show in their paper (Kuhn et al. 2021 ) that the low expression variant of the serotonin transporter gene serves as a risk factor for increased stress reactivity, thus clearly indicating the important role of dispositional factors in stress processing. An interesting factor combining both aspects of dispositional and contextual information is maternal care; Bentele et al. ( 2021 ) in their study are able to show that there was an effect of maternal care on the amylase stress response, while no such effect was observed for cortisol. In a similar vein, Keijser et al. ( 2021 ) showed in their gene-environment interaction study that the effects of FKBP5, a gene very closely related to HPA axis regulation, and early life stress on depressive symptoms among young adults was moderated by a positive parenting style; and (5) the role of stress and anxiety as transdiagnostic factors in mental disorders, be it as an etiological factor, a variable contributing to symptom maintenance, or as a consequence of the condition itself. Stress, e.g., as a common denominator for a broad variety of psychiatric diagnoses has been extensively discussed, and stress as an etiological factor holds specific significance in the context of transdiagnostic approaches to the conceptualization and treatment of mental disorders (Wilamowska et al. 2010 ). The HPA axis, specifically, is widely known to be dysregulated in various conditions. Fischer et al. ( 2021 ) discuss in their comprehensive review the role of this important stress system in the context of patients with post-traumatic disorder. Specifically focusing on the cortisol awakening response, Rausch and colleagues provide evidence for HPA axis dysregulation in patients diagnosed with borderline personality disorder (Rausch et al. 2021 ). As part of a longitudinal project on ADHD, Szep et al. ( 2021 ) investigated the possible impact of child and maternal ADHD symptoms on mothers’ perceived chronic stress and hair cortisol concentration; although there was no direct association, the findings underline the importance of taking stress-related assessments into consideration in ADHD studies. As the HPA axis is closely interacting with the immune system, Rhein et al. ( 2021 ) examined in their study the predicting role of the cytokine IL-6 on psychotherapy outcome in patients with PTSD, indicating that high reactivity of IL-6 to a stressor at the beginning of the therapy was associated with a negative therapy outcome. The review of Kyunghee Kim et al. ( 2021 ) also demonstrated the critical role of immune pathways in the molecular changes due to antidepressant treatment. As for the therapy, the important role of cognitive-behavioral therapy with its key elements to address both stress and anxiety reduction have been shown in two studies in this special issue, evidencing its successful application in obsessive–compulsive disorder (Ivarsson et al. 2021 ; Hollmann et al. 2021 ). Thus, both stress and anxiety are crucial transdiagnostic factors in various mental disorders, and future research needs elaborate further on their role in etiology, maintenance, and treatment.

In conclusion, a number of important questions are being asked in stress and anxiety research, as has become evident above. The Special Issue on “Recent developments in stress and anxiety research” attempts to answer at least some of the raised questions, and I want to invite you to inspect the individual papers briefly introduced above in more detail.

al’Absi M, Nakajima M, Bruehl S (2021) Stress and pain: modality-specific opioid mediation of stress-induced analgesia. J Neural Transm. https://doi.org/10.1007/s00702-021-02401-4

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Nater, U.M. Recent developments in stress and anxiety research. J Neural Transm 128 , 1265–1267 (2021). https://doi.org/10.1007/s00702-021-02410-3

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DOI : https://doi.org/10.1007/s00702-021-02410-3

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Anxiety Disorders and Depression Essay (Critical Writing)

Introduction, description section, feelings section, action plan, reference list.

Human beings become anxious in different situations that are uncertain to them. Depression and anxiety occur at a similar time. Anxiety is caused due to an overwhelming fear of an expected occurrence of an event that is unclear to a person. More than 25 million people globally are affected by anxiety disorders. People feel anxious in moments such as when making important decisions, before facing an interview panel, and before taking tests. Anxiety disorders are normally brained reactions to stress as they alert a person of impending danger. Most people feel sad and low due to disappointments. Feelings normally overwhelm a person leading to depression, especially during sad moments such as losing a loved one or divorce. When people are depressed, they engage in reckless behaviors such as drug abuse that affect them physically and emotionally. However, depression manifests in different forms in both men and women. Research shows that more women are depressed compared to men. This essay reflects on anxiety disorders and depression regarding from a real-life experience extracted from a publication.

“Every year almost 20% of the general population suffers from a common mental disorder, such as depression or an anxiety disorder” (Cuijpers et al. 2016, p.245). I came across a publication by Madison Jo Sieminski available who was diagnosed with depression and anxiety disorders (Madison 2020). She explains how she was first diagnosed with anxiety disorders and depression and how it felt unreal at first. She further says that she developed the need to get a distraction that would keep her busy so that she won’t embrace her situation. In her case, anxiety made her feel that she needed to do more, and everything needed to be perfect.

Madison further said that the struggle with anxiety is that it never seemed to happen, but it happened eventually. She always felt a feeling of darkness and loneliness. She could barely stay awake for more than 30 minutes for many days. Anxiety and depression made her question herself if she was good enough, and this resulted in tears in her eyes due to the burning sensation and overwhelmed emotions. In her own words, she said, “Do I deserve to be here? What is my purpose?” (Madison 2020). Anxiety made her lose confidence in herself and lowered her self-esteem. She could lay in bed most of the time and could not take any meal most of the days.

Madison said that since the sophomore year of high school, all was not well, and she suddenly felt someone in her head telling her to constantly worry and hold back from everything. She could wake up days when she could try a marathon to keep her mind busy. However, she sought help on 1 January 2020, since she felt her mental health was important, and she needed to be strong. She was relieved from her biggest worries, and what she thought was failure turned into a biggest achievement. She realized that her health needed to be her priority. Even after being diagnosed with depression disorders, she wanted to feel normal and have a normal lifestyle like other people.

Madison was happy with her decision to seek medical help even though she had her doubts. She was happy that she finally took that step to see a doctor since she was suffering in silence. She noted that the background of her depression and anxiety disorders was her family. It was kind of genetic since her mom also struggled with depression and anxiety disorders. Her mom was always upset, and this broke her heart. She said it took her years to better herself, but she still had bad days. Madison decided to take the challenge regarding her mother’s experience. Also, Madison said she was struggling to get over depression since her childhood friends committed suicide, and it affected her deeply. She also told the doctor how she often thought of harming herself. The doctor advised her on the different ways she could overcome her situation after discovering she had severe depression and anxiety disorders.

After going through Madison’s story, I was hurt by the fact that he had to go through that for a long time, and something tragic could have happened if she had not resorted to medical help. I felt emotional by the fact that she constantly blamed herself due to her friends who committed suicide, and she decided to accumulate all the pain and worries. The fact that I have heard stories of how people commit suicide due to depression and anxiety disorders made me have a somber mood considering her case. In this case, you will never know what people are going through in their private lives until they decide to open up. We normally assume every person is okay, yet they fight their demons and struggle to look okay. Hence, it won’t cost any person to check up on other people, especially if they suddenly change their social characters.

Madison’s story stood out for me since she had struggled since childhood to deal with depression and anxiety disorders. In her case, she was unable to seek help first even when she knew that she was suffering in silence (Madison 2020). However, most people find it hard to admit they need help regardless of what they are going through, like Madison. People who are depressed cannot work as they lack the motivation to do anything. In my knowledge, depression affects people close to you, including your family and friends. Depression also hurts those who love someone suffering from it. Hence, it is complex to deal with. Madison’s situation stood out for me since her childhood friends committed suicide, and she wished silently she could be with them. Hence, this leads to her constant thoughts of harming herself. Childhood friends at one point can become your family even though you are not related by blood due to the memories you share.

Depression and Anxiety disorders have been common mental health concerns globally for a long time. Depression and anxiety disorders create the impression that social interactions are vague with no meaning. It is argued by Cuijpers (2016, p.245) that people who are depressed normally have personality difficulties as they find it hard to trust people around them, including themselves. In this case, Madison spent most of her time alone, sleeping, and could not find it necessary to hang around other people. Negativity is the order of the day as people depressed find everything around them not interesting.

People who are depressed find it easy to induce negativity in others. Hence, they end up being rejected. Besides, if someone is depressed and is in a relationship, he/she may be the reason for ending the relationship since they would constantly find everything offensive. Research shows that people who are clinically depressed, such as Madison, prefer sad facial expressions to happy facial expressions. Besides, most teenagers in the 21 st century are depressed, and few parents tend to notice that. Also, most teenagers lack parental love and care since their parents are busy with their job routines and have no time to engage their children. Research has shown that suicide is the second cause of death among teenagers aged between 15-24 years due to mental disorders such as suicide and anxiety disorders.

Despite depression being a major concern globally, it can be controlled and contained if specific actions are taken. Any person needs to prioritize their mental health to avoid occurrences of depression and anxiety orders. Emotional responses can be used to gauge if a person is undergoing anxiety and depression. The best efficient way to deal with depression and anxiety is to sensitize people about depression through different media platforms (Cuijpers et al. 2016). A day in a month should be set aside where students in colleges are sensitized on the symptoms of depression and how to cope up with the situation. Some of the basic things to do to avoid anxiety and depression include; talking to someone when you are low, welcoming humor, learning the cause of your anxiety, maintaining a positive attitude, exercising daily, and having enough sleep.

Depression and anxiety disorders are different forms among people, such as irritability and nervousness. Most people are diagnosed with depression as a psychiatric disorder. Technology has been a major catalyst in enabling depression among people as they are exposed to many negative experiences online. Besides, some people are always motivated by actions of other people who seem to have given up due to depression. Many people who develop depression normally have a history of anxiety disorders. Therefore, people with depression need to seek medical attention before they harm themselves or even commit suicide. Also, people need to speak out about what they are going through to either their friends or people they trust. Speaking out enables people to relieve their burden and hence it enhances peace.

Cuijpers, P., Cristea, I.A., Karyotaki, E., Reijnders, M. and Huibers, M.J., 2016. How effective are cognitive behavior therapies for major depression and anxiety disorders? A meta‐analytic update of the evidence . World Psychiatry 15(3), pp. 245-258.

Madison, J. 2020. Open Doors .

• Chicago (A-D)
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IvyPanda. (2022, June 16). Anxiety Disorders and Depression. https://ivypanda.com/essays/anxiety-disorders-and-depression/

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1. IvyPanda . "Anxiety Disorders and Depression." June 16, 2022. https://ivypanda.com/essays/anxiety-disorders-and-depression/.

Bibliography

IvyPanda . "Anxiety Disorders and Depression." June 16, 2022. https://ivypanda.com/essays/anxiety-disorders-and-depression/.

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7 Proven Stress and Anxiety Management Strategies

W hen you are stressed or anxious your breathing becomes noticeably faster and shallower. This can make you feel even more panicked as you attempt to slow down your breathing and gain better control over your emotional state.

Shallow breathing and muscle tension are some of the severe signs of anxiety . It can really help if you can learn some proven stress and anxiety management strategies that you can use when you feel like you are losing control of your emotions.

Here are some techniques and strategies that are well worth learning.

An easy way to slow your breathing down

If you can slow down your breathing, you will immediately feel like you are taking back control of your emotional state.

A simple exercise that can help you to slow down your breathing is to count to three as you breathe in slowly. Repeat the count to three as you exhale.

Continue this exercise until you feel your breathing has come under control again.

Meditation can help

Anxiety is primarily a state of mind where your thoughts turn to what might happen rather than what has actually happened.

When you learn some simple meditation routines it helps you stay in the present moment and banish negative thoughts that are fueling your anxiety.

A simple way to reduce muscle tension

Your muscles tense up when you are anxious. Learn to close your eyes so that you can focus, followed by a routine where you relax each of your muscle groups in turn.

Work your way down from your head to your toe. Tensing and relaxing each muscle group will help to reduce anxiety-induced tension.

Watch what you eat

An excellent coping strategy for anxiety is to ensure that you eat well-balanced and healthy meals on a regular basis. It is also important to avoid skipping any meals because you feel too stressed to eat

Eating some high-energy snacks can also work to counteract feelings of stress when you start to feel more anxious.

Watch your caffeine and alcohol intake

It has been shown that consumption of alcohol and caffeine can adversely influence anxiety levels. That could be enough to trigger a full-scale panic attack. Try to limit your intake of both caffeine and alcohol to manage your stress levels better.

Laughter can make a difference

A simple but effective technique is to seek out humor. The act of laughing is a welcome distraction that can bring down anxiety levels.

Learn to identify the triggers

A good way of managing your anxiety is to learn what situations or circumstances tend to make you feel more stressed than usual.

When you understand what is triggering an adverse stress response you can take steps to avoid exposure to that event or situation. If that’s not possible, you can manage anxiety levels better when you know what might be coming.

If you adopt these proven anxiety and stress management techniques it could really make a positive difference to how you react and cope to the various triggers.