Tuesday, February 23, 2010

How To Get A Better Handle On Dealing With Stress

"The time to relax is when you don't have time for it," an old saying goes.

That obvious advice is frustratingly familiar to anyone who, in the throes of stomach-souring pressure, has been told to "just relax." Or who heard that related bit of bad advice, to avoid things that stress you out.

"I look at that advice, to cut back on stressful things, and think, 'Well, duh,'" said Dr. Donald Rosen, an Oregon Health & Science University psychiatrist who said he's seen increased stress levels in patients in the past year.

So this article won't tell you to avoid stress, or to take a weekend off when you're overwhelmed and underfunded. Fact is, life itself is stressful.

"It's almost impossible to make the stress go away," Dr. Aly Rahimtoola, a cardiologist with the Oregon Clinic and Providence Heart and Vascular Institute. "It's hard to tell someone to get divorced or quit a job."

But you don't have to lay down before the stress juggernaut. While you can't avoid all stress, there are ways to contain and manage some stressful events, as well as how you react to stress. Managing your stress is an ongoing process, not a quick or easy fix. But it's possible, especially if you start when your stress isn't at crisis levels -- say early in a new year with a grimly foreboding economy.

"It's best to strike while the iron is cold," Rosen said.

You don't need an expert to tell you if you're too stressed out, which is good: They can't really tell. Stress isn't a thing you can measure, like temperature or blood pressure. Rahimtoola likened it to Supreme Court Justice Potter Stewart's famous definition of obscenity, "I know it when I see it."

Even if a doctor could measure stress, that wouldn't tell you much. Some people thrive on stress. That's why stage actors can stand spotlighted in front of an audience of strangers while other people sweat like foundrymen when they have to speak to a handful of co-workers.

"Just about everybody has an ambivalent relationship with stress," Rosen said. "Why do people procrastinate before a deadline? Because stress helps. ... We develop strategies to get an optimal level of stress for functioning."

While people's temperament differs, most everyone likes enough stress to feel they are rising to the occasion, from time to time. The problem, Rosen said, is when that deadline level of stress becomes your new baseline and never goes away. That can cause varying problems, including poor sleep and forgetfulness and may contribute to ailments such as diabetes and heart disease.

So what should you do if you're feeling flooded by stress? Start by resisting your impulses, said Cindy Reuter, a naturopath with the Providence Integrative Medicine Program.

"Think about all the things you're inclined to do when you're stressed out," she said. "Generally those are the worst things to do: staying up late, skipping breakfast, having coffee instead of breakfast. All those things wreak havoc on your system."

Instead, experts suggest trying to think categorically about stress -- perhaps with the help of a doctor, therapist, preacher or other neutral person. Try to prioritize what you need to tackle first. Many people have items on mental to-do lists they can actually ignore for a while, Reuter said.

You can also think about ways to contain many common stresses, such as arguments with your partner over relationship or financial issues. It's impossible and unwise to avoid those topics entirely, Rosen said. But you can ask your partner to set a time to deal with those issues -- say, two hours on a Sunday afternoon. Your stress won't go away, but you'll know when it's coming and that it won't last forever.

Similarly, try to replace stressful face-to-face dealings with bosses or co-workers with e-mails, or at least less frequent meetings. You can even sell off objects to pay down debts: "In general, being poor is less stressful than being in debt," Rosen said, because owing money leaves obligations hanging over your head.

Taking steps to schedule or contain stresses may immediately make you feel better because you realize you're not powerless. And feeling powerless is very stressful, Rosen said.

You may not be able to eliminate stressful things, but you can add happy or stress-easing activities to your life, Rosen said. This takes some planning and regular work. So it's best to start when you're not totally stressed out.

The best insulation against getting completely stressed out is regular aerobic exercise -- 30 to 40 minutes three or four times a week, Rahimtoola suggests. What the exercise is doesn't matter so much, as long as it gets your heart rate up. So pick something you'll like more and actually do, whether it's walking, swimming, shooting hoops or pulling weeds. And while asking your boss or partner for a regular hour to work out may sound stressful, remember that making the request is a one-time stress, Rahimtoola said. Once you get permission, it opens up time for you.

Sleeping regularly is another key to managing stress. You'll still face rough nights when you're most stressed out. But you can avoid a big sleep debt by getting seven to eight hours of sleep on a regular schedule. And use good sleep habits -- a dark room, comfortable bed and no TV.

Quiet time while awake is a final good way to manage stress. This can be more formal, such as yoga or mindfulness meditation. Or it can be a more casual practice of prayer, contemplation, even a warm bath in Epsom salts. The key is to have a regular quiet time, even of 10 or 15 minutes, to reinforce the ideas that there is more to life than the crisis du jour.

And if you are in the midst of a crisis so great that you can't imagine taking time to think, work out or sleep, you may want to talk to a doctor or psychologist. Therapy and medication can help deal with stress so overwhelming it's hurting your physical and mental health.

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