By Vintee Narang, MD, Psychiatrist, Community Health Centers – Forest City

Stress is an often mundane yet unavoidable part of life. If not properly managed it can make us feel like the walls are closing in, lead to depression, anxiety, insomnia.  It may often also impact on how we interact with others, both at work and at home. However, we can take the power back and choose how we manage daily stress. We can learn to develop ways and put strategies in place that will help us deal with stressful situations. Simple practices such as establishing a well-rounded daily routine that addresses all three parts of our essence as human beings - mind, body, and spirit – can be an effective way of teaching ourselves to combat stress whenever it arises.

Studies have shown that a healthy amount of manageable stress, or positive stress, can lead to enhanced brain functioning, a boosted immune system and better prep for future stressful situations. However when left unmanaged or chronically unaddressed, it will build up into a negative form of stress which in turn will manifest into somatic or physical symptoms of stress such as insomnia, loss of libido, depression, headaches, indigestion, dizziness, sweating, palpitations, digestive disorders, ulcers, cardiovascular disease, diabetes. Unmanaged stress may also manifest in form of mental health symptoms such as panic attacks, indecision, confusion, decreased working memory, and anger outbursts, among others.

ABC Method

Awareness/Acknowledgement of stress - One first step to tackling stress is to identify the source or cause. Monitor your state of mind throughout the day. If you feel stressed, write down the cause, your thoughts and your mood. Once the source is identified, the plan for resolution becomes more feasible.

Balance - Find balance between positive and negative stress. This is often done through behavioral modification which we can do on a daily basis.

Control - Keep the negative effects managed so they are less likely to build up and manifest into larger more chronic issues.

The following outline the key to maintaining better control:

• Altering maladaptive behaviors
• Changing an unhealthy thought process
• Changing damaging lifestyles

Behavioral Changes

1) Organizational techniques - It is imperative to prioritize objectives and activities to avoid chaos in family life and making mistakes professionally. In this time management technique, we can make lists to separate essential and required priorities to those non-essential. Try to set plans/goals for each day.

2) Assertion - avoid toxic buildup -voice things that are on your mind to family, coworkers, rather than letting it sit and build up over time into something toxic – strengthen our communication- ability to express feelings, desires, opinions with those around us in a healthy manner. Furthermore, we often create stress because we can’t say “no.” We take on additional responsibilities even when we know we don’t have time for them. There are many reasons people can’t say “no.” They may fear conflict or rejection. You have to know and accept your limits and find a gentle and diplomatic way to say “no”.

3) Anger Management - Chronically built up stress often manifests in frustration and anger. Walk away when angry. Before reacting, take time to regroup by counting to ten and reconsider an impulsive reaction.

4) Physical Exercise - Walking or other physical activities can also help burn off steam. Furthermore, exercise increases the production of endorphins, a natural mood-booster. Try incorporating a routine daily walk or other form of exercise.

5) Reframing a negative thought process - Reversing negative attitudes can help reduce tension. Try writing down the problem causing stress and come up with as many solutions as possible and write pros and cons of each one. Once you have a possible solution, note what is needed to put it into action.  This can avoid a panicky, chaotic state of mind. Another way for calm to the mind is to mentally prepare for possible upcoming changes.

6) Stress Diary - This can help identify the causes of stress. Keep a record of the date, time, and place when you feel stressed out and give a stress rating from one to ten. Note down what you were doing at the time and who you were with. Use this diary to try to understand your personal stress triggers. This can help you pinpoint activities you can modify or eliminate. Think of ways you could handle stressful situations differently and coping techniques you could use.

7) Develop a Support Network - In today’s society we find ourselves often so independent we take all burdens on ourselves. We must learn that it is important to rely on each other. Try to turn to friends, colleagues, coworkers for help, perhaps join an interest group (book club, running club). If talking to someone else seems out of reach or too uncomfortable, then perhaps give yourself a little motivational talk. Negative self-talk is damaging. Tell yourself that you can deal with the situation and that everything will turn out fine, thus adopting an optimistic, grateful attitude.

8) Healthy distraction - Find a hobby (music, exercise, something that provides an outlet away from the primary stressors. Taking a reprieve from daily life, listen to some relaxing music (jazz or classical) or gardening. The break will allow you to return to a stressful situation with a different take and a more refreshed state of mind.

9) Lifestyle changes - Regulate sleep, diet, exercise (aerobic exercise-jogging, swimming, bike-riding), relaxation, limit smoking/alcohol.

• Diet - Healthy eating - (more organic, non-processed, whole grain foods), Decrease salt intake, fast food. Unhealthy coping mechanisms like drinking alcohol or resorting to drugs just replaces one maladaptive behavior with a likely much more chronic and complicated one. Also, decrease caffeinated drinks and drink more water, natural fruit juices, and herbal teas. Refined sugars can give the body a temporary boost but then cause an energy crash, which leaves you feeling tired and irritable which can further exacerbate your already maladaptive stress response. A healthy, nourishing and well-balanced diet can help us be better equipped to handle the stress.
• Relaxation techniques - yoga, meditation, religious outlets, massage, aromatherapy, biofeedback, psychotherapy, breathing exercises.
• Rest your mind - To help ensure you get the recommended seven or eight hours of sleep, sleep hygiene is important. Try to cut back on caffeine, remove distractions such as television or computers from your bedroom and go to bed at the same time each night. You may also do nighttime activities like yoga and relaxation exercises to help wind down.

Get help from therapists, counselors, and other mental health professionals. It’s also extremely important to call 9-1-1 or go to the nearest emergency room if you’re having any thoughts of harming yourself or others.

Stress is unfortunately a natural part of our daily lives. The important thing to consider is that, although we are often not in control of what causes us to feel stressed, we can however control the way in which we deal with stress. This involves taking ownership for the things we have control over, while also recognizing that some things are simply not in our control. In these situations, the best thing we can do is to put forth our best efforts and have faith that bad times are temporary with better days ahead.

It’s important to reach out to our support system during stressful times. It never hurts to get a second opinion on ways in which we can more effectively address the stressful situation. Performing selfless acts of kindness towards others, such as volunteering your time at a charitable organization, such as the Salvation Army or Big Brothers/Big Sisters can be a wonderful way to divert our minds from our own personal troubles. It is in the service of others that we truly free ourselves. Finally, if you’re a person of faith, then it’s important to continue or to re-establish your connection with your belief system, which can be so helpful to help us get through the tough times. Lastly, take note that these are trying times for us, so try not to put excess pressure on yourself to accomplish too much, and be kind to yourself.

Community Health Centers, Inc. (CHC), a Federally Qualified Health Center, provides quality and compassionate primary healthcare services to insured, uninsured, underinsured, and underserved children and adults within Central Florida. CHC provides care to more than 66,000 patients, each year, in the Apopka, Bithlo, Clermont, Forest City, Groveland, Lake Ellenor, Leesburg, Meadow Woods, Pine Hills, Tavares and Winter Garden communities.  www.chcfl.org