BlueHealth Advantage - Coping with Stress Guide

Coping with Stress Guide

Coping With Stress

A Guide to Understanding Stress...

  • Understanding Stress
  • Causes Of Stress
  • Skills For Managing Stress
  • Managing Stress At Work
  • Simplifying Your Life
  • Walking Away From Stress
  • Understanding Stress

What Is Stress?

Stress, by definition, is the inability to cope with a threat (real or imagined) to your well-being, which results in a series of responses and adaptations by our bodies. You may respond to a traffic jam on the office commute with anger and frustration. Someone else may view the situation as a time to relax and get away from it all and might listen to music.

A co-worker may thrive on deadlines, but maybe you think of them as “dreadlines.” Therefore, stress can be good stress (eustress) or bad stress (distress). Good stress can take place during happy, exciting times such as a marriage, a promotion, new job, or birth of a child. Most of us are familiar with the bad stress events such as death of a family member or friend, divorce, financial problems, working with and for difficult people.

Are You Running On Empty?

“You often hear that there’s no room in the workplace for emotions, yet many people live in a pool of negative emotions, drowning in anger at the boss, irritation at co-workers, anxiety over downsizing, and worry about family concerns,” says Jerry Kaiser, director of health services for the Institute of HeartMath.

Ever been to a stress management class? Did it work? Not really.

“The reason most well-intended self-help books and stress management programs don’t work,” says Kaiser, “is that people get a lot of information that sounds good (and they know what to do to be healthy), but then they walk out the door and the ‘noise’ of life becomes louder than the information, and life goes back to its baseline of low-grade frustration or worry.”

Feelings—not information—change behavior. Here’s an example: Try to recall something that made you feel angry whether it was 10 minutes ago or 10 years ago. BOOM! The pumping efficiency of your heart has just decreased up to 10 percent, according to one researcher. And these recalled feelings of anger can produce a weakening effect on your heart. But now picture a moment when the boss unexpectedly recognizes something important you’ve done at a company meeting. You feel a boost of energy and clarity. Life feels good.

Shift Your Emotional Gears

“When there’s an angry customer on the phone,” Kaiser explains, “or you’re angry at your boss, you can’t wait four hours to get to the gym to work out your anger.” The key is to shift your emotional gears out of reverse and at least into neutral at the moment.

“Everyone has a picture of their family or a favorite place or their pet Labrador on their desk or wall, in their locker or in their wallet or purse. Simply using that picture to recall the good feeling you associate with it,” Kaiser points out, “can have a powerful effect. Freeze-frame the moment, push the pause button on your inner movie, and find yourself transported for a moment to a more pleasant emotional place.”

“The reason most well-intended self-help books and stress management programs don’t work is that people get a lot of information that sounds good (and they know what to do to be healthy), but then they walk out the door and the ‘noise’ of life becomes louder than the information, and life goes back to its baseline of low-grade frustration or worry.”

Symptoms Of Stress

  • Fatigue or exhaustion
  • Tight neck and shoulder muscles
  • Feelings of anger
  • Feelings of anxiety
  • Insomnia
  • Headaches or migraines
  • Sadness or depression
  • Feelings of hopelessness
  • Colds or congestion
  • Indigestion
  • Diarrhea, spastic colon or intestinal disorder
  • Symptoms of ulcers
  • Sore jaw muscles
  • Poor appetite
  • Bronchitis, pneumonia or asthma

Causes Of Stress

Long-Term Stress Is Bad For Your Health

Some experts think that stress may cause 50% of all disease. Stress contributes to the first and second leading causes of death—heart disease and cancer. It’s also a factor in migraines, digestive problems, mental illness, chronic insomnia, fatigue, high blood pressure, asthma, allergies, ulcers, tooth decay, and the common cold.

We’re not talking about one incident. It’s chronic stress— day in, day out—which can harm your immune system, making you more prone to accidents, illness, and plain old unhappiness.

Many of us have come to accept stress as normal—doesn’t everyone complain about how busy they are? That doesn’t make it okay. Take a look at your stress levels, what causes your stress, and what you can do about it.

Me? Stressed?

Driving home from work with 18 minutes to get to the school program, and traffic has slowed to a crawl. Thoughts are racing: “What do we have for dinner? I’ve got to call Mel... AND get the laundry started or I’ll be up late tonight! What did she mean by “that new procedure” was going to be a challenge? Does she think I can’t do it? They say it may freeze. Are the hoses disconnected?”

The driver is experiencing stress from several sources:

  • Environment—Traffic, pollution, noise, and weather
  • Social—Job pressures, family demands, social obligations
  • Physical—Lack of sleep, possible poor diet
  • Mental—Interpretation of the supervisor’s comment, worry over being late

We all experience stress every day, but people vary in how they handle it. Some people thrive on change, getting a new job, moving or additional responsibilities. Others are upset by changes in their routines. But everyone can benefit by learning stress-reduction techniques and using them in their daily lives.

Some Get Sick, Some Don’t

Ever wonder why some people catch all the colds that go around, and others don’t? In one study, researchers took 276 healthy volunteers and measured their stress levels, then put cold viruses in their noses.

  • People who had been under severe stress for 1 to 6 months were twice as likely to get sick.
  • Those with more than two years of stress were four times more likely to develop colds.
  • Those with the most relationships—family, friends, and community—were the least likely to catch the cold.
  • Stress about intimate relationships doubled cold risk.
  • Stress from unemployment or underemployment made sufferers three and a half times more likely to start sniffling.

Stress Symptoms


  • upset stomach
  • trouble sleeping
  • accidents and injuries
  • tight chest or throat
  • backaches
  • constipation
  • headaches
  • exhaustion


  • trouble concentrating
  • difficulty making decisions
  • forgetfulness
  • scary thoughts
  • making errors
  • repetitive thoughts


  • grumpy
  • tense
  • impatient
  • hopeless
  • hostile
  • easily upset
  • no pleasure in pastimes
  • lonely
  • depressed


  • excessive drinking
  • poor eating habits
  • driving too fast
  • drug use
  • getting into arguments
  • becoming a loner
  • working too much
  • criticizing others a lot


  • financial problems
  • too much driving
  • worry about children
  • health problems
  • pressure at work
  • not enough exercise
  • lousy diet
  • personal relationship issues
  • overweight
  • working too many hours
  • caretaking an elder
  • no quiet time
  • conflict with co-worker
  • bored with routine
  • conflict with family member
  • noisy environment
  • sexual problems
  • nobody to talk to

Review the list above. Are there problems you can solve, simply eliminating them?; Others may be beyond your control— except that if you change your attitude about them, they may bother you less. As you read through the stress management skills on the following pages, think about which skills might help you deal with your stressors.

Skills For Managing Stress

Adjust Your Attitude


You’d never design the world this way. If you had the power, you’d change all sorts of things—at work, about yourself and family members, in your community and the world. Sort out which problems you can solve, and which are truly beyond your control. Work on accepting the things you can’t change. Learn to mentally say, “Oh, well. So it goes.”

Realistic Expectations

“How could she do this to me again?” If you find yourself angry at the same situations over and over, maybe it’s time to look at your expectations. A co-worker who is always late with her work is unlikely to change. Can you learn from experience, and plan around her? If your son would rather read than play basketball, can you give up your dreams of him in the NBA? You can save a lot of stress and conflict by being realistic.

Positive Attitude

“I’ll never get this right.” Negative self-talk tends to come true—or at least make life a lot harder. Be your own coach. Tell yourself “If I keep at this, I’ll figure it out.” Encourage your family and co-workers—positive attitudes are contagious.

The Big Picture

Take a step back from problems. Ask yourself: Will this matter in a year? What do other people do when they have this problem? Is this something time may help?

Recognize Choices

We get in the habit of thinking that we have to live with things as they are. Think again. Do you actually have a choice? Could you speak up, or change things, or say no, or stop? Could you ask someone else to do it? Be honest with yourself, even if you don’t choose to change the situation.

Work It Out!

Exercise is probably the simplest, most popular stress-reliever and antidepressant available. Aerobic exercise for half an hour several times a week does great things for your mood, your heart, and your waistline. It reduces the risk of many diseases and produces endorphins, natural brain chemicals that make you feel good and decrease pain.

The easiest way to get started is with brisk walking outdoors or on a treadmill. As your fitness improves, you may want to try jogging, bicycling, swimming, aerobics classes, or cross-country skiing. See your doctor before starting on a fitness program.

The Art Of Relaxation

You’ll get much better at relaxing if you practice regularly. Pick a method or two and get good at it!

Deep Breathing

You can do this almost anywhere, anytime. The trick is to remember to do it! Inhale through your nose as you count to four. Let your abdomen expand. Exhale slowly through your mouth as you count to eight, letting tension leave your body with your breath. Repeat for a minute or two. Your muscles will relax, and your cells will perk up from the extra oxygen. Repeat whenever you feel tense.

Progressive Muscle Relaxation

Sit or lie down in a quiet place and tense, then relax each muscle group in your body—even your face. Then breathe slowly and deeply for a few minutes. Audio tapes which guide you may be helpful—find them at bookstores.


Sit quietly, close your eyes, and relax your body. Silently repeat a pleasant word like “relax.” When thoughts come, let them go and return to repeating your word. Continue for 10 or 20 minutes. Stop repeating the word. Sit quietly for another minute or two, open your eyes, and feel refreshed.

Stretching Exercises

Tense muscles really appreciate a stretch. Here are a few you can do in a chair.

Fingers: Separate and stretch out your fingers for 10 seconds. Curl your fingers at the knuckles and hold for 10 seconds. Repeat first stretch.

Shoulders: Lift your shoulders toward your ears and hold a few seconds, then relax.

Forearms: Extend one arm straight out, palm up. Gently bend back the extended hand with your other hand.

Neck: Tilt your head to one side and hold for 10 to 20 seconds. Repeat on other side.

Upper Back: Clasp your hands behind your head, elbows out, and squeeze your shoulder blades together for 10 seconds. Relax.

This isn’t a complete body stretch; ask your doctor for a booklet on stretching, or check out a book or video from the library for more great stretches.


Yoga can improve circulation and memory and lower blood pressure and heart rate. The exercises revitalize your inner organs and stretch your muscles and spine. Most classes combine physical exercises, breathing exercises, and meditation.


Nature is truly a great healer, and walking has tremendous health benefits. In a recent study, brisk walking for at least a half hour only six times a month reduced the death rate of participating adults by 43%. To step out into nature and notice the plants and trees is to rejoin the original health club. With no monthly fee!

Massage Therapy

A few decades ago, nurses routinely offered hospital patients massages, which increased the circulation of blood, reduced muscle tension, swelling and inflammation, relieved pain, and promoted recovery from surgery. Massage therapy has moved out of the hospital and into more mainstream use to help people recover from injuries and from the stresses of increasingly busy lives. Look for a licensed massage therapist.

All You Need Is Love

The research keeps coming in—people with good social connections, and plenty of them, enjoy better health. It works both ways. People who suffer loneliness and isolation are two to five times more likely to die prematurely, and those who say they feel loved have less serious health problems, even when they have other high risk factors. Some research results:

  • People with close relationships recover faster from injury and illness.
  • Heart disease patients who reported that they felt the most loved and supported had less coronary artery blockage than others.
  • Women with breast cancer who joined support groups had better long-term survival rates.
  • Having a friend with you at a stressful event can lower your blood pressure and heart rate.
  • Pet owners with heart disease are less likely to die early than those without pets.
  • Heart disease is less likely in people with many social contacts.
  • Touching can reduce irregular heartbeats.
  • Volunteer workers have reduced mortality rates.
  • Retirees who said their lives had improved since retiring had an average of 16 friends. Unsatisfied retirees averaged less than 10.
  • People who have a large circle of friends catch fewer colds. The take home lessons? Nurture your relationships with friends and loved ones. Share your feelings, and ask how they’re doing and really listen. You don’t need to solve their problems—just acknowledge them.
  • Volunteer to help others—at the animal shelter, as a Big Brother, at the homeless shelter, the PTA, local film festival, church, hospital, nursing home, literacy program, or hospice.
  • Get a pet if you haven’t got one. They love and need you unconditionally.
  • Prayer, meditation, being in nature, even gardening can help you experience nurturing spiritual connections.

Get Some Shut Eye

In the early part of the century, people slept about 9 hours a night. These days most of us average only 6-7 hours. Mood, memory, and your ability to pay attention and make good decisions take a nose dive as sleep deficits grow. It’s downright dangerous—23% of us admitted to falling asleep at the wheel in the past year. Make yourself get to bed at a reasonable hour. If you have trouble sleeping, try these suggestions:

  • Program your body clock by going to bed and getting up at the same time every day.
  • Avoid caffeine, alcohol, and nicotine in the late afternoon and evening.
  • Get outside in the daylight every day.
  • Don’t use sleep aids containing antihistamines.
  • Keep a cool bedroom. 60-65° F is ideal.
  • Exercise regularly for longer, deeper sleep.
  • Remove the TV—reserve the bedroom for sleep only.
  • Eat a light carbohydrate snack before bed.
  • Move your bedside clock out of sight, especially if it’s illuminated.
  • Create a “nesting ritual” at bedtime, perhaps including a warm bath or soft music to prepare you for sleep.
  • If you can’t fall asleep after a half hour, get up and leave the bedroom until you feel sleepy.
  • See your doctor if you have chronic trouble sleeping or are drowsy in the daytime. A diagnosis of the underlying cause is important, and treatments are available.

Manage Your Money

In a recent survey, 41% of workers said they felt pressure from personal financial worries. If this is a persistent source of your stress, do something about it.

Credit Card Debt

The more you owe on your credit card, the less of your payment pays for what you bought. It’s worth some sacrifice to bring down your debt, so your money goes towards stuff you need, not interest. Here’s how:

  • Make those payments on time. Many cards can increase your interest rate if you’re late a couple of times—the last thing you need.
  • Pay all, or as much as you can. Minimum monthly payments on many major cards are only about 2% of what you owe. It will take years to pay them off at that rate, and if you keep using the card meanwhile, your debt is guaranteed to grow.
  • Pay off the debt with the highest interest rate first. Then attack the debt with the next highest rate.
  • Call your credit card company. Ask for a lower rate. If you’ve got a good payment history, you may qualify for a lower promotional rate.
  • Use your income tax refund, bonuses or windfalls to pay off debt. This is a golden opportunity—don’t blow it!
  • Consult a credit counselor if you are “in over your head.”

Managing Stress At Work

Six Ways To Cope With Work-Related Stress

1. Talk Freely With One Another

With all the talk about quality, sometimes you need to present your supervisor with the idea that a team approach to problem solving may actually work. Encourage your employer to create an environment in which you and your co-workers may talk freely with one another, AND with their managers, without fear of repercussions; that also means that management must listen and follow through on ideas that are clearly improvements. Working in teams can reduce stress. Talk with your spouse, your friends, your kids. Keep lines of communication open.

2. Reduce Personal Conflicts

There’s nothing worse than not knowing what’s expected of you on the job. Make sure you have clearly defined job duties and that your manager has expressed, often in writing, his or her expectations for you. There’s no reason for you to be “steamed” with no recourse. Attend training sessions offered to you and keep open communication. Learn to defuse your emotions in the moment—remember the tranquil place or photo of your kids, and be there. The same applies at home.

3. Get Control Over Your Schedule

In the era of downsizing when companies are trying to do more with less money and fewer employees, you may often be pressured into more overtime with higher expectations from management. Blue-collar workers, who are never sure which shift they’ll be working next and might be “on call” during off hours, experience a very different kind of job stress. Reduce overtime when possible. Work with management on scheduling issues. Are you over-committed outside the workplace? Take control of your calendar. Just saying no sometimes to meetings or other demands on your time can free up time in your schedule and reduce stress.

4. Use Wellness Benefits

A comprehensive wellness program is a major step toward helping employees make life-saving, lifestyle choices and should be part of every company’s employee benefits package. If you don’t have flextime, ask your supervisor to consider it, especially if you need 15 minutes or more of flexibility in your schedule to get the kids to school or activities or to fit in a workout during the workday. Check your human resource center for other helpful benefits that can reduce your stress.

5. Use Your Personal Leave Or Vacation Benefits

Take your scheduled vacations. Or go on a mini-vacation during the workday (such as a meditation room, a quiet room away from office chatter and lunchroom). Use this time to recharge and relax. A long soak in the bathtub before bed can be the ultimate stress reliever.

6. Use Available Support Options

Use your employee assistance program, local mental health providers, or hospital-based family and mental health counselors to learn coping strategies. Most EAP programs are confidential and off-site. Alcohol and substance abuse problems and marital problems can be devastating and certainly stress producing. Seek help for yourself or your family members.

What We Know About Stress

  • One million people in this country are absent from work each day because of stress-related disorders. Disabling stress has doubled over the last six years.
  • 72% of Americans experience frequent stress-related physical or mental conditions.
  • The top causes of stress in the workplace, according to a survey, are job insecurity, understaffing, personality conflicts, external competitive pressures and changing technology.
  • Unmanaged stress (or your reaction to stress) is a higher risk factor for cancer and heart disease than either cigarette smoking or high cholesterol foods.
  • If you have little or no control over your work or low levels or no levels of support, you are nearly twice as likely to develop heart disease.
  • Up to 44% of women and 36% of men want to quit their jobs because of workplace stress.

Simplifying Your Life

Save On Time

Most of our lives are filled with clutter—stacks of paper, bills, and other should-be-organized stuff. But how does all that clutter affect your time? To illustrate, consider the following example: on a typical work day, a person with a cluttered work area will spend an hour and a half simply looking for things or getting distracted. Over the course of a year, that’s a month and a half of lost time. Consider the following suggestions for taking the clutter out of your day.

  • Cancel subscriptions to magazines you never read. These just add to your list of things you’d LIKE to do—more importantly, it’s a waste of money.
  • Set up automatic bill payments. This process will help alleviate late payments, save you time, and save money on postage.
  • Say no when necessary. You can’t always please everyone, so realize you don’t have to take on every project or responsibility.
  • Simplify your wallet or purse. Take out those unused, unnecessary credit cards and other items that you don’t use. The less clutter, the better
  • Consolidate your debt. Combine your debts and search for one low interest rate. Not only will this save you money, it will save you time.

Organization is not glamorous, nor is it commonly thought of as a time-saver. However, clutter is the companion of inefficiency. Make organization a priority and you’ll find time is on your side.

Source: Families and Work Institute

Reclaim Your Time

If it feels like there’s more day than you, then it’s time to reclaim your stamina and ambition. Perhaps the trick to this lies in better planning of your day. Here’s what you can do.

Know What’s On The Agenda.

This will include everything that should, could, or given the time, would get done. Make this list as extensive as possible—just dump everything in.

Know What’s Most Important.

The second step is to prioritize. This is also the time to decide what, if anything, you’ll allow yourself to get sidetracked by. Some projects must be pursued at all costs, but some crises overrule the importance of a project. In planning your day, anticipate where you may need to divert your focus.

Know What To Do When.

The specifics of how you will spend your day flow directly from the preceding two recommendations—it’s simply a logical extension of what’s on the agenda and what’s most important.

Make It Jump.

The final step is to energize the plan. Without a sense of excitement, your plan becomes a dark storm cloud filled with a day’s worth of stress. But a perspective that includes some measure of excitement changes all of that.

Being More Productive During The Day

At the end of the day when you’re reviewing your to-do list, does it seem like there are more items that have been added than crossed off?& Do you wonder where the day goes and why projects and tasks seem to take more time than they should?

Everyday, we’re constantly interrupted by phone calls, questions, and other distractions that make it difficult to get things done. And while there will always be more work to do, there are ways to increase your productivity and ensure that your list dwindles rather than grows. Here’s how:

  • Try to tackle your most important tasks first. This will allow you to move ahead without dwelling on those items that should have already been taken care of.
  • Only touch paper once.  Determine what needs to be done with the paper, and when finished, either throw it away or file it in the appropriate folder.
  • Make your meetings more efficient. Start on time, be prepared, be concise, and get to the point. If follow up is needed, use a brief memo to summarize the outcomes.
  • Widen the circle. Any time you can involve others on a project, do it. This will help reduce your stress, and the teamwork will likely improve the project’s quality and efficiency.
  • Divide projects into manageable parts. It’s not always possible to complete a project in one day, so give yourself plenty of time to finish and distribute small portions of the project everyday.
“On a typical work day, a person with a cluttered work area will spend an hour and a half simply looking for things or getting distracted. Over the course of a year, that’s a month and a half of lost time.”

Walking Away From Stress

Walking Does A Body Good

If you are serious about relieving the harmful effects of stress in your life, you’ll want to consider taking up a walking program. Indeed, a walking program will not only help you to burn off nervous energy, but it will make you more fit—thus allowing you to handle stress even better.

Walking is an activity that has worked wonders for all kinds of people. But here’s the secret:

You have to do it in order to reap the benefits.

Certainly, there are numerous barriers that can keep you from being physically active. However, each one of the barriers that keep you from this marvelous activity can be overcome.

Check out the information on the following page about starting a walking program. And be sure to check with your healthcare provider if you have any questions prior to starting an exercise program.

Start A Walking Program

Walking does wonders in helping to reduce the harmful effects of stress. But you have to leave time in your busy schedule to follow a walking program that will work for you. In planning your walking program, keep the following points in mind:

  • Choose a safe place to walk. Find a partner or group of people to walk with you. Your walking partner(s) should be able to walk with you on the same schedule and at the same speed.
  • Wear shoes with thick flexible soles that will cushion your feet and absorb shock.
  • Wear clothes that will keep you dry and comfortable. Look for synthetic fabrics that absorb sweat and remove it from your skin.
  • For extra warmth in winter, wear a knit cap. To stay cool in summer, wear a baseball cap or visor.
  • Do light stretching before and after you walk.
  • Think of your walk in three parts. Walk slowly for 5 minutes. Increase your speed for the next 5 minutes. Finally, to cool down, walk slowly again for 5 minutes.
  • Try to walk at least three times per week. Add 2 to 3 minutes per week to the fast walk. If you walk less than three times per week, increase the fast walk more slowly.
  • To avoid stiff or sore muscles or joints, start gradually. Over several weeks, begin walking faster, going further, and walking for longer periods of time.

The more you walk, the better you will feel. You also will use more calories.

Is It OK For Me To Walk?

Answer the following questions before you begin a walking program.

  • Yes _____ No _____ Has your health care provider ever told you that you have heart trouble?
  • Yes _____ No _____ When you are physically active, do you have pains in your chest or on your left side (neck, shoulder, or arm)?
  • Yes _____ No _____ Do you often feel faint or have dizzy spells?
  • Yes _____ No _____ Do you feel extremely breathless after you have been physically active?
  • Yes _____ No _____ Has your health care provider told you that you have high blood pressure?
  • Yes _____ No _____ Has your health care provider told you that you have bone or joint problems, like arthritis, that could get worse if you are physically active?
  • Yes _____ No _____ Are you over 50 years old and not used to a lot of physical activity?
  • Yes _____ No _____ Do you have a health problem or physical reason not mentioned here that might keep you from starting a walking program?

If you answered yes to any of these questions, please check with your health care provider before starting a walking program or other form of physical activity.


Long-Term Stress Is Bad For Your Health

Some experts think that stress may cause 50% of all disease. Stress contributes to the first and second leading causes of death—heart disease and cancer. It’s also a factor in migraines, digestive problems, mental illness, chronic insomnia, fatigue, high blood pressure, asthma, allergies, ulcers, tooth decay, and the common cold.

We’re not talking about one incident. It’s chronic stress—day in, day out—which can harm your immune system, making you more prone to accidents, illness, and plain old unhappiness.

Many of us have come to accept stress as normal— doesn’t everyone complain about how busy they are? That doesn’t make it okay. Take a look at your stress levels, what causes your stress, and what you can do about it.

Coping With Stress: A Guide To Understanding Stress

The information contained in this guide was taken from WELCOA’s line of Stress Man-agement brochures and has been reviewed for accuracy. This information is not intended to replace the advice of your healthcare provider. If you have any questions about managing your own health and/or seeking medical care, please contact a medical professional.

Wellness Councils of America
9802 Nicholas Street, Suite 315
Omaha, NE 68114-2106
Phone: (402) 827-3590 Fax: (402) 827-3594

©2005 Wellness Councils of America