In This Issue:
} How Stress Affects Your Health
} 6 Soothing Ways to Ease Stress
} The New Age of Stress at Work
} Reduce Stress With Time Management
When stress grips your body, you know it. Your
heart starts pounding, your muscles tense, your
stomach feels tied in knots. Sometimes this
response can be a good thing. It may help you
escape from an attacker or win your tennis game.
However, continued stress can have negative effects
on your physical health.
The stages of stress
Over 50 years ago, a scientist named Hans Selye
recognized that stress was a major cause of illness.
He broke the stress response into three stages,
which he called the general adaptation syndrome.
} The alarm stage occurs when you are frightened
or under threat. Your body goes on red alert,
releasing stress hormones such as adrenaline
and cortisol. These increase strength and
concentration. Your heart speeds up, sending
more blood and oxygen to your muscles so you
can take quick action. This “fight or flight”
response can be lifesaving, but if it is prolonged it
can take a toll on your body.
} The resistance stage occurs after the initial
extreme reaction. Your body tries to adapt to the
continued stress. If the stress passes, you can start
to rebuild your defenses. If it becomes long-term,
you move to the third stage.
} The exhaustion stage is the “burnout” or
overload phase. Continued pounding by stress
depletes your body’s reserves, which puts you at
risk for disease.
This sequence may happen in response to either a
physical threat (such as being in a car accident) or
an emotional one (such as being laid off from your
job). Facing multiple longterm stressors piles extra
strain on your system and can quickly lead
How Stress Affects Your Health
Stress can have far-ranging negative effects on your health. Learn
what happens when you live with long-term stress.
The effects of stress
Stress can have effects throughout your body on both your
physical and mental health. It can affect:
} Digestion. Stress hormones slow the release of stomach
acid and interfere with how well the stomach can
empty itself. This can cause stomachaches. These same
hormones cause the colon to work faster and may lead
} Heart and blood vessels. High levels of the stress
hormone cortisol increase your heart rate and your
blood pressure. Cortisol can also raise your cholesterol
levels. These factors raise your risk for heart attacks
} Immune system. Normally, your immune system
responds to infections by releasing chemicals that aid in
the healing process. The stress response weakens your
immune system by reducing the release of chemicals,
slowing wound healing and making you more likely to
get colds and infections.
} Weight. Cortisol makes you crave fats and
carbohydrates, which can cause you to gain weight.
Cortisol also makes you more likely to put on weight
in your abdominal area. Weight gain in this area raises
your risk for heart disease and diabetes.
} Mental health. Being bombarded with stress hormones
creates a constant state of tension and anxiety. Over
time this can set you up for depression, headaches or
other problems, especially if they run in the family.
Also, because your body is in a heightened state of
arousal, you may have trouble sleeping.
Regaining your balance
If stress has taken over your life, it’s time to regain some
control. Your health depends on it. Here are some ideas:
} Make time for regular, moderate exercise. It’s one of
the best stress-busters, and it can improve your mood
and help control your weight. Check with your doctor to
see what activity level is right for you.
} Spend some time doing things you enjoy. Go to
a funny movie, take your kids fishing or have dinner
with a friend.
} Learn some relaxation techniques, such as deep
breathing or meditation.
} Treat yourself well. Make time for healthy meals and
getting enough sleep. Avoid smoking, drinking too
much and overeating.
If you still cannot get a handle on your stress, talk to your
doctor. He or she might recommend a counselor who
could help you find other ways to reduce or manage the
stress in your life.
6 Soothing Ways
to Ease Stress
Learn ways to calm the stress in
Feeling stressed out? Most Americans do.
Not all stress is bad. A certain amount of stress enables
executives to perform at their peak. But too much stress
can be harmful. Stress is linked to such chronic conditions
such as heart disease and depression.
The trick is to manage or control stress to keep it within
healthy limits. If your stress meter is soaring, learn to
relax. Here are some soothing ways to handle the stress in
You’ve heard the expression, “take a breather”? Sometimes
just five minutes of deep breathing is enough to ban stress.
Most people take shallow breaths that fill only part of the
lungs. Deep breathing gets more oxygen into the lungs
and can help calm the brain. Try these steps:
} Sit or lie with one hand on your belly.
} Breathe in through your nose, filling your lungs. Focus
on making the hand on your belly rise.
} Breathe out through your mouth, trying to empty
your lungs as much as you can. The hand on your belly
should move in as your muscles tighten.
} Continue these deep, slow breaths, in through your
nose, out through your mouth, making your belly rise
This simple but powerful exercise can be done almost
anywhere. It can be combined with meditation or
2. Relax your muscles
Progressive muscle relaxation is another simple way to
ease stress. Practicing it can help you become aware of
when you are holding stress in your body. Relaxing your
muscles can help your mind relax too.
} Lie down in a quiet place. Take a few minutes to
breathe slowly and deeply.
} When you feel relaxed, start with your right foot.
Squeeze the muscles as tightly as you can. Hold while
you count to 10.
} Relax your right foot. Take a few deep breaths.
} Next, squeeze the muscles in your left foot while you
count to 10.
} Relax and breathe.
} Slowly work your way up your body (legs, belly, back,
chest, arms, neck, face), squeezing and relaxing each
group of muscles.
3. Say yes to yoga
Yoga is a system of exercises (called asanas) for gaining
bodily or mental control and well-being. The philosophy
is that the breath, the mind and the body are so closely
linked that whatever you do to one will affect the other.
In addition to easing stress, yoga can improve strength,
balance and flexibility.
Yoga is gentle form of exercise that is safe for most people
when it’s practiced correctly. Consult a trained yoga
teacher. Make sure you ask your doctor before you start
any new activity.
4. Try tai chi
Tai chi is a series of postures that flow into one another
through connecting transition moves. These slow, graceful
and precise body movements are said to improve body
awareness and enhance strength and coordination. At
the same time, they are supposed to help the practitioner
achieve inner peace. Like yoga, it is designed to enhance
both physical and emotional health.
Tai chi is a low-impact aerobic activity, so you can
de-stress and burn some calories at the same time.
Another advantage to tai chi is its low risk of injury.
Take a tai chi class or buy a book or instructional video.
Once you learn how to do tai chi, you can practice
Meditation is a centuries-old spiritual practice that is also
a powerful stress-buster. You learn to relax while focusing
on a word, a sound or your own breathing. It can have a
deeply calming effect.
There are many different types of meditation. One type
is mindfulness meditation. You can practice mindfulness
while sitting in a quiet place or while walking. The key is
to keep bringing your focus back to your breathing or your
steps. When distractions come into your mind, observe
them without judging, and let them go. The technique is
simple, but achieving the desired result takes practice.
6. Get a massage
In massage therapy, the hands (or sometimes forearms,
elbows and feet) are used to manipulate the soft body
tissues. A good massage is not only relaxing, but it may
also have some real healing benefits. Some studies have
shown that the kneading and pressing of muscles slows
the heart rate, lowers blood pressure, improves blood
circulation, relaxes muscles and helps reduce stress levels.
If you can’t fit in or afford a visit to a spa, ask your partner
or friend for a neck, back or foot rub. Trading massages
can be a relaxing way to reconnect after a stressful day.
The New Age of
Stress at Work
Long-term job stress can grind you
down. Learn more about stress and
how to tame it in the workplace.
Your job used to be challenging but manageable. Now
it seems no matter how fast you run, you can’t keep up.
Your inbox is piling up and your boss is on your back.
This scenario is all too common, according to the
National Institute of Occupational Safety and Health
(NIOSH). In national surveys:
} 40 percent of workers say their job is very or
} 75 percent say workers suffer more job-related stress
than workers in the previous generation.
} 25 percent of employees say their job is their number
Even if you love your job, long-term stress can grind you
down. Read on to learn more about stress and how to
tame it in the workplace.
From cave to cubicle: the stress response
Stress is a necessary survival response that draws upon
instinct, hormones and muscle. Our distant ancestors’
“fight or flight” response to stress allowed the human race
to survive in a hostile environment.
These days we no longer brandish a spear or need to outrun
predators. Yet we still have the same quickened heartbeat
and surging stress hormones when faced with a stressful
situation. Those biological responses are lifesaving when
we’re in danger, but they can damage our health if they
become a way of life.
A small dose of stress can be helpful. It may help you meet
a deadline or score high on a presentation. But if stress
becomes an everyday reality, it can lead to poor health. At
first it can cause headaches, upset stomach and poor sleep.
Over time it may lead to chronic health problems such as
depression, back pain and heart disease.
Take your stress temperature
Certain factors are well-known causes of stress in the
workplace. Some of these include:
} Lack of control or input
} Heavy workload or too many responsibilities
} Not being recognized or rewarded for your work
} Working in dirty, noisy or uncomfortable surroundings
Are any of these at the bottom of your stress? Are there
other factors that play a role? Pinpointing the causes of
stress can help you find solutions.
Tame your stress
The good news is we live in an age when addressing work
stress is important for business. Many managers know
that stressed workers are not as productive, are more likely
to get injured and take more sick days than workers who
If work stress is getting you down
} Talk to your manager. Ask if there are ways to
restructure your job to make it more manageable. Be
positive. Offer solutions, not just complaints.
} Explore work resources at your company. Find out if
there is an employee assistance program (EAP) or stress
management course you could access.
} Take good care of yourself. Be sure to eat well, get
enough sleep and make time for exercise. You’ll handle
stress better if you’re healthy.
} Get help if you need it. You may want to take a
meditation, yoga or tai chi class. You might also consider
seeing a therapist who could help you seek solutions to
your work situation.
In This Issue:
} 10 Ways to Simplify Your Life and Dial
Down Stress Levels
} Who Can I Talk to About Mental Health
} Can Exercise Keep You Mentally Sharp?
} Treating Depression
It seems like everyone is stressed out these days - from your co-workers, to
your friends, to the person standing next to you in line.
Stress, by itself, isn’t necessarily bad. Low or even moderate amounts of
stress can be good for us, provided we manage it in healthy ways. But
poorly managed stress can take a toll. Heart disease, fatigue, and obesity
are just a few of the potential consequences.
If stress is bothering you, consider the following 10 ways to regain control:
1. Recognize your symptoms. Your signs of stress may be different
from someone else’s. Some people get angry. Others have trouble
concentrating or making decisions. Some feel worried or depressed. For
some, stress leads to physical symptoms such as headache, back pain,
upset stomach, or trouble sleeping.
10 Ways to Simplify
Your Life and Dial
Down Stress Levels
Stress may be inevitable. But how you deal
with it is largely up to you. Here are some tools
to help you manage the stress in your life.time.
Even quick workouts can benefit your heart.
Job Stress: How to Keep Your
Attention Deficit Hyperactivity
Disorder: Myths and Facts
2. Identify the sources. What situations trigger your
stress? Among other things, your stress may be
linked to your family, health, work, or personal
relationships. Keep in mind that stress is often
caused by a change in your life, negative or positive.
Marriage, divorce, job loss, or a promotion may all
3. Evaluate your coping strategies. Examine the ways
in which you deal with situations that cause you
stress. Responses like smoking, drinking alcohol, or
eating too much may feel good in the short run, but
they can cause long-term harm.
4. Learn to say ‘no.’ Sometimes the best way to deal
with unnecessary stress is to avoid it. Know your
limits, and refuse to take on more responsibilities
than you can handle.
5. Plan ahead. Don’t let your to-do list get out of
control. Think about your day, and decide which
tasks are the most important. Do those items first.
Let other tasks drop to the bottom of - or even off -
6. Create time to relax. It’s not always easy, but it’s
important to make time for yourself. Take vacations
or other breaks. Make time to read a good book,
listen to music, watch a comedy, or just have a
warm cup of tea. Some people find deep breathing
exercises helpful for relieving stress.
7. Exercise regularly. A brisk walk, a bike ride, and a
trip to the gym are just some of the physical activities
that can help prevent or reduce stress. Aim to get 2
hours and 30 minutes of exercise each week. Talk to
your doctor before increasing your activity level.
8. Eat healthfully. Eating balanced, nutritious meals
throughout the day will help you cope with stress by
keeping you energized and focused. Also, cut back
on caffeine. You’ll feel more relaxed and will likely
9. Talk to family and friends. Simply talking with
supportive people can often bring stress relief, even
if the stressful situation doesn’t change. By the same
token, limit the time you spend with people who
only add to your stress.
10. Get help. If stress seems overwhelming, consider
talking to a mental-health professional. He or she
can offer healthy stress-busting techniques.
A psychiatrist is a medical or osteopathic doctor with
special training in the diagnosis and treatment of
mental and emotional illnesses. Like other doctors,
psychiatrists can prescribe medication. A psychiatrist
should have a state medical license and be board-
eligible or board-certified by the American Board of
Psychiatry and Neurology.
A psychologist has an advanced degree from an
accredited graduate program in psychology and two
or more years of supervised work experience. Most
states require a doctoral degree and a state license for
psychologists. Psychologists can make diagnoses, do
psychological testing, and provide therapy.
Clinical social workers
Social workers have a master’s degree in social work
from an accredited graduate program. They are trained
to make diagnoses and provide individual and group
therapy. Their qualifications should include a state
license and membership in the Academy of Certified
Licensed professional counselors
A licensed professional counselor has a master’s degree
in psychology, counseling or a related field. Licensed
counselors are trained to diagnose and treat mental and
emotional disorders. They are required to have a state
Marriage and family therapists
A marriage and family therapist (MFT) has at least
a master’s degree and two years of supervised clinical
experience. They are trained to diagnose and treat
mental health and substance abuse problems from
a family perspective. They can provide individual,
couples, family and group therapy.
Certified mental health counselors
These professionals have a master’s degree and several
years of supervised clinical work experience in mental
health. They can diagnose and provide treatment for
many emotional and mental health issues. They are
certified by the National Academy of Certified Clinical
Mental Health Counselors.
Certified alcohol and drug abuse
Certified alcohol and drug abuse counselors have
specific clinical training in alcohol and drug abuse.
They can diagnose substance abuse issues and provide
individual and group counseling. They must carry a
Who Can I Talk
to About Mental
Many different types of professionals
offer talk therapy. Learn more about
their training and how to choose a
If you are struggling with an emotional problem, a mental health professional can help. Psychotherapy offered by a
trained and licensed therapist can often successfully treat relationship problems and many mental health conditions,
including depression and anxiety.
Many different types of professionals offer psychotherapy (talk therapy). Some of them can also prescribe
medication if needed.
Can Exercise Keep You
Exercise helps both body and mind.
Exercise maintains your body by keeping it fit and strong. Physical
activity also helps ward off serious conditions like heart disease, diabetes
and cancer. But exercise doesn’t just work wonders for your body. These
effects apply to your brain, too. Physical activity sustains brain function
and wards off declines in mental ability, too.
Experts say that exercise can help prevent mental decline as we age.
Regular exercise may enhance memory and mood, and may improve our
ability to juggle multiple mental tasks.
The aging brain
Severe memory loss or other serious mental
impairments are most often caused by disease. But
age-related mental declines may be the result of
decreased brain activity and stimulation. Both mental
and physical exercise can help keep your brain sharp.
Your brain with exercise
So how does physical activity boost brain power? It
} Think more clearly. Getting your heart rate up
pumps blood to the brain. This helps your brain
perform better. Low-impact exercises like walking
may be best for “clearing your head” because
muscles don’t work hard enough to use up extra
oxygen and glucose.
These are registered nurses (RNs) with a master’s
degree in psychiatric and mental health nursing. They
may also be called advanced practice registered nurses,
psychiatric nurse practitioners or psychiatric clinical
nurse specialists. They can diagnose and treat people
with mental health disorders, and in most states they
can prescribe medication. They are certified by the
American Nurses Credentialing Center and must have
a state license.
Pastoral counselors are clergy with a degree in mental
health and extensive supervised clinical practice. As
a result, they approach emotional issues from both
a psychological and a spiritual perspective. They are
required to have certification from the American
Association of Pastoral Counselors.
Choosing a therapist
Picking a therapist is a very personal matter. It’s fine
to get a name from a friend or family member. But a
therapist may work well with someone you know and
yet not be a good match for you.
To choose a therapist, first talk with him or her on the
phone or in person. Find out about licensing and level
of training, approach to psychotherapy, fees and any
specialty area. Some therapists focus on one area, such
as treating depression, traumatic stress, substance abuse
If you feel the therapist is a good fit for you, the next
step is to make an appointment. But if you are not
satisfied after meeting in person, keep looking. The
type of training or license a therapist has is not the
most important factor. What matters most is how well
you connect with the therapist. You should be able to
talk openly and feel heard and understood.
} Improve your memory. Experts say that exercise
brings on the growth of nerve cells in the hippo
campus, the region of your brain involved in
memory. Studies show that seniors who walk
regularly have better memories than inactive older
adults. And the more you exercise, the better your
} Better your ability to do complex tasks. One
study found that aerobic exercise helped people
with mild cognitive problems to organize
information, pay attention and multi-task better.
This may be because exercise helps the body move
glucose to the brain, which improves its function.
} Possibly ward off Alzheimer’s disease. There is
growing research that suggests regular exercise
is linked with a lower risk of Alzheimer’s. Brain
activity has been shown to increase with physical
fitness. One study found that adults who exercised
three times a week had a much lower chance of
getting Alzheimer’s than those who didn’t.
} Ease depression and anxiety. Exercise increases
the level of serotonin (a chemical that affects
mood) in the brain. Low levels of serotonin are
linked with clinical depression. Some studies
show that exercise can work just as well as
medication in treating mild depression in some
} Reduce stress. Physical activity helps lower
the release of cortisol in your body. Cortisol is a
hormone linked with stress.
} Help keep your blood pressure in check. High
blood pressure can harm blood vessels in your
brain and reduce your brain’s oxygen supply. This
damages nerve cells that are used for decision-
making and memory.
Time to get moving
Check with your doctor first before starting an
exercise program. Then use these tips to get moving:
} Pick an activity you enjoy. Try walking,
swimming or playing tennis. You’ll be more likely
to stick with exercising if you enjoy doing it.
} Start slowly. Work your way up to at least 30
minutes of exercise most days of the week.
} Get a workout buddy. Exercise can help build
friendships. It may be easier to stick to a fitness
schedule if you have someone counting on you to
Even if you’ve lived an inactive lifestyle up until now,
regular activity will help keep your body - and brain -
Depression is an illness, and it can
be treated successfully. Learn about
medications, talk therapy and other
treatments that may be used.
A first step in escaping from the fog of depression is recognizing
that it is not part of who you are. Depression is an illness like high
blood pressure, asthma and other medical problems, and it can be
treated successfully. With proper treatment and support, you could
feel better in a matter of weeks.
For treatment to work, you need help from an experienced doctor,
one who can recommend treatments that are likely to work for your
form of depression. A doctor may prescribe medications and/or refer
you for psychotherapy or other treatments.
There are many medications that are used to treat
depression. Experts think they work by altering
the levels of brain chemicals that affect mood.
} Selective serotonin reuptake inhibitors (SSRIs).
These are the most commonly prescribed
antidepressants. They include fluoxetine (Prozac),
sertraline (Zoloft), paroxetine (Paxil) and
citalopram (Celexa). Common side effects include
nausea, insomnia, restlessness, dry mouth and
decreased sex drive. SSRI side effects are usually
mild, and most of them will go away within a few
} Other antidepressants such as bupropion
(Wellbutrin), venlafaxine (Effexor) and duloxetine
(Cymbalta).The side effects of these drugs vary.
They may include nausea, fatigue, weight gain,
nervousness, dry mouth and blurred vision.
} Tricyclic antidepressants such as amitriptyline
or desipramine. Tricyclics are an older class of
drugs, and they are more likely than SSRIs to
cause side effects such as drowsiness, dry mouth
and constipation. They may be tried if other
antidepressants don’t work.
} Monoamine oxidase inhibitors (MAOIs). These
older medications are rarely prescribed because of
the risk of serious interactions with other drugs
and certain foods.
Important things to keep in mind:
} Antidepressants need time to work. It may be
as long as 12 weeks after you start taking an
antidepressant before you feel better.
} People respond differently to antidepressants.
Don’t be discouraged if one medication doesn’t
work for you. Your doctor can change the dose or
prescribe a different medication.
} Antidepressants often work best when combined
with psychotherapy. Therapy can sometimes get to
the root of the problems that contributed to your
} Do not suddenly stop taking an antidepressant.
This can cause unpleasant symptoms, including a
return of depression. When you are ready to quit,
your doctor can work with you to slowly taper the
NOTE: Anyone being treated with antidepressants,
especially people being treated for depression,
should be watched closely for worsening depression
and for suicidal thinking or behavior. Close
watching may be especially important early in
treatment or when the dose is changed (either
increased or decreased). Discuss any concerns with
your doctor. Call 9-1-1 right away if you or anyone is
having thoughts of suicide or death.
NOTE: SSRI antidepressants, such as sertraline,
citalopram and paroxetine, may slightly raise the
risk of congenital heart defects if taken during the
first trimester of pregnancy. Discuss the benefits
and risks of antidepressants with your doctor if you
are pregnant or plan to get pregnant. Do not stop
taking these medications without first talking to
Psychotherapy involves talking with a mental health
professional. It could be a psychiatrist, social worker,
psychologist or counselor. Therapists can help
depressed people gain insights about themselves and
make positive changes in their behavior and feelings.
There are many types of psychotherapy to choose
from. Two that are commonly used to treat depression
are cognitive-behavioral therapy and interpersonal
} Cognitive-behavioral therapy can help identify
and correct negative thought patterns. This can
improve a person’s outlook and sense of self-
} Interpersonal therapy looks at the relationships
that may be at the root of depression.
Psychotherapy can often help relieve symptoms of
depression. In general, people with severe depression
respond best to a combination of psychotherapy and