Stress reduction
Stress reduction encompasses a variety of strategies aimed at alleviating both physical and mental tension, promoting overall well-being. Effective stress management is crucial as stress can hinder daily functioning, slow recovery from health issues, and negatively impact immune system performance. Various techniques exist, including physical therapies, biofeedback, meditation, hypnosis, and psychotherapy, all designed to help individuals manage their stress levels. Psychotherapy encourages the development of coping skills and the identification of unhelpful thought patterns. Biofeedback utilizes monitoring devices to help patients gain control over physiological processes, while meditation promotes mindfulness and relaxation. Relaxation training and stress inoculation therapy further aid in managing anxiety by teaching individuals how to respond to stressors effectively. Although medications can be beneficial for stress reduction, they should be used judiciously and typically only when psychological therapies are insufficient. Overall, engaging in these techniques can enhance mental clarity, reduce anxiety, and improve physical health, making stress reduction an essential focus for many individuals across diverse backgrounds.
Stress reduction
DEFINITION: Efforts to decrease bodily and mental tension by increasing rest and coping skills
ANATOMY OR SYSTEM AFFECTED: All
Indications and Procedures
Stress can exacerbate difficulties in daily functioning, slow recovery from mental or physical problems, and impede immunological functioning. Stress reduction techniques represent a cluster of procedures that share the goal of reducing bodily and emotional tension: physical therapies, exercise, biofeedback training, meditation, hypnosis, psychotherapy, relaxation training, stress inoculation therapy, and medications.
Psychotherapy is a common treatment for stress implemented by psychiatrists, psychologists, social workers, psychiatric nurses, and counselors. Not only does it help individuals to sort out their problems mentally, but it is also an effective stress management strategy. Psychotherapy helps individuals learn new coping skills and identify unhealthy and unhelpful thought patterns that are contributing to or exacerbating one's stress levels. When individuals analyze their lifestyles and life events, stress-inducing behaviors and life patterns can be explored and targeted for modification.
Biofeedback training, meditation, hypnosis, and relaxation training all focus on inducing relaxation or altered consciousness by shifting a person’s attention. Biofeedback uses monitoring devices attached to the body to provide visual or aural feedback to the trainee. Such devices include the electromyograph (EMG), which measures muscle tension, and the psychogalvanometer, which measures galvanic skin response (GSR). An EMG involves placing sensors on various muscle groups to record muscular electrical potentials. GSR also relies on sensors, but these sensors record bodily responses caused by sweat gland activity and emotional arousal. The feedback from such devices allows a trainee to learn to control certain bodily processes (for example, muscle tension, brain waves, heart rate, temperature, and blood pressure). Biofeedback training is also used to treat headaches, syndrome, high blood pressure, and tics, and it can also facilitate neuromuscular responses in stroke patients.
Meditation is a focused thinking exercise involving a quiet setting and nonjudgmental mindfulness of the thoughts that arise. Meditation may also involve the repetition of a word or phrase called a mantra. By blocking distracting thoughts and refocusing one's attention, meditation reduces anxious thinking and promotes clarity. It is useful for anxiety, minor concentration difficulties, and daily relaxation.
Hypnosis involves the use of suggestion or concentrated attention to induce a sleeplike state or trance. Hypnosis can be induced by a hypnotist or via self-hypnosis. Hypnotic states are characterized by increased suggestibility, the ability to recall forgotten events, decreased pain sensitivity, and increased vasomotor control. The ability to be hypnotized varies from person to person based on susceptibility to suggestion and psychological needs. Hypnosis is used as a brief therapy targeting such problems as insomnia, pain, panic, addiction, and sexual dysfunction.
Relaxation training involves three primary methods: autogenic training, which involves such techniques as head, heart, and abdominal exercises; progressive relaxation, which involves becoming aware of tension in the various muscle groups by relaxing one group at a time in a specific order; and breathing exercises. Relaxation training is best learned when a therapist trains an individual in person, and then the exercises are practiced independently. Relaxation can be practiced several times daily, as well as in response to stressful events. High blood pressure, ulcers, insomnia, asthma, drug and alcohol problems, spastic colitis, tachycardia (rapid heartbeat), pain management, and anxiety disorders are treated with relaxation training.
Stress inoculation therapy is a specific type of psychotherapy involving techniques that alter patterns of thinking and acting. It comprises three steps: education about stress and fear reactions, rehearsal of coping behaviors, and application of coping behaviors in stress-provoking situations. It is useful for treating anxiety disorders related to stress.
For individuals with post-traumatic stress disorder, an anxiety disorder, or acute stress disorder, drugs may be used to promote stress reduction alongside other relaxation techniques. Medications should not be used unless the severity of one's distress cannot be managed by psychological therapy. These drugs can provide overall bodily relaxation, induce rest, or decrease the anxious thinking that exacerbates stressful experiences. Sedatives, tranquilizers, benzodiazepines, beta-blockers, and barbiturates are examples of such drugs, although most should only be used in the short term and under the monitoring of a medical professional. Selective serotonin uptake inhibitors (SSRIs) are drugs typically used in the treatment of depression; however, they are also useful in stress reduction. SSRIs can be used on a longer-term basis than benzodiazepines. Additionally, physical therapies and exercise are recommended for stress reduction. Baths (hydrotherapy), massages, yoga, and aerobic exercise are effective elements of a stress reduction program.
Uses and Complications
Individuals should not apply stress reduction procedures without proper consultation; medical conditions that might be causing symptoms should be assessed or ruled out first. Biofeedback training for headaches, for example, would be unwarranted until other, more serious causes of headaches had been eliminated from consideration. Similarly, exercise, drug, and physical therapies could potentially worsen conditions such as high blood pressure, alcohol and drug problems, and chronic pain if applied incorrectly. For example, where stress or pain is chronic, drug therapies might encourage the development of drug dependence.
Instead, skilled providers should administer these procedures. Training via self-help materials alone or by an unskilled provider may provide no benefit or create difficulties. Poor training could result in frustration, hypervigilance, heightened anxiety, depression, or pain caused by over-attention to symptoms or conflicts. In fact, some individuals are prone to these effects even with good training. Therefore, ongoing assessment is necessary. Finally, interpretation of any memories provoked by hypnosis should be done with caution because of the suggestibility that is characteristic of hypnotic states.
Perspective and Prospects
Stress reduction techniques evolved from ancient meditation practices and simpler methods of pain management, predating the development of modern anesthetics. The palliative and preventive effects of these techniques have given these procedures a sure hold in medical practice, while benefits such as decreased absenteeism and increased feelings of wellness in employees have secured these strategies in the workplace. The expanded use of stress reduction procedures in prenatal care and with older adults has also become prevalent.
Bibliography
Cassano, Giovanni B et al. “Psychopharmacology of Anxiety Disorders.” Dialogues in Clinical Neuroscience, vol. 4, no. 3, 2002, pp. 271–85, doi:10.31887/DCNS.2002.4.3/gcassano. Accessed 8 July 2024.
"Coping with Stress." Centers for Disease Control and Prevention. US Dept. of Health and Human Services, 21 May 2024, www.cdc.gov/mentalhealth/cope-with-stress/index.html. Accessed 8 July 2024.
Davis, Martha, Elizabeth Robbins Eshelman, and Matthew McKay. The Relaxation and Stress Reduction Workbook. 7th ed. New Harbinger, 2019.
Humphrey, James H. Stress among Older Adults: Understanding and Coping. Thomas, 1992.
"Manage Stress." HealthFinder.gov. US Dept. of Health and Human Services, 2 Apr. 2024, health.gov/myhealthfinder/health-conditions/heart-health/manage-stress. Accessed 8 July 2024.
Manning, George, Kent Curtis, Steve McMillen, and Bill Attenweiler. Stress: Living and Working in a Changing World. 3rd ed. Savant Learning Systems, 2016.
Newton, Tim, with Jocelyn Handy and Stephen Fineman. Managing Stress: Emotion and Power at Work. Sage, 1996.
Pelletier, Kenneth. The Best Alternative Medicine. Fireside, 2002.
Schafer, Walt. Stress Management for Wellness. 4th ed. Thomson/Wadsworth, 2000.
Seaward, Brian Luke. Managing Stress: Principles and Strategies for Health and Well-Being. 9th ed. Jones and Bartlett Learning, 2017.
"Stress Management." American Heart Association. American Heart Assn., 2024, www.heart.org/en/healthy-living/healthy-lifestyle/stress-management. Accessed 8 July 2024.
Tummers, Nanette E. Stress Management: A Wellness Approach. Human Kinetics, 2013.