Integrative Health: Coping Skills to Prevent and Manage Stress

by Amy Hendel, P.A. Health Writer

Are you stressed? According to yearly American Academy of Pediatrics surveys since 2005, 50-58 percent of Americans report being stressed or very stressed, including 38 percent of children. Correlated with these statistics is another data set that suggests that close to 43 percent of respondents reported having “two or more adverse childhood experiences” (substance abuse or mental illness, verbal or physical abuse, sexual abuse, family member in prison, witnessing domestic violence) in the family home. Based on current research, the lifetime prevalence of any anxiety disorder is 28.8 percent. We know that chronic stress can drive the risk of developing a number of chronic diseases. High levels of stress are associated with a 50 percent increased risk of heart disease. Stress disrupts metabolic homeostasis and can increase the risk of visceral obesity, type 2 diabetes, and metabolic syndrome. Stress also impacts DNA repair, can fuel growth of cancers and metastasis, and is known to impair immune response. Chronic stress creates a level of inflammation in the body that essentially fuels the flames of all these negative physical outcomes. Rajit Sinha, Ph.D., from the department of Psychiatry, Neurobiology, and Child Study at Yale University School of Medicine, presented a lecture on stress at the Integrative Health Symposium (IHS2017), and she suggests that there is clear evidence that the very first “target” of stress is the brain. Any stimulus or event that is challenging, threatening, overwhelming, uncontrollable, or unpredictable causes stress and if there is no resolution, the stress can become chronic. Loss of a loved one, work burdens, divorce, mental illness, or experiencing physical or verbal abuse, alcohol or substance abuse instigate stress and that, in turn, can affect:

  • Physical functions like sleep and eating

  • Creativity

  • Attention/awareness/mental flexibility/memory/problem-solving

  • Mood So when we experience stress, there are cognitive, emotional, behavioral, and physical symptoms. You’ve likely broken out in a cold sweat, felt stomach upset, grabbed a donut, or experienced racing thoughts right before an important event. If daily work is stressing you out on a more chronic and persistent basis, you may be biting your nails or isolating from others, or maybe you’re having constant pessimistic thoughts. To cope with stress, you need to identify specifically what is stressing you and take stock of the stress levels in your life. It’s important to remember that short-term stress is not necessarily a bad thing. If you have a sudden deadline, then stress is a good reaction because it energizes you, helps to get you focused on the task at hand, improves your working memory, and actually enhances your performance. It’s is when stress is repetitive and unresolved or is present chronically, that it becomes a dangerous health liability. A February 2017 study based on information extrapolated from the International Journal of Epidemiology confirms that chronic elevated levels of cortisol (resulting from stress) are an independent risk factor for obesity. Your brain will try to regulate stress in order to prevent brain drain and all the negative consequences discussed previously. High, persistent levels of stress (and cortisol) can reduce brain tissue levels especially in the prefrontal region, the area that acts as a regulator. This is the area that’s supposed to regulate many cognitive operations, including stress, so loss of tissue in that brain region will clearly impair effective regulatory function. Dr. Sinha suggests that we need to protect our brain, a dynamic organ. The brain responds well to a number of simple, affordable, and accessible “treatments,” especially those aimed at intercepting stress and its impact. Let’s take a deep breath and look at some ways to relax. ### Simple stress relief exercise

Sit quietly and close your eyes. First, turn your focus to your breathing. Next, place one of your hands on your belly. Begin to breathe deeply enough so that your hand feels the depth of the breathing in your belly region. After about a minute, move your hand to your chest and breathe so that you now feel the rise and fall of your chest. After about a minute, move your hand to the final resting point, your upper chest, near your clavicle, and continue to breathe focusing on the rise and fall of that area for about a minute. Release your hand and open your eyes.

A simple breathing exercise like this, performed regularly and especially when you feel stress rising, can intercept the negative consequences of persistent stress.

Mental check-in

The doctor also recommends “checking in with your body.” The mental check in list includes asking yourself:

  • What’s your current level of energy or fatigue?

  • Are you hungry or full or neutral?

  • Are you too warm or too cold?

  • Are you experiencing any discomfort?

Just becoming aware of your posture, the position of your body in the chair, your arms and legs position, and noticing any mental judgments you now make once aware of the positions, can help to mitigate stress. Sitting up straighter with a more “in control” posture, placing your hands firmly on your thighs, uncrossing your legs and planting them on the floor can also help to limit or eliminate stress that is building up. It’s a take charge position that can help to limit stress.

You can also take hold of the mind in the moment, according to Dr. Sinha. That is basically the practice known as mindfulness. That effort requires:

  • Paying attention in the moment

  • Being non-judgmental

  • Being aware of your real-time thoughts, feelings, sensations, and urges

  • Training so you consistently let go of negative sensations, and bringing yourself “into the moment”

  • Self-training to keep practicing mindfulness

One sector of health especially linked to stress is binge/addictive behaviors. Binge eating, heavy alcohol use, and incessant tech device use (cell phone, computer, and other gadgets) also results in increased cortisol levels. The stress and increased cortisol levels use brain fuel quickly and can instigate high calorie snacking. Of course, that type of eating is associated with an increased risk of obesity, which in turn fuels a host of chronic diseases. So stress can cause obesity, and then cyclically, the nature of obesity can stress the person.

There are certainly drugs to treat stress. There are also behavioral strategies to help manage stress. In addition to the breathing and mindfulness techniques just shared, other strategies include:

  • Yoga

  • Regular exercise

  • Meditation

  • Planning ahead of time to mitigate stress (saving money, having a support system)

  • Psychotherapies like cognitive behavioral therapy and dialectical behavioral therapy

How habits, diet help

It’s also important to build resilience into your day. Build a morning and night reserve with breathing exercises. Take pauses during the day and hit the reset button if you feel symptoms of stress. Be mindful when negative thoughts start creeping into your brain and learn to give yourself a quick supportive pep talk. Learn to have compassion for yourself and for others. A study released in January 2017 also suggests that focusing on dietary prebiotics can help to buffer stress and improve sleep. A prebiotic diet focuses on fiber-rich foods like chicory, artichokes, garlic, leeks, and onions and can help to reduce anxiety and stress. Exercise can also help to alleviate stress so the cornerstones of a balanced lifestyle — diet and exercise — can be the cornerstones of a stress-busting program. Source: Stress Coping to Optimize Brain Function and Prevent Stress-related Chronic Diseases --- Amy Hendel, also known as The HealthGal, is a Physician Assistant, nutritionist and fitness expert. As a health media personality, she's been reporting and blogging on lifestyle issues and health news for over 20 years. Author of The 4 Habits of Healthy Families, her website offers daily health reports, links to her blogs, and a library of lifestyle video segments.

Amy Hendel, P.A.
Meet Our Writer
Amy Hendel, P.A.

Known as "The HealthGal", Amy Hendel P.A. is a medical and lifestyle reporter, nutrition and fitness expert, health coach and brand ambassador. Trained as a physician assistant, she maintains a health coach private practice in New York and Los Angeles. Author of The Four Habits of Healthy Families, find her on Twitter @Healthgal1103 and on Facebook @TheHealthGal. Check “Daily Health News” at Her personal mantra? “Fix it first with food, fitness, and lifestyle.”