Reduce your stress levels through behavioural and relaxation techniques

Reducing or eliminating the things that cause stress, when possible, and changing how you react to it are the safest and most effective ways to treat stress. No single method of stress management is always successful, so you might want to try a variety of approaches. Treating any medical symptoms caused by stress is important. Work with your GP and/or complementary health professional to determine what treatments work best for any stress-related illnesses you may have - from headache to high blood pressure and irritable bowel syndrome.

Part of your job will be to try and reduce your stress levels to improve your physical health. But, bear in mind that treating the stress may not cure the medical problems. However, a recent study indicated that stress management programmes might reduce the risk of cardiac events - like heart attack - by up to 75 per cent in people with heart disease.

Reducing stress is difficult. Often people succeed in relieving stress in the short term but return to old stress-producing habits. And personal responsibilities don't always lend themselves to stress-reducing tactics. The process of learning to control or redirect stress is life-long, but working to master it will improve your health.

Behavioural techniques
Cognitive-behavioural therapies, which help you substitute desirable responses and behaviour patterns for undesirable ones, are the most effective ways to reduce stress. Your GP may refer you to a mental health professional to help you learn these techniques. They include:

Identifying sources of stress. You may want to keep a stress diary in which you record the occasions that were stressful to you, triggered anger or anxiety or caused a physical response like sour stomach or headache. Jot down the time of day and the circumstances that led to it, then try to identify the types of events or activities that cause stress. See if you can alter or avoid these circumstances.

Restructuring priorities. Examine your priorities and goals to determine which stressful activities or situations can be eliminated. Learn to replace time-consuming chores that aren't really necessary with activities that are pleasurable or interesting, for example. Find ways to balance the stress inducers you can't eliminate - like unpleasant working conditions, an unhappy family situation or a significant loss - by including stress-reducing activities in your day. A recent study indicated that daily pleasant events have positive effects on the immune system. Making time for recreation is as essential as paying bills or shopping for groceries.

Adjusting your responses to stress. You can change the ways you respond to stress. Because you can't simply wish some stresses away - you can't just quit your job or walk out on your family, for example - you have to learn how to respond to stress to reduce its effects. Some ways of adjusting your responses to stress include:

• Discussing your feelings. Feelings of anger or frustration that are not expressed in an acceptable way may lead you to feel hopeless and depressed. The suggestion of letting your feelings out is good advice. The goal is to assert yourself and your needs in a positive way; doing so in a negative way (yelling and behaving aggressively, for example) can be counterproductive. Also important is learning to listen, empathise and respond to others with understanding. If you can't talk to a trusted friend, try writing in a journal or composing a letter.

• Keeping your perspective and looking for the positive. Focus on positive outcomes in stressful situations. It helps by thinking of the worst possible outcomes and assessing the likelihood of those coming to bear (usually small). Then, envision a positive outcome and develop a plan to achieve that outcome. Also helpful: remembering past situations that initially seemed negative but ended well.

• Using humour. Keeping a sense of humour during difficult situations is a common recommendation from stress management experts. Laughing releases the tension of pent-up feelings and helps keep perspective. Research has shown that humour is a very effective mechanism for coping with acute stress.

Relaxation techniques
In addition to cognitive-behavioural methods to approaching stress, learning relaxation techniques - the natural unwinding of the stress response - can be helpful. Your GP may refer you to a stress management specialist who can teach you some relaxation techniques, including:

Deep breathing. During stress, breathing becomes shallow and rapid. Taking a deep breath is an effective technique for winding down. Inhale through your nose slowly and deeply to the count of ten, making sure your stomach and abdomen expand but your chest does not rise. Exhale through your nose also to the count of ten. Concentrate fully on the breathing and counting. Repeat five to ten times. The goal is to take six deep breaths per minute.

Relaxing your muscles. Sitting anywhere, even at your desk, relax your shoulders, let your arms drop to your side, rest your hands on top of your thighs, relax your legs, and don't forget your jaw muscles, which often tense with stress. Close your eyes and breathe deeply. You can also do this lying in bed: beginning with the top of the head and progressing downward, focus on tensing then relaxing all the muscles in the body one by one while maintaining a slow, deep breathing pattern.

Passive stretches. Allow gravity to help you relax and stretch your muscles. Relax your neck and let your head fall forward to the right. Then let it drop even more as you breathe slowly. Do the same with your shoulders, arms and back.

Visualisation. Remember a relaxing time or place like a lakeside picnic or a beautiful beach scene. Close your eyes for a few minutes and picture it in your mind.

Meditation. The goal of meditation is to quiet the mind and to relax thought. Meditation can reduce your heart rate, blood pressure, adrenaline levels and skin temperature. It involves concentrating on a simple image or sound while in a comfortable place away from distractions. A number of organisations teach meditation.

Biofeedback. During this totally painless process, your relaxation skills are reinforced. You are encouraged to relax using methods such as those described above. Your brainwaves are measured via electric leads taped to your head, and a biofeedback machine emits an auditory signal when it detects alpha waves - a frequency that coincides with a state of deep relaxation. By repeating the process, you associate the sound with the relaxed state and learn to achieve relaxation by yourself.

Massage therapy appears to slow down the heart and relax the body. Rather than causing drowsiness, however, massage actually increases alertness.

Other stress-relief strategies

Your GP will probably discuss other issues with you, such as the necessity of:

Maintaining healthy habits. People who are trying to deal with stress often resort to unhealthy habits including high-fat and high-salt diets, tobacco use, alcohol abuse and a sedentary lifestyle.

Avoiding stimulants like tobacco, which contain nicotine that makes you feel calm in the short term, but actually rev up your nervous system. The addictive characteristics of some stimulants like nicotine also leave you anxious until your next fix.

Getting regular aerobic exercise - even a brisk walk - can reduce the level of stress hormones in your blood. At least 30 minutes a day (or two 15-minute sessions) is best, but even three times a week offers benefits. In addition, as your body gets fit, its ability to withstand stress is enhanced and your mind is often better able to cope with stress and stay on an even, happier keel. Start slowly. Strenuous exercise in people who are not used to it can be very dangerous and any exercise programme should be discussed with your doctor.

Strengthening or establishing a support network, even having a pet, reduces medical problems aggravated by stress. Studies of people who remain happy and healthy despite many life stresses conclude that most have very good networks of social support.

Reducing stress at work by establishing a network of friends, seeking out a sympathetic manager or scheduling daily pleasant activities and physical exercise during free time.

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