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Ask the Mental Health Expert Archives 2001-2004

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How to Manage Stress

Q. What do you do for managing stress? How do you handle great amounts of stress? What do you recommend for coping with stress for young people, say ages 12-16? Do young people have more good stress or bad stress? How does caffeine impact stress? What about exercise?

A. Let's first try to clarify terms such as "stress", "stressor", and "stress reaction". Stress is best understood as the experience a person has when first faced with a challenge (good or bad) to one's adaptive capacities. Those challenges-whether a new job, a death in the family, or an upcoming marriage-are termed stressors. A stress reaction is the psychological and physical outcome of the individual's dealing with or processing the stressor.

Here's an example: A man walks into your office and hands you a subpoena (stressor). You immediately feel your heart pounding and your pulse racing (you are stressed). Over the next two days, you find that you have lost your appetite, are not sleeping, and are having nightmares of being dragged into court (you are having a stress reaction).

Some individuals have more serious and prolonged reactions to traumatic stress, termed post-traumatic stress disorder (PTSD). Now-to your questions. I think the most radical and comprehensive way of managing stress for people of all ages is to learn new ways of thinking and coping. This means changing some of the irrational and self-defeating ideas we have, such as "It's the end of the world if my relationship breaks up" or "If I don't get this project done on time, I'm a complete flop as a human being!" It is this sort of exaggerated catastrophizing that creates serious and prolonged stress reactions, in my view. The best book I know of on this is "A Guide to Rational Living", by Drs. Albert Ellis and Robert Harper.

Regarding stress in adolescents, I would agree with Dr. Derek Miller who says, in his book "The Age Between", that "Adolescence can appropriately be called an age of anxiety." Miller goes on to discuss numerous factors that generate so much anxiety in this age group; e.g., physical and emotional changes; parental and school pressure; peer-group competitiveness, and so on. Ideally, teens and early adolescents would deal with their stress by confiding in their parents and in their peers, and getting empathic, helpful feedback from both.

In reality, this often doesn't happen-and sometimes, friends can make matters worse by suggesting alcohol or drugs as a way of dealing with stress. Still, some high schools and colleges do offer peer counseling programs with trained volunteers. Some on-line support groups may also be helpful, but I think parents need to be very careful about this, and provide careful supervision. One good on-line source for teens is KidsPeace (www.kidspeace.org). For day-to-day, minor stresses, both teens and adults can use simple relaxation techniques, such as deep breathing, muscle relaxation, or meditation. Many of these are described in Herbert Benson's classic, "The Relaxation Response". For some teens, music, sports, or hobbies can also be a source of solace and relaxation. Exercise has been shown to reduce both anxiety and depression in a number of studies, and I would recommend this (in moderation) to anyone experiencing stress.

Regarding caffeine: most studies suggest that for the average individual without underlying cardiovascular disease, high blood pressure, or panic disorder, moderate amounts of caffeine (say, 1-2 cups of coffee per day) are usually not harmful. However, high caffeine consumption can trigger anxiety or panic attacks in some sensitive individuals, and may also disrupt sleep. Again-all things in moderation! A good approach to stress for people of all ages may be found in "The Relaxation & Stress Reduction Workbook" by Martha Davis et al. Another book you might be interested in is Sol Gordon's "The Teenage Survival Book".

I hope the above helps reduce a bit of your stress!

April 2001

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