Stress management refers to a wide spectrum of techniques and psychotherapies aimed at controlling a person's levels of stress, especially chronic stress, usually for the purpose of improving everyday functioning. It involves controlling and reducing the tension that occurs in stressful situations by making emotional and physical changes. Prevention and resilience building Decreasing stressful behaviors is a part of prevention. Some of the common strategies and techniques are: self-monitoring, tailoring, material reinforcement, social reinforcement, social support, self-contracting, contracting with significant other, shaping, reminders, self-help groups, and professional help. Although many techniques have traditionally been developed to deal with the consequences of stress, considerable research has also been conducted on the prevention of stress, a subject closely related to psychological resilience-building. A number of self-help approaches to stress-prevention and resilience-building have been developed, drawing mainly on the theory and practice of cognitive-behavioral therapy. Biofeedback may also play a role in stress management. A randomized study by Sutarto et al. assessed the effect of resonant breathing biofeedback (recognize and control involuntary heart rate variability) among manufacturing operators; depression, anxiety and stress significantly decreased. Exercising to reduce stress Studies have shown that exercise reduces stress. Exercise effectively reduces fatigue, improves sleep, enhances overall cognitive function such as alertness and concentration, decreases overall levels of tension, and improves self-esteem. Because many of these are depleted when an individual experiences chronic stress, exercise provides an ideal coping mechanism. Despite popular belief, it is not necessary for exercise to be routine or intense in order to reduce stress; as little as five minutes of aerobic exercise can begin to stimulate anti-anxiety effects. Further, a 10-minute walk may have the same psychological benefits as a 45-minute workout, reinforcing the assertion that exercise in any amount or intensity will reduce stress. Cycling and walking activities have lower stress scores when compared to all other activities. Theoretical explanations A multitude of theories have been presented in attempts to explain why exercise effectively reduces stress. One theory, known as the time-out hypothesis, claims that exercise provides distraction from the stressor. The time out hypothesis claims that exercise effectively reduces stress because it gives individuals a break from their stressors. This was tested in a recent study of college women who had identified studying as their primary stressor. The women were then placed under four conditions at varying times: "rest," "studying," "exercising," and "studying while exercising." The stress levels of the participants were measured through self-assessments of stress and anxiety symptoms after each condition. The results demonstrated that the "exercise" condition had the most significant reduction in stress and anxiety symptoms. These results demonstrate the validity of the time-out hypothesis. It is also important to note that exercise provided greater stress reduction than rest. Coping mechanisms The Lazarus and Folkman model suggests that external events create a form of pressure to achieve, engage in, or experience a stressful situation. Stress is not the external event itself, but rather an interpretation and response to the potential threat; this is when the coping process begins. There are various ways individuals deal with perceived threats that may be stressful. However, people have a tendency to respond to threats with a predominant coping style, in which they dismiss feelings, or manipulate the stressful situation. There are different classifications for coping, or defense mechanisms, however they all are variations on the same general idea: There are good/productive and negative/counterproductive ways to handle stress. Because stress is perceived, the following mechanisms do not necessarily deal with the actual situation that is<unk> ng an individual stress. However, they may be considered coping mechanisms if they allow the individual to cope better with the negative feelings/anxiety that they are experiencing due to the perceived stressful situation, as opposed to actually fixing the concrete obstacle<unk> ng the stress. The following mechanisms are adapted from the DSM-IV Adaptive Functioning Scale, APA, 1994. Highly adaptive/active/problem-focused mechanisms These skills are what one could call as “facing the problem head on”, or at least dealing with the negative emotions experienced by stress in a constructive manner. (generally adaptive) * Affiliation ("tend and befriend") – involves dealing with stress by turning to a social network for support, but an individual does not share with others in order to diffuse or avoid the responsibility. * Humour – the individual steps outside of a situation in order to gain greater perspective, and also to highlight any comic aspect to be found in their stressful circumstances. Coping through laughter ::“The Association for Applied and Therapeutic Humour defines therapeutic humour as ‘any intervention that promotes health and wellness by stimulating a playful discovery, expression or appreciation of the absurdity of or incongruity of life’s situations. This intervention may enhance health or be used as a complementary treatment of illness to facilitate healing or coping whether physical, emotional, cognitive, or spiritual”. ::Sigmund Freud, a well known neurologist, suggests the humour was an excellent defensive strategy in emotional situations. When one laughs during a tough situation they feel absent from their worries, and this allows them to think differently. When one experiences a different mind set, they feel more in control of their response, and how they would go about dealing with the event that<unk> d stress. ::Lefcourt (2001) suggests that this perspective-taking humour is the most effective due to its ability to distance oneself from the situation of great stress. Studies show that the use of laughter and humour creates a sense of relief of stress that can last up to 45 minutes post-laughter. ::Also, most hospitalized children have been seen to use laughter and play to relieve their fear, pain and stress. It has been discovered that there is a great importance in the use of laughter and humour in stress coping. Humans should use humour as a means to transcend their original understanding of an external event, take a different perspective, in which their anxiety may be minimized by. * Sublimation – allows an "indirect resolution of conflict with neither adverse consequences nor consequences marked by loss of pleasure." Essentially, this mechanism allows channeling of troubling emotions or impulses into an outlet that is socially acceptable. * Positive reappraisal – redirects thoughts (cognitive energy) to good things that are either occurring or have not occurred. This can lead to personal growth, self-reflection, and awareness of the power/benefits of one's efforts. For example, studies on veterans of war or peacekeeping operations indicate that persons who construe a positive meaning from their combat or threat experiences tend to adjust better than those who do not. The final path model fitted well (CF1 = 1, RMSEA = 0.00) and showed that direct quality of life paths with β = -0.2, and indirect social support with β = -0.088 had the most effects on reduction of stress during pregnancy. Other adaptive coping mechanisms include anticipation, altruism, and self-observation. Mental inhibition/disavowal mechanisms These mechanisms<unk>  the individual to have a diminished (or in some<unk> s non-existent) awareness about their anxiety, threatening ideas, fears, etc., that come from being conscious of the perceived threat. * Displacement – This is when an individual redirects their emotional feelings about one situation to another, less threatening one. * Repression – Repression occurs when an individual attempts to remove all their thoughts, feelings, and anything related to the upsetting/stressful (perceived) threat out of their awareness in order to be disconnected from the entire situation. When done long enough in a successful way, this is more than just denial. * Reaction formation – An attempt to remove any “unacceptable thoughts” from one's consciousness by replacing them with the exact opposite. Other inhibition coping mechanisms include undoing, dissociation, denial, projection, and rationalization. Although some people claim that inhibition coping mechanisms may eventually increase the stress level because the problem is not solved, detaching from the stressor can sometimes help people to temporarily release the stress and become more prepared to deal with problems later on. Active mechanisms These methods deal with stress by an individual literally taking action, or withdrawing. * Acting out – Often viewed as counter-normative, or problematic behavior. Instead of reflecting or problem-solving, an individual takes maladaptive action. * Passive aggression – When an individual indirectly deals with their anxiety and negative thoughts/feelings stemming from their stress by acting in a hostile or resentful manner towards others. Help-Rejecting Complaining can also be included in this category. Health promotion There is an alternative method to coping with stress, in which one works to minimize their anxiety and stress in a preventative manner. If one works towards coping with stress daily, the feeling of stress and the ways in which one deals with it as the external event arises becomes less of a burden. Suggested strategies to improve stress management include: # Regular exercise – set up a fitness program, 3–4 times a week # Support systems – to listen, offer advice, and support each other # Time management – develop an organizational system # Guided imagery and visualization – create a relaxing state of mind # Progressive muscle
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