Stress - Lifestyle Changes

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Relaxation and Other Alternative Techniques

Relaxation Methods. Because stress is here to stay, everyone needs to develop methods to promote the relaxation response, the natural unwinding of the stress response. Relaxation lowers blood pressure, respiration, and pulse rate, releases muscle tension, and eases emotional strain. This response is highly individualized, but there are certain approaches that seem to work for most people.

Combinations of these techniques probably work best. No one should expect these approaches to completely relieve their stress, but if they are done regularly, these programs can be very effective. In a recent review, it was shown that mindfulness bases stress reduction (MBSR) techniques are effective stress relievers and reduced stress in healthy people. Techniques include yoga and meditation. Significant reductions in stress levels were seen in participants compared to those not engaging in any treatment. Outcomes were assessed using the Mindfulness Attention Awareness Scale (MAAS).

Acupuncture. Some evidence suggests that acupuncture might improve some of the physical factors associated with both stress and health problems. For example, acupuncture may improve stress-related heart muscle activity in heart failure patients, which could provide an important benefit to these patients. However, acupuncture has no effect on stress-related blood pressure or heart rate.

Hypnosis. Hypnosis may benefit some people with severe stress. In one study of patients with irritable bowel syndrome, stress reduction from hypnosis led to improvements in many bowel symptoms.

Relaxation Methods

Specific Procedure

Deep Breathing Exercises. During stress, breathing becomes shallow and rapid. Taking a deep breath is an automatic and effective technique for winding down. Deep breathing exercises consciously intensify this natural physiologic reaction and can be very useful during a stressful situation, or for maintaining a relaxed state during the day.

Inhale through the nose slowly and deeply to the count of 10.
Make sure that the stomach and abdomen expand, but the chest does not rise.
Exhale through the nose, slowly and completely, also to the count of 10.
To help quiet the mind, concentrate fully on breathing and counting through each cycle.
Repeat five to 10 times, and make a habit of doing the exercise several times each day, even when not feeling stressed.

Muscle Relaxation. Muscle relaxation techniques, often combined with deep breathing, are simple to learn and very useful for getting to sleep. In the beginning it is useful to have a friend or partner check for tension by lifting an arm and dropping it. The arm should fall freely. Practice makes the exercise much more effective and produces relaxation much more rapidly. Small studies have reported beneficial effects on blood pressure in patients with high blood pressure who use this technique.

After lying down in a comfortable position without crossing the limbs, concentrate on each part of the body.
Maintain a slow, deep breathing pattern throughout this exercise.
Tense each muscle as tightly as possible for a count of five to 10, and then release it completely.
Experience the muscle as totally relaxed and lead-heavy.
Begin with the top of the head and progress downward to focus on all the muscles in the body.
Be sure to include the forehead, ears, eyes, mouth, neck, shoulders, arms and hands, fingers, chest, belly, thighs, calves, and feet.
Once the review is complete, imagine tensing and releasing the internal muscles.

Meditation. Meditation, used for many years in Eastern cultures, is now widely accepted in this country as a relaxation technique. The goal of all meditative procedures, both religious and therapeutic, is to quiet the mind (essentially, to relax thought). Small studies have suggested that regular meditation can benefit the heart and help reduce blood pressure. Better research is needed, however, to confirm such claims.

Some experts recommend meditating for no longer than 20 minutes in the morning after waking up and then again in the early evening before dinner. Even meditating just once a day is helpful. Note: Meditating before going to bed may cause some people to wake up in the middle of the night, alert and unable to return to sleep.

New practitioners should understand that it can be difficult to quiet the mind, and should not be discouraged by a lack of immediate results.

Several techniques are available. A few are discussed here.

The only potential risks from meditating are in people with psychosis, in whom meditating may trigger a psychotic event.

Mindfulness Meditation. Mindfulness is a common practice that focuses on breathing. It employs the basic technique used in other forms of meditation.

Sit upright with the spine straight, either cross-legged or sitting on a firm chair with both feet on the floor, uncrossed.
With the eyes closed or gently looking a few feet ahead, observe the exhalation of the breath.
As the mind wanders, simply note it as a fact and return to the "out" breath. It may be helpful to imagine the thoughts as clouds dissipating away.

Transcendental Meditation (TM). TM uses a mantra (a word that has a specific chanting sound but no meaning). The person meditating repeats the word silently, letting thoughts come and go.

Mini-Meditation. The method involves heightening awareness of the immediate surrounding environment. Choose a routine activity, for example:

While washing dishes, concentrate on the feel of the water and dishes.
Allow the mind to wander to any immediate sensory experience (sounds outside the window, smells from the stove, colors in the room).
If the mind begins to think about the past or future, or fills with unformed thoughts or worries, redirect it gently back.
This redirection of brain activity from your thoughts and worries to your senses disrupts the stress response and prompts relaxation. It also helps promote an emotional and sensual appreciation of simple pleasures.

Biofeedback. Biofeedback is a technique that measures bodily functions, such as breathing, heart rate, blood pressure, skin temperature, and muscle tension. By watching these measurements, individuals can learn how to alter these functions by relaxing or holding pleasant images in their mind.

During biofeedback, electric leads are taped to a subject's head.
The person is encouraged to relax using methods such as those described above.
Brain waves are measured and an audible signal is emitted when alpha waves are detected, a frequency that coincides with a state of deep relaxation.
By repeating the process, patients associate the sound with the relaxed state and learn to achieve relaxation by themselves.

Massage Therapy. Massage therapy decreases cortisol levels, and some reasearch finds that it is more beneficial than receiving social support from a partner. This indicates a possible role of physical touch in managing stress.

Many massage techniques are available, such as the following:

Swedish massage is the standard massage technique. It uses long smooth strokes, and kneading and tapping of the muscles.

Shiatsu applies intense pressure to the same points targeted in acupuncture. It can be painful, but people report deep relaxation afterward.

Reflexology manipulates acupuncture points in the hands and feet.