Managing stress effectively includes changing your mindset about stress, learning how to relax and how to cope effectively with stress-inducing situations.

Stress management

What is stress?

Stress is defined as a threatening of the body’s homeostasis by external or internal stressors or when environmental demands tax or exceed an individual’s capacity to adapt.

The stress response

Imagine the prehistoric hunter and and gatherer roaming the forests and suddenly standing in front of a saber-toothed tiger. He feels his heart throbbing, his muscles tensing, a sense of bright vision and oversensitivity to noise, and some cold sweat on his forehead. These are all symptoms of the stress response. Now the hunter generally has two options: He can run away from the tiger („flight“) or fight it.

Latest research has found that – in addition to fight and flight – there are actually another two steps in the stress response: Freeze and fright (also called „immobility“). Maybe you had this experience in your life while walking through a forest and suddenly you see a deer hiding between the trees. You continue to walk a few steps but you realize that the deer is not moving at all: It looks like frozen. This is the „freeze“ in the stress response: By not moving, the animal wants to be overlooked by a predator. If „fight“ or „flight“ is not possible, the last chance to escape a probable attack is just to feign death: This final step of the stress response is called tonic immobility.

To initiate an adaptive response to acute stress the organism evolved the stress response (or alarm reaction) which function is to re-establish homeostasis; it contains four well-defined phases:

  • freeze
  • flight
  • fight
  • tonic immobility.


  • work stressors
  • environmental stressors
  • family, social stressors
  • change stressors (leave a job, retirement, loss of a family member/friend)

The short-term effects of stress

The rapid adaptive response: Activation of the sympathetic nervous system and release of epinephrine (adrenaline), noradrenaline and cortisol:
  • increase in heart rate and blood pressure
  • slowing down of digestion
  • increase in respiration
  • increase in perspiration
  • increase in muscle tone
  • increase in blood clotting

The consequences of prolonged exposure to stress

  • Short term effects
    • physical: aches and pains, headaches, gastrointestinal problems, trembling, sweating, insomnia, elevated blood pressure
    • psychological: anxiety/panic, depression, helplessness, aggression, poor concentration, lack of confidence, withdrawal
  • Long term effects
    • physical: gastric ulcers, increased risk for infections, hypertension, myocardial infarction and stroke
    • psychological: chronic depression, breakdown

The New Science of Stress

Is stress good or bad?

We have been taught for decades that stress is something inherently bad. Something that deteriorates your health and might even kill us. But research during the last decade has changed our perception of stress.

Is stress really that bad? Or could it even be something good that is beneficial to us?

In the 1998 National Health Interview Survey participants were also asked questions about stress. Let’s have a closer look at two of the questions:
1) During the past 12 months, would you say that you experienced a lot of stress, a moderate amount of stress, relatively little stress, or almost no stress at all?
2) During the past 12 months, how much effect has stress had on your health – a lot, some, hardly any, or none?
The participants in this survey were followed up for 8 years after the year they were interviewed, and the results of the interviews were linked to mortality data. As expected, the results showed that high amounts of stress cause bad health outcomes. But the surprising fact of this study was that it showed an interaction between the perception that stress impacts health and a high amount of stress: Those individuals that responded „I have a lot of stress“ and „stress affects my health a lot“ had a 43% increased risk of dying prematurely.

Is there only one stress response?

For decades there was only one stress response: Stress is threat and we have the option of fight or flight. Nowadays we have come to the conclusion that there is no uniform stress response. There are at least two other stress responses apart from the traditional threat or fight-and-flight response: The challenge response and the tend-and-befriend response.

What is the mindset of somebody showing a threat response?
„Stress is harmful and should be avoided.“
„Stress impairs my performance and inhibits my learning.“

What is the mindset of somebody showing a challenge response?
„Stress is enhancing and should be embraced.“
„Stress enhances my performance and facilitates my learning.“

Therapy and prevention

  • Education about stressors and the stress response
  • Cognitive therapy: Identification of unhelpful attitudes and cognitive distortions
    • Formulation of functional/helpful thoughts
    • Perceiving stress as a challenge instead seeing it as a threat
  • Hypnotherapy
    • setting anchors (a kind of programming a reflex to deal with stressful situations in a healthier way)
    • ego boosting and positive suggestions
    • goal setting and age progression (visualization of how to cope better in a stressful situation)
    • self-hypnosis (learning a very effective and fast tool for relaxation)
    • there are many other hypnotherapeutic techniques such as regression, dissociation, etc.
  • Eye movement desensitization and reprocessing (EMDR)
  • Time management
    • checklists, diary, set goals and priorities, balance work and leisure
  • Physical activity and exercise

Scientific studies have found that regular physical activity has various health benefits, such as controlling weight, reducing the risk of cardiovascular disease, diabetes, some cancers, strengthening your bones and muscles, and improving your mental health and mood.

The general recommendation is 150 minutes of moderate intensity or 75 minutes of vigorous physical activity plus 2 days of muscle-strengthening activities per week.

Examples for moderate-intensity activities are brisk walking, gardening, water aerobics and dancing. Vigorous intensity includes jogging, running, hiking uphill, swimming laps and bicycling 10 miles per hour or faster.

  • Diet
    • avoid caffeine, alcohol, sugar
  • Various relaxation techniques: progressive relaxation, biofeedback, visualization, whole-body breathing, tai chi, meditation, and yoga

How effective is medical hypnosis for stress management?

Self-hypnosis and Jacobson’s progressive muscle relaxation reduce psychological and physiological symptoms of stress:

  • decrease pulse rate and blood pressure
  • increase skin temperature
  • reduce cholesterol levels
  • decrease anxiety and perceived stress
  • improve sleep quality


Kelly McGonical: The Upside of Stress

Charlesworth and Nathan: Stress Management