Meeting the Challenges of Long-Term Illness

Stress Reduction & Stress Prevention

By Bruce Campbell

The last article discussed relaxation as a stress reduction technique. This article describes six other approaches to stress reduction and also explains how to prevent stress through stress avoidance. Before that discussion, I’d like to say that because stress is so pervasive in chronic illness, I recommend you consider using a variety of techniques to combat it. Here’s how two students in our program responded when asked what they do to control stress.

I do a variety of things to manage stress, such as deep breathing, listening to relaxation tapes, getting regular massages, walking with my dog, and writing in my journal.

For stress reduction I use stretching and yoga; relaxing activities like time in our hot-tub or in the swing in the back yard; spiritually enhancing activities such as prayer and Bible study; and fun activities both mental or physical, like reading, movies, playing with the grandchildren, playing with the dog, and spending quality time with my husband.

Stress Reduction

1) Problem-Solving

Taking practical steps to improve your situation can also help reduce anxiety and worry. A member of one of our Internet groups provided a good example. This person had gone to the emergency room because she had taken her medications three times in one day. When she got home, she was concerned that brain fog might lead her to make the same mistake again. After getting suggestions from her group, she decided to use a pill box with compartments for each day of the week. She thanked the group, saying she was much less worried about repeating her mistake because she had a system she trusted.

2) Positive Experiences

Doing things that are enjoyable can be a stress reducer. Positive experiences counteract the thought that illness means only suffering. Also, pleasurable activities lower the frustration of being ill.

Here are several types of positive experiences, all of which can help lower stress.

A. Pleasurable Activities: Doing things that bring you pleasure can distract you from stress and reduce preoccupation with problems. Examples include seeing a movie, spending time in nature, listening to or playing music and reading.

B. Exercise and Movement: Exercise is a natural stress reducer, since it causes your body to produce endorphins and other soothing body chemicals. A similar effect can be obtained through other forms of movement. Especially if you are worried, just getting up and moving around can change your mood.

C. Journaling: Writing may be useful as a stress reducer. You might find it helpful to write out what’s bothering you as a way of venting frustration and lessening worry. Another use of journaling is to help you change perspective on your life. Some students have said they found it very helpful to keep a gratitude journal in which they noted positive events for each day. Over time, they observed a change in their attitude toward their illness and their life.

D. Talking and Being Listened To: In a survey, talking to a friend was rated as the number one way to combat worry. Talking to someone you trust provides reassurance and a sense of connection.

E. Music, the Arts and Other Absorbing Activities: Listening to or playing music or engaging in other artistic pursuits are good stress reducers. The same can be said of reading a good book or seeing an engrossing movie. The key is to find an activity in which you can become absorbed. By immersing yourself, you interrupt the worry cycle, distract yourself from symptoms and experience some relaxing pleasure.

F. Laughter and Humor: This is another good stress reducer. Watching a funny movie or laughing with friends can be a great release. Like exercise, laughter promotes the production of endorphins. Research suggests that it can strengthen the immune system, counteract depression and even provide a substitute for aerobic exercise.

G. Solitude: For some people, just having time alone can be helpful.

3) Mental Adjustments

Our thoughts can be another source of stress. One such cause of stress is having unrealistic or inappropriate expectations. For example, we may hold ourselves to housecleaning standards that may no longer make sense. Becoming aware of the standards you have for yourself and for others can help you avoid overdoing.

4) Assertiveness

Speaking up for yourself can be a stress reducer in a number of ways. Saying ‘no’ can help you avoid doing things that would intensify your symptoms. Also, presenting your position rather than suffering in silence can replace frustration with action.

5) Support

Being ill is both inherently stressful and isolating. Having people in your life who understand and respect you is a balm to the soul. Just being listened to and feeling connected to others is healing. Beyond that, talking may help you clarify your situation or their response may enable you to see your life in a different and more constructive way. Family members may provide such support and you may also find it through developing relationships with fellow patients. Support also means practical assistance, which might include such things as shopping, cooking, bill paying or housecleaning.

6) Medications

Prescription medications may be helpful for some patients as part of a stress management program. Here’s what one student said:

I've been on Zoloft for over two years. I resisted the idea for a long time, and now kick myself for having done so. It has helped level off my reactions to everyday stress and evened out my mood...I've learned to keep my mind open to treating all aspects of my life and not relying on solely one approach.

Stress Avoidance

Stress avoidance is preventive. It involves using self-observation to learn how stress affects you and then taking measures to avoid stressful circumstances. For example, you may notice that when you hit a limit, any further activity will intensify your symptoms. In such circumstances, rest can reduce the stress on your body. Planned rest can be an effective stress avoidance strategy.

The main ways that people in our groups prevent stress are by avoiding stress triggers and by using routine or scheduling.

Avoidance of stress triggers

We may have particular circumstances in our lives that “set us off.” If we can identify these stress triggers, we may be able to avoid them or reduce their impact. You might think of triggers in the categories of people, substances and situations.

Some patients find interactions with particular people are the cause of disabling stress. Responses they have made include talking with the person, limiting contact, getting professional help with the relationship, and ending the relation. Food, chemicals and other substances can trigger symptoms. By identifying and avoiding specific foods or other substances you may be able to avoid relapses. In terms of situations, if you are particularly sensitive to light, noise or crowds or experience sensory overload in other ways, avoiding those situations can help you control symptoms.

I gave up on several difficult relationships. I was amazed at how great I felt and also how those people never even tried to resurrect the relationship. Guess I wasn't as indispensable as I thought!

Eliminating or at least restricting aspartame and other sweeteners, MSG, and caffeine has helped to keep me more even-keeled.

Scheduling and Routine

Novelty is another source of stress. It takes more energy to respond to a new situation than it does to something familiar. Given our limited energy, saving it for healing is desirable. One way to do that is through making your life predictable. Some patients have done that through routine: living their lives according to a schedule. They have been able to reduce the surprises and emotional shocks in their lives, and thereby reduce their stress. By knowing what to expect, they have reduced pressures on themselves.  Any steps in the direction of giving predictability to life is likely to lower stress.

Up until two years ago my life had little routine in it and the result was frequent, lengthy crashes. My life was one big roller coaster. Now that I have a regular schedule, I can plan much better. Routine may sound boring, but it’s a must for me.

Many of the pacing strategies described in an earlier article are also effective stress reducers. Scheduling activity based on priorities, timing activity for the best hours of the day, and staying within known limits all help control stress.

I found that I can avoid much stress by knowing my limits. Planning too many activities in one day or scheduling them too close together are big stress triggers, so I try to prevent their activation by limiting the number of activities in a day and by giving myself plenty of time in between two activities.

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