Stress is an automatic reaction to something bothersome. Stress compromises the way we think and feel. It complicates life, making everything seem difficult, heavy, and overwhelming.1 Stress creates many negative effects on our physical and mental health, but the good news is that we can disrupt this automatic reaction and learn to respond to stressors differently.
What Causes Stress?
Sometimes, stress can be positive. Short-term stress, for instance, can be motivating and helpful in meeting challenges. A moderate amount of stress is actually desirable, according to the Yerkes-Dodson Law describing stress and efficiency;2 indeed, if stress is too low, performance and efficiency can suffer. The Yerkes-Dodson law also warns that high stress negatively affects us.
Chronic, excessive stress can be damaging to our total well-being, including physical health and mental health. Knowing the causes of this negative stress can help you make positive changes to minimize and manage it. It’s important to know, though, that while the body’s stress response is universal, what triggers it is individualized and dependent on things such as life circumstances, age, developmental stage and one’s role in life.2 What causes one person to feel stressed out might not bother someone else at all, and vice versa.
General causes of stress may include:
- Situations that threaten your sense of safety, health, or well-being
- Thoughts and emotions that involve a fear of loss (such as relationship, job, your health, or money
- Repetitive worry about something in particular or vague worries about many different things
- Uncertainty
- Perceived lack of control over one or more aspects of your life
- Habitual thought patterns that involve negative beliefs or a pessimistic outlook on life
- A lack of self-efficacy (the belief that you don’t have the resources or ability to deal with challenges)
Whether your stress is triggered by an external cause like a difficult circumstance, an internal one such as negative thoughts, or both, the triggers create a flurry of activity in your brain and body that is responsible for your stress reaction: that feeling of being stressed out and frazzled.1
The Physiology of Stress: What Causes Stress Reactions
Your stress reaction, or what we often think of simply as stress, happens when something triggers your fight-or-flight reaction.
This is a body-wide reaction that involves your brain, autonomic nervous system, hormones, and other substances that affect a variety of biological functions:2,3
- Your senses notice something bothersome
- The sensory input is processed by the thalamus in your brain
- The thalamus warns your amygdala, another brain region, that something negative is happening (the amygdala is an emotional center within the brain, responsible for feelings including fear)
- The amygdala and other emotion-related areas of the brain alert the motor cortex, which sends messages through nerve pathways, instructing muscles to tense and tighten to prepare to react to the stressor
- The amygdala also wakes up the hypothalamus, an area in the brain right above the brainstem
- The hypothalamus jumps into action and alerts the pituitary gland, causing it to send a chemical messenger called corticotropin-releasing factor (CRF) all the way down to the adrenal glands on top of the kidneys
- The adrenal glands join this reaction by releasing stress hormones such as cortisol, epinephrine (adrenaline), and norepinephrine (noradrenaline)
- Meanwhile, the part of the autonomic nervous system known as the sympathetic nervous system revs up and sends warnings through the spinal cord and out into the nerves throughout the body to further prepare you to flee from or fight the stressor
- As a result of all this activity, your senses sharpen, breathing rate speeds up, heart rate and blood pressure increase, and glucose and fats are released into the bloodstream to keep you on high alert for more danger
- Your immune system is also prodded into high gear and causes inflammation in your body just in case you are injured by the stressor and need to heal
A lot happens inside of you when you face something that causes stress. Your physiological reaction to a trigger leads to the symptoms of stress.
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Symptoms of Stress
Because our entire system—body, brain (the physical organ), and mind (thoughts and feelings)—is involved in our stress reaction, we can feel many different types of symptoms of stress: cognitive (thought-based), emotional, physical, and behavioral.2
Cognitive symptoms of stress include:
- Constant or near-constant worry about one or many different things
- Difficulty concentrating
- Problems remembering things
- Troubles making decisions
- Brain fog, difficulty thinking clearly
- Decreased creativity or problem-solving ability
- Reduced sense of humor
Emotional symptoms of stress:
- Irritability, anger, or a short temper
- Increased crying spells or crying easily at little things
- Nervousness, feeling keyed-up or on edge
- Restlessness
- Loneliness
- Vague feelings of unhappiness
- Sense of purposelessness
- Feeling easily overwhelmed
- Decreased motivation
Physical symptoms of stress include:
- Muscle tension
- Pain anywhere in the body
- Fatigue
- Difficulty falling or staying asleep
- Palpitations
- Shakiness, tremors
- Increased sweating
- Ringing in the ears
- Teeth grinding
- Dizziness, with or without fainting
- Choking sensation and/or difficulty swallowing
- Digestive troubles
- Frequent need to urinate
- Decreased libido
Behavioral symptoms of stress:
- Difficulty starting or finishing tasks
- Using avoidance coping strategies to avoid people, situations, or tasks
- Criticizing others or making many negative statements about life in general
- Frequent brooding
- Fidgeting
- Emotional eating
- Substance use, including smoking
- Withdrawal from friends and family
- Isolation
Whether you experience many symptoms or just a few, the symptoms of stress are highly disruptive to life.1 They affect us on all levels and disturb our sense of ourselves and our place in the world. Therefore, stress management is crucial to our well-being.
5 Tips for Stress Management
We can’t always control what happens in our lives that causes us to experience stress. That doesn’t mean, however, that our well-being is at the mercy of outside forces. No matter what stressors you are facing, you can manage your stress reaction and feel well mentally and physically.
Try these 5 tips for managing stress:
1. Increase Your Awareness of Your Stressors & Stress Response
The more you know about what sets off your stress reaction and how you experience stress—your symptoms—the sooner you can take measures to manage things.4 Tune into your thoughts, feelings, and physical sensations to catch feelings of stress before it grows out of control.2 Once you know what triggers you and recognize when it happens, you can cope by using one or more of the these tips.
2. Start With What Is Within Your Control
Identifying what you can control and taking small action steps can help you feel more centered and empowered.4 Perhaps simplify a large project by breaking it down into small, manageable components, take a stressful situation one moment at a time, or choose to spend more time with people who encourage you and less time with those who are toxic.1 If you find yourself stuck in a terrible situation, take some control of your response by drawing on relaxation strategies.
3. Use Purposeful Relaxation Strategies Often
When you teach yourself to relax, you learn to control your physiological stress response. The fight-or-flight response happens automatically, but you can intentionally switch it off by using relaxation techniques that deactivate the sympathetic nervous system (SNS) and activate its physiologic counterpart, the parasympathetic (i.e., “rest and relax”) nervous system (PNS).2,3 The moment you notice yourself feeling stressed, begin to take slow, deep, mindful breaths. The act of breathing this way calms the body’s stress reaction.
You can also prevent your fight-or-flight response from dominating by engaging in regular practices to strengthen your body’s natural relaxation response. Practices such as yoga, tai chi, and meditation have been found in studies to reduce stress and increase feelings of calm.2 Also, having massages, watching something that makes you laugh, or doing anything healthy that to you is relaxing can reduce stress in a given moment and over time.4
Regular relaxation can be as simple as listening to music you find calming or inspiring. In a study reported in 2019 in the journal Anestesiologica, music was found to disrupt the stress response.5 The study showed that listening to or creating music directly impacts the nervous system, brain, heart rate, blood pressure, breathing rate, and hormone production.
Stepping outside is a stress-reducing, relaxation strategy that is quick and easy to do. A review, published in 2020, of 14 studies investigating the effects of nature on well-being revealed that even just 10 minutes of being outside in nature (such as a backyard or park) can reduce feelings of stress.6 Taking frequent breaks to step outside and breathe deeply can reset your body and center your mind.
4. Nourish Your Body & Brain
Taking care of your whole self helps reduce the negative effects of stress. Proper diet and physical activity are vital for both short- and long-term stress management.7
Exercise improves sleep by increasing the amount of restorative slow wave sleep cycles each night, boosts mood, decreases anxiety, and increases positive feelings about yourself and your circumstances.
What you eat also directly impacts your mental health. Eating lots of processed foods, sugars, and unhealthy fats can worsen the effects of stress and disrupt mood. Eating healthy foods like complex carbohydrates, lean proteins, healthy fats, and antioxidant-rich produce, spices, and beans nourishes your brain and body with nutrients like magnesium, vitamin C, and omega-3 fatty acids—all of which have been found to reduce the effects of stress on the body and mind.
5. Find What You Enjoy, & Do It Often and Regularly
An important key to dealing positively with stress is to experiment with stress-management techniques to find what works for you. Just as the causes of stress differ from person to person, so, too, do the tools that relieve stress. Discover what you enjoy doing and gradually do more of it over time.
Working stress management naturally and pleasantly into your daily life will prevent it from becoming one more thing on your already-long to-do list and thus another source of stress. When stress management is pleasant, you are more likely to engage in it regularly, which is another important key to coping with stress. Stress management isn’t a single event but instead is something done regularly to keep your PNS activated and working to keep you calm.2,4
Why Is Managing Stress Important?
Our body’s stress response exists to help us deal with immediate, threatening situations. When our mind and body are on alert, we are poised to deal with problems. This fight-or-flight response is supposed to be temporary, however, deactivating when a stressor passes. Unfortunately, in our hectic modern era, stressors are frequent and numerous, thus our physiological stress response is often robbed of the chance to turn off completely. Our physical and mental health can suffer damage as a result.2 Chronic stress can lead to serious problems such as heart disease, stroke, headaches, inflammation, pain, digestive problems, sleep disturbances, anxiety, and depression.2
The good news is that taking intentional steps to manage and cope with stress works. When you step in and do things that help your body and mind rest and reset, you can prevent your physiological stress reaction from wreaking havoc on your entire being. With regular stress management, you can respond thoughtfully to challenges rather than reacting in a way that makes you feel worse.
Stress & Your Mental Health
Stress begins with your body’s physiological response to something upsetting or threatening, but once that stress reaction begins, thoughts and emotions follow and perpetuate the fight-or-flight response.2 Worries and fears about perceived problems or consequences can run rampant, thus leading to mental health challenges.
For example, you might work for a critical boss and are entangled in a difficult project with a lengthy deadline. Your boss, project, and deadline trigger your fight-or-flight reaction. The resulting hormonal and neural activity keeps you on high alert for danger, and thoughts such as “What if I lose my job because I can’t please my boss with this project? I won’t be able to afford my mortgage, and how will I continue to support my children? My daughter has some health issues. What if I can’t afford to take her to the doctor? What if she actually has cancer and it spreads because I can’t afford treatment…”
These stressful, anxiety-provoking thoughts and emotions not only feed on themselves but they fuel the body’s stress reaction. It becomes a vicious cycle that is hard to escape and can worsen without proper stress management and treatment.
Stress has been linked to mental health challenges such as:2,8
- Anxiety
- Depression
- Sleep problems, including insomnia
- Worsening symptoms of other mental illnesses
If you feel that stress is interfering in your mental health, dominating your thoughts, or disrupting your emotions, working with a mental health therapist may be helpful.
How Therapy Can Help You Manage Stress
If you are suffering because of stress, know that you aren’t alone. Everyone experiences stress. You don’t have to work your way through it by yourself; it’s okay to seek help from others, including professional therapists. A therapist can help you identify and better understand your triggers, deal effectively with concerns and problems underlying stress, and develop an action plan to manage stress in a way that works for you.9
Sometimes, people are hesitant to seek professional help for stress because they think that therapy is only for those with diagnosable mental health conditions. According to the American Psychological Association, therapy helps people of all ages and backgrounds address a wide variety of concerns, including life stressors in order to boost well-being.10
In working with a therapist, you can:2,4,11
- Develop tools to help you manage your body’s stress reaction so you aren’t at the mercy of your stressors
- Boost your resiliency
- Make changes for a healthy lifestyle to keep stress at bay
- Learn new insights and form a new relationship with your triggers so you can use stress for positive outcomes
- Feel more in control of your life
- Discover ways to replace stress with a sense of meaning and purpose
- Identify and change negative thought patterns that both contribute to and result from stress
7 Therapy Options for Stress Management
Therapy can be beneficial for stress management, helping people deal with it positively.7 Specific therapeutic approaches are particularly helpful in dealing with and managing stress. Here is a brief overview of stress-management therapy options.
1. Cognitive Behavioral Therapy (CBT) for Stress
Cognitive behavioral therapy (CBT) is an approach to mental health that involves learning to identify negative thinking patterns that can increase stress and contribute to anxiety and depression.2 In working with a CBT therapist, you can recognize and change maladaptive thought patterns, identify your triggers, create and implement new, helpful behaviors, improve your emotions, and develop specific tools for dealing with problems.12,13
Cognitive-behavior therapy varies in length depending on the needs of the individual client. Sometimes, therapy is completed in 10 to 20 sessions (sessions are often 45-60 minutes in length), but other times the duration is shorter or longer.14 As with the length, the cost of CBT varies greatly, from about $20 per session in a community-based mental health center offering sliding scale fees to more than $180 in a private setting.15 Insurance often covers all or part of the cost of CBT.
2. Acceptance and Commitment Therapy (ACT) for Stress
Acceptance and commitment therapy (ACT) is an approach to therapy that helps people move past challenges like stress and create their own version of a quality life.16 With ACT, you learn to stop struggling against stress, change your response to it, and live in a way that reduces it. Acceptance and commitment therapy changes how people respond to stress and increases feelings of well-being.17
The cost and length of ACT vary. The cost of psychotherapy in general can range from approximately $50 to $150 per session,18 with rates falling outside of that range depending on things like geographic location, setting (community health center or private practice), and qualifications of the therapist. The length differs for each client depending on their needs.
3. Positive Psychology for Stress
Positive psychology is a scientific field of study that identifies and develops characteristics that help people flourish, and it is useful for stress because it helps build skills and perspectives to increase what works instead of focusing on what is wrong.2 Working with a therapist who incorporates positive psychology can help you increase such stress-reducing abilities and outlooks such as optimism and gratitude. Furthermore, this therapeutic approach helps people identify and use their unique character strengths as well as planning and taking positive action to improve their life—important skills for keeping stress at bay.
While positive psychology is a fairly new approach to therapy, it is a legitimate field of psychology recognized by the American Psychological Association that can help people rise above stress and thrive.2 Principles of positive psychology are often incorporated into many different types of therapy. As such, the cost and length of therapy vary greatly.
4. Mindfulness-Based Stress Reduction (MBSR) & Mindfulness-Based Cognitive Therapy (MBCT) for Stress
Mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT) are structured group programs that help people manage stress and cope positively with general life challenges. Both emphasize mindfulness, living fully in and paying attention to the present moment rather than being stuck in stress-perpetuating thoughts and emotions.
Participants in MBSR programs learn mindfulness, meditation, yoga, and information about stress as well as stress-management tools.12,19 In an MBCT program, participants learn a combination of mindfulness and CBT techniques to deal positively with stress.20Both MBSR and MBCT have been shown to reduce stress and ease symptoms of anxiety and depression.2
Mindfulness-based stress reduction and MBCT are eight-week programs offered in many different settings. An MBSR program offered at the University of Massachusetts, for instance, costs about $850 and may or may not be covered by insurance, depending on the insurance company and policy.21
5. Music Therapy for Stress
Music therapy involves purposefully listening to or creating music in order to create positive changes in emotional and physical health.5 While people can listen to music on their own as a relaxation technique, music therapy involves specific music interventions led by a trained music therapist.22 Many studies show that the benefits of music therapy include helping one reduce and better manage their stress, because it induces calmness and a state of relaxation by decreasing the body’s physiological stress reaction and boating positive emotions.5,22
Music therapy ranges in cost from approximately $50 to $90 for each individual session and about $60 to $90 an hour for group sessions.23 Music therapy can be an out-of-pocket expense but is sometimes covered by insurance or Medicaid.24
6. Art Therapy for Stress
Art therapy is a creative approach to mental health therapy that can involve such activities as collage-making, creative journaling, drawing, and painting, as well as discussion and processing of creations that leads to personal insight and discovery.25 It has been found to help people reduce stress by lowering cortisol levels in the body resulting in better mood, relaxation, and reduced physical symptoms such as headaches, chest pain, and sleep problems.25
Art therapy is often done in group settings but can be done individually as well. The cost varies greatly—from low to up to $100 per session—and depends on location, setting, and the qualifications of the therapist.26
7. Biofeedback & Autogenic Training for Stress
Biofeedback and autogenic training are interventions designed to help people become more in tune with their physiological stress reaction and what happens in their bodies when they’re stressed.27 During a biofeedback session, a therapist uses noninvasive instruments to measure brain waves, heart rate and rhythm, breathing rate, and muscle activity, and helps a client recognize these bodily sensations.
Then, people learn relaxation techniques to calm the body’s stress reaction when they notice it. The number of biofeedback sessions necessary to learn to recognize and control the physiological stress response varies. Biofeedback is often conducted in 30-60 sessions over three- to six months and ranges in price from $35 to $85 per session.28
Autogenic training typically occurs over four to six months and involves specific lessons, techniques, and practices. Over the course of training, people learn to activate the PNS and induce the relaxation response.
Where to Find a Therapist for Stress
Seeking a therapist for stress can seem overwhelming at first—especially when you are stressed and don’t want one more thing on your already too-full plate. Knowing where to look can make the process makes it much more workable.
You can find a mental health professional by using an online directory, asking family for friends, or checking with your primary care physician for a recommendation or referral.
It’s okay to ask for a consultation with a therapist before committing to therapy sessions. It’s important that you feel at ease with your therapist and feel that the two of your like, trust, and respect each other. The quality of the relationship between a therapist and client is perhaps the biggest factor in success.29
Cost of Therapy for Stress
Many factors determine the cost of therapy, including a therapist’s geographic location; setting (e.g., a community health center versus private practice); and education or experience. A session with a therapist—which is often 45-60 minutes but this, too, varies—can range from about $50 to $250.18 Some therapists offer a sliding scale in which you pay according to your income level.
Mental health therapy is increasingly covered by insurance, although not all plans do provide this coverage. Some policies require a mental-health diagnosis, such as major depressive disorder or an anxiety disorder, to cover the cost. To discover whether your insurance covers therapy for stress, you can check their website or call the number on the back of your card.
Is Therapy Effective for Managing Stress?
Studies are revealing that therapy is effective for managing stress. A review published in 2011 in >Health Science Journal found that therapy for stress management is safe and effective in helping people cope with stressors and manage their response to stress.27
Many studies point to the effectiveness of cognitive behavior therapy in particular for stress management. A review of 122 studies conducted between 2007-2018 found evidence to support the effectiveness of therapy, particularly cognitive behavioral therapy, for stress management in students.30 A different review, published in 2013, of 106 studies found strong support for the effectiveness of CBT for managing and reducing stress.31 A 2018 research study involving 30 medical students in Iran who reported feelings of stress and anxiety indicated that group-based CBT decreased their symptoms and increased their sense of hope.32
Studies into other forms of therapy for managing stress also show positive results. For example, a study published in 2016 examined 50 men with heart disease reporting negative stress and associated symptoms of stress. They attended eight 90-minute ACT sessions over two months, and at the end of the study reported feeling significantly reduced negative effects of stress.33
Stress can be incredibly disruptive to life, affecting people in many different negative ways. Learning healthy ways to cope with and manage stress and working with a therapist can bring positive changes and help you handle problems and thrive.
For Further Reading
To learn more about stress and how to manage it, consult these reputable mental health organizations:
Stress Management Infographics
