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Section: 3
Executive Summery
Stressors are events or stimuli that cause stress, and they can vary from daily hassles to significant
life changes. College students often face unique stressors due to the academic environment, lifestyle
changes, and reduced access to traditional support systems.
While moderate stress can be beneficial by alerting us to potential threats and providing energy to
confront or avoid them, chronic or intense stress can lead to negative physical and psychological
outcomes. These include impaired attention, concentration, decision-making, emotional disturbances,
and physical health concerns like cardiovascular disease and immune system suppression.
Effective stress management techniques aim to maintain stress levels within an optimal range rather
than eliminating stress entirely. They include regular physical activity and exercise, healthy eating,
adequate sleep, relaxation exercises, mindfulness, meditation, laughter, social support, and cognitive
restructuring.
Physical activity and exercise can reduce stress reactivity and help prevent and treat anxiety and
mood disorders. Healthy eating, including nutrient-rich foods, can improve mood and stress hormone
levels. Adequate sleep is crucial for managing stress, as poor sleep can lead to heightened stress and
anxiety.
Relaxation techniques like diaphragmatic breathing, progressive muscle relaxation, guided imagery,
and meditation help reduce stress and promote relaxation. Cognitive restructuring involves
recognizing and challenging irrational or maladaptive thoughts to improve mood and reduce negative
emotions.
To effectively manage stress, individuals should incorporate these techniques into their daily lives to
enhance their physical and psychological well-being.
STRESS MANAGEMENT
Module Overview
What is Stress
Stress Management
Reference
Module Objectives:
Define key terms related to stress, the stress response, and stress management.
Explain the physiological and psychological changes that occur in response to stress.
Key Terms
Cognitive restructuring
Diaphragmatic breathing
A relaxation technique consisting of deep abdominal breathing designed to expand and contract the
diaphragm, slow breathing, and regulate oxygen intake.
Fight-or-flight response
Activation of the sympathetic nervous system that occurs in response to a stressor and prepares the
organism for dealing with a stressor.
Guided imagery
A relaxation technique involving the use of language to create calming, sensory rich experiences in
one’s imagination.
Homeostasis
Meditation
A relaxation technique that combines focusing on a specific object or sensation while disengaging
from other distracters and regulating internal experiences through non-judgmental acceptance.
A relaxation technique involving the repeated tensing and relaxing of various muscle groups
throughout the body.
Stress
Emotional, cognitive, behavioral, and physiological reactions a person experiences in response to
Stress hormones
Hormones, including Cortisol and Norepinephrine, that are released by the body during a fight-or-
flight response.
Stressor
Yerkes-Dodson Law
Law dictating that physiological and mental functioning is optimal at mild to moderate levels of
arousal, but diminishes as arousal becomes extreme (high or low).
What is Stress?
Although “stress” is a commonly used term in today’s vernacular, and most people appear to have an
intuitive sense of what it means, stress is difficult to precisely define as it is often used
interchangeably with a variety of other terms, such as anxiety, pressure, or strain. In a general sense,
stress refers to a collection of physiological, emotional, behavioral and cognitive reactions that occur
in response to environmental demands. As we interact with the world around us, we must make
constant appraisals of environmental threats, challenges, and demands and attempt to cope with any
issues that arise. At times, environmental demands are easily handled, such as when you have to
press a button on a key to unlock your car. However, at other times, the demands of the environment
can seem daunting or unmanageable, such as when you have to take three exams on the same day,
and result in feelings of physical tension, negative thought patterns, and unpleasant emotional
experiences. Lazarus and Folkman (1984) suggested that stress results when the demands of the
environment are greater than the individual’s perceived coping resources.
A “stressor” is any event or stimulus that causes stress. However, what serves as a stressor for one
person may not be the same for another. For example, being asked to attend a social event may create
stress for someone who perceives that they lack the necessary social skills to fit in, whereas another
person who feels comfortable in social situations may not experience any stress. Stressors can take
many forms, ranging from the daily hassles of life to significant life changes. Daily hassles are the
regularly occurring events or situations that we experience in everyday life, such as misplacing items,
concerns about weight, or having to wait your turn. Any one of these events is unlikely to have a
major impact on our overall quality of life. In contrast, life changes, such as death of a family
member, getting married, or a negative health diagnosis are more significant. Notice that not all
stressors are negative. Getting married, having children, and starting a new job are often positive
experiences, though they can create a significant amount of stress because they require us to alter our
lives and adjust to new circumstances. College is a transitional time of life when new and unique
stressors are often being encountered. Not only are college students often away from home for the
first time and forced to be more self-sufficient, but they must also cope with the increasing demands
of the academic environment. Changes in sleep and eating habits, increased financial responsibilities,
having to share living space and possessions with strangers, and increased exposure to alcohol, drugs,
and sex are only a few of the additional stressors often encountered by college students. To
exacerbate matters, college students are often forced to cope with the challenges of college stressors
with reduced access to their traditional support systems, such as family and long-time friends. Thus,
it is important for college students to increase their awareness about stress, the impact that excessive
stress can have on physical and mental health, and various coping strategies and techniques available
to help cope with the challenges of the college environment.
Although we generally think of stress as something to avoid, stress is a natural, adaptive response
that serves a protective function. At moderate levels, stress helps alert us to potential threats in the
environment and enables us to focus our attention on resolving the threat. Stress also provides us
with the energy needed to confront or retreat from the threat via the “fight-flight” response. Although
some stress is beneficial, prolonged or intense stress can be associated with a variety of negative
physical and psychological outcomes. For example, whereas moderate amounts of stress help to
focus our attention, excessive stress leads to diminished attention, concentration, decision-making,
and short-term memory. High stress can also lead to a variety of emotional disturbances, including
irritability, depression, and anxiety disorders. Indeed, many researchers consider stress a core
component of the cause of emotional disorders. Chronic high stress is associated with serious
physical health concerns, including cardiovascular disease, hypertension, immunosuppression and
more frequent illnesses, sexual dysfunction, gastrointestinal disorders, and recurrent headaches. High
levels of stress are also associated with a variety of behaviors and lifestyle choices that can have
negative health outcomes. Research indicates that individuals experiencing high stress are more
likely to engage in excessive alcohol consumption and increased use of drugs and tobacco products.
Ironically, alcohol increases cortisol levels, which can prolong the feeling of tension generated by
stress responses. Stress can change the way the body processes alcohol, resulting in a reduction in the
pleasant effects of alcohol and increased craving for more alcohol. In addition, chronic alcohol
consumption and tobacco use are leading causes of a variety of chronic health problems, including
lung and liver cancer, cirrhosis of the liver, emphysema, coronary heart disease, and stroke. It is
important to recognize that exceptionally low levels of stress can have negative consequences as
well. For example, when arousal levels are too low, people generally experience boredom, poorer
cognitive and physical performance, procrastination, and lack of attention to detail. The Yerkes-
Dodson Law, developed by psychologists in the early 1900’s, holds that organisms’ physiological
and mental functioning tends to be optimal when experiencing mild to moderate levels of arousal.
Although the level of stress and arousal required for optimal functioning varies depending on the
type of task, research over the past century has generally been supportive of this notion, which has
shaped how stress and anxiety are conceptualized and treated.
Stress Management
Given the beneficial nature of mild to moderate levels of stress, the goal of stress management is not
to eliminate all stress. Rather, stress management techniques are designed to keep stress levels within
an optimal range. Engaging in healthy lifestyle behaviors can help to reduce stress and maximize the
likelihood of living a long, healthy life. The following stress management techniques have been
consistently supported by empirical research.
Healthy eating; adequate sleep; relaxation, mindfulness and meditation; laughter, self-expression and
social support; and cognitive restructuring. Physical Activity and Exercise Considerable evidence has
accumulated indicating that regular physical exercise is associated with numerous physical and
psychological health benefits. For example, regular engagement in moderate exercise, such as a brisk
walk, strengthens the immune system and decreases rates of illness. Exercise also strengthens body
muscles, including the heart, preserves muscle mass, and helps with weight management. Individuals
who exercise regularly are also at a reduced risk for some chronic diseases, such as diabetes and
hypertension. Although exercise is, technically, a stressor itself, requiring the body to adapt to the
demands of the activity, research suggests that regular physical exercise can help to reduce the
body’s reactivity to other stressors. In fact, several studies have demonstrated that individuals who
exercise demonstrate lower physiological (e.g., blood pressure, heart rate) markers of stress and
report less anxiety in response to a stressful situation than those who do not exercise. This finding is
particularly important given that stressful events precede approximately 80 percent of major
depressive episodes, and stress is a central risk factor for the development of panic attacks,
generalized anxiety, posttraumatic stress, social anxiety, and phobias. Thus, involvement in regular
exercise may help protect against or prevent the onset of anxiety and mood disturbances. In addition,
accumulating research suggests that regular physical activity is effective in treating many of these
conditions
once they develop. In fact, some studies suggest that exercise is as effective as psychotherapy or
medication in treating some anxiety and mood disorders. For example, in one study, individuals who
experienced recurrent panic attacks responded to 12 weeks of aerobic exercise in a comparable
manner to those taking psychiatric medication. Other research has suggested that aerobic exercise
reduces symptom severity among individuals with obsessive compulsive disorder, and a recent
review of 11 studies comparing the effects of regular exercise with psychotherapy for depression
revealed that two to four sessions of exercise per week was just as effective in treating depression as
psychotherapy. Furthermore, although most professionals recommend regular involvement in an
exercise regimen to maximize benefits, research suggests that even a single bout of aerobic exercise
or weightlifting can reduce perceived stress levels and improve mood. It appears that exercise s
medicine!
Healthy Eating
When experiencing high levels of stress, research suggests that many people change their eating
patterns. One of the most common dietary changes associated with stress involves the increased
consumption of caffeine in an effort to improve early morning or late-night productivity. Ironically,
although caffeine is associated with short term increases in alertness, caffeine can also exacerbate the
stress response. For example, caffeine stimulates the body to release various stress hormones,
including cortisol and glucocorticoids, as well as catecholamines, which include epinephrine
(adrenaline), norepinephrine, and dopamine. The release of these chemicals is associated with
heightened levels of stress for hours after ingestion. In addition, caffeine consumption can lead to
other conditions that can affect the body’s ability to respond to stress, including insomnia,
hypertension, increased risk of heart disease, gastrointestinal problems, and immune system
suppression, making you more prone to infections. As noted earlier, high levels of stress are also
associated with increases in cortisol, which tend to lead to cravings for high fat or sugary foods. In
addition, when busy, people often resort to skipping meals or eating fast foods. These dietary
changes can actually make it more difficult for our bodies to manage stress. Eating a healthy diet full
of nutrient rich foods can help your mange stress in several ways. For example, complex
carbohydrates, like oatmeal and whole grain breads and cereals, cause your brain to release
Serotonin, a neurotransmitter associated with positive mood. Even simple carbohydrates, such as
candy or chocolate can be good for a quick spike in Serotonin. Research suggests that foods rich in
Vitamin C (e.g., Oranges) and Omega-3 fatty acids (e.g., salmon) can help reduce levels of stress
hormones and improve immune functioning. A well-balanced diet improves one’s ability to manage
stress.
Adequate Sleep
Research suggests that the relationship between stress and sleep is bidirectional in that high levels of
stress tend to be associated with impaired sleep, and lack of sleep tends to exacerbate the experience
of stress. Numerous studies have indicated that excessive stress tends to lead to diminished ability to
fall and stay asleep, increased rate of nightmares, and poorer sleep quality. In addition, various
emotional disorders associated with stress and anxiety, such as posttraumatic stress disorder and
generalized anxiety disorder, are often associated with significant sleep disruption. On the other
hand, lack of sufficient sleep often leads to suboptimal physiological and psychological functioning.
For example, sleep deprived individuals report higher levels of stress, anxiety and anger in response
to even low-level psychological demands. Further, some evidence suggests that sleep deprivation
affects cortisol (a stress hormone) levels, and neuroimaging studies indicate that sleep deprivation is
associated with impaired neurological functions, including increased amygdala (part of the brain
associated with emotional responses) reactivity and pre-frontal control regions of the brain. In
addition, considerable evidence indicates that poor sleep is associated with poorer immune
functioning. Epidemiological research suggests that most individuals require 7 to 8 hours of sleep
nightly to obtain the maximum physiological and psychological benefits from sleep.
Relaxation, or easing of physical or mental stress, is often thought to be the antidote to stress.
Relaxation and anxiety are thought to be opposing emotions, in that one cannot be relaxed and
anxious at the same time. Indeed, the achievement of a state of relaxation during a period of stress is
often a challenging task. However, a variety of techniques have been devised with the intention of
helping one to reach a state of relaxation, several of which have demonstrated reliable efficacy in
psychological research: Diaphragmatic breathing, progressive muscle relaxation, guided imagery,
and meditation exercises. Diaphragmatic breathing, or deep abdominal breathing, is a technique
designed to slow one’s breathing and regulate oxygen intake. Diaphragmatic breathing involves
taking slow, deep breaths with the intention of expanding and contracting the diaphragm, which is a
muscle separating the chest and abdominal cavities. Typically, diaphragmatic breathing exercises
involve sitting in a comfortable chair or lying down and taking slow, deep breaths with the intention
of breathing so that the air expands the abdomen more than the chest. Research suggests that
practicing diaphragmatic breathing can significantly reduce perceived stress. In one study, a sample
of medical school students participated in a deep breathing program for 5 minutes per day prior to
class over a 10-month period. After six weeks, students engaging in the deep breathing exercises
reported significantly less test anxiety, self-doubt, nervousness and increased concentration during
exams. Progressive muscle relaxation (PMR) refers to a series of techniques that involves the
repeated tensing and relaxing of various muscle groups in the body. Often, deep breathing is
integrated, whereby an individual undergoes a deep breathing exercise while also tensing and
relaxing muscle groups. The goal of PMR is to affect the autonomic arousal component of stress and
anxiety via a reduction in skeletal muscle tension. It is believed that as skeletal muscle tension
diminishes, other aspects of autonomic arousal, such as blood pressure and heart rate, also decrease.
Although the original progressive muscle relaxation paradigm was extremely time-intensive (i.e.,
involving nearly 30 muscle groups and as many as 100 individual practice sessions carried out over
months or years), subsequent research has suggested that comparable effects can be generated with
far fewer sessions. Similar to diaphragmatic breathing, PMR sessions typically involve assuming a
comfortable position and taking deep breaths while tensing and relaxing 16 different muscle groups
(e.g., starting with the head muscles and working down the body before ending with the feet). As part
of the Personal Discovery Assessment (PDA) within this module, you will have the opportunity to
experience PMR for yourself.
Cognitive Restructuring
Often, we presume that the events that we experience have a direct effect on our emotions. For
example, finding out that you made a poor grade on an exam or that your partner wants to break up
with you causes you to feel sad. However, it is not the event itself that leads to the emotion. Rather, it
is the meaning that you give to the event or your interpretation of the situation that determines the
event’s emotional impact. If you interpret the poor grade to mean that you are not very intelligent or
that you will never succeed in school no matter how hard you try, you will likely experience a
depressed mood. In contrast, if you interpret the grade as a fluke or the wake-up call you have needed
to enhance your motivation for school, your mood will likely be much less negative. As you can see,
the way that we perceive or think about a situation or event can dramatically affect the emotions we
experience. Cognitive restructuring involves learning to recognize the irrational or maladaptive
thoughts we experience that contribute to negative mood states and then altering them to more
accurately reflect the situation. For example, if you are preparing for a presentation, and you
repeatedly think, “I know I’m going to say something stupid, and everyone will laugh at me” or
“Everyone is going to be able to see how anxious I am, and they will think I’m an idiot”, you will
likely be fairly anxious. However, are these rational thoughts? Unless you are particularly adept at
foretelling the future (in which case, I would appreciate some help selecting my lottery numbers!),
these thoughts are likely examples of catastrophizing thoughts, which serve to increase anxiety.
Although it is possible that you will say something stupid, what are the chances if you thoroughly
prepare and rehearse your presentation? How many times have you given a presentation in the past
and NOT said anything stupid? Even if you do say something that does not sound particularly
intellectual, is it possible that some, most, or all of the people in the class might not notice or think
negatively about you? If people do notice your anxiety, is it possible that they might interpret it in a
different way than assuming you’re “an idiot?” Might some people not have empathy for you
considering that public speaking is one of the greatest fears among college students? After
challenging the irrational or maladaptive thoughts in this manner, it is important to select a rational
alternative to substitute. A more rational alternative to the first assumption might be, “If I prepare
well and know what I am going to say in advance, I will probably do a fine job of delivering the
presentation.” For the second statement, you might substitute, “most people will be anxious when
they present, and even if they do notice my anxiety, they will probably be able to relate to it.”
Research suggests that cognitive restructuring or learning to recognize maladaptive thoughts and
change them to reflect more adaptive, rational thought patterns can significantly improve mood,
reduce stress, and decrease negative emotions.
1. Exercise Regularly. Engage in 3-5 sessions of moderate intensity exercise each week to enhance
your immune system and reduce your risk of developing anxiety and mood disorders. However, even
if you cannot exercise regularly, remember that even a single episode of exercise can be a great way
to relieve stress and improve mood.
2. Eat a Healthy Diet. Eat plenty of fruits, vegetables, whole grains, and fatty fish to maximize your
physical health and your body’s ability to manage stress.
3. Sleep. Get 7-8 hours of uninterrupted sleep per night to improve your mood and boost your
immune functioning.
5. Express Yourself. Look for the humor in stressful situations, and find ways to express your
emotions through writing, art, or talking with friends and family.
6. Reframe. Attend to the ways in which you think about and interpret stressful situations and look
for opportunities to reframe the situation in a more rational or positive manner. Remember, the test
atthe end of this chapter is not something to be feared. Instead, it represents an opportunity for you to
demonstrate how much you have learned about stress and stress management!
References
MacLean, C. R., Walton, K. G., Wenneberg, S. R., Levitsky, D. K., & al, e. (1997). Effects of the
Transcendental Meditation program on adaptive mechanisms: Changes in hormone levels and
responses to stress after 4 months of practice.
White, S., & Camarena, P. (1989). Laughter as a stress reducer in small groups. Humor:
International Journal of Humor Research.
Hains, A. A., & Szyjakowski, M. (1990). A cognitive stress-reduction intervention program for
adolescents. Journal of Counseling Psychology.
Szabo, A. (2003). The acute effects of humor and exercise on mood and anxiety. Journal of Leisure
Research.
Segrin, C., & Passalacqua, S. A. (2010). Functions of Loneliness, Social Support, Health
Behaviors, and Stress in Association with Poor Health. Health Communication
Gross, J. J., & Levenson, R. W. (1997). Hiding feelings: The acute effects of inhibiting negative
and positive emotion. Journal of Abnormal Psychology
Eysenck, M. W., Derakshan, N., Santos, R., & Calvo, M. G. (2007). Anxiety and cognitive
performance Attentional control theory