Stress Reduction Treatments
According to the American Psychological Association, “stress is any uncomfortable ‘emotional experience accompanied by predictable biochemical, physiological and behavioral changes.”
Stress might spark irritability, sadness, and mood swings. It might sink your energy and your drive and impair your sleep. It might trigger headaches, an upset stomach, and other aches and pains.
Stress is complex because it can look different in different people, and it can stem from a variety of sources. Your stress may stem from an impending divorce, a demanding job, a devastating loss, or a never-ending to-do list. It might stem from caring for your elderly parents or from having a child with a chronic illness. It might stem from moving, losing your job, having an illness yourself, or being in debt.
However, this stress doesn’t have to derail you. Depending on the severity of the stressor and your symptoms, you can manage it on your own with helpful tools and techniques, and/or work with a therapist. A clinician can help you better understand what’s going on and effectively address it.
Several types of psychotherapy can be helpful for individuals who are struggling with stress. According to research, these include:
Cognitive behavioral therapy (CBT) is one of the most well-researched interventions for a variety of conditions and concerns. It was developed by Aaron T. Beck in the 1960s. CBT helps individuals identify and change the negative, distorted thoughts and unhealthy behaviors that trigger and perpetuate stress. Treatment is tailored to your specific needs, challenges, situation, and resources.
CBT also is available in group format. According to a 2018 article, “CBT in groups offers unique therapeutic opportunities: For example, the patient learns to recognize cognitive mistakes made by others, and a group can give more examples of links between thoughts and feelings than is possible in individual therapy.”
Cognitive behavioral stress management (CBSM) is a short-term group intervention that blends traditional CBT with relaxation techniques. Specifically, CBSM includes reframing thoughts, learning coping skills, managing anger, and being assertive, along with practicing guided visual imagery, progressive muscle relaxation, and deep breathing. Research exploring CBSM’s efficacy in women with breast cancer, pregnant women, and individuals with HIV has found the intervention to be effective.
Mindfulness-based stress reduction (MBSR) is an 8-week group program that includes meditative practices, gentle stretching and yoga, and body awareness techniques. It ends with a day-long retreat. MBSR was created by Jon Kabat-Zinn in the 1970s. He defines mindfulness as “paying attention in a particular way: on purpose, in the present moment, and non-judgmentally.” Today, MBSR is used in medical and non-medical centers all over the world.
You can learn more about MBSR at The Center for Mindfulness. Online courses also are available. Kabat-Zinn discusses the program in his book Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. This website offers a free, online, self-paced MBSR course.
Mindfulness-based cognitive therapy (MBCT) is based on MBSR and combines mindfulness meditation—breathing techniques, body scan practices, yoga, mindful walking—with cognitive therapy. MBCT helps individuals identify unhelpful patterns of thinking and use an accepting, curious, non-judgmental approach to your experiences (i.e., your thoughts, emotions, and behavior). It was originally developed to prevent relapse in depression. You can learn more at MBCT.com.
Problem solving therapy (PST) is a cognitive-behavioral intervention that “aims to help individuals adopt a realistically optimistic view of coping, understand the role of emotions more effectively, and creatively develop an action plan geared to reduce psychological distress and enhance well-being.”
According to the American Psychological Association, the goals specifically include: identifying the stressors that trigger different emotions (such as sadness and anger); managing negative emotions; becoming more hopeful about your ability to deal with problems; accepting problems that can’t be solved; systematically and thoughtfully resolving stressful problems; and reducing the tendency to avoid problems, and/or be impulsive in trying to solve them.
PST can be conducted in a group setting or on an individual basis, and can be part of other interventions.
When looking for a therapist to help you manage stress, inquire about their experience and ask them how they’d go about helping you navigate your concerns. When possible, shop around and interview several therapists to find one you feel comfortable working with.
There’s no medication that specifically targets stress. However, antidepressants—such as selective serotonin reuptake inhibitors (SSRIs)—or anti-anxiety medication may be prescribed when someone is struggling with severe, debilitating stress and is unable to function day to day.
This also could be a sign that something deeper is going on, such as clinical depression or an anxiety disorder. In this case, it’s critical to get a comprehensive evaluation from a mental health professional.
There are many effective ways you can reduce stress on your own, whether you’re working with a clinician or not.
Practice self-compassion. Acknowledge and accept how you’re feeling and what’s stressing you out—without judging yourself. Remind yourself that everyone struggles, too, and many people have been in similar situations. Then gently consider what you need, and try to meet that need. Try to empathize with yourself, and be supportive. Try to avoid being self-critical and harsh. Try to treat yourself like you would a friend or child.
Problem solve. Once a week or daily, jot down a list of everything that’s stressing you out. Then consider what you can and can’t control. For the stressors you can control, consider the steps you can take right now to move forward. Try to see these stressors as opportunities to flex your creative problem-solving skills.
For the stressors you can’t control, consider the coping strategies you can use to relax and reduce your overwhelmed feelings (e.g., getting enough sleep, practicing progressive muscle relaxation, journaling about your feelings).
Practice empowering self-talk. The way we talk to ourselves can make or break how we manage stress. The great news is that you can change your negative self-talk. You don’t have to believe everything you think. When revising your self-talk, the key is to empower yourself—to be your own cheerleader and coach.
For instance, instead of telling yourself, “I can’t do this!” say, “This is a tough situation, and I’ll do the best I can.” Instead of saying, “I’m helpless and hopeless,” say, “There are always things I can do. For starters, I can reach out for support. I can call a friend and make an appointment with a therapist.”
Turn to books. There are literally thousands of books on stress management, which take different approaches and offer different suggestions. Here’s a list of titles you might check out:
- A Mindfulness-Based Stress Reduction Workbook
- The Stress-Proof Brain: Master Your Emotional Response to Stress Using Mindfulness and Neuroplasticity
- The Stress Management Workbook: De-Stress in 10 Minutes or Less
- The Relaxation and Stress Reduction Workbook
- Mindfulness for Stress Management: 50 Ways to Improve Your Mood and Cultivate Calmness
- The Mindful Self-Compassion Workbook: A Proven Way to Accept Yourself, Build Inner Strength, and Thrive
Engage in energizing and calming exercise. Moving our bodies can be a big stress reliever. The key is to connect to yourself and identify the kind of movement you need at the time. Would you like to participate in aerobic, high-energy exercise? Or would taking a short walk or riding your bike be more enjoyable? Maybe you’d benefit from taking a restorative yoga class (see more below), or dancing around the house.
Practice yoga. According to a 2015 review article, “Overall the 25 randomized control studies discussed provide preliminary evidence to suggest that yoga practice leads to better regulation of the sympathetic nervous system and hypothalamic-pituitary-adrenal system, as well as a decrease in depressive and anxious symptoms in a range of populations.” There are numerous types of yoga. It’s important to find a practice that resonates with you. You might try online classes or an in-person studio.
Spend more time in nature. Nature can be soothing and energizing. Try to get outside as much as possible—take walks; sit on a park bench; sit on your patio; make it a point to stare at the sky; visit the botanical gardens; and surround yourself with fresh plants and herbs at home (and include a plant on your desk at the office).
Focus on the basics. Make sure you’re getting enough sleep, eating foods packed with nutrients, and drinking plenty of water.
Create calming routines. Start and end your day with calm (as much as possible). Set morning and evening routines filled with relaxing activities. Make your bedroom into a sanctuary (e.g., clear surfaces; soft, clean sheets; your favorite essential oils; cool, dark atmosphere). Include meditation, prayer, journaling—or any other activities that contribute to your well-being.
Rethink stress. Stress is certainly complex, but it isn’t all bad. Indeed, we can embrace stress and use it as fuel. In fact, when harnessed, stress can boost our energy levels, sharpen our focus, increase our productivity, and make us more resilient. You can learn more on harnessing stress in this Psych Central piece, and in the popular TED talk “How to Make Stress Your Friend” by psychologist Kelly McGonigal.
Set boundaries. Identify what (and who) causes or exacerbates your stress, and then try to set boundaries around that. For instance, tell your friend, who inevitably calls right before family dinner, that you can only talk on Wednesday afternoons for 20 minutes. Keep your phone in a drawer after 8 p.m. When setting boundaries, be direct, specific, and clear. Use a neutral tone of voice (versus screaming or seething with anger). Here’s more on setting boundaries with kindness.
Practice meditation. If you’re new to meditation, listening to guided practices is a great way to start. The UCLA Mindfulness Center offers a variety of 3- to 19-minute options. Meditation teacher and psychologist Tara Brach also includes a comprehensive collection of practices on her website, which she updates regularly. Researcher Kristin Neff shares seven soothing, self-compassionate mediations on her site.
Practice other relaxation techniques. Explore different breathing techniques. One example is alternate nostril breathing: Begin by using your right thumb to block your right nostril. Breathe out of your left nostril, and then breathe in. Next, use your ring finger—on your right hand— to block your left nostril. Breathe out through the right nostril, and then breathe in through the same nostril. Switch to the left nostril, and keep repeating this cycle for several minutes. Check out three other breathing techniques in this Psych Central piece.
Another helpful technique is progressive muscle relaxation, where you tense and relax one body part at a time. Start with your forehead, and finish with your feet.
Try an app. There’s a wide array of apps that can help with managing stress and boosting well-being. Check out this article from The American Institute of Stress for the specifics.
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