It is nearly impossible to avoid stress. We experience it on the street, in our cars, at school, work, and in our homes.

It comes at us in the form of noise, crowds, traffic, deadlines, bills, and conflict with friends and family. It doesn’t feel good. We tense up, get anxious, irritable, and lose sleep. In addition, stress can cause medical and emotional illness. (See: Stress and Heart Health.) A single significant stressor, such as the death of a loved one; exposure to a severe traumatic event, like 9/11 or Hurricane Katrina; or simply the effects of lots of “average” stressors can lead to depression and anxiety disorders.*

Any little bit you can do to chip away at the total amount of stress in your life will be helpful. This article describes ways to handle the “average” stressors we experience in day-to-day life. We’ll explore ways to avoid unnecessary stressors, cope better with the stressors you have, cut down on chronic worry and learn some ways to relax. Not all of the following suggestions can be put into practice in every situation. But you may find that with practice you can use these tools to start to tackle things that you thought you had no control over.

• Avoid avoidable stressors

There are basically two types of stressors: Things we can avoid and things that we can’t. Unavoidable stressors include natural disasters, terrorism, job layoffs and cancer. Avoidable stressors include things we chose and want to have in our lives like a job, a spouse, and children; as well as things we bring into our lives but don’t want, traffic jams in L.A. and crowds in N.Y.C.

The first way to reduce stress is to cut out things that create unnecessary stress. Are you spending money you don’t have just to buy something on impulse? Are you staying in a relationship that makes you unhappy? Are you staying up too late, waking late in the morning then rushing to work? In each of these situations you can do or change something that can avoid the stressor.

• Do what you can and let go of the rest

What about unavoidable stressors? You might think that if you can’t avoid a certain situation that there is nothing you can do about the stress it will cause you. This is not true. You may not be able to fix the problem, but you can change the way you think about it.

With every stressful situation consider what you can do to fix or change it and what you can’t. Then, do the best you can with what you can, and LET GO of the rest.

• Do what you can

If there’s something you can do, do it. Or at least do some part of it. Some solutions can feel even more overwhelming than the problems. If you can’t tackle the whole solution then at least do something. Let’s say you need to make a difficult phone call. If you aren’t ready make the call, at least look up the number and start to think of what you might say and write some notes. Need to clean up a messy home? Start with a corner.

Worry is work. If it’s a problem that needs solving, set aside time to think about it and try to not think about it on your “off” time. It’s important to take time off to let your mind rest and refresh itself. But, it can be hard to stop our minds from thinking once we’ve given ourselves a problem to solve, so keep a pen and paper (or your PDA) with you during the day or near your bed at night just in case you have a stray thought in your “off” time that might be helpful. You can write it down and then “let the thought go” until the time you’ve set aside to work on it.

• Let go of the rest

When we can’t fix or control things we need to let them go. This is simple, but easier said than done. We struggle the most when we feel out of control. But let me assure you, there are very few things in this world that we can control. We can barely control ourselves. Holding on to an anxious thought that you can do nothing about, serves no purpose and just contributes to the total amount of stress in your mind and body. For some people, one way of letting go may be to turn the problem over in a spiritual way whether it’s to God, Karma, fate, or the universe.

• Don’t ignore your anxious thoughts
Anxious thoughts are unwelcome thoughts, so they often get pushed out of the way during the day. (This is not the same thing as “letting go”.) They then rise up to haunt us the moment we turn off the TV, put down our book or get into bed. All of a sudden we’re flooded with concerns at a time when we can’t do anything but worry. Don’t avoid these thoughts but don’t let them spin noisily, senselessly in your head. Write these things down and promise your brain’s gremlins that you will attend to these thoughts at the proper time — then be sure you do.

• Make lemonade from life’s lemons

OK, so something stressful just happened. Is there anything you can do with the negative? Say you’re caught in a traffic jam. You’re feeling out of control. You want to lean on your horn, hit the wheel or perhaps do damage to the car in front of you. None of those responses are going to help. So, since you’re going to be stuck in your car for a while is there something you can do with the time? Try to have an audio book handy. A story may distract you. Consider language lessons on tape or CD or sing along really loudly with your favorite tunes.

• Don’t hold onto old wounds

Be reasonable with your expectations and forgive others.

We often feel stress in our relationships. We hold high expectations of many people in our lives and this can lead to disappointment. When our partner doesn’t do something we wanted, we get hurt, and often this shifts to anger. We replay these wounds in our head and turn them into stress. Holding onto grudges or other negative thoughts will hurt you more than the other person.

Ask yourself the following questions: Did the person MEAN to hurt me? Was my level of expectation too high? Did the person know what I was expecting? Ninety-nine times out of 100 the wound was unintentional, in which case you can simply let the person know that what they did hurt or disappointed you or you can just let it go. Were your expectations unreasonable? Do you want your family to have a “Norman Rockwell-type” Christmas and they never have? Holding onto this as an expectation will probably lead to un-necessary stress while you try to make it happen and repeated disappointment when your efforts fail.

Apologize

Chances are at some time in your life you’ll do something that hurts or disappoints someone you care about. Then they’ll get angry with you, and, you’ll get angry in return. Once again you are holding on to negative emotions un-necessarily. Apologize. Say something like: “I know my being late and not calling caused you to worry and waste your time waiting. I did not mean to upset you. I’ll try to remember to call next time.”

• Be reasonable with your expectations of yourself. Forgive yourself

We often carry around a lot of expectations of ourselves to be or do something. When we are not the best, or if we feel that we are failing at something, our own voices fill our heads with negative, criticizing chatter. Let’s say, you’re beating yourself up for getting home late and causing your partner to worry. Stop being so unkind and forgive yourself. Try to learn from your mistakes. Make an honest effort to grow and change but forgive yourself when you fall short.

• Create balance. Make time for yourself

Most of us spend too much of our lives at work or doing things for other people and we don’t leave enough time for ourselves. We tell ourselves “Tomorrow I’ll do things differently.” but tomorrow never comes. Don’t put off creating balance until another day. Think about how you are spending your time and energy and set aside some time for yourself, even if it’s just a few minutes or an hour a day. Sit in the park, play with your child or pet, read a book, take a bath, listen to music or even watch TV. (Caution, certain programs might add to your stress. Try to avoid those!)

Eat right, exercise and get your sleep

Good nutrition can nourish the brain and improve our body’s response to stress. Try to make healthier food choices. Start slowly. Can you put more fiber in your diet, reduce your unhealthy fats, substitute lower or no-fat milk, and consume less caffeine? (A moderate amount is OK, too much can over-stimulate your body.) You don’t have to give up everything you like. Just eat foods that are “less healthy” in moderation. Also, take time to eat at least one meal per day in a relaxed manner, pay attention and allow yourself to taste and enjoy what you’re eating.

Exercise is very important for keeping both mind and body healthy. It can help balance your stress response system (See: Effects of Stress on the Heart.) Schedule some time for exercise at least a few times per week. Try to pick something you enjoy. At the minimal, if you can, walk more. Take the stairs, park farther from the shopping mall entrance, or get off the bus one stop early. Don’t ask yourself if you want to work out today. Just do it. If you have any health risks consult your doctor before you begin an exercise regimen.

Stress can cause lack of sleep or disturbed sleep. In addition to the gremlins which keep us from falling asleep because we’re spinning in all of our anxious thoughts, we “burn the candle at both ends” and try to do too much. Often we believe that we can sacrifice our sleep in order to get more work done. Stop working, turn off the computer and TV and get to bed at a reasonable time. Sleep is critical for brain and body health. Don’t short change yourself.

• Relax, and release your tension

Pay attention to how you hold your body. Chances are you’re holding some stress in your muscles. Are your eyebrows and forehead knotted, jaws clenched, shoulders hunched, fists tight? A few times a day take a moment to stretch, make a big yawn, and consciously relax your muscles from the very top of your head down to your toes.

• Last, but not least, Breathe

When we’re tense we often hold our breath or breathe shallowly. While you’re relaxing your muscles try taking a few slow deep breaths. Consider learning some yoga breathing exercises, pranayama. They can slow the heart rate, relieve tension and help restore balance to your body’s stress response.

Sometimes it’s more than just stress

If you have suffered a significant loss or traumatic event, or, if you are feeling overwhelmed by things in your life now and have symptoms such as feeling constantly sad, anxious, irritable, have difficulty concentrating, a change in appetite or sleep patterns, you should seek help. Contact your physician or seek out the assistance of a mental health professional such as a therapist or psychiatrist. See the links and phone numbers below for education about mental health, mental illness and ways to find help.

Helpful links:

1. American Psychiatric Association • (888) 357-7924
http://www.healthyminds.org/

2. American Psychological Association
• (202) 336-5980
http://www.apa.org/

3. National Association of Social Workers • (202) 408-8600
• http://www.helpstartshere.org/home.html

4. The Substance Abuse and Mental Health Services Administration's (SAMHSA) National Mental Health Information Center • 800-789-2647

5. Mental Health Services Locator

Dr. Elizabeth Getter received her undergraduate degree from Brown University and medical degree from the University of North Carolina at Chapel Hill. Dr. Getter has lectured on and worked extensively with the problem of addictions as well as the psychiatric problems of persons with HIV and AIDS. She is an Assistant Clinical Professor of Psychiatry & Behavioral Sciences at Albert Einstein College of Medicine of Yeshiva University and currently has a private practice in psychiatry in New York City.