When I discharge people from the ED and send them home, we quite often sit down and make a list of many of these things and actually write them out on their discharge note, as a kind of "toolkit" to take home, so they can have it on hand for next time they're stressing out. I found a similar list at the Reader's Digest web site. Of course I had to add my two, or three cents to the pot, eh? :-) But I thought such a practical "tips" list might be handy for folks. Some you will like - some you will loathe. Some will work one day, and another day that same thing will feel useless. It varies. Pick and choose what feels good to you. Enjoy!

 

God bless,

Lisa

 

36 Stress Management Tips
 
 
Alternatives to Anxiety   - Stress is a fact of life, but being stressed out is not. We don't always have control over what happens to us, says Allen Elkin, Ph.D., director of the Stress Management Counseling Center in New York City, and yet, that doesn't mean we have to react to a difficult, challenging situation by becoming frazzled or feeling overwhelmed or distraught. Being overly anxious is not just a mental hazard; it's a physical one too. The more stressed out we are the more vulnerable we are to colds, flu, and a host of chronic or life-threatening illnesses. And the less open we are to the beauty and pleasure of life. For your emotional and bodily benefit, we've consulted experts and come up with 36 easy, natural alternatives to anxiety. Enjoy!
 
 
1.        Breathe Easily - "Breathing from your diaphragm oxygenates your blood, which helps you relax almost instantly," says Robert Cooper, Ph.D., the San Francisco coauthor of The Power of 5 (Rodale Press, 1996), a book of five-second and five-minute health tips. "Shallow chest breathing, by contrast, can cause your heart to beat faster and your muscles to tense up, exacerbating feelings of stress." To breathe deeply, begin by putting your hand on your stomach, just below the navel. Inhale slowly through your nose and watch your hand move out as your belly expands. Hold the breath for a few seconds, and then exhale slowly. Repeat several times.


2.        Visualize Calm - It sounds a little odd, but at least one study, done at the Cleveland Clinic Foundation, has found that it's highly effective in reducing stress. Dr. Cooper recommends imagining you're in a hot shower and a wave of relaxation is washing your stress down the drain. Gerald Epstein, M.D., the New York City author of Healing Visualizations (Bantam Doubleday Dell Press, 1989), suggests the following routine: Close your eyes, take three long, slow breaths, and spend a few seconds picturing a relaxing scene, such as walking in a meadow, kneeling by a brook, or lying on the beach. Focus on the details -- the sights, the sounds, the smells. (I taught my child at age 4 to "wash away" his headaches by imagining a cool brook or creek full of sparkling clear water that would wash through his head, from the center of his forehead, across the top of his head, down the back of his neck, and wash his pain and discomfort away. He would actually report that he felt "cooler" in about a minute of sitting or lying down with his eyes closed and doing this simple visualization.)  – Lisa Alekna, M.Ed., LSWA of the Psychiatric Crisis Team in Westfield, MA.
 
3.        Make Time for a Mini Self-Massage - Maria Hernandez-Reif, Ph.D., of the Touch Research Institute at the University of Miami School of Medicine, recommends simply massaging the palm of one hand by making a circular motion with the thumb of the other. 

 
4.        Say Cheese - Smiling is a two-way mechanism. We do it when we're relaxed and happy, but doing it can also make us feel relaxed and happy. "Smiling transmits nerve impulses from the facial muscles to the limbic system, a key emotional center in the brain, tilting the neurochemical balance toward calm," Dr. Cooper explains. Go ahead and grin. Don't you feel better already?
 
5.        Do Some Math - Using a scale of one to 10, with one being the equivalent of a minor hassle and 10 being a true catastrophe, assign a number to whatever it is that's making you feel anxious. "You'll find that most problems we encounter rate somewhere in the two to five range -- in other words, they're really not such a big deal," says Dr. Elkin.
 

6.        Stop Gritting Your Teeth - Stress tends to settle in certain parts of our bodies, the jaw being one of them. When things get hectic, try this tip from Dr. Cooper: Place your index fingertips on your jaw joints, just in front of your ears; clench your teeth and inhale deeply. Hold the breath for a moment, and as you exhale say, "Ah-h-h-h," then unclench your teeth. Repeat a few times.
 

7.        Devise an affirmation -- a short, clear, positive statement that focuses on your coping abilities. "Affirmations are a good way to silence the self-critical voice we all carry with us that only adds to our stress," Dr. Elkin says. The next time you feel as if your life is one disaster after another, repeat 3 - 5 times, "I feel calm. I can handle this."  Develop a personal "key phrase", such as "Maranatha" – a popular Christian "meditation phrase" which is a transliteration of an Aramaic phrase, "Come, Lord Jesus" and repeat this a few times to your self when you feel stressed or anxious.
 

8.        Stretch it out! - Ching-Tse Lee, Ph.D., a professor of psychology at Brooklyn College in New York, recommends this calming exercise: Stand with your feet shoulder-width apart and parallel. Bend your knees to a quarter-squat position (about 45 degrees) while keeping your upper body straight. Observe your breathing for a couple of breaths. Inhale and bring your arms slowly up in front of you to shoulder height with your elbows slightly bent. Exhale, stretching your arms straight out. Inhale again, bend your elbows slightly and drop your arms down slowly until your thumbs touch the sides of your legs. Exhale one more time, then stand up straight.
 

9.        Be a Fighter - "At the first sign of stress, you often hear people complain, 'What did I do to deserve this?'" says Dr. Cooper. The trouble is, feeling like a victim only increases feelings of stress and learned helplessness. Instead, focus on being pro-active. If your flight gets canceled, don't wallow in self-pity. Find another flight. If your office is too hot or too cold, don't suffer, or whine about it. Call the building manager.  Do SOMETHING to change your situation, even if it's something small! It will empower you, and teach you that change is possible.

 
10.     Put It on Paper - Writing provides perspective, says Paul J. Rosch, M.D., president of the American Institute of Stress in Yonkers, NY. Divide a piece of paper into two parts. On the left side, list the stressors you may be able to change, and on the right, list the ones you can't. "Change what you can," Dr. Rosch suggests, "and tell yourself to stop fretting over what you can't."  You can also try starting a journal – but instead of writing out all the miserable things that happen, and having a journal of how sad and stressed you are all the time – create a "blessing book", suggests Lisa Alekna, M.Ed., LSWA of the Psychiatric Crisis Team in Westfield, MA. She says, "every day sit down and write out at least one thing you are grateful for, and you will find that there are many more positive things going on in your life, once you start to look for them, than you realized."

 
11.     Count to 10 - Before you say or do something you'll regret, step away from the stressor and collect yourself, advises Dr. Cooper. Give yourself a small, personal "time out". You can also look away for a moment, (and take a breath) or put the caller on hold (and take a breath). Lisa Alekna, M.Ed., LSWA of the Psychiatric Crisis Team in Westfield MA suggests use your time-out to take a break – de-stress with a few deep breaths, some stretching, or recite an affirmation. Do NOT use the time to vent, complain, or whine about the situation, etc., this will only make you more stressed an irritable, making the situation worse!

 
12.     Switch to Decaf - Wean yourself slowly, or you might get a caffeine-withdrawal headache that could last for several days, cautions James Duke, Ph.D., the Fulton, MD, author of The Green Pharmacy (Rodale Press, 1997). Subtract a little regular coffee and add some decaf to your morning cup. Over the next couple of weeks, gradually increase the proportion of decaf to regular until you're drinking all decaf. You should also consider switching from regular soft drinks to caffeine-free ones or sparkling mineral water.

 
13.     Just Say No - Trying to do everything is a one-way ticket to serious stress. Be clear about your limits, and stop trying to please everyone all the time.

 
14.     Take a Whiff – Certain scents - oils of basil, bay, chamomile, eucalyptus, lavender, peppermint, rose, and thyme are all soothing, say Kathy Keville and Mindy Green, coauthors of Aromatherapy: A Complete Guide to the Healing Art (Crossing Press, 1995). Place a few pieces of rock salt in a small vial, and then add a couple of drops of the oil of your choice (the rock salt absorbs the oil and is much less risky to carry around in your purse than a bottle of oil). Open the vial and breathe in the scent whenever you need a quick stress release. Look for the oils in your local health food store or online

 
15.     Warm Up - Try this tip from David Sobel, M.D., in San Jose, CA, author of The Healthy Mind, Healthy Body Handbook (I S H K Book Service, 1997) : Rub your hands together vigorously until they feel warm. Then cup them over your closed eyes for five seconds while you breathe deeply. The warmth and darkness are comforting.

 
16.     Schedule Worry Time - Some stressors demand immediate attention -- a smoke alarm siren or a police car's whirling red light. But many low-grade stressors can be dealt with at a later time, when it's more convenient. "File them away in a little mental compartment, or make a note," Dr. Elkin says, "then deal with them when the time is right. Don't let them control you."

 
17.     Shake It Up - This quick exercise helps loosen the muscles in your neck and upper back, says Dr. Sobel: Stand or sit, stretch your arms out from your sides and shake your hands vigorously for about 10 seconds. Combine this with a little deep breathing, Dr. Sobel says, and you'll do yourself twice as much good.

 
18.     Munch Some Snacks - Foods that are high in carbohydrates stimulate the release of serotonin, feel-good brain chemicals that help induce calm, says Dr. Cooper. Crackers, pretzels, some toast, or a bagel should do the trick.

 
19.     Boost Your Vitamin Intake - Elizabeth Somer, R.D., author of Food and Mood (Owl Books, 1999), in Salem, OR, recommends that women take a daily multivitamin and mineral formula that contains between 100% and 300% of the recommended dietary allowances of vitamin B, as well as the minerals calcium, magnesium, chromium, copper, iron, manganese, molybdenum, selenium and zinc. Avoid stress formulas, which often contain large amounts of randomly formulated nutrients, such as the B vitamins, but little or nothing else, Somer says.

 
20.     Get Horizontal - If sex has been on the bottom of your to-do list for too long, move it to the top. Sex increases levels of endorphins, those mood-boosting chemicals in the brain, and it's one of the best total-body relaxers around, says Louanne Cole Weston, Ph.D., a sex therapist in Sacramento, CA. Make a date with your spouse, and don't let anything get in the way.

 
21.     Admit It - Each of us has uniquely individual stress signals -- neck or shoulder pain, shallow breathing, stammering, teeth gritting, queasiness, loss of temper. Learn to identify yours, then say out loud, "I'm feeling stressed," when these signals crop up, recommends Dr. Rosch. Recognizing your personal stress signals helps slow the buildup of negativity and anxiety.

 
22.     Space Out - Look out the window and find something natural that captures your imagination, advises Dr. Sobel. Notice the clouds rolling by or the wind in the trees.

 
23.     Try Tea - By now most of us know about the calming properties of chamomile tea. But a steaming cup of catnip, passionflower, skullcap or kava kava can also be quite soothing, according to Dr. Duke. Steep the tea for about 10 minutes to get the full benefits of the herbs. Most of these teas are available in local grocery stores or health food stores. Try Celestial Seasonings "Tension Tamer" or "Sleepytime" teas, which are easily found in the coffee/tea section of most grocery stores.

 
24.     Take a Walk - It forces you to breathe more deeply and improves circulation, says Dr. Cooper. Step outside if you can; if that's not possible, you can gain many of the same benefits simply by walking down the hallway or water cooler, or by pacing back and forth. "The key is to get up and move," Dr. Cooper says. Don't forget to pump your arms, get the blood flowing!

 
25.     Soak it Up - "When I have the time, nothing is more stress relieving for me than a hot bath," Dr. Weston says. "But when I don't have time, I do the next-best thing: I wash my face or even just my hands and arms with hot water. The key is to imagine that I'm taking a hot bath. It's basically a visualization exercise, but the hot water makes it feel real." Don't have a nice big bathtub? Take a long, hot shower. Try adding aromatherapy Batherapy Shower Tablets – they come in Lavender, Green Tea & Mint, and Mandarin, and can be ordered online at Amazon.com.

 
26.     Play a Few Bars - A number of recent studies have shown that music can do everything from slow heart rate to increase endorphins. Good bets: Bach's "Air on the G-String," Beethoven's Pastorale symphony, Chopin's Nocturne in G, Handel's Water Music, or pianist George Winston's CDs Autumn or December.

 
27.     Fall for Puppy Love - In a study of 100 women conducted last year at the State University of New York at Buffalo, researchers found that those who owned a dog had lower blood pressure than those who didn't. If you don't have a pooch, visit a friend's: Petting an animal (puppy, kitty, ANY animal!) for just a couple of minutes helps relieve stress, and lowers blood pressure, researchers have found.

 
28.     Practice Mindfulness - Heighten your awareness of the moment by focusing intently on an object. Notice a pencil's shape, color, weight and feel. Or slowly savor a raisin or a piece of chocolate. Drink your tea, and savor the color, the temperature, and the scent as well as the flavor. Lisa Alekna, M.Ed., LSWA of the Psychiatric Crisis Team in Westfield MA reminds us "Don't rush on in your thoughts to the next activity, or next thing to worry about. Focus on what you are doing now, at this one moment." Mindfulness leads to relaxation.

 
29.     Dial a Friend - Sharing your troubles can give you perspective, help you feel cared for, and relieve your burden. (But be careful to use this support in moderation! You don't want to abuse the charity of the person who is being supportive to you, and listening to your woes – or you will become a "stressor" to them!) Be constructive – ask for ideas, even constructive criticism, and ask your friend to help you keep the conversation short, so you can stay on topic. Then, move on to other topics, and include your friend in the conversation!

 
30.     Say a Little Prayer - Studies show that compared with those who profess no faith, religious and spiritual people are calmer and healthier. Carry a favorite prayer card with you, or a set of rosary beads in your pocket, to remind you to take a "prayer break" when you need a quiet moment for yourself.

 
31.     Make Plans - "Looking forward to something provides calming perspective," Dr. Elkin says. Buy concert tickets, or make an appointment for a massage. Use your vacation time – even if it's only to schedule a long weekend!

 
32.     Goof Off - It temporarily removes you from a potentially stressful situations. Esther Orioli, president of Essi Systems, a San Francisco consultant company that organizes stress-management programs, keeps a harmonica in the drawer for when she's feeling stressed out. Bonus: Playing it promotes deep breathing.

 
33.     Straighten Up - When people are under stress, they often tend to hunch over as if they have the weight of the world on their shoulders. "Slumping restricts breathing and reduces blood and oxygen flow to the brain, adding to muscle tension to the body, and magnifying feelings of panic and helplessness in the mind," Dr. Cooper explains. Straightening your spine has just the opposite effect. It promotes circulation, increases oxygen levels in your blood and helps lessen muscle tension, all of which promote relaxation.

 
34.     Tiptoe Through the Tulips - Tending your garden helps get you out of your head and lets you commune with nature, a known stress reliever. If you're not a gardener, tend to a houseplant. Plants = growth = cycle of life, a nice reminder that stress, too, will pass.
 
35.     Curl Up – Browse your local library and discover a new treat – reading! Dive into a mystery, wander into a fantasy, or even do a bit of scriptural reading every day. Make yourself a "quiet space" – a corner of the couch, a favorite rocking chair – supply yourself with a cozy blanket, a comfy pillow, an end table for a cup of herbal tea – and give yourself some "quality time" for a half hour or so – and let yourself drift away to, as Mr. Rogers said, "The Land of Make-Believe".

 
36.     Look for a Good Quote - Tired of the steady stream of action-packed shoot 'em ups at the movies these days? Can't deal with one more teen flick? Tired of figuring out "who done it?" Why not go back to a more graceful age? Look up some of the stars of yesteryear, and run away to Casablanca with Bogie, or sail off with Cary Grant on a long cruise. Pull out an old favorite – and if you don't have an old favorite – get one! And then look for a good quote, or your favorite one-liner! "I was looking up... it was the nearest thing to heaven! You were there..."