Stress Management for the Health of It

Stress! The idea stirs up many images - rushing to work, watching the stock market drop daily, seeing a hail storm wipe out a newly emerging crop, working long into the night on a project. All of these situations can build up irritation and fatigue that dare not show at an important meeting. Stress in such situations means pressure, conflict, loss of control, and uncertainty. These feelings can lead to a variety of problems for all members of a family. That is why stress has such an ugly ring.

What Is Stress?

Stress is your body's physical and psychological response to anything you perceive as overwhelming. This may be viewed as a result of life's demands, pleasant or unpleasant, and your lack of resources to meet them.

When stressed, your body creates extra energy to protect itself. This additional energy cannot be destroyed. If not used, it creates an imbalance within your system. Somehow the energy must be channeled into responses to regain a balance.

Stress is a natural part of your life. Without some stress you would lose your energy for living. You will thrive on certain amounts; but too much or too little stress will limit your effectiveness. Ideally, you find your optimal level of stress-the balance at which you are most motivated. This home study program is designed to help you do that.

Why Be Concerned About Stress?

Excessive stress in your life interferes with your interpersonal relationships at home, on the job, and socially. It can make you spend your efforts on not being unhappy, rather than on being happy. Stress can waste your vitality and deplete your personal energy resources that could be used for enjoyment. You can become negatively influenced in your attitudes and feelings about yourself more easily. In addition, medical research estimates as much as 90 percent of illness and disease is stress-related. Stress can interfere with your physical functioning and bodily processes. High blood pressure, cardiovascular disease, and heart disease have been linked to stress factors. Other stress-related ailments include ulcers, allergies, asthma, and migraine headaches. Most health professionals agree stress can be a contributing factor in making existing medical problems worse.

Environmental and societal pressures-our competitive, success-oriented way of life-may lead us to potentially hazardous health. According to the United States Center for Disease Control in Atlanta, Georgia, "Eighty-three percent of all deaths for adults between the age of 21 and 65 are related to lifestyle." Unmanaged stress is increasingly a characteristic of many Americans today.

During peak activity periods, do you:

  • Rest adequately?
  • Eat well-balanced meals?
  • Take breaks?
  • Rebuild energy resources with time off?

How does your lifestyle influence your health and ability to manage stress? First, take the Healthstyle Quiz (Appendix 1). Then read the rest of this lesson to learn about causes of stress and responses to stress.

Causes of Stress

Everyone differs in what is stressful or potentially stressful. What for one person might seem to be a catastrophic event may be a minor setback for another.

Fears Cause Stress

Some physical fears that can cause stress are:

  • Dangerous machinery;
  • Exposure to toxic chemicals;
  • Dangerous, congested traffic.

Psychological fears associated with stress include:

  • Failure;
  • Not being able to get the job done;
  • Inability to manage debts; and
  • Adult children who do not want the family business.
Uncertainty Causes Stress

In each person's life there are uncertainties that can cause stress. The change of a job may necessitate many other changes in the life of a person or family members. Trying to sell a home and buy another in the new location may be stressful. Logic and informed predictions have a place, but often stress piles up because there are so many "unknowns" in such situations.

Life is filled with uncertainty. It is discomforting not to know what is going to happen, particularly if your control of the situation is impeded by:

  • Government policies and controls;
  • Weather;
  • Market fluctuations;
  • Illness;
  • Interest rates;
  • Mechanical breakdowns; and
  • Accidents.

Uncertainty may cause feelings of being out of control, which can cause stress.

Attitudes Cause Stress

A positive or negative attitude influences a person's reaction to stressful situations. For example, if you feel your job is worthwhile, you may see some of the problems you encounter as challenges. Seen as pluses, the problems or potential problems become motivators. However, if you resent your situation or feel "stuck" in your job, similar experiences create stress, a stress that frustrates instead of motivating you.

Perceptions Cause Stress

Past experiences and the resources you feel you have available to meet life's demands will affect the degrees of stress you may experience. The degree of stress experienced will be affected by your perception of your ability to meet the particular demands. How you perceive the situation determines if it is or is not stressful.

Perception can be broken down in the following ways:

  • Self Your sense of competency, self-esteem, values, interests, needs.
  • Resources Personal resources: Past experience in handling stress, health;
    Material resources: Finances, equipment, storage; and People resources: Other people who can assist you, such as friends, coworkers, family members, professionals.
Change Causes Stress

All change produces stress, even positive changes. Marriage is a positive change that is also a period when adjustment is necessary. For some people, this adjustment can be stressful. A vacation may also be stressful; arrangements must be made for the trip and for work, and there is always a tendency to plan too many activities.

Negative changes are not as difficult to identify as stress-producing. These are situations you would not like to occur, such as children leaving home to start careers, economic recession causing financial crisis, or loss of a valuable possession.

Change demands your adjustment to the particular situation, whether you desire the change or not. Developmental changes that you are able to plan for- pregnancy and birth, children growing up, the aging process-may still be stressful even though anticipated.

The following are more examples of stress-causing changes:

  • Work/business Operational change due to technological advancement; Major change in responsibility or work load due to shift in partnership; Expansion or reduction in production; Increasing skills to increase efficiency, and Inflationary operating costs.
  • Personal Illness or injury; Personal achievement or disappointment, and Retirement.
  • Social Illness or death of close friend; Beginning or ending of formal education; Change in social activities; and Involvement in community service.
  • Financial Major change in financial state; Major purchase (home, equipment, land); Additional family expenses (education, insurance, illness); and Partial liquidation. What changes have you and family members experienced in the past several years?

Family relationships?







Work situation?







How Do You Respond to Stress?

When experiencing stress, you may be affected totally, not only in your body but also in your emotional reactions, your personal thoughts, and your relations with others.

The following list of stress symptoms contains the most typical reactions to stress. It can also help you begin focusing on ways to manage stress.

Check any symptoms you have noticed lately in yourself. Add any symptoms that are not on the list.

____ headaches             ____ accident prone
____ fatigue               ____ teeth grinding
____ insomnia              ____ restlessness
____ weight change         ____ increased alcohol,
____ colds                        drug, tobacco use
____ digestive upsets      ____ neck and shoulders
____ pounding heart               tighten up/ache

____ forgetfulness         ____ confusion
____ dull senses           ____ lethargy
____ poor concentration    ____ no new ideas
____ low productivity      ____ boredom
____ negative attitude

____ anxiety               ____ irritability
____ the "blues"           ____ depression
____ mood swings           ____ nervous laugh
____ bad temper            ____ worrying
____ crying spells         ____ easily discouraged
____ isolation             ____ lowered sex drive
____ resentment            ____ nagging
____ loneliness            ____ fewer contacts
____ lashing out                  with friends
____ clamming up           ____ using people

Look over the symptoms you've checked and circle those that occur frequently or regularly.

Study your list. Which symptoms cause you the most concern? Are you always aware when they are happening to you? Can you stop them from happening? Do you see a pattern in your symptoms? Are they mostly physical or do they usually involve other people? This might give you a clue in directing your stress management program.

This lesson has outlined several causes of stress in our daily lives. Before Lesson 2 arrives, spend some time thinking about personal causes of stress and ways to manage them. The Healthstyle Quiz (Appendix 1) presents some suggestions. Lesson 2 will provide detailed ideas on taking charge of stress.

Additional Reading

Aerobics by K. Cooper, New York, N.Y: Bantam Books, 1968.

The American Way of Life Need Not Be Hazardous to Your Health by J. Farquhar, New York, N.Y.: W.W. Norton, 1978.

The Joy of Working by D. Waitley and R. Witt, New York, N.Y.: Ballentine Books, 1985.

Managing Stress Before It Manages You by J. Steinmetz, J. Blankenship, L. Brown, D. Hall, and G. Miller, Palo Alto, CA: Bull Publishing, 1980.

Nutrition, Weight Control and Exercise by F. Katch and W. McArdle, Boston, Mass.: Houghton Mifflin, 1977.

Stress and the Healthy Family by D. Curran, Minneapolis, MN: Winston Press, 1985.

The Wellness Workbook by R. Ryan and J. Travis, Berkeley, CA: Ten Speed Press, 1981.

Appendix 1

Healthstyle Quiz

How Healthy Are You?

All of us want good health. But many of us do not know how to be as healthy as possible. Health experts now describe lifestyle as one of the most important factors affecting health. In fact, it is estimated that as many as 7 of the 10 leading causes of death could be reduced through commonsense changes in lifestyle. That is what this brief test, by the Public Health Service, is all about. Its purpose is simply to tell you how well you are doing to stay healthy. The behaviors covered in the test are recommended for most Americans. Some of them may not apply to people with certain chronic diseases or handicaps or to pregnant women. Such people may require special instructions from their physicians.

4, 3, 2=Almost Always    1=Sometimes    0=Almost Never

Cigarette Smoking

If you never smoke, enter a score of 10 for this section and go to the next section on Alcohol and Drugs.

1. I avoid smoking cigarettes                        2 1 0

2. I smoke only low tar and nicotine
   cigarettes or I smoke a pipe or cigars.           2 1 0

                                      Smoking score:_______

Alcohol and Drugs

1. I avoid drinking alcoholic beverages or
   I drink no more than one or two drinks a day.     4 1 0

2. I avoid using alcohol or other drugs especially
   illegal drugs, as a way of handling stressful
   situations or the problems in my life.            2 1 0

3. I am careful not to drink alcohol when taking
   certain medicines (examples: medicine for 
   sleeping, pain, colds, and allergies) 
   or when pregnant.                                 2 1 0

4. I read and follow the label directions when 
   using prescribed and over-the-counter drugs.      2 1 0

                            Alcohol and drugs score:______

Eating Habits

1. I eat a variety of foods each day, such as fruits 
   and vegetables, whole grain breads and cereals, 
   lean meats, dairy products, dry peas and beans, 
   and nuts and seeds.                               4 1 0

2. I limit the amount of fat, saturated fat, and
   cholesterol I eat, including fat on meats, eggs,
   butter, cream, shortenings, and organ meats such
   as liver.                                         2 1 0

3. I limit the amount of salt I eat by cooking with
   only small amounts, not adding salt at the table,
   and avoiding salty snacks.                        2 1 0

4. I avoid eating too much sugar, especially frequent
   snacks of sticky candy or soft drinks.            2 1 0

                                Eating habits score:______

Exercise Fitness

1. I maintain a desired weight, avoiding overweight
   and underweight.                                  3 1 0

2. I do vigorous exercises for 15 to 30 minutes at
   least three times a week (examples: running,
   swimming, brisk walking).                         3 1 0

3. I do exercises that enhance my muscle tone for
   15 to 30 minutes at least three times a week
   (examples include yoga and calisthenics).         2 1 2

4. I use part of my leisure time participating in 
   individual, family, or team activities that 
   increase my level of fitness, such as gardening, 
   bowling, golf, and baseball.                      2 1 0

                              Exercise/fitness score:_____

Stress Control

1. I have a job or do other work that I enjoy.       2 1 0

2. I find it easy to relax and express my 
   feelings freely.                                  2 1 0

3. I recognize early, and prepare for, events or 
   situations likely to be stressful for me.         2 1 0

4. I have close friends, relatives, or other people 
   I can talk to about personal matters and call on
   for help when needed.                             2 1 0

5. I participate in group activities, such as 
   church and community organizations, or hobbies 
   that I enjoy.                                     2 1 0

                                Stress control score:_____


1. I wear a seat belt while riding in a car.         2 1 0

2. I avoid driving while under the influence of
   alcohol and other drugs.                          2 1 0

3. I obey traffic rules and the speed limit 
   while driving.                                    2 1 0

4. I am careful when using potentially harmful
   products or substances, such as chemicals,
   poisons, and electrical devices.                  2 1 0

5. I make use of clothing and equipment provided
   for safety at work and/or recreation 
   (i.e. gloves, lifejackets, etc.).                 2 1 0

                                        Safety score:_____

What Do Your Scores Mean?

Scores of 9 and 10

Excellent! Your answers show that you are aware of the importance of this area to your health. More important, you are putting your knowledge to work for you by practicing good health habits. As long as you continue to do so, this area should not pose a serious health risk. It is likely that you are setting an example for your family and friends to follow. Since you got a very high test score on this part of the test you may want to consider other areas where your scores indicate room for improvement.

Scores of 6 to 8

Your health practices in this area are good, but there is room for improvement. Look again at the items you answered with Sometimes or Almost Never. What changes can you make to improve your score? Even a small change can often help you achieve better health.

Scores of 3 to 5

Your health risks are showing! Would you like more information about the risks you are facing and about why it is important for you to change these behaviors? Perhaps you need help in deciding how to successfully make the changes you desire. In either case, help is available.

Scores of 0 to 2

Obviously, you were concerned enough about your health to take the test, but your answers show that you may be taking serious and unnecessary risks with your health. Perhaps you are not aware of the risks and what to do about them. You can easily get the information and help you need to improve, if you wish. The next step is up to you.

When Can You Start Changing?

In the test you just completed were numerous suggestions to help you reduce your risk of disease and premature death, starting now. Here are some of the most significant.

Avoid Cigarettes

Cigarette smoking is the single most important preventable cause of illness and early death. It is especially risky for pregnant women and their unborn babies. People who stop smoking reduce their risk of getting heart disease and cancer. So if you're a cigarette smoker, think twice about lighting that next cigarette. If you choose to continue smoking, try decreasing the number of cigarettes you smoke and switching to a low tar and nicotine brand.

Follow Sensible Drinking Habits

You may be tempted to drink more alcoholic beverages during times of stress. Stress has been blamed for a large percentage of cases of alcohol and drug abuse. If you do drink, remember these facts:

  • Alcoholic beverages are high in calories and low in nutrients and may contribute to a weight problem.
  • Heavy drinking may lead to nutritional deficiencies if alcohol is substituted for nutritious foods. Alcohol also interferes with the body's use of some nutrients.
  • Heavy drinking can lead to serious diseases, such as cirrhosis of the liver and certain types of cancer.
  • Consumption of alcoholic beverages by pregnant women may cause birth defects or other problems during pregnancy.

One or two standard-size drinks daily appear to cause no harm in normal, healthy, nonpregnant adults. So, if you drink alcoholic beverages, do so in moderation.

Eat Sensibly

A person's ability to cope with stress is affected by his/her nutritional status. Poor nutrition before and during periods of high stress will make you more likely to develop health problems and will reduce your ability to cope with stress. Prolonged stress affects nutritional status in the following ways:

  • Stress causes our body to need more of certain nutrients that are directly involved in the stress response. Other nutrients are lost from the body at an increased rate.
  • Stress often leads to altered eating habits, including an increased intake of snack foods that are high in sugar, fat, and salt. Consuming excess amounts of these components may lead to obesity, high blood pressure, and heart disease.

To get all the nutrients you need for body requirements during stress, you should eat a variety of foods including fruits, vegetables, whole-grain and enriched breads, cereals, and other grain products, milk, cheese, yogurt, meats, poultry, fish, eggs, and dry beans and peas. If you eat a variety of foods in sufficient amounts, there will be no need to take vitamin/mineral pills, except in a few cases such as during pregnancy. Be careful not to eat excessive amounts of sweet, salty, or high-fat snack foods.

Exercise Regularly

Almost everyone can benefit from exercise, and there is some form of exercise almost everyone can do. If you have any doubt, check first with your doctor. Usually, as little as 15 to 30 minutes of vigorous exercise three times a week will help you have a healthier heart, eliminate excess weight, tone up sagging muscles, and sleep better. Think how much difference all these improvements could make in the way you feel.

Learn to Handle Stress

Stress is a normal part of living. Everyone faces it to some degree. The causes of stress can be good or bad; desirable or undesirable, such as a promotion on the job or the loss of a spouse. Properly handled, stress need not be a problem. But unhealthy responses to stress, such as driving too fast or erratically, drinking too much, or prolonged anger or grief, can cause a variety of physical and mental problems. Even on a very busy day, find a few minutes to slow down and relax. Talking over a problem with someone you trust can often help you find a satisfactory solution. Learn to distinguish between things that are worth fighting about and things that are less important.

Be Safety Conscious

Think "safety first" at home, work, school, play, and on the highway. Buckle seat belts and obey traffic rules. Keep poisons and weapons out of the reach of children, and keep emergency numbers by your telephone. When the unexpected happens, you will be prepared.

Where Do You Go from Here?

Start by asking yourself a few frank questions: Am I really doing all I can to be as healthy as possible? What steps can I take to feel better? Am I willing to begin now? If you scored low in one or more sections of the test, decide what changes you want to make for improvement. You might pick that aspect of your lifestyle where you feel you have the best chance for success and tackle that one first. Once you have improved your score there, go on to other areas.

If you already have tried to change your health habits (to stop smoking or exercise regularly, for example), do not be discouraged if you have not yet succeeded. The difficulty you have encountered may be due to influences you have never really thought about, such as advertising, or to a lack of support and encouragement. Understanding these influences is an important step toward changing the way they affect you.

There is help available. In addition to personal actions you can take on your own, there are community programs and groups that can help you and your family make the changes you want to make. If you want to know more about support groups or about any of the topics above, contact your county Extension home economist. There is a lot you can do to stay healthy or to improve your health. Start today.

Changing Healthstyle

My new lifestyle habit:

Short-range goal:______________________________



Date I will start:______________________________



Name of friend or group with whom I will do this activity:



Healthstyle, a U.S. Public Health Service publication, was adapted for use in Iowa by Randy R. Weigel, extension specialist-human development and family life, from a Kansas Extension publication by Michael Bradshaw.

Study Questions

Lesson 1
Stress Management for the Health of It

1. A person who is nervous about talking in front of a group is suffering what kind of stress?





2. Why do some people view stressful events as challenges while others fear stressful events?





3. Why is improving one's lifestyle important for stress management?





4. What are some common symptoms of stress?





5. There is no way to be completely rid of stress. Improving your life and health provides the physical and emotional strength to cope with the inevitable stresses of life. What are some ways you can revamp your health and life to manage stress?





Study Answers

Lesson 1
Stress Management for the Health of It

1. Psychological, because the cause of this stress is mental; the person is afraid he/she may stutter, forget the words, etc. Problems are anticipated, but they have not actually occurred.

2. Three reasons for different reactions to stress are a person's attitude, perception, and skills for managing stress. If your attitude toward life is positive, then stress may be seen as a challenge and not a problem. Past experiences and the skills you feel you have to meet life's demands will affect the degree of stress you experience.

3. It is estimated that as many as 7 of the 10 leading causes of death could be reduced through common sense changes in lifestyle. According to the U.S. Center for Disease Control, 83 percent of all deaths of adults between ages of 21 and 65 are related to lifestyle.

4. Physical discomfort (headaches, insomnia, muscle tics, digestive upsets), emotional discomfort (bad temper, mood swings, crying spells, nervousness), mental confusion (forgetfulness, boredom, poor concentration), and relationships (loneliness, nagging, staying away from others).

5. Exercise (walking, jogging, swimming, sports), sensible eating habits, recreation and hobbies, relaxation, reaching out to family and friends for support.

This lesson was revised by Brenda J. Thames, EdD, Program Development Specialist, and Deborah J. Thomason, EdD, Family and Youth Development Specialist, Department of Family and Youth Development. These materials were originally adapted by Lucy J. Pearson from the "Stress on the Farm Home Study Course" prepared by Randy Weigel, Sharon Mays, and Barb Abbott, Cooperative Extension Service, Iowa State University of Science and Technology. This material was adapted, in part, from Sally Middleton's "Farm Family Stress", Cooperative Extension Service, Michigan State University, May 1983, E-1697.

The Clemson University Cooperative Extension Service offers its programs to people of all ages, regardless of race, color, sex, religion, national origin, or disability and is an equal opportunity employer.

Clemson University Cooperating with U.S. Department of Agriculture and South Carolina Counties. Issued in Furtherance of Cooperative Extension Work in Agriculture and Home Economics, Acts of May 8 and June 30, 1914.

Disclaimer and Reproduction Information: Information in NASD does not represent NIOSH policy. Information included in NASD appears by permission of the author and/or copyright holder. More