STRESS MANAGEMENT

HEALTH SERVICES

A PRACTICAL GUIDE

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Stress is a part of life. A little stress can be helpful: it stimulates you to accomplish your goals. Too often, though, stress becomes overwhelming and is more harmful than beneficial. Learning to manage stress is an important skill for healthy living.

WHAT IS STRESS?

Stress is the body’s response to danger. This response helped our early ancestors survive.

To survive an encounter with a predator our ancestors had to attack (“fight”), or run away (“flight”). The stress reaction – the fight-or-flight response– activates the nervous system, releasing hormones like cortisol and adrenaline, and stimulates the body into action. Once the danger is gone, the fight-or-flight response fades and the body returns to its preferred state of balance.

The days of being chased by a predator are long gone, but we are still wired for a “fight-or-flight” response. Today’s threats and demands are diverse and can last for long periods of time. The pressures of being a student, managing finances, dealing with conflict in your personal life or as part of your job, raising a family: these are just a few of the many long-lasting, stress-provoking situations people face today. The body responds to these demands the same way it did when our ancestors faced a predator. Staying in a heightened state of stimulation contributes to health problems.

•heartdisease•highbloodpressure•stomachproblems•respiratoryproblems•typeIIdiabetes•backproblems•headachesand

migraines •obesity•arthritis•cancer•skinproblems•mentalhealth

problems

•immunesystemproblems

•childandpartnerabuse

•suicide•homicide•alcoholanddruguse

and abuse •tobaccouse•violenceand

aggressive behaviour •accidents•sleepproblems•sexualproblems

THE FIGHT-OR-FLIGHT RESPONSE

The fight-or-flight response stimulates these functions of the body :

•heartrate•breathingrate•muscletension•bloodpressure•insulinsecretion•bloodflowtothebrain,lungs,

heart and muscles•bloodclotting

Fight-or-flight can also decrease these functions:•bloodflowtothedigestivetract,

kidneys and skin•interestinsex•tissuerepair•immunesystemresponse

STRESS AND HEALTH

Stress can play a role in the development of serious problems, such as:

STRESS IS A RESPONSE TO DANGER. NO DANGER…NO STRESS!

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A5-STEPGUIDETO MANAGINGSTRESS

STEP 1: IDENTIFY IF YOU ARE STRESSED

Each of us reacts to stress in our own way, so look for your particular signs. They might include trouble sleeping, back pain, aggressive behaviour, sleeping a lot, forgettingthings,andsexualproblems.Takesometimeto think about how you respond to stress and write your signs in the space below.

Some signs of stress, like chest pain, indicate a potential health problem. Consult a health professional if you experienceseriousorongoingsymptoms.

COMMON SIGNS OF STRESS

Physical signs Behavioural signs

•drymouth•increasedheartrate•muscleaches,stiffness

or pain (especially in the neck, shoulders and lower back)

•highbloodpressure•frequentcoldsorflu•worseningofan

existingillness(e.g.asthma, skin rashes)

•chestpain•headache•indigestion•constipation•stomachcramps•sweating•nausea•trembling•fatigue•weightgainorloss

•increasedsmoking,drinking, drug use

•yelling•swearing•aggression•changesineating

habits •changesinsleeping

habits •nervousness(nail

biting, fidgeting, pacing, etc.)

Mental signs Emotional signs

•difficultyconcentrating•decreasedmemory•difficultymaking

decisions •mindgoingblankor

racing •confusion•lossofsenseof

humour •decreasedlibido•inattention•baddreams

•anxiety•anger•irritability•impatience•shorttemper•frustration•worry•fear

My signs of stress are:

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STEP 2: IDENTIFY THE STRESSOR

Look for the cause of your stress. The following tips can help you identify your stressors. Write them down in the space below.

•Sincestressisoftenrelatedtochange,examinerecent changes in your life.

•Pinpointwhenthesymptomsstarted.Forexample,if you started having problems sleeping two weeks ago, look at the changes in your life that took place around that time.

•Asklovedonesfortheiropinion.•Reviewthelistontherightofcommonstressors.

COMMON SOURCES OF STRESS

Physical environment Social/relational

•brightlights•noise•discomfortdueto

excessiveheat•discomfortdueto

excessivecold•weather•traffic

•rudenessoraggression in others

•conflictwithothers•notspendingenough

time with important people

•lackofsocialsupport

•loneliness

Financial Organizational

•taxes•unpaidbills•unplannedexpenses•thepressureof

“making ends meet”

•overlyrestrictiverules or regulations

•schoolorworkdeadlines

•pressuretopassaclass or get a good grade

•aggressiveorhigh-pressure work culture

The cause of my stress is:

Life events Lifestyle choices

•deathofalovedone•losingajob•illness•startinguniversity•workpromotion•birthofachild•marriage•winningthelottery

•notenoughsleep•toomuchcaffeine•toomuchalcohol•drugconsumption•poortime

management •poordiet

Physiological

•poorhealth•physicalillness•pregnancy•injury

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STEP 3: IDENTIFY THE REASON FOR THE STRESSOR

Askyourself:“WhydoIseethissituationasadanger?”

Ingeneralyouseeasituationasadangerwhenyouthink you don’t have enough resources to handle it. Look at two aspects of the situation: the demands and theresources.Ifyouthinkyouhaveenoughresourcesto meet the demands, you will be able to handle the situation. You won’t see it as a danger and will not experiencestress.

Ifyoufeelyourresourcesfallshortofwhat’sneededtohandlethesituation,youwillexperiencestress.

List the demands and resources for your stressor in the boxbelow.

The Demands and Resources of my Stressor

DEMANDS: In this situation I need:

RESOURCES: To handle this situation I have:

IS YOUR STRESS REAL OR SELF-CREATED?

Somestressorsarereal.Forexample,youdon’thave enough money to pay the bills because your student loan hasn’t arrived. The reality is there is no money to pay the bills.

Somestressorsareself-created.Forexample,you don’t have enough money to pay the bills because you bought a new wardrobe with your student loan. You did this because you believe you need nice clothes for school. You had money to pay the bills but your values and beliefs led you to spend it in a way that created stress.

Theseexamplesshowthatthestressoris the same (not enough money) but how they cametobeisverydifferent.Theserequiredifferent solutions.

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STEP 4: CHOOSE AN APPROPRIATE STRESS MANAGEMENT STRATEGY AND APPLY IT

There are hundreds of strategies for managing stress. Generally, they fall into two categories:

1. Strategies that address the symptoms of stress.

2. Strategies that address the stressor.

STRATEGIES THAT ADDRESS THE SYMPTOMS OF STRESS

Strategies that address the symptoms of stress are typicallyrelaxationstrategies.Theymoderatethestimulation that occurs during the body’s fight-or-flight response. Since these strategies don’t remove the source of the stress, they need to be used with long-term strategies that address the stressor itself. Effectiverelaxationstrategiesforshort-termstressmanagement include:

Breathing exercisesOnemethod,calledthe“relaxingbreath,”comestousfrom yoga. You can find various audio files to guide you throughthistechnique.Onecanbefoundatdrweil.com; type‘breathingexercises’inthesearchbox.

Progressive Muscle Relaxation Thegoalofprogressivemusclerelaxation(PMR)istoprogressivelytenseandthenrelaxmusclegroupstherebyachievinggreateroverallrelaxation.Therearemany audio guides available online, such as this one: oyh.org.au/training-resources/free-downloads/pause

Massage Massagerelaxestensemusclesandreducesstressinthebody.TolearnmoresearchtheInternetusingthekeywords“massagetechniques”or“self-massage”.

Exercise Althoughexercisestimulatesthebody,arelaxedstatefollows. When you are feeling stressed, take some time to go for a brisk walk or run, hit the gym, do some yoga or any type of physical activity you enjoy. Physical activity – especially when done regularly – enhances mental ANDphysicalwell-being.Forinformationonthesebenefits, see the Canadian Physical Activity Guidelines at csep.ca/guidelines.

VisualizationThe mind and body are connected. Your thoughts can lead to changes in your body. With visualization, you use the power of your imagination to create feelings ofrelaxation.

Close your eyes and imagine things that make you feel goodorthatarerelaxing.Imaginesittingonthebeach,watching a waterfall or looking out at a lake surrounded bymountains.Don’tjustvisualizethisscene,feelitasif you were there. When negative thoughts creep in, acknowledgethemandgobacktoyourrelaxingscene.There are many guided imagery audio files available online, such as this one: oyh.org.au/training-resources/free-downloads/pause

You can also visualize tension fading away. Get in a comfortable position, close your eyes and imagine the tension in your body as a tight rope. Then, visualize that rope loosening up as the tension leaves your body.

Another way is to imagine a situation you’re worried about—such as giving a presentation—and visualize yourself performing well.

THE RELAXING BREATH1. Sit or lie comfortably and place your tongue

in what is called the yogic position: touch the tip of your tongue to the back of your upper front teeth and slide it up until it rests on the ridge of tissue between your teeth and palate. Keep your tongue there forthedurationoftheexercise.

2. Put one hand on your chest and the other on your stomach.

3. Exhalecompletelythroughyourmouth,making a whoosh sound.

4. Inhaledeeplythroughyournose,countingtofour. The hand on your stomach should rise and the one on your chest move very little. This will ensure that you are breathing deeply.

5. Hold your breath, counting to seven.6. Exhalethroughyourmouthcountingto

eight. The hand on your stomach should fall. 7. Repeatstepsfourthroughsixforatotalof

four cycles. Breathe normally and observe how your body feels.

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MeditationMeditation involves focusing attention and awareness to gain greater control over your thoughts. There are different methods of practicing meditation. Some key steps are:

•Assumeacomfortablepositioninaplacewhere you won’t be disturbed.

•Closeyoureyes.•Relaxyourmuscles.•Clearyourmind.•Focusonthepresentmoment(e.g.focuson

your breathing).

The goal is to reach a point where your thoughts disappear and you are left with a clear mind.

Mindful meditation is an adaptation of traditional meditation. The goal is to train your mind to observe your thoughts non-judgementally. You are aware of all the information that your senses pick up, but you apply an accepting attitude to your thoughts and emotions. You become an impartial observer of what is going on around you.

Jon Kabat-Zinn has adapted mindfulness into a program called Mindfulness-Based Stress Reduction (MBSR). You can find out more in the book A Mindfulness-based Stress Reduction Workbook by Bob Stahl. Counselling andDevelopmentandMulti-FaithChaplaincyalsoofferservices related to meditation and mindfulness.

Hot bath, sauna, hot tubWhen you are stressed your blood vessels constrict, which increases blood pressure. The warmth of a hot bath, a sauna or a hot tub opens up blood vessels, whichhelpsyourelax.Besidesfeelinggood,simply taking time to have a hot bath or sit in a sauna or hot tubcanberelaxing.

Sex Sexcanreleasetensionandtakeyourmindoffyourproblems for a while. After an orgasm, an intense wave ofcalmandrelaxationcanovercomeyou.The“fight- or-flight”responsedecreaseslibido(i.e.sexualinterest) soitcanbedifficulttobereadyforsexwhenyou are stressed.

Sexforrelaxationdoesnotmeananonymousorunsafesex.Thiscancontributetomorestressbecauseoftheriskofcontractingsexuallytransmittedinfections,therisk to your personal safety or an unwanted pregnancy.

HobbyMany people put hobbies aside when they get busy. A hobby can take your mind off stress-producing thoughtsandcanberelaxing.However,ahobbythatistoodemanding,time-consuming,orexpensivewillprobably add to stress, as will hobbies that are overly stimulating, such as playing fast-paced video games or gambling.

Hobbies that reduce stress are ones that are creative, productive or build a skill. Some ideas include crafts, gardening, playing non-competitive sports, playing an instrument, writing, dancing or listening to calming music.

Spending time with loved ones, including pets The time we spend with people (or animals) we love promotesfeelingsofcalmnessandrelaxation.

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STRATEGIES THAT ADDRESS THE STRESSOR

Stress is a response to a perceived danger. You see a situation as a threat when you feel you don’t have the resources to deal with the demand.

Thedangermaybereal(e.g.“Idon’thaveenoughmoney to pay the bills”) or it may be based on somethingthat’sactuallynottrue(e.g.“MylifeisoverifIdon’t get an “A” in all my courses”). Managing your stress requirestwoapproaches:

1. The problem solving approach for real dangers.

2. The cognitive approach for self-created dangers.

The goal of these approaches is to reduce the demands and build your resources so the situation is no longer adanger.IntheproblemsolvingapproachyouDOSOMETHINGtoremovethedanger.Inthecognitiveapproach YOUCHANGETHEWAYYOUTHINK to remove the danger.

THE PROBLEM-SOLVING APPROACH

The goal of these strategies is to remove the stressor by taking action: reduce the demands or increase your resources.Theactionyoutakewillrequirebuilding skills. These will depend on the stressor. They include:

PROBLEM-SOLVING SKILLSReview the demands you listed in Step 3 and identify how you can use your problem-solving skills to reduce them.Forexample,couldyouwithdrawfromsome

tasksordeferthemtoalaterdate?Also,reviewtheresources available to you from Step 3 and find even more.Forexample,asksomeonetohelp.

Good problem-solving skills are developed and refined over time. See “The Problem-solving Process” on this page for an outline of effective problem-solving. For more information on problem-solving, consult mindtools.com, managementhelp.org or mayoclinic.com.

DECISION MAKING SKILLSThe decisions you make can determine the resources requiredtohandleasituation.Forexample,youmaytakeonextracoursestofinishyourdegreeearlier;thisdecisionwilladdtoyouracademicdemands.Ifyoubaseyourdecisionononecriteriononly(“Iwanttofinish my degree early”) without considering the impact it will have on other parts of your life, such as your relationships, you may be setting yourself up for several stressful semesters.

Good decisions are best made using a systematic and disciplined approach. For more information on decision making consult mindtools.com.

PROBLEM-SOLVING PROCESSDefinetheproblem

•Beclearandspecific.

Analyze the problem •Whoisinvolved?•Whendiditbegin?•Whyisithappening?

Brainstorm possible solutions•Writedownasmanysolutionsasyoucan

without discarding any right away.

Evaluate each solution and select the best option•Whataretheprosandcons?•Doyouhaveenoughresourcesto

implementthissolution?•Isthissolutionrealistic?•Whatwillbetheimpact?•Willitresolvetheproblem?•Willitcreatenewproblems?Whatarethey?

Implementthebestsolution•Makeaplanofaction.•Whowilldowhat?When?etc.

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CRITICAL THINKING SKILLSCritical thinking helps you make good decisions, helps you analyse your reasoning and provides strategies for improving it. We recommend the method developed by Richard Paul and Linda Elder. You can learn more about this approach on the website criticalthinking.org or in the book Critical Thinking: Tools for taking charge of your professional and personal life.

TIME MANAGEMENT SKILLSA big source of stress for many people is having too much to do and not enough time. Since you can’t increase the resource (i.e. time) you have to reduce the demands.

Effective time management starts by identifying your values.

How to identify valuesA value is something that is important to you. Good health, meaningful friendships, adventure, education and independenceareexamplesofvalues.Tryansweringthesequestionstomakeyourownlist:

•Whatinspiresme,andmakesmefeel‘alive’?•WhenhaveIfelttrulysatisfied?WhatwasIdoing?•Ifmoneywerenoobject,whatwouldIdo?•WhatamIdoingwhenIlosetrackoftime?•Whatwouldmakemylifemoresatisfying?•HowdoIdefinesuccess?•WhatdoIneedinmylifetofeelwholeorfulfilled?•WhatwouldIliketosayaboutmyselfattheendof

mylife?WhatwouldIlikeotherstosay?

EFFECTIVE TIME MANAGEMENT STRATEGIESOnceyouaredoingthethingsthatyouvalue,examinehowwellyouareusingyourtime.Ifnecessary,modifyyour approach.

Be realistic People underestimate how much time an activity will take.Ithelpstoaddabuffer.Ifyouthinkitwilltake30minutestogettotheairport,plansothatyouhave50minutestogetthere,givingyourselfa20-minutebuffer.

Plan out daily activities The most popular way to plan activities is to use an agenda. Think about the most efficient way to complete activities,forexample,byrunningerrandsinanorderthat minimizes travel time.

Use a “to do” listPrioritize each item on your list. Complete the most pressing items first.

Delegate Youdon’tneedtodoeverythingyourself.Ifpossible,delegate tasks to others who should be doing the work, are willing to do it, or are able to do it well.

ABOUT PROCRASTINATIONSome people are procrastinators: they delay doing things until the last minute. Procrastination leads to stress from time pressures. There are many websites helpful for fighting procrastination such as mindtools.com andtheinfopaxPut off Procrastinating: cci.health.wa.gov.au/resources/consumers.cfm

A useful book is The Complete Idiot’s Guide to Overcoming Procrastination. You can also speak with a counselor at Counselling and Developmentortakeoneoftheirworkshopson time management and procrastination (cdev.concordia.ca/workshops-and-events/workshops).

THE INTERNET AND TIME MANAGEMENTHourscanflybywhilesurfingtheInternet.Ifyouneedmoretimeforimportantthings,consider reducing your time online.

Ifyouareconcernedaboutyourtechnologyuse, consider this: one sign that a behaviour may be problematic is the fact that a person is asking whether they have a problem. This suggests that their life has been disrupted in some way by the behaviour.

Book an appointment with a nurse at Health Services to discuss your concerns. She can refer you to helpful resources.

TIME MANAGEMENT TIPSpend your time doing things that are important to you.

Stop doing things that are meaningless and that don’t enhance your life.

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Take advantage of “wasted” time Forexample,catchuponreadingwhilewaitingatthedoctor’s office or while riding the bus or metro.

Manage interruptions Focusononetaskatatime.Interruptionscanbreakmomentum. Some ways to manage interruptions are to read your e-mail only a few times a day, close the door to your room or office, and turn off your phone when studying.

BUILD ORGANIZATIONAL SKILLS Being well-organized can save a lot of time. Some things to try:

•Createanefficientsystemforfilingandretrievingdocuments.

•Layoutyourclothesthenightbefore.•Prepareyourlunchforthenextday.

For more information see mindtools.com or mentalhelp.net.

COMMUNICATION SKILLSYour interactions with others can be a source of stress if they’re characterized by conflict, feeling you are not being heard, and working in a group that is not functioning well. Building good communication skills can help you manage stress in these and other social situations.

There are three general communication styles: aggressive, passive and assertive. The most effective is the assertive style. Here, you honestly communicate your thoughts and needs in a respectful manner. Some assertive communication strategies include:

Use “I” statements Through“I”statementsyouspeakaboutthingsfromyour perspective.

•“Ifeelanxiousthatwearegoingtobelatefordinner with friends.”

•“WhatIwantisforustoworktogethertogetthehouse cleaned up.”

“Istatements”arehelpfultoasksomeonetochangetheirbehaviour.Usetheformat:“When(you)...,Ifeel....WhatIneedis.....”Forexample,“Whenyouinterruptme,Ifeellikemycontributiondoesn’tmatter.WhatIneedisforyoutolistentomeuntilIfinishspeaking”.

Be clear and direct AdheretotheKISSprinciple:KeepitShortandSimple.

•Don’tuse50wordswhen10willdo.•Speakonlyaboutwhatisimportant.•Stayontopic.•Don’tgiveconflictingmessages.

Use assertive non-verbal communication Communication includes what you say (verbal) and how you say it (non-verbal). To effectively communicate non-verbally:

•Maintaineyecontact.•Smile,whereappropriate.•Keeparelaxed,comfortableposture.•Speakinaclear,steadyvoice.•Useappropriategestures.

Rehearse and practiceLearning to communicate assertively does not come naturally:itrequireseffortandpractice.Thinkthroughwhat you will say and even practice it out loud before engaging in a conversation.

CONFLICT RESOLUTION AND NEGOTIATION SKILLS Conflict is normal, but it can be a source of stress. However, when resolved appropriately it enhances relationships.

Conflict involves differences in values, opinions and ideas. Resolving differences is best achieved using the conflict resolution process. Negotiation is often part of this process. The book Getting to Yes: Negotiating agreement without giving in by Fisher, Ury and Patton providesaframeworkforeffectivenegotiation.Itcanbeused in every type of conflict. The authors stress four main points:

•Separatethepeoplefromtheproblem.•Focusoninterests,notpositions.•Inventoptionsformutualgain.•Insistonusingobjectivecriteria.

You can find other negotiation resources online at sites such as changingminds.org and mindtools.com.

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BUDGETING SKILLSFinances are a cause of stress for many people, especially those that spend more money than they make. Building budgeting skills can help you manage financial stress by reducing the amount you spend or increasing how much you bring home.

The Financial Aid and Awards Office (concordia.ca/offices/faao.html) has budgeting resources for students.

OTHER SKILLS Identifythesourceofyourstressanddetermineotherskills you can build. These include parenting skills and academic/professional skills such as writing, presentation, public speaking, and leadership.

THE COGNITIVE APPROACH

Stress is a response to danger. The previous section presented stress management skills that remove the danger by reducing your demands and increasing your resources. These strategies are helpful when you can actually do something about the stressor. However, sometimes stress is created by how you see a situation. Imagineddangersemergefromself-createddemands,the inability to recognize resources, or minimizing the resources you have. Consider the stress provoked by these beliefs:

•“ImustbeperfectineverythingIdo.”•“Imustwinthecompetition.”•“ImustlooklikethepeopleIseeinmagazines.”•“Imustbepopular.”•“Imustbehappyallthetime.” •“Imustbebetterthanothers.”

These thoughts and beliefs magnify the demands.An imagined danger can also result from minimizing the resourcesyouhaveatyourdisposal.Examplesinclude:

•“I’mnotrichenough.” •‘I’mnotpopularenough.”•“I’mnotattractiveenough.” •“Idon’thavetherespectofeveryone.”•“Idon’thaveenoughfriends.”•“Idon’thaveenoughtalent.”

Inthissectionwepresentstrategiesthatwillhelpyouchange your perception of the demands and resources. You do this by identifying stress-producing thoughts —

also called maladaptive thoughts, cognitive distortions or “stinkin’ thinkin’” — and replacing them with thoughts that don’t produce stress.

STRESS-PRODUCING THINKING Each of us views the world through a filter. A situation may cause stress in one person but no stress at all in another. Fortunately, stress-producing thoughts can be changed. They occur on three levels:

•negativeautomaticthoughts•rulesandassumptions•Corebeliefs

Negative automatic thoughtsNegative automatic thoughts are the unhelpful thoughts that spontaneously come to mind. Here are some ways to identify negative automatic thoughts:

Let your emotions guide you Whenyouexperiencenegativeemotionsask

yourself,“Whatisgoingthroughmymindrightnow?”

Mental images Sometimes negative automatic thoughts are

revealedthroughmentalimages.Forexample,aperson who finds public speaking stressful imagines themself turning red and stuttering while giving a

HARD TIMESTherearesomedifficultlifeexperiencesthatincrease the demands in our life greatly; for example,gettingdiagnosedwithanillness.Thestressor is very real, but there are beliefs that can further increase stress.

Thoughtslike“No-onewillwantmenowthatIhavethisdisease”or“There’snowayI’llsurvivethis illness” will increase the demands and decrease the resources you have to cope with the situation.

With both real and self created dangers, the stress management approach includes changing the way you think about the situation: changing your perceptions of demands and resources.

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speech. They also imagine members of the audience laughing.Thenegativeautomaticthoughtis“IamnogoodatpublicspeakingandpeoplewillthinkIamanidiot and laugh at me!”

Worst-case scenario Asking,“Whatistheworstthatcouldhappen?”can

revealanegativeautomaticthought.Forexample,your partner tells you he’s going away for work to another city for three days. This causes you stress but you don’t know why. Asking the worst case scenarioquestionmayrevealthatyouthink“Hewillhave an affair when he is away” or “He might die in a plane crash.”

Most negative automatic thoughts fall into one or more broadcategoriesofexaggeratedorirrationalthoughtpatterns called cognitive distortions. These include “all-or-nothing thinking”, “discounting the positives” and“personalizing”.Itcanbehelpfultoreviewalistofcognitive distortions to identify your stress-provoking thought patterns. For a list of cognitive distortions and how to change them, search “Challenging Our Cognitive Distortions”onpsychcentral.com.

Rules and assumptionsRules are statements about how you believe the world should work or how you and others should behave. They often contain the word “must” or “should”.

Examplesofrulesinclude:“Peoplemustalwaysbepolite”and“ImustbeperfectineverythingIdo.”Assumptions are statements about what you believe will happen in a situation. They are usually stated in the form of“If...,then...”Examplesofassumptionsinclude,“IfmypartnerandIbreakup,thenIwillbealoneforever”and“IfsomeoneasksmeforhelpandIsay“no”,thentheywill hate me”. Core beliefs Core beliefs are deeply held beliefs about yourself, others, the world or the future. Of the three levels of maladaptive thinking, they the most difficult to identify and the most difficult to change.

Maladaptive core beliefs are maintained through regularly acknowledging information that supports the belief while ignoring information that contradicts it. Examplesofcorebeliefsinclude:

•Iamweak.•Iamafailure.•Iamunlovable.•Iamunattractive.•Iamboundtoberejected.•Theworldisadangerousplace.•Otherpeoplecannotbetrusted.

HOW TO MODIFY STRESS-PRODUCING THINKING Changing the way you think is never easy. However, you canuseproventechniquestochangeyourmaladaptivethoughts into helpful, stress-relieving ones.

Cognitive restructuringCognitiverestructuringisatechniquethathasbeenused effectively to treat a variety of problems including depression,anxiety,backpainandmore.Thegoalisto replace irrational, maladaptive thoughts with more balanced ones. Although cognitive restructuring can be done in your head, it is more effective as a written exercise.Seethenextpageforexamplesofcognitiverestructuring.

Learnmoreaboutthistechniquebyconsultingthehighlyrecommended books Mind Over Mood: Change the way you feel by changing the way you think by Greenberger and Padesky and Feeling Good: The new mood therapy byDavidBurns.

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Socratic questioningTo change your thinking you need to challenge it. Socraticquestioningisatypeofcriticalthinkingwhereyouaskquestionstodispelirrationalthinkingandformulate alternative thoughts. Questions include:

•WhatexperiencesdoIhavethatshowthatthisthoughtisnottrue100%ofthetime?

•IfapersonclosetomeknewIwasthinkingthis,whatwouldtheysaytome?Whatevidencewouldthat person point out to me to show that my thoughtisnot100%true?

•WhatwouldIsaytoafriendinthesamesituation?•WhenIamnotfeelinglikethis,wouldIthink

differentlyaboutthissituation?•InthepastwhenIhavefeltthisway,whathaveIsaid

tomyselftofeelbetter?

•HaveIbeeninsimilarsituationsinthepast?HowdidIcopethen?WhatdidIlearnfromthatsituationthatIcouldusenow?IsthissituationanydifferentthanwhatIexperiencedinthepast?

•Fiveyearsfromnow,howwillIlookatthissituation?WillIfocusondifferentaspectsofit?

•DoIhaveanystrengths,skillsorotherpositiveaspectsthatIamignoring?

•AmIblamingmyselfforsomethingoverwhichIdonothavecompletecontrol?

•AmIfocusingontheevidence,oraremythoughtsguidedbythewayIfeel?

•AmIassumingthatthisistheonlywayoflooking atthings?

•AmImakinganythinkingerrors?(seenextpage for common thinking errors)

•AmIjudgingmyselfmoreharshlythanIwould judgeothers?

SCENARIO1 SCENARIO2

1. Situation Some friends are going out to dinner thisweekendandIwasn’tinvited.

Imadeasuggestionattheweeklystaffmeeting and most people thought it wasn’t a good idea.

2. Thoughts My friends don’t like me. They thinkIamboring.Iwillendup having no friends.

PeoplethinkIamstupid.Iamterribleat mywork.Ihavenogoodideas.

3. Feelings Sad.Disliked.Alone.Stressed. Anxious.Disrespected.Stupid.Stressed.

4. Evidence that supports the thought

Idogetmoodyeverynowandthen. My boss said “no” to my suggestions.

5. Evidence that doesn’t support the thought

My friends have told me several times thattheythinkIamfunandthatImake them laugh. Other friends have notbeeninvitedtootheractivities.Ido get invited to most things.

Afewpeopledidthinkitwasagoodidea.Ioften get complimented on my ability to think outsidethebox.Minewasnottheonlyideathat the group didn’t like. People tell me they likethewayIwork.Iusuallydoagoodjob.

6. Alternative/balanced thought

My friends like me but that doesn’t mean they have to invite me to everything.

PeopleatworkthinkthatIamcapableandoftenhavegoodideas.Idomyworkwell, but this wasn’t one of my best ideas.

7. Outcome Ifeelhappier.Inolongerfeelstressedabout this.

Ifeelcalmer.Inolongerfeelstressed about this.

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Consult the booklet Healthy Eating: A Practical Guide for moreinformation.ItisavailableontheHealthServiceswebsite www.concordia.ca/students/health/topics.html as well as in the waiting room of both Health Services locations.

STEP 5: EVALUATE

You have done your best to manage stress. Now it’s time to evaluate whether your efforts were successful. GobacktoStep1:areyoustillexperiencingthesymptomsofstress?

Ifyouarenolongerfeelingstressed,congratulateyourself for doing a good job and note what strategies helped so you can use them again in future situations.

Ifyouarestillstressed,reviewthesteps.Maybeyoudidn’t accurately identify the stressor or why it is a stressor. Maybe you selected an inappropriate stress management strategy. Maybe your stress is not a result of the situation as much as a result of your perception of the situation. Adjust your stress management approach in light of what you discover.

Ifyouaretryinghardtoreduceyourstressanditisnotworking, consider meeting with a counselor or other mental health professional. Concordia University has many professionals who can help, including those at HealthServicesandCounsellingandDevelopment.

HEALTHY LIVING AND STRESS Adopting a healthy lifestyle enhances your health and reducesyourvulnerabilitytostress.Italsomakesyoubetter able to manage stress when it arises. After all, good health is arguably your greatest resource, and the more resources you have, the better able you are to manage stress.

Eat a healthy diet The best advice for healthy eating is to eat a plant-based diet. This means choosing lots of fruit, vegetables, grains, beans, nuts and seeds. The Canada Food Guide (www.hc-sc.gc.ca/fn-an/food-guide-aliment/index-eng.php) offers guidelines for healthy eating, including:

•Eatadietthatisrichinplantfoods.•Eatadietthatislowintotalfat,saturatedfat,

sodium and added sugars.•Avoidtransfatsandhydrogenatedfats,found

mostly in commercially-prepared baked goods (e.g. cookies, crackers, cakes, pies), shortening and some margarines.

•Eatregularlythroughouttheday.•Eatavarietyoffoods.•Eatrealfood,not“junk”suchasfastfoodandhighly

processed foods.

STRESS AND THE SOCIAL DETERMINANTS OF HEALTHThis stress management guide provides information on what you, as an individual, can do to manage stress. However, many factors beyond the individual—such as family, organizations, community, society and culture—contribute to stress by creating the conditions thatmakeusstressedinthefirstplace.Intheworkplace,forexample,manyemployeesattribute job stress to unrealistic workloads and unpaid overtime. For others, stress is a result of living in substandard housing and unsafe neighbourhoods.

Itisimportantforindividualstolearnstressmanagement skills for themselves. However, an approach that can reduce everyone’s stress is to change the conditions that cause it in the first place. These are called the “Social DeterminantsofHealth”.

Itisnoteasytochangeaschoolorworkplaceculture, the education system, or housing and safety in entire neighbourhoods. Some ways you can make a difference are to:

•Learnmoreaboutthesocialdeterminantsof health (search “What Makes Canadians Healthy or Unhealthy” on the Public Health Agency of Canada website, or visit www.thecanadianfacts.org).

•Voteforpoliticianswhoworktochangestress-producing conditions.

•Supportinitiativesthatremovebarrierstohealthy living.

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Engage in regular physical activity Regular physical activity is associated with many health benefits.Engagein150minutesofmoderate-intensityor 75 minutes of vigorous-intensity physical activity each week.

The Canadian Physical Activity Guidelines at www.csep.ca/guidelines has more information.

Don’t use tobacco Ifyouusetobacco,thebestthingyoucandoforyourhealth—byfar—istoquit.Consult“YourGuidetoQuitting Smoking for Good” on the Health Services website or pick up a copy in the waiting room of both Health Services locations.

Ifyouwouldlikefreeprofessionalhelptoquitsmoking,contact Concordia University Health Services.

Get suff icient, quality sleepNotgettingenoughqualitysleepdiminishesyourenergy,decreases your ability to think clearly and problem solve, negatively affects your mood, and weakens your immune system, among other adverse effects.

Thebestwaytogetsufficient,qualitysleepistoestablish a routine: go to bed at the same time every night and get up at the same time every morning. For more information consult Health Services’ Sleep handout, available on the Health Services website, as well as:

National Sleep Foundation (www.sleepfoundation.org)

Medicinenet (www.medicinenet.com/sleep/article.htm)

Establish and maintain healthy relationshipsThepeopleinyourlifeareextremelyimportantresources for stress management. They provide help, from feeding your cat when you are away, to emotional support and more. Qualities of healthy relationships includeabalanceoftakingandgiving,sharing,expressingvulnerability, being trustworthy, and showing respect.

Just as important as nurturing good relationships is lettinggoofbadones.Ifthereissomeoneinyour lifewhoisabusiveorotherwise“toxic”,considerbreaking the ties.

For more on healthy relationships see:

Friendships: Enrich your life and improve your health (www.mayoclinic.com/health/friendships/MH00125)

How to Find a Friend & Build Friendships (www.helpguide.org/life/how-find-friend.htm)

Build skillsTheproblem-solvingapproachrequiresbuildingandusingskillstoremovedanger.Don’twaituntilyouarestressed to learn these skills. The best time to build themiswhenyouarenotexperiencingstress.Learnmore about the skills outlined in this booklet. Practice and refine them whenever you can.

Find meaning and purposeThink about ways you can connect with something bigger than you. Some ways to find meaning include:

•Practicingareligion;consultMulti-FaithChaplaincy.•Takingtimetomeditate.•Spendingtimeinnature.•Servingotherse.g.volunteering;consultConcordia’s

LIVECentreforvolunteeringopportunitiesvolunteer.concordia.ca.

•Acceptingandgivingforgiveness.

LEARN MORE AT:concord i a .c a /hea l th

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