Stress Relief

P20.  Stress Relief, 3 CE hours course

Description:  STRESS is the internal or external force that causes a person to become tense, upset or anxious. Distress is negative stress that may causes illness.
Objectives: At the end of this course, you will  1. Know your stress-level and monitor the stress levels of others. 2. Know how to break the immediate stress cycle and help others to do so. 3. Develop a lifestyle that is to a large extent stress-free. 4. Be able to put your mind into a stress-free mode.

Test: Click here for the self-correcting test

How can I prevent it? How can I deal with it? How can I keep it from knocking me down?

True  False  Some of life’s happiest moments are very stressful.

True  False  All stressors are personal in nature.

True  False  College students have among the lowest rates of suicide.

True  False  There are no specific remedies for adjustment disorders.

1: What is Your Stress?


1.1 What Is Stress?

STRESS is the internal or external force that causes a person to become tense, upset or anxious. Distress is negative stress that may causes illness. What we usually call stress may be better called distress. Eustress is positive stress that stimulates a person to function better.  Burnout is a state of exhaustion that results from repeated emotional pressure. Our bodies try to keep in balance (homeostasis), but stress may upset that balance. Hans Selye explained stress through GAS (general adaptation syndrome), a way that the body tries to keep in balance. The GAS stages are alarm, resistance and exhaustion.

Stress is either acute (short-term) or chronic. People with chronic stress, such as ongoing conflicts, respond less well to many vaccines, and are more likely to develop colds, memory loss, heart attacks, strokes, problems with their immune system, digestive problems, headaches, ulcers and have some types of obesity. 

Researchers now categorize people as either hot or cool responders to stress. Cool responders responded less to higher cortisol levels than hot responders. Cool responders just do not react to stress as much as hot responders. Women, children, young adults, divorced and separated  persons tend to have higher stress levels. Men, married people, and individuals between ages 55 and 64 tend to have lower stress levels.

1.2 How the Body Copes With Stress

The body reacts to stress by secreting two types of chemical messengers – hormones in the blood and neurotransmitters in the brain. Scientists think that some of the neurotransmitters may be the same or similar chemicals as the hormones but acting in a different capacity.

Some of the hormones travel throughout the body, altering the metabolism of food so that the brain and muscles have sufficient stores of metabolic fuel for activities, such as fighting or fleeing, that help the person cope with the source of the stress. In the brain, the neurotransmitters trigger emotions, such as aggression or anxiety, that prompt the person to undertake those activities.

Normally, stress hormones are released in small amounts throughout the day, but when the body is under stress the level of these hormones increases dramatically. The release of stress hormones begins in the brain. First, a hormone called corticotropin-releasing factor (CRF) is released from the brain into the blood, which carries the CRF to the pituitary gland, located directly underneath the brain. There, CRF stimulates the release of another hormone, adrenocorticotropin (ACTH), which, in turn, triggers the release of other hormones – principally cortisol – from the adrenal glands. Cortisol travels throughout the body, helping it to cope with stress. If the stressor is mild, when the cortisol reaches the brain and pituitary gland it inhibits the further release of CRF and ACTH, which return to their normal levels. But if the stressor is intense, signals in the brain for more CRF release outweigh the inhibitory signal from cortisol, and the stress hormone cycle continues.

Researchers speculate that CRF and ACTH may be among the chemicals that serve dual purposes as hormones and neurotransmitters. The researchers posit that if, indeed, these chemicals also act as neurotransmitters, they may be involved in producing the emotional responses to stress.

The stress hormone cycle is controlled by a number of stimulatory chemicals in addition to CRF and ACTH and inhibitory chemicals in addition to cortisol both in the brain and in the blood. Among the chemicals that inhibit the cycle are neurotransmitters called opioid peptides, which are chemically similar to opiate drugs such as heroin and morphine. Dr. Kreek has found evidence that opioid peptides also may inhibit the release of CRF and other stress-related neurotransmitters in the brain, thereby inhibiting stressful emotions. Source:

1.3 What are Stressors?

STRESSORS are the pressures from the inside or the outside that cause stress. Stress is your RESPONSE to these stressors. Some common stressors are anger, conflicts, illnesses, violence, money difficulties, job problems, tests, tense relationships, competition, changes and losses. Review the Model of Stress.

1.4 What is Your Stress Level?

CHECK your stress level with some of the following stress tests. Record it. Stress & Depression    Self-Assessment Tests

2: How Do You Get Quick Relief?

Can I get Quick Relief? Stress is best taken care of right away actively and effectively. Deal with the immediate issue first, be optimistic, see things in the context of a larger positive plan that makes sense to you, and recognize that troubles are temporary. Don’t blame yourself needlessly. Meditate, pray, relax one muscle at a time, and ever so often enjoy a massage. 

2.1 Stress-Relief to do right now

Practice deep breathing, tighten and relax the parts of your body, refocus your thinking to something pleasant, put things into perspective, find time to be alone, talk to a friend or family member and involve yourself in some recreation or physical work.  Avoid sugary snacks, smoking, alcohol, drugs, overeating and caffeine.

2.2 Break the stress cycle

By doing some short-term stress-relief, you break the stress cycle that can spin out of control. If you do not relief the immediate stress, the stress may keep on accumulating until it becomes too great to bear. Stress can lead to burnout, workaholic and adjustment disorders, posttraumatic stress disorders, and diseases related to the cardiovascular, immune and digestive systems.

2.3 Stress as a Normal Part of Living

Recognize stress as 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.


3: How Do You Develop Stamina to Prevent Stress?

You can prevent stress. Don’t feel that you are a victim. Build a good support group around you. Improving your emotional, physical and spiritual health may take care of part of your stress.  Do exercise (researchers found that students who worked out half-an-hour on a treadmill lowered their scores on an anxiety test by 25%). 

3.1 Explore your life-style approach to Stress Reduction

Strive for balance, talk, write, prioritize, relax and help others. Learn to defuse stress by making a habit of planning ahead, being positive, taking breaks, and rehearsing (that is, walking through) difficult anticipated situations. You can develop the stamina that makes you more stress-resistant through simplicityexercise, humor, nutritionThe most common stress in the USA is problems with work.

3.2 What Controls You?

At various times of your life, you may be controlled mainly by your 1) emotions, 2) principles, or 3) mission. Emotionally-controlled people are often at the mercy of their moods and other people’s attitude. That may be very stressful. But they can gain emotional strength by learning to focus on healthy emotions and filling their lives with positives.  Principle-controlled people live by some givens and when situations or people interfere with these, high stress can result. But they can learn flexibility and give in where that is appropriate. Mission-controlled people live by some vision and try to move in a selected direction.  All can find their perspective and balance by developing stress resistance through special stress-resisters and healthy lifestyles.

3.3 Stress Interventions:

Review some ways to develop stamina to prevent stress:

  1. Do a minimum of 30 minutes of aerobic exercise daily. Or take a walk.
  2. Eat 3 balanced meals.
  3. Avoid caffeine, drugs and tobacco..
  4. Reduce refined sugars and alcohol intake.
  5. Sleep about 8 hours nightly.
  6. Spend time each day with relaxation techniques – imagery, daydreaming, meditation or prayer.
  7. Take a warm bath or shower.
  8. Hug someone, hold hands, or stroke a pet.

3.4 An Individual Stress Management Program

  • Positive thinking. Refocus the negative to be positive. Make an effort to stop negative thoughts.
  • Plan some fun. Take a break.

Physical activity:

  • Start an individualized program of physical activity. Most experts recommend doing 20 minutes of aerobic activity 3 times per week.
  • Decide on a specific time, type, frequency, and level of physical activity. Make this dedicated time fit into your schedule so it can be part of your routine.
  • Find a buddy to exercise with: it is more fun and it will encourage you to stick with your routine.
  • You do not have to join a gym: twenty minutes of brisk walking outdoor will do the trick.


  • Plan to eat foods for improved health and well-being. For example, increase the amount of fruits and vegetables you eat.
  • Use the food guide pyramid to help select healthy food choices. Eat an appropriate amount of food at a reasonable schedule.

Social support:

  • Make an effort to interact socially with people: even though you feel stressed, you will be glad to have gone out to meet your friends if only to get your mind off of things. Reach out to individuals.
  • Nurture yourself and others.


  • Use relaxation techniques. There are many relaxation techniques (guided imagery, listening to music, etc.); learn about and try different techniques and choose one or two that work for you.
  • Take time for personal interests and hobbies. Listen to one’s body.
  • Take a mini retreat.


4: How Do You Prevent Stress Overload?

What about stress overload? When all the components of your life fit nicely together, you can go through life with normal, bearable stress. When your physical, mental, emotional, social or spiritual health is damaged, stress becomes a byproduct of that health problem.  Thus taking care of that problem may also take care of that stress. Thus proper eating, exercise, relationships, meditation and spiritual exercises all contribute to stress-relief. In may ways, stress is an attitude. If you let everything bug (or distress) you, you will have a lot of stress. 

4.1 Think for Stress Resistance

In a way, the stress is in your mind. Changing your thinking changes your reaction to stress. Consider re-framing,  which deals with changing of the way you interpret events and situations. If you let something stress you, it will. Also make a TO-DO list and manage your time. Don’t procrastinate, JUST DO IT.

4.2 Put your mind into a Stress-Free mode

Start each day with a short review of your life-mission and weekly plan. Work daily on your stress-resistance stamina through exercise, good nutrition and drug-abstinence. Then determine to enjoy the things that fit into your life that day. Deal with the things that do not fit into your life in a problem-solving way (that is, look at your alternatives and choose the best). Thus you can face each day in a STRESS-FREE mode, well prepared for the stress that will come. Explore the resources of other stress courses:

4.3 Stress Quotations

Consider how they may apply to you and your situation. Rule 1. Don’t sweat the small stuff. Rule 2. It’s all small stuff. Rule 3. If you can’t fight or flee, then flow. Man’s troubles are rooted in extreme attention to senses, thoughts, and imagination. Attention should be focused internally to experience a quiet body and a calm mind. – Buddha. Every good thought you think is contributing its share to the ultimate result of your life. – Grenville Kleiser. What happens is not as important as how you react to what happens. – Thaddeus Golas. No one can make you feel inferior without your consent. – Eleanor Roosevelt. Everything has its beauty but not everyone sees it. – Confucius. An optimist may see a light where there is none, but why must the pessimist always run to blow it out? – Michel De Saint-Pierre. As a man thinks in his heart, so is he. – Proverbs 23:7 of the Bible. Its not what you think you are – but what you think, you are. – Author Unknown. The mind is its own place, and in itself, can make heaven of Hell, and a hell of Heaven.” -John Milton. I’m an old man and I’ve had many troubles, most of which never happened. – Mark Twain. When it rains, I let it. – Unknown. We are more often frightened than hurt; and we suffer more from imagination than from reality.   – Marcus Annaeus Seneca. People see the world not as it is, but as they are. – Al Lee. No one dies from working too hard. But when people don’t get any recognition in their work, the stress of that lack of control can kill them. – Barrie S. Greiff.

4.4 Job Stress Prevention Programs

Consider What One Organization Has Done

A department head in a small public service organization sensed an escalating level of tension and deteriorating morale among her staff. Job dissatisfaction and health symptoms such as headaches also seemed to be on the rise. Suspecting that stress was a developing problem in the department, she decided to hold a series of all-hands meetings with employees in the different work units of the department to explore this concern further. These meetings could be best described as brainstorming sessions where individual employees freely expressed their views about the scope and sources of stress in their units and the measures that might be implemented to bring the problem under control.

Using the information collected in these meetings and in meetings with middle managers, she concluded that a serious problem probably existed and that quick action was needed. Because she was relatively unfamiliar with the job stress field, she decided to seek help from a faculty member at a local university who taught courses on job stress and organizational behavior.

After reviewing the information collected at the brainstorming sessions, they decided it would be useful for the faculty member to conduct informal classes to raise awareness about job stress-its causes, effects, and prevention-for all workers and managers in the department. It was also decided that a survey would be useful to obtain a more reliable picture of problematic job conditions and stress-related health complaints in the department. The faculty member used information from the meetings with workers and managers to design the survey. The faculty member was also involved in the distribution and collection of the anonymous survey to ensure that workers felt free to respond honestly and openly about what was bothering them. He then helped the department head analyze and interpret the data.

Analysis of the survey data suggested that three types of job conditions were linked to stress complaints among workers:

Unrealistic deadlines
Low levels of support from supervisors
Lack of worker involvement in decision-making.

Having pinpointed these problems, the department head developed and prioritized a list of corrective measures for implementation. Examples of these actions included (1) greater participation of employees in work scheduling to reduce unrealistic deadlines and (2) more frequent meetings between workers and managers to keep supervisors and workers updated on developing problems. (Source: NIOSH)

Consider ways that you can change your environment or lifestyle to reduce your stress?

4.5 Do a Stress Update with current news, information and research

4.6. Stress Management Exercises

(As you have time, do some)

4.7  Optional Stress Libraries


Provider approved by the California Board of Registered Nursing, Provider Number (RN-CEP 16144) for 3 contact hours. Continuing Education Certificate (0.3 CEUs) completed after studying the website and successfully passing the test. Click her for the self-correcting test.


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