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What is stress management?

• Identify the causes
• Replace unhealthy coping strategies
• Practice the 4 As

Avoid unnecessary stress

Alter the situation, adapt to the stressor.

• Accept the things you can't change

Move more during your day

• Time management
• Reach out and connect

Make time for fun and relaxation

Maintain balance with a healthy lifestyle.

• Reducing stress in the moment

Stress Management Techniques & Strategies to Deal with Stress

While it may seem like there’s nothing you can do about stress in your life, there are healthy steps you can take to destress and regain control.

It may seem like there’s nothing you can do about stress—no way to avoid it and no way to de-stress completely when it hits. The bills won’t stop coming, there will never be more hours in the day, and your work and family responsibilities will always be demanding. But the truth is, you have a lot more control over stress than you may think. In fact, the simple realization that you’re in control of your life is the foundation of stress management.

Managing stress is all about taking charge: of your thoughts, emotions, schedule, environment, and the way you deal with problems. The ultimate goal is a balanced life, with time for work, relationships, relaxation, and fun—plus the ability to hold up under pressure and meet challenges head on.

Stress management involves using various techniques and coping strategies to improve the way you react to stressful things in your life and build resilience . But it’s not one-size-fits-all. That’s why it’s important to experiment and find out what works best for you. Whether you’re looking to reduce your overall stress levels, avoid unnecessary stressors in your life, or deal with stress in the moment, the following stress management techniques and strategies can help.

Why does stress management matter?

If you’re living with high levels of stress, you’re putting your entire well-being at risk. Stress wreaks havoc on your emotional equilibrium, as well as your overall physical and mental health. It narrows your ability to think clearly, function effectively, and enjoy life.

Identify the causes of stress in your life

Stress management starts with identifying the sources of stress in your life. This isn’t as straightforward as it sounds. While it’s easy to identify major stressors such as changing jobs, moving, or going through a divorce, pinpointing the sources of chronic stress can be more complicated.

It’s all too easy to overlook how your own thoughts, feelings, and behaviors contribute to your everyday stress levels. Sure, you may know that you’re constantly worried about work deadlines, but maybe it’s your procrastination, rather than the actual job demands, that is causing the stress.

To identify what’s really stressing you out, look closely at your habits, attitude, and excuses:

• Do you explain away stress as temporary (“I just have a million things going on right now”) even though you can’t remember the last time you took a breather?
• Do you define stress as an integral part of your work or home life (“Things are always crazy around here”) or as a part of your personality (“I have a lot of nervous energy, that’s all”)?
• Do you blame your stress on other people or outside events, or view it as entirely normal and unexceptional?

Until you accept responsibility for the role you play in creating or maintaining it, your stress level will remain outside your control.

Keep a stress journal

A stress journal can help you identify the regular stressors in your life and the way you deal with them. Each time you feel stressed, make a note of it in your journal or use a stress tracker on your phone. As you keep a daily log, you will begin to see patterns and common themes. Write down:

• What caused your stress (make a guess if you’re unsure).
• How you felt, both physically and emotionally.
• How you acted in response.
• What you did to make yourself feel better.

Replace unhealthy coping strategies with healthy ones

Think about the ways you currently manage and cope with stress in your life. Your stress journal can help you identify them. Are your coping strategies healthy or unhealthy? Many of us cope with stress in ways that make us feel better temporarily—but compound the problem in the long run.

Unhealthy ways of dealing with stress

• Using alcohol or drugs to relax .
• Bingeing on junk or comfort food.
• Zoning out for hours on your phone or TV.
• Withdrawing from friends, family, and social activities.
• Sleeping too much.
• Filling up every minute of the day to avoid facing problems.
• Taking out your stress on others
• Procrastinating.

If your methods of coping with stress aren’t contributing to your greater emotional and physical health, it’s time to find healthier ones. No single method works for everyone or in every situation, so experiment with different stress management techniques and strategies. Focus on what makes you feel calm and in control.

Practice the 4 As of stress management

There are many healthy ways to reduce stress or cope with its effects, but they all require change. You can either change the situation or change your reaction. When deciding which option to choose, it’s helpful to think of the four As: avoid , alter , accept , or adapt .

Not all stress can be avoided, and it’s not healthy to avoid a situation that needs to be addressed. But you may be surprised by the number of stressors in your life that you can eliminate.

Learn how to say “no.” Know your limits and stick to them. Whether in your personal or professional life, taking on more than you can handle is a surefire recipe for stress.

Avoid people who stress you out. If someone consistently causes stress in your life, limit the amount of time you spend with that person, or end the relationship.

Take control of your environment. If the evening news makes you anxious, turn off the TV. If traffic makes you tense, take a longer but less-traveled route. If going to the market is an unpleasant chore, do your grocery shopping online.

Avoid hot-button topics . If you get upset over religion or politics, cross them off your conversation list. If you repeatedly argue about the same subject with the same people, stop bringing it up or excuse yourself when it’s the topic of discussion.

Pare down your to-do list. Analyze your schedule, responsibilities, and daily tasks. If you’ve got too much on your plate, distinguish between the “shoulds” and the “musts.” Drop tasks that aren’t truly necessary to the bottom of the list or eliminate them entirely.

If you can’t avoid a stressful situation, try to alter it. Often, this involves changing the way you communicate and operate in your daily life.

Express your feelings instead of bottling them up. If something or someone is bothering you, communicate your concerns in an open and respectful way. If you don’t voice your feelings, resentment will build and the stress will increase.

Be willing to compromise. When you ask someone to change their behavior, be willing to do the same. If you both are willing to bend at least a little, you’ll have a good chance of finding a happy middle ground.

Be more assertive.  Don’t take a backseat in your own life. Deal with problems head on, doing your best to anticipate and prevent them. If you’ve got an exam to study for and your chatty roommate just got home, say up front that you only have five minutes to talk.

Find balance. All work and no play is a recipe for burnout. Try to find a balance between work and family life, social activities and solitary pursuits, daily responsibilities and downtime.

If you can’t change the stressor, change yourself. You can adapt to stressful situations and regain your sense of control by changing your expectations and attitude.

Reframe problems. Try to view stressful situations from a more positive perspective. Rather than fuming about a traffic jam, look at it as an opportunity to pause and regroup, listen to your favorite radio station, or enjoy some alone time.

Look at the big picture. Take perspective of the stressful situation. Ask yourself how important it will be in the long run. Will it matter in a month? A year? Is it really worth getting upset over? If the answer is no, focus your time and energy elsewhere.

Adjust your standards. Perfectionism is a major source of avoidable stress. Stop setting yourself up for failure by demanding perfection. Set reasonable standards for yourself and others, and learn to be okay with “good enough.”

Practice gratitude. When stress is getting you down, take a moment to reflect on all the things you appreciate in your life , including your own positive qualities and gifts. This simple strategy can help you keep things in perspective.

Accept the things you can’t change

Some sources of stress are unavoidable. You can’t prevent or change stressors such as the death of a loved one, a serious illness, or a national recession. In such cases, the best way to cope with stress is to accept things as they are. Acceptance may be difficult, but in the long run, it’s easier than railing against a situation you can’t change.

Don’t try to control the uncontrollable. Many things in life are beyond our control, particularly the behavior of other people. Rather than stressing out over them, focus on the things you can control such as the way you choose to react to problems.

Look for the upside. When facing major challenges, try to look at them as opportunities for personal growth. If your own poor choices contributed to a stressful situation, reflect on them and learn from your mistakes.

Learn to forgive. Accept the fact that we live in an imperfect world and that people make mistakes. Let go of anger and resentments. Free yourself from negative energy by forgiving and moving on.

Share your feelings. Expressing what you’re going through can be very cathartic, even if there’s nothing you can do to alter the stressful situation. Talk to a trusted friend or make an appointment with a therapist.

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When you’re stressed, the last thing you probably feel like doing is getting up and exercising. But physical activity is a huge stress reliever—and you don’t have to be an athlete or spend hours in a gym to experience the benefits. Exercise releases endorphins that make you feel good, and it can also serve as a valuable distraction from your daily worries.

While you’ll get the most benefit from regularly exercising for 30 minutes or more, it’s okay to build up your fitness level gradually. Even very small activities can add up over the course of a day. The first step is to get yourself up and moving. Here are some easy ways to incorporate exercise into your daily schedule:

• Put on some music and dance around.
• Take your dog for a walk .
• Walk or cycle to the grocery store.
• Use the stairs at home or work rather than an elevator.
• Park your car in the farthest spot in the lot and walk the rest of the way.
• Pair up with an exercise partner and encourage each other as you work out.
• Play ping-pong or an activity-based video game with your kids.

Using mindful rhythmic exercise to manage stress

While just about any form of physical activity can help burn away tension and stress, rhythmic activities are especially effective. Good choices include walking, running, swimming, dancing, cycling, tai chi, and aerobics. But whatever you choose, make sure it’s something you enjoy so you’re more likely to stick with it.

While you’re exercising, make a conscious effort to pay attention to your body and the physical (and sometimes emotional) sensations you experience as you’re moving. Focus on coordinating your breathing with your movements, for example, or notice how the air or sunlight feels on your skin. Adding this mindfulness element will help you break out of the cycle of negative thoughts that often accompanies overwhelming stress.

Learn to manage your time better

Poor time management can cause a lot of stress. When you’re stretched too thin and running behind, it’s hard to stay calm and focused. Plus, you’ll be tempted to avoid or cut back on all the healthy things you should be doing to keep stress in check, like socializing and getting enough sleep. The good news: there are things you can do to achieve a healthier work-life balance.

Don’t over-commit yourself. Avoid scheduling things back-to-back or trying to fit too much into one day. All too often, we underestimate how long things will take.

Prioritize tasks. Make a list of tasks you have to do, and tackle them in order of importance. Do the high-priority items first. If you have something particularly unpleasant or stressful to do, get it over with early. The rest of your day will be more pleasant as a result.

Break projects into small steps. If a large project seems overwhelming, make a step-by-step plan. Focus on one manageable step at a time, rather than taking on everything at once.

Delegate responsibility. You don’t have to do it all yourself, whether at home, school, or on the job. If other people can take care of the task, why not let them? Let go of the desire to control or oversee every little step. You’ll be letting go of unnecessary stress in the process.

Reach out and connect to people who make you feel good

There is nothing more calming than spending quality time with another human being who makes you feel safe and understood. In fact, face-to-face interaction triggers a cascade of hormones that counteracts the body’s defensive “fight-or-flight” response. It’s nature’s natural stress reliever (as an added bonus, it also helps stave off depression and anxiety). So make it a point to connect regularly—and in person—with family and friends.

[Read: Social Support for Stress Relief]

Keep in mind that the people you talk to don’t have to be able to fix your stress. They simply need to be good listeners. And try not to let worries about looking weak or being a burden keep you from opening up. The people who care about you will be flattered by your trust. It will only strengthen your bond.

Of course, you may not always have someone close by to lean on when you feel overwhelmed by stress, but by building and maintaining a network of close friends you can improve your resiliency to life’s stressors.

Tips for building relationships

• Reach out to a colleague at work.
• Help someone else by volunteering .
• Have lunch or coffee with a friend.
• Ask a loved one to check in with you regularly.
• Call or email an old friend.
• Go for a walk with a workout buddy.
• Schedule a weekly dinner date.
• Meet new people by taking a class or joining a club.
• Confide in a clergy member, teacher, or sports coach.
• Join a support group—either in-person or via on online therapy platform .

Beyond a take-charge approach and a positive attitude, you can reduce stress in your life by carving out “me” time. Don’t get so caught up in the hustle and bustle of life that you forget to take care of your own needs. Nurturing yourself is a necessity, not a luxury. If you regularly make time for fun and relaxation, you’ll be in a better place to handle life’s stressors.

Set aside leisure time. Include rest and relaxation in your daily schedule. Don’t allow other obligations to encroach. This is your time to take a break from all responsibilities and recharge your batteries.

Do something you enjoy every day. Make time for leisure activities that bring you joy, whether it be stargazing, playing the piano, or working on your bike.

Keep your sense of humor. This includes the ability to laugh at yourself. The act of laughing helps your body fight stress in a number of ways.

Take up a relaxation practice. Relaxation techniques such as yoga, meditation, and deep breathing activate the body’s relaxation response , a state of restfulness that is the opposite of the fight or flight or mobilization stress response. As you learn and practice these techniques, your stress levels will decrease and your mind and body will become calm and centered.

In addition to regular exercise, there are other healthy lifestyle choices that can increase your resistance to stress.

Eat a healthy diet . Well-nourished bodies are better prepared to cope with stress, so be mindful of what you eat. Start your day right with breakfast, and keep your energy up and your mind clear with balanced, nutritious meals throughout the day.

Reduce caffeine and sugar. The temporary “highs” caffeine and sugar provide often end with a crash in mood and energy. By reducing the amount of coffee, soft drinks, chocolate, and sugar snacks in your diet , you’ll feel more relaxed and you’ll sleep better.

Avoid alcohol, cigarettes, and drugs. Self-medicating with alcohol or drugs may provide an easy escape from stress, but the relief is only temporary. Don’t avoid or mask the issue at hand; deal with problems head on and with a clear mind.

Get enough sleep. Adequate sleep fuels your mind, as well as your body. Feeling tired will increase your stress because it may cause you to think irrationally.

Tips for reducing stress in the moment

When you’re frazzled by your morning commute, stuck in a stressful meeting at work, or fried from another argument with your spouse, you need a way to manage your stress levels right now . That’s where quick stress relief comes in.

The fastest way to reduce stress is by taking a deep breath and using your senses—what you see, hear, taste, and touch—or through a soothing movement. By viewing a favorite photo, smelling a specific scent, listening to a favorite piece of music, tasting a piece of gum, or hugging a pet, for example, you can quickly relax and focus yourself.

[Read: Quick Stress Relief]

Of course, not everyone responds to each sensory experience in the same way. The key to quick stress relief is to experiment and discover the unique sensory experiences that work best for you.

More Information

• Special Health Report - Special Health Report from Harvard Medical School on Stress. (Harvard Health)
• Tolerating Distress - Workbook and information sheets to help you manage feelings of distress. (Centre for Clinical Interventions)
• How To Relax (Video) - Video to help you ease stress. (Mind)
• Trauma- and Stressor-Related Disorders. (2013). In Diagnostic and Statistical Manual of Mental Disorders . American Psychiatric Association. Link
• Can, Yekta Said, Heather Iles-Smith, Niaz Chalabianloo, Deniz Ekiz, Javier Fernández-Álvarez, Claudia Repetto, Giuseppe Riva, and Cem Ersoy. “How to Relax in Stressful Situations: A Smart Stress Reduction System.” Healthcare 8, no. 2 (April 16, 2020): 100. Link
• Norelli, Samantha K., Ashley Long, and Jeffrey M. Krepps. “Relaxation Techniques.” In StatPearls . Treasure Island (FL): StatPearls Publishing, 2021. Link
• Toussaint, Loren, Quang Anh Nguyen, Claire Roettger, Kiara Dixon, Martin Offenbächer, Niko Kohls, Jameson Hirsch, and Fuschia Sirois. “Effectiveness of Progressive Muscle Relaxation, Deep Breathing, and Guided Imagery in Promoting Psychological and Physiological States of Relaxation.” Evidence-Based Complementary and Alternative Medicine 2021 (July 3, 2021): e5924040. Link
• Unger, Cynthia A, David Busse, and Ilona S Yim. “The Effect of Guided Relaxation on Cortisol and Affect: Stress Reactivity as a Moderator.” Journal of Health Psychology 22, no. 1 (January 1, 2017): 29–38. Link
• Singh, Karuna. “Nutrient and Stress Management.” Journal of Nutrition & Food Sciences 6, no. 4 (2016). Link
• Katsarou, Alexia L., Marios M. Vryonis, Athanassios D. Protogerou, Evangelos C. Alexopoulos, Apostolos Achimastos, Dimitrios Papadogiannis, George P. Chrousos, and Christina Darviri. “Stress Management and Dietary Counseling in Hypertensive Patients: A Pilot Study of Additional Effect.” Primary Health Care Research & Development 15, no. 1 (January 2014): 38–45. Link
• Errisuriz, Vanessa L., Keryn E. Pasch, and Cheryl L. Perry. “Perceived Stress and Dietary Choices: The Moderating Role of Stress Management.” Eating Behaviors 22 (August 1, 2016): 211–16. Link
• Choi, Dong-Woo, Sung-Youn Chun, Sang Ah Lee, Kyu-Tae Han, and Eun-Cheol Park. “Association between Sleep Duration and Perceived Stress: Salaried Worker in Circumstances of High Workload.” International Journal of Environmental Research and Public Health 15, no. 4 (April 2018): 796. Link
• Blaxton, Jessica M., Cindy S. Bergeman, Brenda R. Whitehead, Marcia E. Braun, and Jessic D. Payne. “Relationships Among Nightly Sleep Quality, Daily Stress, and Daily Affect.” The Journals of Gerontology: Series B 72, no. 3 (May 1, 2017): 363–72. Link
• Saleh, Dalia, Nathalie Camart, Fouad Sbeira, and Lucia Romo. “Can We Learn to Manage Stress? A Randomized Controlled Trial Carried out on University Students.” PLOS ONE 13, no. 9 (September 5, 2018): e0200997. Link
• Loprinzi, Paul D., and Emily Frith. “Protective and Therapeutic Effects of Exercise on Stress-Induced Memory Impairment.” The Journal of Physiological Sciences: JPS 69, no. 1 (January 2019): 1–12. Link
• Salmon, P. “Effects of Physical Exercise on Anxiety, Depression, and Sensitivity to Stress: A Unifying Theory.” Clinical Psychology Review 21, no. 1 (February 2001): 33–61. Link

More in Stress

The power of the relaxation response to reduce stress and boost mood

Using your senses to relieve stress on the spot

How to Stop Worrying

Self-help strategies for anxiety relief

Tips and prompts to journal

Quick tips for when you’re short on time

Using close relationships to manage stress and improve well-being

Fill your life with music that reduces daily stress

Tips for overcoming adversity

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An Overview of Stress Management

Stress management.

Stress management is the range of techniques, strategies, and therapies designed to help people control their stress. This can include lowering acute stress, but it is often aimed at lowering chronic stress to improve health, happiness, and overall well-being. Stress management strategies may include:

• Deep breathing
• Eating a healthy diet
• Getting enough sleep
• Guided visualization
• Hobbies and leisure activities
• Mindfulness
• Positive thinking
• Progressive muscle relaxation
• Psychotherapy
• Social support

We all experience stress in our lives. Because many health problems are caused or influenced by stress, it's essential to understand how stress affects your body and learn effective stress management techniques to make stress work for you rather than against you.

What Is Stress?

Stress is your body’s response to changes in your life. Because life involves constant change—ranging from everyday, routine changes like commuting from home to work to adapting to major life changes like marriage, divorce, or death of a loved one—there is no avoiding stress.  

Your goal shouldn't be to eliminate all stress but to eliminate unnecessary stress and effectively manage the rest. There are some common causes of stress that many people experience, but each person is different.

Stress can come from many sources, which are known as " stressors ." Because our experience of what is considered "stressful" is created by our unique perceptions of what we encounter in life (based on our own mix of personality traits, available resources, and habitual thought patterns), a situation may be perceived as "stressful" by one person and merely "challenging" by someone else.

Simply put, one person's stress trigger may not register as stressful to someone else. That said, certain situations tend to cause more stress in most people and can increase the risk of burnout .

For example, when we find ourselves in situations where there are high demands on us but we little control and few choices, we are likely to experience stress. We might also feel stress when we don't feel equipped; where we may be harshly judged by others; and where consequences for failure are steep or unpredictable.

Many people are stressed by their jobs , relationships , financial issues , and health problems, as well as more mundane things like clutter or busy schedules . Learning skills to cope with these stressors can help reduce your experience of stress.  

Press Play for Advice On Dealing With Money Issues

Hosted by therapist Amy Morin, LCSW, this episode of The Verywell Mind Podcast shares what to do when financial stress is impacting your mental health. Click below to listen now.

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Just as stress is perceived differently by each of us, stress affects us all in ways that are unique to us. One person may experience headaches, while another may find stomach upset is a common reaction, and a third may experience any of a number of other symptoms.

While we all react to stress in our own ways, there is a long list of commonly experienced effects of stress that range from mild to life-threatening. Stress can affect immunity, which can impact virtually all areas of health. Stress can affect mood in many ways as well. Creating a stress management plan is often one part of a plan for overall wellness.

If you find yourself experiencing physical symptoms you think may be related to stress, talk to your doctor to be sure you are doing what you can to safeguard your health. Symptoms that may be exacerbated by stress are not "all in your head" and need to be taken seriously.

Stress can be effectively managed in many different ways. The best stress management plans usually include a mix of stress relievers that address stress physically and psychologically and help to develop resilience and coping skills.

7 Highly Effective Stress Relievers

Use quick stress relievers.

Some stress relief techniques can work in just a few minutes to calm the body's stress response. These techniques offer a "quick fix" that helps you feel calmer at the moment, and this can help in several ways.

When your stress response is not triggered, you may approach problems more thoughtfully and proactively. You may be less likely to lash out at others out of frustration, which can keep your relationships healthier. Nipping your stress response in the bud can also keep you from experiencing chronic stress.

Quick stress relievers like breathing exercises, for example, may not build your resilience to future stress or minimize the stressors that you face. But they can help calm the body's physiology once the stress response is triggered.  

Develop Stress-Relieving Habits

Some techniques are less convenient to use when you are in the middle of a stressful situation. But if you practice them regularly, they can help you manage stress in general by being less reactive to it and more able to reverse your stress response quickly and easily.

Long-term healthy habits, like exercise or regular meditation , can help to promote resilience toward stressors if you make them a regular part of your life.   Communication skills and other lifestyle skills can be helpful in managing stressors and changing how we feel from "overwhelmed" to "challenged" or even "stimulated."

Eliminate Stressors When You Can

You may not be able to completely eliminate stress from your life or even the biggest stressors, but there are areas where you can minimize it and get it to a manageable level.

Any stress that you can cut out can minimize your overall stress load. For example, ending even one toxic relationship can help you more effectively deal with other stress you experience because you may feel less overwhelmed.  

Discovering a wide variety of stress management techniques, and then choosing a mix that fits your needs, can be a key strategy for effective stress relief.

Stress FAQs

There are a number of common questions that you might ask about stress and stress management.

Is All Stress Harmful to Health?

There are several different types of stress , and not all are harmful. Eustress , for example, is a positive form of stress. But chronic stress has been linked to many serious health issues and is the type of negative stress most often mentioned in the news.   While we want to manage or eliminate negative stress, we also want to keep positive forms of stress in our lives to help us remain vital and alive.

However, if we experience too much stress in our lives, even "good" stress can contribute to excessive stress levels, which can lead to feeling overwhelmed or having your stress response triggered for too long. This is why it is still important to learn to relax your body and mind periodically and cut down on unnecessary stress whenever possible.

How Can I Tell When I’m Too Stressed?

Stress affects us all in different ways, not all of which are negative. In fact, the stress of an exciting life can actually serve as a good motivator and keep things interesting. When stress levels get too intense, however, there are some stress symptoms that many people experience.

For example, headaches, irritability, and "fuzzy thinking" can all be symptoms that you’re under too much stress.   While not everybody who’s under stress will experience these specific symptoms, many will.

If you find that you don't realize how stressed you are until you are overwhelmed, it's important to learn to notice your body's subtle cues and your own behavior, almost like an outside observer might. To notice how your body is reacting to stress, you can try this body scan meditation (it helps relax at the same time).

What Can I Do When I Feel Overwhelmed?

We all feel overwhelmed from time to time; that’s normal. While it’s virtually impossible to eliminate times when events conspire and the body’s stress response is triggered, there are ways that you can quickly reverse your body’s reaction to stress, buffering the damage to your health and keeping your thinking clear, so you can more effectively deal with what’s going on in the moment.

Is There a Way to Be Less Affected by Stress?

By practicing regular stress management techniques, you can eliminate some of the stress you feel and make yourself more resilient in the face of stress in the future. There are several things you can try, ranging from a morning walk to an evening journaling practice to just making more time for friends. The trick is to find something that fits with your lifestyle and personality, so it’s easier to stick with.

National Institute of Mental Health. 5 Things You Should Know About Stress .

Ma X, Yue ZQ, Gong ZQ, et al. The effect of diaphragmatic breathing on attention, negative affect and stress in healthy adults .  Front Psychol . 2017;8:874. doi:10.3389/fpsyg.2017.00874

National Center for Complementary and Integrative Medicine. Mind and Body Approaches for Stress: What the Science Says . 2020.

Bota PG, Miropolskiy E, Nguyen V. Stop caretaking the borderline or narcissist: How to end the drama and get on with life .  Ment Illn . 2017;9(1):6985. doi:10.4081/mi.2017.6985

Lehrer PM, Woolfolk RL, Sime WE. Principles and Practice of Stress Management . 3rd edition. New York: The Guilford Press; 2007.

By Elizabeth Scott, PhD Elizabeth Scott, PhD is an author, workshop leader, educator, and award-winning blogger on stress management, positive psychology, relationships, and emotional wellbeing.

Stress effects on the body

Stress affects all systems of the body including the musculoskeletal, respiratory, cardiovascular, endocrine, gastrointestinal, nervous, and reproductive systems.

Our bodies are well equipped to handle stress in small doses, but when that stress becomes long-term or chronic, it can have serious effects on your body.

Musculoskeletal system

When the body is stressed, muscles tense up. Muscle tension is almost a reflex reaction to stress—the body’s way of guarding against injury and pain.

With sudden onset stress, the muscles tense up all at once, and then release their tension when the stress passes. Chronic stress causes the muscles in the body to be in a more or less constant state of guardedness. When muscles are taut and tense for long periods of time, this may trigger other reactions of the body and even promote stress-related disorders.

For example, both tension-type headache and migraine headache are associated with chronic muscle tension in the area of the shoulders, neck and head. Musculoskeletal pain in the low back and upper extremities has also been linked to stress, especially job stress.

Millions of individuals suffer from chronic painful conditions secondary to musculoskeletal disorders. Often, but not always, there may be an injury that sets off the chronic painful state. What determines whether or not an injured person goes on to suffer from chronic pain is how they respond to the injury. Individuals who are fearful of pain and re-injury, and who seek only a physical cause and cure for the injury, generally have a worse recovery than individuals who maintain a certain level of moderate, physician-supervised activity. Muscle tension, and eventually, muscle atrophy due to disuse of the body, all promote chronic, stress-related musculoskeletal conditions.

Relaxation techniques and other stress-relieving activities and therapies have been shown to effectively reduce muscle tension, decrease the incidence of certain stress-related disorders, such as headache, and increase a sense of well-being. For those who develop chronic pain conditions, stress-relieving activities have been shown to improve mood and daily function.

Respiratory system

The respiratory system supplies oxygen to cells and removes carbon dioxide waste from the body. Air comes in through the nose and goes through the larynx in the throat, down through the trachea, and into the lungs through the bronchi. The bronchioles then transfer oxygen to red blood cells for circulation.

Stress and strong emotions can present with respiratory symptoms, such as shortness of breath and rapid breathing, as the airway between the nose and the lungs constricts. For people without respiratory disease, this is generally not a problem as the body can manage the additional work to breathe comfortably, but psychological stressors can exacerbate breathing problems for people with pre-existing respiratory diseases such as asthma and chronic obstructive pulmonary disease (COPD; includes emphysema and chronic bronchitis).

Some studies show that an acute stress—such as the death of a loved one—can actually trigger asthma attacks. In addition, the rapid breathing—or hyperventilation—caused by stress can bring on a panic attack in someone prone to panic attacks.

Working with a psychologist to develop relaxation, breathing, and other cognitive behavioral strategies can help.

Cardiovascular system

The heart and blood vessels comprise the two elements of the cardiovascular system that work together in providing nourishment and oxygen to the organs of the body. The activity of these two elements is also coordinated in the body’s response to stress. Acute stress—stress that is momentary or short-term such as meeting deadlines, being stuck in traffic or suddenly slamming on the brakes to avoid an accident—causes an increase in heart rate and stronger contractions of the heart muscle, with the stress hormones—adrenaline, noradrenaline, and cortisol—acting as messengers for these effects.

In addition, the blood vessels that direct blood to the large muscles and the heart dilate, thereby increasing the amount of blood pumped to these parts of the body and elevating blood pressure. This is also known as the fight or flight response. Once the acute stress episode has passed, the body returns to its normal state.

Chronic stress, or a constant stress experienced over a prolonged period of time, can contribute to long-term problems for heart and blood vessels. The consistent and ongoing increase in heart rate, and the elevated levels of stress hormones and of blood pressure, can take a toll on the body. This long-term ongoing stress can increase the risk for hypertension, heart attack, or stroke.

Repeated acute stress and persistent chronic stress may also contribute to inflammation in the circulatory system, particularly in the coronary arteries, and this is one pathway that is thought to tie stress to heart attack. It also appears that how a person responds to stress can affect cholesterol levels.

The risk for heart disease associated with stress appears to differ for women, depending on whether the woman is premenopausal or postmenopausal. Levels of estrogen in premenopausal women appears to help blood vessels respond better during stress, thereby helping their bodies to better handle stress and protecting them against heart disease. Postmenopausal women lose this level of protection due to loss of estrogen, therefore putting them at greater risk for the effects of stress on heart disease.

Endocrine system

When someone perceives a situation to be challenging, threatening, or uncontrollable, the brain initiates a cascade of events involving the hypothalamic-pituitary-adrenal (HPA) axis, which is the primary driver of the endocrine stress response. This ultimately results in an increase in the production of steroid hormones called glucocorticoids, which include cortisol, often referred to as the “stress hormone”.

The HPA axis During times of stress, the hypothalamus, a collection of nuclei that connects the brain and the endocrine system, signals the pituitary gland to produce a hormone, which in turn signals the adrenal glands, located above the kidneys, to increase the production of cortisol.

Cortisol increases the level of energy fuel available by mobilizing glucose and fatty acids from the liver. Cortisol is normally produced in varying levels throughout the day, typically increasing in concentration upon awakening and slowly declining throughout the day, providing a daily cycle of energy.

During a stressful event, an increase in cortisol can provide the energy required to deal with prolonged or extreme challenge.

Stress and health Glucocorticoids, including cortisol, are important for regulating the immune system and reducing inflammation. While this is valuable during stressful or threatening situations where injury might result in increased immune system activation, chronic stress can result in impaired communication between the immune system and the HPA axis.

This impaired communication has been linked to the future development of numerous physical and mental health conditions, including chronic fatigue, metabolic disorders (e.g., diabetes, obesity), depression, and immune disorders.

Gastrointestinal system

The gut has hundreds of millions of neurons which can function fairly independently and are in constant communication with the brain—explaining the ability to feel “butterflies” in the stomach. Stress can affect this brain-gut communication, and may trigger pain, bloating, and other gut discomfort to be felt more easily. The gut is also inhabited by millions of bacteria which can influence its health and the brain’s health, which can impact the ability to think and affect emotions.

Stress is associated with changes in gut bacteria which in turn can influence mood. Thus, the gut’s nerves and bacteria strongly influence the brain and vice versa.

Early life stress can change the development of the nervous system as well as how the body reacts to stress. These changes can increase the risk for later gut diseases or dysfunctioning.

Esophagus When stressed, individuals may eat much more or much less than usual. More or different foods, or an increase in the use of alcohol or tobacco, can result in heartburn or acid reflux. Stress or exhaustion can also increase the severity of regularly occurring heartburn pain. A rare case of spasms in the esophagus can be set off by intense stress and can be easily mistaken for a heart attack.

Stress also may make swallowing foods difficult or increase the amount of air that is swallowed, which increases burping, gassiness, and bloating.

Stomach Stress may make pain, bloating, nausea, and other stomach discomfort felt more easily. Vomiting may occur if the stress is severe enough. Furthermore, stress may cause an unnecessary increase or decrease in appetite. Unhealthy diets may in turn deteriorate one’s mood.

Contrary to popular belief, stress does not increase acid production in the stomach, nor causes stomach ulcers. The latter are actually caused by a bacterial infection. When stressed, ulcers may be more bothersome.

Bowel Stress can also make pain, bloating, or discomfort felt more easily in the bowels. It can affect how quickly food moves through the body, which can cause either diarrhea or constipation. Furthermore, stress can induce muscle spasms in the bowel, which can be painful.

Stress can affect digestion and what nutrients the intestines absorb. Gas production related to nutrient absorption may increase.

The intestines have a tight barrier to protect the body from (most) food related bacteria. Stress can make the intestinal barrier weaker and allow gut bacteria to enter the body. Although most of these bacteria are easily taken care of by the immune system and do not make us sick, the constant low need for inflammatory action can lead to chronic mild symptoms.

Stress especially affects people with chronic bowel disorders, such as inflammatory bowel disease or irritable bowel syndrome. This may be due to the gut nerves being more sensitive, changes in gut microbiota, changes in how quickly food moves through the gut, and/or changes in gut immune responses.

Nervous system

The nervous system has several divisions: the central division involving the brain and spinal cord and the peripheral division consisting of the autonomic and somatic nervous systems.

The autonomic nervous system has a direct role in physical response to stress and is divided into the sympathetic nervous system (SNS), and the parasympathetic nervous system (PNS). When the body is stressed, the SNS contributes to what is known as the “fight or flight” response. The body shifts its energy resources toward fighting off a life threat, or fleeing from an enemy.

The SNS signals the adrenal glands to release hormones called adrenalin (epinephrine) and cortisol. These hormones, together with direct actions of autonomic nerves, cause the heart to beat faster, respiration rate to increase, blood vessels in the arms and legs to dilate, digestive process to change and glucose levels (sugar energy) in the bloodstream to increase to deal with the emergency.

The SNS response is fairly sudden in order to prepare the body to respond to an emergency situation or acute stress—short term stressors. Once the crisis is over, the body usually returns to the pre-emergency, unstressed state. This recovery is facilitated by the PNS, which generally has opposing effects to the SNS. But PNS over-activity can also contribute to stress reactions, for example, by promoting bronchoconstriction (e.g., in asthma) or exaggerated vasodilation and compromised blood circulation.

Both the SNS and the PNS have powerful interactions with the immune system, which can also modulate stress reactions. The central nervous system is particularly important in triggering stress responses, as it regulates the autonomic nervous system and plays a central role in interpreting contexts as potentially threatening.

Chronic stress, experiencing stressors over a prolonged period of time, can result in a long-term drain on the body. As the autonomic nervous system continues to trigger physical reactions, it causes a wear-and-tear on the body. It’s not so much what chronic stress does to the nervous system, but what continuous activation of the nervous system does to other bodily systems that become problematic.

Male reproductive system

The male reproductive system is influenced by the nervous system. The parasympathetic part of the nervous system causes relaxation whereas the sympathetic part causes arousal. In the male anatomy, the autonomic nervous system, also known as the fight or flight response, produces testosterone and activates the sympathetic nervous system which creates arousal.

Stress causes the body to release the hormone cortisol, which is produced by the adrenal glands. Cortisol is important to blood pressure regulation and the normal functioning of several body systems including cardiovascular, circulatory, and male reproduction. Excess amounts of cortisol can affect the normal biochemical functioning of the male reproductive system.

Sexual desire Chronic stress, ongoing stress over an extended period of time, can affect testosterone production resulting in a decline in sex drive or libido, and can even cause erectile dysfunction or impotence.

Reproduction Chronic stress can also negatively impact sperm production and maturation, causing difficulties in couples who are trying to conceive. Researchers have found that men who experienced two or more stressful life events in the past year had a lower percentage of sperm motility (ability to swim) and a lower percentage of sperm of normal morphology (size and shape), compared with men who did not experience any stressful life events.

Diseases of the reproductive system When stress affects the immune system, the body can become vulnerable to infection. In the male anatomy, infections to the testes, prostate gland, and urethra, can affect normal male reproductive functioning.

Female reproductive system

Menstruation Stress may affect menstruation among adolescent girls and women in several ways. For example, high levels of stress may be associated with absent or irregular menstrual cycles, more painful periods, and changes in the length of cycles.

Sexual desire Women juggle personal, family, professional, financial, and a broad range of other demands across their life span. Stress, distraction, fatigue, etc., may reduce sexual desire—especially when women are simultaneously caring for young children or other ill family members, coping with chronic medical problems, feeling depressed, experiencing relationship difficulties or abuse, dealing with work problems, etc.

Pregnancy Stress can have significant impact on a woman’s reproductive plans. Stress can negatively impact a woman’s ability to conceive, the health of her pregnancy, and her postpartum adjustment. Depression is the leading complication of pregnancy and postpartum adjustment.

Excess stress increases the likelihood of developing depression and anxiety during this time. Maternal stress can negatively impact fetal and ongoing childhood development and disrupt bonding with the baby in the weeks and months following delivery.

Premenstrual syndrome Stress may make premenstrual symptoms worse or more difficult to cope with and premenses symptoms may be stressful for many women. These symptoms include cramping, fluid retention and bloating, negative mood (feeling irritable and “blue”) and mood swings.

Menopause As menopause approaches, hormone levels fluctuate rapidly. These changes are associated with anxiety, mood swings, and feelings of distress. Thus menopause can be a stressor in and of itself. Some of the physical changes associated with menopause, especially hot flashes, can be difficult to cope with.

Furthermore, emotional distress may cause the physical symptoms to be worse. For example, women who are more anxious may experience an increased number of hot flashes and/or more severe or intense hot flashes.

Diseases of the reproductive system When stress is high, there is increased chance of exacerbation of symptoms of reproductive disease states, such as herpes simplex virus or polycystic ovarian syndrome. The diagnosis and treatment of reproductive cancers can cause significant stress, which warrants additional attention and support.

Stress management

These recent discoveries about the effects of stress on health shouldn’t leave you worrying. We now understand much more about effective strategies for reducing stress responses. Such beneficial strategies include:

• Maintaining a healthy social support network
• Engaging in regular physical exercise
• Getting an adequate amount of sleep each night

These approaches have important benefits for physical and mental health, and form critical building blocks for a healthy lifestyle. If you would like additional support or if you are experiencing extreme or chronic stress, a licensed psychologist can help you identify the challenges and stressors that affect your daily life and find ways to help you best cope for improving your overall physical and mental well-being.

APA gratefully acknowledges the assistance of William Shaw, PhD; Susan Labott-Smith, PhD, ABPP; Matthew M. Burg, PhD; Camelia Hostinar, PhD; Nicholas Alen, BA; Miranda A.L. van Tilburg, PhD; Gary G. Berntson, PhD; Steven M. Tovian, PhD, ABPP, FAClinP, FAClinHP; and Malina Spirito, PsyD, MEd; in developing this article.

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16 Effective Stress-Management Activities and Worksheets

The interview is in 10 minutes, yet I want to run away.

Sound familiar?

Fear and anxiety lead to stress responses – cognitive, physical, and behavioral.

Deeply embedded and automatic, they evolved to provide humans with warnings, guiding present and future behavior while attempting to maintain a relatively stable internal state known as homeostasis (Brosschot, Verkuil, & Thayer, 2016; Varvogli & Darviri, 2011).

However innate these responses may be, there are ways to manage the stress you perceive.

This article offers our favorite stress-management activities and worksheets to help you deal with whatever challenge lies in your path.

Before you continue, we thought you might like to download our three Stress & Burnout Prevention Exercises (PDF) for free . These science-based exercises will equip you and those you work with, with tools to manage stress better and find a healthier balance in your life.

This Article Contains:

A note on stress-management approaches, keeping a digital stress diary with quenza, our 3 favorite stress-management worksheets, 3 activities to help manage stress, stress management within therapy sessions.

• Worksheets for Your CBT Sessions

3 Printable Tools for Children

Top 3 exercises for helping students, for group therapy sessions, a take-home message.

Stress, or rather the perception of stressors, can be managed, and there are ways to do so:

• Preparation increases our sense of control and improves confidence.
• Relaxation reduces anxiety and restores focus.
• Maintaining physical health via a healthy lifestyle, balanced diet, and exercise underpins overall mental wellbeing.

Another way to manage stress is to reframe our perception of it.

Rather than see it as unwelcome and to be avoided, pressure can provide an essential opportunity for development and learning. Viewed as an opportunity to thrive, stress can be the motivation to perform at our very best and adopt a growth mindset (Lee, Park, & Hwang, 2016).

In what follows, we will point you toward a range of useful worksheets and tools you can use to help your clients better manage stress. Most are free, but some of these come from our own Positive Psychology Toolkit© , which is a comprehensive subscription-based resource containing more than 400 exercises, activities, interventions, questionnaires, and assessments you can use to support your clients.

If you’re looking for more ways to grow your coaching or therapy practice using engaging, science-backed tools, be sure to check it out.

Despite the dangers of experiencing prolonged stress, many of us are likely to be tuned out to our body’s signals that we are experiencing stress.

Likewise, we may not have stopped to consider the factors in our lives that are most responsible for causing us stress.

To help strengthen your clients’ awareness of the drivers and experience of stress, consider inviting them to complete a one-week stress diary.

The purpose of a stress diary is to help them look for patterns and insights into the most common causes of stress in their life and their reactions to stressful events. From here, you can help your clients find effective ways of dealing with stress in the future.

For a great, easy-to-administer tool, consider taking a look at the Stress Diary tool available via the blended care app Quenza .

The platform features a growing library of pre-programmed psychoeducational activities, within which is the Stress Diary Pathway. This pathway invites clients to reflect on the day’s stressful experiences for eight days and culminates in an in-depth reflection into the patterns of stressors, as well as the client’s reactions to these across the eight days.

Download 3 Free Stress & Burnout Prevention Exercises (PDF)

These detailed, science-based exercises will equip you or your clients with tools to manage stress better and find a healthier balance in their life.

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A 2022 report found that in the UK alone, 17 million working days were lost due to stress, depression, and anxiety.

But help is at hand.

Multiple, evidence-based stress reduction techniques have been shown to lower stress levels, “ resulting in a reduction of disease symptoms, lowering of biological indicators of disease, prevention of disease and improvement of patient’s quality of life ” (Varvogli & Darviri, 2011).

Many of these techniques are described below and will help you to manage stress in your life.

1. Breath Awareness

Breathing exercises can be a powerful way to place your body in a relaxed state. Sitting in a comfortable position and drawing your attention to your breath can release tension and offer a method for ongoing relaxation and a tool to use for times of stress.

Breath Awareness was created to help individuals cultivate a mindful awareness of their breathing and the present moment rather than get caught up in their thoughts.

Once comfortable, clients are asked to release any unnecessary tension and tune in to their breath. They are invited to observe the movements and sensations in their body with each inhale and exhale, without trying to change anything.

The exercise can be useful during moments of distress to unhook someone from their thoughts or as a mindfulness exercise.

Try out the Breath Awareness worksheet and practice it daily.

2. Anchor Breathing

Similar to the last activity, anchor breathing involves inhaling and exhaling consciously while focusing on the physical experience. In this exercise, clients are also instructed to imagine a peaceful scene – being on a boat, feeling calm and safe.

Deep breathing techniques have been shown to lead to decreased oxygen consumption and heightened alertness. EEG recordings have also recorded increases in theta wave amplitude when participants engage in certain deep breathing exercises, which is associated with reduced symptoms of generalized anxiety disorder (Jerath, Edry, Barnes, & Jerath, 2006).

By showing patients how combine mindful breathing with calming, peaceful visualization, Anchor Breathing  provides an effective relaxation technique, reducing residual stress levels and providing support during acute episodes of stress (Varvogli & Darviri, 2011).

3. The Five Senses Worksheet

Mindfulness can be cultivated by paying attention to what we observe and feel while using our different senses one at a time. During mindfulness practice, distractions are observed, and attention is gently returned to the body part receiving focus.

This exercise works in a similar way to the Body Scan exercise, which helps clients cultivate a mindful awareness of different body parts. Evidence from functional magnetic resonance imagining found that body scan meditation heightens brain activity linked to increased awareness of the present moment, focus, and stress reduction (Sevinc et al., 2018).

To read more about the steps involved, you can view or download The Five Senses worksheet .

If you’re looking for more tools, our free Mindfulness Exercises Pack  includes the popular Leaves on a Stream tool and audio meditation, as well as two other mindfulness tools and audio files that you can download for free.

1. Nature effect

The powerful effect of being outdoors has been validated many times and should not be underestimated.

Visitors to a park in Zurich were found to have significantly lower levels of stress, a reduced number of headaches, and a 40% increase in feelings of wellbeing. These positive effects were further elevated in those taking part in sports (Hansmann, Hug, & Seeland, 2007).

While drugs and therapy are often used as treatments for soldiers returning home with post-traumatic stress disorder, the medications and treatment frequently have to be continued for many years without providing a lasting cure. In response, nature-based therapy has begun to receive increased scientific attention.

In a 2016 study, veterans reported that merely being in the garden, often performing mindfulness activities, could improve the symptoms of their post-traumatic stress disorder (Poulsen, Stigsdotter, Djernis, & Sidenius, 2016).

The simple act of getting out into an open space can provide stress relief. We delve deeper into this in our post on Environmental Psychology .

2. Exercise

We are all aware of the physiological rewards of exercise, but the psychological benefits are equally impressive and backed up by research.

A seven-week exercise program was found to improve people’s moods ; reduce perceived stress; and increase optimism, self-belief , resilience, and a growth mindset (Cassidy, 2016).

Exercise regimes need not be extreme to be effective. Even modest levels of physical activity if performed regularly provide ongoing support for mental wellbeing, a growth mindset, and reduced levels of stress.

3. Mindful movement

By replacing or combining some of our everyday car journeys with walking, we can become fully present in our day-to-day lives and improve mental health.

Indeed, a trial in 2017 found that combining walking with relaxation techniques is a great way to reduce levels of stress (Matzer, Nagele, Lerch, Vajda, & Fazekas, 2017).

Mindful walking combines the benefits of exercise, nature, and mindfulness.

Its goal is not to reach a destination, but to build an awareness of the moment, using the feet to anchor in the present. Pleasant and unpleasant bodily sensations such as muscle soreness are merely observed without opinion and let go.

3-Minute stress management: reduce stress with this short activity – Therapy in a Nutshell

Many people seek help when stress makes healthy living difficult. Therapy can help address immediate difficulties and work on the underlying causes (Strauss et al., 2018).

1. Anxiety Record

We often feel more vulnerable when we are asked to share what is making us anxious. The Anxiety Record worksheet helps individuals to understand what is causing their anxiety and learn appropriate coping skills.

Using this worksheet, clients can record their anxieties, triggers, and their effects. Afterward, they are guided through a breathing exercise and asked to revisit their answers to the questions.

A few prompts from this exercise are listed below:

• When do you feel anxious?
• What thoughts are you having before or during feeling anxious?
• Do you think these thoughts are realistic?
• What thoughts could you replace them with?

Click to download the Anxiety Record worksheet and give it a try.

2. Biofeedback training

Biofeedback builds on the concept of homeostasis introduced earlier. Using technology to measure and report brainwaves, skin temperature, breathing, and heart rate, the individual learns how to gain self-control over apparently involuntary bodily functions.

A recent meta-analysis of 24 studies confirmed that biofeedback training led to improvements in coping and offers a promising approach for treating stress and anxiety (Goessl, Curtiss, & Hofmann, 2017).

Individuals can ultimately learn to control their heart rate and blood pressure, reduce levels of stress, and even successfully treat high blood pressure and cardiac disease. Performed with a qualified therapist, these changes ultimately persist beyond the therapy (Varvogli & Darviri, 2011).

Worksheet Suggestions for Your CBT Sessions

Many of us experience spontaneous thoughts as images rather than individual words or an internal conversation (Beck & Beck, 2011).

A child pictures an angry parent, and an employee imagines a demanding boss. They can be powerful, representing moments of fear or anxiety, and can be used in Cognitive-Behavioral Therapy (CBT) sessions.

The following questions can form the basis of a conversation to explore a mental image and the individual’s relationship with it, cognitively restructuring its interpretation.

Imagery can feel as real to the mind as being in the situation, so playing through images in advance can restructure thoughts and emotions and reframe the stress.

2. Daily Exceptions Journal

A journal can be a fruitful way to track life’s ups and downs. Positive CBT encourages monitoring the client’s strengths and the positive outcomes of life rather than focusing on the negatives.

By capturing what went well in a Daily Exceptions Journal, it is possible to identify and record the skills and talents for reuse in other areas of your life.

Subsequently, walking through the journal during therapy reinforces successes, provides praise, and encourages discussion of the problems overcome.

World’s Largest Positive Psychology Resource

The Positive Psychology Toolkit© is a groundbreaking practitioner resource containing over 500 science-based exercises , activities, interventions, questionnaires, and assessments created by experts using the latest positive psychology research.

Updated monthly. 100% Science-based.

“The best positive psychology resource out there!” — Emiliya Zhivotovskaya , Flourishing Center CEO

Sensory awareness involves paying attention to a specific sensory aspect of the body. It can be a great way to teach mindfulness to children.

Such activities can also improve focus, increase self-awareness, help regulate emotions , and reduce anxiety.

1. The Raisin Meditation

The following exercise is a fun, palpable way for a child to develop mindfulness as a skill and notice the present.

Work through the Raisin Meditation worksheet following the steps with the child, paying attention to each sense in turn.

Children paying increased attention to their senses can learn to improve their focus and feel calmer.

2. Nature Play

Ongoing research has recognized the importance of playing and spending time outdoors on children’s mental wellbeing (Dankiw, Tsiros, Baldock, & Kumar, 2020).

Practicing underused senses such as sound can heighten a sense of awareness and promote mindfulness. This can be especially true in an unfamiliar environment, including walking through the countryside with family.

The questions can be tailored to the environment. Starting or pausing somewhere relatively quiet may assist the child’s focus more at the start.

Print the Nature Play worksheet here.

3. Anchor Breathing

Anchor breathing can be quickly learned and helps a child to focus their mind on one point.

Such mental training offers a valuable method for gaining perceived self-control and reducing stress.

The Anchor Breathing method also works with hands placed gently on the belly or in front of the nose.

The following three examples, along with the activities described above, can be learned quickly and implemented into a student’s daily routine to help manage both acute and chronic stress.

1. Urge Surfing

Coping with (often self-destructive) urges can be difficult, especially in times of stress. Such behavior can become a crutch, making us feel like we are taking control, when in reality, we are relinquishing it.

The Urge Surfing worksheet is available with a subscription to the Positive Psychology Toolkit© . Backed up by scientific research, mindful self-acceptance can teach individuals to observe their cravings rather than act upon them.

2. Meditation on the Soles of the Feet

Meditation on the Soles of the Feet  provides a safe space to work on managing strong emotions and regulating the urge to be aggressive , often a byproduct of stressful situations (Kruk, Halász, Meelis, & Haller, 2004).

The individual is not asked to stop angry thoughts – anger does serve a useful purpose at times – but rather to bring them under control through a shift of focus.

The client, standing or sitting with their feet on the ground, is asked to cast their mind back to a time that caused them to react very angrily. Then they are told to stick with those angry thoughts, letting them flow without hindrance. After that, they shift their attention to the soles of their feet.

Stretching and moving their toes, they feel the texture of their socks, the surface of the ground, or the insole in their shoes. They maintain focus, breathing naturally until feeling calm and in control.

Learning to manage anger more effectively reduces stress and anxiety, and increases feelings of control.

The full exercise is accessible with a subscription to the Positive Psychology Toolkit© .

3. Mindfulness

Working through the Leaves on a Stream and anchor breathing techniques, which are part of our free Mindfulness Exercises Pack , will help students focus awareness on the present moment and acknowledge and accept their feelings, thoughts, and emotions.

Research has identified the benefits of combining mindfulness and group therapy to help manage stress and increase resilience and positivity (Seyyed Moharrami, Pashib, Tatari, & Mohammadi; Babakhani, 2017).

Here is an example of a group exercise in mindfulness.

Walking Down the Street

The ability to observe, rather than react to, thoughts, emotions, and sensations is central to positive psychology.

The challenge is that the event and our thoughts about it are far from being the same.

The steps involved in the following exercise can be performed individually or in a group exercise, where everyone benefits from hearing one another’s thoughts.

Walking through the scene and discussing it in the group can help to develop positive behavioral change by separating thoughts and feelings from impulses and actions and, importantly, shape feelings while breaking a negative cycle of thinking.

17 Exercises To Reduce Stress & Burnout

Help your clients prevent burnout, handle stressors, and achieve a healthy, sustainable work-life balance with these 17 Stress & Burnout Prevention Exercises [PDF].

Created by Experts. 100% Science-based.

Resources from PositivePsychology.com

Building resilience helps clients bounce back from stressful situations and use coping mechanisms to turn them into opportunities for growth.

The Realizing Resilience Masterclass© provides guidance, along with a set of practical tools, to build a more resilient mindset.

If you’re looking for more science-based ways to help others manage stress without spending hours on research and session prep, this collection contains 17 validated stress management tools for practitioners. Use them to help others identify signs of burnout and create more balance in their lives.

Stress does not have to rule us. Stress should not be allowed to prevent us from doing what we want or need to do.

Instead, stress should be an enabler and drive us forward to build what we want and take on challenges that will allow us to grow.

There should be no excuse to hide from stress or become overwhelmed by it.

By using tools for coping and taking control, we can see stress as something natural that can invigorate and motivate us to overcome both planned and unexpected challenges.

These activities we shared will definitely help you manage stress. However, there are many other stress-management techniques to try out too. Identify those that work for you and implement them into your life. You will reap the benefits, especially before the next job interview or presentation.

Thank you for reading!

We hope you enjoyed reading this article. Don’t forget to download our three Stress & Burnout Prevention Exercises (PDF) for free .

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• Matzer, F., Nagele, E., Lerch, N., Vajda, C., & Fazekas, C. (2017). Combining walking and relaxation for stress reduction: A randomized cross-over trial in healthy adults. Stress and Health , 34 (2), 266–27.
• Poulsen, D. V., Stigsdotter, U. K., Djernis, D., & Sidenius, U. (2016). ‘Everything just seems much more right in nature’: How veterans with post-traumatic stress disorder experience nature-based activities in a forest therapy garden. Health Psychology Open, 3 (1).
• Sevinc, G., Hölzel, B. K., Hashmi, J., Greenberg, J., McCallister, A., Treadway, M., … Lazar, S. W. (2018). Common and dissociable neural activity after mindfulness-based stress reduction and relaxation response programs. Psychosomatic Medicine , 80 (5), 439–451.
• Seyyed Moharrami, I., Pashib, M., Tatari, M., & Mohammadi, S. (2017). The efficiency of stress management group therapy in job‌ stress and self-efficacy of nurses. Journal of Torbat Heydariyeh University of Medical Sciences, 5 (1), 42–49
• Strauss, C., Gu, J., Pitman, N., Chapman, C., Kuyken, W., & Whittington, A. (2018). Evaluation of mindfulness-based cognitive therapy for life and a cognitive behavioral therapy stress-management workshop to improve healthcare staff stress: Study protocol for two randomized controlled trials. Trials , 19 (209).
• Varvogli, L. & Darviri, C. (2011). Stress management techniques: Evidence-based procedures that reduce stress and promote health. Health Science Journal , 5 , 74–89.

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The resources was very helpful. thanks.

Interesting article although I wasn‘t able to open the links as it sent me to a site saying I had to purchase a toolkit in order to access them! I don‘t know why I get sent emails with resources that I‘m unable to access. Shame!

Glad you found the article interesting, and I’m sorry our distinction between the free and paid resources here is not as clear as it could be — I’ll flag this with our editor. Yes, some of the resources listed are freely available while others are available to subscribers of the Positive Psychology Toolkit . However, the three resilience exercises mentioned at the beginning are free and should instantly arrive in your inbox and be available to use.

– Nicole | Community Manager

These will be most helpful with the Native American population I serve

Very practical exercises of relaxation. True we have to rule ourselves not left to unnecessary stress which consequently results in low well being and reduce quality of life. Thank you Jeremy

Very helpful and easy to understand and practice documents. Grateful.

The article was more helpful and am looking forward to read more of this kind.

Hi Moses, So glad you found the resources helpful. Another great tool for dealing with stress is journaling, which you can read up about in our dedicated article here. – Nicole | Community Manager

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Article contents

Work, stress, coping, and stress management.

• Sharon Glazer Sharon Glazer University of Baltimore
• , and  Cong Liu Cong Liu Hofstra University
• https://doi.org/10.1093/acrefore/9780190236557.013.30
• Published online: 26 April 2017

Work stress refers to the process of job stressors, or stimuli in the workplace, leading to strains, or negative responses or reactions. Organizational development refers to a process in which problems or opportunities in the work environment are identified, plans are made to remediate or capitalize on the stimuli, action is taken, and subsequently the results of the plans and actions are evaluated. When organizational development strategies are used to assess work stress in the workplace, the actions employed are various stress management interventions. Two key factors tying work stress and organizational development are the role of the person and the role of the environment. In order to cope with work-related stressors and manage strains, organizations must be able to identify and differentiate between factors in the environment that are potential sources of stressors and how individuals perceive those factors. Primary stress management interventions focus on preventing stressors from even presenting, such as by clearly articulating workers’ roles and providing necessary resources for employees to perform their job. Secondary stress management interventions focus on a person’s appraisal of job stressors as a threat or challenge, and the person’s ability to cope with the stressors (presuming sufficient internal resources, such as a sense of meaningfulness in life, or external resources, such as social support from a supervisor). When coping is not successful, strains may develop. Tertiary stress management interventions attempt to remediate strains, by addressing the consequence itself (e.g., diabetes management) and/or the source of the strain (e.g., reducing workload). The person and/or the organization may be the targets of the intervention. The ultimate goal of stress management interventions is to minimize problems in the work environment, intensify aspects of the work environment that create a sense of a quality work context, enable people to cope with stressors that might arise, and provide tools for employees and organizations to manage strains that might develop despite all best efforts to create a healthy workplace.

• stress management
• organization development
• organizational interventions
• stress theories and frameworks

Introduction

Work stress is a generic term that refers to work-related stimuli (aka job stressors) that may lead to physical, behavioral, or psychological consequences (i.e., strains) that affect both the health and well-being of the employee and the organization. Not all stressors lead to strains, but all strains are a result of stressors, actual or perceived. Common terms often used interchangeably with work stress are occupational stress, job stress, and work-related stress. Terms used interchangeably with job stressors include work stressors, and as the specificity of the type of stressor might include psychosocial stressor (referring to the psychological experience of work demands that have a social component, e.g., conflict between two people; Hauke, Flintrop, Brun, & Rugulies, 2011 ), hindrance stressor (i.e., a stressor that prevents goal attainment; Cavanaugh, Boswell, Roehling, & Boudreau, 2000 ), and challenge stressor (i.e., a stressor that is difficult, but attainable and possibly rewarding to attain; Cavanaugh et al., 2000 ).

Stress in the workplace continues to be a highly pervasive problem, having both direct negative effects on individuals experiencing it and companies paying for it, and indirect costs vis à vis lost productivity (Dopkeen & DuBois, 2014 ). For example, U.K. public civil servants’ work-related stress rose from 10.8% in 2006 to 22.4% in 2013 and about one-third of the workforce has taken more than 20 days of leave due to stress-related ill-health, while well over 50% are present at work when ill (French, 2015 ). These findings are consistent with a report by the International Labor Organization (ILO, 2012 ), whereby 50% to 60% of all workdays are lost due to absence attributed to factors associated with work stress.

The prevalence of work-related stress is not diminishing despite improvements in technology and employment rates. The sources of stress, such as workload, seem to exacerbate with improvements in technology (Coovert & Thompson, 2003 ). Moreover, accessibility through mobile technology and virtual computer terminals is linking people to their work more than ever before (ILO, 2012 ; Tarafdar, Tu, Ragu-Nathan, & Ragu-Nathan, 2007 ). Evidence of this kind of mobility and flexibility is further reinforced in a June 2007 survey of 4,025 email users (over 13 years of age); AOL reported that four in ten survey respondents reported planning their vacations around email accessibility and 83% checked their emails at least once a day while away (McMahon, 2007 ). Ironically, despite these mounting work-related stressors and clear financial and performance outcomes, some individuals are reporting they are less “stressed,” but only because “stress has become the new normal” (Jayson, 2012 , para. 4).

This new normal is likely the source of psychological and physiological illness. Siegrist ( 2010 ) contends that conditions in the workplace, particularly psychosocial stressors that are perceived as unfavorable relationships with others and self, and an increasingly sedentary lifestyle (reinforced with desk jobs) are increasingly contributing to cardiovascular disease. These factors together justify a need to continue on the path of helping individuals recognize and cope with deleterious stressors in the work environment and, equally important, to find ways to help organizations prevent harmful stressors over which they have control, as well as implement policies or mechanisms to help employees deal with these stressors and subsequent strains. Along with a greater focus on mitigating environmental constraints are interventions that can be used to prevent anxiety, poor attitudes toward the workplace conditions and arrangements, and subsequent cardiovascular illness, absenteeism, and poor job performance (Siegrist, 2010 ).

Even the ILO has presented guidance on how the workplace can help prevent harmful job stressors (aka hindrance stressors) or at least help workers cope with them. Consistent with the view that well-being is not the absence of stressors or strains and with the view that positive psychology offers a lens for proactively preventing stressors, the ILO promotes increasing preventative risk assessments, interventions to prevent and control stressors, transparent organizational communication, worker involvement in decision-making, networks and mechanisms for workplace social support, awareness of how working and living conditions interact, safety, health, and well-being in the organization (ILO, n.d. ). The field of industrial and organizational (IO) psychology supports the ILO’s recommendations.

IO psychology views work stress as the process of a person’s interaction with multiple aspects of the work environment, job design, and work conditions in the organization. Interventions to manage work stress, therefore, focus on the psychosocial factors of the person and his or her relationships with others and the socio-technical factors related to the work environment and work processes. Viewing work stress from the lens of the person and the environment stems from Kurt Lewin’s ( 1936 ) work that stipulates a person’s state of mental health and behaviors are a function of the person within a specific environment or situation. Aspects of the work environment that affect individuals’ mental states and behaviors include organizational hierarchy, organizational climate (including processes, policies, practices, and reward structures), resources to support a person’s ability to fulfill job duties, and management structure (including leadership). Job design refers to each contributor’s tasks and responsibilities for fulfilling goals associated with the work role. Finally, working conditions refers not only to the physical environment, but also the interpersonal relationships with other contributors.

Each of the conditions that are identified in the work environment may be perceived as potentially harmful or a threat to the person or as an opportunity. When a stressor is perceived as a threat to attaining desired goals or outcomes, the stressor may be labeled as a hindrance stressor (e.g., LePine, Podsakoff, & Lepine, 2005 ). When the stressor is perceived as an opportunity to attain a desired goal or end state, it may be labeled as a challenge stressor. According to LePine and colleagues’ ( 2005 ), both challenge (e.g., time urgency, workload) and hindrance (e.g., hassles, role ambiguity, role conflict) stressors could lead to strains (as measured by “anxiety, depersonalization, depression, emotional exhaustion, frustration, health complaints, hostility, illness, physical symptoms, and tension” [p. 767]). However, challenge stressors positively relate with motivation and performance, whereas hindrance stressors negatively relate with motivation and performance. Moreover, motivation and strains partially mediate the relationship between hindrance and challenge stressors with performance.

Figure 1. Organizational development frameworks to guide identification of work stress and interventions.

In order to (1) minimize any potential negative effects from stressors, (2) increase coping skills to deal with stressors, or (3) manage strains, organizational practitioners or consultants will devise organizational interventions geared toward prevention, coping, and/or stress management. Ultimately, toxic factors in the work environment can have deleterious effects on a person’s physical and psychological well-being, as well as on an organization’s total health. It behooves management to take stock of the organization’s health, which includes the health and well-being of its employees, if the organization wishes to thrive and be profitable. According to Page and Vella-Brodrick’s ( 2009 ) model of employee well-being, employee well-being results from subjective well-being (i.e., life satisfaction and general positive or negative affect), workplace well-being (composed of job satisfaction and work-specific positive or negative affect), and psychological well-being (e.g., self-acceptance, positive social relations, mastery, purpose in life). Job stressors that become unbearable are likely to negatively affect workplace well-being and thus overall employee well-being. Because work stress is a major organizational pain point and organizations often employ organizational consultants to help identify and remediate pain points, the focus here is on organizational development (OD) frameworks; several work stress frameworks are presented that together signal areas where organizations might focus efforts for change in employee behaviors, attitudes, and performance, as well as the organization’s performance and climate. Work stress, interventions, and several OD and stress frameworks are depicted in Figure 1 .

The goals are: (1) to conceptually define and clarify terms associated with stress and stress management, particularly focusing on organizational factors that contribute to stress and stress management, and (2) to present research that informs current knowledge and practices on workplace stress management strategies. Stressors and strains will be defined, leading OD and work stress frameworks that are used to organize and help organizations make sense of the work environment and the organization’s responsibility in stress management will be explored, and stress management will be explained as an overarching thematic label; an area of study and practice that focuses on prevention (primary) interventions, coping (secondary) interventions, and managing strains (tertiary) interventions; as well as the label typically used to denote tertiary interventions. Suggestions for future research and implications toward becoming a healthy organization are presented.

Defining Stressors and Strains

Work-related stressors or job stressors can lead to different kinds of strains individuals and organizations might experience. Various types of stress management interventions, guided by OD and work stress frameworks, may be employed to prevent or cope with job stressors and manage strains that develop(ed).

A job stressor is a stimulus external to an employee and a result of an employee’s work conditions. Example job stressors include organizational constraints, workplace mistreatments (such as abusive supervision, workplace ostracism, incivility, bullying), role stressors, workload, work-family conflicts, errors or mistakes, examinations and evaluations, and lack of structure (Jex & Beehr, 1991 ; Liu, Spector, & Shi, 2007 ; Narayanan, Menon, & Spector, 1999 ). Although stressors may be categorized as hindrances and challenges, there is not yet sufficient information to be able to propose which stress management interventions would better serve to reduce those hindrance stressors or to reduce strain-producing challenge stressors while reinforcing engagement-producing challenge stressors.

Organizational Constraints

Organizational constraints may be hindrance stressors as they prevent employees from translating their motivation and ability into high-level job performance (Peters & O’Connor, 1980 ). Peters and O’Connor ( 1988 ) defined 11 categories of organizational constraints: (1) job-related information, (2) budgetary support, (3) required support, (4) materials and supplies, (5) required services and help from others, (6) task preparation, (7) time availability, (8) the work environment, (9) scheduling of activities, (10) transportation, and (11) job-relevant authority. The inhibiting effect of organizational constraints may be due to the lack of, inadequacy of, or poor quality of these categories.

Workplace Mistreatment

Workplace mistreatment presents a cluster of interpersonal variables, such as interpersonal conflict, bullying, incivility, and workplace ostracism (Hershcovis, 2011 ; Tepper & Henle, 2011 ). Typical workplace mistreatment behaviors include gossiping, rude comments, showing favoritism, yelling, lying, and ignoring other people at work (Tepper & Henle, 2011 ). These variables relate to employees’ psychological well-being, physical well-being, work attitudes (e.g., job satisfaction and organizational commitment), and turnover intention (e.g., Hershcovis, 2011 ; Spector & Jex, 1998 ). Some researchers differentiated the source of mistreatment, such as mistreatment from one’s supervisor versus mistreatment from one’s coworker (e.g., Bruk-Lee & Spector, 2006 ; Frone, 2000 ; Liu, Liu, Spector, & Shi, 2011 ).

Role Stressors

Role stressors are demands, constraints, or opportunities a person perceives to be associated, and thus expected, with his or her work role(s) across various situations. Three commonly studied role stressors are role ambiguity, role conflict, and role overload (Glazer & Beehr, 2005 ; Kahn, Wolfe, Quinn, Snoek, & Rosenthal, 1964 ). Role ambiguity in the workplace occurs when an employee lacks clarity regarding what performance-related behaviors are expected of him or her. Role conflict refers to situations wherein an employee receives incompatible role requests from the same or different supervisors or the employee is asked to engage in work that impedes his or her performance in other work or nonwork roles or clashes with his or her values. Role overload refers to excessive demands and insufficient time (quantitative) or knowledge (qualitative) to complete the work. The construct is often used interchangeably with workload, though role overload focuses more on perceived expectations from others about one’s workload. These role stressors significantly relate to low job satisfaction, low organizational commitment, low job performance, high tension or anxiety, and high turnover intention (Abramis, 1994 ; Glazer & Beehr, 2005 ; Jackson & Schuler, 1985 ).

Excessive workload is one of the most salient stressors at work (e.g., Liu et al., 2007 ). There are two types of workload: quantitative and qualitative workload (LaRocco, Tetrick, & Meder, 1989 ; Parasuraman & Purohit, 2000 ). Quantitative workload refers to the excessive amount of work one has. In a summary of a Chartered Institute of Personnel & Development Report from 2006 , Dewe and Kompier ( 2008 ) noted that quantitative workload was one of the top three stressors workers experienced at work. Qualitative workload refers to the difficulty of work. Workload also differs by the type of the load. There are mental workload and physical workload (Dwyer & Ganster, 1991 ). Excessive physical workload may result in physical discomfort or illness. Excessive mental workload will cause psychological distress such as anxiety or frustration (Bowling & Kirkendall, 2012 ). Another factor affecting quantitative workload is interruptions (during the workday). Lin, Kain, and Fritz ( 2013 ) found that interruptions delay completion of job tasks, thus adding to the perception of workload.

Work-Family Conflict

Work-family conflict is a form of inter-role conflict in which demands from one’s work domain and one’s family domain are incompatible to some extent (Greenhaus & Beutell, 1985 ). Work can interfere with family (WIF) and/or family can interfere with work (FIW) due to time-related commitments to participating in one domain or another, incompatible behavioral expectations, or when strains in one domain carry over to the other (Greenhaus & Beutell, 1985 ). Work-family conflict significantly relates to work-related outcomes (e.g., job satisfaction, organizational commitment, turnover intention, burnout, absenteeism, job performance, job strains, career satisfaction, and organizational citizenship behaviors), family-related outcomes (e.g., marital satisfaction, family satisfaction, family-related performance, family-related strains), and domain-unspecific outcomes (e.g., life satisfaction, psychological strain, somatic or physical symptoms, depression, substance use or abuse, and anxiety; Amstad, Meier, Fasel, Elfering, & Semmer, 2011 ).

Individuals and organizations can experience work-related strains. Sometimes organizations will experience strains through the employee’s negative attitudes or strains, such as that a worker’s absence might yield lower production rates, which would roll up into an organizational metric of organizational performance. In the industrial and organizational (IO) psychology literature, organizational strains are mostly observed as macro-level indicators, such as health insurance costs, accident-free days, and pervasive problems with company morale. In contrast, individual strains, usually referred to as job strains, are internal to an employee. They are responses to work conditions and relate to health and well-being of employees. In other words, “job strains are adverse reactions employees have to job stressors” (Spector, Chen, & O’Connell, 2000 , p. 211). Job strains tend to fall into three categories: behavioral, physical, and psychological (Jex & Beehr, 1991 ).

Behavioral strains consist of actions that employees take in response to job stressors. Examples of behavioral strains include employees drinking alcohol in the workplace or intentionally calling in sick when they are not ill (Spector et al., 2000 ). Physical strains consist of health symptoms that are physiological in nature that employees contract in response to job stressors. Headaches and ulcers are examples of physical strains. Lastly, psychological strains are emotional reactions and attitudes that employees have in response to job stressors. Examples of psychological strains are job dissatisfaction, anxiety, and frustration (Spector et al., 2000 ). Interestingly, research studies that utilize self-report measures find that most job strains experienced by employees tend to be psychological strains (Spector et al., 2000 ).

Leading Frameworks

Organizations that are keen on identifying organizational pain points and remedying them through organizational campaigns or initiatives often discover the pain points are rooted in work-related stressors and strains and the initiatives have to focus on reducing workers’ stress and increasing a company’s profitability. Through organizational climate surveys, for example, companies discover that aspects of the organization’s environment, including its policies, practices, reward structures, procedures, and processes, as well as employees at all levels of the company, are contributing to the individual and organizational stress. Recent studies have even begun to examine team climates for eustress and distress assessed in terms of team members’ homogenous psychological experience of vigor, efficacy, dedication, and cynicism (e.g., Kożusznik, Rodriguez, & Peiro, 2015 ).

Each of the frameworks presented advances different aspects that need to be identified in order to understand the source and potential remedy for stressors and strains. In some models, the focus is on resources, in others on the interaction of the person and environment, and in still others on the role of the person in the workplace. Few frameworks directly examine the role of the organization, but the organization could use these frameworks to plan interventions that would minimize stressors, cope with existing stressors, and prevent and/or manage strains. One of the leading frameworks in work stress research that is used to guide organizational interventions is the person and environment (P-E) fit (French & Caplan, 1972 ). Its precursor is the University of Michigan Institute for Social Research’s (ISR) role stress model (Kahn, Wolfe, Quinn, Snoek, & Rosenthal, 1964 ) and Lewin’s Field Theory. Several other theories have since evolved from the P-E fit framework, including Karasek and Theorell’s ( 1990 ), Karasek ( 1979 ) Job Demands-Control Model (JD-C), the transactional framework (Lazarus & Folkman, 1984 ), Conservation of Resources (COR) theory (Hobfoll, 1989 ), and Siegrist’s ( 1996 ) Effort-Reward Imbalance (ERI) Model.

Field Theory

The premise of Kahn et al.’s ( 1964 ) role stress theory is Lewin’s ( 1997 ) Field Theory. Lewin purported that behavior and mental events are a dynamic function of the whole person, including a person’s beliefs, values, abilities, needs, thoughts, and feelings, within a given situation (field or environment), as well as the way a person represents his or her understanding of the field and behaves in that space. Lewin explains that work-related strains are a result of individuals’ subjective perceptions of objective factors, such as work roles, relationships with others in the workplace, as well as personality indicators, and can be used to predict people’s reactions, including illness. Thus, to make changes to an organizational system, it is necessary to understand a field and try to move that field from the current state to the desired state. Making this move necessitates identifying mechanisms influencing individuals.

Role Stress Theory

Role stress theory mostly isolates the perspective a person has about his or her work-related responsibilities and expectations to determine how those perceptions relate with a person’s work-related strains. However, those relationships have been met with somewhat varied results, which Glazer and Beehr ( 2005 ) concluded might be a function of differences in culture, an environmental factor often neglected in research. Kahn et al.’s ( 1964 ) role stress theory, coupled with Lewin’s ( 1936 ) Field Theory, serves as the foundation for the P-E fit theory. Lewin ( 1936 ) wrote, “Every psychological event depends upon the state of the person and at the same time on the environment” (p. 12). Researchers of IO psychology have narrowed the environment to the organization or work team. This narrowed view of the organizational environment is evident in French and Caplan’s ( 1972 ) P-E fit framework.

Person-Environment Fit Theory

The P-E fit framework focuses on the extent to which there is congruence between the person and a given environment, such as the organization (Caplan, 1987 ; Edwards, 2008 ). For example, does the person have the necessary skills and abilities to fulfill an organization’s demands, or does the environment support a person’s desire for autonomy (i.e., do the values align?) or fulfill a person’s needs (i.e., a person’s needs are rewarded). Theoretically and empirically, the greater the person-organization fit, the greater a person’s job satisfaction and organizational commitment, the less a person’s turnover intention and work-related stress (see meta-analyses by Assouline & Meir, 1987 ; Kristof-Brown, Zimmerman, & Johnson, 2005 ; Verquer, Beehr, & Wagner, 2003 ).

Job Demands-Control/Support (JD-C/S) and Job Demands-Resources (JD-R) Model

Focusing more closely on concrete aspects of work demands and the extent to which a person perceives he or she has control or decision latitude over those demands, Karasek ( 1979 ) developed the JD-C model. Karasek and Theorell ( 1990 ) posited that high job demands under conditions of little decision latitude or control yield high strains, which have varied implications on the health of an organization (e.g., in terms of high turnover, employee ill-health, poor organizational performance). This theory was modified slightly to address not only control, but also other resources that could protect a person from unruly job demands, including support (aka JD-C/S, Johnson & Hall, 1988 ; and JD-R, Bakker, van Veldhoven, & Xanthopoulou, 2010 ). Whether focusing on control or resources, both they and job demands are said to reflect workplace characteristics, while control and resources also represent coping strategies or tools (Siegrist, 2010 ).

Despite the glut of research testing the JD-C and JD-R, results are somewhat mixed. Testing the interaction between job demands and control, Beehr, Glaser, Canali, and Wallwey ( 2001 ) did not find empirical support for the JD-C theory. However, Dawson, O’Brien, and Beehr ( 2016 ) found that high control and high support buffered against the independent deleterious effects of interpersonal conflict, role conflict, and organizational politics (demands that were categorized as hindrance stressors) on anxiety, as well as the effects of interpersonal conflict and organizational politics on physiological symptoms, but control and support did not moderate the effects between challenge stressors and strains. Coupled with Bakker, Demerouti, and Sanz-Vergel’s ( 2014 ) note that excessive job demands are a source of strain, but increased job resources are a source of engagement, Dawson et al.’s results suggest that when an organization identifies that demands are hindrances, it can create strategies for primary (preventative) stress management interventions and attempt to remove or reduce such work demands. If the demands are challenging, though manageable, but latitude to control the challenging stressors and support are insufficient, the organization could modify practices and train employees on adopting better strategies for meeting or coping (secondary stress management intervention) with the demands. Finally, if the organization can neither afford to modify the demands or the level of control and support, it will be necessary for the organization to develop stress management (tertiary) interventions to deal with the inevitable strains.

Conservation of Resources Theory

The idea that job resources reinforce engagement in work has been propagated in Hobfoll’s ( 1989 ) Conservation of Resources (COR) theory. COR theory also draws on the foundational premise that people’s mental health is a function of the person and the environment, forwarding that how people interpret their environment (including the societal context) affects their stress levels. Hobfoll focuses on resources such as objects, personal characteristics, conditions, or energies as particularly instrumental to minimizing strains. He asserts that people do whatever they can to protect their valued resources. Thus, strains develop when resources are threatened to be taken away, actually taken away, or when additional resources are not attainable after investing in the possibility of gaining more resources (Hobfoll, 2001 ). By extension, organizations can invest in activities that would minimize resource loss and create opportunities for resource gains and thus have direct implications for devising primary and secondary stress management interventions.

Transactional Framework

Lazarus and Folkman ( 1984 ) developed the widely studied transactional framework of stress. This framework holds as a key component the cognitive appraisal process. When individuals perceive factors in the work environment as a threat (i.e., primary appraisal), they will scan the available resources (external or internal to himself or herself) to cope with the stressors (i.e., secondary appraisal). If the coping resources provide minimal relief, strains develop. Until recently, little attention has been given to the cognitive appraisal associated with different work stressors (Dewe & Kompier, 2008 ; Liu & Li, 2017 ). In a study of Polish and Spanish social care service providers, stressors appraised as a threat related positively to burnout and less engagement, but stressors perceived as challenges yielded greater engagement and less burnout (Kożusznik, Rodriguez, & Peiro, 2012 ). Similarly, Dawson et al. ( 2016 ) found that even with support and control resources, hindrance demands were more strain-producing than challenge demands, suggesting that appraisal of the stressor is important. In fact, “many people respond well to challenging work” (Beehr et al., 2001 , p. 126). Kożusznik et al. ( 2012 ) recommend training employees to change the way they view work demands in order to increase engagement, considering that part of the problem may be about how the person appraises his or her environment and, thus, copes with the stressors.

Effort-Reward Imbalance

Siegrist’s ( 1996 ) Model of Effort-Reward Imbalance (ERI) focuses on the notion of social reciprocity, such that a person fulfills required work tasks in exchange for desired rewards (Siegrist, 2010 ). ERI sheds light on how an imbalance in a person’s expectations of an organization’s rewards (e.g., pay, bonus, sense of advancement and development, job security) in exchange for a person’s efforts, that is a break in one’s work contract, leads to negative responses, including long-term ill-health (Siegrist, 2010 ; Siegrist et al., 2014 ). In fact, prolonged perception of a work contract imbalance leads to adverse health, including immunological problems and inflammation, which contribute to cardiovascular disease (Siegrist, 2010 ). The model resembles the relational and interactional psychological contract theory in that it describes an employee’s perception of the terms of the relationship between the person and the workplace, including expectations of performance, job security, training and development opportunities, career progression, salary, and bonuses (Thomas, Au, & Ravlin, 2003 ). The psychological contract, like the ERI model, focuses on social exchange. Furthermore, the psychological contract, like stress theories, are influenced by cultural factors that shape how people interpret their environments (Glazer, 2008 ; Thomas et al., 2003 ). Violations of the psychological contract will negatively affect a person’s attitudes toward the workplace and subsequent health and well-being (Siegrist, 2010 ). To remediate strain, Siegrist ( 2010 ) focuses on both the person and the environment, recognizing that the organization is particularly responsible for changing unfavorable work conditions and the person is responsible for modifying his or her reactions to such conditions.

Stress Management Interventions: Primary, Secondary, and Tertiary

Remediation of work stress and organizational development interventions are about realigning the employee’s experiences in the workplace with factors in the environment, as well as closing the gap between the current environment and the desired environment. Work stress develops when an employee perceives the work demands to exceed the person’s resources to cope and thus threatens employee well-being (Dewe & Kompier, 2008 ). Likewise, an organization’s need to change arises when forces in the environment are creating a need to change in order to survive (see Figure 1 ). Lewin’s ( 1951 ) Force Field Analysis, the foundations of which are in Field Theory, is one of the first organizational development intervention tools presented in the social science literature. The concept behind Force Field Analysis is that in order to survive, organizations must adapt to environmental forces driving a need for organizational change and remove restraining forces that create obstacles to organizational change. In order to do this, management needs to delineate the current field in which the organization is functioning, understand the driving forces for change, identify and dampen or eliminate the restraining forces against change. Several models for analyses may be applied, but most approaches are variations of organizational climate surveys.

Through organizational surveys, workers provide management with a snapshot view of how they perceive aspects of their work environment. Thus, the view of the health of an organization is a function of several factors, chief among them employees’ views (i.e., the climate) about the workplace (Lewin, 1951 ). Indeed, French and Kahn ( 1962 ) posited that well-being depends on the extent to which properties of the person and properties of the environment align in terms of what a person requires and the resources available in a given environment. Therefore, only when properties of the person and properties of the environment are sufficiently understood can plans for change be developed and implemented targeting the environment (e.g., change reporting structures to relieve, and thus prevent future, communication stressors) and/or the person (e.g., providing more autonomy, vacation days, training on new technology). In short, climate survey findings can guide consultants about the emphasis for organizational interventions: before a problem arises aka stress prevention, e.g., carefully crafting job roles), when a problem is present, but steps are taken to mitigate their consequences (aka coping, e.g., providing social support groups), and/or once strains develop (aka. stress management, e.g., healthcare management policies).

For each of the primary (prevention), secondary (coping), and tertiary (stress management) techniques the target for intervention can be the entire workforce, a subset of the workforce, or a specific person. Interventions that target the entire workforce may be considered organizational interventions, as they have direct implications on the health of all individuals and consequently the health of the organization. Several interventions categorized as primary and secondary interventions may also be implemented after strains have developed and after it has been discerned that a person or the organization did not do enough to mitigate stressors or strains (see Figure 1 ). The designation of many of the interventions as belonging to one category or another may be viewed as merely a suggestion.

Primary Interventions (Preventative Stress Management)

Before individuals begin to perceive work-related stressors, organizations engage in stress prevention strategies, such as providing people with resources (e.g., computers, printers, desk space, information about the job role, organizational reporting structures) to do their jobs. However, sometimes the institutional structures and resources are insufficient or ambiguous. Scholars and practitioners have identified several preventative stress management strategies that may be implemented.

Planning and Time Management

When employees feel quantitatively overloaded, sometimes the remedy is improving the employees’ abilities to plan and manage their time (Quick, Quick, Nelson, & Hurrell, 2003 ). Planning is a future-oriented activity that focuses on conceptual and comprehensive work goals. Time management is a behavior that focuses on organizing, prioritizing, and scheduling work activities to achieve short-term goals. Given the purpose of time management, it is considered a primary intervention, as engaging in time management helps to prevent work tasks from mounting and becoming unmanageable, which would subsequently lead to adverse outcomes. Time management comprises three fundamental components: (1) establishing goals, (2) identifying and prioritizing tasks to fulfill the goals, and (3) scheduling and monitoring progress toward goal achievement (Peeters & Rutte, 2005 ). Workers who employ time management have less role ambiguity (Macan, Shahani, Dipboye, & Philips, 1990 ), psychological stress or strain (Adams & Jex, 1999 ; Jex & Elaqua, 1999 ; Macan et al., 1990 ), and greater job satisfaction (Macan, 1994 ). However, Macan ( 1994 ) did not find a relationship between time management and performance. Still, Claessens, van Eerde, Rutte, and Roe ( 2004 ) found that perceived control of time partially mediated the relationships between planning behavior (an indicator of time management), job autonomy, and workload on one hand, and job strains, job satisfaction, and job performance on the other hand. Moreover, Peeters and Rutte ( 2005 ) observed that teachers with high work demands and low autonomy experienced more burnout when they had poor time management skills.

Person-Organization Fit

Just as it is important for organizations to find the right person for the job and organization, so is it the responsibility of a person to choose to work at the right organization—an organization that fulfills the person’s needs and upholds the values important to the individual, as much as the person fulfills the organization’s needs and adapts to its values. When people fit their employing organizations they are setting themselves up for experiencing less strain-producing stressors (Kristof-Brown et al., 2005 ). In a meta-analysis of 62 person-job fit studies and 110 person-organization fit studies, Kristof-Brown et al. ( 2005 ) found that person-job fit had a negative correlation with indicators of job strain. In fact, a primary intervention of career counseling can help to reduce stress levels (Firth-Cozens, 2003 ).

Job Redesign

The Job Demands-Control/Support (JD-C/S), Job Demands-Resources (JD-R), and transactional models all suggest that factors in the work context require modifications in order to reduce potential ill-health and poor organizational performance. Drawing on Hackman and Oldham’s ( 1980 ) Job Characteristics Model, it is possible to assess with the Job Diagnostics Survey (JDS) the current state of work characteristics related to skill variety, task identity, task significance, autonomy, and feedback. Modifying those aspects would help create a sense of meaningfulness, sense of responsibility, and feeling of knowing how one is performing, which subsequently affects a person’s well-being as identified in assessments of motivation, satisfaction, improved performance, and reduced withdrawal intentions and behaviors. Extending this argument to the stress models, it can be deduced that reducing uncertainty or perceived unfairness that may be associated with a person’s perception of these work characteristics, as well as making changes to physical characteristics of the environment (e.g., lighting, seating, desk, air quality), nature of work (e.g., job responsibilities, roles, decision-making latitude), and organizational arrangements (e.g., reporting structure and feedback mechanisms), can help mitigate against numerous ill-health consequences and reduced organizational performance. In fact, Fried et al. ( 2013 ) showed that healthy patients of a medical clinic whose jobs were excessively low (i.e., monotonous) or excessively high (i.e., overstimulating) on job enrichment (as measured by the JDS) had greater abdominal obesity than those whose jobs were optimally enriched. By taking stock of employees’ perceptions of the current work situation, managers might think about ways to enhance employees’ coping toolkit, such as training on how to deal with difficult clients or creating stimulating opportunities when jobs have low levels of enrichment.

Participatory Action Research Interventions

Participatory action research (PAR) is an intervention wherein, through group discussions, employees help to identify and define problems in organizational structure, processes, policies, practices, and reward structures, as well as help to design, implement, and evaluate success of solutions. PAR is in itself an intervention, but its goal is to design interventions to eliminate or reduce work-related factors that are impeding performance and causing people to be unwell. An example of a successful primary intervention, utilizing principles of PAR and driven by the JD-C and JD-C/S stress frameworks is Health Circles (HCs; Aust & Ducki, 2004 ).

HCs, developed in Germany in the 1980s, were popular practices in industries, such as metal, steel, and chemical, and service. Similar to other problem-solving practices, such as quality circles, HCs were based on the assumptions that employees are the experts of their jobs. For this reason, to promote employee well-being, management and administrators solicited suggestions and ideas from the employees to improve occupational health, thereby increasing employees’ job control. HCs also promoted communication between managers and employees, which had a potential to increase social support. With more control and support, employees would experience less strains and better occupational well-being.

Employing the three-steps of (1) problem analysis (i.e., diagnosis or discovery through data generated from organizational records of absenteeism length, frequency, rate, and reason and employee survey), (2) HC meetings (6 to 10 meetings held over several months to brainstorm ideas to improve occupational safety and health concerns identified in the discovery phase), and (3) HC evaluation (to determine if desired changes were accomplished and if employees’ reports of stressors and strains changed after the course of 15 months), improvements were to be expected (Aust & Ducki, 2004 ). Aust and Ducki ( 2004 ) reviewed 11 studies presenting 81 health circles in 30 different organizations. Overall study participants had high satisfaction with the HCs practices. Most companies acted upon employees’ suggestions (e.g., improving driver’s seat and cab, reducing ticket sale during drive, team restructuring and job rotation to facilitate communication, hiring more employees during summer time, and supervisor training program to improve leadership and communication skills) to improve work conditions. Thus, HCs represent a successful theory-grounded intervention to routinely improve employees’ occupational health.

Physical Setting

The physical environment or physical workspace has an enormous impact on individuals’ well-being, attitudes, and interactions with others, as well as on the implications on innovation and well-being (Oksanen & Ståhle, 2013 ; Vischer, 2007 ). In a study of 74 new product development teams (total of 437 study respondents) in Western Europe, Chong, van Eerde, Rutte, and Chai ( 2012 ) found that when teams were faced with challenge time pressures, meaning the teams had a strong interest and desire in tackling complex, but engaging tasks, when they were working proximally close with one another, team communication improved. Chong et al. assert that their finding aligns with prior studies that have shown that physical proximity promotes increased awareness of other team members, greater tendency to initiate conversations, and greater team identification. However, they also found that when faced with hindrance time pressures, physical proximity related to low levels of team communication, but when hindrance time pressure was low, team proximity had an increasingly greater positive relationship with team communication.

In addition to considering the type of work demand teams must address, other physical workspace considerations include whether people need to work collaboratively and synchronously or independently and remotely (or a combination thereof). Consideration needs to be given to how company contributors would satisfy client needs through various modes of communication, such as email vs. telephone, and whether individuals who work by a window might need shading to block bright sunlight from glaring on their computer screens. Finally, people who have to use the telephone for extensive periods of time would benefit from earphones to prevent neck strains. Most physical stressors are rather simple to rectify. However, companies are often not aware of a problem until after a problem arises, such as when a person’s back is strained from trying to move heavy equipment. Companies then implement strategies to remediate the environmental stressor. With the help of human factors, and organizational and office design consultants, many of the physical barriers to optimal performance can be prevented (Rousseau & Aubé, 2010 ). In a study of 215 French-speaking Canadian healthcare employees, Rousseau and Aubé ( 2010 ) found that although supervisor instrumental support positively related with affective commitment to the organization, the relationship was even stronger for those who reported satisfaction with the ambient environment (i.e., temperature, lighting, sound, ventilation, and cleanliness).

Secondary Interventions (Coping)

Secondary interventions, also referred to as coping, focus on resources people can use to mitigate the risk of work-related illness or workplace injury. Resources may include properties related to social resources, behaviors, and cognitive structures. Each of these resource domains may be employed to cope with stressors. Monat and Lazarus ( 1991 ) summarize the definition of coping as “an individual’s efforts to master demands (or conditions of harm, threat, or challenge) that are appraised (or perceived) as exceeding or taxing his or her resources” (p. 5). To master demands requires use of the aforementioned resources. Secondary interventions help employees become aware of the psychological, physical, and behavioral responses that may occur from the stressors presented in their working environment. Secondary interventions help a person detect and attend to stressors and identify resources for and ways of mitigating job strains. Often, coping strategies are learned skills that have a cognitive foundation and serve important functions in improving people’s management of stressors (Lazarus & Folkman, 1991 ). Coping is effortful, but with practice it becomes easier to employ. This idea is the foundation for understanding the role of resilience in coping with stressors. However, “not all adaptive processes are coping. Coping is a subset of adaptational activities that involves effort and does not include everything that we do in relating to the environment” (Lazarus & Folkman, 1991 , p. 198). Furthermore, sometimes to cope with a stressor, a person may call upon social support sources to help with tangible materials or emotional comfort. People call upon support resources because they help to restructure how a person approaches or thinks about the stressor.

Most secondary interventions are aimed at helping the individual, though companies, as a policy, might require all employees to partake in training aimed at increasing employees’ awareness of and skills aimed at handling difficult situations vis à vis company channels (e.g., reporting on sexual harassment or discrimination). Furthermore, organizations might institute mentoring programs or work groups to address various work-related matters. These programs employ awareness-raising activities, stress-education, or skills training (cf., Bhagat, Segovis, & Nelson, 2012 ), which include development of skills in problem-solving, understanding emotion-focused coping, identifying and using social support, and enhancing capacity for resilience. The aim of these programs, therefore, is to help employees proactively review their perceptions of psychological, physical, and behavioral job-related strains, thereby extending their resilience, enabling them to form a personal plan to control stressors and practice coping skills (Cooper, Dewe, & O’Driscoll, 2011 ).

Often these stress management programs are instituted after an organization has observed excessive absenteeism and work-related performance problems and, therefore, are sometimes categorized as a tertiary stress management intervention or even a primary (prevention) intervention. However, the skills developed for coping with stressors also place the programs in secondary stress management interventions. Example programs that are categorized as tertiary or primary stress management interventions may also be secondary stress management interventions (see Figure 1 ), and these include lifestyle advice and planning, stress inoculation training, simple relaxation techniques, meditation, basic trainings in time management, anger management, problem-solving skills, and cognitive-behavioral therapy. Corporate wellness programs also fall under this category. In other words, some programs could be categorized as primary, secondary, or tertiary interventions depending upon when the employee (or organization) identifies the need to implement the program. For example, time management practices could be implemented as a means of preventing some stressors, as a way to cope with mounting stressors, or as a strategy to mitigate symptoms of excessive of stressors. Furthermore, these programs can be administered at the individual level or group level. As related to secondary interventions, these programs provide participants with opportunities to develop and practice skills to cognitively reappraise the stressor(s); to modify their perspectives about stressors; to take time out to breathe, stretch, meditate, relax, and/or exercise in an attempt to support better decision-making; to articulate concerns and call upon support resources; and to know how to say “no” to onslaughts of requests to complete tasks. Participants also learn how to proactively identify coping resources and solve problems.

According to Cooper, Dewe, and O’Driscoll ( 2001 ), secondary interventions are successful in helping employees modify or strengthen their ability to cope with the experience of stressors with the goal of mitigating the potential harm the job stressors may create. Secondary interventions focus on individuals’ transactions with the work environment and emphasize the fit between a person and his or her environment. However, researchers have pointed out that the underlying assumption of secondary interventions is that the responsibility for coping with the stressors of the environment lies within individuals (Quillian-Wolever & Wolever, 2003 ). If companies cannot prevent the stressors in the first place, then they are, in part, responsible for helping individuals develop coping strategies and informing employees about programs that would help them better cope with job stressors so that they are able to fulfill work assignments.

Stress management interventions that help people learn to cope with stressors focus mainly on the goals of enabling problem-resolution or expressing one’s emotions in a healthy manner. These goals are referred to as problem-focused coping and emotion-focused coping (Folkman & Lazarus, 1980 ; Pearlin & Schooler, 1978 ), and the person experiencing the stressors as potential threat is the agent for change and the recipient of the benefits of successful coping (Hobfoll, 1998 ). In addition to problem-focused and emotion-focused coping approaches, social support and resilience may be coping resources. There are many other sources for coping than there is room to present here (see e.g., Cartwright & Cooper, 2005 ); however, the current literature has primarily focused on these resources.

Problem-Focused Coping

Problem-focused or direct coping helps employees remove or reduce stressors in order to reduce their strain experiences (Bhagat et al., 2012 ). In problem-focused coping employees are responsible for working out a strategic plan in order to remove job stressors, such as setting up a set of goals and engaging in behaviors to meet these goals. Problem-focused coping is viewed as an adaptive response, though it can also be maladaptive if it creates more problems down the road, such as procrastinating getting work done or feigning illness to take time off from work. Adaptive problem-focused coping negatively relates to long-term job strains (Higgins & Endler, 1995 ). Discussion on problem-solving coping is framed from an adaptive perspective.

Problem-focused coping is featured as an extension of control, because engaging in problem-focused coping strategies requires a series of acts to keep job stressors under control (Bhagat et al., 2012 ). In the stress literature, there are generally two ways to categorize control: internal versus external locus of control, and primary versus secondary control. Locus of control refers to the extent to which people believe they have control over their own life (Rotter, 1966 ). People high in internal locus of control believe that they can control their own fate whereas people high in external locus of control believe that outside factors determine their life experience (Rotter, 1966 ). Generally, those with an external locus of control are less inclined to engage in problem-focused coping (Strentz & Auerbach, 1988 ). Primary control is the belief that people can directly influence their environment (Alloy & Abramson, 1979 ), and thus they are more likely to engage in problem-focused coping. However, when it is not feasible to exercise primary control, people search for secondary control, with which people try to adapt themselves into the objective environment (Rothbaum, Weisz, & Snyder, 1982 ).

Emotion-Focused Coping

Emotion-focused coping, sometimes referred to as palliative coping, helps employees reduce strains without the removal of job stressors. It involves cognitive or emotional efforts, such as talking about the stressor or distracting oneself from the stressor, in order to lessen emotional distress resulting from job stressors (Bhagat et al., 2012 ). Emotion-focused coping aims to reappraise and modify the perceptions of a situation or seek emotional support from friends or family. These methods do not include efforts to change the work situation or to remove the job stressors (Lazarus & Folkman, 1991 ). People tend to adopt emotion-focused coping strategies when they believe that little or nothing can be done to remove the threatening, harmful, and challenging stressors (Bhagat et al., 2012 ), such as when they are the only individuals to have the skills to get a project done or they are given increased responsibilities because of the unexpected departure of a colleague. Emotion-focused coping strategies include (1) reappraisal of the stressful situation, (2) talking to friends and receiving reassurance from them, (3) focusing on one’s strength rather than weakness, (4) optimistic comparison—comparing one’s situation to others’ or one’s past situation, (5) selective ignoring—paying less attention to the unpleasant aspects of one’s job and being more focused on the positive aspects of the job, (6) restrictive expectations—restricting one’s expectations on job satisfaction but paying more attention to monetary rewards, (7) avoidance coping—not thinking about the problem, leaving the situation, distracting oneself, or using alcohol or drugs (e.g., Billings & Moos, 1981 ).

Some emotion-focused coping strategies are maladaptive. For example, avoidance coping may lead to increased level of job strains in the long run (e.g., Parasuraman & Cleek, 1984 ). Furthermore, a person’s ability to cope with the imbalance of performing work to meet organizational expectations can take a toll on the person’s health, leading to physiological consequences such as cardiovascular disease, sleep disorders, gastrointestinal disorders, and diabetes (Fried et al., 2013 ; Siegrist, 2010 ; Toker, Shirom, Melamed, & Armon, 2012 ; Willert, Thulstrup, Hertz, & Bonde, 2010 ).

Comparing Coping Strategies across Cultures

Most coping research is conducted in individualistic, Western cultures wherein emotional control is emphasized and both problem-solving focused coping and primary control are preferred (Bhagat et al., 2010 ). However, in collectivistic cultures, emotion-focused coping and use of secondary control may be preferred and may not necessarily carry a negative evaluation (Bhagat et al., 2010 ). For example, African Americans are more likely to use emotion-focused coping than non–African Americans (Knight, Silverstein, McCallum, & Fox, 2000 ), and among women who experienced sexual harassment, Anglo American women were less likely to employ emotion focused coping (i.e., avoidance coping) than Turkish women and Hispanic American women, while Hispanic women used more denial than the other two groups (Wasti & Cortina, 2002 ).

Thus, whereas problem-focused coping is venerated in Western societies, emotion-focused coping may be more effective in reducing strains in collectivistic cultures, such as China, Japan, and India (Bhagat et al., 2010 ; Narayanan, Menon, & Spector, 1999 ; Selmer, 2002 ). Indeed, Swedish participants reported more problem-focused coping than did Chinese participants (Xiao, Ottosson, & Carlsson, 2013 ), American college students engaged in more problem-focused coping behaviors than did their Japanese counterparts (Ogawa, 2009 ), and Indian (vs. Canadian) students reported more emotion-focused coping, such as seeking social support and positive reappraisal (Sinha, Willson, & Watson, 2000 ). Moreover, Glazer, Stetz, and Izso ( 2004 ) found that internal locus of control was more predominant in individualistic cultures (United Kingdom and United States), whereas external locus of control was more predominant in communal cultures (Italy and Hungary). Also, internal locus of control was associated with less job stress, but more so for nurses in the United Kingdom and United States than Italy and Hungary. Taken together, adoption of coping strategies and their effectiveness differ significantly across cultures. The extent to which a coping strategy is perceived favorably and thus selected or not selected is not only a function of culture, but also a person’s sociocultural beliefs toward the coping strategy (Morimoto, Shimada, & Ozaki, 2013 ).

Social Support

Social support refers to the aid an entity gives to a person. The source of the support can be a single person, such as a supervisor, coworker, subordinate, family member, friend, or stranger, or an organization as represented by upper-level management representing organizational practices. The type of support can be instrumental or emotional. Instrumental support, including informational support, refers to that which is tangible, such as data to help someone make a decision or colleagues’ sick days so one does not lose vital pay while recovering from illness. Emotional support, including esteem support, refers to the psychological boost given to a person who needs to express emotions and feel empathy from others or to have his or her perspective validated. Beehr and Glazer ( 2001 ) present an overview of the role of social support on the stressor-strain relationship and arguments regarding the role of culture in shaping the utility of different sources and types of support.

Meaningfulness and Resilience

Meaningfulness reflects the extent to which people believe their lives are significant, purposeful, goal-directed, and fulfilling (Glazer, Kożusznik, Meyers, & Ganai, 2014 ). When faced with stressors, people who have a strong sense of meaning in life will also try to make sense of the stressors. Maintaining a positive outlook on life stressors helps to manage emotions, which is helpful in reducing strains, particularly when some stressors cannot be problem-solved (Lazarus & Folkman, 1991 ). Lazarus and Folkman ( 1991 ) emphasize that being able to reframe threatening situations can be just as important in an adaptation as efforts to control the stressors. Having a sense of meaningfulness motivates people to behave in ways that help them overcome stressors. Thus, meaningfulness is often used in the same breath as resilience, because people who are resilient are often protecting that which is meaningful.

Resilience is a personality state that can be fortified and enhanced through varied experiences. People who perceive their lives are meaningful are more likely to find ways to face adversity and are therefore more prone to intensifying their resiliency. When people demonstrate resilience to cope with noxious stressors, their ability to be resilient against other stressors strengthens because through the experience, they develop more competencies (Glazer et al., 2014 ). Thus, fitting with Hobfoll’s ( 1989 , 2001 ) COR theory, meaningfulness and resilience are psychological resources people attempt to conserve and protect, and employ when necessary for making sense of or coping with stressors.

Tertiary Interventions (Stress Management)

Stress management refers to interventions employed to treat and repair harmful repercussions of stressors that were not coped with sufficiently. As Lazarus and Folkman ( 1991 ) noted, not all stressors “are amenable to mastery” (p. 205). Stressors that are unmanageable and lead to strains require interventions to reverse or slow down those effects. Workplace interventions might focus on the person, the organization, or both. Unfortunately, instead of looking at the whole system to include the person and the workplace, most companies focus on the person. Such a focus should not be a surprise given the results of van der Klink, Blonk, Schene, and van Dijk’s ( 2001 ) meta-analysis of 48 experimental studies conducted between 1977 and 1996 . They found that of four types of tertiary interventions, the effect size for cognitive-behavioral interventions and multimodal programs (e.g., the combination of assertive training and time management) was moderate and the effect size for relaxation techniques was small in reducing psychological complaints, but not turnover intention related to work stress. However, the effects of (the five studies that used) organization-focused interventions were not significant. Similarly, Richardson and Rothstein’s ( 2008 ) meta-analytic study, including 36 experimental studies with 55 interventions, showed a larger effect size for cognitive-behavioral interventions than relaxation, organizational, multimodal, or alternative. However, like with van der Klink et al. ( 2001 ), Richardson and Rothstein ( 2008 ) cautioned that there were few organizational intervention studies included and the impact of interventions were determined on the basis of psychological outcomes and not physiological or organizational outcomes. Van der Klink et al. ( 2001 ) further expressed concern that organizational interventions target the workplace and that changes in the individual may take longer to observe than individual interventions aimed directly at the individual.

The long-term benefits of individual focused interventions are not yet clear either. Per Giga, Cooper, and Faragher ( 2003 ), the benefits of person-directed stress management programs will be short-lived if organizational factors to reduce stressors are not addressed too. Indeed, LaMontagne, Keegel, Louie, Ostry, and Landsbergis ( 2007 ), in their meta-analysis of 90 studies on stress management interventions published between 1990 and 2005 , revealed that in relation to interventions targeting organizations only, and interventions targeting individuals only, interventions targeting both organizations and individuals (i.e. the systems approach) had the most favorable positive effects on both the organizations and the individuals. Furthermore, the organization-level interventions were effective at both the individual and organization levels, but the individual-level interventions were effective only at the individual level.

Individual-Focused Stress Management

Individual-focused interventions concentrate on improving conditions for the individual, though counseling programs emphasize that the worker is in charge of reducing “stress,” whereas role-focused interventions emphasize activities that organizations can guide to actually reduce unnecessary noxious environmental factors.

Individual-Focused Stress Management: Employee Assistance Programs

When stress become sufficiently problematic (which is individually gauged or attended to by supportive others) in a worker’s life, employees may utilize the short-term counseling services or referral services Employee Assistance Programs (EAPs) provide. People who utilize the counseling services may engage in cognitive behavioral therapy aimed at changing the way people think about the stressors (e.g., as challenge opportunity over threat) and manage strains. Example topics that may be covered in these therapy sessions include time management and goal setting (prioritization), career planning and development, cognitive restructuring and mindfulness, relaxation, and anger management. In a study of healthcare workers and teachers who participated in a 2-day to 2.5-day comprehensive stress management training program (including 26 topics on identifying, coping with, and managing stressors and strains), Siu, Cooper, and Phillips ( 2013 ) found psychological and physical improvements were self-reported among the healthcare workers (for which there was no control group). However, comparing an intervention group of teachers to a control group of teachers, the extent of change was not as visible, though teachers in the intervention group engaged in more mastery recovery experiences (i.e., they purposefully chose to engage in challenging activities after work).

Individual-Focused Stress Management: Mindfulness

A popular therapy today is to train people to be more mindful, which involves helping people live in the present, reduce negative judgement of current and past experiences, and practicing patience (Birnie, Speca, & Carlson, 2010 ). Mindfulness programs usually include training on relaxation exercises, gentle yoga, and awareness of the body’s senses. In one study offered through the continuing education program at a Canadian university, 104 study participants took part in an 8-week, 90 minute per group (15–20 participants per) session mindfulness program (Birnie et al., 2010 ). In addition to body scanning, they also listened to lectures on incorporating mindfulness into one’s daily life and received a take-home booklet and compact discs that guided participants through the exercises studied in person. Two weeks after completing the program, participants’ mindfulness attendance and general positive moods increased, while physical, psychological, and behavioral strains decreased. In another study on a sample of U.K. government employees, study participants receiving three sessions of 2.5 to 3 hours each training on mindfulness, with the first two sessions occurring in consecutive weeks and the third occurring about three months later, Flaxman and Bond ( 2010 ) found that compared to the control group, the intervention group showed a decrease in distress levels from Time 1 (baseline) to Time 2 (three months after first two training sessions) and Time 1 to Time 3 (after final training session). Moreover, of the mindfulness intervention study participants who were clinically distressed, 69% experienced clinical improvement in their psychological health.

Individual-Focused Stress Management: Biofeedback/Imagery/Meditation/Deep Breathing

Biofeedback uses electronic equipment to inform users about how their body is responding to tension. With guidance from a therapist, individuals then learn to change their physiological responses so that their pulse normalizes and muscles relax (Norris, Fahrion, & Oikawa, 2007 ). The therapist’s guidance might include reminders for imagery, meditation, body scan relaxation, and deep breathing. Saunders, Driskell, Johnston, and Salas’s ( 1996 ) meta-analysis of 37 studies found that imagery helped reduce state and performance anxiety. Once people have been trained to relax, reminder triggers may be sent through smartphone push notifications (Villani et al., 2013 ).

Smartphone technology can also be used to support weight loss programs, smoking cessation programs, and medication or disease (e.g., diabetes) management compliance (Heron & Smyth, 2010 ; Kannampallil, Waicekauskas, Morrow, Kopren, & Fu, 2013 ). For example, smartphones could remind a person to take medications or test blood sugar levels or send messages about healthy behaviors and positive affirmations.

Individual-Focused Stress Management: Sleep/Rest/Respite

Workers today sleep less per night than adults did nearly 30 years ago (Luckhaupt, Tak, & Calvert, 2010 ; National Sleep Foundation, 2005 , 2013 ). In order to combat problems, such as increased anxiety and cardiovascular artery disease, associated with sleep deprivation and insufficient rest, it is imperative that people disconnect from their work at least one day per week or preferably for several weeks so that they are able to restore psychological health (Etzion, Eden, & Lapidot, 1998 ; Ragsdale, Beehr, Grebner, & Han, 2011 ). When college students engaged in relaxation-type activities, such as reading or watching television, over the weekend, they experienced less emotional exhaustion and greater general well-being than students who engaged in resources-consuming activities, such as house cleaning (Ragsdale et al., 2011 ). Additional research and future directions for research are reviewed and identified in the work of Sonnentag ( 2012 ). For example, she asks whether lack of ability to detach from work is problematic for people who find their work meaningful. In other words, are negative health consequences only among those who do not take pleasure in their work? Sonnetag also asks how teleworkers detach from their work when engaging in work from the home. Ironically, one of the ways that companies are trying to help with the challenges of high workload or increased need to be available to colleagues, clients, or vendors around the globe is by offering flexible work arrangements, whereby employees who can work from home are given the opportunity to do so. Companies that require global interactions 24-hours per day often employ this strategy, but is the solution also a source of strain (Glazer, Kożusznik, & Shargo, 2012 )?

Individual-Focused Stress Management: Role Analysis

Role analysis or role clarification aims to redefine, expressly identify, and align employees’ roles and responsibilities with their work goals. Through role negotiation, involved parties begin to develop a new formal or informal contract about expectations and define resources needed to fulfill those expectations. Glazer has used this approach in organizational consulting and, with one memorable client engagement, found that not only were the individuals whose roles required deeper re-evaluation happier at work (six months later), but so were their subordinates. Subordinates who once characterized the two partners as hostile and akin to a couple going through a bad divorce, later referred to them as a blissful pair. Schaubroeck, Ganster, Sime, and Ditman ( 1993 ) also found in a three-wave study over a two-year period that university employees’ reports of role clarity and greater satisfaction with their supervisor increased after a role clarification exercise of top managers’ roles and subordinates’ roles. However, the intervention did not have any impact on reported physical symptoms, absenteeism, or psychological well-being. Role analysis is categorized under individual-focused stress management intervention because it is usually implemented after individuals or teams begin to demonstrate poor performance and because the intervention typically focuses on a few individuals rather than an entire organization or group. In other words, the intervention treats the person’s symptoms by redefining the role so as to eliminate the stimulant causing the problem.

Organization-Focused Stress Management

At the organizational level, companies that face major declines in productivity and profitability or increased costs related to healthcare and disability might be motivated to reassess organizational factors that might be impinging on employees’ health and well-being. After all, without healthy workers, it is not possible to have a healthy organization. Companies may choose to implement practices and policies that are expected to help not only the employees, but also the organization with reduced costs associated with employee ill-health, such as medical insurance, disability payments, and unused office space. Example practices and policies that may be implemented include flexible work arrangements to ensure that employees are not on the streets in the middle of the night for work that can be done from anywhere (such as the home), diversity programs to reduce stress-induced animosity and prejudice toward others, providing only healthy food choices in cafeterias, mandating that all employees have physicals in order to receive reduced prices for insurance, company-wide closures or mandatory paid time off, and changes in organizational visioning.

Organization-Focused Stress Management: Organizational-Level Occupational Health Interventions

As with job design interventions that are implemented to remediate work characteristics that were a source of unnecessary or excessive stressors, so are organizational-level occupational health (OLOH) interventions. As with many of the interventions, its placement as a primary or tertiary stress management intervention may seem arbitrary, but when considering the goal and target of change, it is clear that the intervention is implemented in response to some ailing organizational issues that need to be reversed or stopped, and because it brings in the entire organization’s workforce to address the problems, it has been placed in this category. There are several more case studies than empirical studies on the topic of whole system organizational change efforts (see example case studies presented by the United Kingdom’s Health and Safety Executive). It is possible that lack of published empirical work is not so much due to lack of attempting to gather and evaluate the data for publication, but rather because the OLOH interventions themselves never made it to the intervention stage, the interventions failed (Biron, Gatrell, & Cooper, 2010 ), or the level of evaluation was not rigorous enough to get into empirical peer-review journals. Fortunately, case studies provide some indication of the opportunities and problems associated with OLOH interventions.

One case study regarding Cardiff and Value University Health Board revealed that through focus group meetings with members of a steering group (including high-level managers and supported by top management) and facilitated by a neutral, non-judgemental organizational health consultant, ideas for change were posted on newsprint, discussed, and areas in the organization needing change were identified. The intervention for giving voice to people who initially had little already had a positive effect on the organization, as absence decreased by 2.09% and 6.9% merely 12 and 18 months, respectively, after the intervention. Translated in financial terms, the 6.9% change was equivalent to a quarterly savings of £80,000 (Health & Safety Executive, n.d. ). Thus, focusing on the context of change and how people will be involved in the change process probably helped the organization realize improvements (Biron et al., 2010 ). In a recent and rare empirical study, employing both qualitative and quantitative data collection methods, Sørensen and Holman ( 2014 ) utilized PAR in order to plan and implement an OLOH intervention over the course of 14 months. Their study aimed to examine the effectiveness of the PAR process in reducing workers’ work-related and social or interpersonal-related stressors that derive from the workplace and improving psychological, behavioral, and physiological well-being across six Danish organizations. Based on group dialogue, 30 proposals for change were proposed, all of which could be categorized as either interventions to focus on relational factors (e.g., management feedback improvement, engagement) or work processes (e.g., reduced interruptions, workload, reinforcing creativity). Of the interventions that were implemented, results showed improvements on manager relationship quality and reduced burnout, but no changes with respect to work processes (i.e., workload and work pace) perhaps because the employees already had sufficient task control and variety. These findings support Dewe and Kompier’s ( 2008 ) position that occupational health can be reinforced through organizational policies that reinforce quality jobs and work experiences.

Organization-Focused Stress Management: Flexible Work Arrangements

Dewe and Kompier ( 2008 ), citing the work of Isles ( 2005 ), noted that concern over losing one’s job is a reason for why 40% of survey respondents indicated they work more hours than formally required. In an attempt to create balance and perceived fairness in one’s compensation for putting in extra work hours, employees will sometimes be legitimately or illegitimately absent. As companies become increasingly global, many people with desk jobs are finding themselves communicating with colleagues who are halfway around the globe and at all hours of the day or night (Glazer et al., 2012 ). To help minimize the strains associated with these stressors, companies might devise flexible work arrangements (FWA), though the type of FWA needs to be tailored to the cultural environment (Masuda et al., 2012 ). FWAs give employees some leverage to decide what would be the optimal work arrangement for them (e.g., part-time, flexible work hours, compressed work week, telecommuting). In other words, FWA provides employees with the choice of when to work, where to work (on-site or off-site), and how many hours to work in a day, week, or pay period (Kossek, Thompson, & Lautsch, 2015 ). However, not all employees of an organization have equal access to or equitable use of FWAs; workers in low-wage, hourly jobs are often beholden to being physically present during specific hours (Swanberg McKechnie, Ojha, & James, 2011 ). In a study of over 1,300 full-time hourly retail employees in the United States, Swanberg et al. ( 2011 ) showed that employees who have control over their work schedules and over their work hours were satisfied with their work schedules, perceived support from the supervisor, and work engagement.

Unfortunately, not all FWAs yield successful results for the individual or the organization. Being able to work from home or part-time can have problems too, as a person finds himself or herself working more hours from home than required. Sometimes telecommuting creates work-family conflict too as a person struggles to balance work and family obligations while working from home. Other drawbacks include reduced face-to-face contact between work colleagues and stakeholders, challenges shaping one’s career growth due to limited contact, perceived inequity if some have more flexibility than others, and ambiguity about work role processes for interacting with employees utilizing the FWA (Kossek et al., 2015 ). Organizations that institute FWAs must carefully weigh the benefits and drawbacks the flexibility may have on the employees using it or the employees affected by others using it, as well as the implications on the organization, including the vendors who are serving and clients served by the organization.

Organization-Focused Stress Management: Diversity Programs

Employees in the workplace might experience strain due to feelings of discrimination or prejudice. Organizational climates that do not promote diversity (in terms of age, religion, physical abilities, ethnicity, nationality, sex, and other characteristics) are breeding grounds for undesirable attitudes toward the workplace, lower performance, and greater turnover intention (Bergman, Palmieri, Drasgow, & Ormerod, 2012 ; Velez, Moradi, & Brewster, 2013 ). Management is thus advised to implement programs that reinforce the value and importance of diversity, as well as manage diversity to reduce conflict and feelings of prejudice. In fact, managers who attended a leadership training program reported higher multicultural competence in dealing with stressful situations (Chrobot-Mason & Leslie, 2012 ), and managers who persevered through challenges were more dedicated to coping with difficult diversity issues (Cilliers, 2011 ). Thus, diversity programs can help to reduce strains by directly reducing stressors associated with conflict linked to diversity in the workplace and by building managers’ resilience.

Organization-Focused Stress Management: Healthcare Management Policies

Over the past few years, organizations have adopted insurance plans that implement wellness programs for the sake of managing the increasing cost of healthcare that is believed to be a result of individuals’ not managing their own health, with regular check-ups and treatment. The wellness programs require all insured employees to visit a primary care provider, complete a health risk assessment, and engage in disease management activities as specified by a physician (e.g., see frequently asked questions regarding the State of Maryland’s Wellness Program). Companies believe that requiring compliance will reduce health problems, although there is no proof that such programs save money or that people would comply. One study that does, however, boast success, was a 12-week workplace health promotion program aimed at reducing Houston airport workers’ weight (Ebunlomo, Hare-Everline, Weber, & Rich, 2015 ). The program, which included 235 volunteer participants, was deemed a success, as there was a total weight loss of 345 pounds (or 1.5 lbs per person). Given such results in Houston, it is clear why some people are also skeptical over the likely success of wellness programs, particularly as there is no clear method for evaluating their efficacy (Sinnott & Vatz, 2015 ).

Moreover, for some, such a program is too paternalistic and intrusive, as well as punishes anyone who chooses not to actively participate in disease management programs (Sinnott & Vatz, 2015 ). The programs put the onus of change on the person, though it is a response to the high costs of ill-health. The programs neglect to consider the role of the organization in reducing the barriers to healthy lifestyle, such as cloaking exempt employment as simply needing to get the work done, when it usually means working significantly more hours than a standard workweek. In fact, workplace health promotion programs did not reduce presenteeism (i.e., people going to work while unwell thereby reducing their job performance) among those who suffered from physical pain (Cancelliere, Cassidy, Ammendolia, & Côte, 2011 ). However, supervisor education, worksite exercise, lifestyle intervention through email, midday respite from repetitive work, a global stress management program, changes in lighting, and telephone interventions helped to reduce presenteeism. Thus, emphasis needs to be placed on psychosocial aspects of the organization’s structure, including managers and overall organizational climate for on-site presence, that reinforces such behavior (Cancelliere et al., 2011 ). Moreover, wellness programs are only as good as the interventions to reduce work-related stressors and improve organizational resources to enable workers to improve their overall psychological and physical health.

Concluding Remarks

Future research.

One of the areas requiring more theoretical and practical attention is that of the utility of stress frameworks to guide organizational development change interventions. Although it has been proposed that the foundation for work stress management interventions is in organizational development, and even though scholars and practitioners of organization development were also founders of research programs that focused on employee health and well-being or work stress, there are few studies or other theoretical works that link the two bodies of literature.

A second area that requires additional attention is the efficacy of stress management interventions across cultures. In examining secondary stress management interventions (i.e., coping), some cross-cultural differences in findings were described; however, there is still a dearth of literature from different countries on the utility of different prevention, coping, and stress management strategies.

A third area that has been blossoming since the start of the 21st century is the topic of hindrance and challenge stressors and the implications of both on workers’ well-being and performance. More research is needed on this topic in several areas. First, there is little consistency by which researchers label a stressor as a hindrance or a challenge. Researchers sometimes take liberties with labels, but it is not the researchers who should label a stressor but the study participants themselves who should indicate if a stressor is a source of strain. Rodríguez, Kozusznik, and Peiró ( 2013 ) developed a measure in which respondents indicate whether a stressor is a challenge or a hindrance. Just as some people may perceive demands to be challenges that they savor and that result in a psychological state of eustress (Nelson & Simmons, 2003 ), others find them to be constraints that impede goal fulfillment and thus might experience distress. Likewise, some people might perceive ambiguity as a challenge that can be overcome and others as a constraint over which he or she has little control and few or no resources with which to cope. More research on validating the measurement of challenge vs. hindrance stressors, as well as eustress vs. distress, and savoring vs. coping, is warranted. Second, at what point are challenge stressors harmful? Just because people experiencing challenge stressors continue to perform well, it does not necessarily mean that they are healthy people. A great deal of stressors are intellectually stimulating, but excessive stimulation can also take a toll on one’s physiological well-being, as evident by the droves of professionals experiencing different kinds of diseases not experienced as much a few decades ago, such as obesity (Fried et al., 2013 ). Third, which stress management interventions would better serve to reduce hindrance stressors or to reduce strain that may result from challenge stressors while reinforcing engagement-producing challenge stressors?

A fourth area that requires additional attention is that of the flexible work arrangements (FWAs). One of the reasons companies have been willing to permit employees to work from home is not so much out of concern for the employee, but out of the company’s need for the focal person to be able to communicate with a colleague working from a geographic region when it is night or early morning for the focal person. Glazer, Kożusznik, and Shargo ( 2012 ) presented several areas for future research on this topic, noting that by participating on global virtual teams, workers face additional stressors, even while given flexibility of workplace and work time. As noted earlier, more research needs to be done on the extent to which people who take advantage of FWAs are advantaged in terms of detachment from work. Can people working from home detach? Are those who find their work invigorating also likely to experience ill-health by not detaching from work?

A fifth area worthy of further research attention is workplace wellness programing. According to Page and Vella-Brodrick ( 2009 ), “subjective and psychological well-being [are] key criteria for employee mental health” (p. 442), whereby mental health focuses on wellness, rather than the absence of illness. They assert that by fostering employee mental health, organizations are supporting performance and retention. Employee well-being can be supported by ensuring that jobs are interesting and meaningful, goals are achievable, employees have control over their work, and skills are used to support organizational and individual goals (Dewe & Kompier, 2008 ). However, just as mental health is not the absence of illness, work stress is not indicative of an absence of psychological well-being. Given the perspective that employee well-being is a state of mind (Page & Vella-Brodrick, 2009 ), we suggest that employee well-being can be negatively affected by noxious job stressors that cannot be remediated, but when job stressors are preventable, employee well-being can serve to protect an employee who faces job stressors. Thus, wellness programs ought to focus on providing positive experiences by enhancing and promoting health, as well as building individual resources. These programs are termed “green cape” interventions (Pawelski, 2016 ). For example, with the growing interests in positive psychology, researchers and practitioners have suggested employing several positive psychology interventions, such as expressing gratitude, savoring experiences, and identifying one’s strengths (Tetrick & Winslow, 2015 ). Another stream of positive psychology is psychological capital, which includes four malleable functions of self-efficacy, optimism, hope, and resilience (Luthans, Youssef, & Avolio, 2007 ). Workplace interventions should include both “red cape” interventions (i.e., interventions to reduce negative experiences) and “green cape” interventions (i.e., workplace wellness programs; Polly, 2014 ).

A Healthy Organization’s Pledge

A healthy workplace requires healthy workers. Period. Among all organizations’ missions should be the focus on a healthy workforce. To maintain a healthy workforce, the company must routinely examine its own contributions in terms of how it structures itself; reinforces communications among employees, vendors, and clients; how it rewards and cares for its people (e.g., ensuring they get sufficient rest and can detach from work); and the extent to which people at the upper levels are truly connected with the people at the lower levels. As a matter of practice, management must recognize when employees are overworked, unwell, and poorly engaged. Management must also take stock of when it is doing well and right by its contributors’ and maintain and reinforce the good practices, norms, and procedures. People in the workplace make the rules; people in the workplace can change the rules. How management sees its employees and values their contribution will have a huge role in how a company takes stock of its own pain points. Providing employees with tools to manage their own reactions to work-related stressors and consequent strains is fine, but wouldn’t it be grand if organizations took better notice about what they could do to mitigate the strain-producing stressors in the first place and take ownership over how employees are treated?

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Exercise and stress: Get moving to manage stress

Exercise in almost any form can act as a stress reliever. Being active can boost your feel-good endorphins and distract you from daily worries.

You know that exercise does your body good, but you're too busy and stressed to fit it into your routine. Hold on a second — there's good news when it comes to exercise and stress.

Virtually any form of exercise, from aerobics to yoga, can act as a stress reliever. If you're not an athlete or even if you're out of shape, you can still make a little exercise go a long way toward stress management. Discover the connection between exercise and stress relief — and why exercise should be part of your stress management plan.

Exercise and stress relief

Exercise increases your overall health and your sense of well-being, which puts more pep in your step every day. But exercise also has some direct stress-busting benefits.

• It pumps up your endorphins. Physical activity may help bump up the production of your brain's feel-good neurotransmitters, called endorphins. Although this function is often referred to as a runner's high, any aerobic activity, such as a rousing game of tennis or a nature hike, can contribute to this same feeling.
• It reduces negative effects of stress. Exercise can provide stress relief for your body while imitating effects of stress, such as the flight or fight response, and helping your body and its systems practice working together through those effects. This can also lead to positive effects in your body — including your cardiovascular, digestive and immune systems — by helping protect your body from harmful effects of stress.

It's meditation in motion. After a fast-paced game of racquetball, a long walk or run, or several laps in the pool, you may often find that you've forgotten the day's irritations and concentrated only on your body's movements.

As you begin to regularly shed your daily tensions through movement and physical activity, you may find that this focus on a single task, and the resulting energy and optimism, can help you stay calm, clear and focused in everything you do.

• It improves your mood. Regular exercise can increase self-confidence, improve your mood, help you relax, and lower symptoms of mild depression and anxiety. Exercise can also improve your sleep, which is often disrupted by stress, depression and anxiety. All of these exercise benefits can ease your stress levels and give you a sense of command over your body and your life.

Put exercise and stress relief to work for you

A successful exercise program begins with a few simple steps.

• Consult with your doctor. If you haven't exercised for some time or you have health concerns, you may want to talk to your doctor before starting a new exercise routine.

Walk before you run. Build up your fitness level gradually. Excitement about a new program can lead to overdoing it and possibly even injury.

For most healthy adults, the Department of Health and Human Services recommends getting at least 150 minutes of moderate aerobic activity or 75 minutes of vigorous aerobic activity a week, or a combination of moderate and vigorous activity. Examples of moderate aerobic activity include brisk walking or swimming, and vigorous aerobic activity can include running or biking. Greater amounts of exercise will provide even greater health benefits.

Also, aim to do strength training exercises for all major muscle groups at least two times a week.

Do what you love. Almost any form of exercise or movement can increase your fitness level while decreasing your stress. The most important thing is to pick an activity that you enjoy. Examples include walking, stair climbing, jogging, dancing, bicycling, yoga, tai chi, gardening, weightlifting and swimming.

And remember, you don't need to join a gym to get moving. Take a walk with the dog, try body-weight exercises or do a yoga video at home.

• Pencil it in. In your schedule, you may need to do a morning workout one day and an evening activity the next. But carving out some time to move every day helps you make your exercise program an ongoing priority. Aim to include exercise in your schedule throughout your week.

Stick with it

Starting an exercise program is just the first step. Here are some tips for sticking with a new routine or refreshing a tired workout:

Set SMART goals. Write down SMART goals — specific, measurable, attainable, relevant and time-limited goals.

If your primary goal is to reduce stress in your life, your specific goals might include committing to walking during your lunch hour three times a week. Or try online fitness videos at home. Or, if needed, find a babysitter to watch your children so that you can slip away to attend a cycling class.

• Find a friend. Knowing that someone is waiting for you to show up at the gym or the park can be a powerful incentive. Try making plans to meet friends for walks or workouts. Working out with a friend, co-worker or family member often brings a new level of motivation and commitment to your workouts. And friends can make exercising more fun!
• Change up your routine. If you've always been a competitive runner, take a look at other, less competitive options that may help with stress reduction, such as Pilates or yoga classes. As an added bonus, these kinder, gentler workouts may enhance your running while also decreasing your stress.

Exercise in short bursts. Even brief bouts of physical activity offer benefits. For instance, if you can't fit in one 30-minute walk, try a few 10-minute walks instead. Being active throughout the day can add up to provide health benefits. Take a mid-morning or afternoon break to move and stretch, go for a walk, or do some squats or pushups.

Interval training, which entails brief (60 to 90 seconds) bursts of intense activity at almost full effort, can be a safe, effective and efficient way of gaining many of the benefits of longer duration exercise. What's most important is making regular physical activity part of your lifestyle.

Whatever you do, don't think of exercise as just one more thing on your to-do list. Find an activity you enjoy — whether it's an active tennis match or a meditative meander down to a local park and back — and make it part of your regular routine. Any form of physical activity can help you unwind and become an important part of your approach to easing stress.

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• Physical Activity Guidelines for Americans. 2nd ed. U.S. Department of Health and Human Services. https://health.gov/our-work/physical-activity/current-guidelines. Accessed Aug. 10, 2020.
• AskMayoExpert. Physical activity (adult). Mayo Clinic; 2020.
• Working out boosts brain health. American Psychological Association. https://www.apa.org/topics/exercise-stress. Accessed Aug. 10, 2020.
• Seaward BL. Physical exercise: Flushing out the stress hormones. In: Essentials of Managing Stress. 4th ed. Jones & Bartlett Publishers; 2017.
• Bodenheimer T, et al. Goal-setting for behavior change in primary care: An exploration and status report. Patient Education and Counseling. 2009; doi:10.1016/j.pec.2009.06.001.
• Locke E, et al. Building a practically useful theory of goal setting and task motivation: A 35-year odyssey. American Psychologist. 2002; doi:10.1037//0003-066x.57.9.705.
• Olpin M, et al. Healthy lifestyles. In: Stress Management for Life. 4th ed. Cengage Learning; 2016.
• Laskwoski ER (expert opinion). Mayo Clinic. Aug. 12, 2020.

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3 types of stress and what you can do to fight them

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What is stress?

What causes stress, what are the 3 types of stress, symptoms of stress, 6 consequences of stress, 7 ways to fight stress, know which types of stress require professional help.

The extent to which stress impacts our lives is hard to fathom. This is more true than ever in the face of the COVID-19 crisis . In fact, 78% of American adults say the coronavirus pandemic is a significant source of stress in their lives .

Although levels of stress have increased globally  in the past few years, the conversation around stress is growing . And with this growing conversation comes more insight into the causes of stress and how we experience stress differently.

You may think of stress as simply a feeling of being overwhelmed. But there are different types of stress, each with its own physical and mental consequences.

Effective stress management begins with recognizing the specific types of stress affecting you. Let’s explore the different types of stress, their causes, and what you can do to fight them.

Stress is our psychological and physiological reaction to an event or condition that is considered a threat or challenge.

Stress affects numerous systems within us, including our metabolism, memory, and immune system. Have you ever gone to take an important test and forgotten the answer to a question you know you prepared for? Or maybe you had an intense project at work, only to come down with a cold as soon as it was finished? That’s stress making its mark. 

That said, under normal circumstances, our mental , emotional , and physical state should return to normal once a stressful event has passed. This is where mental fitness comes into play, helping us maintain our wellness levels even when dealing with stress. 

While small amounts of positive stress can help us perform better, the key is that this stress is brief. Acute and prolonged stress may lead to long-term health problems and exacerbate existing conditions.

The hormonal shifts behind stress

Whenever you experience something stressful, like when a car cuts you off on the highway, your hypothalamus (a tiny region at the base of your brain) kicks off your stress response. 

Your stress response is basically an advanced, complex alarm system that sends a series of signals to the adrenal glands. From there, your body will release various stress hormones to help prepare your body for a fight-or-flight response . 

According to the American Psychological Association (APA), the primary stress hormone is cortisol , which increases glucose (sugars) in the bloodstream to enhance brain and muscle repair functions. This hormone also helps your body become more efficient by dampening nonessential functions like your reproductive and digestive systems.

Adrenaline, one of the other main stress hormones, makes it easier for your muscles to use the increased levels of glucose in your bloodstream provided by cortisol. Together, these two hormones are very helpful during stressful times. 

However, triggering the release of stress hormones too often can have negative effects on your well-being. Learning to manage all types of stress, whether it’s emotional stress from a break-up or daily annoyances like traffic, is crucial to your well-being.

There are many different causes of stress, and each one can affect you differently. If you can find the root cause of your stress, it can help you manage and even resolve it. 

Here are some of the most common reasons we experience stress.

1. Financial obligations

Not being able to meet financial obligations is a big stressor for a lot of people. Some situations that might cause financial stress include:

Some situations that might cause financial stress include:

• The inability to pay your bills
• Long-term unemployment
• Increasing debt

2. Death of a loved one

Most of us have experienced the devastating emotional impact of the passing of a loved one.

For many of us, it is not only grief that we feel . As well as the stress from a major loss, some people experience a mix of other emotions like loneliness , disappointment , and even anger.

3. Job loss

The loss of a job is not just about the loss of income. Very often, it causes our self-confidence to take a knock as well.

In some cases, being stressed and unable to find work for a long period of time can lead to job search depression . Feeling hopeless about your job prospects and career path can further exacerbate stress levels.

4. Traumatic events

Traumatic events like natural disasters and car accidents are often completely out of our control.

These kinds of unpredictable and unforeseen events naturally create a lot of stress and even post-traumatic stress disorder (PTSD)  for those that experience them.

5. Problems at work

In today’s increasingly fast-paced world, many of us feel that we constantly have to do more at work to keep our jobs. This compounds with the increase in time pressure that most of us feel from today’s near-instantaneous communications.

Workplace stress can be especially prevalent among working parents and women in male-dominated industries . Regardless of the reason, though, constant stressors at work can cause many employees to suffer from burnout .

6. Emotional well-being struggles

All of us are subject to low moods and experience worry . But these emotional states can lead to chronic stress without the right emotional regulation skills .

In turn, this can develop into anxiety  and depression.

7. Relationship issues

While all relationships create stress, many types of stressors are relatively mild and easily dealt with.

It is the larger issues within relationships , such as divorce or an unhappy marriage, that produce a lot of stress for the people involved.

The 3 types of stress

Acute stress, episodic acute stress, chronic stress.

There are many different kinds of stress. However, based on research studies about the types of stress in psychology, stress can be divided into three primary types:

1. Acute stress

Acute stress results from your body’s reaction to a new or challenging situation. It’s that feeling you get from an approaching deadline or when you narrowly avoid being hit by a car.

We can even experience it as a result of something we enjoy. Like an exhilarating ride on a roller coaster or an outstanding personal achievement .

Acute stress is classified as short-term. Usually, emotions and the body return to their normal state relatively soon.

2. Episodic acute stress

Episodic acute stress is when acute stresses happen on a frequent basis. This can be because of repeatedly tight work deadlines. It can also be because of the frequent high-stress situations experienced by some professionals, such as healthcare workers .

With this type of stress, we don’t get time to return to a relaxed and calm state . And the effects of the high-frequency acute stresses accumulate.

It often leaves us feeling like we are moving from one crisis to another.

3. Chronic stress

Chronic stress is the result of stressors that continue for a long period of time. Examples include living in a high-crime neighborhood or constantly fighting with your life partner.

This type of stress feels never-ending. We often have difficulty seeing any way to improve or change the situation that is the cause of our chronic stress.

Stress can affect many aspects of your health and well-being , even though you might not realize it. Here are some signs and symptoms of each type of stress.

1. Pupil dilation . As part of the fight-or-flight reaction, our pupils dilate to allo w more li ght t o enter the eyes  and enable us to see our surroundings more clearly.

2. Heart rate increases . This is another part of the fight-or-flight reaction that can be disconcerting if it feels like heart palpitations.

3. Perspiration . When we are stressed, our body temperature rises, which causes us to sweat more.

4. Fast and heavy breathing . This symptom is also part of the fight-or-flight reaction. This aims to introduce more oxygen into the body's systems so it can more effectively react to stress.

5. Anxiety . This is the feeling of worry and fear that results from exposure to a stressor.

6. Emotional ups and downs . In other words, irritability and mood swings.

7. Poor sleep . Our sleep is often disrupted by our anxiety  and the cocktail of hormones produced by the fight-or-flight reaction.

1. Muscle tension . This is meant to help our body guard against injury and pain. When exposed to episodic acute stressors, our muscles don’t get the opportunity to relax.

3. Feeling overwhelmed . This is the feeling of not being able to cope nor able to visualize effective solutions  to the causes of your stress.

4. Uncontrolled anger and irritability . We find ourselves lashing out more often and with less provocation. We may also find ourselves reacting strongly to things that normally we would tolerate.

5. Migraines . These are often the result of muscle tension. The frequency and severity of migraines are likely to increase under episodic acute stress.

6. Hypertension . A majority of people will be unaware of having high blood pressure. The only reliable way to detect hypertension is to have your blood pressure measured by a health professional.

1. Weight gain . This is often the result of “stress eating,” but it can also result from long-term hormonal imbalances caused by chronic stress.

3. Insomnia . Difficulty in falling and staying asleep , often resulting in not feeling rested from whatever sleep you did get.

4. Panic attacks . Sudden onset of feelings of fear and anxiety  accompanied by the symptoms of acute stress.

6. Chronic headaches . Frequently occurring tension headaches, generally defined as occurring more th an 15 d ay s in a month .

7. Emotional fatigue . This manifests as feeling tired a majority of the time , irrespective of the type of rest  you’re getting or sleep.

It should be noted that some stress, if effectively dealt with, is fine. It is unlikely to result in long-term negative effects on your health and well-being .

But chronic stress can result in serious health problems, such as:

1. Anxiety disorders

Anxiety disorders can manifest as an inability to control our emotional responses  to situations. These disorders often involve persistent fear and worry that hinder our ability to function in daily life.

The high-stress state that accompanies panic disorders also has serious long-term consequences for physical health. Panic attacks, panic disorder, and PTSD are all types of anxiety disorders.

2. Depression

Depression often presents as persistent feelings of helplessness and low self-worth. It saps us of our motivation , vitality , and creativity . Depression is often associated with losing interest or pleasure in previously enjoyed activities.

Major Depressive Disorder (MDD) also affects our thinking, feelings, and behavior. It hinders our ability to function in daily life.

Burnout is the consequence  of chronic stress that results in feelings of mental , emotional, and physical exhaustion .

It is often accompanied by self-doubt  and a feeling of detachment from the world with an increasingly negative outlook.

4. Digestive problems

Stress can affect the speed with which food moves through our intestines . This can cause several digestive conditions, such as:

• Irritable bowel syndrome
• Inflammatory bowel disease

It has been shown that stress can weaken our intestinal barrier , thereby compromising our immune system.

5. Heart disease

When chronic stress results in prolonged periods of heightened adrenaline and cortisol levels, there can be serious consequences for your heart .

High blood pressure can result in the hardening of the arteries. This requires the heart to work harder while getting less blood and oxygen.

6. Obesity and disordered eating

Some people binge or stress eat as a result of high stress levels rather than practice intuitive eating . When this happens over longer periods of time, it can result in obesity, related health conditions, and eating disorders.

Other people experiencing chronic stress eat less, which can result in undernourishment.

Let's look at different types of stress management activities you can do to make stress work for you .

1. exercise.

Engaging in regular physical exercise is an excellent way to help manage your stress. Ideally, you should aim for at least 30 minutes of exercise five times a week.

Whether that’s taking a walk in nature or doing a virtual workout  like yoga , getting your body moving has many benefits for the mind, body, and soul.

2. Utilize mindfulness

Mindfulness and meditation  are relaxation techniques that can be practiced anywhere. Focused, deep breathing promotes self-awareness  and can reduce the effects of stress and worry.

3. Try therapy and coaching

Professional therapy and coaching  can help us develop stress management techniques. Seeking professional help also helps us uncover the underlying causes of our chronic stress.

4. Time management

Effective time management  is about finding the right work-life balance . Good time management provides us with time to do positive, nurturing things for ourselves.

It can also help you track when stress arises — is it when you’re rushing to an appointment? Seeing these types of triggers will help motivate you to make positive changes that reduce stress.

5. Spend time in nature

Spending time in nature can be very therapeutic. In addition to fresh air and sunlight, this self-care practice  provides an excellent space for us to slow down.

6. Eat healthily

Maintaining a nutritious diet  ensures that we are getting the right nutrients and enough water to promote our physical and mental health. A healthy diet can improve and help stabilize our moods.

7. Spend time with friends and family

By maintaining our connections with close friends and family, we develop a social support network. Spending time with these people is a great method of stress relief , whether it’s asking for advice or simply taking a moment to laugh together.

Stress is a recurring condition within our lives. But it doesn’t need to become a long-term problem. Don’t be too hard on yourself .

By developing good habits  and stress management techniques, we can reduce the chances of suffering from the long-term health impacts of stress.

If you feel that you can’t manage your stress or stress-related symptoms, it’s important to obtain professional help.

Learn more about how BetterUp’s expert coaches can help you. Don’t let stress get the better of you.

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Elizabeth Perry, ACC

Elizabeth Perry is a Coach Community Manager at BetterUp. She uses strategic engagement strategies to cultivate a learning community across a global network of Coaches through in-person and virtual experiences, technology-enabled platforms, and strategic coaching industry partnerships. With over 3 years of coaching experience and a certification in transformative leadership and life coaching from Sofia University, Elizabeth leverages transpersonal psychology expertise to help coaches and clients gain awareness of their behavioral and thought patterns, discover their purpose and passions, and elevate their potential. She is a lifelong student of psychology, personal growth, and human potential as well as an ICF-certified ACC transpersonal life and leadership Coach.

Chronic stress is a chronic problem. Here's how to cope

Where’s your stress from learn about different types of stressors, how stress trackers can help you stay calm, stress or stressor learn the difference to unlock growth, good stress vs. bad stress: definitions, examples, and uses, just relax find out how with progressive muscle relaxation techniques, how does stress affect the body a breakdown by system, 15 tips for stress relief to deal with your stress on the daily, how to sleep when you're stressed and anxious (16 tips to get zzz's), stress or survival: what is the fight or flight response, what is workplace stress, and what are its effects, how does exercise help with anxiety, distracted 3 ways coaches help you improve your focus, general adaptation syndrome: understanding the impact of stress, feeling anxious here’s how to take your life back from anxiety, here are 10 stressor examples and proof that you can manage them, stay connected with betterup, get our newsletter, event invites, plus product insights and research..

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What Is Stress and How Can I Recognize It?

Risk factors.

• Health Consequences
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• Next in Stress Guide Understanding the Stress Response

Stress is your body's natural response to physical and psychological challenges or threats. During moments of stress, the body releases two hormones called epinephrine (adrenaline) and cortisol that trigger a chain of events to help you better cope with stressful situations.

Stress can be a positive thing, helping you overcome obstacles and push yourself to new levels of personal growth.

But when stress is persistent, it can be damaging to your health, reducing your immune response, increasing your risk of certain infections, raising your blood pressure and risk of heart disease, and sapping your concentration, energy levels, and overall sense of well-being.

The article describes the different types of stress and how they impact you physically and emotionally. It also looks at some of the complications of stress and ways to reduce stress if it is affecting your health and quality of life.

Illustration by Laura Porter for Verywell Health

Types of Stress

Stress can be short-lasting, long-lasting, or come and go. While stress is often considered "bad" and something you need to manage, it can be beneficial in certain situations.

Stress can be broadly described as:

• Acute stress : This is stress that comes on abruptly and resolves once the perceived or actual threat is resolved. Acute stress can occur when faced with a traumatic situation but can also be something that gradually builds over time and suddenly comes to a head.
• Chronic stress : This is stress that is persistent or recurrent. It can be triggered by ongoing emotional distress or an illness or medical condition that you are managing. If left unchecked, chronic stress can have serious health consequences.
• Episodic acute stress : This is when someone experiences intense stress on a routine basis. It is common in people who face high-stress situations, such as law enforcement officers, firefighters, and soldiers on wartime duty.
• Eustress : This is the term for beneficial stress. Eustress is associated with excitement or motivation, such as riding a rollercoaster or starting a new job. Once the immediate stress eases, there is often a feeling of accomplishment.

Signs of Stress

Stress is regulated by the autonomic nervous system . This is a part of the nervous system that oversees involuntary functions like heart rate, respiration, blood pressure, and digestion. During moments of extreme stress, it also triggers the "fight-or-flight" response.

The fight-or-flight response is characterized by the spontaneous release of epinephrine and cortisol. These hormones trigger physiological and psychological changes to prepare you to either face or flee from the threat, whether real or perceived.

It does so by temporarily redirecting the body's resources—like blood, oxygen, and glucose (blood sugar)—away from non-essential organs (like the stomach, intestines, and bladder) to essential ones (like the muscles and eyes). These changes are responsible for the functional signs of stress.

Common signs of stress include:

• Rapid heartbeat
• Rapid breathing
• Muscle tension
• Flush or pale skin
• Dilated pupils
• Agitation or feeling on edge
• Trembling or shaking
• Sudden sweating (including sweaty palms)
• Queasy stomach
• Weak bladder or a sudden urge to pee

Once the threat is gone, the body will release other hormones, such as oxytocin , to bring epinephrine and cortisol back in check.

Symptoms of Too Much Stress

If stress is chronic, it can lead to a broader range of potentially disruptive symptoms. This is because the overload of cortisol and epinephrine can not only amplify the physiological symptoms of stress but also start to affect the brain, triggering psychological symptoms.

Symptoms of chronic stress may include:

• A pounding headache
• Heart palpitations
• Chest pains
• Muscle spasms and cramps
• Back and shoulder pain
• Nausea and vomiting
• Shortness of breath
• Forgetfulness
• Loss of concentration
• Daytime sleepiness
• Disorganized or racing thoughts
• Emotional outbursts
• Panicky feelings
• Ringing in the ears
• Numbness in the fingers and toes
• Changes in appetite (eating too much or not at all)
• Depression and anxiety

Many of these symptoms can also occur when acute stress is severe, such as during a panic attack . Sometimes, the symptoms come on so quickly and profoundly that it may seem like you're having a heart attack .

It is also possible to get a "stress rash" when the body is spontaneously flooded with cortisol and epinephrine. This can trigger an inflammatory reaction and the release of a chemical called histamine that instigates allergic reactions, In some people with extreme stress, this can lead to itching and hives ( urticaria ).

Causes of Stress

The body's stress response system is called the hypothalamic-pituitary-adrenal axis (HPA axis) . When faced with a stressor (a situation that causes stress), a part of the brain called the  hypothalamus sends a chemical message to the pituitary gland which, in turn, instructs the  adrenal glands to start secreting cortisol and epinephrine.

There are two broad categories of stressors: physiological stressors and psychological stressors.

Physiological and psychological stressors can also overlap. For instance, a physiological stressor such as a chronic illness can cause psychological stress, further amplifying symptoms.

Examples of stressors include;

Extreme temperatures

Strenuous physical activity

Injury or pain

Chronic illness

Acute infections

Being overworked

A noisy or chaotic environment

Relationship problems

Financial problems

Trouble at work or school

Loss and grief

Worry about the future

Heavy traffic

We are all wired to feel stress, but certain factors can predispose you to unhealthy levels of stress, including:

• Being over 50
• Being a caregiver to an ill family member
• Living with depression
• Being raised in a stressful family environment
• Being a victim of crime or abuse
• Living in a high-crime neighborhood
• Living with chronic illness
• Living in poverty
• Having financial problems
• Being socially isolated
• Have an alcohol or substance abuse problem

Related Conditions and Complications

The long-term effects of uncontrolled stress can take a toll on your health. Chronic stress is characterized by sustained high blood pressure , which not only affects your heart but all other organs connected to the circulatory system.

Chronic stress can also affect your sense of well-being, which also has health consequences.

Over time, uncontrolled stress can contribute to:

• Atherosclerosis (hardening of the arteries)
• Coronary artery disease (which increases the risk of heart attack or stroke)
• Type 2 diabetes
• Stomach ulcers
• Major depression
• Anxiety disorders

Is Stress a Mental Illness?

Stress is not a mental illness, but it can contribute to mental illness. Persistently high levels of cortisone—referred to as hyperadrenocorticism —have been independently linked to an increased risk of anxiety disorders, bipolar disorder , and major depressive disorder (MDD) .

Treatments and Ways to Cope With Stress

Managing stress is key to avoiding long-term health problems. Depending on your levels of stress and general coping skills, you may be able to manage on your own. In other instances, you may benefit from working with a healthcare provider or mental health specialist.

You can’t always avoid stress, but you can manage it by making healthy lifestyle choices, including:

• Exercising regularly : Exercise not only makes you feel better but also boosts "feel-good" hormones called endorphins . Just 30 minutes of walking per day can lift your spirits and improve your cardiovascular health.
• Setting goals : Establish what you intend to achieve for your day, week, and month. Setting priorities will help you feel more in control.
• Being practical : Be realistic about what you can achieve. While stress can be beneficial within limits, overtaxing yourself can undermine your health. Focus on what is truly important to you and adjust your goals to maintain a healthy work-life balance.
• Staying positive : At the end of a stressful day, don't just drop into bed and try to forget about it. Take a moment to think about what you’ve accomplished and not what you didn’t get done.
• Staying connected : Keep in touch with people who can provide emotional support and practical help. Ask for help from friends, family, and community or religious organizations if you are feeling overtaxed and stressed.

Mind-Body Therapies

There are many stress management tools you can turn to if you live a hectic lifestyle. Many of these approaches are endorsed by healthcare providers who understand how the mind influences the body and your overall health.

Some effective mind-body therapies for stress include:

• Deep breathing exercises
• Guided imagery
• Progressive muscle relaxation (PMR)
• Biofeedback

Psychotherapy

Psychotherapy (talk therapy) involves working with a therapist who can help you identify your sources of stress so you can better manage them. Although therapy is typically done in person, you can also have online sessions with a therapist who can see you regularly.

Different approaches may help depending on the source of your stress:

• Cognitive behavioral therapy (CBT) : This involves identifying problematic behaviors or thought patterns so you can build strategies to change them.
• Dialectical behavioral therapy (DBT) : This is a form of therapy intended for people who experience emotions very intensely.
• Family therapy
• Couples therapy

Prescription Medications

Sometimes medications are needed to help you through a stressful time. In such cases, you would need to get a prescription from your healthcare provider or a psychiatrist (rather than a therapist who cannot prescribe medications).

Some medications commonly prescribed for stress and anxiety include:

• Benzodiazepines : These are sedatives that include Valium (diazepam), Xanax (alprazolam), Klonopin (clonazepam), and Ativan (lorazepam).
• Selective serotonin reuptake inhibitors (SSRIs) : These are antidepressants that include Paxil (paroxetine), Prozac (fluoxetine), Zoloft (sertraline), and Lexapro (escitalopram).
• Serotonin-norepinephrine reuptake inhibitors (SNRIs) : These are antidepressants that include Effexor (venlafaxine), Cymbalta (duloxetine), and Pristiq (desvenlafaxine).
• Tricyclic antidepressants : These are a class of antidepressants that include Elavil (amitriptyline), Norpramin (desipramine), and Sinequan (doxepin).

When to Contact a Healthcare Provider

It can be easy to miss the signs of stress, particularly if you live a hectic lifestyle or are managing a heavy workload at work. Even so, it's important to notice the signs and take appropriate action if stress is interfering with your relationships, health, quality of life, and ability to function normally.

It may be time to see if a therapist or healthcare provider if:

• You find yourself having regular outbursts for little or no reason.
• You have trouble sleeping and are sleep-deprived .
• You have gained a lot of weight because you are stress eating.
• You have lost a lot of weight because you are too stressed to eat .
• You are drinking, smoking, or taking drugs to deal with stress.
• You find it hard to get out of bed and feel persistently on the verge of tears.
• You have panic attacks .

Stress is a natural response to physiological or psychological threats or challenges. Stress can be beneficial, helping push you to achieve more, but it can affect your health if it is extreme or chronic. Left untreated, chronic stress can contribute to heart disease, mood disorders, stomach ulcers, and diabetes.

The best way to manage stress is to live a healthy, balanced lifestyle and practice relaxation techniques like yoga, meditation, or deep breathing exercises. Psychotherapy and prescription medications (like antidepressants) can help if self-help treatments are not enough.

Centre for Studies of Human Stress. Biology of stress .

Romano A, Tempesta B, Di Bonaventura MVM, Gaetani S.  From autism to eating disorders and more: the role of oxytocin in neuropsychiatric disorders . Front Neurosci. 2015;9:497. doi:10.3389/fnins.2015.00497

Yarikbeygi H, Panahi Y, Sahreai H, Johnston TP, Sahebkar A. The impact of stress on body function: s review . EXCLI J.  2017;16:1057–1072. doi:10.17179/excli2017-480

National Institute of Mental Health.  Panic disorder: when fear overwhelms .

Konstantinou GN, Konstantinou GN.  Psychological stress and chronic urticaria: a neuro-immuno-cutaneous crosstalk. A systematic review of the existing evidence .  Clin Therapeutics . 2020;42(5):771-782. doi:10.1016/j.clinthera.2020.03.010

Oyola MG, Handa RJ.  Hypothalamic-pituitary-adrenal and hypothalamic-pituitary-gonadal axes: sex differences in regulation of stress responsivity .  Stress . 2017;20(5):476-494. doi:10.1080/10253890.2017.1369523

James KA, Stromin JI, Steenkamp N, Combrinck MI. Understanding the relationships between physiological and psychosocial stress, cortisol and cognition . Front Endocrinol (Lausanne). 2023;14:1085950. doi:10.3389/fendo.2023.1085950

American Psychological Association. Stress in America: our health at risk .

Mariotta A. The effects of chronic stress on health: new insights into the molecular mechanisms of brain–body communication . Future Sci OA. 2015 Nov;1(3):FSO23. doi:10.4155/fso.15.21

Lin TY, Hanna J, Ishak WW. Psychiatric symptoms in Cushing’s syndrome: a systematic review . Innov Clin Neurosci. 2020 Jan 1;17(1-3):30–35.

Ramirez-Garcia MP, Gagnon MP, Colson S, Cote J, Flores-Aranda J, Dupont M. Mind-body practices for people living with HIV: a systematic scoping review . BMC Complement Altern Med. 2019;19:25. doi:10.1186/s12906-019-2502-z

American Psychological Association.  Psychotherapy .

National Institute of Mental Health.  Anxiety disorders .

National Institute of Mental Health. 5 things you should know about stress .

By Michelle Pugle Michelle Pugle, MA is a freelance writer and reporter focusing on mental health and chronic conditions. As seen in Verywell, Healthline, Psych Central, Everyday Health, and Health.com, among others.

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Stress can be defined as a state of worry or mental tension caused by a difficult situation. Stress is a natural human response that prompts us to address challenges and threats in our lives. Everyone experiences stress to some degree. The way we respond to stress, however, makes a big difference to our overall well-being.

Stress affects both the mind and the body. A little bit of stress is good and can help us perform daily activities. Too much stress can cause physical and mental health problems. Learning how to cope with stress can help us feel less overwhelmed and support our mental and physical well-being.

Stress makes it hard for us to relax and can come with a range of emotions, including anxiety and irritability. When stressed, we may find it difficult to concentrate. We may experience headaches or other body pains, an upset stomach or trouble sleeping. We may find we lose our appetite or eat more than usual. Chronic stress can worsen pre-existing health problems and may increase our use of alcohol, tobacco and other substances.

Stressful situations can also cause or exacerbate mental health conditions, most commonly anxiety and depression, which require access to health care. When we suffer from a mental health condition, it may be because our symptoms of stress have become persistent and have started affecting our daily functioning, including at work or school.

No, everyone reacts differently to stressful situations. Coping styles and symptoms of stress vary from person to person. ​​

Yes, it is natural to feel stressed in challenging situations such as job interviews, school exams, unrealistic workloads, an insecure job, or conflict with family, friends or colleagues. For many people stress reduces over time as the situation improves or as they learn to cope emotionally with the situation. Stress tends to be widespread during events such as major economic crises, disease outbreaks, natural disasters, war, and community violence. 

Most of us manage stress well and continue to function. If we have difficulties coping with stress, we should seek help from a trusted health-care provider or from another trusted person in our community.

Learn stress management

WHO’s stress management guide – Doing what matters in times of stress – aims to equip people with practical skills to cope with stress. A few minutes each day are enough to practise the guide’s self-help techniques. The guide can be used alone or with its accompanying audio exercises.

Keep a daily routine

Having a daily schedule can help us use our time efficiently and feel more in control. Set time for regular meals, time with family members, exercise, daily chores and other recreational activities. 

Get plenty of sleep

Getting enough sleep is important for both body and mind. Sleep repairs, relaxes and rejuvenates our body and can help reverse the effect of stress.

Good sleep habits (also known as sleep hygiene) include:

• Be consistent. Go to bed at the same time each night and get up at the same time each morning, including on the weekends.
• If possible, make your sleeping area quiet, dark, relaxing and at a comfortable temperature.
• Limit your use of electronic devices, such as TVs, computers and smart phones, before sleeping.
• Avoid large meals, caffeine and alcohol before bedtime.
• Get some exercise. Being physically active during the day can help you fall asleep more easily at night.

Connect with others  ​

Keep in touch with family and friends and share your concerns and feelings with people you trust. Connecting with others can lift our mood and help us feel less stressed.

Eat healthy​

What we eat and drink can affect our health. Try to eat a balanced diet and to eat at regular intervals. Drink enough fluids. Eat lots of fresh fruits and vegetables if you can.

Exercise regularly ​

Regular daily exercise can help to reduce stress. This can include walking, as well as more intensive exercise.

Limit time following news ​

Spending too much time following news on television and social media can increase stress. Limit the time you spend following the news if it increases your stress.

Doing What Matters in Times of Stress: An Illustrated Guide