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How to Be Better at Stress

How to Be Better at Stress

 


Originally published on July 24, 2017

Stress is unavoidable in modern life, but it doesn’t have to get you down. Work, money and family all create daily stress, while bigger issues like the global pandemic and politics contribute to our underlying stress levels. But approach it the right way, and it won’t rule your life — it can even be good for you. Here are ways to deal with stress, reduce its harm and even use your daily stress to make you stronger.


Stress is inevitable; getting sick from it is not.

While we know that stress is associated with health problems, plenty of people with high-stress lives are thriving. How is that possible? In 2012, researchers from the University of Wisconsin-Madison published a seminal study looking at how 28,000 people perceived stress in their lives. People in the study answered these two questions:

  • During the past 12 months, would you say that you experienced:

    A lot of stress
    A moderate amount of stress
    Relatively little stress
    Almost no stress at all

  • How much effect has stress had on your health?

    A lot
    Some
    Hardly any
    None

    The researchers looked at death rates in the study group over nine years. The results are startling. The study found that having a lot of stress in your life was not linked with premature death. But having a lot of stress in your life and believing it was taking a toll on your health increased risk of premature death by 43 percent.

With stress, the mind and the body are intrinsically linked. You can view stress as something that is wreaking havoc on your body (and it can) or as something that is giving you the strength and energy to overcome adversity. Here’s a quick way to think about these two very different views of stress. Read the statement, and then think about your own reaction to the biological changes that occur during times of stress.

1. When I’m stressed, my body releases adrenaline and cortisol. My heart is beating faster. This means that:

  • Common View: Stress is increasing my risk for cardiovascular disease and heart attack.

  • Alternative View: My heart is working harder and my body is mobilizing its energy to get ready for this challenge.

2. When I’m stressed, my stress response is causing my breathing rate to increase. This means that:

  • Common View: My fast breathing is a sign of anxiety. I worry about how stress is affecting my mental and physical health.

  • Alternative View: I should take a deep breath. My faster breathing means more oxygen is getting to my brain so I can think more clearly.

3. When I’m stressed, my heart and circulatory system respond, causing my blood pressure to rise. This means that:

  • Common View: I can feel my blood pressure rising. This can’t be good for my health.

  • Alternative View: Circulatory changes are allowing more oxygen and nutrients to fuel my muscles. I’m feeling stronger and ready for the challenge ahead.

It’s probably clear to you that the alternative view is the better choice for thinking about stress. It may be hard to believe that such a small shift in thinking could make a difference, but that’s what Harvard researchers found when they paid 50 study subjects $25 each to take part in a lab experiment designed to induce stress. The test involves giving a talk in front of a group of unfriendly evaluators, followed by a tricky word test. (Researchers have consistently found that this formula of public speaking plus testing in front of a hostile crowd is incredibly uncomfortable and stress-inducing for the poor people who agree to take part in the study.)

Before the social stress test, one group was allowed to play video games; another was taught to simply ignore stressful feelings if they experienced them during the test. But a third group was given advice similar to the quiz above. They got a primer about the physical stress response and were told how a higher heart rate, faster breathing and internal jitters were all tools for making you strong during a stressful event. They were told how the body’s stress response evolved to help us succeed, and that the increased arousal symptoms of stress can aid your performance during times of stress. The bottom line of the lesson was this: In a tough situation, stress makes you stronger.

The group that learned to rethink the role of stress in their lives did far better on the test. They gave better speeches and were rated as more confident. They smiled more and had more-positive body language. And physiological indicators showed that their bodies were also managing the stress response better than those of test subjects who were taught to ignore stress or given no advice at all.

The Stanford psychologist Kelly McGonigal has been a champion of rethinking stress, noting that the right approach can make you smarter and stronger. Her TED talk on the subject, “How To Make Stress Your Friend,” has been viewed 14 million times.

“What I learned from these studies, surveys and conversations truly changed the way I think about stress,” Dr. McGonigal wrote in her book “The Upside of Stress: Why Stress Is Good for You, and How to Get Good at It.” “The best way to manage stress isn’t to reduce or avoid it, but rather to rethink and even embrace it.”


Learn skills to better handle stress.

The best way to get better at stress is to practice it. Scientists call this “stress inoculation,” and just as exposure to a virus will inoculate you from contracting a virus a second time, regular exposure to small amounts of stress can inoculate you from the most detrimental effects of stress when you suffer a big stressful event in your life.

Stress inoculation has three phases.

1. Education: Learn what to expect. If you need chemotherapy, are experiencing a divorce or have had a setback at work, talk to people who have been through it and learn what to expect going forward so you can be prepared, rather than blindsided, by the stressors ahead of you.

2. Rehearsal: While you can’t rehearse for life’s biggest moments, you can live your life in a way that prepares you for stress. It can be a physical challenge like competing in a triathlon or conquering a mountain. It can be an intellectual stressor like reading your poetry in public or giving a speech. The point is that you need to rehearse stressful situations in order to perform your best under stress.

3. Implementation: When the stressful event hits, you are prepared. You know what to expect, and you’ve experienced stressful situations before. You’ve got this.

Think about how firefighters train. They educate themselves about fire and how it behaves in different situations. They put themselves through grueling physical training to practice carrying heavy equipment, navigating smoky, dark buildings and stairwells, and braving the heat of a raging fire. They practice running into burning buildings. The training is hard and highly stressful.

Now imagine you are out for a nightly walk and you see that a neighbor’s house is on fire. Your heart races. You panic. You fumble with your phone. You take a step toward the house. You hesitate. What do you do? Fortunately, the firefighters arrive and race into the home without hesitation. Your moment of stress and anxiety is just another day at the office for them. They know what to expect. They trained for it.

You can practice for everyday stress in similar ways, by putting yourself in challenging situations. The good news is that practicing stress can actually be enjoyable, even thrilling. The key is to push yourself out of your comfort zone. Here are some suggestions:

  • Run a marathon

  • Play in a Scrabble competition

  • Read an original poem at a poetry slam

  • Climb a mountain

  • Sing karaoke

  • Tell a story in front of a crowd

  • Take on a tough project at work

  • Kayak the Colorado rapids

  • Train to scuba dive

  • Attend a boot camp

Not only will challenging experiences give you more confidence, but the repeated exposure to stressful situations can also change your body’s biological response to stress. Your stress hormones become less responsive, allowing you to better handle stress when it comes.

Dr. Dennis Charney, a psychiatrist and the dean of the Icahn School of Medicine at Mount Sinai in New York City, notes that programs like Outward Bound and basic military training are all designed to make people uncomfortable and build their skills so that they will be better able to handle stress later on. When his children were young, he took them on adventure trips that included “a degree of anxiety” like exposure to wildlife or kayaking in remote areas as a way to build confidence and prepare them to deal with stressful events. Putting yourself or your children in difficult social situations or speaking in public can help adults and children accumulate social and intellectual skills that help in times of stress.

“Live your life in a way that you get the skills that enable you to handle stress,” says Dr. Charney. “Put yourself out of your comfort zone.”

Another factor in how you handle a stressful situation is resilience. The American Psychological Association defines resilience this way:

Resilience is the process of adapting well in the face of adversity, trauma, tragedy, threats or significant sources of stress — such as family and relationship problems, serious health problems or workplace and financial stressors. It means “bouncing back” from difficult experiences.

You can boost your resilience in a number of ways. In the book “Resilience: The Science of Mastering Life’s Greatest Challenges,” the authors, Dr. Steven M. Southwick and Dr. Charney, studied people who experienced great stressors — prisoners of war, men in the special forces, victims of trauma or survivors of catastrophic events. They found that people with the most resilience in the face of extreme challenges shared several behaviors and mind-sets. From that research, the duo identified 10 factors associated with resilience. You don’t need to practice all 10 behaviors to build resilience; just pick the two or three or four that speak to you.

1. Adopt a positive attitude. Optimism is strongly related to resilience.

2. Reframe the situation. Just like the stressed-out study subjects were taught to reappraise stress as their friend, people who are resilient typically reframe a negative situation as an opportunity for growth, learning or change.

3. Focus on core beliefs. People with a deeply held core belief, strong faith or a commitment to altruism often show more resilience.

4. Find a role model. Seeing someone else who has come through adversity can strengthen your own resilience.

5. Face your fears. Confronting a challenge rather than avoiding it will help you cope and build confidence.

6. Fall back on religion or spirituality. For many people, strong faith or spiritual beliefs can fuel resilience.

7. Seek social support. People who reach out to friends, family and support groups fare better during stressful times.

8. Exercise. It improves mood, relieves stress and makes you physically stronger.

9. Inoculate against stress. Challenge yourself regularly in the areas of emotional intelligence, moral integrity and physical endurance.

10. Find meaning and purpose. Having a clear purpose in life can boost your emotional strength during difficult times.


Numerous studies have shown us that exercise can improve your mood.

Exercise can channel your stress response into something constructive and distract your mind from the challenges at work or home that make you feel chronically stressed. In many ways exercise appears to be a form of stress inoculation. In studies, mice given access to running wheels and tubes to explore for just two weeks became resistant to stress compared with mice who had not exercised. They measured this by exposing the mice to an aggressive mouse. After the bullying, the exercising-mice bounced back, but the sedentary mice continued to show signs of stress. The bottom line: Exercise doesn’t eliminate stress, but it does give your body the physical conditioning it needs to recover from it.

How Much Exercise Do I Need to Manage Stress? It doesn’t take much. Even small amounts of exercise can help you manage your stress. The key is consistency. Don’t let the stress of your day push exercise off the schedule.

Does the Type of Exercise Matter? The exercise that is best for relieving stress is the one you will do consistently. Find something that fits your schedule and that you enjoy. For some, that will be a morning spin class or an evening run. For others, it will be a 30-minute walk at lunch time. A Norwegian study found that people who engaged in any exercise, even a small amount, reported improve mental health compared with people who never exercised.

What About Weight Training? One study showed that six weeks of bicycle riding or weight training eased symptoms in women who received a diagnosis of anxiety disorder. The weight training was especially effective at reducing irritability.

Indeed, some research suggests that when it comes to reducing stress, you’ll get more out of exercise if you incorporate some weight training. Studies show that anaerobic or resistance exercises (working with weights) taxes muscles more than aerobic exercise like walking or running. The result is that weight training, done right, may produce more mood-boosting endorphins than cardio exercise. Exercises that stress the large muscles seem to have the biggest effect, like squats, leg presses, incline situps, military presses and bench presses.

Simply taking your exercise outdoors can have a significant effect on your mood.

In a number of recent studies, volunteers who walked outdoors reported enjoying the activity more than those who walked indoors on a treadmill. Subsequent psychological tests showed outdoor exercisers scored significantly higher on measures of vitality, enthusiasm, pleasure and self-esteem and lower on tension, depression and fatigue.

A study last year of older adults found that those who exercised outside did so longer and more often than those working out indoors. The outdoor exercisers averaged about 30 minutes more exercise each week than those who walked or otherwise exercised indoors.

A few small studies have found that people have lower blood levels of cortisol, a hormone related to stress, after exerting themselves outside as compared with inside. There’s speculation, too, that exposure to direct sunlight, known to affect mood, plays a role.

A study in Austria found that almost all the participants reported that the outdoor effort had felt less strenuous to them than their time on the treadmill. And they enjoyed it more.

A small study from the University of Essex found that exercisers exposed to the color green found it easier to exercise and were in a better mood than exercisers exposed to gray or red. (Think green trees versus a cement-walled gym.)


Exercise your mind and let it rest to help it better process stress.

For people dealing with high levels of stress, it can be hard to fathom how a few moments of meditation will help. After meditation, the stressors are still there — you’re still getting divorced, caring for an aging parent, struggling with the demands of a high-stress job. How can a few moments of deep thought possibly help your life?

It may help to think about how muscles get stronger. Unrelenting exercise simply tears down a muscle and leads to injury. Smart exercisers know the value of a day of rest — that’s when your muscles regenerate and come back stronger than before.

Now think about your mind as an emotional muscle. Unrelenting stress without a break will not make it stronger. Your emotions, your brain and your body need moments of recovery to get stronger from stress.

“It’s about stress and recovery. Just like you build a physical muscle, just like you build biceps, you have to take the same approach to life stressors,” says Jack Groppel, co-founder of the Johnson & Johnson Human Performance Institute, which offers a course called “The Power of Positive Stress.“

Think of meditation like high-intensity interval training (H.I.I.T.) for the brain. During H.I.I.T., you go as hard as you can, then you give yourself a few minutes of recovery before returning to the exercise. This cycle is repeated multiple times and has been shown to be more effective for building strength than long, slow bouts of exercise.

Now imagine a high-intensity, high-stress workday. But every hour, you take two minutes to let your brain recover. “Stress is the stimulus for growth,” says Dr. Groppel. “Recovery is when growth occurs. If there is no recovery, there is no growth. That’s how we build the resilience muscle.”

Controlled breathing has been shown to reduce stress, increase alertness and boost your immune system. For centuries yogis have used breath control, or pranayama, to promote concentration and improve vitality. The Buddha advocated breath-meditation as a way to reach enlightenment.

Science is just beginning to provide evidence that the benefits of this ancient practice are real. Studies have found, for example, that breathing practices can help reduce symptoms associated with anxiety, insomnia, post-traumatic stress disorder, depression and attention deficit disorder.

When your mind is racing or you feel keyed up, try Rock and Roll breathing, which has the added benefit of strengthening your core.


1. Sit up straight on the floor or the edge of a chair.

2. Place your hands on your belly.

3. As you inhale, lean forward and expand your belly.

4. As you exhale, squeeze the breath out and curl forward while leaning backward; exhale until you’re completely empty of breath.

5. Repeat 20 times.


Meditation

One study recruited 35 unemployed men and women who were seeking work and experiencing considerable stress. All of them participated in stretching exercises, but half of them were also taught formal mindfulness meditation. After three days, everyone said they felt refreshed and better able to withstand the stress of unemployment. Yet follow-up brain scans showed differences in only those who underwent mindfulness meditation. There was more activity, or communication, among the portions of their brains that process stress-related reactions and other areas related to focus and calm. Four months later, those who had practiced mindfulness showed much lower levels in their blood of a marker of unhealthy inflammation than the relaxation group, even though few were still meditating.

To learn more about meditation, try the introductory exercise below.

Learn how to pay close attention to the present moment with this meditation exercise.


STEP 1

Find a comfortable place to sit, and a posture that is both alert and relaxed at the same time. See if you can make the spine erect, without being too rigid.

STEP 2

Close your eyes (or leave them slightly open if you prefer), and take a few slow breaths. Take a few moments to loosen your body from your head to your toes, and take a few more deep breaths.

STEP 3

Stop to notice the sensations throughout your body — the warmth, the coolness or any discomfort. Be aware of them, but try not to fidget too much.

STEP 4

Pick one sensation — such as the feeling of your breath going in and out — and devote your attention to it. Just focus on that.

STEP 5

When your mind wanders, bring your attention back to the breath. After a few moments, your mind may wander again. Once again, notice that and simply return your attention back to the present moment.

STEP 6

When you’re ready — after one minute, 10 minutes or 30 minutes — open your eyes. Though your formal meditation practice may have ended, your mindful awareness can continue throughout the day.


Write it down

Another way to cope with stress: writing. It is based on the idea that we all have a personal narrative that shapes our view of the world and ourselves. But sometimes our inner voice doesn’t get it completely right. Some researchers believe that by writing and then editing our own stories, we can change our perceptions of ourselves and identify obstacles that stand in the way of better health. It may sound like self-help nonsense, but research suggests the effects are real.

Timothy D. Wilson, a University of Virginia psychology professor and author of “Redirect: Changing the Stories We Live By,” believes that while writing doesn’t solve every problem, it can definitely help people cope. “Writing forces people to reconstrue whatever is troubling them and find new meaning in it,” he said.

There are a number of methods to tap into the power of expressive writing:

Journal every day. Just writing about your thoughts, feelings and experiences every day can help. Explore your thoughts and feelings about an issue. Don’t just re-live the stress in your life but try to find meaning in it or explore how well you’ve handled certain situations. Be disciplined and write at the same time every day so it becomes a habit. In a University of Texas study, students who wrote about stressful or traumatic events for four days in a row reaped the benefits for months after. For the next six months, the writing students had fewer visits to the campus health center and used fewer pain relievers than the students in the experiment who wrote about trivial matters.

Change your story. Use writing to force yourself to confront the changes you need to make in your life. On the first day, write down your goals, then write down why you haven’t achieved them (“I don’t have the time or the money,” “Too many family responsibilities,” etc.) The next day review your writing. Now ask: What is really standing in the way of your goals? Change the story so you have control. Maybe the answer is: I don’t put myself first. I don’t make exercise a priority. I let other people talk me into spending money rather than saving.

Write a mission statement. People deal with stress better when they have a strong moral compass. This means knowing what you value in life and using that as a guidepost for all decision. By creating a mission statement people can begin to identify the underlying causes of behaviors, as well as what truly motivates them to change. “A mission statement becomes the North Star for people,” says Dr. Groppel. “It becomes how you make decisions, how you lead and how you create boundaries.” To learn more, read our article “Creating a New Mission Statement.”

Stress can have a huge impact on your eating habits. During acute stress (the hours after a car accident or the shock of a layoff announcement at work), the stress response can shut down appetite. The fight-or-flight response is designed to suppress hunger — you won’t be effective in battle or run that fast if you are thinking about food. But chronic stress has the opposite effect. Repeated doses of cortisol in your body due to high stress can lead to an increase in appetite.

According to the Harvard Health Letter, gender can play a role in how you eat during times of stress. Some research suggests women are more likely overeat due to stress while men turn to alcohol or smoking.

And the reality is that food really can make you feel better during times of stress. So-called comfort food like chocolate cake and ice cream literally blunt the body’s response to chronic stress. The problem with continuing to self-medicate chronic stress with comfort foods is that it will lead to weight gain and poor health.

Just as you need to reframe your view of stress and exercise and meditate to give your body a break from stress, you can also adopt strategies to use food to help you better cope with stress.

During times of stress, we can be particularly careless about what we eat and resort to mindless snacking, grabbing sweets from the office treat table or eating bags of junk food on the run. During times of stress, it’s particularly important to engage in “mindful eating,” which involves eating slowly and relishing every bite.

“The question isn’t what are the foods to eat, in my mind,” says Dr. Michael Finkelstein, a holistic physician who oversees SunRaven, a holistic-living center in Bedford, N.Y. “Most people have a general sense of what the healthy foods are, but they’re not eating them. What’s on your mind when you’re eating: That’s mindful eating to me.”

Here’s a simple exercise to try next time you are sitting down to a delicious meal:

  • Place a forkful of food in your mouth. Make it something you love.

  • Put the fork down and resist the temptation to take a second bite.

  • Chew slowly. Tune in to the texture of the food, the flavor, the aroma. Focus on the colors on your plate.

  • Be present in the moment and think only about the food in your mouth. Reflect on the effort that went into growing or producing this food; the effort it took to prepare this meal.

  • Savor the moment.

To learn more, read “Mindful Eating as Food for Thought.”


Your friends and family can be both a cause of stress and a cure for it.

The pressure of family responsibilities is one of the most common forms of stress. But during times of stress, our friends and family members are most likely to give us the support we need to get through it.

One of my favorite friendship studies involved a steep hill, a heavy backpack and 34 university students. Students were fitted with a backpack full of free weights equivalent to 20 percent of their body weight. They stood at the base of a hill on the University of Virginia campus with a 26-degree incline. Wearing the heavy backpack, they had to imagine climbing that hill and guess the incline. When a student stood alone, he or she tended to guess that the hill was very steep. But when they stood next to a friend, the hill didn’t look as daunting. Overall, students in pairs consistently gave lower estimates of the hill’s incline compared with students who were alone. And the longer the friends had known each other, the less steep the hill appeared.

The lesson: The world does not look as challenging with a friend by your side.

For people who study stress, the role of friendship, family and support networks can’t be overstated. Time and again research shows that social support is a defining element in our happiness, quality of life and ability to cope with stress.

During times of high stress we have a tendency to retreat. We cancel social plans and focus on the work, money crisis or trauma that is our source of stress. But friends and social support are among the best forms of therapy to help you escape stress for brief periods of time. Friends can also make you feel better about yourself, and that mountain of stress in your life won’t look so steep.

When Dr. Southwick, Yale Medical School psychiatrist, co-wrote his book on resilience, he interviewed a number of people who had shown resilience against all odds, including former prisoners of war and people who had survived trauma. One thing they had in common was social support.

“The resilient people we interviewed actively reached out for support,” said Dr. Southwick. “They don’t sit around and wait.”

Even POWs held in isolation devised a tapping method of communication with their fellow prisoners. “Most, if not all, said it was life-saving to know they weren’t alone and they were cared for,” said Dr. Southwick.

When Dr. Southwick, a psychiatrist, meets with a new patient, one of the first things he does is construct a diagram of the patient’s social network. Sometimes they just talk about it; some patients want to map it out on paper. “Who is in your life? Who can you count on?” asks Dr. Southwick. Make your own list of your social network and keep it handy when you need to call on someone for support.

If you lead a highly stressful life, the solution may be to add one more task to your daily to-do list. Give back.

Research consistently shows that helping other people and giving social support is a powerful way to manage the stress in your life and boost your resilience. Volunteer work, mentoring, mowing your elderly neighbor’s lawn, listening to a friend who is struggling — all these can enhance your own ability to manage stress and thrive.“

Time spent helping others, sharing our knowledge and providing social and emotional support gives meaning and purpose to our lives,” said Adam Grant, a Wharton management professor and co-author of the book “Option B: Facing Adversity, Building Resilience and Finding Joy” with Sheryl Sandberg. “Getting out of yourself and helping others may be even more powerful than receiving social support.”

The simple act of touching another person — or being touched — can ease your stress. James A. Coan, an assistant professor of psychology and a neuroscientist at the University of Virginia, recruited 16 women who felt they had strong support in their relationships. To simulate stress, he subjected each woman to a mild electric shock under three conditions, all while monitoring her brain. The shocks were administered in no particular order while the woman was 1) alone, 2) holding a stranger’s hand, and 3) holding her husband’s hand.

Notably, both instances of hand-holding reduced the neural activity in areas of the woman’s brain associated with stress. But when the woman was holding her husband’s hand, the effect was even greater, and it was particularly pronounced in women who had the highest marital-happiness scores. Holding a husband’s hand during the electric shock resulted in a calming of the brain regions associated with pain similar to the effect brought about by use of a pain-relieving drug.

Coan says the study simulates how a supportive marriage and partnership gives the brain the opportunity to outsource some of its most difficult neural work. “When someone holds your hand in a study or just shows that they are there for you by giving you a back rub, when you’re in their presence, that becomes a cue that you don’t have to regulate your negative emotion,” he told me. “The other person is essentially regulating your negative emotion but without your prefrontal cortex. It’s much less wear and tear on us if we have someone there to help regulate us.”

Spending time with your pet can offer a temporary reprieve from stress. Spending time with your dog and taking it for a walk is a twofer — you get the stress reduction of a pet plus the stress-busting benefits of a walk outdoors.

The evidence that pets are a source of comfort and stress relief is compelling. At Veterans Affairs hospitals, therapy animals including dogs and parrots have helped patients undergoing treatment for post-traumatic stress reduce their anxiety.

Studies have shown that after just 20 minutes with a therapy dog, patients’ levels of stress hormones drop and levels of pain-reducing endorphins rise.

In a controlled study of therapy dog visits among patients with heart disease, researchers at the University of California, Los Angeles, found a significant reduction in anxiety levels and blood pressure in the heart and lungs in those who spent 12 minutes with a visiting animal, but no such effect occurred among comparable patients not visited by a dog.


Excessive stress can take a physical toll if it’s not managed correctly.

While some stress is essential for human function, chronic stress creates a cascade of physical changes throughout your body.

Heart: During a stressful event, your heart rate increases and your body releases the stress hormones — cortisol, adrenaline and noradrenaline. In some parts of the body (skin, digestive system, brain) blood vessels constrict, allowing blood flow to increase to larger systems (heart, large muscles). The body is redirecting oxygen and nutrients to the areas where they are needed most to give you the strength to fight or flee. But blood flowing to a smaller area causes blood pressure to rise. Normally the effects are temporary, but some research suggests that in people with chronic stress, the effects on the heart are unrelenting, raising the risk for high blood pressure, heart attack and stroke.

Immune System: Chronic stress can depress the immune system and make you more vulnerable to colds or more serious illnesses.

Diabetes Risk: During stress, the liver increases glucose production for a boost of energy to propel you during an emergency. Chronic stress can lead to extra blood sugar, increasing risk for diabetes, especially among those already at high risk, such as the overweight or those with a family history of the disease. According to the American Psychological Association, learning to manage your stress can be nearly as effective at controlling blood sugar as medication.

Stomach and Digestion: Stress can affect how fast food moves through your body, stomach acid and the absorption of nutrients. Chronic stress can also lead to overeating or alcohol use. All of these factors can contribute to a number of gastrointestinal issues including acid reflux, heartburn pain, nausea, stomach pain, ulcers and diarrhea.

Sex and Reproduction: In men, chronic stress can affect testosterone levels and sperm count, and contribute to erectile dysfunction. In women, stress can create irregular menstrual cycles and painful periods and exacerbate premenstrual syndrome. Stress can also worsen the symptoms of menopause, including more frequent and more severe hot flashes. In both men and women, chronic stress can dampen sexual desire.


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