We should all be concerned with how stress affects our health. According to the Labour Force Survey, there were almost 1 million work-related stress, depression, or anxiety cases in the UK in 2021/22. Stress is also linked to the leading causes of death in the UK, including heart disease, diabetes, and cancer.
So, how can you protect yourself from the harmful effects of stress? In this article, we'll talk about the psychology of stress management.
- First, we'll explore the benefits of managing stress.
Next, we'll outline the ways to manage stress.
Then, we'll dive into the role of drug therapies in managing stress and anxiety.
Moving along, we'll explore psychological stress management strategies.
Finally, we'll consider gender differences in stress management.
Fig. 1 - Stress management is crucial to taking care of our health and well-being.
What are the Benefits of Managing Stress?
Stress management is important for individual well-being and our quality of life; it can also improve our productivity and academic and work performance.
Moreover, high levels of stress are also a public health concern, as it's been associated with serious health conditions, including Coronary Heart Disease, cancer, diabetes, and even Alzheimer's disease.
Since most of us won't be able to eliminate stressful situations from our life, it's important to know what strategies could help us manage the effects of stress.
What are the Ways to Manage Stress?
We will look at stress management techniques, including drug therapy and psychological interventions and how they work. Below are the specific ways of managing stress that we'll cover.
Stress management involves reducing the impact of stress on our mind and body through pharmacological or psychological interventions.
Drug therapies:
- Use of benzodiazepines in stress management.
- Use of beta blockers in stress management.
Psychological interventions:
- Use of biofeedback in stress management.
- Stress Inoculation Therapy (SIT).
Drug Therapies in Managing Stress and Anxiety
Drug therapy is one of the stress management tools. Certain medications can act to reduce the body's physiological stress response and trigger a relaxation response instead. The two drug categories used to manage the physiological effects of stress are Benzodiazepines and beta-blockers.
Benzodiazepines work by affecting the GABA and serotonin neurotransmitters.
Neurotransmitters are chemical messengers that essentially tell a neuron when they should or shouldn't perform an action.
Different types of neurotransmitters in the body are responsible for different functions, e.g. serotonin is associated with feelings of happiness. The type of neurotransmitter present has different effects on neurons, i.e. they could be excitatory (increase activity) or inhibitory (reduce activity).
GABA is an inhibitory neurotransmitter which controls our behavioural responses as well as the physiological processes of our body. By enhancing GABA transmission, benzodiazepines reduce physiological arousal (decrease blood pressure, slow breathing, etc.) and cause relaxation and sedation.
Beta-blockers reduce the physiological effects of stress by blocking the effects of adrenaline.
Adrenaline is responsible for heightened physiological arousal when experiencing the fight-or-flight response. It is transported to the heart, where it fuels the beta receptors, increasing blood pressure and heart rate.
Beta-blockers stop adrenaline from binding to beta receptors, keeping the body from heightened states of arousal in response to stress.
Fig. 2 - Stress can be pharmacologically managed with benzodiazepines or beta-blockers, which target the physiological stress response.
The effectiveness of benzodiazepines has been supported in studies. However, it's not always more effective in reducing anxiety than other medications.
Kahn et al. (1986) conducted a double-blind study with 242 participants with anxiety disorders. Participants were randomly assigned to three groups. They were either given a tricyclic antidepressant, benzodiazepine, or placebo treatment.
The group who received antidepressants showed superior effects in terms of reducing anxiety after eight weeks of treatment.
Medication can only provide temporary relief for many. It is important to have skills that can help us cope with daily stressors; this is where psychological interventions come in.
Psychological Stress Management Strategies
Psychological stress management interventions include Stress Inoculation Therapy and biofeedback. Both of these stem from the cognitive behavioural approach and follow a stepwise process.
Stress Management: Stress Inoculation Therapy
Meichenbaum (1975) developed Stress Inoculation Therapy (SIT) based on the techniques used in cognitive behavioural therapies. Sit is used for stress and anxiety management.
Stress Inoculation Therapy follows three steps. It starts with identifying the cause of stress and the irrational thoughts that contribute to one's stress response.
And the next step is learning the cognitive and behavioural skills to manage stress and practising them.
SIT offers three steps to managing stress and anxiety:
Conceptualisation stage: the patients are guided to help individuals analyse different aspects of the stressor and understand how it affects their lives and how they respond to it.
Skill learning and rehearsing stage: the patient is taught some stress coping strategies, including relaxation techniques, practising control, etc.
Practical application: the patient puts the newly acquired knowledge to the test while engaging with real-life situations. The patient is taught to perceive any setbacks from the real-world situation as challenges rather than failures.
Stress Management: Biofeedback
This intervention requires the use of devices that monitor one's arousal, indicated, for example, by increased muscle tension.
Biofeedback uses technology to allow patients to exert conscious control over their physiological responses to stress.
The technology allows people to monitor their physiological response in real-time and learn to downregulate it using feedback from the device consciously.
Three types of technology are often used in biofeedback. And some of these include:
Skin conductance response (SCR) for measuring sweating.
Electromyogram (EMG) for measuring muscle tension due to stress.
Electroencephalogram (EEG) for measuring brain activity.
Electrocardiogram (ECG) for measuring heart rate.
When you notice tension in your muscles, you can start practising relaxation techniques to calm yourself down (e.g. muscle relaxation or deep breathing).
The Electromyogram will tell you when your muscles start to relax in response. This gives you a better awareness of how to control your body's arousal, which can be applied in real-life stressful situations.
Biofeedback interventions involve eight to ten sessions, which may require follow-ups. Each session lasts around an hour, and improvement begins approximately after the ninth or the tenth session.
Fig. 3 - Biofeedback requires access to specialist technology and allows better control of the body's physiological stress response.
How Effective are the Psychological Interventions?
Jay & Elliot (1990) tested the effectiveness of SIT in a sample of parents whose children had leukaemia and had to undergo medical procedures.
- The parents were either assigned to SIT condition or observed their child receiving cognitive-behavioural therapy treatment.
Based on the parents' behaviour, self-reported anxiety and physiological measures of stress, the researchers concluded that SIT reduced parents' anxiety and increased their self-esteem.
Scharff et al. (2002) investigated the effects of biofeedback in a sample of 36 children and adolescents suffering from migraines.
- There were three conditions: stress management and a hand-warming biofeedback condition, a hand-cooling biofeedback condition and a control condition.
Hand-warming and hand-cooling biofeedback involved learning how to either increase or decrease the temperature of one's hands through relaxation and imagery.
The researchers found that hand-warming biofeedback effectively reduced migraines in the sample, lasting approximately six months after the treatment.
But how do the two approaches compare? Holroyd et al. (1977) compared the effectiveness of coping skills and biofeedback in 31 patients with chronic tension headaches.
In this study, cognitive stress coping intervention produced superior effects in reducing tension headaches than biofeedback.
Compare Techniques for Managing Stress
Let's look at how drug therapies and psychological interventions compare.
Comparison of Stress Management Techniques |
|---|
SIT & Biofeedback | Drug Therapies |
| Expensive and not accessible for everyone: requires expert psychologists/ equipment. | The use of drug therapy is accessible, time and cost-effective, which is why it is a popular choice among patients. |
| Results might take time. | Results are immediate. |
| Effectiveness relies on the client's motivation and adherence to treatment. | The client doesn't need to be motivated or put effort into the treatment. |
| Long-term effectiveness. | It may not be effective in the long term. |
| Not appropriate to use for the intervention of some issues, such as dependence or addiction. | Prolonged usage of benzodiazepines may lead to dependence on them, and patients may quickly develop tolerance, requiring larger doses to achieve the same effects. |
| No side effects. | Severe side effects may occur, especially with long-term use. |
Gender Differences in Stress Management
Individual differences and other factors should be considered when considering what intervention we should use for stress management. For instance, there might be gender differences in how we cope with stress.
Peterson et al. (2006) investigated how men and women suffering from infertility coped with stress. He highlighted that women used behaviours or had specific traits, e.g. they were often confrontational, accepted the situation, sought social support and engaged in avoidance.
On the other hand, men preferred distancing and engaging in self-controlling and problem-solving behaviours.
Both men and women engaged in all these strategies, but slight differences in terms of preference were found.
Women were more likely to seek social support to cope with the stressor of infertility, while men were more likely to distance themselves from others and follow a plan of action to address the problem.
Men's behaviour was more in line with problem-focused coping, while women preferred emotion-focused coping.
According to Tayler et al. (2000), women's responses to stress are better characterised by the tend-and-befriend response rather than a fight-or-flight response. The theory suggests that women can regulate their distress levels by focusing on nurturing and maintaining their and their offspring's safety.
This ability to regulate the stress response through caring and attachment is linked to oxytocin and how it affects women's physiology.
Oxytocin is a hormone that fosters social bonds and affiliation behaviours in humans.
Tayler et al. (2000) suggested that oxytocin reduces the effect of cortisol levels (stress hormone) in women, which helps them maintain their stress levels, showing that adverse effects of stress may last longer in males compared to females.
Stress Management - Key takeaways
- Stress management involves reducing the impact of stress on our mind and body either through pharmacological or psychological interventions.
The two pharmaceutical ways to manage stress are using Benzodiazepines or beta-blockers.
Benzodiazepines work by affecting GABA and serotonin neurotransmitters.
- Beta-blockers block the effects of adrenaline.
Stress Inoculation Therapy starts with identifying the cause of stress and the irrational thoughts about it that contribute to one's stress response. The next step is learning the cognitive and behavioural skills to manage stress and practising them.
- Biofeedback uses technology to allow patients to exert conscious control over their physiological responses to stress. Both SIT and biofeedback are psychological stress management techniques.
- There is some evidence for gender differences in stress, e.g. women are more likely to use the tend-and-befriend response than men.
References
- Kahn, R. J., McNair, D. M., Lipman, R. S., Covi, L., Rickels, K., Downing, R., Fisher, S., & Frankenthaler, L. M. (1986). Imipramine and chlordiazepoxide in depressive and anxiety disorders. II. Efficacy in anxious outpatients. Archives of general psychiatry, 43(1), 79–85. https://doi.org/10.1001/archpsyc.1986.01800010081010
- Jay, S. M., & Elliott, C. H. (1990). A stress inoculation program for parents whose children are undergoing painful medical procedures. Journal of consulting and clinical psychology, 58(6), 799–804. https://doi.org/10.1037//0022-006x.58.6.799
- Holroyd, K.A., Andrasik, F. & Westbrook, T. Cognitive control of tension headache. Cogn Ther Res 1, 121–133 (1977). https://doi.org/10.1007/BF01173633
- Lisa Scharff, PhD, Dawn A. Marcus, MD, Bruce J. Masek, PhD, A Controlled Study of Minimal-Contact Thermal Biofeedback Treatment in Children With Migraine, Journal of Pediatric Psychology, Volume 27, Issue 2, March 2002, Pages 109–119, https://doi.org/10.1093/jpepsy/27.2.109
- Taylor, S. E., Klein, L. C., Lewis, B. P., Gruenewald, T. L., Gurung, R. A. R., & Updegraff, J. A. (2000). Biobehavioral responses to stress in females: Tend-and-befriend, not fight-or-flight. Psychological Review, 107(3), 411–429. https://doi.org/10.1037/0033-295X.107.3.411
- Peterson, Newton, C. ., Rosen, K. ., & Skaggs, G. . (2006). Gender differences in how men and women who are referred for IVF cope with infertility stress. Human Reproduction (Oxford), 21(9), 2443–2449. https://doi.org/10.1093/humrep/del145
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