Ask Your Family Doctor

Developed by the College of Family Physicians of Canada

Stress is caused by the body's instinct to defend itself. This instinct - sometimes called the flight-or-fight response - is good in emergencies, such as getting out of the way of a speeding car. But it can cause physical symptoms if it goes on for too long, such as in response to life's daily challenges and changes.
When this happens, it's as though your body gets ready to jump out of the way of the car, but you're sitting still. Your body is working overtime, with no place to put all the extra energy. This can make you feel anxious, afraid, worried and uptight.

What changes may be stressful?

Any sort of change can make you feel stressed, even good change. It's not just the change or event itself, but also how you react to it that matters. What may be stressful is different for each person. For example, one person may not feel stressed by retiring from work, while another may feel stressed.
Other things that may be stressful include being laid off from your job, your child leaving or returning home, the death of your spouse, divorce or marriage, an illness, an injury, a job promotion, money problems, moving, or having a baby.

Can stress hurt my health?

Stress can cause health problems or make problems worse if you don't learn positive ways to deal with it. Talk to your family doctor if you think some of your symptoms are due to stress. It's important to make sure that your symptoms aren't caused by other health problems.

Signs of stress

	Anxiety Insomnia
	Back pain Problems with relationships
	Constipation or diarrhea Shortness of breath
	Depression Stiff neck
	Fatigue Upset stomach
	Headaches Weight gain or loss
	Heart attack Heartburn

What can I do to reduce my stress?

The first step is to learn to recognize when you're feeling stressed. Early warning signs of stress include tension in your shoulders and neck, or clenching your hands into fists. With your doctor's help, you can learn to identify things in your life that are causing stress and you can learn to become aware of how your body reacts to the stress.
The next step is to choose a way to deal with your stress. One way is to avoid the event or thing that leads to your stress - but this is often not possible. A second way is to change how you react to stress. In many cases, this is the best way.

Tips for dealing with stress

	Don't worry about things you can't control, like the weather.
	Do something about the things you can control.
	Prepare to the best of your ability for events you know may be stressful.
	Work to resolve conflicts with other people.
	Ask for help from friends, family or professionals.
	Set realistic goals at home and at work.
	Exercise.
	Meditate.
	Get away from your daily stresses with group sports, social events, hobbies.
	Don't try to do more than you really can. Say no if someone asks you to do something you don't have time to do.
	Try to look at change as a positive challenge, not a threat.

Why is exercise useful?

Exercise is a good way to deal with stress because it is a healthy way to relieve your pent-up energy and tension. It also helps you get in better shape, which makes you feel better overall.

What is meditation?

Meditation is a method that helps you focus on a relaxing thought or activity. Meditation is a form of guided thought. It can take many forms. You may do it with exercise that uses the same motions over and over, like walking or swimming. You may do it by practicing relaxation training, by stretching or by breathing deeply.

Relaxation training is easy. Start by choosing a muscle and holding it tight for a few seconds. Many people find it helps to start with the muscles of the feet and work their way up. Relax the muscle after a few seconds. Do this with all of your muscles.

Stretching can also help relieve tension. Roll your head in a gentle circle. Reach toward the ceiling and bend side to side slowly. Roll your shoulders. All of these things can help you relax.

Deep, relaxed breathing by itself my help relieve stress.

Steps to deep breathing

	Lie down on a flat surface.
	Place one hand on your stomach, just above your navel. Place the other hand on your chest.
	Breathe in through your nose slowly and try to make your stomach rise a little.
	Hold your breath for a second.
	Breathe out through your nose slowly and let your stomach go back down.

While you're meditating, don't try to stop yourself from thinking about things. Just try not to focus on any one thing for too long. Let your thoughts flow.
If you want more help treating stress symptoms, ask your family doctor for advice or for a referral to a health professional with special training.

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Revised 2007 The College of Family Physicians of Canada

This information provides a general overview on this topic and may not apply to everyone. To find out if this information applies to you and to get more information on this subject, talk to your family doctor. This health education material has been favorably reviewed by the Patient Education Review Committee of the College of Family Physicians of Canada: Dr Cathy MacLean, Halifax, NS (Scientific Editor) Dr C. Richard Fischer, Pickering, ON Dr Patrice Laplante, Fleurimont, QC Dr Richard Moffatt, Red Deer, AB Dr David Nunn, Kentville, NS Dr Cornelius Woelk, Winkler, MB The College of Family Physicians of Canada, one of the nation's largest medical groups, is committed to promoting and maintaining high standards for family physicians - the doctors who provide ongoing, comprehensive care for people of all ages. This patient education information was developed by The College of Family Physicians of Canada in cooperation with the American Academy of Family Physicians.

Support for this program has been provided by an educational grant to the Research and Education Foundation by Scotiabank.