Stress - How to cope better with life’s challenges

2011 rev.
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.

What causes stress?

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 unhealthy 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.

Possible signs and symptoms of stress

        Back pain 
        Problems with relationships 
        Constipation or diarrhea 
        Shortness of breath 
        Stiff neck or jaw 
        Upset stomach 
        High blood pressure 
        Weight gain or loss 
        Heart attack 

What can I do to reduce and manage 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. Solve the little problems. This can help you gain a feeling of 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: Talk with a trusted friend, family member, health care professional or a counsellor.
  • Set realistic goals at home and at work. Avoid overscheduling.
  • Exercise regularly.
  • Meditation, prayer, reading, yoga and relaxation techniques can help.
  • 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.
  • Eat regular, well-balanced meals and get enough sleep.
  • Avoid excessive alcohol intake and use of street drugs.

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. Exercise is known to release feel-good brain chemicals. It also helps you get in better shape, which makes you feel better overall.

What is meditation?

Meditation is a method of guided thought that helps you focus on a relaxing thought or activity. 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 through the rest of the body, one muscle group at a time. 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 may help relieve stress. This helps you get plenty of oxygen and activates the relaxation response, the body’s antidote to 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.

What if the above measures don’t help me cope with my stress?

Talk to your family doctor for support and advice on other options to consider to manage your stress. He or she will help you come up with a management plan which may include referral to a health professional with special training, or a trial of medication, among other options, if your symptoms are severe. You may also be referred to local resources or support groups in your community.

If you have recurring thoughts of hurting yourself or others, see your family physician or go to the nearest emergency room as soon as possible to have this addressed.


  1. Kavan MG, Guck TP, Barone EJ. A practical guide to crisis management. Am Fam Physician. 2006 Oct 1; 74(7): 1159-64. Review. 
  2. Torpy JM, Lynm C, Glass RM. JAMA patient page. Chronic stress and the heart. JAMA. 2007 Oct 10; 298 (14): 1722.



This health education material was developed and adapted by The College of Family Physicians of Canada from online materials developed by The American Academy of Family Physicians, with permission. It is regularly reviewed and updated by family physician members of the CFPC Patient Education Committee, who refer to the current evidence-based medical literature. Support for this program has been provided by a grant to the CFPC Research and Education Foundation by Scotiabank.

These pages may be reproduced for not-for-profit educational purposes only.


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