Ten Keys to Coping and Recovery

7: Manage Stress  

By Bruce Campbell

Stress management is an area in which there can be a big payoff for CFIDS and fibromyalgia patients, because the effects of stress on symptoms and quality of life are so great. Using stress management strategies, you can learn how to interrupt the cycle in which symptoms and stress intensify one another. We’ll look at this topic from two perspectives: stress reduction and stress avoidance.

Stress Reduction through Relaxation

How we view and react to a source of stress determines how much stress we experience. If we become worried by an increase in symptoms, we may tense up. The muscle tension in turn can be painful, draining energy and causing fatigue. Stress reduction means learning how to respond differently to stressful situations and events. Relaxation offers a way to interrupt this cycle, by counteracting both the physical and emotional aspects of our response to stress. 

Relaxation involves several things. Physically, it means releasing muscle tension, breathing more slowly and regularly, and letting go of tension. Emotionally, it involves nurturing a sense of equanimity and peace. Mentally, it means observing and letting go of worrisome thoughts.

Because we are different, some techniques work well for one person and other techniques work better for another. In particular, techniques using imagery seem very helpful to some people, but not useful to others. It usually takes several weeks of practice to develop skill in using a technique, so allow some time before expecting results. Learning concentration is also a common problem when doing a relaxation practice. The mind tends to wander, so having patience is necessary. As the saying goes, it takes work to learn how to relax.

Stress Avoidance

Stress avoidance is preventive. Instead of retraining yourself to respond differently to stress, this approach involves observing how stress affects you and then taking steps to avoid stressful circumstances.

One good way to prevent stress is through routine. Novelty is a source of stress, because it takes more energy to respond to a new situation than it does to something familiar.  Given our limited energy, saving it for recovery is desirable.  One way to do that is through making your life predictable.  Some patients have done that through routine: living their lives according to a schedule.  They have been able to reduce the surprises and emotional shocks in their lives, and thereby reduce their stress.  By knowing what to expect, they have reduced pressures on themselves.  Any steps in the direction of giving predictability to life is likely to lower stress. 

Another stress avoidance strategy is to identify and then avoid stress triggers. We may have particular circumstances in our lives that “set us off.”  If we can identify these stress triggers, we may be able to avoid them or reduce their impact.  Some patients find interactions with particular people are the cause of disabling stress.  Responses they have made include talking with the person, limiting contact, getting professional help with the relationship, and ending the relation.  Food, chemicals and other substances can trigger symptoms.  By identifying and avoiding specific foods or other substances you may be able to avoid relapses. Third, many patients have sensitivity to light or noise, so avoiding them can help control symptoms.

A Few Ideas for Getting Started

Here are a few ideas if you would like to experiment with new ways to control stress.

Create Positive Experiences: Doing things that are enjoyable can be a great stress reducer. For example, seeing a movie, spending time in nature, listening to music, taking a bath, getting a massage or reading can distract from stress and reduce preoccupation with symptoms. Exercise is a natural stress reducer, because it causes your body to produce endorphins. Just getting up and moving around can break a mood of worry.

Practice Relaxation Through Breathing: When we are under tension and stressed out, our breathing can become shallow.  Becoming aware of your breathing and deliberately breathing in a deep and easy manner is a technique you can use to help you relax.  You might try it when caught in traffic, stuck in line, or when in an heated discussion.  The basic principle is to focus on your breathing in order to slow down anxious or negative thoughts and to reduce the adrenaline flowing through your body. 

 To practice this type of breathing, focus your attention on your breath.  Take in a long, slow breath through your nose, hold it one or two seconds, then breathe out through your mouth.  As you exhale, you can say a calming word to yourself, like “relax.” The idea is to focus your attention on your breathing, keeping it slow and easy.  As you breathe in this way, you should be able to feel your body relax and a sense of calmness replace your anxiety.  To avoid becoming dizzy, keep your breathing slow and easy.

You may be able to achieve some benefits from a less formal procedure than the one just outlined.  Simply noticing your breathing can often reduce anxiety.  If you feel yourself worrying, tell yourself your are going to shift your attention to your breathing.  Sometimes even taking one deep breath and letting it out slowly can reduce anxiety. 

Develop a Routine: Any steps you take that give predictability to your life are likely to lower your stress. So choose some part of your life that is not consistent and give it a schedule. You might begin by bringing routine to your sleep, having a consistent time at which you go to bed and get up. Or you might take a rest at a set time each day or eat at a regular hour. Or get dressed on a schedule each day. One student who regulated her day by having scheduled times for going to bed and waking up, eating meals, resting, exercising and watching TV said: “I know it sounds boring, but I swear it helps.”

In Summary

Relaxation techniques --such as meditation, deep breathing, the use of imagery or listening to music or soothing sounds from nature-- offer a way to help us change our habitual ways of responding to stressors and to reduce our habitual stress level.  Stress avoidance enables us to prevent stress. 

Ten Keys Series