National Center for Health Promotion and Disease Prevention
- Pay attention to stress. Tools are available to help you manage and reduce your stress.
Manage Stress Workbook
- If you are having difficulty coping with life's demands, we call this "stress." A life without some stress would be boring. Most of us like some challenges, but too much stress creates problems.
- People who are overly stressed often report difficulty concentrating, feelings of worry and fear, a sense that the body is wound up (for example, tense muscles, sweaty palms, and a pounding heart), irritability with others, or exhaustion. Too much stress over a long period of time can put your health at risk.
- If you or someone you know is in an emotional crisis call The Veterans' Crisis Line at 1-800-273-TALK (8255) and press 1 for Veterans.
- Stress management suggestions:
- Problem Solving—Learn problem-solving skills as this can often improve your ability to cope. Your health care team may offer a class or information sessions on problem-solving or you can visit http://http://www.veterantraining.va.gov/.
- Physical Activity—Take a brisk walk or engage in other physically demanding activities. This may reduce your stress. Regular physical activity is best. See the Be Physically Active Handout.
- Relaxation Training—Learn relaxation and mindfulness can help you manage stress. Daily relaxation may protect you form the impact of stress on your body. You can find self-help books on relaxation at libraries and book stores. Your health care team may offer relaxation or mindfulness training, or you can use the NCP Manage Stress Workbook. In addition, relaxation recordings can be very helpful. There are links to relaxation recordings below, and on the Center for Integrated Healthcare site (http://www.mentalhealth.va.gov/coe/cih-visn2/clinical_resources.asp) as well as on mobile apps such as "PTSD Coach" and "Breathe2Relax".
- Expression—Speak up in respectful ways. Sharing thoughts and feelings in an assertive and respectful manner can sometimes help buffer stress. Ask your health care team for guidance.
- Time Management—List what needs to get done, make plans for addressing items, and stick to the plan. There are several self-help books on time management at libraries and book stores.
- Positive Thinking—Stress is often associated with negative, self-critical thinking. Focus your attention on positive thoughts about yourself, your accomplishments, things you feel proud of or grateful for, etc. It can help to list 3-5 things you feel grateful for each day.
- Pleasant Activities—Make time for fun. Plan regular, enjoyable activities and see if this reduces your stress. The Pleasant Activities Tip Sheet includes ideas for you to consider.
- Relaxation recording on NCP site
- NCP is grateful to David Kearney, MD, Carolyn McManus, PT, MS, MA and Rev. Tim Burnett for sharing these additional mindfulness meditation recordings:
- Veterans Crisis Line:
- VA Mental Health Services:
- Manage Stress:
- Coping with stress:
- The American Psychological Association Health and Wellness tips:
* Indicates that the link leads to a non-VA website. The VA is not responsible for the content that is on the site.
If you have questions about how to make healthy living changes, please talk with your VA health care team.
- Stress: When the demands of life are greater than our ability to cope with the demands, this state is commonly called stress. Although the experience of stress varies from one individual to another, stress often affects attention, thoughts, brain activity, and emotion; parts of the body regulated by the autonomic nervous system (heart rate, breathing, palmar sweat, blood pressure, digestion); and the muscular system (typically resulting in muscle tension, and either increased or decreased movement); and hormones (cortisol, norepinephrine, and growth hormone). When stress is chronic, and the body remains in high gear, it can become problematic.
VA/DOD Clinical Practice Guidelines
- VA/DoD Clinical Practice Guidelines for PTSD
- VA/DoD Clinical Practice Guidelines for Depression
- Goldberger LaB, S., ed Handbook of Stress: Theoretical and Clinical Aspects. 2nd ed. ed. New York: The Free Press; 1993.
- Lehrer PaW, RL, ed Principles and Practice of Stress Management. 2nd ed. ed. New York: Guilford Press; 1993.
- Selye H. The Stress of Life. New York: McGraw-Hill; 1956.
- Maddi S. The Story of Hardiness: Twenty Years of Theorizing, Research, and Practice. Consulting Psychology Journal: Practice and Research. 2002;54(3):175-185.
- Maddi S. Relevance of Hardiness Assessment and Training to the Military Context. Military Psychology. 2007;19(1):61-70.
- Maddi SK, S; Maddi, KL. The Effectiveness of Hardiness Training. Consulting Psychology Journal: Practice and Research. 1998;50(2):78-86.
- Bartone P. Hardiness Protects Against War-related Stress in Army Reserve Forces. Consulting Psychology Journal: Practice and Research. 1999;51:72-82.
- Pietrzak RH, Johnson DC, Goldstein MB, Malley JC, Southwick SM. Psychological resilience and postdeployment social support project against traumatic stress and depressive symptoms in soldiers returning from Operations Enduring Freedom and Iraqi Freedom. J Spec Oper Med. Summer 2009;9(3):67-73.
- Waite PJ, Richardson GE. Determining the efficacy of resiliency training in the work site. J Allied Health. Fall 2004;33(3):178-183.
- Cohen S, Janicki-Deverts D, Miller GE. Psychological stress and disease. JAMA. Oct 10 2007;298(14):1685-1687.
- Batey DM, Kaufmann PG, Raczynski JM, et al. Stress management intervention for primary prevention of hypertension: detailed results from Phase I of Trials of Hypertension Prevention (TOHP-I). Ann Epidemiol. Jan 2000;10(1):45-58.
- Hunter, CL et al. Integrated Behavioral Health in Primary Care: Step-by-Step Guidance for Assessment and Intervention. Washington: APA;2009.
- Davis, M., Eshelman, E.R. & McKay, M. The Relaxation and Stress Reduction Workbook, Oakland: New Harbinger;2008.
- Bourne, E. The Anxiety and Phobia Workbook. Oakland: New Harbinger;2010.