We need affection to thrive. Research has shown that people who regularly give and receive affection live longer, are healthier, and report a higher quality of life than those who do not. Even having a plant to take care of has been shown to improve health. Gentle, caring touch is therapeutic. One study showed that elders who were taught to massage infants gained benefits for themselves- including increased self-esteem and decreased depression -- from giving massages, while the babies gained by receiving them.

Be generous with your warmth and affection. A kind smile, a handshake, a gentle hug, and saying, "I'm glad to see you," are simple tokens, but mean a lot.

Be willing to ask for affection when you need it. Wanting affection isn't the same as wanting sex. It can be as simple as asking for a hug, or sharing the sofa with a friend. Don't be so sensitive to rejection that you are afraid to ask.

If you are in a relationship where there is no affectionate give and take, talk with your partner about it and see what can be done about filling this important need for both of you. Ask what you could do to restore a feeling of affection with your partner. If necessary, seek professional relationship counseling.

If you don't have a partner, initiate contacts with people you think could become good friends. Get involved in a social activity that you genuinely like. Consider getting a pet. Studies indicate that single people who have pets are happier, healthier, and live longer than single people who don't. The point is, you need affection to resist the ravages of stress - whether it comes from a friend, a family member, or a pet!

Gentle caring touch positively affects stress. Research shows that touch can cause significant changes in physiology for mammals. A horse's heart rate goes down when touched by his trainer. In humans, the effects of massage are quite powerful. Premature babies who received regular massage gained 47% more weight and were hospitalized fewer days than babies who weren't massaged regularly. Massage has been shown to reduce chronic pain conditions such as fibromyalgia, lower back pain and migraines. It can lower blood pressure, reduce asthma attacks in children, and reduce anxious and depressed moods. It has been shown to reduce cortisol levels that dampen immune function and increase natural killer cell activity in HIV-positive adults. Pregnant women who received daily massage for a month reported lower anxiety and depression and had lower stress hormone levels (cortisol and norepinephrine), less sleep disturbance, and fewer complications.

In coping with stress and the demands and pressures of life, money can be a powerful resource. But when income isn't adequate to meet basic expenses, it is nerve wracking to juggle bills while trying to put money aside for emergencies. Not being able to cover basic needs leads to chronic worry about the future. Living above your means, impulse buying, unusual obligations, or job loss are just some of the situations that increase financial pressures.

Our research with the Personal Stress Navigator indicates that stress levels are lower for individuals with higher incomes, or with incomes that have been stable for two years or more. Money can buy you assistance with household chores, enable you to afford childcare, buy food and shelter, and pay for vacations. Having money can bolster your self-esteem and eliminate many of your worries about tomorrow. Money won't buy happiness, but poverty can buy misery.

Money can be a big problem at all socioeconomic levels. At lower income levels, having enough money to meet basic expenses is a challenge: at higher income levels, money can take on other meanings involving status, expectations or control of family members.

Establishing financial security takes long term planning, including career planning, budgeting, and regulating impulse spending. In today's economy people are working longer and harder. Even two income families are having difficulty staying ahead of housing, medical and education costs. A period of unemployment can be devastating. Stability and predictability of income and expenses is the most important aspect of financial security. When income fluctuates, it is hard to plan. For example, senior citizens on fixed incomes are particularly susceptible to changes beyond their control.

In order to have more money, you have to change your mindset, to think and act differently about money. Think about selling instead of buying. Think about saving instead of spending. Concentrate on getting out of debt instead of charging more on your credit cards.

If possible, don't let spending exceed your income. If you must, adjust your standard of living to fit the realities of your finances. It is difficult to limit your spending in the face of advertising, credit cards, and the visible wealth of others around you. But the anguish of mounting debt with no plan for payment can be a chronic source of strain. If you lower your desire for material things, you are repaid with greater peace of mind.

You may have heard the slogan "When the going gets tough, the tough go shopping". For many people, it's no joke. Buying nice things is a way to cope with feeling down. Be careful not to reduce your stress through shopping unless you can afford it. Playing the lottery is another way some people attempt to cope with stress, always hoping for the big hit, and not wanting to look at the actual amounts they've spent each week on tickets.

For many people anxieties about money lead them to avoid thinking closely about finances. But such avoidance just worsens the problem. You need to face up to the actual figures of what you spend or owe if you're going to find a solution. Here are some things you can do:

Finally, most importantly, don't measure your worth in terms of what's in your bank account. Money and what it buys are a poor barometer of your worth and value as a human being.

Anger, anxiety, and depression are the predominant stress emotions. You need to speak more openly about your feelings when you're upset. While hurtful or sarcastic thoughts are better left unsaid, expressing your emotions in an appropriate way is an important way to prevent future problems.

If you are feeling angry, it is usually because of an unresolved problem. Be assertive and communicate your feelings to people in a direct, honest, and non-manipulative way. Stand up for your rights while, at the same time, be sensitive to the rights and feelings of others. When you are angry with someone, arrange a time to talk.  Then tell them rationally what it is about the aggravating behavior that makes you angry, rather than mounting an emotional personal attack. Use "I" statements in explaining how you feel and why -- that is, speak from your own feelings, using statements that begin with "I feel.., I think.., It seems to me.., I prefer...," etc.

Expressing your feelings in a non-harmful way will help them subside more quickly. A non-attacking approach allows others to hear you better and to speak up about their feelings as well. An assertive approach allows both parties to better understand each other. Take your fair share of responsibility in addressing emotional concerns. If communicating your emotional feelings remains a problem for you, seek professional assistance.

If you are worried or discouraged, speaking up lets others understand your feelings. They may be able to reassure you, help you focus on what to do, or simply listen as you come to your own conclusions. Some worries sound foolish once they have been said out loud. The "what ifs" or catastrophic thoughts about what might happen are often debunked by an outside neutral person.  Talking about feelings also helps to feel less alone in the world when at least one other person really understands you.

If communicating your emotional feelings remains a problem for you, professional assistance might be quite beneficial to your health and emotional wellbeing. For information on skills and techniques such as communication, assertiveness, active listening, overcoming shyness, and relationship enhancement go to our TOOLS section.

You say you have trouble organizing your time. If you have too much to do in too little time, you have a sure-fire recipe for stress. You can't make more time, but you can make better use of what time you have. Those who manage their time effectively have far less stress and fewer symptoms of stress. The three P's central to effective time management are:

• PRIORITIZE -- Spend time on things that are important to you; set priorities on how to use your time through goal setting and project planning.
  
  
• PLAN-- Plan time to handle your priorities. Decide on a schedule, know the times of day you function best, set realistic deadlines, and take time daily to think, relax, and exercise.
  
  
• PROTECT --Most of all, protect your time. Avoid unwanted demands and time wasters. Learn to delegate tasks, utilize teamwork, and enlist support.

Watch out for the biggest time waster of all: PROCRASTINATION. Procrastination is a mix of perfectionism, overestimation of the difficulty of the task, and undervaluing the rewards. Fear of failure and criticism, low frustration tolerance, guilt and helplessness also contribute. Don't wait until you feel motivated: act! Motivation will follow when you see the results of your actions, and this will propel you onward.

Getting started is often the most difficult part. To help you get going, try the "15- minute rule." It's simple: don't plan to work for several hours on your project. Decide only to do fifteen-minute segments at a time.You can do more than you think you can in a short period. At the end of fifteen minutes, if you are working well, you can decide to continue for another fifteen minutes. If, however, you want to stop, you may.  One of Murphy's Laws states: "The task expands to fill the time allotted to it." In any case, after 15 minutes you will know what needs to be done next. When you decide to quit for the time being, reward yourself for what you accomplished, rather than berate yourself for what you left undone. Driving yourself with anxiety will only increase your avoidance of the task the next time.

For help with time management and overcoming procrastination go to TOOLS section.

Stress Factors Section

Factor scores are based on a mathematical analysis that looks for patterns across items of the Stress Navigator. These scores offer additional information about the nature of the stress you're experiencing and about the stress issues that cut across the various parts of your life.

Right now acute stress is a serious problem for you, but don't panic. Acute stress is easily recognizable and can be dealt with quickly. Acute stressors are those situations which make you feel pressured, discouraged, and out of control. You may even be experiencing emotional reactions to stress, such as anxiety, depressed mood, irritability or preoccupation. Physically, acute stress can cause muscular aches and pains, sleep disturbance, or intestinal tract problems.

Chronic stress is more difficult to deal with than acute stress. Count yourself lucky: you only have a mild amount of chronic stress, so it shouldn't be much of a problem for you.

You also have a few specific points in your stress profile of which you should be aware. The first of these is Financial Pressure.

A significant part of your stress comes from your financial pressures and problems. You may feel there's no escaping the financial pressures creating stress for you. All is not lost. You can get control over your financial situation and alleviate the stress it is creating for you. It's a matter of getting things organized and setting up an action plan for taking control of your finances.

Start by setting up a budget that will meet your needs (food, shelter, clothing, transportation, etc.) and your wants (entertainment, dining out, travel, etc.) without exceeding your income. Make up a five-year financial plan, decide on your goals, and outline the steps to meet them. If you have a family, hold family business meetings to discuss family finances. Seek professional advice if budget and financial planning overwhelm you. Refinance your credit card debt. Set up a contingency fund for emergencies and make regular contributions to it. Think about taking automatic payroll deductions. Nothing relieves financial pressures like money in the bank. But you've got to put it there first.

Stress arising from Social Demands is another element of your stress pattern.

It's nice to be part of a group or to have an active social life, but your social demands are getting out of hand and starting to create a lot of stress for you. Address it now, before it gets worse. Learn to put limits on others' demands on your time and energy. Learn to say - and mean --"no" graciously. Some of these demands may be from responsibilities to a group at work. It's not serious right now, but it could get that way if you don't get it under control soon. Another part of group pressures may be related to feeling excluded.

Personal Isolation is another stress point for you to keep in mind.

Feelings of being personally isolated and alone are creating a lot of your stress. Social support is an important buffer to stress. Your relationships aren't providing you with the sense of "connectedness" that you need. Make an effort to meet and connect with others. For more on relationship and interpersonal skills go to our Tools section.

Sources of Demands and Pressures Section

This section of your Stress Navigator report tells you where your stress comes from in your life and gives you some ideas on what you can do to make these life areas less stressful. Your stress appears to be rooted in at least  at least 4 areas of your life.

Your biggest source of stress is your social situation. This may be from responsibility to a group or from feeling excluded from a group. Starting, ending or having to take extra care of a relationship may be a part of your stress. Feelings of competition and comparison are often a major source of social stress. Too little social stimulation can leave you feeling lonely, estranged, and isolated; too much stimulation and you can be overwhelmed by social demands and the needs of other people. Finding balance in your social situation is the key to lessening social stress.

There are a number of ways to reduce the stress of social situations, but they boil down to a few basic principals:

¬ Be assertive but gracious. Stand up for your right to participate or not, but in a way that doesn't alienate others. This is particularly applicable when people want too much of your time.

¬ Use positive assertive skills to compliment people, ask them about themselves, or invite them to join you in a social event.

¬ Seek out people who share your interests.

¬ Be open with people and allow them to be open with you.

¬ When you find yourself thinking about how you compare with others, redirect your thoughts to how you might connect with them instead. Look for what you have in common or what you might learn from them rather than looking for the differences.

¬ If you tend to become tense in social situations, practice relaxing in advance. Imagine the situation and how you hope to handle it.

One way to reduce isolation and loneliness is to stay in touch with people you already know - i.e., work to keep the friends you already have. To make new friends may require overcoming shyness and developing good assertive skills. Skills like good manners (the art of knowing what to say or do in an awkward moment), public speaking, listening and conversation, delegation, leadership, and self-esteem enhancement can also be helpful. See our Tools section for more information on how you can develop these skills.

Personal experiences and feelings are a secondary source of stress in your life.
Not having enough time to get things done, not having time for yourself, difficulty meeting your own expectations of yourself, or lack of stimulating experiences can generate lots of stress. Or you may have experienced other problems, such as an assault or harassment, legal difficulties, personal injury or illness, or a change in your living conditions or personal habits. Personal stress may also result from success or personal achievement. It can come from a lack of comfort with yourself as a person, or from confusion about who you are and how you want to be as a person. Problems with drugs or alcohol, weight issues, or concerns about personal appearance may also evoke stress. Sometimes it's difficult to maintain your personal integrity and self-esteem while dealing with such problems and that can be stressful in and of itself.

Personal stress can affect your performance on the job as well as your relationships. If you are preoccupied with personal stress, you may have less energy to devote to your work, have less confidence in your decisions or be less assertive.  High personal stress often means we become less sensitive to others' moods or reactions and miss important information about what is going on interpersonally.

There are several ways to sort out your particular stressors and develop an action plan for dealing with them. The practice of writing in a journal helps you to put your thoughts out in front where you can see them clearly. If you notice certain negative thoughts coming out repeatedly, challenge those thoughts by asking: "What evidence do I have that this is true? " Or, "What is the probability that this will come to pass?" Record what you would like to believe, feel, or have happen.

Daily meditation also will help you slow down and observe your thoughts and feelings more clearly. This practice develops mindfulness, the art of seeing the world and yourself with more clarity. As you develop a "wise mind," you are better able to balance your rational thoughts with your emotions. Knowledge of what personal path to take emerges more easily. This practice also sharpens your intuition -- that ability to access your deepest wisdom in dealing with personal and life problems.

During times of personal stress, your social support network becomes quite important. While you may want to avoid people because you don't feel good about yourself, maintaining contact or reconnecting with friends, spiritual community, or family elders can help you through difficult times.  See Tools and our Books sections for help in developing stress reduction skills and for some suggestions on which self-help books might be helpful.

If you think you might need professional help, ask your primary care physician for a reference. Set up exploratory sessions with several providers in order to find someone with whom you feel comfortable working. While it may be hard work, it is also an important investment in your personal happiness.

Your finances are an additional source of stress for you.

Nothing dictates how you live your life more than the amount of money you have at your disposal. Change is, by definition, stressful. Any sudden change in finances, up or down, sends shock waves of change through every other part of your life. In general, the longer your finances have been stable or the more money you have, the less stress you are likely to suffer.

Take an honest look at your relationship with money. Many people avoid thinking about money because they become anxious when they do. Do you avoid looking at the actual figures of what you spend or owe? If so, the first step is to approach the problem in order to define it and find a proper solution.

Not having enough money to pay bills and being unable to buy the things you want may be particularly stressful. It can also be difficult to live in a society with large discrepancies in income, where you are bombarded with messages about the importance of wealth and possessions. Consumer credit card debt is one of easiest traps to fall into and most difficult to pull out of.

Things you can do to get your finances under control include:

¬ Make a budget and stick to it.  Write down all your "fixed" or regular expenses like rent, phone, food, utilities, auto. Add all other expenses for the month, including budgeting for gifts, clothes, vacations.  Then compare your expenses with your income. 

¬ Construct a realistic five-year financial plan.

¬ Hold family business meetings.

¬ Get financial advice from someone trained and equipped to deal with finances.

¬ If you have credit card debt, contact the Consumer Credit Counseling Service in your area. They will help protect you from the further aggravation and stress of fending off bill collectors. You are protected from harassment of bill collectors by the Fair Debt Collection Practices Act. You can get a copy of the Act from the Division of Credit Practice, Federal Trade Commission, Pennsylvania Avenue at 6th Street, Washington, DC 20580.

Most importantly, don't measure your worth in terms of material wealth. Money and what it buys is a poor barometer of your worth and value as a human being.

Stress Symptoms Section

This section of your Stress Navigator report addresses the symptoms that are causing you distress and discomfort. The more susceptible you are to stress and the higher the stress levels you're experiencing, the more likely you are to experience symptoms. The most effective ways of dealing with stress symptoms are to take better care of yourself, so you are less susceptible to stress, to find ways to reduce stress at its source, and to treat your symptoms.

Have you had a recent medical check up?

This report is not a substitute for good medical care. The mind can only help so much with health-related difficulties. Sometimes symptoms usually associated with stress have other causes; it may require a medical examination to determine if this is the case.

In our Tools section, we offer you a number of behavioral techniques for dealing with stress-related symptoms. These techniques can help to relieve the discomfort and distress of your symptoms. But there are no substitutes for proper medical attention and care. If you have high scores on particular stress symptoms, see your doctor. Stress may well be the culprit, but let your doctor help determine that.

You seem to be experiencing both physical and mental symptoms of stress.

Muscular complaints are your primary physical symptom of stress.

Muscle contraction headaches, jaw pain, back pain, tight muscles, shakiness or difficulty sitting still are among the most common symptoms of stress, and can interfere with work, family life, and simple activities of daily life. The human body has more than 690 separate muscles. People often take them for granted, expecting good performance day in and day out. Understanding the relationship between stress and your muscles can help you tend to the special needs of this important organ system: good nutrition, frequent exercise, strength training, flexibility through stretching and good posture and balance. The good news is that these straightforward interventions can make big differences in healing and protecting your muscles.

Increased muscle tension is part of a "fight or flight" response. Noradrenalin alerts the muscles to tense up in preparation for action. Tense muscles get set to act quickly in response to threat or danger. You move faster and have greater strength during an emergency because of this boost.  However, modern stress is often not physical, but social or economic. Generally we neither fight nor flee. Without a strong physical reaction to release it, muscle tension remains. You may adopt an "on guard" posture that lasts as long as you feel tense: shoulders up, arms slightly forward. The "pain in the neck" tightness across your upper back and furrows across your forehead can bring on a tension headache. Clenched teeth or a fixed smile can turn into jaw pain caused by tension in the powerful masseter muscles that operate your jaws.  In addition, when the major muscles become tense, they communicate this tension to other systems. Nearby muscles become tense, heart rate speeds up, digestion slows.  When the threat passes, so should the tension. The major muscles relax, other parts of the body become calmer. Unfortunately, the human mind can remember and imagine danger and keep the body tense for hours or days.

Muscle fibers are designed to tense and then relax. A muscle can go through this tense/relax cycle indefinitely, as when you walk a long way. However, a muscle under sustained tension without an alternating relaxation phase eventually develops spasm and pain. Chronic muscle tension pulls on the muscle's tendon and can lead to pain where the tendon is attached to the bone. This can pull the body out of balance, creating new pains, or cause an inflammation of the tendons, resulting in painful tendonitis. When weakened muscles are pushed beyond their physical limits, they spasm, which we experience as cramps in large muscles. If you press firmly into the muscle, you may feel a hard and painful knot the size of a marble deep in the muscle.  At that point, massage, acupressure or trigger point release and stretching may be needed.

Stress also distracts you from paying attention to your body's signals, increasing the likelihood that you will sit, stand, or move in ways that strain your muscles. This can be especially dangerous if you lift heavy objects. If you are not moving with awareness, you could easily strain your back or joints.

In the physics of muscles and bones, good balance and posture is key. A well-balanced body takes a minimum of effort to move. For example, bending the head too far forward puts strain on the upper back. Hunched shoulders lead to upper back soreness. A chair or desk that is not the right size, or bone misalignment may also cause painful muscles.

Things to do:

•  Develop a regular exercise program of overall muscle strengthening and stretching. Strong, healthy, well-conditioned muscles tolerate more tension than weak, poorly conditioned ones.  Keep going on your exercise program especially when life stress increases.
•  Notice when your muscles are tight and learn to release and relax them. The Progressive Muscle Relaxation (PMR) exercise is the most helpful for learning this important skill. Do the PMR exercise twice a day for 10 days and notice the difference. 
  
•  Pay special attention to the specific muscles which cause you pain. Slowly build up strength and flexibility and make a special effort to notice tension in that area.
  
•  Use massage and moist heat to relieve muscle tension
  
•  Explore something new – martial arts, yoga, Pilates, dance, TaiChi, swimming, video tapes, classes.  Have fun and meet people while you are strengthening your muscles.
  
•  Consult a professional for electromyographic (EMG) biofeedback, physical therapy, trigger point release, myotherapy, or postural adjustment.
• Consult a rehabilitation physician or physiatrist who specializes in the treatment of muscular aches and pains to determine if further diagnostic information is necessary. If physical therapy is recommended, do the exercises regularly even after visits are discontinued.
  
• Check out the TOOLS section of the web site for more detailed information on each of these suggestions.
• Stay with your exercise program even after your muscular symptoms are gone to prevent relapse and build endurance and energy.
  

Your secondary stress symptoms are cognitive such as preoccupation, racing thoughts, difficulty falling asleep, indecisiveness, or the conviction that everything turns out for the worst.

Stress changes the way the brain works. You may feel that you become sharper and more clear thinking under pressure. That may be true up to a point. If there's no challenge, the mind tends to wander or become bored. As the challenge or motivation increases, the brain becomes more alert, takes in more information and mobilizes resources. At high levels of stress, your brain becomes hyperactive and so do you. Adrenaline can cause the neurons in the brain to fire two to three times faster than normal. Thoughts race in bits and pieces, memory is impaired and judgment deteriorates.

 Peak performance occurs when a high degree of skill meets optimal motivation. For example, a musician who has practiced consistently has the best performance at an important concert. If there is too much pressure or in dangerous situations, mistakes start to appear, especially for tasks that require complex, creative thought. This stress/performance ratio changes depending on the type of task, fatigue levels, and the individual's experience. If an action has been rehearsed repeatedly, it becomes automatic, even under pressure. This is why police officers, fire fighters and soldiers drill emergency procedures over and over. In contrast, problems that require unusual or creative solutions may need long periods of uninterrupted quiet.

When stressed, the brain tends to oversimplify and jump to quick, easy solutions. Immediate risks loom larger than long term ones. Certain information is ignored and other information is magnified. Thinking becomes distorted. Memory is affected. Complex problems become simplified. Attention narrows down to one or two things, instead of the big picture.

Problems in thinking can become particularly difficult when there is insufficient time for your brain to return to normal levels of activity before something else happens. It's not just stress, but recurrent episodes of stress that over-stimulate your brain.

Things to do:
 

•  When you are faced with a complex decision, take time to slow your thoughts. Then focus your attention on the question.
• Listen to your body.  Physical signs of stress may be more noticeable than subtle changes in alertness or thinking.
  
•  If possible, put a time limit on stressful meetings, activities or conversations. Short bursts of stress are OK if you follow them with a break.
  
• Use short breaks to rest and reflect.  Don’t just jump into the next thing. 
  
• Avoid precipitous, impulsive actions but don’t get paralyzed either.
  
• Defer important or difficult decisions until you have had quiet time to think things through. Practice saying, “I’ll think about it and get back to you in a bit.”
•  If you realize you have made a hasty decision, be flexible enough to change your mind.
• Rest up and slow down. Let your brain recover from being overworked. As needed, take a few minutes, hours, or days off until you feel your best.
  
• “Sleep on it.” If you can’t sleep because your head's awhirl with too many thoughts, use Progressive Muscle Relaxation (PMR) exercises or other activities to quiet down before bed.
  
•  Don’t try to resolve issues late at night, especially over the phone.
  
•  Keep a journal or thought record to keep track of how stress affects your thinking. 
  
• Read Edward DeBono’s book Six Thinking Hats, an excellent, short analysis on types of thinking that go into good decision-making. Feeling Good, by David Burns has a good chapter on types of errors in thinking and their effect on mood.
•  If the cognitive symptoms continue, see a specialist in cognitive therapy and stress management who can help you recognize your particular patterns of thought and develop strategies for more effective approaches.
•  Check out Cognitive and Mental Skills in our TOOLS section for information on techniques such as calming the mind, meditation, decision-making skills, and worry control.
  

Your third group of stress symptoms has to do with your emotions.

You report a lot of emotional distress, such as anxiety, frustration, anger, or feeling discouraged. Such emotions are usually due to recurring episodes of stress. How we feel about things is important information. When we are threatened, we may feel anxious or angry. When we experience loss, we may feel sad, discouraged, or depressed. When life doesn't go as planned, we may feel frustrated and hopeless. In general, the three emotional symptoms of stress are anxiety, anger, and depression. These three emotions are sometimes so entangled that you don't know what you're feeling, except that you're "upset."

Sometimes stress-related emotions get so intense people develop the additional fear of being overcome by their emotions -- a "feeling that things are getting out of control." In the extreme, people fear they may be overwhelmed, "go crazy" or end up in the hospital. While this rarely happens, that thought can be extremely upsetting.

We tend to seek pleasant emotions and avoid feelings such as anger, fear, sadness, grief, guilt, etc. But that doesn't make them go away. Painful as it may be, confronting unpleasant feelings makes you stronger.  This may mean writing, talking or just thinking about the situation at length and in detail.

Recurrent, episodic stress creates these strong emotional reactions by activating the emotional centers in your nervous system so frequently they don't have sufficient recovery time between stress episodes. As a result, these emotional centers can become irritable and/or exhausted. Lasting emotional disorders can occur where there is no opportunity for recovery over long stretches of time.

Humans experience a full range of emotions that often go undefined. One way to control your emotions is to sort them out by labeling them, identifying the "triggers" or situations that elicit the feelings and the thoughts that escalate them, and then challenge those thoughts and beliefs. This is what happens in a conversation with a good friend or in psychotherapy, where you describe the situation, your feelings and then think through and decide how to react differently.

Things to do to regulate emotional reactions:

•  The main thing is to believe you can make a difference in how you feel and take the steps to get there. Take a few moments to review how you cope with emotional distress. Think of times when you were really feeling good about yourself and how you were coping with stressful events in your life. Note those actions that seem to work for you.
•  Take care of the physical needs of your body.  Emotions run higher when we are hungry, tired, or under the influence. Eat regularly, sleep, exercise and avoid alcohol, caffeine or mind altering substances.
  
•  Learn to talk calmly and gently to yourself in times of crisis. Notice and let go of "catastrophizing" thoughts.
  
•  Take action to cope directly with the situation. Get advice or read up on the problem so you become more. knowledgeable and skillful in problem solving. Avoid or accept the situation if there is nothing you can do.
  
• Distract yourself by other activities.
  
•  Pray or meditate to develop mindfulness about your emotions.
  
• Write in a journal about what is upsetting you until you understand everything you can about the problem.
  
•  Relax your muscles and breathe deeply and slowly until you are calmer and can let go of negative feelings.
•  Exercise. A 40-minute walk improves mood for up to four hours.
  
•  Stay connected with people who care about you. Come out of self-imposed isolation.
•  Create a soothing environment you can use as a retreat.
•  Learn to tolerate intense emotion if you can't make it stop, i.e. sit with it or ride the wave of feeling.
  
•  Practice "grounding," or focusing on the here and now. Notice what is happening in the moment, not what might happen later or what happened before.
  
•  Learn assertive skills to help with angry or helpless feelings.
• Ask for help. Talk to a friend or family member. Consider seeing a mental health professional for help with your emotional reactions to stress. If you don't have someone to talk with, your physician can direct you to an appropriate counselor.
•  Consider medication for short-term relief.  You may need pharmacological help in getting your symptoms under control. It is most effective in combination with cognitive-behavioral therapy that develops your skills in coping with stress.
• Check out Cognitive and Mental Skills in the TOOLS section for more suggestions. You may need a combination of one or more of the techniques listed to get lasting relief from your emotional symptoms.