Not all stress is bad. But long-term stress can lead to health problems.

Preventing and managing long-term stress can lower your risk for other conditions like heart disease, obesity, high blood pressure, and depression.

You can prevent or reduce stress by:

• Planning ahead
• Deciding which tasks need to be done first
• Preparing for stressful events

Some stress is hard to avoid. You can find ways to manage stress by:

• Noticing when you feel stressed
• Taking time to relax
• Getting active and eating healthy
• Talking to friends and family

Strong emotions like fear, sadness, or other symptoms of depression are normal, as long as they are temporary and don’t interfere with daily activities. If these emotions last too long or cause other problems, it’s a different story.

Sometimes stress can be good. It can help you develop skills needed to manage potentially threatening situations. Stress can be harmful, however, when it is prolonged or severe enough to make you feel overwhelmed and out of control.

Physical or emotional tension are often signs of stress. They can be reactions to a situation that cause you to feel threatened or anxious. Stress can be related to positive events (such as planning your wedding) or negative events (such as dealing with the effects of a natural disaster).

Symptoms of Stress

Common reactions to a stressful event include:

• Disbelief and shock
• Tension and irritability
• Fear and anxiety about the future
• Difficulty making decisions
• Feeling numb
• Loss of interest in normal activities
• Loss of appetite
• Nightmares and recurring thoughts about the event
• Anger
• Increased use of alcohol and drugs
• Sadness and other symptoms of depression
• Feeling powerless
• Crying
• Sleep problems
• Headaches, back pains, and stomach problems
• Trouble concentrating

Tips for Self-Care

The best ways to manage stress in hard times are through self-care.

• Avoid drugs and alcohol. They may seem to be a temporary fix to feel better, but in the long run drugs and alcohol can create more problems and add to your stress—instead of taking it away.
• Find support. Seek help from a partner, family member, friend, counselor, doctor, or clergyperson. Having someone with a sympathetic, listening ear and sharing about your problems and stress really can lighten the burden.
• Connect socially. After a stressful event, it is easy isolate yourself. Make sure that you are spending time with loved ones. Consider planning fun activities with your partner, children, or friends.
• Take care of yourself.
  • Eat a healthy, well-balanced diet
  • Exercise regularly
  • Get plenty of sleep
  • Give yourself a break if you feel stressed out—for example, treat yourself to a therapeutic massage
  • Maintain a normal routine
• Stay active. You can take your mind off your problems with activities like helping a neighbor, volunteering in the community, and taking the dog on a long walk. These can be positive ways to cope with stressful feelings.

When unavoidable, relentless stress pervades your life, the health risks are wide-ranging and serious. Those who serve as caregivers to disabled family member, work in high-stress professions or experience prolonged traumatic events are at greatest risk. The physical evidence of stress appears in their cardiovascular system, brain, nerves, immune response, and psychological health.

Some of us have natural coping instincts that help us weather stress with fewer ill effects. Read below to see how factors such as our gender, age, and genes can help us deal with stress.

Gender Matters

Women have a tendency to respond to stress by caring for children, reaching out to other women, and engaging in other community forming behaviors. Men are less likely to respond in this way, which is not to say that men are incapable of tending and befriending in the face of stress. The hormonal equation, however, is not in men's favor for developing this coping mechanism. They experience a testosterone surge as part of the parasympathetic response to stressors, and this tends to override the “love” hormone oxytocin which (along with estrogen) is believed to account for women's nurturing response in times of stress. Similarly, some women will respond to stressors with more of a fight-or-flight reaction. Our inherent hormone biochemistry differs from person to person, and humans have a range of natural responses to stress.

Youth Helps

Being young seems to help us recover from any challenge more easily, and stress is no exception. As the images of pyramidal neurons from the brain show, younger people can recover their neuronal connections after dendrites retract after stressful events. The cumulative damage in an older brain is more likely to be permanent.

However, children are not impervious to stress. If you have children, there are ways to provide a lower-stress environment for them, and teach them coping strategies. Some to try:

• Don't allow kids to skip meals. The effects of stress are exacerbated by poor nutrition.
• Exercise! It helps everyone relieve stress. If your family exercises together, it could be an important, stabilizing factor in your family life.
• Set clear expectations and be consistent about discipline. Feeling that a punishment could come out of nowhere or that the rules aren't clear can be very confusing and stressful.
• Hug and touch your kids. Older kids may resist, but find a way to show your support and love physically. It's a great stress reliever.
• Listen to your child's account of his or her day with as much patience as possible. No need to respond, unless the child asks you a question. Simply listen.
• Don't be a “mistake cop.” Teach kids that everyone makes mistakes, including you. Be clear that everyone should try his or her best to do well in school and other pursuits, but that perfection is unattainable, and it's not expected in your family.

Your Genes Matter, Too

Decades ago, cardiologists identified the stress-prone “type A” personality. These people are constantly called out for their intensely competitive, aggressive, and impatient nature. However, the same cardiologists also identified the less-discussed “type B” personality. This group is the exact opposite of the type As—even-keeled, resilient, and quick to recover from stress.

More recent studies have identified another inherited trait, the levels of a substance called neuropeptide Y (NPY), as a determining factor in a person's ability to handle stress. NPY is a signaling molecule that alters emotional responses. Researchers took images of subjects' brains as they looked at photos of threatening facial expressions. Those who had low levels of NPY showed greater changes in the brain regions involved in processing emotions. Those with higher levels did not show such activity, nor other signs of anxiety. The low-NPY subjects also had a lower tolerance of physical pain, suggesting that NPY might have wide-ranging effects on our ability to process and recover from adversity.

Over time, long-term stress can lead to health problems. Managing stress can help you:

• Sleep better
• Control your weight
• Have less muscle tension
• Be in a better mood
• Get along better with family and friends

You can’t always avoid stress, but you can take steps to deal with stress in a positive way. Follow these tips for preventing and managing stress.

Being prepared and feeling in control of your situation might help lower your stress.

Plan your time.

Think ahead about how you're going to use your time. Write a to-do list and figure out what’s most important – then do that thing first. Be realistic about how long each task will take.

Prepare yourself.

Prepare ahead for stressful events like a hard conversation with a loved one. You can:

• Picture what the room will look like and what you'll say.
• Think about different ways the conversation could go – and how you could respond.
• Have a plan for ending the conversation early if you need time to think.

Relax with deep breathing or meditation.

Deep breathing and meditation can help relax your muscles and clear your mind.

• Learn how to use deep breathing to relax.
• Try meditating for a few minutes today.

Relax your muscles.

Stress causes tension in your muscles. Try stretching or taking a hot shower to help you relax.

Stress is a physical and emotional reaction that people experience as they encounter challenges in life. When you’re under stress, your body reacts by releasing hormones that produce the “fight-or-flight” response. Your heart rate, breathing rate, and blood pressure go up, your muscles tense, and you sweat more. Occasional stress is a normal coping mechanism. However, long-term stress (also called chronic stress) may contribute to or worsen a range of health problems including digestive disorders, headaches, sleep disorders, and other symptoms. Stress may worsen asthma and has been linked to depression, anxiety, and other mental illnesses.

There is no drug to cure stress. But we do have access to a built-in “stress reset button.” It’s called the relaxation response. In contrast to the stress response, the relaxation response slows the heart rate, lowers blood pressure, and decreases oxygen consumption and levels of stress hormones.

Some people use psychological and physical approaches, such as yoga, mindfulness, or relaxation techniques, to release tension and to counteract the ill effects of stress.

Recognize When You Need More Help

If you are struggling to cope, or if the symptoms of your stress won’t go away, it may be time to talk to a professional.

If you are in immediate distress or are thinking about hurting yourself, call, text, or chat 988. This 3-digit number will route you to the 988 Suicide & Crisis Lifeline, which is now active across the United States. The Lifeline provides 24-hour, confidential support to anyone in suicidal crisis or emotional distress.

If you or someone you know has a mental illness, is struggling emotionally, or has concerns about their mental health, there are ways to get help. Read more about getting help.

The Bottom Line

Relaxation Techniques

Creating the relaxation response through the use of relaxation techniques can counteract the negative effects of stress. There is evidence that relaxation techniques can reduce blood pressure, inflammatory cytokines, and oxidative stress, as well as improve glycemic control in people with type 2 diabetes.

Relaxation techniques often combine breathing and focused attention on pleasing thoughts and images to calm the mind and the body. Some examples of relaxation techniques are autogenic training, biofeedback, deep breathing, guided imagery, progressive relaxation, and self-hypnosis.

• Deep Breathing
  • Studies have shown that slow, deep breathing (also called diaphragmatic breathing) exercises may modestly lower blood pressure and reduce levels of cortisol (a main stress hormone in the body).
  • A 2019 review of 3 studies, with a total of 880 participants, found preliminary evidence suggesting that diaphragmatic breathing exercises may help to reduce stress. Promising positive changes were seen in mental health self-evaluations and in certain physical measures, such as cortisol levels and blood pressure.
  • There is evidence that deep breathing reduces glycemia (the concentration of glucose or sugar in the blood) in people with type 2 diabetes, which may make it a useful addition to standard care for this condition.
• Biofeedback
  • A 2018 review found that relaxation therapies and biofeedback might be helpful for reducing blood pressure, but only weak recommendations were made for their use because the quality of data from the 29 studies ranged from low to very low.
  • Several studies have looked at heart rate variability (HRV) biofeedback. One review of 24 studies involving a total of 484 participants found that HRV biofeedback is helpful for reducing self-reported stress and anxiety, and the researchers saw it as a promising approach with further development of wearable devices such as a fitness tracker.
• Progressive Muscle Relaxation
  • Studies have shown that progressive muscle relaxation may produce stress-alleviating effects, as well as have a positive effect on anxiety and depression in some people.
  • A 2016 study showed that progressive muscle relaxation can decrease blood pressure during pregnancy.

Meditation and Mindfulness Practices

• Mindfulness
  • Current scientific evidence suggests that mindfulness meditation—a practice that cultivates abilities to maintain focused and clear attention and develop increased awareness of the present—may help reduce symptoms of stress, including anxiety and depression, and may help improve sleep.
    • A 2022 study found that participants who practiced mindfulness had a significant reduction in perceived stress and anxiety levels, as well as an improved balance of some key mediators of inflammatory states.
    • A 2021 study conducted in university students found that mindfulness was associated with low levels of psychological distress and that a brief mindfulness-based intervention was useful to reduce distress measures in this population.
    • A 2019 review of 18 studies found moderately strong evidence that mindfulness meditation interventions significantly improved sleep quality in a variety of groups of people with sleep disturbances.
    • A 2018 review of scientific literature that examined mindfulness-based programs targeting workplace stress or work engagement found that mindfulness-based interventions may be a promising avenue for improving stress indicators in the body.
• Meditation
  • A 2017 review of research on meditation and physiological markers of stress that included eight studies of focused attention meditation found that this type of meditation reduced blood pressure and cortisol levels.
  • Results of a 2009 NCCIH-funded trial involving 298 university students suggest that practicing Transcendental Meditation (TM) may lower the blood pressure of people at increased risk of developing high blood pressure. The findings also suggested that practicing meditation can help with psychological distress, anxiety, depression, anger/hostility, and coping ability.
  • A literature review and scientific statement from the American Heart Association suggest that evidence supports the use of TM to lower blood pressure. However, the review indicates that it’s uncertain whether TM is truly superior to other meditation techniques in terms of lowering blood pressure because there are few head-to-head studies.
  • Clinical practice guidelines issued in 2014 by the Society for Integrative Oncology recommend meditation as supportive care to reduce stress, anxiety, depression, and fatigue in patients treated for breast cancer. Stress management, yoga, massage, music therapy, energy conservation, and meditation are recommended for stress reduction, anxiety, depression, fatigue, and quality of life.

Yoga

• Some but not all studies of yoga for stress management have shown improvements in physical or psychological measures related to stress.
  • A 2020 review of 12 studies of a variety of types of yoga for stress management in healthy adults found beneficial effects of yoga on measures of perceived stress.
  • Of 17 older studies of yoga for stress management included in a 2014 review, 12 showed improvements in physical or psychological measures related to stress.
  • A 2018 study involving 90 participants investigated the effects of 8- and 16-week gym yoga on stress and psychological health. The study found that when compared to the control group, those who practiced yoga showed significant decreases in stress and anxiety, improvements in general psychological health, and increases in well-being.
  • 2017 clinical practice guidelines issued by the American Cancer Society on the evidence-based use of integrative therapies during and after breast cancer treatment recommend yoga for anxiety/stress reduction.

Safety

• Meditation and mindfulness practices usually are considered to have few risks. However, few studies have examined these practices for potentially harmful effects, so it isn’t possible to make definite statements about safety.
• Relaxation techniques are generally considered safe for healthy people. In most research studies, there have been no reported negative side effects. However, occasionally, people report negative experiences such as increased anxiety, intrusive thoughts, or fear of losing control.
• There have been rare reports that certain relaxation techniques might cause or worsen symptoms in people with epilepsy or certain psychiatric conditions, or with a history of abuse or trauma.
• Yoga is generally considered a safe form of physical activity for healthy people when performed properly, under the guidance of a qualified instructor. However, as with other forms of physical activity, injuries can occur. The most common injuries are sprains and strains, and the parts of the body most commonly injured are the knee or lower leg. Serious injuries are rare. The risk of injury associated with yoga is lower than that for higher impact physical activities.
• If you have high blood pressure, it’s important to follow the treatment plan prescribed by your health care provider. Following your treatment plan is important because it can prevent or delay serious complications of high blood pressure. If you’re considering a complementary or integrative approach for your high blood pressure, discuss it with your health care provider.

When you’re under stress, your body reacts by releasing hormones that produce the “fight-or-flight” response. Your heart rate and breathing rate go up and blood vessels narrow (restricting the flow of blood). Occasional stress is a normal coping mechanism. But over the long-term, stress may contribute to or worsen a range of health problems including digestive disorders, headaches, sleep disorders, and other symptoms.

In contrast to the stress response, the relaxation response slows the heart rate, lowers blood pressure, and decreases oxygen consumption and levels of stress hormones. In theory, voluntarily creating the relaxation response through regular use of relaxation techniques could counteract the negative effects of stress.

1. Relaxation techniques are generally safe, but there is limited evidence of usefulness for specific health conditions. Research is under way to find out more about relaxation and health outcomes.

2. Relaxation techniques include a number of practices such as progressive relaxation, guided imagery, biofeedback, self-hypnosis, and deep breathing exercises. The goal is similar in all: to consciously produce the body's natural relaxation response, characterized by slower breathing, lower blood pressure, and a feeling of calm and well-being.

3. Relaxation techniques often combine breathing and focused attention to calm the mind and the body. These techniques may be most effective when practiced regularly and combined with good nutrition, regular exercise, and a strong social support system.

4. Most relaxation techniques can be self-taught and self-administered. Most methods require only brief instruction from a book or experienced practitioner before they can be done without assistance.

5. Do not use relaxation techniques as a replacement for conventional care or to postpone seeing a doctor about a medical problem. Talk to your health care providers if you are considering using a relaxation technique for a particular health condition. This will help ensure coordinated and safe care.

Eat healthy.

Give your body plenty of energy by eating healthy — including vegetables, fruits, grains, and proteins. Get tips for healthy eating.

Drink alcohol only in moderation.

Avoid using alcohol or other drugs to manage stress. If you choose to drink, drink only in moderation. This means:

• 1 drink or less in a day for women
• 2 drinks or less in a day for men

Learn more about drinking in moderation.

Some people smoke when they feel stressed. They use smoking as a way to cope. There are many problems with using cigarettes as a way to cope with stress or other unpleasant feelings.

Smoking isn’t a long-term stress reliever. In the time it takes to smoke a cigarette, you could do something else that’s more effective and healthy—like take a short walk or try a relaxation exercise.

Smoking doesn’t solve the problem that’s giving you stress. Your stress will return.

Nicotine addiction causes stress. Cravings for nicotine feel stressful because your body begins to go through withdrawal.

Some smokers find it hard to give up cigarettes as a way to cope with stress. It’s important to find healthy ways to handle stress and take care of yourself without smoking. There are many other ways to cope with stress that don’t involve smoking.

Regular physical activity can help prevent and manage stress. It can also help relax your muscles and improve your mood. So get active:

• Aim for 150 minutes a week of moderate-intensity aerobic activity — try going for a bike ride or taking a walk
• Do strengthening activities — like push-ups or lifting weights — at least 2 days a week

Remember, any amount of physical activity is better than none!

Talk to friends and family.

Tell your friends and family if you're feeling stressed. They may be able to help.

Get help if you need it.

Stress is a normal part of life. But if your stress doesn’t go away or keeps getting worse, you may need help. Over time, stress can lead to serious problems like depression or anxiety.

• If you're feeling down or hopeless, talk with your doctor about depression
• If you're feeling anxious, find out how to get help for anxiety
• If you've lived through a traumatic event (like a major accident, crime, or natural disaster), find out about treatment for PTSD, or post-traumatic stress disorder

A mental health professional (like a psychologist or social worker) can help treat these conditions with talk therapy (called psychotherapy) or medicine.

Finally, keep in mind that lots of people need help dealing with stress — it’s nothing to be ashamed of.

As recent months have demonstrated, stress is unavoidable. Now more than ever, it’s important to understand stress and how we can manage it. While stress can be beneficial, too much of it can be harmful.

When the body senses a threat (or stressor), it goes on high alert, and once the threat passes, the body quickly recovers. At least that’s the way it’s supposed to work. Stressors can include health matters, work, money, family issues, racism or gender inequality, and regular daily hassles. With unrelenting or too many stressors, your body might be on a constant state of high alert, leading to poor concentration, bad moods, professional burnout, and mental and physical health problems. When stress becomes chronic, the body cannot return to normal functioning. Chronic stress can be linked with health conditions such as heart disease, high blood pressure, diabetes, depression and anxiety.

Stress affects women and men differently. Many conditions associated with stress — such as post-traumatic stress disorder, depression and anxiety — are more common in women than men.

Beyond sex and gender differences, there are individual differences, too. Some people are more resilient than others. Stress affects them less or more temporarily, and they might even perform better under stress. “There’s a saying, ‘It’s not how far you fall; it’s how high you bounce.’ For those of us who don’t bounce back so easily, there’s good news. Resilience, to some extent, can be learned and there are some simple, practical things that people can do that may make a noticeable difference,” says Dr. Janine Austin Clayton, Director of the NIH Office of Research on Women’s Health. Clayton explains that some resilient people might also develop a greater appreciation for their lives, family, friends or other matters after stress.

Stress management and resilience building are particularly important to the health of women. Here are several tips to help women as well as men:

1. Recognize and counter signs of stress. Your body sends signals that it’s stressed, including difficulty concentrating, headaches, cold hands, tight muscles, a nervous stomach, clenched teeth, feeling on edge, fidgety, irritable or withdrawn. Knowing how your body communicates can help you deal with stressful moments. Learn to not only recognize but also to name these feelings, either to oneself or to a friend. Then, take action to counter their effects. For example, deep breathing, stretching, going for a walk, writing down your thoughts and taking quiet time to focus can help induce relaxation and reduce tension.
2. Take time for yourself. Make taking care of yourself a daily routine. It’s not selfish or self-indulgent — and it might require saying “no” to requests or prioritizing yourself along with your responsibilities. Start with small changes in your routine to help build resilience to stressful circumstances. Work in time to exercise, eat healthy foods, participate in relaxing activities and sleep. In fact, including a regimen of exercise, which for some may include yoga or meditation, can be very important when feeling stressed. Also, take time to notice the “good minutes” in each day or to do something that you enjoy, such as reading a book or listening to music, which can be a way to shift your attention and focus on the positive rather than the negative.
3. Try new routines. From scheduling bath and bedtimes to blocking off time to plan and prioritize tasks, additional structure can provide a daily framework that allows you to attune to your body’s signals. Then, you can take steps to potentially manage stress earlier than you once did.
4. Stay connected and make new friends. Stay in touch with family, friends and groups in your life — technology makes this easier than ever. Having or being a person to talk with can be reassuring and calming. Using video features can enhance the connection in telecommunication or online communications for some people.
5. See problems through a different lens. Experts call changing the way we think about and respond to stress “reframing.” View sitting in traffic or around the house as an opportunity to enjoy music, podcasts or pleasant views. Reduce anger in response to rude or aggressive behavior by imagining what might be happening in that person’s life. Keeping situations in perspective is an important way to boost stress resilience. Other steps include positive thinking and creating plans before you begin to resolve problems. You can practice reframing and get better at it over time.
6. Seek help with problems. Many people experience the same day-to-day strains related to caregiving, relationships, health, work and money. Look to friends and family, as appropriate, or other trusted individuals or resources for tips and information.
7. Talk to a health professional if stress is affecting your well-being, you feel you cannot manage the stress you’re experiencing, or stress has caused you to engage in or increase substance use. Seek appropriate care if stress is harming your relationships or ability to work. If you have suicidal thoughts, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255). Lifeline chat is a service available to everyone 24 hours a day, 7 days a week. In addition, if you need help locating a mental health provider, the Substance Abuse and Mental Health Services Administration (SAMHSA) offers a site that can assist you at https://findtreatment.samhsa.gov. People who have experienced traumatic stress (directly or indirectly experiencing life-threatening and dangerous events) should find a treatment provider who practices trauma informed care. Additionally, in times of disasters and other sorts of emergencies, the National Disaster Distress Helpline (Call 1-800-985-5990 or text “TALKWITHUS” to 66746) can provide crisis counseling, emotional support and referrals to care related to disasters and public health emergencies.

Recognizing individual signals of a body’s stress responses and learning to respond to those signals in new ways can help build the emotional, intellectual and physical strength that comprise resilience, which can help you tackle future stressors.