Ounce of Prevention MD: Use These Four “A’s” to Cope With Stress


Use These Four “A’s” to Cope With Stress

It is commonly stated that stress is bad for you, and that people are feeling more stressed than ever before. Yet, those are seemingly vague statements. What does it actually mean to be “stressed”? Does stress really affect us?

Stress is your body’s way of reacting to a physical, mental, or emotional challenge. Challenges can be positive, such as planning a wedding; or negative, such as an illness or loss of a loved one. In our own way, we all experience stress. Acute stress (you know that feeling you may get before taking a test or preparing for a speech?) can be good for you, due to the increasing levels of adrenaline your body produces to prepare you for a challenge. But over time, persistent stress may cause significant health problems such as an increased risk of depression, anxiety, heart attacks, high blood pressure, obesity, and substance abuse.

Stress: Something We’re All Too Familiar With 

Even before COVID, stress was a regular part of life for many Americans. In 2018, a third of U.S. adults visited a physician for a stress-related condition. Similarly, as of 2019, the U.S. ranked 7th in the world of most stressed-out countries, with 55% of the population experiencing significant chronic stress. Since the pandemic, heightened feelings of stress have occurred due to concerns over money, health, and lack of socialization. Sadly, stress has become very commonplace in our daily lives. However, there are steps we can take to ensure stress doesn’t take over.

I always tell patients that stress is your internal response to new events, or “stressors.”  We all react to the same stressors differently. Some people thrive in stressful environments, while others may feel their world fall apart when they run out of milk.  The fact is, you may have real stressors in your life (we all do), but that doesn’t mean you have to suffer from strain as a result.

Everyone has a breaking point – so if you have difficulty controlling your perception of tension due to overwhelming stressors, that doesn’t mean that there is something “wrong” with you. If you are going through a divorce, or you lost your job, it’s normal to feel a significant amount of angst. But we can also mitigate our distress with certain tools, no matter the severity of the challenge.

How Do We Manage Stress?

The first steps to managing your pressure gauge is the same as just about everything else – diet, exercise, and sleep, which can have profound positive impacts. The healthier you are, the more equipped you are to manage chronic tension. However, simply staying healthy may not be enough if your burdens are significant. So, let’s discuss some methods to manage feelings of overwhelm.

The Four A’s

One of the best approaches touted is to use the Four A’s:  avoid, alter, adapt, or accept.

Avoid” is learning to say no. We have a lot of “should do’s” in life, but not many “musts.” Try to prioritize what “must” be done. If you’re feeling overwhelmed, pass up the happy hour or soccer game. Close your office door at work. Leave the laundry for another day. Order (healthy) delivery rather than shopping and cooking. It’s okay to press the “easy” button if life gets too busy.

Next, “alter” your situation. In other words, try to be more efficient with your time. Take a business call in the car on your way to the supermarket. If possible, delegate work to others. Also, voice your limitations in advance (ie. “I only have five minutes for this call”).

You can “adapt” by changing your expectations and attitude. Maybe it’s time to lower your standards and definition of success. Is more money really going to make you happier if you’re always tense? Sometimes “good enough” really is good enough. This is also the place to practice gratitude and meditation, which are two great tools to combat stress.

If the above doesn’t work, you can “accept” your situation as it is. Be kind to yourself and be sure to forgive yourself for the current situation. You didn’t intentionally cause your stressful situation. Talk to a friend or a counselor to help you cope with the way things are.

The Other A’s…

I’d personally add two more “A’s” to this list. The first is “alcohol.” It is helpful to significantly cut down your alcohol intake if you are feeling anxious. Alcohol is actually a great way to increase your stress. This may sound counterintuitive, considering alcohol seems to lower your stress levels. But the next day after drinking, your perceived stress levels will be far greater than if you had no alcohol, even possibly from one or two drinks. The immediate relief you get from alcohol is not worth the anxiety you will feel the next day. If you can delay your gratification, you will likely feel better over the long term and be much better at managing your stress levels.

And finally, the last “A” is “ask”. Connection is really important to help any mental condition, so ask for help to manage your situation.

There is no “one-size-fits-all,” so find what works best for you. But realize only you have tools that can help you cope. Pick the one that is easiest or makes the most sense to you. As for me, I have a punching bag in my basement that works wonders after a stressful day.

Good luck, and good health!

Ken Zweig, M.D.

Northern Virginia Family Practice

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