Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In general, stress is related to both external and internal factors. External factors include your physical environment, your job, relationships with others, your home, and all the
situations, challenges, difficulties, and expectations you're confronted with on a daily basis. Internal factors determine your body's ability to respond to, and deal with, the external stress-inducing factors. Internal factors which influence your ability to handle stress include your nutritional status, overall
health and fitness levels, emotional well-being, your ability to control stress through relaxation techniques or other strategies, and the amount of sleep and rest you get.
Managing stress, therefore, can involve learning tips to change the external factors which confront you or the internal factors which strengthen your ability to deal with what comes your way.
What are some effective techniques to cope with stress?
Exercise
Exercise can be a key, central method to compensate for stressors. Physical exercise not only promotes overall fitness, but
it helps you to manage emotional stress and tension as well. Exercise can also aid in relaxation and improve sleep. For one thing, exercise can emotionally remove one temporarily from a stressful environment or situation. Being fit and healthy also increases your ability to deal with stress as it arises.
Relaxation techniques and meditation
There are many ways to use structured relaxation techniques to help control stress and improve your physical and mental well-being. While some types of meditation and relaxation
therapies are best learned in a class, it's also possible to learn meditation techniques on your own. There are literally hundreds of different types of relaxation methods ranging from audio CDs to group martial arts and fitness classes. The following are only examples of the types of structured programs available that can increase our capacity for relaxation:
Autogenic training:
Developed in the early 20th century, this technique is based upon passive concentration and awareness of body sensations. Through repetition of so-called autogenic "formulas" one focuses upon different sensations, such as warmth or
heaviness, in different regions of the body. Autogenic training has been used by physicians as a part of therapy for many conditions. Popular in Europe (where it is even covered by some insurance plans), this method is currently gaining acceptance in the United States. No particular physical skills or exercises are involved; however, people desiring to learn this technique must be prepared to invest
time and patience. Since this technique is slightly more complex than some relaxation methods, a course is generally the best way to learn the method.
Biofeedback: Biofeedback is one method of learning to achieve relaxation, control stress responses, or modify the body's reactions through the use of monitoring
equipment that provides information from the body which would normally not be available. This method is based upon the principle first advanced in the early 1960s that the autonomic nervous system (the part we don't consciously use) is trainable. For example, instruments can be used to measure heart rate, blood
pressure, brain activity, stomach acidity, muscle tension, or other parameters while people experiment with postural changes, breathing techniques, or thinking patterns. By receiving this feedback, one can learn to identify the processes that achieve the desired result, such as reduction in heart rate and blood pressure. Biofeedback is used by many practitioners for a variety of psychological and physical conditions. Because the technique involves the use of
measuring devices, it can only be performed by a professional.
Imagery: Imagery, sometimes referred to as guided imagery, is the use of pleasant or relaxing
images to calm the mind and body. By controlling breathing and visualizing a soothing image, a state of deep relaxation can occur. This method can be learned by anyone and is relatively easy to try out.
Meditation techniques: Ranging from
practices associated with specific religions or beliefs to methods focusing purely on physical relaxation, meditation is one of the most popular techniques to achieve physical and mental relaxation. There are thousands of different types of meditation, and many can be learned on your own. The meditative state is one in which there is a deep centering and focusing upon the
core of one's being; there is a quieting of the mind, emotions, and body. The meditative state can be achieved through structured (as in a daily practice of a routine) or unstructured (for example, while being alone outdoors) activities. While teachers of meditative arts are readily available, some techniques can be
learned though books or online tutorials.
A form of meditation popularized for several decades is transcendental meditation (TM). TM has the goal of achieving transcendental consciousness
(the simplest form of awareness). It is
practiced for 15-20 minutes in the mornings and evenings and is relatively easy to learn. Numerous classes and teaching materials are available for beginners.
Another variant of a meditation technique has gained popularity in the U.S. since its description in the 1970s by Harvard physician Herbert Benson. This technique involves generation of the so-called relaxation response through the repetition of a word of phrase while quietly seated, 10-20 minutes per day.
Designed to evoke the opposite bodily reaction to the stress response (or "fight or flight" reaction), this method carries no religious or spiritual overtones. Its value has been documented in the reduction of blood pressure and other bodily stress responses. Like other forms of meditation, it can be learned on one's own, but time and practice are required to elicit the desired relaxation
state.
Progressive muscle relaxation: Progressive muscle relaxation is a method developed in the 1930s in which muscle groups are tightened and then relaxed in succession. This method is based upon the idea that mental relaxation will be a natural outcome of physical relaxation. Although muscle activity is involved,
this technique requires no special skills or conditioning, and it can be learned by almost anyone. Progressive muscle relaxation is generally practiced for 10-20 minutes a day. As with the
relaxation response, practice and patience are required for maximum benefits.
Qigong: The martial art qigong is an ancient Chinese health-care system that combines physical training (such as isometrics, isotonics, and aerobic conditioning) with Eastern philosophy and relaxation techniques. There are many
different kinds of qigong, including medical qigong. Some forms are practiced while standing, sitting, or lying down; others involve structured movements or massage. Over 70 million Chinese practice some form of
qigong daily. Qigong has
been used for centuries in China for the treatment of a variety of medical conditions. Learning
qigong involves time, commitment, patience, and determination, and learning from a master or group is advisable. Since this technique involves physical exertion, check with your doctor before beginning, particularly if you have a chronic medical condition or are over 40 years old.
Tai chi: Like qigong, tai chi is a Chinese martial art. It has been termed a kind of "meditation in motion" and is characterized by soft, flowing movements that stress precision and force. Also known as
tai chi chuan, this method is thousands of years old. As with qigong, training from a master is necessary to
learn the art of tai chi. Again, since motion and force are required, check with your doctor before beginning training.
Yoga: There are many forms of yoga, an ancient Indian form of exercise based upon the premise that the body and breathing are connected with the mind. The practice of yoga is thought to be over 5,000 years old. One goal of yoga is to restore balance and harmony to the body
and emotions through numerous postural and breathing exercises. Yoga, which means "joining" or "union" in Sanskrit, has been called the "search for the soul" and the "union between the individual and the divine." Among the benefits
of yoga are increased flexibility and capability for relaxation. No special level of conditioning is required; yoga can be learned by nearly anyone. Classes, books, and videos are widely available. Those with special or chronic physical conditions will want to get clearance from their doctor before beginning.
High blood pressure, also known as hypertension, is a repeatedly
elevated blood pressure exceeding 140 over 90 mmHg -- a systolic pressure above
140 with a diastolic pressure above 90. There are two causes of high blood pressure, primary and secondary. Primary high blood pressure is much more common that secondary and its basic causes or underlying defects are not always known. It is known that a diet high in salt increases the risk for high blood pressure, as well as high cholesterol. Genetic factors are also a primary cause. Secondary high blood pressure is generally caused by another condition such as renal hypertension, tumors, and other conditions. Treatment for high blood pressure is generally lifestyle changes and if necessary, diet.
Anxiety is a feeling of apprehension and fear characterized by physical symptoms. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults.
Panic attacks are sudden feelings of terror that strike without warning. These episodes can occur at any time, even during sleep. A person experiencing a panic attack may believe that he or she is having a heart attack or that death is imminent. The fear and terror that a person experiences during a panic attack are not in proportion to the true situation and may be unrelated to what is happening around them. Most people with panic attacks experience several of the following symptoms: racing heartbeat, faintness, dizzyness, numbness or tingling in the hands and fingers, chills, chest pains, difficulty breathing, and a feeling of loss or control. There are several treatments for panic attacks.
Fibromyalgia, formerly
known as fibrositis, causes chronic pain, stiffness, and
tenderness of muscles, tendons, and joints without detectable inflammation. Fibromyalgia patients have an unusually low pain threshold. Symptoms of fibromyalgia include fatigue, abnormal sleep, mental/emotional disturbances, abdominal pain, migraine and tension headaches, and irritable bladder. Treatment of fibromyalgia involves patient education, medication, exercise, and stress reduction.
Stress occurs when forces from the outside world impinge on the individual. Stress is a normal part of life. However, over-stress, can be harmful. There is now speculation, as well as some evidence, that points to the abnormal stress responses as being involved in causing various diseases or conditions.
Depression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. The principal types of depression are major depression, dysthymia, and bipolar disease (also called manic-depressive disease).
Temporomandibular joint disorder, or TMJ, is a disorder of the temporomandibular joint(s) that causes signs and symptoms including ear pain, bite problems, headaches, dizziness, clicking sounds in the jaw, tinnitus and/or locked jaws. Behaviors or conditions that can lead to TMJ include teeth grinding or clenching, fingernail biting, habitual gum chewing, trauma to the jaw, stress, and occupational hazards. Treatment for TMJ may include heat, ice, a soft diet, antiinflammatory medications, physical therapy, stress management, occlusal therapy, correction of bite abnormalities, and surgery.
Toothache usually refers to pain around the teeth or jaws. In most instances, toothaches are caused by tooth or jaw problems, such as a dental cavity, a cracked tooth, an exposed tooth root, gum disease, disease of the jaw joint (TMJ), or spasms of the muscles used for chewing. A toothache can also be caused by a problem that does not originate from a tooth or the jaw, like diseases of the heart (angina or heart attack), ear infections, and sinus infections. A thorough oral examination, which includes dental X-rays, can help determine the cause.
Dyspepsia (indigestion) is a functional disease in which the gastrointestinal organs, primarily the stomach and first part of the small intestine, function abnormally. It is a chronic disease in which the symptoms fluctuate infrequency and intensity. Symptoms of dyspepsia include upper abdominal pain, belching, nausea, vomiting, abdominal bloating, early satiety, and abdominal distention (swelling). These symptoms are most often provoked by eating.
Insulin resistance is the diminished ability of cells to respond to the action of insulin in transporting glucose (sugar) from the bloodstream into muscle and other tissues. Causes of insulin can include conditions such as stress, obesity, metabolic syndrome, and steroid use. Some of the risk factors for insulin resistance include fatty liver, heart disease, strokes, peripheral vascular disease, high cholesterol, and smoking. Treatment for insulin resistance are lifestyle changes and if necessary, medication.
Hot flashes (or flushing) is the most common symptom experienced by a woman prior to and during the early stages of menopause. Hot flashes can be caused by other conditions. Diagnosis is made by taking a patient history and at times, blood tests. Treatment options include hormone therapy, bioidentical hormone therapy, and medications. There are non-FDA approved natural remedies.
Alzheimer's disease is a common cause of dementia. Symptoms and warning signs of Alzheimer's disease include memory loss, difficulty performing familiar tasks, disorientation to time and place, misplacing things, and more. The biggest risk factor for Alzheimer's disease is increased age. Treatment for Alzheimer's is often targeted toward decreasing the symptoms and progression of the disease.
ADHD afflicts approximately 3 percent to 5 percent of school-age children and an estimated 60 percent of those maintain the disorder into adulthood. Symptoms of adult ADHD include chronic lateness, anxiety, low self esteem, employment problems, difficulty controlling anger, impulsiveness, poor organization skills, procrastination, chronic boredom among others.
Insomnia is the perception or complaint of inadequate or poor-quality sleep because of difficulty falling asleep; waking up frequently during the night with difficulty returning to sleep; waking up too early in the morning; or unrefreshing sleep. Secondary insomnia is the most common type of insomnia. Treatment for insomnia include lifestyle changes, cognitive behavioral therapy, and medication.
Alcohol is the most frequently used drug by American teenagers. Teens that drink are more likely to drive under the influence, have unprotected sex, and use other drugs, like marijuana, cocaine, and heroin. Symptoms of alcohol abuse in teens include lying, breaking curfew, becoming verbally or physically abusive toward others, making excuses, smelling like alcohol, having mood swings, and stealing.
The connection between stress and heart disease is not clear. Stress itself may be a risk factor, or high levels of stress may make risk factors for heart disease worse. The warning signs of stress can be physical, mental, emotional, or behavioral. Reducing stressors in an individuals life not only can lead to a more productive life, but may also decrease the risk for heart disease and causes of heart disease.
Heartburn is a burning sensation experienced from acid reflux (GERD). Symptoms of heartburn include chest pain, burning in the throat, difficulty swallowing, the feeling of food sticking in the throat, and a burning feeling in the chest. Causes of heartburn include dietary habits, lifestyle habits, and medical causes. Treatments for heartburn include lifestyle changes, OTC medication, prescription medication, and surgery.
Enjoying a satisfying sex life as we age is important to both physical and mental health. As we age, diseases and conditions may pose challenges in our sexual health, and sexual experiences. Learn how to manage your conditions and still have a gratifying sex life as you age.
Sleepwalking is a condition in which an individual walks or does other activities while asleep. Factors associated with sleepwalking include genetic, environmental, and physiological. Episodes of sleepwalking may include quiet walking to agitated running. Conditions that may have similar symptoms of sleepwalking, but are not include night terrors, confusional arousals, and nocturnal seizures. Treatment of sleepwalking generally include preventative measures. Medication may be prescribed if necessary.
Heart disease, particularly coronary artery disease is the leading cause of heart attacks. Women are more likely to die from a heart attack than men. High cholesterol, high blood pressure, obesity, and high triglycerides are contributors to heart disease. Some of the common symptoms of a heart attack in women include chest pain, shortness of breath, nausea, feeling faint or woozy, and more. Heart disease can be prevented by lifestyle changes and controlling high blood pressure, cholesterol, weight, and diseases such as diabetes.
Regular physical activity can reduce the risk of disease. Regular exercise can also reduce the symptoms of stress and anxiety. There are fitness programs that fit any age or lifestyle.
Irritable bowel syndrome (IBS) in children is a functional gastrointestinal disorder with symptoms of abdominal pain, bloating, diarrhea or constipation. The cause of IBS is unknown, however, certain foods, stress, anxiety, and depression may contribute to the symptoms of IBS. There is no cure for IBS in children; however, medications, dietary changes, and stress management may relieve symptoms.
Caring for a loved one or patient with Alzheimer's can become a difficult and overwhelming task at times. This guide helps caregivers of individual's with Alzheimer's deal with communicating, bathing, and dressing; as well as problem solving with incontinence, sleeping, wandering; and coping with difficulties Alzheimer's patients present.
Attention deficit hyperactivity disorder (ADHD) can be challenging for a parent or caregiver with a child with this disorder. There are steps, routines, and help for parents and caregivers of children with ADHD to help guide the family toward a productive and healthy life.
The importance of a healthy lifestyle in disease prevention is widely understood and most people know that lifestyle changes and choices can be critical to good health. Yet, few practice healthy behaviors that constitute healthy living.
Irritable bowel syndrome (IBS) is a functional disease that can affect the quality of those who suffer from this condition. Individuals with IBS can make lifestyle changes that may modify or control the number and severity of episodes. Certain foods, medications, and hormone levels may trigger IBS episodes. Learn how to prevent the number and severity of IBS episodes of diarrhea and constipation.
Disease prevention in women includes screening tests that are a basic part of prevention medicine. All screening tests
are commonly available through your general doctor. Some specialized tests may be available elsewhere.
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