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.
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.
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.