how to deal with stress

how stress differs from anxiety

Stress is about being revved up. Hard to unwind, reactions larger than their cause, everything that interrupts you is unbearable, and the evening won’t switch off. From the inside, it feels like an engine that keeps running after the key is out.

Anxiety is fear, and what fear does to a body. Dry mouth, hands that shake, a heart you can hear without moving, the sense that something bad is arriving. More on that in constant anxiety.

They travel together often, which is why the standard questionnaire for this keeps both scales side by side. But only one of them comes down in minutes. Fear takes longer.

To see which of the two is louder right now, there is the stress test — twenty-one questions, about three minutes, and it scores anxiety and low mood along the way.

what breathing does, and by how much

A meta-analysis of twelve randomised trials, 785 adults: breathing practices lowered self-reported stress more than the control conditions did. The effect size is small-to-medium, g = −0.35. In the same paper the authors ask that the finding not be inflated.

Small-to-medium is not nothing. It won’t remove the manager, the debt or the child who doesn’t sleep; it returns the body to a condition from which those things can be handled.

A figure three times larger often turns up in the same searches: g = 0.83 against control. It is real, and it belongs to something else — biofeedback, where a device shows people their own pulse and they tune their breathing to it. We have no device, only a set rhythm, and carrying that number across would be sleight of hand.

In that same biofeedback work the number of sessions did not predict the effect. More practice did not buy more benefit. Which leaves a six-week course and a streak of ticked boxes unsupported — and five minutes when it gets bad is, on this evidence, no worse than a course.

what helps right now

An even 5-5 rhythm. Five seconds in, five out — six cycles a minute, the slow range the research actually covers. The dullest and the most dependable: the timer does the counting, you only follow. Five minutes, and the revving usually drops. More in resonance breathing.

The physiological sigh, when it has hit hard and you don’t have five minutes of patience in you. Two inhales through the nose, one long exhale through the mouth, five or six times. In a month-long trial that set three five-minute practices against mindfulness meditation, this one lifted mood most. How to do it: physiological sigh.

A long exhale before bed. Stress usually takes the evening first, and 4-7-8 breathing is built for exactly that.

Body before head. When thoughts won’t sort themselves, it is sometimes easier to come at it from the other end and release the grip directly: progressive muscle relaxation. It takes longer, and it doesn’t require you to calm down first in order to start.

what helps when it lasts

Five-minute practices are for the moment. When the tension holds for weeks, the work moves to whatever is holding it up.

Sleep before anything else. Short sleep raises reactivity, reactivity spoils the next night, and the circle closes. If you take one thing, take a fixed wake-up time: can’t sleep.

Separate what can be solved from what can only be lived through. This sounds obvious right up to the moment you sit down and write the list. Half the background load usually turns out to be items already decided, where the only thing left is waiting.

Watch where the evening goes. An evening won back from sleep feels like a win and turns out by morning to have been a loan at a high rate. More in unwind after work.

Notice where this stopped being stress. If interest has drained out of what used to hold you, if mornings begin with emptiness where the tension used to be, the picture is closer to burnout, and practices do less there.

when to see someone

Some things don’t yield to practices, and waiting costs more than the visit.

• the tension holds for more than a month and doesn’t drop even at weekends;
• sleep has broken: it won’t come, or you wake at four and that’s that;
• the body has joined in — blood pressure, stomach, headaches that don’t stop;
• alcohol has become the way the evening switches off;
• what used to give pleasure has stopped, and that has held for weeks — worth reading signs of depression at that point;
• the tension ended one evening with nothing left to hold on with: what that was and what comes next is in nervous breakdown;
• holding yourself together has got harder — what is genuinely under control is taken apart in how to control emotions.

A GP is a reasonable first stop: thyroid trouble, anaemia and vitamin deficiencies produce the same picture as stress and are worth ruling out. After that, a therapist or a psychiatrist — and there is nothing unusual in that. A conversation about what is holding the tension up is a shorter road than any set of techniques.

short answers