Reducing and Preventing Stress
By Bruce Campbell
(From the series What Works for Managing ME/CFS and Fibromyalgia)
Both ME/CFS and fibromyalgia are very stress-sensitive illnesses. Even moderate amounts of stress can greatly intensify symptoms. Because the effects of stress on quality of life are so great, the use of stress management techniques can produce a big payoff.
This article describes stress management techniques used by people taking our introductory self-help course.
Using Many Techniques
Stress is so pervasive in ME/CFS and fibromyalgia that most people in our program report using multiple methods to combat it. Here is what some said when asked what they do to control stress.
I do a variety of things to manage stress, such as deep breathing, listening to relaxation tapes, getting regular massages, walking with my dog, and writing in my journal.
The ways I try to handle stress are: meditating daily, scheduling a regular time in bed each night, keeping our home an emotionally welcoming place for my husband, engaging in pleasurable activities, and avoiding unwanted situations which will drain my energy.
For stress reduction I use stretching and yoga; relaxing activities like time in our hot-tub or in the swing in the back yard; spiritually enhancing activities such as prayer and Bible study; and fun activities both mental or physical, like reading, movies, playing with the grandchildren, playing with the dog, and spending quality time with my husband.
Stress Reduction
In the remainder of the article, we will focus on strategies in two broad categories: stress reduction and stress avoidance. Stress reduction means learning how to respond differently to stressful situations and events.
Often, how we view and react to a stressor determines how much stress we experience. For example, worry in response to an increase in symptoms may lead to muscle tension. The tension, in turn, can create pain, which drains energy and causes fatigue. By learning to relax, we can reduce muscle tension and therefore symptoms.
People in our program have described using 13 different stress reduction techniques.
1) Physically-Relaxing Activities
For stress reduction I use deep relaxation through therapeutic massage and healing bodywork, long soaks in a hot tub or steam room, exercise/movement such as long, deep yoga stretches, and tai chi. Sometimes something more vigorous for a short period of time works best, like a brisk walk or jumping on my mini-trampoline.
Acupuncture really helps me with the stress and the fibro symptoms. Also helpful to me are massage and or chiropractic.
I find that using slow-breathing techniques helps reduce my stress. If I find that I am running late for an appointment, I make myself slow down and take deep breaths to reduce stress that I am feeling. I tell myself it is o.k. if I am late, the doctor will still be there, and 9 times out of 10, he is running behind himself.
2) Rest
Resting helps release my stress, so I try to keep a regular rest schedule.
I have been using planned rest periods for almost two years, and I now feel more in control of my fatigue with these preemptive rests.
3) Meditative Activities
A strategy that I have found particularly helpful in lessening stress is to integrate a regular meditation practice into my daily rests. Doing so has helped reduce my overall anxiety level.
I have been doing meditative exercise like tai chi for about five years, and I find that very relaxing. I also listen to meditation tapes for relaxation, and I use deep breathing a lot to stay calm.
4) Solitary Pleasures
I find that taking a walk helps if I can get outside and be alone to do it. If I can't, lying down in my bedroom which is very soothing (sage green walls, wood floors, candles lit) can also be great. I am an avid reader, so reading some fiction for pleasure helps me relax.
I spend much of my time in quiet, relaxing activities such as TV, reading, needlework, etc. If I have a day that does not allow me to participate in these activities to some minimal extent, I find myself extremely tense, stressed out and emotional.
5) Problem-Solving
I try to work out a practical plan for the things that are bugging me that I feel I can change. Sometimes the problems seem overwhelming, but the advice of tackling one thing at a time really works.
I have spent quite a bit of time analyzing my activities, everything from how long I stayed somewhere to ways to minimize pain in doing chores. From this analysis, I have tried many different props which have proved to be very helpful, such as a book holder for the newspaper.
6) Enjoyable Activities
When I was first sick, I had a lot of guilt about not being a productive individual and thought I did not deserve any fun. Later I thought that because my stress was big, the stress reliever had to be big, too. What I finally learned was that fun was really key to helping me reduce my stress and that fun can come in many ways, big or small.
Also helpful in stress reduction is planning positive experiences. Outings with my husband and children, watching a favorite TV show at night, and taking overnight trips to nearby towns or state parks, I find particularly stress-relieving.
Enjoyable activities are so very important to me to show me that I can have a good life even though I have ME/CFS, things like hobbies, outings with a friend, having a friend over or shopping.
7) Humor
I keep a large collection of favorite comedy programs on tape. They are very easy to watch or listen to, and provide a great means of escape.
Often the more stressful things get, the more I rely on humor. I enjoy laughing with friends on the phone, or watching a good sit com or funny movie.
Remember "STRESSED" spelled backwards is "DESSERTS."
8) Changing Expectations
A major thing that I do in life to avoid stress, is to avoid expectations. By that I mean that I let go expecting people to respond to me the way I think they "should." For example, I let go of expecting that people will understand my disease. So with no expectations, I get fewer resentments, which leads to less stress in life.
Another area I've worked on is to reduce expectations of myself and others. I'm a "recovering perfectionist." I frequently battle with those tendencies. When they get the better of me I always overdo, even when I'm not feeling well to begin with.
I'm learning to recognize that in the long run it doesn't really matter if my floors aren't spotless or the laundry doesn't get done on Saturday.
9) Making Mental Adjustments
I am training myself to ask "is this my problem or responsibility?" Often the answer is "no" and then I try very hard to sit on my hands and not interfere. If "yes," I try and do something about it, even if the plan has to be done in bits and pieces over a period of time.
I have come to accept my situation, as it is now, and have been successful in creating a life that is happy and fulfilling, even though one very different than I expected.
When I catch myself thinking global thoughts like "I am never going to get well," I replace them with thoughts like "I am doing so much better" or "This moment is tough, but I know it will get better."
10) Pursuing Creative Activities
I have recently re-awakened a life-long interest in artistic pursuits. Earlier in my life, I liked music, then needle crafts, now it is calligraphy and rubber stamping, in which I find a tremendous amount of pleasure and comfort.
11) Writing
Journaling has been very helpful to me because by simply writing about what is bothering me I am usually able to let it go instead of worrying about it.
The thing that has worked best for me is to record the things that are stressing me in a stress journal. It seems that identifying them and putting them in writing, not only helps the stress level, but by identifying them I am able to pinpoint the problem. This keeps the churning worries in my mind to a minimum.
12) Assertiveness
I have recently begun to be more assertive with people who ‘set me off' and put me on an emotional roller coaster.
I have stopped trying to be everyone's friend and do whatever people need from me. I have now a few, close friends who I can count on and who count on me.
13) Medications
I've been on Zoloft for over two years. I resisted the idea for a long time, and now kick myself for having done so. It has helped level off my reactions to everyday stress and evened out my mood. Medications are not for everyone, but I've learned to keep my mind open to treating all aspects of my life and not relying on solely one approach.
Stress Avoidance
Stress avoidance is preventive, involving self-observation to learn how stress affects you and then taking steps to avoid stressful circumstances. Sometimes rest is an effective stress avoidance strategy.
When we hit a limit and any further activity will intensify symptoms, rest can reduce the stress on our bodies. Planned rest can help reduce background stress. The main ways that people in our groups prevent stress is to avoid stress triggers and to live by a routine or schedule.
1) Avoiding Certain People
I gave up on several difficult relationships. I was amazed at how great I felt and also how those people never even tried to resurrect the relationship. Guess I wasn't as indispensable as I thought!
I have cut people out of my life that only irritate or don't support me. It was a hard thing to do but has made a big difference in how I feel.
I have managed to get rid of some toxic relationships, people who talked all the time, were very scattered and unfocused, and not on the path of self-discovery. It took me a while to recognize that these types of relationships were causing me so much stress.
There are some people who I have to avoid or limit contact with since they seem to stress me due to their negativity and/or wanting to push me to the limit both physically and emotionally.
2) Avoiding Particular Situations
Awareness and acceptance of my limits has helped me to avoid certain situations that are stressful, such as being with large groups of people or spending too much time in a store with bright fluorescent lighting.
To avoid stress I try to avoid situations that cause me stress. I only drive when I have to. I avoid crowds. I try to avoid arguing with people to whom I am close.
Avoiding Harmful Substances
I avoid eating foods that I am allergic or intolerant to and stay out of smoke-filled rooms.
Eliminating or at least restricting aspartame and other sweeteners, MSG, and caffeine has helped to keep me more even-keeled.
3) Using Routine
Up until two years ago my life had little routine in it and the result was frequent, lengthy crashes. My life was one big roller coaster. Now that I have a regular schedule, I can plan much better. Routine may sound boring, but it's a must for me.
Having a regular routine has been very useful, because having a predictable life has been the most effective way for me to reduce stress. A life with few surprises has reduced the pressure on me and given my body more time to heal.
A set routine is most helpful to me in managing stress. I can vary slightly without a significant increase in symptoms. I don't like surprises, I need to be able to anticipate and plan out my day.
4) Scheduling Activity
I have a fairly routine lifestyle, with specific activities sprinkled throughout the week, both health-related and fun, giving me plenty of time to rest and relax at home, but also leaving me time for socializing.
I plan activities that will take more energy (physical, emotional, or mental) during my good times of day.
I found that I can avoid much stress by knowing my limits. Planning too many activities in one day or scheduling them too close together are big stress triggers, so I try to prevent their activation by limiting the number of activities in a day and by giving myself plenty of time in between two activities.
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