Avoiding Stress

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By Bruce Campbell

There are two main approaches to managing stress: stress reduction and stress avoidance. The first, which was explored in the previous two articles in this series, involves learning how to respond differently to stressors so that they do not have the same effct as in the past.

Stress avoidance, the topic of this article, is preventive. It involves using self-observation to learn how stress affects you and then taking measures to avoid stressful circumstances.

For example, you may notice that when you hit a limit, any further activity will intensify your symptoms. In such circumstances, rest can reduce the stress on your body. Having good relationships are a buffer against stress. People with supportive relationships have lower anxiety and depression.

Overall, the idea of prevention is to avoid generating a stress response by avoiding stressful situations. Fewer stress hormones means more time for your body to repair itself. The main ways that people in our groups prevent stress are by avoiding stress triggers and by using pacing, order and routine.

Avoiding Stress Triggers

There are three types of stress triggers:·

Substances that create allergic reactions
Situations that produce sensory overload
Certain people

1) Substances: You can reduce symptoms by avoiding foods and other substances to which you are allergic or sensitive, minimizing situations that create sensory overload and limiting contact with anxious, negative or overly-demanding people.

2) Sensory Overload: If you are particularly sensitive to light, noise or crowds, or experience sensory overload in other ways, avoiding or limiting your exposure to those situations can help you control symptoms.

For example, if you are susceptible to sensory overload, you may socialize mostly at home or in small groups, limit your time in crowded stores or go to restaurants at off-peak times. Also, many people with ME/CFS and FM are selective about their exposure to television and movies, avoiding material that is emotionally arousing or has rapid scene changes.

Some people have “media fasts,” periods in which they watch no television, listen to no radio and avoid newspapers. For more, see the article “Sensory Overload: Sources and Strategies.”

3) Particular People: Some people with ME/CFS and FM experience high levels of stress when they interact with people who are anxious, negative or demanding. Responses they have made include talking with the person, limiting contact, getting professional help, and ending the relationship.

As one person wrote, “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.”

Another said, “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.”

Pacing, Routine and Order

Another category of stress avoidance strategies is the combination of pacing, routine and order.

1) Pacing: Pacing strategies reduce stress. For example, reducing activity level, scheduling activity based on priorities, having short activity periods, scheduling important tasks for your best time of day, taking regular rests, and taking time for meditation or prayer all help control stress.

As one person wrote, “I found that I could 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 activities.”

2) Routine: Another way to reduce stress is through routine: doing things in familiar ways and living your life according to a schedule reduces stress by reducing decision making and increasing predictability.

One of my chief ways to avoid stress was to make my life as predictable as I could by using routine, living my life as much as I could according to a plan. Having a daily schedule of activity, rest, exercise and socializing at set times gave structure to my life.

With routine I had less pressure, and fewer surprises and emotional shocks. I had adopted routine as a pacing strategy, but found that it also helped me control stress.

The price of making decisions was brought home to me in an incident that occurred in the first year or so I was ill. I went to the store to buy toothpaste and felt overwhelmed at my options. Not only were there multiple brands of toothpaste, but for each brand there were several different types/flavors and each of them came in several different sizes.

The experience taught me that even apparently small decisions took thought and energy. Recognizing that new situations require decisions, I decided to save energy for healing by living my life using routines, doing the same things at the same time each day.

Like me, some other people with ME/CFS and FM create routine by living their lives according to a plan. By living their plan, they reduce the surprises, emotional shocks and decisions in their lives, and thereby reduce their stress.

One wrote, “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.”

Another said, “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.”

3) Order: A final area of stress avoidance is order. Living in a well-organized environment reduces stress in two ways. First, you avoid the stress of having to hunt for things. If you always put your keys in your purse, you know where to find them.

Second, an orderly environment reduces the emotional distress and the stress of social isolation that can be triggered by a cluttered house, as people feel embarrassed about having guests.

In the article Illness and Housekeeping, Nancy Fortner describes how she identified a series of small practical steps she could take to bring order to her house. The first was to get medical help.

She writes, “Doing what I could to improve my health made it easier to tackle the housekeeping problem.” Second, she learned to use pacing. She says, “I finally realized that when I am tired, I should rest.” She uses pre-emptive rests to improve her energy.

Third, she developed a series of anti-cluttering strategies. For example, she sorts the mail as soon as it arrives instead of letting it pile up. Fourth, she accepted that progress would be slow but real and congratulated herself for every step forward. Fifth, she enlisted help from her family.

In conclusion, she writes, “I would summarize the changes I have made as: keeping my expectations realistic, delegating some tasks, establishing routines, picking up after myself, pacing myself, resting before I get tired, and praising myself for the effort I am making. The result of my efforts is a house that is a clean and welcoming place for me and my husband.”