Important things to know about stress, how to control it, an 18-item stress test, and an easy way to profoundly relax.
Let me guess: You’re having weird dreams. Trouble sleeping. It’s hard to concentrate. Loneliness and boredom stalk, ever ready to pounce. You’re irritable, anxious and depressed more often than you used to be.
Be assured this is not your fault. There is a tendency to believe it is, to excoriate yourself for being such a weakling. Put those thoughts out of your mind. We are genetically conditioned to respond to threat—as this pandemic and its accompanying ills certainly is—so anxiety and feelings of insecurity are normal.
The things listed above are some of the more typical symptoms of stress and anxiety, distressful ingredients of what the coronavirus syndrome is causing in us during the pandemic. With the worldwide requirements of social distancing, lock downs, quarantines and closed businesses it feels like we are living in a war zone.
These sources of stress are going to be with us for a while. Count on it to continue to cause ever worsening psychological, emotional and physical symptoms.
That’s the bad news. Here’s the good: There is a way to deal with all this coronavirus, this Covid-19, stress, a way that significantly reduces the psychological pain, anxiety and resulting physical maladies of these trying times.
An effective (and, dare I say it, blissful) kind of stress management can be yours without drugs or psychotherapy. Without leaving the safety of wherever you happen to be hunkered down. No shrink required. No fancy equipment required. All that this magical form of stress management requires is a simple, easily learned exercise. No, not calisthenics or push ups. You don’t have to exhaust yourself on a treadmill. The kind of exercise required for this particular way to deal with stress is something you can do practically anywhere. At any time. Even in bed (no, not that one; this is a different kind of exercise).
If you get the sense I am beating around the bush here, you’re right. Without the right kind of preparation and build-up, most people have a tendency to dismiss this exercise when they hear what it is. It’s just too simple, they think, too easy to really be effective. And besides all that, it’s physical! How can that have much of a psychological or emotional effect?
Assumptions like these are a big mistake and couldn’t be more wrong. For one thing it is just plain wrong to make a hard and fast distinction between our physical, emotional and psychological parts. All three are closely tied and they have profound influence on each another.
It is at this point that people who know what they are talking about (ahem!) tend to get all techno-blabby and scientific and spit out a bunch of jargon on clinical stress-related topics like the corticotropin-releasing hormone system or the locus ceruleus-autonomic nervous system manipulation as a way to manage stress and anxiety. But I promise not to do that (again). In return I hope you will hear me out. Because if you do, and you give it a try, you stand to gain some big benefits. Like:
- Vastly improved sleep quality.
- Reduction or elimination of troubling dreams.
- Improved calmness and reduced moodiness, anger and irritability.
- Fewer gastric disturbances (diarrhea, upset stomach, etc.).
- Less fear and anxiety.
- More energy.
- No more (or certainly fewer) stress-related headaches.
- More happiness, less sadness.
- Get back to feeling good about things, at least once in a while.
The wide-spread and seemingly miraculous benefits of stress management have long been scientifically accepted, by the way. As for those benefits listed above, they are all known (usually in their negative form) to be common symptoms of stress. And there are a lot more where they come from. Like acne, for instance. Who would have thought that emotional stress could cause pimples? Or obesity. Skin conditions of all kinds. Aches and pains in muscles and joints. Ringing in the ears. The list of things that can be caused by stress just goes on and on.
Symptoms a response to stress
What we call symptoms of stress are the ways we respond to a stressor, which can be anything that is threatening (scary) to us. Sometimes we are not even consciously aware of stressors. Or if we are aware of them, we might not consciously think of them as being scary. Noise can be like that, for example. While we consciously tune it out we subconsciously cause symptoms that are seemingly unrelated to the noise. Symptoms like gastric distress or disturbed sleep.
All of this is why things can go wrong — we get sick or depressed or feel bad — without knowing why. When we perceive — consciously or subconsciously — some stressor (something that somehow threatens our well being, remember), an immensely complicated system of triggers and internal events is initiated in our mind and body. Psychological and biological things happen which are intended to direct us to, or help us with, those well known options of fight or flight.
But if we can’t fight the thing (the stressor), or flee from it, the arousal is sustained. It just keeps on keeping on. That’s when tension results in anxiety.
Normal life is full of stressors. Careers, parenting, healthcare, politicians — you don’t have to think about it long to come up with lots of stressors in everyday life. In fact it is estimated that about 25 percent of people’s mental and physical problems stem from anxiety of one sort or another. Add to all that what we’ve got facing us now (the covid pandemic; sorry to remind you again).
With the appearance of the pandemic it seems like the world is descending into terminal darkness. It is hard to see the light at the end of the tunnel. In fact it is hard to be confident that there is an end to the tunnel at all. Hence it is not crazy to have a whole bunch of symptoms of stress and anxiety. It is also not crazy to not have them. Many peoplePeople for whom some of the pandemic dynamics are actually a benefit. Like the slowing down of a hectic lifestyle or a reduction in social pressures, for example. who normally suffer from anxiety and panic attacks are actually feeling better at this time of pandemic lockdown. But here is an important fact about all of this. All of our internal defense mechanisms and response systems tend to stay quiet and more or less mind their own business when we are relaxed.
Let me put that a little differently. When your body — muscles and tendons and all the physical stuff — is relaxed, so is your mind. And by relaxed I mean deeply relaxed with most of your muscles limp and untensed. If you can get yourself that relaxed, all those painful and uncomfortable symptoms take a powder. So why not just take a drug that does that? you’re wondering. Nope. Doesn’t work right. I experimented with neuromuscular agents many years ago. Methohexitone was one of them, an amazingly effective muscle relaxant. One dose of this stuff and all physical tension disappears completely. Problem was, no one liked the experience with methohexitone or any of the other compounds we experimented with. I mean no one. People would rather keep their crippling anxieties and stress disorders than tolerate what they often referred to as forced relaxation.
Our need to be in control of our body is high on the list of things that are important to us humans. There are of course a host of pharmaceutical products that sedate or tranquilize one but they are all addictive and can eventually lead to more problems than they solve.
The best, and easiest, way to deal with stress
And this brings us (finally! you’re thinking) to the crux of the matter. The very best way to deal with stress, to manage stress and anxiety, is a progressive form of structured deep relaxation. At this point I would love to launch into excruciatingly painful scientific detail about how this form of relaxation works its magic, but I promised not to do that. So instead I’ll offer you a way to prove to yourself just how beneficial this exercise is. Sans the technical gobbledygook.
Test to measure your stress
To do this you should first establish a baseline stress level. That is, how stressed are you now? And we need more than the old California cliche: “Like I’m really bummed out, Dude!” We need a metric that is a bit more specific than that. To that end I’ve put together a little quickie quiz for you.
Unimaginative clod that I am, I named it the Quickie Stress Test. It is composed of the kinds of questions I would work into a conversation with you to get a fix on your level of stressed-out-ness if we were talking in person.
The Quickie Stress Test will give you an actual number to indicate your stress level. By the way, this test is just for your own information. I just made it up but I’m sure it’s accurate. I am confident that it at least closely approximates the information we would get from taking one of the more rigorous stress tests used commonly used in professional situations (labs, clinics — you know, fun places like that).
The Quickie Stress Test has not been subjected to the kinds of validating procedures that would qualify it for clinical use. But that is unnecessary for your own personal insight. It is a quick and easy way for you to gauge your own personal stress level. Just don’t try to compare yours with other people’s scores. Don’t ask someone else to take the Quickie Stress Test and then compare yours and their scores. Another person could arrive at half your score and be twice as stressed.
So this is just a personal measure for your own use. And it is repeatable. You can take it as often as you like, which you definitely should do; measure your stress management progress by taking the test again later. So take the test now to get a fix on your current level of stress and anxiety. Though connected, stress and anxiety are two different things. Stress is a response to threat, and anxiety is a response to stress. But we can just kind of lump them together for the purpose of you getting control of your stress and anxiety.
You can either print out the test to complete it, or you can record your answers separately. Be sure to add your name, date, time and, when you’re finished, your score. Scoring is easy and simple. Just add up your ratings. The total is your score. I’ll give you more information about that after you have completed the test.
One last bit of advice for taking the test. Show each item some respect. That is, think about the statement and be as honest as you can with your answer. There is no right answer to any given item, nor is there a perfect score. It is what it is, and whatever it is now, that’s what you want to know.
Quickie Stress Test
Date & Time ___________________
Score ___________
Name __________________________
Instructions: Read the statement, then on the blank line enter the number corresponding to the most appropriate response. CAREFUL! Read the scale values for each item because they are not all the same.
-
- ____ I have difficulty falling or staying asleep.
1-never 2-seldom 3-sometimes 4-often 5-always - ____ I have trouble concentrating.
1-never 2-seldom 3-sometimes 4-often 5-always - ____ I am calm.
1-always 2-often 3-sometimes 4-seldom 5-never - ____ My hands tremble.
1-never 2-seldom 3-sometimes 4-often 5-always - ____ I stick to a daily routine.
1-always 2-often 3-sometimes 4-seldom 5-never - ____ I am depressed or anxious.
1-never 2-seldom 3-sometimes 4-often 5-always - ____ I get plenty of exercise.
1-always 2-often 3-sometimes 4-seldom 5-never - ____ I have hope for the future.
1-always 2-often 3-sometimes 4-seldom 5-never - ____ I am moody and irritable.
1-never 2-seldom 3-sometimes 4-often 5-always - ____ I have lots of energy.
1-always 2-often 3-sometimes 4-seldom 5-never - ____ I have rapid heart beat.
1-never 2-seldom 3-sometimes 4-often 5-always - ____ I am happy.
1-always 2-often 3-sometimes 4-seldom 5-never - ____ I have headaches.
1-never 2-seldom 3-sometimes 4-often 5-always - ____ I have acne.
1-never 2-seldom 3-sometimes 4-often 5-always - ____ I have upset stomach or diarrhea.
1-never 2-seldom 3-sometimes 4-often 5-always - ____ I am tired and exhausted.
1-never 2-seldom 3-sometimes 4-often 5-always - ____ I am angry.
1-never 2-seldom 3-sometimes 4-often 5-always - ____ I am sleepy during the day.
1-never 2-seldom 3-sometimes 4-often 5-always
- ____ I have difficulty falling or staying asleep.
Score: ______ (add all your answers together—the sum is your score)
Comparable test level scores
Now, having completed the test, you have a beginning number, which is your stress level score at the time you completed the test. Your score will be somewhere between 18 and 90. The higher the number, the more stressed you are.
If your score is 18 or very close to it, better check for a pulse. A score at or around 18 is just too low to be real. Have a talk with yourself and take the test again. Same with a score that is too high. A score even approaching 90 would mean you are about to blow your lid.
If you are at least able to take the test at all, you are probably not a 90. You can take the test again later, or as often as you like, as a metric that tells you how much good your stress management program (for which full details follow below) is helping.
By the way, many of the conditions represented by the test can be caused by something other than stress. That is why there are more than just a couple of questions. Taken as a whole you will find that this is a pretty good barometer of your current level of stress and anxiety, even if a few of the items don’t seem to apply to you.
One more time, if I may: This test is not intended to be valid for comparisons between two or more people’s scores. The main purpose here is to provide a marker against which you can measure your own progress toward a more comfortable, less stressful state of mind. I’m sure you get this; I won’t bring it up again.
You should also understand there are no national norms, no large-sample averages for you to compare your score against. Having said that, I do know it is helpful to have at least some nominal idea of where your score puts you on the stress continuum, so I have prepared the following ranges to give you a rough idea.
DEEP RELAXATION PROCEDURE
Deep relaxation is a skill. As with any skill, the more you do it the better, and faster, you get at it. Keep in mind that this is “deep” relaxation. It is a far cry from what usually passes for relaxation.
Practicing deep relaxation is a lot more than just deciding to take it easy for awhile. For one thing, just telling yourself to relax is not a good way to develop this skill. In fact, when you tell yourself to relax it can have just the opposite effect. Telling someone else to relax or calm down is almost guaranteed to have the opposite effect.
Cops have a habit of doing that. “Uh, Sir, calm down.” It hardly ever works for them, and it is even less likely to work when someone tells himself to settle down and relax.
It takes something that goes far beyond a simple admonition to chill out. All our lives we’ve had people telling us to relax. “Just settle down.” Hollywood and fiction writers love to think it works that way, but we all know it doesn’t really work that way.
The method I’m going to tell you about is one I have used in both clinical and experimental circumstances with lots of different people. It has worked for young and old alike in laboratory research settings, seminar training programs, and clinical applications.
This is a modified version of the Jacobson method of progressive relaxation. It involves tensing and releasing your muscles in specific groups. Fourteen discrete muscle groups to be exact. These are groups like the upper arm, lower leg, and so on.
Each group is first tensed, held for a brief period, then released.
After going through the entire set of fourteen muscle groups your body will be significantly more relaxed than when you began. Now, just in case you happen to be one of those classroom trouble makers who love to ask difficult questions, no, you can’t single out every single muscle of the body in fourteen groups. That is obvious. There are, for instance, six pairs of muscles just for the eyeballs. I wouldn’t even begin to know how to tense and release each of them separately.
There are six separate muscles just for the tongue. The muscles of expression for the face number more than forty. Like for instance the levator labii superioris alaequae nasi, the muscle you use to sneer (no, this won’t be on the final). But even though there are many muscles that are not specifically addressed in this progressive relaxation procedure, all those little muscles will relax if you relax the big guys. Because for muscles it is pretty much monkey see, monkey do.
If the leader muscles relax — those are the ones you will be tensing and relaxing — the follower muscles will also relax.
Here is a really great thing about deep relaxation: When your body is relaxed, your mind will be relaxed. It is not humanly possible to be mentally stressed if your body is limp and relaxed.
This is not a two-way street, however. It is possible for muscles to be tense without any conscious help at all. It is not at all uncommon for someone to think she is not stressed but her muscles are almost crippling her with tension. Or her stomach is pumping out enough gastric juices to eat a hole in it. It is rather easy, more so for some than others, to be tensed tighter than a drum and not be aware of it mentally.
Being unaware of stress does not mean it is not doing its damage. It is best to know your current stress level so you can do something about it before does its damage. That is another positive thing about the regular practice of deep relaxation. You learn to spot the earliest signs of stress; you become much more sensitized to it. So you can stop it in its tracks.
During the tensing and releasing exercise it is important for you to pay close attention to how a tensed muscle feels, then how it feels after the tension has been released. It may seem strange to you at first to tense your muscles when it is relaxation you’re after. The main reason is the increased oomph it gives to the message sent to the brain to open the neuronal gates.
Think of bouncing a ball. The higher you want the ball to bounce, the higher you hold it before letting go. Expecting the ball to bounce without dropping it is… well, you get the point.
Now for the procedure itself. I’ll go through each muscle group and describe the muscles. You can practice as you read. It will probably take you a few times to remember the muscle groups and their order, although the order in which you tense and release the groups is not all that important. It is just convenient to have a routine order of groups.
As your skill develops you will be able to relax faster and easier. You will also know your practice is having an effect because you will feel it. From time to time you can re-take the Quickie Stress Test to see if your score is getting lower. Keep in mind, though, that you can be more or less stressed from one time to the next. Occasionally getting a higher score does not mean anything is broken. You are looking for a downward trend in your stress score. So don’t obsess over a single score.
Begin by reading through the description that follows, trying each muscle group as it is described. Then, when you feel that you are familiar enough with the muscle groups, get comfortable and go through the process on your own.
You should refer back to the muscle group descriptions from time to time until you have the procedure down pat.
After you have been practicing daily for a week or so, reread this section to make sure you are doing it right and not leaving anything out.
The first muscle group is your dominant hand Dominant meaning the hand you write with. It doesn’t make any difference which hand you start with. If you have a handicap on one side or the other just do what is most comfortable for you. and forearm. Tense the muscles in your hand and lower arm by making a tight fist. You should be able to feel the tension in your hand, over the knuckles, and up into your lower arm.
Hold the tension for about five to seven seconds Count one-thousand-one, one-thousand-two, one-thousand-three up to one-thousand-seven. Then release the tension abruptly.
I want to emphasize abruptly. Do not release the muscles gradually. It is important to release the tension in each muscle group as quickly as you can.
During the process of tensing, holding and releasing, pay close attention to the feelings associated with each state. Follow this procedure of paying close attention to the feelings of tension throughout the entire fourteen muscle group practice. Remember, your awareness of what the tension and relaxation feels like in each muscle group is an important part of the learning process.
Now move to the second muscle group. These are the muscles of the upper arm (still on the same side). You can tense these muscles by pushing your elbow down against the arm of your chair or bed, or against your body, or both. Do not make a fist or otherwise disturb the relaxation you have already achieved in your hand and wrist.
Once you have tensed and released a muscle group, keep it as relaxed and still as possible. Hold the tension five to seven seconds, paying attention to how it feels, then quickly let go of the tension.
Now, don’t try to make or force the muscles relax when you let go. Just let the momentum carry the muscles into deeper relaxation.
The third muscle group is the non-dominant hand, and fourth muscle group is the upper arm. Just repeat what you did with muscle groups one and two, except with the other side.
After you have relaxed the muscles of both hands and arms, move to the fifth muscle group which is the face and jaw muscles. These muscles are tensed by simultaneously:
- clamping your teeth together with moderate force (don’t try to break anything);
- wrinkling your forehead and nose, tightly closing your eyes in the process; and
- pulling the corners of your mouth back and up as far as you can, as if you were making a big, phony smile.
Hold the tension for five to seven seconds, then release.
The sixth muscle group is made up of the muscles of the neck. This area is particularly important because the neck muscles are often a repository of tension. Tense the neck muscles by pulling your chin down toward your chest. At the same time, exert force to prevent your chin from actually touching the chest. By doing this you are counter-posing the muscles in the front part of your neck against those of the back of your neck.
If you are doing it correctly you should experience some trembling or shaking in your neck and head. You will discover that the abruptness with which you can relax your muscles after tensing them takes a little time to learn. This will be particularly true of the muscles in the face and in the back of the neck.
As you continue to practice and get better at deep relaxation, you will find it easier to let the muscles relax quickly. Keep the concept of abrupt release in mind as you practice. The more tension you can muster (up to a point) and the faster you release, the more momentum to relaxation you generate.
The seventh muscle group is the muscles in your chest, shoulders, and upper back. There are considerably more muscles in this group and they are generally larger. To tense this group, pull your shoulder blades together as though you were trying to get them to touch. Whether or not they actually do touch is not important. Just push them back far enough to feel a good amount of tension in the muscles of your shoulders, chest and upper back.
Now, a note about breathing. Deep breathing is an aid to deep relaxation. It is a good idea to take two or three deep breaths before starting your deep relaxation exercises. Do this by inhaling deeply, filling your lungs, and holding the breath momentarily. Then exhale slowly, imagining that you are exhaling tension as you release your breath. Repeat this procedure with a single deep breath several times during your relaxation exercise.
Like for example after each upper arm, the facial muscles, the lower torso muscle group, and after each leg and foot group.
Move now to the eighth muscle group, those of the lower torso. Tense these muscles by making your stomach hard, tightening the muscles of the stomach as if you were about to take a punch to the gut. That’s not a very relaxing thought; it is just to give you an idea as to how to tense your stomach. Don’t think any more about getting punched after this.
It seems natural, when tensing the stomach muscles, to hold the breath and push out. This is bad. Don’t do it. It tends to elevate diastolic blood pressure in some people and you might be one of them. Try to breathe a little while you are tensing the stomach muscles.
Some people, for reasons I’ve never quite understood, just don’t seem to get it about tensing their stomach muscles. If you are not confident that you are tensing your stomach muscles correctly, you can achieve approximately the same results by either sucking your stomach in or pushing it out as far as you can.
Now tense the muscles of the ninth muscle group which is your upper leg. Start with your dominant side, just to stick with the pattern. Tense this part of your leg by counter-posing the large muscles on top of the leg against the smaller ones underneath. If you are doing it right the muscles will feel hard and stiff.
Another way to achieve this is to lie flat on your back and, keeping the leg straight, lift your foot a few inches.
The tenth muscle group is the muscles of the lower leg, which are primarily the calf muscles. Point your foot upward toward your head as far as you can. Just curling your toes upward is not right; the whole foot has to point upward, stretching the calf muscles between your heel and the back of your knee. The result should be as if you were standing on an incline going up in front of you.
Next, the eleventh muscle group, is the muscles of the dominant foot. Tense these muscles by turning your foot inward and pointing it downward. Don’t try to get too much tension in the foot muscles, and release the tension after a couple of seconds instead of the five to seven seconds for the other muscle groups. This is to avoid cramping. Tense just enough to feel the tightness in your ankle, under your arch and in the ball of your foot.
Now repeat the tensing and relaxing process with the upper leg (muscle group 12), lower leg (muscle group 13), and foot (muscle group 14) on your non-dominant side. The instructions are the same as for those just given for muscle groups nine, ten and 11 on the dominant side.
And that’s it. Fourteen muscle groups tensed, held and released, with a few deep breaths taken and briefly held here and there. Most people prefer to do the deep relaxation exercise lying down, but that is not strictly required. You may find that sitting back in a reclining chair can be just as effective.
Avoid practicing in straight-backed chairs or other less comfortable positions until you are completely familiar and comfortable with the exercise. The less effort it takes to maintain your position, the better.
How often should you practice, and when? The answer to the first question depends on how tense you are to begin with, and how much time you have. At the time I write this the world is in the grip of the covid pandemic. We all have radically different schedules than we did before the pandemic. For many people it will not be difficult to work in at least one daily exercise.
It should take only about fifteen minutes, start to finish, once you are familiar with the different muscle groups and how to tense them. Once a day is good; three times a day is probably a reasonable upper limit; and two or three times a week is about the minimum required to make noticeable progress.
Try to avoid practicing within an hour or so after eating. Metabolism changes when you eat, and this interferes with relaxation. The reverse of this is not true. You don’t have to wait an hour after practicing relaxation to eat.
Here, in brief summary, are the things you want to keep in mind as you practice:
- Keep your attention focused on one muscle group at a time.
- Maintain tension in each group for a period of five to seven seconds except for the feet, which should be tensed for only a few seconds.
- When you release the tension in a muscle group, do it abruptly.
- Pay close attention to the differences in feeling between tension and relaxation.
Here is a list of the fourteen muscle groups:
- Dominant hand and forearm Dominant biceps (upper arm)
- Non-dominant hand and forearm
- Non-dominant biceps (upper arm)
- Face and jaw Neck and throat
- Chest, shoulders, and upper back
- Abdominal or stomach region
- Dominant upper leg
- Dominant lower leg (calf)
- Dominant foot
- Non-dominant upper leg
- Non-dominant lower leg (calf)
- Non-dominant foot
Ideally you should do this deep relaxation exercise one to three times a day for about 21 days. Three weeks. Then re-take the Quickie Stress Test and see how your score compares with your first score. The later score should be lower. How much lower? A lot would be nice, but take what you can get.
You are quite likely to be pleased with your results. But even if it seems like you have not reduced your stress level much, you don’t know that it would not have been considerably higher without the deep relaxation exercises.
Don’t worry about minor variations in scores from one week to the next (if you test yourself that often). The following graph represents a typical chart of weekly scores taken over a ten or 11 week period.
If you are like most people (I hope you’re not), at this point you will quit practicing deep relaxation for a while. And return to the way you were. That is, stress will come back. Often in spades. When that happens you can count on your attitude and overall outlook on life to go back to crappy (or worse).
It is at this point that you will probably realize that maybe you’d better plan on continuing the regular practice of deep relaxation for the foreseeable future. You will have discovered that the regular practice of progressive relaxation is one of the best ways to deal with stress, especially during a stressful time like this covid pandemic.
Now, though, being more familiar with the procedure and having practiced for a while, you will be able to get yourself more deeply relaxed, and you will be able to do it faster.
If once a day is hard to work into your schedule, you can still maintain your relaxation skill with two or three practices a week. And it is possible to develop a speed-relaxation process which takes just a couple of minutes. It is a kind of recall method, an additional dividend for having paid attention to the feelings of tension and relaxation as you practiced. It is those feelings that you “recall” in the accelerated procedure. You can do this because you know more about tension feels like in a muscle, and how it feels when the muscle is relaxed. Just imagine that feeling of relaxation in the muscles and that is all it takes. But you have to have practiced for a while, maybe a few months, before you can do this effectively.
Practice deep relaxation diligently and regularly for a few months and you will find your self happier and healthier. So practice and be well.
