The Stress Connection

N
o one can avoid stress. It will be with you, in one form or another,
every day of your life—within your working relationships and when
you are at home, with friends, on the freeway, in a crowded depart-
ment store, or watching the evening news. Stressors, great and small,
surround us at every turn.
Suppose your alarm clock fails to go off one morning and you
discover that you have overslept by half an hour. You shake your hus-
band awake, leap out of bed, take a five-minute shower, skip your
makeup, and pull a brush through your hair. Somehow you manage
to get both kids dressed, fed, and out the door to the school bus. But
you have no time for coffee and your own breakfast, so you start the
day hungry and not looking your best. When you get to work, you
find out that your secretary is out sick, so you must answer your own
phone and deal with tasks that you would normally allocate to him.
Somehow you get through the morning. But when you come up
for air, you remember that the Tuesday noon staff meeting has been
switched to Monday. Your secretary would normally have reminded
you of this, but he isn’t there. The quiet lunch you planned is out, so
you order a sandwich from the deli and wolf it down in five minutes.
All through the meeting you have indigestion.
On your way home you stop at the gas station to fill your nearly
empty tank. There is a line of cars waiting and you notice that gas
prices have gone up another ten cents per gallon. When you stop by
the bank, both of the ATM machines aren’t working, so you have to
go inside and wait in line to get some cash. When you stop by the
grocery store to pick up something for dinner you buy prepackaged,
frozen entrées because you are just too tired to cook. Your cell
phone rings and it’s your husband telling you that he’s stuck at the
office and won’t be home for a couple of hours. When you get home,
the nanny is on the phone with her boyfriend and the kids are fight-
ing in the living room. You speak more sharply than you’d like to the
nanny, quiet the kids and give them dinner, then eat with your hus-
band when he gets home at nine. You both watch half an hour of tel-
evision and fall into bed exhausted.
Everyone’s life is filled with small stressful episodes like this.
None of them, taken individually, will kill you. But over time the
effects of constant stress become cumulative, causing your health,
well-being, and energy levels to deteriorate. Stress causes wear and
tear on the body, keeping you on edge, giving you heartburn and a
jumpy stomach, making it difficult for you to sleep soundly at night,
unbalancing your hormone levels, elevating your pulse rate, and
making you cranky and irritable. It also makes you more susceptible
to colds, flu, and more serious types of disease by lowering the effi-
ciency of your immune system. If you factor in lifestyle choices such
as being overweight, drinking too much, poor nutritional habits,
and not exercising, you are only increasing the long-term effects of
stress, both physically and emotionally.
The trick is learning how both to manage stress and to raise your
stress threshold. Minor incidents add up over a long time until they
do as much damage to your mind and body as one major, traumatic
incident. If you don’t learn to release stress daily or find a way to
make it work for you over the long haul, eventually stress will make
you sick or even kill you. It will certainly rob your life of energy, joy,
motivation, and fulfillment.
Negative Effects of Stress
Here is a quick overview of some of the negative effects of stress. This
list was compiled by Dean Sunseri, M.A., L.P.C. based on findings of
experts at the Centers for Disease Control and the National Institute
of Occupational Safety and Health.
• Stress is linked to physical and mental health, as well as to
decreased willingness to take on new and creative endeavors.
• The job burnout experienced by 25 to 40 percent of U.S.
workers is blamed on stress.
• More than ever before, employee stress is being recognized as
a major drain on corporate productivity and competitiveness.
• It is predicted that depression, which is only one type of stress
reaction, will be the leading occupational disease of the
twenty-first century and will be responsible for more days of
work lost than any other single factor.
• In the United States $300 billion, or $10,000 per employee, is
spent annually on stress-related compensation claims, reduced
productivity, absenteeism, health insurance costs, direct med-
ical expenses (nearly 50 percent higher for workers who
report stress), and employee turnover.
• The six leading causes of death in the United States—heart
disease, cancer, lung ailments, accidents, cirrhosis of the liver,
and suicide—are directly related to stress.
What Is Stress?
If stress is so bad for us, why have our bodies developed the stress
response in the first place? From an evolutionary standpoint, stress is
not only useful but also necessary for our very survival. For the first
200,000 years of humanity’s existence, stress was a useful mechanism
to get us physically prepared to hunt a wild animal, run for our lives,
fight an opponent, or survive a natural disaster such as a flash flood.
Greater physical strength from the adrenaline rush, sharper hearing
and vision, heightened brain function, and more energy to fight or
run were certainly useful.
The catch-22 is that stress is not meant to be a long-term condi-
tion of daily life. Our ancestors experienced the heightened physical
response of a stress reaction during times of real physical danger, dis-
charged their energy dealing with the problem, and then returned
to a physiologically normal state. But in the modern world most of
our stress, unless we are getting mugged at knifepoint in a dark alley,
is psychological in nature. Therefore it is difficult to make it go away
by an immediate action that discharges the stress. When you have
twenty hyperactive eight-year-olds over for a birthday party and sud-
denly the power goes out and you find yourself in the dark, what can
you do except light candles, try to avoid burning down the house
when a child accidentally knocks one over, and somehow keep them
all safe and happy until their parents come to get them in two hours.
Yelling at the kids or banging on the kitchen counter with frustration
isn’t going to solve the problem.
Chemical Changes That Occur during Stress
When you find yourself in a situation that your body perceives as stress-
ful, a number of chemical reactions occur that push certain body sys-
tems into higher gear by shutting down or cutting off energy to others.
1. Stress affects the cardiovascular system. The first to be affected is the
cardiovascular system. In the presence of danger, much of the blood in
your outer extremities is shunted to organs that need more oxygen,
such as the brain (the decision maker), the heart, and your other vital
organs, such as the lungs and the liver. The constricting of the blood
supply to your hands, arms, feet, and legs has another role—it decreases
your blood loss should you be injured. Your body also increases its pro-
duction of endorphins and other pain-reducing chemicals so that you
won’t feel the injury as keenly as you normally would. When these
changes happen, your blood pressure rises, your pulse races, and your
heart must beat faster and harder to handle the strain. Adrenaline
causes glucose and fat to be released from your tissues to give your body
a much-needed energy surge in case you must fight or flee.
2. Some systems shut down. This enormous surge of energy comes
at a price, however. Certain other bodily systems must be shut down
somewhat in order to compensate. Your reproductive system, which
is normally very energy intensive, is suspended so that its energies
can be directed elsewhere. In the short term, this isn’t a bad thing,
since you would never think about fighting off the cave bear and
making love to your mate at the same time. But you can see how
living in a constant state of stress would erode your libido over the
long term.
3. How cortisol affects the body. Another chemical downside follow-
ing the release of stress hormones is that cortisol accumulates in
your body. As the adrenaline rush that released fat and glucose as an
energy source subsides, the stress hormone cortisol becomes active,
causing insulin to be released to stimulate your appetite so that you
can replenish your fat stores. Since most of us don’t reach for an
apple or a piece of swordfish when we are ravenous, this usually leads
to craving a quick carbohydrate snack such as candy, pizza, cookies,
ice cream, or high-carbohydrate fast foods. Unfortunately, living
with a high level of daily stress causes the body to produce a consis-
tently high level of cortisol, leading to overeating and weight gain,
especially in the all-important abdominal area in men.
4. The immune system is weakened. One of the more serious effects
of stress is the redirecting of energy away from the immune system. A
tremendous amount of energy is necessary to operate the complex
cells, hormones, and organs that make up this system. Fifteen min-
utes of danger and a return to normal isn’t going to compromise
your immune system, but living with constant stress will surely make
you more susceptible to illness.
In What Ways Are You Vulnerable to Stress?
One of the first steps toward managing stress is to identify the areas
in your life where you are most vulnerable to stress. While no one
can eliminate stress from their lives 100 percent, you can always
decrease your stress load by modifying the behaviors that are con-
tributing to your stress. The following questionnaire, created by Lyle
Miller and Alma Dell Smith of Boston University Medical Center, is
designed to help you pinpoint the trouble spots in your life so that
you can work on them. Nearly all of the questions listed refer to situ-
ations and behaviors over which you have a great deal of control. If
you score higher than 3 on any item, try to modify that behavior. Try
first to modify those behaviors that seem easiest for you to change
and work your way up to the ones you perceive as difficult.
Score each item from 1 (always) to 5 (never), according to how
often the statement accurately describes your behaviors. Be sure to
mark each item, even if it does not apply to you. For example, if you do
not smoke, circle 1 for that question. To figure your score, add up all
the numbers and subtract 20. A score below 10 indicates a high resist-
ance to stress. A score over 30 indicates a moderate vulnerability to
stress. If your score is over 50, you have a serious vulnerability to stress.
How Vulnerable Are You to Stress?
1. I eat at least one hot, balanced meal per day.
2. I get 7 to 8 hours sleep at least 4 nights a week.
3. I give and receive affection regularly.
4. I have at least one relative within 50 miles
upon whom I can rely.
5. I exercise to the point of perspiration at least
twice a week.
6. I limit myself to less than half a pack of
cigarettes a day.
7. I have fewer than five alcoholic drinks a week.
8. I am the appropriate weight for my height.
9. I have an income adequate to meet basic
expenses.
10. I get strength from my religious beliefs.
11. I regularly attend club or social activities.
12. I have a network of friends and acquaintances.
13. I have one or more friends to confide in
about personal matters.
14. I am in good health (including eyesight,
hearing, and teeth).
15. I am able to speak openly about my feelings
when I am angry.
16. I have regular conversations with the people
with whom I live about domestic problems—
for example, chores and money.
17. I do something for fun at least once a week.
18. I am able to organize my time effectively.
19. I drink fewer than three cups of coffee
(or other caffeine-rich drinks) a day.
20. I take some quiet time for myself during the day.
Evaluate Your Stress Behaviors
I also find this brief stress questionnaire by Dean Sunseri to be quite
helpful in identifying areas of stress in your life. Answering yes to any
of these behaviors is a sure indication that a significant amount of
stress has accumulated in your life.
A Quick Stress Evaluation
1. Do you have difficulty sleeping because you are
constantly thinking about a future event or
completing a certain task?

2. Have your eating habits changed in an unhealthy
way because your schedule is too busy?
3. Is your schedule so busy that you don’t have time
for leisure or fun activities?
4. Do you have tightness or stiffness in your shoulder
or stomach area?
5. Do you have a difficult time slowing down and
function as if you are run by a motor?
6. Is your level of anxiety higher than normal?
The Rahe Life Stress Scale
The well-known Rahe Life Stress Scale, developed by Dr. Thomas
Holmes, M.D., and Richard H. Rahe, M.D., two researchers at the
University of Washington School of Medicine in Seattle, actually
assigns a number to a stressful event, based on Holmes’s and Rahe’s
years of research regarding the connection between stress and
health. For example, the death of a spouse is 119 points, pregnancy
is 67, divorce is 96, changing jobs is 51, and having sexual difficulties
is 44. Even events that you might think of as being positive have an
impact on your stress load. Marriage is 50 points, a major increase in
income is 38 points, a vacation is 24, and the birth of a grandchild is
43. According to Holmes and Rahe, if you score below 200, you have
a low risk of illness. Between 201 and 300, your chances of getting
sick are moderate. A score between 301 and 450 increases your odds
considerably, and a score greater than 450 puts you at imminent risk.
If you wish to take this test, you can access it on the Internet at Dr.
Rahe’s Web site, www.hapi-health.com.
Keep in mind, however, that your score is not an absolute indica-
tor of your actual risk for disease. According to Janelle M. Barlow,
Ph.D., author of The Stress Manager, a study conducted by Dr.
Suzanne Kobassa at the University of Chicago showed that certain
individuals who had high stress scores actually enjoyed fairly good
health. These individuals, whom Dr. Kobassa called the “hardy exec-
utives,” all had the following characteristics:
• An internal sense of control
• Action oriented
• High levels of self-esteem
• A life plan with established priorities
Dan: The Hardy Executive
I have a client named Dan who is a good example of the hardy exec-
utive. Dan, a forty-year-old vice president of a major bank, often does
not get home until eight-thirty at night and, during certain times of
the year, works seven days a week. His demanding workload, which
used to be parceled out between two other employees, carries a high
level of stress and responsibility. If he took the Rahe Life Stress Scale,
he would likely score relatively high.
Yet Dan, thanks to my program, is fit, slender, and in good
health. He has a positive self-image, exercises regularly with weights,
is very good at problem solving, is great with people, and is very intel-
ligent. He and his wife have almost paid off their home, have
planned well for their retirement (which they will both take early),
have made wise investments, and have even provided for the college
education of their six-year-old daughter. Their lives are well organ-
ized, and they both take time off for pleasure, such as playing golf
and taking family vacations.
Most of us, however, have not yet mastered the art of being a
hardy executive. We need to develop special skills to manage our
stress and increase our stress threshold before it makes us emotion-
ally upset and then physically ill.
Stress and Nutrition
In a healthy person who is fasting or starving, 90 percent of their
calories will come from fat stores and only 10 percent from protein.
When a person is undergoing significant and continual stress, even if
they are not injured or sick, only 70 percent of their calories will
come from fat stores, and 30 percent will come from lean protein.
The breakdown of protein for fuel comes as a direct response to
the body’s greater need for glucose during times of stress. Glucose
comes from amino acids taken from lean muscle mass that are then
converted to alanine, and then to glucose to be dispersed to all of
the tissues as an emergency energy supply. After surgery, a person’s
metabolic rate increases 20 percent, and after a severe burn 100 per-
cent. A wound, infection, or traumatic injury falls between these two
extremes with a 50 percent increase.
You can see, then, that following a well-balanced and nutritional
food program such as the one I will present in chapter 10 becomes
even more crucial when you are undergoing the effects of illness or
long-term stress. This can be seen in the story of a client of mine who
had difficulty healing following an automobile accident.
Bronwen totaled her brand-new car on the freeway 450 miles from
home on her way to a health conference. Her airbag saved her life, and
she had no serious injuries other than severe bruising of her arms and
chest. But the trauma of arranging for her now undriveable car to be
repaired so far from home; coordinating towing costs and repairs with
a branch office of her insurance company; and getting herself back
home took its toll on her energy reserves. Added to this was the stress of
getting her house fumigated for termites a week after she returned.
There was no way she could cancel or reschedule this appointment. So
in her physically and emotionally weakened state, she was forced to
pack up and prepare the house, which added to her stress load.
While she was moving some boxes, her cat became startled and
scratched her leg. Bronwen, who is physically fit, slender, and enjoys
excellent health, thought nothing of this. She usually doesn’t even
wash out a cat scratch because she heals so well. However, this small
scratch quickly became so infected that she could hardly walk on her
leg and had to take antibiotics. Eventually, after she could return to
her home, rest, and get her routine back to normal, her infected leg
and bruises from the car accident healed. But she was in a state of
severe stress and great pain during the entire time she had to pack
her house, stay at a friend’s home during the fumigation, and
unpack upon her return.
What is significant about Bronwen’s story is not only the burden
that stress put upon her body’s normal ability to heal, but also her lack
of good nutritional habits during this time. Because she was so busy
and so stressed, Bronwen sometimes neglected to eat during these
events. While the regular food program my nutritionist had designed
for her was sufficient to keep her body working properly under nor-
mal conditions of stress and metabolic activity, it was not sufficient to
help her heal during a two-week period of severe physical and emo-
tional stress. Bronwen ate less, not more, and felt worse and worse.
When she finally phoned me for help, I told her how important
it was for her to follow her nutrition program to the letter, eating
three well-balanced meals each day and two snacks. I also encour-
aged her to increase the amount of protein in her daily diet to 100
grams per day until her body healed, since protein is what repairs
muscle tissue and injury, and to make sure that she took all her sup-
plements faithfully. After a few days, Bronwen began feeling much
better physically and less stressed.
This story and what we have already seen about how chronic
stress weakens the immune system illustrate why an important part
of any stress management program is proper nutrition. Your body
simply will not be able to bear up under the effects of stress without
appropriate fuel.
Stress, High Blood Pressure,
and Heart Disease
As we have seen, any time you face a stressful situation, your body
rushes blood to your brain and organ systems. This is not a problem
over the short term, but constant stress can lead to hypertension
(high blood pressure) and heart disease. For example, being down-
sized from your job will probably create additional stresses as you
rebalance your finances, your relationship with your spouse, and
your self-esteem while hunting for a new job. Your tension and blood
pressure levels will be quite high for weeks or even months until you
get things sorted out again. This increased hypertension could cause
a blood vessel to rupture, causing a heart attack.
Beta-blockers are medications used to lower blood pressure and
are essentially designed to prevent the body from producing stress-
related chemicals. But ultimately the body will continue to elevate
those chemicals when under prolonged stress, no matter how many
blood pressure medications you are using. The only cure for hyper-
tension is stress management and instituting lifestyle changes such
as weight loss and proper nutrition.
The NFL Combine is a yearly event that takes place in the Indi-
anapolis Hoosier Dome where scouts and coaches from each of the
major teams gather to look over and audition new prospective talent
for their teams in preparation for the upcoming NFL draft. These
players are usually college seniors in their early twenties.
One year a young man named Greg came to see me with a knee
injury. Greg weighed 340 pounds, had a waist measurement of 50
inches, and was a standout player at a major university. While the
nurse was taking his history, I said, “Do you mind taking his blood
pressure?” Sitting down, Greg’s pressure was 140 over 85. According
to the latest figures, anything over the diastolic figure 85 represents
borderline risk. While a systolic number of 140 isn’t bad, it’s better to
keep that figure in the 130s.
I asked the technician to take Greg’s pressure again while he was
standing. When Greg stood up, his pressure went up to 145 over 90.
This was a 23-year-old young man! I asked his mother, who was sitting
in the room, if there was any history of hypertension in the family. As
it turned out, Greg’s uncle died from a stroke.
High blood pressure in someone as young as Greg is more wide-
spread than you would think. A recent study of freshmen coming into
college football programs found that 24 percent had abnormal blood
lipids. Some of these students had high blood pressure as well. I have
been encountering hypertension more and more in the promising
college athletes who take part in my performance enhancement pro-
grams. The lifestyle profiles of these young men are very similar. They
eat a lot of fast foods with high fat and salt content, are carrying too
much weight, and have a high percentage of body fat. And they don’t
have a clue that they have high blood pressure. Everyone perceives
them as being big strong football players. Chances are they would
never even know they had hypertension unless they were tested for it.
Take responsibility for your health and take it early in life.
The greater flow of blood to your cranial vessels caused by the body’s
stress response increases the pressure inside those vessels. The
longer one’s stress levels continue to remain high on a daily basis,
the greater the vulnerability to stroke. To make matters worse, the
brain responds to higher levels of blood pressure by thickening its
blood vessels. This results in pressure on nearby nerves, causing head-
aches and loss of the blood vessels’ flexibility, making them more
liable to rupture during extreme surges of blood, causing stroke.
Since the stress response elevates chemicals that increase the
amount of fat (an energy source) in your blood stream, long-term
stress also makes you more vulnerable to developing high choles-
terol. High blood pressure, if allowed to continue unchecked, will
exacerbate this process, eventually causing small tears within the
walls of your arteries that will collect the LDL (bad cholesterol fats)
racing through your bloodstream due to stress elevation. The very
hormones that cause stress also destroy HDL, the good cholesterol
that keeps your blood vessels clear by counteracting the negative
effects of too much LDL.
If you lead a stress-filled life, the elevated blood sugar levels in
your body will eventually make you vulnerable to type 2 diabetes, the
fourth leading cause of death in the United States. During short-term
stress, you would normally burn off the increase in glucose produc-
tion, but not if you live with constant worry and anxiety. Long-term
stress will leave you with permanently elevated blood sugar.
Stress Contributes to Some Cancers
While the relationship between stress and cancer has not been defi-
nitely proven, enough information has been gathered to cause
researchers to continue to explore the question. For example, the
National Cancer Institute reports that some studies of women with
breast cancer have shown significantly higher rates of occurrence of
this disease among women who have experienced traumatic life
events and stress within several years of their diagnosis. These factors
include death of a spouse, social isolation, and other psychological
factors.
Studies are also under way to explore the effects of stress on the
immune response of women already diagnosed with cancer to see if
stress reduction can slow the progression of the cancer. One major
study conducted by Ohio State University and published in the Jour-
nal of the National Cancer Institute involved high-stress and low-stress
women following surgery for stage II and stage III breast cancer. The
researchers found that the women who reported high levels of per-
sonal stress had significantly lower blood levels of three important
immune factors. The first two were the NK cells, which play a large
role in the immune system’s search for tumors and virally infected
cells, and T-lymphocytes, also known as white blood cells. When the
researchers exposed the NK cells within the bloodstream of the
high-stress women to extra amounts of gamma interferon, a com-
pound that naturally enhances NK cell activity and the replication of
viruses, they found a third significantly lowered immune response.
The more stress a woman reported, the less effect the gamma inter-
feron had on her NK cells.
Stress and Inflammatory Bowel Diseases
There have been several studies about the effects of stress on people
suffering from inflammatory bowel diseases such as Crohn’s disease
and ulcerative colitis. (Inflammatory bowel disease is a condition in
which a person’s immune system attacks its own body.) A recent arti-
cle in Nature Medicine quoted Dr. Stephen Collins, chief of gastroen-
terology at McMaster University in Hamilton, Ontario as saying,
“[Stress] is, in my opinion, a very common reason for flare-ups of the
disease. . . . There is indeed a causal link between stress and relapse,
and this should motivate [patients] to address coping with stress in
their lives.” Among the evidence that Dr. Collins and his colleagues
observed in their study was the effects of stress on the mucous mem-
branes of the colon, making them more porous and more suscepti-
ble to being attacked by the individual’s own immune system.
I have a client called Ann, whom I have successfully helped to
manage her ulcerative colitis for eight years. Stress management—
along with appropriate nutrition and exercise—has been instrumen-
tal in helping her keep her condition under control. When Ann’s
husband, an officer in the Coast Guard, was arrested and imprisoned
while trying to file conscientious objector status during the Gulf War
after his unit had been called up, Ann’s colitis flared up to such a
degree that she went down to eighty-six pounds and almost died.
That was when she came to me and we began an intensive study of
how nutrition and stress management could alleviate symptoms of
her disease. Ann, who has a Ph.D. in psychotherapy, now uses stress
management as part of her therapeutic approach when working with
her clients.
Stress Can Cause Brain Damage
and Memory Loss
One of the body’s responses to stress is a heightened mental state and
the ability to think on your feet. While this sounds wonderful, the
downside is that the chemical that causes this mental alertness, corti-
sol, also kills brain cells. According to Dr. Robert Sapolsky, a Stanford
University biologist who has extensively researched the physical effects
of stress, the cells that are most vulnerable to destruction are the ones
located in the hippocampus, the part of the brain responsible for
memory. The hippocampus is also the area that deteriorates when
patients contract Alzheimer’s disease and other memory disorders.
This research seems to point to the idea that prolonged stress could be
directly related to memory problems and other cognitive disorders.
Now that we’ve seen the toll that stress takes on the body and the
emotions, let’s look at several strategies for managing stress.
which a person’s immune system attacks its own body.) A recent arti-
cle in Nature Medicine quoted Dr. Stephen Collins, chief of gastroen-
terology at McMaster University in Hamilton, Ontario as saying,
“[Stress] is, in my opinion, a very common reason for flare-ups of the
disease. . . . There is indeed a causal link between stress and relapse,
and this should motivate [patients] to address coping with stress in
their lives.” Among the evidence that Dr. Collins and his colleagues
observed in their study was the effects of stress on the mucous mem-
branes of the colon, making them more porous and more suscepti-
ble to being attacked by the individual’s own immune system.
I have a client called Ann, whom I have successfully helped to
manage her ulcerative colitis for eight years. Stress management—
along with appropriate nutrition and exercise—has been instrumen-
tal in helping her keep her condition under control. When Ann’s
husband, an officer in the Coast Guard, was arrested and imprisoned
while trying to file conscientious objector status during the Gulf War
after his unit had been called up, Ann’s colitis flared up to such a
degree that she went down to eighty-six pounds and almost died.
That was when she came to me and we began an intensive study of
how nutrition and stress management could alleviate symptoms of
her disease. Ann, who has a Ph.D. in psychotherapy, now uses stress
management as part of her therapeutic approach when working with
her clients.
Stress Can Cause Brain Damage
and Memory Loss
One of the body’s responses to stress is a heightened mental state and
the ability to think on your feet. While this sounds wonderful, the
downside is that the chemical that causes this mental alertness, corti-
sol, also kills brain cells. According to Dr. Robert Sapolsky, a Stanford
University biologist who has extensively researched the physical effects
of stress, the cells that are most vulnerable to destruction are the ones
located in the hippocampus, the part of the brain responsible for
memory. The hippocampus is also the area that deteriorates when
patients contract Alzheimer’s disease and other memory disorders.
This research seems to point to the idea that prolonged stress could be
directly related to memory problems and other cognitive disorders.
Now that we’ve seen the toll that stress takes on the body and the
emotions, let’s look at several strategies for managing stress.