Types of therapy for stress and anxiety

Deborah C. Escalante

Symptoms of Stress

Because our entire system—body, brain (the physical organ), and mind (thoughts and feelings)—is involved in our stress reaction, we can feel many different types of symptoms of stress: cognitive (thought-based), emotional, physical, and behavioral.2

Cognitive symptoms of stress include:

  • Constant or near-constant worry about one or many different things
  • Difficulty concentrating
  • Problems remembering things
  • Troubles making decisions
  • Brain fog, difficulty thinking clearly
  • Decreased creativity or problem-solving ability
  • Reduced sense of humor

Emotional symptoms of stress:

  • Irritability, anger, or a short temper
  • Increased crying spells or crying easily at little things
  • Nervousness, feeling keyed-up or on edge
  • Restlessness
  • Loneliness
  • Vague feelings of unhappiness
  • Sense of purposelessness
  • Feeling easily overwhelmed
  • Decreased motivation

Physical symptoms of stress include:

  • Muscle tension
  • Pain anywhere in the body
  • Fatigue
  • Difficulty falling or staying asleep
  • Palpitations
  • Shakiness, tremors
  • Increased sweating
  • Ringing in the ears
  • Teeth grinding
  • Dizziness, with or without fainting
  • Choking sensation and/or difficulty swallowing
  • Digestive troubles
  • Frequent need to urinate
  • Decreased libido

Behavioral symptoms of stress:

  • Difficulty starting or finishing tasks
  • Using avoidance coping strategies to avoid people, situations, or tasks
  • Criticizing others or making many negative statements about life in general
  • Frequent brooding
  • Fidgeting
  • Emotional eating
  • Substance use, including smoking
  • Withdrawal from friends and family
  • Isolation

Whether you experience many symptoms or just a few, the symptoms of stress are highly disruptive to life.1 They affect us on all levels and disturb our sense of ourselves and our place in the world. Therefore, stress management is crucial to our well-being.

5 Tips for Stress Management

We can’t always control what happens in our lives that causes us to experience stress. That doesn’t mean, however, that our well-being is at the mercy of outside forces. No matter what stressors you are facing, you can manage your stress reaction and feel well mentally and physically.

Try these 5 tips for managing stress:

1. Increase Your Awareness of Your Stressors & Stress Response

The more you know about what sets off your stress reaction and how you experience stress—your symptoms—the sooner you can take measures to manage things.4 Tune into your thoughts, feelings, and physical sensations to catch feelings of stress before it grows out of control.2 Once you know what triggers you and recognize when it happens, you can cope by using one or more of the these tips.

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2. Start With What Is Within Your Control

Identifying what you can control and taking small action steps can help you feel more centered and empowered.4 Perhaps simplify a large project by breaking it down into small, manageable components, take a stressful situation one moment at a time, or choose to spend more time with people who encourage you and less time with those who are toxic.1 If you find yourself stuck in a terrible situation, take some control of your response by drawing on relaxation strategies.

3. Use Purposeful Relaxation Strategies Often

When you teach yourself to relax, you learn to control your physiological stress response. The fight-or-flight response happens automatically, but you can intentionally switch it off by using relaxation techniques that deactivate the sympathetic nervous system (SNS) and activate its physiologic counterpart, the parasympathetic (i.e., “rest and relax”) nervous system (PNS).2,3 The moment you notice yourself feeling stressed, begin to take slow, deep, mindful breaths. The act of breathing this way calms the body’s stress reaction.

You can also prevent your fight-or-flight response from dominating by engaging in regular practices to strengthen your body’s natural relaxation response. Practices such as yoga, tai chi, and meditation have been found in studies to reduce stress and increase feelings of calm.2 Also, having massages, watching something that makes you laugh, or doing anything healthy that to you is relaxing can reduce stress in a given moment and over time.4

Regular relaxation can be as simple as listening to music you find calming or inspiring. In a study reported in 2019 in the journal Anestesiologica, music was found to disrupt the stress response.5 The study showed that listening to or creating music directly impacts the nervous system, brain, heart rate, blood pressure, breathing rate, and hormone production.

Stepping outside is a stress-reducing, relaxation strategy that is quick and easy to do. A review, published in 2020, of 14 studies investigating the effects of nature on well-being revealed that even just 10 minutes of being outside in nature (such as a backyard or park) can reduce feelings of stress.6 Taking frequent breaks to step outside and breathe deeply can reset your body and center your mind.

4. Nourish Your Body & Brain

Taking care of your whole self helps reduce the negative effects of stress. Proper diet and physical activity are vital for both short- and long-term stress management.7
Exercise improves sleep by increasing the amount of restorative slow wave sleep cycles each night, boosts mood, decreases anxiety, and increases positive feelings about yourself and your circumstances.

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What you eat also directly impacts your mental health. Eating lots of processed foods, sugars, and unhealthy fats can worsen the effects of stress and disrupt mood. Eating healthy foods like complex carbohydrates, lean proteins, healthy fats, and antioxidant-rich produce, spices, and beans nourishes your brain and body with nutrients like magnesium, vitamin C, and omega-3 fatty acids—all of which have been found to reduce the effects of stress on the body and mind.

5. Find What You Enjoy, & Do It Often and Regularly

An important key to dealing positively with stress is to experiment with stress-management techniques to find what works for you. Just as the causes of stress differ from person to person, so, too, do the tools that relieve stress. Discover what you enjoy doing and gradually do more of it over time.

Working stress management naturally and pleasantly into your daily life will prevent it from becoming one more thing on your already-long to-do list and thus another source of stress. When stress management is pleasant, you are more likely to engage in it regularly, which is another important key to coping with stress. Stress management isn’t a single event but instead is something done regularly to keep your PNS activated and working to keep you calm.2,4

Why Is Managing Stress Important?

Our body’s stress response exists to help us deal with immediate, threatening situations. When our mind and body are on alert, we are poised to deal with problems. This fight-or-flight response is supposed to be temporary, however, deactivating when a stressor passes. Unfortunately, in our hectic modern era, stressors are frequent and numerous, thus our physiological stress response is often robbed of the chance to turn off completely. Our physical and mental health can suffer damage as a result.2 Chronic stress can lead to serious problems such as heart disease, stroke, headaches, inflammation, pain, digestive problems, sleep disturbances, anxiety, and depression.2

The good news is that taking intentional steps to manage and cope with stress works. When you step in and do things that help your body and mind rest and reset, you can prevent your physiological stress reaction from wreaking havoc on your entire being. With regular stress management, you can respond thoughtfully to challenges rather than reacting in a way that makes you feel worse.

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Stress & Your Mental Health

Stress begins with your body’s physiological response to something upsetting or threatening, but once that stress reaction begins, thoughts and emotions follow and perpetuate the fight-or-flight response.2 Worries and fears about perceived problems or consequences can run rampant, thus leading to mental health challenges.

For example, you might work for a critical boss and are entangled in a difficult project with a lengthy deadline. Your boss, project, and deadline trigger your fight-or-flight reaction. The resulting hormonal and neural activity keeps you on high alert for danger, and thoughts such as “What if I lose my job because I can’t please my boss with this project? I won’t be able to afford my mortgage, and how will I continue to support my children? My daughter has some health issues. What if I can’t afford to take her to the doctor? What if she actually has cancer and it spreads because I can’t afford treatment…”

These stressful, anxiety-provoking thoughts and emotions not only feed on themselves but they fuel the body’s stress reaction. It becomes a vicious cycle that is hard to escape and can worsen without proper stress management and treatment.

Stress has been linked to mental health challenges such as:2,8

  • Anxiety
  • Depression
  • Sleep problems, including insomnia
  • Worsening symptoms of other mental illnesses

If you feel that stress is interfering in your mental health, dominating your thoughts, or disrupting your emotions, working with a mental health therapist may be helpful.

How Therapy Can Help You Manage Stress

If you are suffering because of stress, know that you aren’t alone. Everyone experiences stress. You don’t have to work your way through it by yourself; it’s okay to seek help from others, including professional therapists. A therapist can help you identify and better understand your triggers, deal effectively with concerns and problems underlying stress, and develop an action plan to manage stress in a way that works for you.9

Sometimes, people are hesitant to seek professional help for stress because they think that therapy is only for those with diagnosable mental health conditions. According to the American Psychological Association, therapy helps people of all ages and backgrounds address a wide variety of concerns, including life stressors in order to boost well-being.10

In working with a therapist, you can:2,4,11

  • Develop tools to help you manage your body’s stress reaction so you aren’t at the mercy of your stressors
  • Boost your resiliency
  • Make changes for a healthy lifestyle to keep stress at bay
  • Learn new insights and form a new relationship with your triggers so you can use stress for positive outcomes
  • Feel more in control of your life
  • Discover ways to replace stress with a sense of meaning and purpose
  • Identify and change negative thought patterns that both contribute to and result from stress

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