From the Guidelines
Effective stress management involves a combination of lifestyle changes and targeted techniques, with cognitive behavioral therapy (CBT) being a highly effective approach, as evidenced by a Cochrane systematic review including 28 RCTs (n=3,940) showing that CBT interventions favorably address anxiety, depression, and mood disturbance in patients with nonmetastatic breast cancer 1. Regular physical activity, such as 30 minutes of moderate exercise most days of the week, releases endorphins that naturally improve mood and reduce tension. Mindfulness meditation practiced for just 10-15 minutes daily helps calm the mind by focusing attention on the present moment, with yoga also being associated with better function at short-term and long-term follow-up, as seen in a systematic review for an American College of Physicians clinical practice guideline 1. Deep breathing exercises, particularly the 4-7-8 technique (inhale for 4 counts, hold for 7, exhale for 8), can quickly activate the parasympathetic nervous system to counter stress responses. Adequate sleep of 7-9 hours nightly is essential, as sleep deprivation amplifies stress reactivity. Limiting caffeine and alcohol consumption helps prevent anxiety and sleep disruption. Social connection through regular interaction with supportive friends and family provides emotional buffering against stress. Time management strategies, including prioritizing tasks and setting boundaries, prevent overwhelming feelings. For those with persistent stress, CBT has strong evidence for effectiveness, with a meta-analysis including 14 articles on 10 RCTs on mindfulness-based stress reduction and cognitive therapy for 1,709 patients with breast cancer showing that these interventions have short-term effects on anxiety and depression 1. Medications like selective serotonin reuptake inhibitors (SSRIs) such as sertraline (50-200mg daily) or escitalopram (10-20mg daily) may be prescribed for stress-related anxiety disorders, typically requiring 4-6 weeks for full effect and continued for at least 6-12 months. These approaches work by addressing both the physiological stress response and the psychological patterns that maintain stress. Some key points to consider when managing stress include:
- Regular exercise and physical activity
- Mindfulness meditation and yoga
- Deep breathing exercises
- Adequate sleep
- Limited caffeine and alcohol consumption
- Social connection and support
- Time management and prioritization
- CBT for persistent stress
- Medications like SSRIs for stress-related anxiety disorders.
From the Research
Effective Remedies for Managing Stress
The following are some effective remedies for managing stress:
- Mindfulness-based stress reduction (MBSR) which combines mindfulness meditation and yoga in an 8-week training program 2
- Stress management interventions such as mind body therapies, mindfulness, relaxation, or talking therapies which have been shown to positively influence cortisol levels 3
- MBSR therapy which has been used to treat a variety of illnesses such as depression, anxiety, chronic pain, cancer, diabetes mellitus, hypertension, skin and immune disorders 4
- Combining selective serotonin reuptake inhibitors (SSRIs) and cognitive behavioral therapy (CBT) which has been shown to produce greater improvement in symptoms of depression and anxiety than either treatment alone 5
- Regular exercise, such as voluntary wheel running, which has been shown to alleviate anxiety- and depression-like behaviors in stressed male rats 6
Types of Stress Management Interventions
Some types of stress management interventions that have been shown to be effective include:
- Mindfulness and meditation which have been shown to have a medium positive effect size in changing cortisol levels 3
- Relaxation interventions which have been shown to have a medium positive effect size in changing cortisol levels 3
- Mind body therapies which have been shown to have a smaller effect size in changing cortisol levels 3
- Talking therapies which have been shown to have a smaller effect size in changing cortisol levels 3
Benefits of Stress Management Interventions
The benefits of stress management interventions include: