75 Percent of Teen Girls Have Anxiety — What We Can Do About It

ParentMap

Author and researcher Rachel Simmons talks raising daughters in a toxic culture

PUBLISHED ON: JANUARY 17, 2018

 
anxious-teen-girl

Roughly three out of four teenage girls experience anxiety, according to the 2016 Washington State Healthy Youth Survey. Seventy-six percent of tenth grade girls have felt extremely nervous or anxious and 13 percent have attempted suicide.

What is going on and how can we as parents help? We turned to educator and researcher Rachel Simmons. Founder of Oakland-based outreach organization Girls Leadership and leadership development specialist at Smith College, Simmons believes there’s no one reason why so many young women feel anxious.

Still, there is one reason she often sees in her work: more pressure.

“We hope for girls to be smart and brave and interested in STEM fields, but we still expect them to be thin and sexually attractive and have a witty and appealing online presence,” she says. “No matter how many achievements they accrue, they feel that they are not enough as they are … We haven’t really upgraded our expectations, we’ve just added on to the old ones.”

She addresses this pressure and how parents can help their daughters thrive in her latest book, “Enough As She Is” (out Feb. 27).

It’s not a bad thing that we’re instilling more confidence in our girls, Simmons says. The problem is that we’re still raising them in a toxic culture that hasn’t caught up with those new expectations.

“That’s how girls wind up feeling something is wrong with themwhen in fact … something is deeply wrong with our culture,” she says. In the last decade alone, Simmons says she’s seen “the rise of social media, arrival of college admissions mania, and ever more ruthless pressure to be thin tighten the rules of success for girls in punishing ways.”

And that, she notes, undermines the development of their confident, authentic selves. But that doesn’t mean there’s no solution. We asked Simmons why our daughters are experiencing so much anxiety — and what parents can do to help.

Why does more opportunity lead to increased anxiety in teenage girls?

Girls have too many roles to play and too many roles conflict with each other. Add this role overload to the fact that girls continue to need to please others first and be likable. Girls are still raised with a psychology that is trained to think about other people before themselves. This all is a real recipe for unhappiness.

My goal is to give parents tools to help girls carve out a life and a sense of self that feels authentic and important to them that isn’t fully shaped by what other people expect of them. It’s not that challenges are going to go away; it’s about how to manage these challenges. For example, I never tell girls that they are going to stop overthinking things. The question is: Do you know how to manage overthinking and how to understand it?

Got any tips for how to get your teen daughter to actually, you know, talk?

Teenagers are notorious for not wanting to talk when you want to talk. Annoyingly, they’re not interested in talking on your schedule and they want to talk when it’s not convenient for you. If they are deflecting your attempt to talk, ask yourself, ’Is this the right time for them to talk?’ Can you agree upon a different time to talk?

It’s also super important for parents to find that middle way between being authoritarian versus permissive. Kind but firm, gentle, curious and humble. Try saying, ‘There’s a lot I don’t know, and I would love to hear more about what I don’t know; here’s what I am thinking as your parent.’

Every teenager wants to have respect. I’m not talking about them getting to go out until 1 a.m. I’m talking about establishing trust in your teenager’s perspective. That’s being able to say, ‘Hey, listen. There are things you have to tell me’ while [also] standing firm with the fact that you’re the parent and the boss.

And how should you respond when your daughter does tell you something big?

When your child does open up and tell you something big, it’s so important to note that. You say to your kid in that situations, ‘Thank you so much for telling me that.’ Their job is not to serve you by telling you things — their job is to be secretive — so be grateful when they tell you things.

Where does the use of social media come into this?

There’s a real trend of using fear and shame to teach about social media: ‘Your life will be ruined if you do the wrong thing online.’ But teaching through fear and shame isn’t effective for teens.

Social media in and of itself is not harmful — it’s the way in which it’s used that can be harmful. It’s important for parents to make an effort to understand why their kids love it, and to understand their kids are going to make mistakes … Parents need to be clear with their kids about parameters and expectations around use. I don’t think that means being a spy, but you must play a role in how your kids learn to be online through rules and expectations.

In your book, you recommend creating a ‘failure resume’ that lists ways you have failed in your life and sharing that with your daughter. Why?

If you create a failure resume and talk about it with your daughter, you’re desensitizing her to the power of failure. You’re talking about something that’s often taboo and lessening the shame around it. You’re also normalizing failure, making it fun and funny, which makes it less scary. To be comfortable with your setbacks is a muscle that you must flex again and again. It’s a skill.

A failure resume is an ingredient for the recipe [of how to deal with failure]. Essentially my whole book is about this recipe for building resilience. I talk about what is threatening girls and how to respond to it, how to be resilient. I’ve learned that what girls really need are the skills to lean inside as much as to lean in: to practice self-compassion, nourish their most important relations and seek support when needed.

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The Harvey Weinstein Challenge: Combating Sexual Harassment In and Out of School

NAIS

I don’t know what the world record is, but I’m pretty sure I’m close: My first experience with sexual harassment occurred within the first 10 minutes on my first shift at my very first job.

Newly hired as a hostess for a local restaurant, I was excited to have landed a summer job between college semesters. I was nervous, too, because I had no idea what to expect. What I definitely didn’t expect was Mr. Leonard.

As the restaurant manager, Mr. Leonard, a married man in his mid-40s, made a point of “joking” with every new hire that while he lived on Maryland’s Eastern Shore, once his car crossed the midpoint on the Chesapeake Bay Bridge on his way to work every morning, he was “single.”

At first, and in my naïveté, I wasn’t quite sure what he meant. It soon became clear. I heard him repeatedly telling obscene “jokes” about sex, and witnessed him ogling and making disgusting comments about waitresses’ bodies to their faces and from behind them. Once, I saw him snap the bra strap of a woman who bent over to take something out of a case. One day he told me he could see the outline of my bra under my hostess dress (which he was staring at) and then sent me home to put on a slip to avoid “offending the customers.”

I lasted two weeks. While the term “hostile work environment” had not yet been coined, I knew emotionally I was in one. Looking back, my most important lesson was recognizing that I left because I couldThe older women did not have the privilege of quitting. Most were caring for children at home, and the loss of income would have been devastating for their families. Their only option was to suffer through it in silence. Besides, to whom could they complain, since the perpetrator was also the boss?

A Pervasive Problem

Sexual harassment was a ubiquitous problem that had no name until the early 1980s, when federal courts defined it as an illegal form of “gender discrimination” in violation of the 1964 Civil Rights Act. The U.S. Office of Equal Employment Opportunity (OEEO) was charged with creating mechanisms for filing complaints and procedures for ongoing enforcement. Later court cases made these new rules applicable to school environments as well.

But, it was not until 1991, during Clarence Thomas’s U.S. Senate Supreme Court confirmation hearings—when Anita Hill famously accused Thomas of sexual harassment, while both were working at the OEEO, which he headed, no less—that the entire nation, all at once, received its first meaningful education about this scourge. Now, it had an official name as well as the force of the federal government behind its adjudication.

As recent high-profile events make clear, nonetheless, sexual harassment remains ever-present in our society, even in the lives of women (and men) who are powerful in their own right. This time, however, I’m much more optimistic about the prospects for lasting awareness and change.

The Prospects for Change

First, and really only within the past five years, American society has finally begun to treat the problem of sexual assault—sexual harassment in its most extreme form—with the seriousness it deserves. Moreover, a new standard for defining “sexual consent” has emerged: What counts is no longer “the absence of no,” but rather “the unequivocal presence of an enthusiastic verbal yes.” This is no mere linguistic change, since as a very practical matter it shifts the onus for establishing consent squarely on the person who desires sexual activity, not the person they desire. Verbal permission before crossing another person’s sexual boundaries is required.

These two developments have been hugely important in helping us and our students to better understand and help prevent sexual assault. Now, as our collective attention is drawn to highly publicized disclosures of chronic sexual harassment perpetrated by powerful, well-known men across diverse businesses and professional fields, another new and potentially transformative element is in the mix: public accountability.

The swift, hard fall from positions of enormous power, status, and wealth for many of these men delivers a resounding message: “This behavior, once and for all, is intolerable and will bring serious consequences.” Public accountability inevitably begets more public accountability, because victims feel supported in knowing they are not alone and can recognize, finally, they were in no way at fault; it also exposes to public scrutiny the hidden malignancies that keep entrenched patriarchy and “toxic masculinity” alive.

What About Our Students?

Sexual harassment statutes pertain only to schools and workplaces, because students must go to school and most people have to work. (If someone is the recipient of catcalls on a particular street, on the other hand, they can simply take another route.) Educational institutions, of course, are both workplaces and schools. Without question, it is incumbent upon all schools to establish policies and practices that provide clear, equitable procedures for reporting, investigating, and resolving sexual harassment complaints—involving students of all sexual and gender identities—and maintaining safe school environments. A recently launched campaign, #MeTooK12, aims to lobby and support schools in improving their efforts. Read about it here.

It’s vital to recognize, though, that most of the sexual harassment today’s students perpetuate and/or experience does not occur in formal settings like schools and workplaces, but within their everyday social interactions, much of it in the form of hostile, cruel, degrading, and coercive online communication. Regardless of venue, though, it is shaped and fueled by the very same patriarchal mix that defines “real” masculinity in terms of superiority, entitlement, dominance, winning at all costs, and the conflation of sex and power.

Before men are men, they are boys. Until parents and schools commit to intentionally raising both boys and girls with high expectations and a single standard of values based on empathy and fairness—with sex and gender being no exception—we can expect these harmful and oppressive patterns to continue. Now is a very good time to take on this challenge. 

iPhones and Children Are a Toxic Pair, Say Two Big Apple Investors

The Wall Street Journal

Two activist shareholders want Apple to develop tools and research effects on young people of smartphone overuse and addiction

Teens took a group selfie with a smartphone in New York’s Times Square on Dec. 1.
Teens took a group selfie with a smartphone in New York’s Times Square on Dec. 1. PHOTO: DREW ANGERER/GETTY IMAGES

The iPhone has made Apple Inc. AAPL 1.03% and Wall Street hundreds of billions of dollars. Now some big shareholders are asking at what cost, in an unusual campaign to make the company more socially responsible.

A leading activist investor and a pension fund are saying the smartphone maker needs to respond to what some see as a growing public-health crisis of youth phone addiction.

Jana Partners LLC and the California State Teachers’ Retirement System, or Calstrs, which control about $2 billion of Apple shares, sent a letter to Apple on Saturday urging it to develop new software tools that would help parents control and limit phone use more easily and to study the impact of overuse on mental health.

The Apple push is a preamble to a new several-billion-dollar fund Jana is seeking to raise this year to target companies it believes can be better corporate citizens. It is the first instance of a big Wall Street activist seeking to profit from the kind of social-responsibility campaign typically associated with a small fringe of investors.

Adding splash, rock star Sting and his wife, Trudie Styler, will be on an advisory board along with Sister Patricia A. Daly, a nun who successfully fought Exxon Mobil Corp. over environmental disclosures, and Robert Eccles, an expert on sustainable investing.

The Apple campaign would be unusual for an activist like Jana, which normally urges companies to make financial changes. But the investors believe that Apple’s highflying stock could be hurt in coming decades if it faces a backlash and that proactive moves could generate goodwill and keep consumers loyal to Apple brands.

“Apple can play a defining role in signaling to the industry that paying special attention to the health and development of the next generation is both good business and the right thing to do,” the shareholders wrote in the letter, a copy of which was reviewed by The Wall Street Journal. “There is a developing consensus around the world including Silicon Valley that the potential long-term consequences of new technologies need to be factored in at the outset, and no company can outsource that responsibility.”

Obsessive teenage smartphone usage has sparked a debate among academics, parents and even the people who helped create the iPhone.

Two teenage boys use smartphones in Vail, Colo., in June 2017.
Two teenage boys use smartphones in Vail, Colo., in June 2017. PHOTO: ROBERT ALEXANDER/GETTY IMAGES

Some have raised concerns about increased rates in teen depression and suicide and worry that phones are replacing old-fashioned human interaction. It is part of a broader re-evaluation of the effects on society of technology companies such as Google and Amazon.com Inc.and social-media companies like Facebook Inc. and Snap chat owner Snap Inc., which are facing questions about their reach into everyday life.

Apple hasn’t offered any public guidance to parents on how to manage children’s smartphone use or taken a position on at what age they should begin using iPhones.

Apple and its rivals point to features that give parents some measure of control. Apple, for instance, gives parents the ability to choose which apps, content and services their children can access.

The basic idea behind socially responsible investing is that good corporate citizenship can also be good business. Big investors and banks, including TPG, UBS Group AG and Goldman Sachs Group Inc.are making bets on socially responsible companies, boosting what they see as good actors and avoiding bad ones.

How the iPhone Was Born: Inside Stories of Missteps and Triumphs
On the iPhone’s 10th birthday, former Apple executives Scott Forstall, Tony Fadell and Greg Christie recount the arduous process of turning Steve Jobs’s vision into one of the best-selling products ever made. (Originally published June 25, 2017)

Big-name activists increasingly view bad environmental, social or governance policies as red flags. Jana plans to go further, putting its typical tools to work to drive change that may not immediately pay off.

Apple is an ambitious first target: The combined Jana-Calstrs stake is relatively small given Apple’s nearly $900 billion market value. Still, in recent years Apple has twice faced activists demanding it pare its cash holdings, and both times the company ceded some ground.

 

Chief Executive Tim Cook has led Apple’s efforts to be a more socially responsible company, for instance on environmental and immigration issues, and said in an interview with the New York Times last year that Apple has a “moral responsibility” to help the U.S. economy.

Apple has shown willingness to use software to address potentially negative consequences of phone usage. Amid rising concerns about distracted driving, the company last year updated its software with a “do not disturb while driving” feature, which enables the iPhone to detect when someone is behind the wheel and automatically silence notifications.

The iPhone is the backbone of a business that generated $48.35 billion in profit in fiscal 2017. It helped turn Apple into the world’s largest publicly listed company by market value, and anticipation of strong sales of its latest model, the iPhone X, helped its stock rise 50% in the past year. Apple phones made up 43% of U.S. smartphones in use in 2016, according to comScore , and an estimated 86 million Americans over age 13 own an iPhone.

Jana and Calstrs are working with Jean M. Twenge of San Diego State University, who chronicled the problem of what she has dubbed the “iGen” in a book that was previewed in a widely discussed article in the Atlantic magazine last fall, and with Michael Rich of Harvard Medical School and Boston Children’s Hospital, known as “the mediatrician” for his work on the impact of media on children.

The investors believe both the content and the amount of time spent on phones need to be tailored to youths, and they are raising concern about the public-health effects of failing to act. They point to research from Ms. Twenge and others about a “growing body of evidence” of “unintentional negative side effects,” including studies showing concerns from teachers. That is one reason Calstrs was eager to support the campaign, according to the letter.

The group wants Apple to help find solutions to questions like what is optimal usage and to be at the forefront of the industry’s response—before regulators or consumers potentially force it to act.

The investors say Apple should make it easier and more intuitive for parents to set up usage limits, which could head off any future moves to proscribe smartphones.

The question is “How can we apply the same kind of public-health science to this that we do to, say, nutrition?” Dr. Rich said in an interview. “We aren’t going to tell you never go to Mickey D’s, but we are going to tell you what a Big Mac will do and what broccoli will do.”

(We’d like to hear from you: Is smartphone addiction among young people a public-health concern? Should companies like Apple be held responsible for tackling the issue? Email us at socialmedia@wsj.com with your comments.)

Write to David Benoit at david.benoit@wsj.com

OPEN LETTER FROM JANA PARTNERS AND CALSTRS TO APPLE INC.

Think Differently About Kids

January 6, 2018

Board of Directors
Apple Inc.
1 Infinite Loop
Cupertino, California 95014

Ladies & Gentlemen,

JANA Partners LLC and the California State Teachers’ Retirement System (“we” or “us”) collectively own approximately $2 billion in value of shares of Apple Inc. (“Apple” or “you”).  As shareholders, we recognize your unique role in the history of innovation and the fact that Apple is one of the most valuable brand names in the world.  In partnership with experts including Dr. Michael Rich, founding director of the Center on Media and Child Health at Boston Children’s Hospital/Harvard Medical School Teaching Hospital and Associate Professor of Pediatrics at Harvard Medical School, and Professor Jean M. Twenge, psychologist at San Diego State University and author of the book iGen, we have reviewed the evidence and we believe there is a clear need for Apple to offer parents more choices and tools to help them ensure that young consumers are using your products in an optimal manner.  By doing so, we believe Apple would once again be playing a pioneering role, this time by setting an example about the obligations of technology companies to their youngest customers.  As a company that prides itself on values like inclusiveness, quality education, environmental protection, and supplier responsibility, Apple would also once again be showcasing the innovative spirit that made you the most valuable public company in the world.  In fact, we believe that addressing this issue now will enhance long-term value for all shareholders, by creating more choices and options for your customers today and helping to protect the next generation of leaders, innovators, and customers tomorrow.

More than 10 years after the iPhone’s release, it is a cliché to point out the ubiquity of Apple’s devices among children and teenagers, as well as the attendant growth in social media use by this group. What is less well known is that there is a growing body of evidence that, for at least some of the most frequent young users, this may be having unintentional negative consequences:

  • A study conducted recently by the Center on Media and Child Health and the University of Alberta found that 67% of the over 2,300 teachers surveyed observed that the number of students who are negatively distracted by digital technologies in the classroom is growing and 75% say students’ ability to focus on educational tasks has decreased. In the past 3 to 5 years since personal technologies have entered the classroom, 90% stated that the number of students with emotional challenges has increased and 86% said the number with social challenges has increased.  One junior high teacher noted that, “I see youth who used to go outside at lunch break and engage in physical activity and socialization.  Today, many of our students sit all lunch hour and play on their personal devices.”[i]
  • Professor Twenge’s research shows that U.S. teenagers who spend 3 hours a day or more on electronic devices are 35% more likely, and those who spend 5 hours or more are 71% more likely, to have a risk factor for suicide than those who spend less than 1 hour.[ii]
  • This research also shows that 8th graders who are heavy users of social media have a 27% higher risk of depression, while those who exceed the average time spent playing sports, hanging out with friends in person, or doing homework have a significantly lower risk.  Experiencing depression as a teenager significantly increases the risk of becoming depressed again later in life.[iii]
  • Also, teens who spend 5 or more hours a day (versus less than 1) on electronic devices are 51% more likely to get less than 7 hours of sleep (versus the recommended 9).  Sleep deprivation is linked to long-term issues like weight gain and high blood pressure.[iv]
  • A study by UCLA researchers showed that after 5 days at a device-free outdoor camp, children performed far better on tests for empathy than a control group.[v]
  • According to an American Psychological Association (APA) survey of over 3,500 U.S. parents, 58% say they worry about the influence of social media on their child’s physical and mental health, 48% say that regulating their child’s screen time is a “constant battle,” and 58% say they feel like their child is “attached” to their phone or tablet.[vi]

Some may argue that the research is not definitive, that other factors are also at work, and that in any case parents must take ultimate responsibility for their children.  These statements are undoubtedly true, but they also miss the point.  The average American teenager who uses a smart phone receives her first phone at age 10vii and spends over 4.5 hours a day on it (excluding texting and talking).viii  78% of teens check their phones at least hourly and 50% report feeling “addicted” to their phones.ix It would defy common sense to argue that this level of usage, by children whose brains are still developing, is not having at least some impact, or that the maker of such a powerful product has no role to play in helping parents to ensure it is being used optimally.  It is also no secret that social media sites and applications for which the iPhone and iPad are a primary gateway are usually designed to be as addictive and time-consuming as possible, as many of their original creators have publicly acknowledged.x  According to the APA survey cited above, 94% of parents have taken some action to manage their child’s technology use, but it is both unrealistic and a poor long-term business strategy to ask parents to fight this battle alone.  Imagine the goodwill Apple can generate with parents by partnering with them in this effort and with the next generation of customers by offering their parents more options to protect their health and well-being.

To be clear, we are not advocating an all or nothing approach.  While expert opinions vary on this issue, there appears to be a developing consensus that the goal for parents should be ensuring the developmentally optimal amount and type of access, particularly given the educational benefits mobile devices can offer.  For example, Professor Twenge’s research cited above has revealed peak mental health levels among teenagers who use devices 1 hour or less a day, with teens engaging in this limited use happier than teens who do not use devices at all.  According to a study of more than 10,000 North American parents conducted by researcher Alexandra Samuel, the children of parents who focus primarily on denying screen access are more likely to engage in problematic behaviors online than the children of parents who take an active role in guiding their technology usage.xi  Likewise, researchers at the University of Pittsburgh Center for Research on Media, Technology, and Health have found that while using a high number of social media platforms daily is linked to depression and anxiety in young adults, using a limited number does not have the same impact.xii

While these studies (and common sense) would suggest a balanced approach, we note that Apple’s current limited set of parental controls in fact dictate a more binary, all or nothing approach, with parental options limited largely to shutting down or allowing full access to various tools and functions.  While there are apps that offer more options, there are a dizzying array of them (which often leads people to make no choice at all), it is not clear what research has gone into developing them, few if any offer the full array of options that the research would suggest, and they are clearly no substitute for Apple putting these choices front and center for parents.  As Apple understands better than any company, technology is best when it is intuitive and easy to use.  More importantly, technology will continue to evolve as time goes on and play a greater and greater role in all of our lives.  There is a developing consensus around the world including Silicon Valley that the potential long-term consequences of new technologies need to be factored in at the outset, and no company can outsource that responsibility to an app designer, or more accurately to hundreds of app designers, none of whom have critical mass.

This is a complex issue and we hope that this is the start of a constructive and well-informed dialogue, but we think there are clear initial steps that Apple can follow, including:

  • Expert Committee: Convening a committee of experts including child development specialists (we would recommend Dr. Rich and Professor Twenge be included) to help study this issue and monitor ongoing developments in technology, including how such developments are integrated into the lives of children and teenagers.
  • Research: Partnering with these and other experts and offering your vast information resources to assist additional research efforts.
  • New Tools and Options: Based on the best available research, enhancing mobile device software so that parents (if they wish) can implement changes so that their child or teenager is not being handed the same phone as a 40-year old, just as most products are made safer for younger users.  For example, the initial setup menu could be expanded so that, just as users choose a language and time zone, parents can enter the age of the user and be given age-appropriate setup options based on the best available research including limiting screen time, restricting use to certain hours, reducing the available number of social media sites, setting up parental monitoring, and many other options.
  • Education: Explaining to parents why Apple is offering additional choices and the research that went into them, to help parents make more informed decisions.
  • Reporting: Hiring or assigning a high-level executive to monitor this issue and issuing annual progress reports, just as Apple does for environmental and supply chain issues.

It is true that Apple’s customer satisfaction levels remain incredibly high, which is no surprise given the quality of its products.  However, there is also a growing societal unease about whether at least some people are getting too much of a good thing when it comes to technology,xiii which at some point is likely to impact even Apple given the issues described above.  In fact, even the original designers of the iPhone user interface and Apple’s current chief design officer have publicly worried about the iPhone’s potential for overuse,xiv and there is no good reason why you should not address this issue proactively.  As one of the most innovative companies in the history of technology, Apple can play a defining role in signaling to the industry that paying special attention to the health and development of the next generation is both good business and the right thing to do.  Doing so poses no threat to Apple, given that this is a software (not hardware) issue and that, unlike many other technology companies, Apple’s business model is not predicated on excessive use of your products. In fact, we believe addressing this issue now by offering parents more tools and choices could enhance Apple’s business and increase demand for its products.

Increasingly today the gap between “short-term” and “long-term” thinking is narrowing, on issues like public health, human capital management, environmental protection, and more, and companies pursuing business practices that make short-term sense may be undermining their own long-term viability. In the case of Apple, we believe the long-term health of its youngest customers and the health of society, our economy, and the Company itself, are inextricably linked, and thus the only difference between the changes we are advocating at Apple now and the type of change shareholders are better known for advocating is the time period over which they will enhance and protect value. As you can imagine, this is a matter of particular concern for CalSTRS’ beneficiaries, the teachers of California, who care deeply about the health and welfare of the children in their classrooms.

While you may already have started work on addressing the issues raised here, we would nonetheless appreciate the opportunity to discuss this matter further with the board to bring in a wider range of voices. We also encourage you to discuss this matter directly with Dr. Rich, Professor Twenge, or any member of JANA’s board of advisors for our new impact investing fund, which includes Patricia A. Daly, OP, Professor Robert G. Eccles, Sting, and Trudie Styler. In the meantime, should you wish to contact us we can be reached at (212) 455-0900 or (916) 414-7410.

Sincerely,

Barry Rosenstein
Managing Partner
JANA Partners LLC

Anne Sheehan
Director of Corporate Governance
The California State Teachers’ Retirement System

How to Be Better at Stress

By Tara Parker-Pope @nytimes

Stress is unavoidable in modern life, but it doesn’t have to get you down. Work, money and family all create daily stress, while bigger issues like politics and terrorism contribute to our underlying stress levels. But approach it the right way, and it won’t rule your life — it can even be good for you. Here are ways to deal with stress, reduce its harm and even use your daily stress to make you stronger.

Take Control

Stress is inevitable; getting sick from it is not.

THE PERCEPTION OF STRESS

While we know that stress is associated with health problems, plenty of people with high-stress lives are thriving. How is that possible? In 2012, researchers from the University of Wisconsin-Madison published a seminal study looking at how 28,000 people perceived stress in their lives. People in the study answered these two questions:

  1. During the past 12 months, would you say that you experienced:
    1. A lot of stress
    2. A moderate amount of stress
    3. Relatively little stress
    4. Almost no stress at all
  2. How much effect has stress had on your health?
    1. A lot
    2. Some
    3. Hardly any
    4. None

The researchers looked at death rates in the study group over nine years. The results are startling. The study found that having a lot of stress in your life was not linked with premature death. But having a lot of stress in your life and believing it was taking a toll on your health increased risk of premature death by 43 percent.

CHANGING YOUR PERCEPTION

With stress, the mind and the body are intrinsically linked. You can view stress as something that is wreaking havoc on your body (and it can) or as something that is giving you the strength and energy to overcome adversity. Here’s a quick way to think about these two very different views of stress. Read the statement, and then think about your own reaction to the biological changes that occur during times of stress.1. When I’m stressed, my body releases adrenaline and cortisol. My heart is beating faster. This means that:

  • Common View: Stress is increasing my risk for cardiovascular disease and heart attack.
  • Alternative View: My heart is working harder and my body is mobilizing its energy to get ready for this challenge.

2. When I’m stressed, my stress response is causing my breathing rate to increase. This means that:

  • Common View: My fast breathing is a sign of anxiety. I worry about how stress is affecting my mental and physical health.
  • Alternative View: I should take a deep breath. My faster breathing means more oxygen is getting to my brain so I can think more clearly.

3. When I’m stressed, my heart and circulatory system respond, causing my blood pressure to rise. This means that:

  • Common View: I can feel my blood pressure rising. This can’t be good for my health.
  • Alternative View: Circulatory changes are allowing more oxygen and nutrients to fuel my muscles. I’m feeling stronger and ready for the challenge ahead.

It’s probably clear to you that the alternative view is the better choice for thinking about stress. It may be hard to believe that such a small shift in thinking could make a difference, but that’s what Harvard researchers found when they paid 50 study subjects $25 each to take part in a lab experiment designed to induce stress. The test involves giving a talk in front of a group of unfriendly evaluators, followed by a tricky word test. (Researchers have consistently found that this formula of public speaking plus testing in front of a hostile crowd is incredibly uncomfortable and stress-inducing for the poor people who agree to take part in the study.)

Before the social stress test, one group was allowed to play video games; another was taught to simply ignore stressful feelings if they experienced them during the test. But a third group was given advice similar to the quiz above. They got a primer about the physical stress response and were told how a higher heart rate, faster breathing and internal jitters were all tools for making you strong during a stressful event. They were told how the body’s stress response evolved to help us succeed, and that the increased arousal symptoms of stress can aid your performance during times of stress. The bottom line of the lesson was this: In a tough situation, stress make you stronger.

The group that learned to rethink the role of stress in their lives did far better on the test. They gave better speeches and were rated as more confident. They smiled more and had more-positive body language. And physiological indicators showed that their bodies were also managing the stress response better than those of test subjects who were taught to ignore stress or given no advice at all.

The Stanford psychologist Kelly McGonigal has been a champion of rethinking stress, noting that the right approach can make you smarter and stronger. Her TED talk on the subject, “How To Make Stress Your Friend,” has been viewed 14 million times.

“What I learned from these studies, surveys and conversations truly changed the way I think about stress,” Dr. McGonigal wrote in her book “The Upside of Stress: Why Stress Is Good for You, and How to Get Good at It.” “The best way to manage stress isn’t to reduce or avoid it, but rather to rethink and even embrace it.”

Practice Stress

Learn skills to better handle stress.

STRESS INOCULATION

The best way to get better at stress is to practice it. Scientists call this “stress inoculation,” and just as exposure to a virus will inoculate you from contracting a virus a second time, regular exposure to small amounts of stress can inoculate you from the most detrimental effects of stress when you suffer a big stressful event in your life.

Stress inoculation has three phases.

1. Education: Learn what to expect. If you need chemotherapy, are experiencing a divorce or have had a setback at work, talk to people who have been through it and learn what to expect going forward so you can be prepared, rather than blindsided, by the stressors ahead of you.

2. Rehearsal: While you can’t rehearse for life’s biggest moments, you can live your life in a way that prepares you for stress. It can be a physical challenge like competing in a triathlon or conquering a mountain. It can be an intellectual stressor like reading your poetry in public or giving a speech. The point is that you need to rehearse stressful situations in order to perform your best under stress.

3. Implementation: When the stressful event hits, you are prepared. You know what to expect, and you’ve experienced stressful situations before. You’ve got this.

STILL SKEPTICAL?

Think about how firefighters train. They educate themselves about fire and how it behaves in different situations. They put themselves through grueling physical training to practice carrying heavy equipment, navigating smoky, dark buildings and stairwells, and braving the heat of a raging fire. They practice running into burning buildings. The training is hard and highly stressful.

Now imagine you are out for a nightly walk and you see that a neighbor’s house is on fire. Your heart races. You panic. You fumble with your phone. You take a step toward the house. You hesitate. What do you do? Fortunately, the firefighters arrive and race into the home without hesitation. Your moment of stress and anxiety is just another day at the office for them. They know what to expect. They trained for it.

You can practice for everyday stress in similar ways, by putting yourself in challenging situations. The good news is that practicing stress can actually be enjoyable, even thrilling. The key is to push yourself out of your comfort zone. Here are some suggestions:

  • Run a marathon
  • Play in a Scrabble competition
  • Read an original poem at a poetry slam
  • Climb a mountain
  • Sing karaoke
  • Tell a story in front of a crowd
  • Take on a tough project at work
  • Kayak the Colorado rapids
  • Train to scuba dive
  • Attend a boot camp

Not only will challenging experiences give you more confidence, but the repeated exposure to stressful situations can also change your body’s biological response to stress. Your stress hormones become less responsive, allowing you to better handle stress when it comes.

Dr. Dennis Charney, a psychiatrist and the dean of the Icahn School of Medicine at Mount Sinai in New York City, notes that programs like Outward Bound and basic military training are all designed to make people uncomfortable and build their skills so that they will be better able to handle stress later on. When his children were young, he took them on adventure trips that included “a degree of anxiety” like exposure to wildlife or kayaking in remote areas as a way to build confidence and prepare them to deal with stressful events. Putting yourself or your children in difficult social situations or speaking in public can help adults and children accumulate social and intellectual skills that help in times of stress.

“Live your life in a way that you get the skills that enable you to handle stress,” says Dr. Charney. “Put yourself out of your comfort zone.”

AN RX FOR RESILIENCE

Another factor in how you handle a stressful situation is resilience. The American Psychological Association defines resilience this way:

Resilience is the process of adapting well in the face of adversity, trauma, tragedy, threats or significant sources of stress — such as family and relationship problems, serious health problems or workplace and financial stressors. It means “bouncing back” from difficult experiences.

You can boost your resilience in a number of ways. In the book “Resilience: The Science of Mastering Life’s Greatest Challenges,” the authors, Dr. Steven M. Southwick and Dr. Charney, studied people who experienced great stressors — prisoners of war, men in the special forces, victims of trauma or survivors of catastrophic events. They found that people with the most resilience in the face of extreme challenges shared several behaviors and mind-sets. From that research, the duo identified 10 factors associated with resilience. You don’t need to practice all 10 behaviors to build resilience; just pick the two or three or four that speak to you.

1. Adopt a positive attitude. Optimism is strongly related to resilience.

2. Reframe the situation. Just like the stressed-out study subjects were taught to reappraise stress as their friend, people who are resilient typically reframe a negative situation as an opportunity for growth, learning or change.

3. Focus on core beliefs. People with a deeply held core belief, strong faith or a commitment to altruism often show more resilience.

4. Find a role model. Seeing someone else who has come through adversity can strengthen your own resilience.

5. Face your fears. Confronting a challenge rather than avoiding it will help you cope and build confidence.

6. Fall back on religion or spirituality. For many people, strong faith or spiritual beliefs can fuel resilience.

7. Seek social support. People who reach out to friends, family and support groups fare better during stressful times.

8. Exercise. It improves mood, relieves stress and makes you physically stronger.

9. Inoculate against stress. Challenge yourself regularly in the areas of emotional intelligence, moral integrity and physical endurance.

10. Find meaning and purpose. Having a clear purpose in life can boost your emotional strength during difficult times.

Exercise

Numerous studies have shown us that exercise can improve your mood.

Exercise can channel your stress response into something constructive and distract your mind from the challenges at work or home that make you feel chronically stressed. In many ways exercise appears to be a form of stress inoculation. In studies, mice given access to running wheels and tubes to explore for just two weeks became resistant to stress compared with mice who had not exercised. They measured this by exposing the mice to an aggressive mouse. After the bullying, the exercising-mice bounced back, but the sedentary mice continued to show signs of stress. The bottom line: Exercise doesn’t eliminate stress, but it does give your body the physical conditioning it needs to recover from it.

How Much Exercise Do I Need to Manage Stress?
It doesn’t take much. Even small amounts of exercise can help you manage your stress. The key is consistency. Don’t let the stress of your day push exercise off the schedule.

Does the Type of Exercise Matter?
The exercise that is best for relieving stress is the one you will do consistently. Find something that fits your schedule and that you enjoy. For some, that will be a morning spin class or an evening run. For others, it will be a 30-minute walk at lunch time. A Norwegian study found that people who engaged in any exercise, evan a small amount, reported improve mental health compared with people who never exercised.

What About Weight Training?
One study showed that six weeks of bicycle riding or weight training eased symptoms in women who received a diagnosis of anxiety disorder. The weight training was especially effective at reducing irritability.

Indeed, some research suggests that when it comes to reducing stress, you’ll get more out of exercise if you incorporate some weight training. Studies show that anaerobic or resistance exercises (working with weights) taxes muscles more than aerobic exercise like walking or running. The result is that weight training, done right, may produce more mood-boosting endorphins than cardio exercise. Exercises that stress the large muscles seem to have the biggest effect, like squats, leg presses, incline situps, military presses and bench presses.

Don’t go for a powerlifting record. The best weight training to manage stress consists of three moderate-weight sets of 10 repetitions with one minute of rest. The U.S. Army Research Institute of Environmental Medicine found in a small study that this 3-10-1 moderate weight strategy produced more endorphins than using heavier weights for five reps and a longer rest.

TAKE IT OUTSIDE

Simply taking your exercise outdoors can have a significant effect on your mood.

In a number of recent studies, volunteers who walked outdoors reported enjoying the activity more than those who walked indoors on a treadmill. Subsequent psychological tests showed outdoor exercisers scored significantly higher on measures of vitality, enthusiasm, pleasure and self-esteem and lower on tension, depression and fatigue.

study last year of older adults found that those who exercised outside did so longer and more often than those working out indoors. The outdoor exercisers averaged about 30 minutes more exercise each week than those who walked or otherwise exercised indoors.

few small studies have found that people have lower blood levels of cortisol, a hormone related to stress, after exerting themselves outside as compared with inside. There’s speculation, too, that exposure to direct sunlight, known to affect mood, plays a role.

A study in Austria found that almost all the participants reported that the outdoor effort had felt less strenuous to them than their time on the treadmill. And they enjoyed it more.

A small study from the University of Essex found that exercisers exposed to the color green found it easier to exercise and were in a better mood than exercisers exposed to gray or red. (Think green trees versus a cement-walled gym.)

Mind

Exercise your mind and let it rest to help it better process stress.

GIVING YOUR MIND A REST

For people dealing with high levels of stress, it can be hard to fathom how a few moments of meditation will help. After meditation, the stressors are still there — you’re still getting divorced, caring for an aging parent, struggling with the demands of a high-stress job. How can a few moments of deep thought possibly help your life?

It may help to think about how muscles get stronger. Unrelenting exercise simply tears down a muscle and leads to injury. Smart exercisers know the value of a day of rest — that’s when your muscles regenerate and come back stronger than before.

Now think about your mind as an emotional muscle. Unrelenting stress without a break will not make it stronger. Your emotions, your brain and your body need moments of recovery to get stronger from stress.

“It’s about stress and recovery. Just like you build a physical muscle, just like you build biceps, you have to take the same approach to life stressors,” says Jack Groppel, co-founder of the Johnson & Johnson Human Performance Institute, which offers a course called “The Power of Positive Stress.“

Think of meditation like high-intensity interval training (H.I.I.T.) for the brain. During H.I.I.T., you go as hard as you can, then you give yourself a few minutes of recovery before returning to the exercise. This cycle is repeated multiple times and has been shown to be more effective for building strength than long, slow bouts of exercise.

Now imagine a high-intensity, high-stress workday. But every hour, you take two minutes to let your brain recover. “Stress is the stimulus for growth,” says Dr. Groppel. “Recovery is when growth occurs. If there is no recovery, there is no growth. That’s how we build the resilience muscle.”

CONTROLLED BREATHING

Controlled breathing has been shown to reduce stress, increase alertness and boost your immune system. For centuries yogis have used breath control, or pranayama, to promote concentration and improve vitality. The Buddha advocated breath-meditation as a way to reach enlightenment.

Science is just beginning to provide evidence that the benefits of this ancient practice are real. Studies have found, for example, that breathing practices can help reduce symptoms associated with anxiety, insomnia, post-traumatic stress disorder, depression and attention deficit disorder.

Rock and Roll Breathing

When your mind is racing or you feel keyed up, try Rock and Roll breathing, which has the added benefit of strengthening your core.

MEDITATION

One study recruited 35 unemployed men and women who were seeking work and experiencing considerable stress. All of them participated in stretching exercises, but half of them were also taught formal mindfulness meditation. After three days, everyone said they felt refreshed and better able to withstand the stress of unemployment. Yet follow-up brain scans showed differences in only those who underwent mindfulness meditation. There was more activity, or communication, among the portions of their brains that process stress-related reactions and other areas related to focus and calm. Four months later, those who had practiced mindfulness showed much lower levels in their blood of a marker of unhealthy inflammation than the relaxation group, even though few were still meditating.

To learn more about meditation, try the introductory exercise below.

Basic Mindfulness Meditation

Learn how to pay close attention to the present moment with this meditation exercise.

TRY IT!

WRITE IT DOWN

Another way to cope with stress: writing. It is based on the idea that we all have a personal narrative that shapes our view of the world and ourselves. But sometimes our inner voice doesn’t get it completely right. Some researchers believe that by writing and then editing our own stories, we can change our perceptions of ourselves and identify obstacles that stand in the way of better health. It may sound like self-help nonsense, but research suggests the effects are real.

Timothy D. Wilson, a University of Virginia psychology professor and author of “Redirect: Changing the Stories We Live By,” believes that while writing doesn’t solve every problem, it can definitely help people cope. “Writing forces people to reconstrue whatever is troubling them and find new meaning in it,” he said.

There are a number of methods to tap into the power of expressive writing:

Journal every day. Just writing about your thoughts, feelings and experiences every day can help. Explore your thoughts and feelings about an issue. Don’t just re-live the stress in your life but try to find meaning in it or explore how well you’ve handled certain situations. Be disciplined and write at the same time every day so it becomes a habit. In a University of Texas study, students who wrote about stressful or traumatic events for four days in a row reaped the benefits for months after. For the next six months, the writing students had fewer visits to the campus health center and used fewer pain relievers than the students in the experiment who wrote about trivial matters.

Change your story. Use writing to force yourself to confront the changes you need to make in your life. On the first day, write down your goals, then write down why you haven’t achieved them (“I don’t have the time or the money,” “Too many family responsibilities,” etc.) The next day review your writing. Now ask: What is really standing in the way of your goals? Change the story so you have control. Maybe the answer is: I don’t put myself first. I don’t make exercise a priority. I let other people talk me into spending money rather than saving.

Write a mission statement. People deal with stress better when they have a strong moral compass. This means knowing what you value in life and using that as a guidepost for all decision. By creating a mission statement people can begin to identify the underlying causes of behaviors, as well as what truly motivates them to change. “A mission statement becomes the North Star for people,” says Dr. Groppel. “It becomes how you make decisions, how you lead and how you create boundaries.” To learn more, read our article “Creating a New Mission Statement.”

Food

STRESS AND YOUR APPETITE

Stress can have a huge impact on your eating habits. During acute stress (the hours after a car accident or the shock of a layoff announcement at work), the stress response can shut down appetite. The fight-or-flight response is designed to suppress hunger — you won’t be effective in battle or run that fast if you are thinking about food. But chronic stress has the opposite effect. Repeated doses of cortisol in your body due to high stress can lead to an increase in appetite.

According to the Harvard Health Letter, gender can play a role in how you eat during times of stress. Some research suggests women are more likely overeat due to stress while men turn to alcohol or smoking.

And the reality is that food really can make you feel better during times of stress. So-called comfort food like chocolate cake and ice cream literally blunt the body’s response to chronic stress. The problem with continuing to self-medicate chronic stress with comfort foods is that it will lead to weight gain and poor health.

Just as you need to reframe your view of stress and exercise and meditate to give your body a break from stress, you can also adopt strategies to use food to help you better cope with stress.

MINDFUL EATING

During times of stress, we can be particularly careless about what we eat and resort to mindless snacking, grabbing sweets from the office treat table or eating bags of junk food on the run. During times of stress, it’s particularly important to engage in “mindful eating,” which involves eating slowly and relishing every bite.

“The question isn’t what are the foods to eat, in my mind,” says Dr. Michael Finkelstein, a holistic physician who oversees SunRaven, a holistic-living center in Bedford, N.Y. “Most people have a general sense of what the healthy foods are, but they’re not eating them. What’s on your mind when you’re eating: That’s mindful eating to me.”

Here’s a simple exercise to try next time you are sitting down to a delicious meal:

  1. Place a forkful of food in your mouth. Make it something you love.
  2. Put the fork down and resist the temptation to take a second bite.
  3. Chew slowly. Tune in to the texture of the food, the flavor, the aroma. Focus on the colors on your plate.
  4. Be present in the moment and think only about the food in your mouth. Reflect on the effort that went into growing or producing this food; the effort it took to prepare this meal.
  5. Savor the moment.

To learn more, read “Mindful Eating as Food for Thought.”

Support and Relationships

Your friends and family can be both a cause of stress and a cure for it.

LEAN ON LOVED ONES

The pressure of family responsibilities is one of the most common forms of stress. But during times of stress, our friends and family members are most likely to give us the support we need to get through it.

One of my favorite friendship studies involved a steep hill, a heavy backpack and 34 university students. Students were fitted with a backpack full of free weights equivalent to 20 percent of their body weight. They stood at the base of a hill on the University of Virginia campus with a 26-degree incline. Wearing the heavy backpack, they had to imagine climbing that hill and guess the incline. When a student stood alone, he or she tended to guess that the hill was very steep. But when they stood next to a friend, the hill didn’t look as daunting. Overall, students in pairs consistently gave lower estimates of the hill’s incline compared with students who were alone. And the longer the friends had known each other, the less steep the hill appeared.

The lesson: The world does not look as challenging with a friend by your side.

For people who study stress, the role of friendship, family and support networks can’t be overstated. Time and again research shows that social support is a defining element in our happiness, quality of life and ability to cope with stress.

MAP YOUR SOCIAL NETWORK

During times of high stress we have a tendency to retreat. We cancel social plans and focus on the work, money crisis or trauma that is our source of stress. But friends and social support are among the best forms of therapy to help you escape stress for brief periods of time. Friends can also make you feel better about yourself, and that mountain of stress in your life won’t look so steep.

When Dr. Southwick, Yale Medical School psychiatrist, co-wrote his book on resilience, he interviewed a number of people who had shown resilience against all odds, including former prisoners of war and people who had survived trauma. One thing they had in common was social support.

“The resilient people we interviewed actively reached out for support,” said Dr. Southwick. “They don’t sit around and wait.”

Even POWs held in isolation devised a tapping method of communication with their fellow prisoners. “Most, if not all, said it was life-saving to know they weren’t alone and they were cared for,” said Dr. Southwick.

When Dr. Southwick, a psychiatrist, meets with a new patient, one of the first things he does is construct a diagram of the patient’s social network. Sometimes they just talk about it; some patients want to map it out on paper. “Who is in your life? Who can you count on?” asks Dr. Southwick. Make your own list of your social network and keep it handy when you need to call on someone for support.

DON’T JUST SEEK SUPPORT, GIVE IT

If you lead a highly stressful life, the solution may be to add one more task to your daily to-do list. Give back.

Research consistently shows that helping other people and giving social support is a powerful way to manage the stress in your life and boost your resilience. Volunteer work, mentoring, mowing your elderly neighbor’s lawn, listening to a friend who is struggling — all these can enhance your own ability to manage stress and thrive.“

Time spent helping others, sharing our knowledge and providing social and emotional support gives meaning and purpose to our lives,” said Adam Grant, a Wharton management professor and co-author of the book “Option B: Facing Adversity, Building Resilience and Finding Joy” with Sheryl Sandberg. “Getting out of yourself and helping others may be even more powerful than receiving social support.”

REACH OUT AND TOUCH SOMEONE

The simple act of touching another person — or being touched — can ease your stress. James A. Coan, an assistant professor of psychology and a neuroscientist at the University of Virginia, recruited 16 women who felt they had strong support in their relationships. To simulate stress, he subjected each woman to a mild electric shock under three conditions, all while monitoring her brain. The shocks were administered in no particular order while the woman was 1) alone, 2) holding a stranger’s hand, and 3) holding her husband’s hand.

Notably, both instances of hand-holding reduced the neural activity in areas of the woman’s brain associated with stress. But when the woman was holding her husband’s hand, the effect was even greater, and it was particularly pronounced in women who had the highest marital-happiness scores. Holding a husband’s hand during the electric shock resulted in a calming of the brain regions associated with pain similar to the effect brought about by use of a pain-relieving drug.

Coan says the study simulates how a supportive marriage and partnership gives the brain the opportunity to outsource some of its most difficult neural work. “When someone holds your hand in a study or just shows that they are there for you by giving you a back rub, when you’re in their presence, that becomes a cue that you don’t have to regulate your negative emotion,” he told me. “The other person is essentially regulating your negative emotion but without your prefrontal cortex. It’s much less wear and tear on us if we have someone there to help regulate us.”

ANIMALS CAN HELP

Spending time with your pet can offer a temporary reprieve from stress. Spending time with your dog and taking it for a walk is a twofer — you get the stress reduction of a pet plus the stress-busting benefits of a walk outdoors.

The evidence that pets are a source of comfort and stress relief is compelling. At Veterans Affairs hospitals, therapy animals including dogs and parrots have helped patients undergoing treatment for post-traumatic stress reduce their anxiety.

Studies have shown that after just 20 minutes with a therapy dog, patients’ levels of stress hormones drop and levels of pain-reducing endorphins rise.

In a controlled study of therapy dog visits among patients with heart disease, researchers at the University of California, Los Angeles, found a significant reduction in anxiety levels and blood pressure in the heart and lungs in those who spent 12 minutes with a visiting animal, but no such effect occurred among comparable patients not visited by a dog.

Health

Excessive stress can take a physical toll if it’s not managed correctly.

While some stress is essential for human function, chronic stress creates a cascade of physical changes throughout your body.

Heart: During a stressful event, your heart rate increases and your body releases the stress hormones — cortisol, adrenaline and noradrenaline. In some parts of the body (skin, digestive system, brain) blood vessels constrict, allowing blood flow to increase to larger systems (heart, large muscles). The body is redirecting oxygen and nutrients to the areas where they are needed most to give you the strength to fight or flee. But blood flowing to a smaller area causes blood pressure to rise. Normally the effects are temporary, but some research suggests that in people with chronic stress, the effects on the heart are unrelenting, raising the risk for high blood pressure, heart attack and stroke.

Immune System: Chronic stress can depress the immune system and make you more vulnerable to colds or more serious illnesses.

Diabetes Risk: During stress, the liver increases glucose production for a boost of energy to propel you during an emergency. Chronic stress can lead to extra blood sugar, increasing risk for diabetes, especially among those already at high risk, such as the overweight or those with a family history of the disease. According to the American Psychological Association, learning to manage your stress can be nearly as effective at controlling blood sugar as medication.

Stomach and Digestion: Stress can affect how fast food moves through your body, stomach acid and the absorption of nutrients. Chronic stress can also lead to overeating or alcohol use. All of these factors can contribute to a number of gastrointestinal issues including acid reflux, heartburn pain, nausea, stomach pain, ulcers and diarrhea.

Sex and Reproduction: In men, chronic stress can affect testosterone levels and sperm count, and contribute to erectile dysfunction. In women, stress can create irregular menstrual cycles and painful periods and exacerbate premenstrual syndrome. Stress can also worsen the symptoms of menopause, including more frequent and more severe hot flashes. In both men and women, chronic stress can dampen sexual desire.

About the Author

Tara Parker-Pope is the founding editor of Well, an award-winning consumer health site with news and features to help readers live well every day.

Twitter: @nytimes

Illustrations by Sam Kalda

Quick Classroom Exercises to Combat Stress

Edutopia

These brain breaks and focused-attention practices can help students cope with stress and trauma and focus on their learning.

The trauma and adversity that students are carrying into classrooms are changing how educators need to address learning and academic performance. Fifty-one percent of children in public schools live in low-income households, and when poverty levels exceed 50 percent, there’s a significant drop in academic performance across all grade levels. At the same time, 25 percent of all adolescents—including 30 percent of adolescent girls—are experiencing anxiety disorders.

Adversity and trauma reside in our biology, not our psychology and cognition, so we educators need to prime students’ brains for learning. This calls for a deeper understanding of how our brains develop and how they respond to adversity and trauma, and how building relationships and providing strategies that promote emotional regulation can positively affect students’ emotional, physiological, and cognitive health.

Brain Breaks

Brain breaks stimulate many areas in the brain that pay attention to novelty and curiosity, sparking the motor and sensory systems while initiating emotional regulation in the more reactive and primitive areas of the brain. Here are a few brain breaks you can try in class.

Funny talk: Have students loosely touch the roof of their mouth with their tongue and begin to speak. Create a class chant to say altogether, or the teacher can address the class, modeling what he or she would like students to say.

Tongue stretch: Have students use clean hands or a Kleenex to stretch their tongue as far as it can go. This relaxes the throat, palate, upper neck, and brain stem. What could you add to this to make it funny?

Hum: There are many ways you can incorporate humming as a break or to begin class. Lead students in Simon Says or Name That Tune, or have them move their arms and legs to someone’s humming. This activity releases stress and blockages in the brain stem.

Bilateral scribbles: Have students hold a different color marker in each hand and draw or scribble to the beat of some music for 30 seconds. When they’re finished, see if the drawings turned into anything familiar or strange. Have them share with a classmate and then give their art a name.

Name scribbles: Have students write their favorite word four times with their dominant hand and then again with their other hand. Discuss how it felt, which they found more difficult and why, and what happened in their brains when they used their non-dominant hand.

Focused-Attention Practices

Focused-attention practices calm the brain’s stress response and stimulate sustained attention and emotional regulation. A regulated and calm brain is a brain that is ready to deeply learn.

When we consciously use sensations, breath, movement, and our body’s awareness, we activate those areas in the brain that pay attention to what is happening in this moment, while supporting areas we need for learning, attention, and engagement. I’ll share four focused-attention practices here.

Ice cube: Give each student an ice cube and a paper towel or napkin to hold. As they hold the ice cube, ask them to focus on what it feels like in their hands and what the sensation reminds them of. Can they sit still and wait for the ice cube to melt?

Deep breathing: Have students scrunch their toes and cross their legs at the ankles. Then they should cross the left arm over the right arm, clasp their hands together, and—keeping their hands clasped—bring them toward their chest. Have them hold that pose for 30 seconds as they take five deep breaths, and then have them take another 30 seconds to uncurl their toes, uncross their legs, extend and unclasp their hands, and uncross their arms while taking another five deep breaths. How did that feel?

So what? As students close their eyes and sit up nice and tall in their chairs, they should visualize a golden thread that connects their hearts to their stomachs. As they breathe in, have them picture a pulse in the thread moving from their stomachs to their hearts; with each exhale, the pulse travels from the heart back down to the stomach. As the students breathe, have them say, “So what?” to themselves if a negative thought occurs.

Feeling phrases: To begin the day, have students share through a picture or description how their bodies feel. Some example phrases: cold/warm/hot; twitchy/butterflies/soft/stuck; sharp/dull/itchy; shaky/trembly/tingly; jittery/weak; empty/full; relaxed/calm/peaceful; flowing/spreading; strong/tight/tense; dizzy/fuzzy/blurry; numb/prickly/jumpy/tearful/goosebumpy.

Sensations are different than emotions in that they describe the way the body feels physically. Children who struggle with speaking can point to places on their body that hold a sensation. Sensory awareness promotes cognitive growth and self-awareness. When students can begin to identify their sensations, they begin to tap into where the negative feelings and images are. This focused-attention practice can be implemented several times a day after different experiences. Questions to ask as part of this practice:

  • What are you sensing? As the teacher, begin by sharing and modeling your own sensations.
  • Where is this in your body?
  • What might be the reason for these butterflies?
  • Can you draw what fuzzy, tingly, tight, etc. looks like?

Spreading First Aid for Teens’ Mental Health by Training Adults to Help

MindShift

iStock/Anna_Isaeva

During the vulnerable transition from childhood to young adulthood, many kids grapple with low self-esteem, anxiety and depression. According to the National Alliance on Mental Illness, 20 percent of adolescents between the ages of 13-18 live with a mental health condition. In fact, a recent study found that nearly 25 percent of teenage girls and almost 10 percent of teen boys suffer from depression by the age of fourteen.

When kids struggle, their emotional problems often unfold in the classroom, affecting their ability to concentrate and straining interactions with teachers and peers. Left untreated, mental health concerns can contribute to high school dropout rates. A 2001 survey conducted by the Department of Education found almost 50 percent of students age 14 and older with mental illness withdraw from school, and a recent study, published in the journal BMC Public Health discovered males with psychological disorders are five times more likely to quit attending school.

While educators often want to assist these students, many feel unsure of what to say, especially during a mental health crisis. But a community-wide intervention called Mental Health First Aid seeks to equip teachers, parents and caregivers with the information and skills they need to intervene during a mental health emergency.

MHFA training, referred to as “CPR for the mind,” teaches educators and caretakers how to recognize, understand and respond to signs of psychological distress. Educators across the country can receive “Youth” First Aid training, a unique version of MHFA teaching individuals how to recognize the psychological challenges that adolescents face.

“The course taught me how to get students the help they need, especially in an emergency,” says Tori Wardrip, an art teacher at Lewis and Clark Middle School in Billings, Montana.

Wardrip completed the training in June. The full-day course taught her several First Aid skills, including how to recognize the signs of a panic attack, psychosis and PTSD. She also learned how to assess for suicide risk by asking questions like, “Are you having thoughts of hurting yourself?” and “Are you in danger?”

Spreading the Word

Since 2013, more than 200,000 educators have been trained in Youth Mental Health First Aid, according to Betsy Schwartz, vice president of public education at the National Council for Behavioral Health; hundreds of middle schools, high schools and 27 state departments of education have implemented it. Schwartz says the results have been positive, resulting in $30 million in grant funding from the Substance Abuse and Mental Health Service Administration’s (SAMHSA) Now is the Time Project AWARE grant initiative.

The initiative also has garnered support from pop star Lady Gaga, who wants to help break silence around mental health. In 2012, the singer and her mother, Cynthia Germanotta started the “Born This Way Foundation,” a nonprofit organization committed to raising awareness about mental wellness, especially for young people. Recently, the foundation partnered with the National Council for Behavioral Health to sponsor Mental Health First Aid training across the nation.

The program trains people how to support and de-escalate an emergency crisis by using a five-step action plan, called ALGEE, according to Schwartz. “ALGEE stands for assessing for suicide risk/self-harm, listening nonjudgmentally, giving reassurance and information, encouraging professional help, and encouraging self-help and additional support strategies,” says Schwartz.

She adds that educators and caregivers who participate in the daylong YMHFA training learn how to recognize risk factors and warning signs of youth mental health challenges. Individuals are also informed about the prevalence of mental illness among adolescents, learning how protective factors, like available mental health resources, can contribute to psychological resilience.

During training, YMHFA participants practice these skills by role-playing with each other. Similar to medical First Aid training, role-play mimics realistic emergencies, allowing people to rehearse what they might “say” and “do” in an actual mental health crisis.

While the training focuses on mental wellness, instructors also discuss topics, like bullying and attention difficulties, teaching educators how these behaviors contribute to mental health concerns, like depression, suicidality and eating disorders.

At Lewis and Clark, Wardrip has put her new knowledge to good use. Since completing the training, she has become the “go to” person for the faculty’s behavioral health questions, serving as a bridge between educators and counselors.

She’s also using her new knowledge to teach students how to look out for each other.

“This year, using my First Aid training, I plan to teach my kids how to recognize the signs of a mental health emergency. If a peer is in danger, I want them to know how to get help,” she says.

Additional Resources

recent report, released by the “Born This Way Foundation,” found that even though adolescents value their psychological well-being, less than half are talking about their mental health. However, research shows teaching kids how to find psychological resources can make a world of difference, helping to break the shame and stigma that surrounds mental illness.

Schwartz says, educators and caregivers who participate in the daylong YMHFA training will learn five First Aid skills, including:

  1. Recognizing risk factors and warning signs of youth mental health challenges
  2. Understanding the prevalence of mental health conditions among young people
  3. Understanding protective factors that contribute to psychological resilience
  4. Learning the ALGEE five-step action plan
  5. Identifying community resources that can help support adolescents and their families

With support from the Born This Way Foundation, the National Council for Behavioral Health hopes to train 150,000 additional educators, parents and caregivers before the end of 2017.

Educators who are interested in setting up a YMHFA training can find courses here. See Lady Gaga and Prince William chat on FaceTime about mental health from earlier this year:

Juli Fraga is a psychologist and writer in San Francisco. You can find her @dr_fraga on Twitter.