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7 Ways to Manage Assignment Stress in Students

• by Psychologs Magazine
• April 3, 2024
• 5 minutes read

The experience of attending university may be both thrilling and stressful at the same time. Beginning college, tests, homework due dates, living with strangers, and future-focused thoughts can all cause stress. Stress is a normal emotion that is meant to assist you deal with difficult circumstances. It might be beneficial in moderation since it motivates you to put in your best effort and work hard—for example, during exams. However, extreme stress or the belief that you are unable to control your stress can result in mental health issues including anxiety and depression. It might also have an impact on your academic standing. Let’s find some effective strategies to help students manage assignment stress with some practical tips.

Students and Stress

Every student experiences stress at some point, whether it’s from having five assignments due on the same day or what seems like endless back-to-back tests. And you have to be superhuman if you don’t.

The American College Health Association (ACHA) reports that 12.7% of college students report having excessive stress, while 44.9% report having stress levels that are above normal. It’s normal for students to experience periods of extreme stress due to the numerous obligations and demands placed on them by their academic programs. However, you need to identify the source of your stress and learn coping mechanisms when it interferes with your everyday tasks.

Also Read: NMC Sets up National Task Force to Address Mental Health of medical students

Students may experience increased stress, and anxiety as a result of the pressure to serve well academically and complete their assignments. It can be extremely stressful to constantly, worry about turning in homework on time and getting good grades.

Here are the ways by which assignment stress can be reduced in College Students:

Making a study schedule:.

The reason most students fail or are unable to complete the given assignment at the right time is that they don’t have a study schedule that corresponds with their academic schedule. They underestimate the amount of study time required to complete tasks and overestimate the amount of time they have available. Also, they mistakenly believe they have enough time to finish their assignments on time because of their current schedule—or lack thereof. They begin too late, get behind, and ultimately take shortcuts. Reaching parity is nearly unattainable.

Making a study timetable is just meant to help you figure out when you have time to study, which will help you become more efficient at task scheduling. This implies that you must schedule time on your calendar for tasks other than studying. Stress levels rise, grades decline, and important time spent with friends, taking care of oneself, or spending time with family is lost.

Set Priority:

College students who prioritize their responsibilities will be more productive, organized, and less likely to feel overwhelmed. Setting priorities can also assist students in achieving their objectives, lowering stress, and managing their time better. You can know what homework assignments to perform and when to finish them if you prioritize your tasks. Setting priorities for your assignment will also aid you when making templates for your homework schedule and completing assignments before the due date.

Also Read: NIMHANS help tribal department for school students’ well-being and mental health

Time Management and Plan:

Although it requires discipline and experience, effective time management can greatly increase your productivity, lower your stress level, and help you succeed as a college student overall.

To keep your obligations, projects, and assignments organized, make a to-do list or utilize a task management app. Establish due dates for all of your tasks and make a realistic timetable that allows time for studying, going to class, finishing assignments, and taking breaks. Acknowledge that unforeseen circumstances or shifts in priorities can happen, and be ready to modify your goals and timetable as necessary. Be adaptable and modify your time management techniques to take into account new information.

Understanding what is required of you before taking on any projects, assignments, or chores lowers your chance of making mistakes. You can finish a task more quickly and accurately if you ask questions to clarify the topic. For instance, you can ask questions that lead to useful responses if an assignment isn’t giving you a sense of direction. Asking clarifying questions might also help you troubleshoot unclear instructions. This will aid in reducing the Anxiety and also improve the performance.

Maintaining your physical and mental health is essential while stressing over incomplete assignments. Exercise, which might include taking a stroll or any other physical activity, is one powerful self-care tactic. You can also de-stress by indulging in a hot bath or relaxing with calming music. Effective stress management techniques can include writing, mindfulness or meditation, and socializing with loved ones. Make sure you eat healthily, exercise frequently, get adequate sleep, and take breaks to refuel. Maintaining your mental well-being through mindfulness exercises or getting help when required can also keep you concentrated and productive.

Break Large Tasks into Smaller steps

It is beneficial to divide a large work into smaller, more manageable ingredients when faced with it. You can prevent tension and procrastination by doing this. Procrastinators frequently lament how overwhelming and unachievable the task seems when they wait until the last minute. If you are prone to procrastination, creating a prioritized to-do list could be beneficial. Work your way down the list, setting reasonable deadlines for yourself.

Even if something isn’t completed right away, there are situations when writing something down can make you feel better about it. As you complete the tasks at hand, make time for yourself to focus on them in short bursts. Multitasking or task-switching can be stressful in and of itself. The work is less daunting and more manageable when priorities are established and the larger project is divided into smaller tasks.

Also Read: Stress from pre-board exams among students: how to minimize exam stress?

Seek Professional Help

Professionals in mental health can offer evidence-based therapies, like counseling and medication, to assist manage symptoms and enhance general functioning. Higher levels of contentment, happiness, and life quality may result from this. Seek assistance before you feel that you can no longer manage the stress. Take the time to speak with a professional or find out what resources your school provides for mental health issues. A mental health specialist can identify the sources of your stress, create a mental health plan, and plan constructive strategies to manage stress.

At last, the idea behind assigning tasks comes from the way that pupils learn. It facilitates the assessment of students’ subject-matter comprehension by teachers. Assignments broaden their knowledge base and help them acquire a variety of practical abilities. Education experts say that if students acquire and hone these skills, learning a subject is not insurmountable. Moreover, having a hectic amount of assignments can drain your mental well-being. It’s also important to look after you through the ways of stress management.

• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9169886/
• https://www.healthline.com/nutrition/16-ways-relieve-stress-anxiety

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All About Stress

Everyone experiences stress at some point in their lives. But what’s stressful to you may not be the same as what’s stressful to others. You might also have your own way of managing that stress.

The intensity and duration of your stress response will depend on many factors that range from your personality to your support system.

And although it may often feel unpleasant, stress is an evolutionary necessity. More importantly, it can be managed. When it isn’t, though, it may develop into an acute or chronic stress disorder.

What is stress?

Stress is the body’s natural response to a stressor. A stressor is a trigger that may cause you to experience physical, emotional, or mental distress and pressure.

In other words, stress is a physical sensation and a feeling of being overwhelmed and not able to deal with the pressures caused by a stressor.

Your mental and physical reactions to a stressor serve a purpose.

For example, in a hazardous situation, stress puts your body in “fight or flight” mode. In this heightened state of alert, your body and brain are doing everything possible to increase your chances of surviving that perceived or real threat.

You may also have a stress reaction to events that might not be life-threatening, like job deadlines or school assignments. In these scenarios, when managed well, stress could help you focus and accomplish your goals at an optimal level.

When stress has this potential for a positive outcome, it’s usually referred to as eustress . When, on the other hand, stress leads you to feel overwhelmed and unable to cope, we refer to it as distress.

In the short and long run, distress may impact your mental health and sense of well-being.

Impact of distress on your mental health

Mental health professionals usually consider three main types of negative stress responses. They each have their own signs and symptoms and may vary in duration too.

Acute stress disorder (ASD)

To reach a diagnosis of acute stress disorder , symptoms must last between 3 days and 1 month. A trigger is usually a traumatic event that causes an intense reaction.

Symptoms of acute stress disorder include:

• feeling emotionally detached or numb
• dissociative amnesia
• derealization and depersonalization
• flashbacks or recurring images from the traumatic event
• hypervigilance and constant state of alert
• anxiety symptoms

For example, after experiencing a jarring car accident, you might start:

• avoiding vehicles altogether
• feeling muscle tension when riding in a car
• having nightmares about the car accident
• experiencing panic attacks with or without an evident cause

If symptoms last for more than a month, a diagnosis of post-traumatic stress disorder (PTSD) is possible.

Episodic acute stress disorder

Folks with episodic acute stress disorder experience intense and heightened distress from everyday challenges. In other words, if you live with this condition, you periodically experience intense and extreme stress reactions to relatively simple stressors.

Contrary to acute stress disorder, which is caused by one traumatic experience, episodic acute stress is a response to several stressors that might not be considered such by people without the condition.

For example, if you have episodic acute stress disorder, you might have an intense stress response from deciding what to do for lunch today, and again later on from thinking about an important report you need to submit tomorrow.

Some people with type A personality develop this condition.

Symptoms of episodic acute stress disorder may include:

• irritability and poor anger management
• heart palpitations and shortness of breath
• muscular stiffness and pain
• panic attacks and other signs of anxiety
• chronic illnesses

Chronic stress

Left unchecked, stress responses can become a chronic condition such as generalized anxiety disorder .

Ongoing stress keeps your nervous system in overdrive. Your cortisol and adrenaline levels are constantly coursing at higher levels, and your body and mind don’t get the opportunity to wind down.

While acute and episodic stress symptoms will eventually ease, chronic stress holds the sympathetic nervous system hostage in a heightened state for an extended and undefined amount of time.

Triggers for chronic stress can vary from person to person, and they may include chronic illness, abuse, racism, and lack of rest and sleep.

Some signs and symptoms of chronic stress include:

• difficulty sleeping
• frequent headaches
• irritability
• physical conditions like acid reflux, cardiovascular disease, and cognitive disorders

Causes of stress 

Maybe you’re late to an appointment because of traffic, or you’re a new parent who hasn’t gotten enough sleep for a while. Life is full of potential stressors, and your threshold for managing these triggers depends on many factors.

What may cause you stress is not necessarily what stresses someone else. We are all unique in our responses and in how we interpret events. While some people get excited by speaking in public, others may experience a panic attack in the same situation.

There are also a few important life events that tend to be more stressful for everyone.

A well-known tool used by health professionals to measure the amount of stress someone’s experiencing is the Holmes-Rahe Life Stress Inventory . According to this scale, the most stressful life events are:

• death of a spouse
• marital separation
• incarceration
• death of a close family member
• major injury or illness
• being fired from a job
• marital reconciliation
• drastic change in the health of a family member

Extreme life changes, such as a pandemic, for example, may also trigger intense stress reactions in many people.

Contributing factors

Any stimulus you experience throughout the day has the potential to activate a stress response.

Different stimuli may cause different biological stress reactions, resulting in physical, psychological, or psychosocial stress. Sometimes, the same stimulus might cause more than one type of stress reaction.

Hypothetically, if you procrastinated on your work presentation and found yourself standing in front of your bosses unprepared, you may feel all three types of stress simultaneously: the physical stress reaction of a stomach ache from nerves; the psychological stress of worrying that this will end your chances at promotion; and the psychosocial stress of fearing ostracization for failing to perform to an expected standard.

What else can cause specific stress responses?

Physical stress

• acute or chronic disease
• poor nutrition
• lack of quality sleep

Psychological stress

• mental health conditions
• attachment style

Psychosocial stress

• relationships

Not everyone reacts the same way to these potential stressors. Your body may adapt better to fewer hours of sleep, or you may not find isolation as unpleasant as other people. If this is the case, your reaction to these stressors would not be as intense.

Your personality also plays an important role in the emotional narrative you craft around stress stimuli.

Your genetic makeup, past experiences, negative thinking patterns and cognitive distortions , and tendency to catastrophize can contribute to how intensely you react to a given situation.

At the same time, stressors don’t exist in a vacuum. They can become exacerbated or subdued due to other circumstances in your life.

In general, factors like a strong support network may positively impact overall mental wellness and your ability to manage stress.

You might also overcome a stressful obstacle when the stressor only happens occasionally. When faced with the same stressor every day, though, you’re likely to handle it better on day 1 than on day 82, for example.

In other words, the longer you’re exposed to an stressor, the greater the impact it will have on you.

Examples of long-term stressors include:

• a toxic workplace
• a chronic illness
• racism and discrimination
• relationship conflict

Symptoms and effects of stress

Acute stress effects.

When you’re exposed to a stressor, your brain and hormones immediately signal your body to be alert. You can thank the hormone epinephrine, more famously known as adrenaline, for symptoms such as:

• rapid heart rate
• focused vision and alertness
• tensed muscles
• increased lung capacity

If the stressful event is ongoing, your body will release adrenocorticotropic hormone (ACTH), which causes the adrenal glands to release cortisol. Cortisol keeps your body in this high-performance state until the peril has passed.

Sometimes, the body gets so hyped up on cortisol that it can’t switch off its high state of alert, even after the threat is gone.

Chronic stress effects

A body that won’t wind down from ACTH and adrenaline can be impacted psychologically, physically, and emotionally.

Left in high-stress mode, your body may respond by developing more symptoms.

These symptoms may be physiological, emotional, cognitive, and behavioral.

Physiological effects

• weight fluctuation
• high blood pressure
• increased chance of heart disease due to high blood pressure
• sexual dysfunction
• chronic muscle tension
• higher severity of acne
• fertility interruptions and irregular periods
• low sex drive
• increased risk of type 2 diabetes
• changes in appetite
• diarrhea or constipation

Emotional and psychological effects

• low energy and motivation
• irritability and anger
• low self-esteem
• changes in mood

Cognitive effects

• cognitive distortions
• memory challenges
• learning difficulties
• poor concentration
• intrusive thoughts

Social and behavioral effects

• social withdrawal
• changes in routines
• substance abuse
• relationship conflicts

How to manage stress 

Stress is inevitable throughout your life, but it can be managed to reduce the chance it affects you in the long term.

Consider these tips to better manage your stress reaction:

1. Take a walk in nature

You don’t have to drive to a mountain resort to feel the stress-relieving benefits of nature. To start coping with stress, find any green space, like:

• a bench under a tree
• a friend’s backyard

A study published in Frontiers in Psychology found that spending just 20 minutes outdoors is associated with the biggest drop in cortisol levels when compared with other stress-reducing initiatives.

Presuming you have to walk to your nature destination, getting outside also has the stress-reducing bonus of some light exercise to help stabilize your sympathetic nervous system.

2. Learn new breathing techniques

Perhaps the most accessible stress reliever is built right into your body. Deep breathing and breathing techniques like belly breathing signal to your brain that it’s time to chill out.

Focusing on your breath is a long-held tenet of meditation for stress.

Learning to control your breathing can keep you anchored in the present moment. Sometimes, reminding yourself of what’s real and happening right now calms your nerves about the future and frustrations about the past.

3. Develop routines that work for you

Change is part of life. But a large part of life is also under your control. Developing a solid routine that promotes your mental wellness is a healthy way to minimize the potential stressful impact of change.

For example, sticking to a routine might help you maintain better sleep or eating habits.

When you know that certain parts of your day are guaranteed to happen, it prevents last-minute decisions that can result in stress.

Particularly during the pandemic, when the days may seem long and unformed, introducing some structure can help our brains and bodies adjust and reduce stress levels.

4. Power down blue screens

Are you using your phone as a tool, or are you addicted to scrolling?

Some studies have found an association between cell phone overuse and increased levels of stress, as well as symptoms of depression and anxiety.

To curb your phone use, consider setting limits on the time you spend with it, particularly before bedtime.

Shutting the phone down 30 minutes before bedtime has been shown to have the potential to improve quality of sleep, working memory, and positive emotions during the day.

5. Organize your stress triggers

You know what may push your buttons. It may be overdue bills or setting up a doctor’s appointment.

Ignoring unpleasant tasks may feel easier than confronting them in the moment. But out of sight doesn’t always mean out of mind, and not resolving things as they arise could clutter your mind with stress.

Consider tackling the junk drawer, making the appointment today, and revamping your important document filing system.

Developing a systematic approach to areas of your life that cause routine stress may leave you feeling lighter and more competent.

When to seek help

Even if you know how to manage stress, there are times when stressors have a greater impact and your responses may be more intense.

It’s natural to need extra help once in a while.

If you feel stress is impacting your day-to-day life, it may be time to reach out for professional help.

It is especially important to seek this support if you’re experiencing symptoms of acute stress disorder.

Getting the necessary help can help manage stress before it impacts other aspects of your life.

Let’s recap

Stress is a natural, biological response to life’s challenges. However, you may react to some of these challenges more intensely, leading you to experience extreme and long-term symptoms.

All types of stress can be managed, though. If you’re having a difficult time dealing with stressors or have experienced a traumatic event, consider reaching out to a mental health professional.

These resources may help:

• American Psychiatric Association’s Find a Psychiatrist tool
• American Psychological Association’s Find a Psychologist tool
• Asian Mental Health Collective’s therapist directory
• Association of Black Psychologists’ Find a Psychologist tool
• National Alliance on Mental Illness Helplines and Support Tools
• National Institute of Mental Health’s Helpline Directory
• National Queer and Trans Therapists of Color Network
• Inclusive Therapists

13 sources collapsed

• 5 Things you should know about stress. (n.d.).  https://www.nimh.nih.gov/health/publications/stress/
• A 20-minute nature break relieves stress. (2019).  https://www.health.harvard.edu/mind-and-mood/a-20-minute-nature-break-relieves-stress
• Anxiety disorders. (2015).  https://www.nami.org/NAMI/media/NAMI-Media/Images/FactSheets/Anxiety-Disorders-FS.pdf
• Aschbacher K, et al. (2013). Good stress, bad stress and oxidative stress: Insights from anticipatory cortisol reactivity. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4028159/
• Chronic stress can cause heart trouble. (2020).  https://www.heart.org/en/news/2020/02/04/chronic-stress-can-cause-heart-trouble
• Coping with stress. (2020). https://www.cdc.gov/violenceprevention/about/copingwith-stresstips.html
• Harandi T, et al. (2017). The correlation of social support with mental health: A meta-analysis.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5633215/
• Shoukat S, et al. (2019). Cell phone addiction and psychological and physiological health in adolescents.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6449671/
• Solan M. (2019).  https://www.health.harvard.edu/blog/ease-anxiety-and-stress-take-a-belly-breather-2019042616521
• Stress effects on the body. (2018).  https://www.apa.org/topics/stress/body#:~:text=When%20the%20body%20is%20stressed,tension%20when%20the%20stress%20passes
• The Holmes-Rahe Life Stress Inventory.  https://www.stress.org/wp-content/uploads/2019/04/stress-inventory-1.pdf
• Xiong J, et al. (2020). Impact of COVID-19 pandemic on mental health in the general population: A systematic review.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7413844/
• Zari S, et al. (2017). The association between stress and acne among female medical students in Jeddah, Saudi Arabia.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5722010/

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An Overview of Stress Management

Elizabeth Scott, PhD is an author, workshop leader, educator, and award-winning blogger on stress management, positive psychology, relationships, and emotional wellbeing.

Carly Snyder, MD is a reproductive and perinatal psychiatrist who combines traditional psychiatry with integrative medicine-based treatments.

Stress Management

Stress management is the range of techniques, strategies, and therapies designed to help people control their stress. This can include lowering acute stress, but it is often aimed at lowering chronic stress to improve health, happiness, and overall well-being. Stress management strategies may include:

• Deep breathing
• Eating a healthy diet
• Getting enough sleep
• Guided visualization
• Hobbies and leisure activities
• Mindfulness
• Positive thinking
• Progressive muscle relaxation
• Psychotherapy
• Social support

We all experience stress in our lives. Because many health problems are caused or influenced by stress, it's essential to understand how stress affects your body and learn effective stress management techniques to make stress work for you rather than against you.

What Is Stress?

Stress is your body’s response to changes in your life. Because life involves constant change—ranging from everyday, routine changes like commuting from home to work to adapting to major life changes like marriage, divorce, or death of a loved one—there is no avoiding stress.  

Your goal shouldn't be to eliminate all stress but to eliminate unnecessary stress and effectively manage the rest. There are some common causes of stress that many people experience, but each person is different.

Stress can come from many sources, which are known as " stressors ." Because our experience of what is considered "stressful" is created by our unique perceptions of what we encounter in life (based on our own mix of personality traits, available resources, and habitual thought patterns), a situation may be perceived as "stressful" by one person and merely "challenging" by someone else.

Simply put, one person's stress trigger may not register as stressful to someone else. That said, certain situations tend to cause more stress in most people and can increase the risk of burnout .

For example, when we find ourselves in situations where there are high demands on us but we little control and few choices, we are likely to experience stress. We might also feel stress when we don't feel equipped; where we may be harshly judged by others; and where consequences for failure are steep or unpredictable.

Many people are stressed by their jobs , relationships , financial issues , and health problems, as well as more mundane things like clutter or busy schedules . Learning skills to cope with these stressors can help reduce your experience of stress.  

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Hosted by therapist Amy Morin, LCSW, this episode of The Verywell Mind Podcast shares what to do when financial stress is impacting your mental health. Click below to listen now.

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Just as stress is perceived differently by each of us, stress affects us all in ways that are unique to us. One person may experience headaches, while another may find stomach upset is a common reaction, and a third may experience any of a number of other symptoms.

While we all react to stress in our own ways, there is a long list of commonly experienced effects of stress that range from mild to life-threatening. Stress can affect immunity, which can impact virtually all areas of health. Stress can affect mood in many ways as well. Creating a stress management plan is often one part of a plan for overall wellness.

If you find yourself experiencing physical symptoms you think may be related to stress, talk to your doctor to be sure you are doing what you can to safeguard your health. Symptoms that may be exacerbated by stress are not "all in your head" and need to be taken seriously.

Stress can be effectively managed in many different ways. The best stress management plans usually include a mix of stress relievers that address stress physically and psychologically and help to develop resilience and coping skills.

7 Highly Effective Stress Relievers

Use quick stress relievers.

Some stress relief techniques can work in just a few minutes to calm the body's stress response. These techniques offer a "quick fix" that helps you feel calmer at the moment, and this can help in several ways.

When your stress response is not triggered, you may approach problems more thoughtfully and proactively. You may be less likely to lash out at others out of frustration, which can keep your relationships healthier. Nipping your stress response in the bud can also keep you from experiencing chronic stress.

Quick stress relievers like breathing exercises, for example, may not build your resilience to future stress or minimize the stressors that you face. But they can help calm the body's physiology once the stress response is triggered.  

Develop Stress-Relieving Habits

Some techniques are less convenient to use when you are in the middle of a stressful situation. But if you practice them regularly, they can help you manage stress in general by being less reactive to it and more able to reverse your stress response quickly and easily.

Long-term healthy habits, like exercise or regular meditation , can help to promote resilience toward stressors if you make them a regular part of your life.   Communication skills and other lifestyle skills can be helpful in managing stressors and changing how we feel from "overwhelmed" to "challenged" or even "stimulated."

Eliminate Stressors When You Can

You may not be able to completely eliminate stress from your life or even the biggest stressors, but there are areas where you can minimize it and get it to a manageable level.

Any stress that you can cut out can minimize your overall stress load. For example, ending even one toxic relationship can help you more effectively deal with other stress you experience because you may feel less overwhelmed.  

Discovering a wide variety of stress management techniques, and then choosing a mix that fits your needs, can be a key strategy for effective stress relief.

Stress FAQs

There are a number of common questions that you might ask about stress and stress management.

Is All Stress Harmful to Health?

There are several different types of stress , and not all are harmful. Eustress , for example, is a positive form of stress. But chronic stress has been linked to many serious health issues and is the type of negative stress most often mentioned in the news.   While we want to manage or eliminate negative stress, we also want to keep positive forms of stress in our lives to help us remain vital and alive.

However, if we experience too much stress in our lives, even "good" stress can contribute to excessive stress levels, which can lead to feeling overwhelmed or having your stress response triggered for too long. This is why it is still important to learn to relax your body and mind periodically and cut down on unnecessary stress whenever possible.

How Can I Tell When I’m Too Stressed?

Stress affects us all in different ways, not all of which are negative. In fact, the stress of an exciting life can actually serve as a good motivator and keep things interesting. When stress levels get too intense, however, there are some stress symptoms that many people experience.

For example, headaches, irritability, and "fuzzy thinking" can all be symptoms that you’re under too much stress.   While not everybody who’s under stress will experience these specific symptoms, many will.

If you find that you don't realize how stressed you are until you are overwhelmed, it's important to learn to notice your body's subtle cues and your own behavior, almost like an outside observer might. To notice how your body is reacting to stress, you can try this body scan meditation (it helps relax at the same time).

What Can I Do When I Feel Overwhelmed?

We all feel overwhelmed from time to time; that’s normal. While it’s virtually impossible to eliminate times when events conspire and the body’s stress response is triggered, there are ways that you can quickly reverse your body’s reaction to stress, buffering the damage to your health and keeping your thinking clear, so you can more effectively deal with what’s going on in the moment.

Is There a Way to Be Less Affected by Stress?

By practicing regular stress management techniques, you can eliminate some of the stress you feel and make yourself more resilient in the face of stress in the future. There are several things you can try, ranging from a morning walk to an evening journaling practice to just making more time for friends. The trick is to find something that fits with your lifestyle and personality, so it’s easier to stick with.

National Institute of Mental Health. 5 Things You Should Know About Stress .

Ma X, Yue ZQ, Gong ZQ, et al. The effect of diaphragmatic breathing on attention, negative affect and stress in healthy adults .  Front Psychol . 2017;8:874. doi:10.3389/fpsyg.2017.00874

National Center for Complementary and Integrative Medicine. Mind and Body Approaches for Stress: What the Science Says . 2020.

Bota PG, Miropolskiy E, Nguyen V. Stop caretaking the borderline or narcissist: How to end the drama and get on with life .  Ment Illn . 2017;9(1):6985. doi:10.4081/mi.2017.6985

Lehrer PM, Woolfolk RL, Sime WE. Principles and Practice of Stress Management . 3rd edition. New York: The Guilford Press; 2007.

By Elizabeth Scott, PhD Elizabeth Scott, PhD is an author, workshop leader, educator, and award-winning blogger on stress management, positive psychology, relationships, and emotional wellbeing.

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What is stress management?

• Identify the causes
• Replace unhealthy coping strategies
• Practice the 4 As

Avoid unnecessary stress

Alter the situation, adapt to the stressor.

• Accept the things you can't change

Move more during your day

• Time management
• Reach out and connect

Make time for fun and relaxation

Maintain balance with a healthy lifestyle.

• Reducing stress in the moment

Stress Management Techniques & Strategies to Deal with Stress

While it may seem like there’s nothing you can do about stress in your life, there are healthy steps you can take to destress and regain control.

It may seem like there’s nothing you can do about stress—no way to avoid it and no way to de-stress completely when it hits. The bills won’t stop coming, there will never be more hours in the day, and your work and family responsibilities will always be demanding. But the truth is, you have a lot more control over stress than you may think. In fact, the simple realization that you’re in control of your life is the foundation of stress management.

Managing stress is all about taking charge: of your thoughts, emotions, schedule, environment, and the way you deal with problems. The ultimate goal is a balanced life, with time for work, relationships, relaxation, and fun—plus the ability to hold up under pressure and meet challenges head on.

Stress management involves using various techniques and coping strategies to improve the way you react to stressful things in your life and build resilience . But it’s not one-size-fits-all. That’s why it’s important to experiment and find out what works best for you. Whether you’re looking to reduce your overall stress levels, avoid unnecessary stressors in your life, or deal with stress in the moment, the following stress management techniques and strategies can help.

Why does stress management matter?

If you’re living with high levels of stress, you’re putting your entire well-being at risk. Stress wreaks havoc on your emotional equilibrium, as well as your overall physical and mental health. It narrows your ability to think clearly, function effectively, and enjoy life.

Identify the causes of stress in your life

Stress management starts with identifying the sources of stress in your life. This isn’t as straightforward as it sounds. While it’s easy to identify major stressors such as changing jobs, moving, or going through a divorce, pinpointing the sources of chronic stress can be more complicated.

It’s all too easy to overlook how your own thoughts, feelings, and behaviors contribute to your everyday stress levels. Sure, you may know that you’re constantly worried about work deadlines, but maybe it’s your procrastination, rather than the actual job demands, that is causing the stress.

To identify what’s really stressing you out, look closely at your habits, attitude, and excuses:

• Do you explain away stress as temporary (“I just have a million things going on right now”) even though you can’t remember the last time you took a breather?
• Do you define stress as an integral part of your work or home life (“Things are always crazy around here”) or as a part of your personality (“I have a lot of nervous energy, that’s all”)?
• Do you blame your stress on other people or outside events, or view it as entirely normal and unexceptional?

Until you accept responsibility for the role you play in creating or maintaining it, your stress level will remain outside your control.

Keep a stress journal

A stress journal can help you identify the regular stressors in your life and the way you deal with them. Each time you feel stressed, make a note of it in your journal or use a stress tracker on your phone. As you keep a daily log, you will begin to see patterns and common themes. Write down:

• What caused your stress (make a guess if you’re unsure).
• How you felt, both physically and emotionally.
• How you acted in response.
• What you did to make yourself feel better.

Replace unhealthy coping strategies with healthy ones

Think about the ways you currently manage and cope with stress in your life. Your stress journal can help you identify them. Are your coping strategies healthy or unhealthy? Many of us cope with stress in ways that make us feel better temporarily—but compound the problem in the long run.

Unhealthy ways of dealing with stress

• Using alcohol or drugs to relax .
• Bingeing on junk or comfort food.
• Zoning out for hours on your phone or TV.
• Withdrawing from friends, family, and social activities.
• Sleeping too much.
• Filling up every minute of the day to avoid facing problems.
• Taking out your stress on others
• Procrastinating.

If your methods of coping with stress aren’t contributing to your greater emotional and physical health, it’s time to find healthier ones. No single method works for everyone or in every situation, so experiment with different stress management techniques and strategies. Focus on what makes you feel calm and in control.

Practice the 4 As of stress management

There are many healthy ways to reduce stress or cope with its effects, but they all require change. You can either change the situation or change your reaction. When deciding which option to choose, it’s helpful to think of the four As: avoid , alter , accept , or adapt .

Not all stress can be avoided, and it’s not healthy to avoid a situation that needs to be addressed. But you may be surprised by the number of stressors in your life that you can eliminate.

Learn how to say “no.” Know your limits and stick to them. Whether in your personal or professional life, taking on more than you can handle is a surefire recipe for stress.

Avoid people who stress you out. If someone consistently causes stress in your life, limit the amount of time you spend with that person, or end the relationship.

Take control of your environment. If the evening news makes you anxious, turn off the TV. If traffic makes you tense, take a longer but less-traveled route. If going to the market is an unpleasant chore, do your grocery shopping online.

Avoid hot-button topics . If you get upset over religion or politics, cross them off your conversation list. If you repeatedly argue about the same subject with the same people, stop bringing it up or excuse yourself when it’s the topic of discussion.

Pare down your to-do list. Analyze your schedule, responsibilities, and daily tasks. If you’ve got too much on your plate, distinguish between the “shoulds” and the “musts.” Drop tasks that aren’t truly necessary to the bottom of the list or eliminate them entirely.

If you can’t avoid a stressful situation, try to alter it. Often, this involves changing the way you communicate and operate in your daily life.

Express your feelings instead of bottling them up. If something or someone is bothering you, communicate your concerns in an open and respectful way. If you don’t voice your feelings, resentment will build and the stress will increase.

Be willing to compromise. When you ask someone to change their behavior, be willing to do the same. If you both are willing to bend at least a little, you’ll have a good chance of finding a happy middle ground.

Be more assertive.  Don’t take a backseat in your own life. Deal with problems head on, doing your best to anticipate and prevent them. If you’ve got an exam to study for and your chatty roommate just got home, say up front that you only have five minutes to talk.

Find balance. All work and no play is a recipe for burnout. Try to find a balance between work and family life, social activities and solitary pursuits, daily responsibilities and downtime.

If you can’t change the stressor, change yourself. You can adapt to stressful situations and regain your sense of control by changing your expectations and attitude.

Reframe problems. Try to view stressful situations from a more positive perspective. Rather than fuming about a traffic jam, look at it as an opportunity to pause and regroup, listen to your favorite radio station, or enjoy some alone time.

Look at the big picture. Take perspective of the stressful situation. Ask yourself how important it will be in the long run. Will it matter in a month? A year? Is it really worth getting upset over? If the answer is no, focus your time and energy elsewhere.

Adjust your standards. Perfectionism is a major source of avoidable stress. Stop setting yourself up for failure by demanding perfection. Set reasonable standards for yourself and others, and learn to be okay with “good enough.”

Practice gratitude. When stress is getting you down, take a moment to reflect on all the things you appreciate in your life , including your own positive qualities and gifts. This simple strategy can help you keep things in perspective.

Accept the things you can’t change

Some sources of stress are unavoidable. You can’t prevent or change stressors such as the death of a loved one, a serious illness, or a national recession. In such cases, the best way to cope with stress is to accept things as they are. Acceptance may be difficult, but in the long run, it’s easier than railing against a situation you can’t change.

Don’t try to control the uncontrollable. Many things in life are beyond our control, particularly the behavior of other people. Rather than stressing out over them, focus on the things you can control such as the way you choose to react to problems.

Look for the upside. When facing major challenges, try to look at them as opportunities for personal growth. If your own poor choices contributed to a stressful situation, reflect on them and learn from your mistakes.

Learn to forgive. Accept the fact that we live in an imperfect world and that people make mistakes. Let go of anger and resentments. Free yourself from negative energy by forgiving and moving on.

Share your feelings. Expressing what you’re going through can be very cathartic, even if there’s nothing you can do to alter the stressful situation. Talk to a trusted friend or make an appointment with a therapist.

Speak to a Licensed Therapist

BetterHelp is an online therapy service that matches you to licensed, accredited therapists who can help with depression, anxiety, relationships, and more. Take the assessment and get matched with a therapist in as little as 48 hours.

When you’re stressed, the last thing you probably feel like doing is getting up and exercising. But physical activity is a huge stress reliever—and you don’t have to be an athlete or spend hours in a gym to experience the benefits. Exercise releases endorphins that make you feel good, and it can also serve as a valuable distraction from your daily worries.

While you’ll get the most benefit from regularly exercising for 30 minutes or more, it’s okay to build up your fitness level gradually. Even very small activities can add up over the course of a day. The first step is to get yourself up and moving. Here are some easy ways to incorporate exercise into your daily schedule:

• Put on some music and dance around.
• Take your dog for a walk .
• Walk or cycle to the grocery store.
• Use the stairs at home or work rather than an elevator.
• Park your car in the farthest spot in the lot and walk the rest of the way.
• Pair up with an exercise partner and encourage each other as you work out.
• Play ping-pong or an activity-based video game with your kids.

Using mindful rhythmic exercise to manage stress

While just about any form of physical activity can help burn away tension and stress, rhythmic activities are especially effective. Good choices include walking, running, swimming, dancing, cycling, tai chi, and aerobics. But whatever you choose, make sure it’s something you enjoy so you’re more likely to stick with it.

While you’re exercising, make a conscious effort to pay attention to your body and the physical (and sometimes emotional) sensations you experience as you’re moving. Focus on coordinating your breathing with your movements, for example, or notice how the air or sunlight feels on your skin. Adding this mindfulness element will help you break out of the cycle of negative thoughts that often accompanies overwhelming stress.

Learn to manage your time better

Poor time management can cause a lot of stress. When you’re stretched too thin and running behind, it’s hard to stay calm and focused. Plus, you’ll be tempted to avoid or cut back on all the healthy things you should be doing to keep stress in check, like socializing and getting enough sleep. The good news: there are things you can do to achieve a healthier work-life balance.

Don’t over-commit yourself. Avoid scheduling things back-to-back or trying to fit too much into one day. All too often, we underestimate how long things will take.

Prioritize tasks. Make a list of tasks you have to do, and tackle them in order of importance. Do the high-priority items first. If you have something particularly unpleasant or stressful to do, get it over with early. The rest of your day will be more pleasant as a result.

Break projects into small steps. If a large project seems overwhelming, make a step-by-step plan. Focus on one manageable step at a time, rather than taking on everything at once.

Delegate responsibility. You don’t have to do it all yourself, whether at home, school, or on the job. If other people can take care of the task, why not let them? Let go of the desire to control or oversee every little step. You’ll be letting go of unnecessary stress in the process.

Reach out and connect to people who make you feel good

There is nothing more calming than spending quality time with another human being who makes you feel safe and understood. In fact, face-to-face interaction triggers a cascade of hormones that counteracts the body’s defensive “fight-or-flight” response. It’s nature’s natural stress reliever (as an added bonus, it also helps stave off depression and anxiety). So make it a point to connect regularly—and in person—with family and friends.

[Read: Social Support for Stress Relief]

Keep in mind that the people you talk to don’t have to be able to fix your stress. They simply need to be good listeners. And try not to let worries about looking weak or being a burden keep you from opening up. The people who care about you will be flattered by your trust. It will only strengthen your bond.

Of course, you may not always have someone close by to lean on when you feel overwhelmed by stress, but by building and maintaining a network of close friends you can improve your resiliency to life’s stressors.

Tips for building relationships

• Reach out to a colleague at work.
• Help someone else by volunteering .
• Have lunch or coffee with a friend.
• Ask a loved one to check in with you regularly.
• Call or email an old friend.
• Go for a walk with a workout buddy.
• Schedule a weekly dinner date.
• Meet new people by taking a class or joining a club.
• Confide in a clergy member, teacher, or sports coach.
• Join a support group—either in-person or via on online therapy platform .

Beyond a take-charge approach and a positive attitude, you can reduce stress in your life by carving out “me” time. Don’t get so caught up in the hustle and bustle of life that you forget to take care of your own needs. Nurturing yourself is a necessity, not a luxury. If you regularly make time for fun and relaxation, you’ll be in a better place to handle life’s stressors.

Set aside leisure time. Include rest and relaxation in your daily schedule. Don’t allow other obligations to encroach. This is your time to take a break from all responsibilities and recharge your batteries.

Do something you enjoy every day. Make time for leisure activities that bring you joy, whether it be stargazing, playing the piano, or working on your bike.

Keep your sense of humor. This includes the ability to laugh at yourself. The act of laughing helps your body fight stress in a number of ways.

Take up a relaxation practice. Relaxation techniques such as yoga, meditation, and deep breathing activate the body’s relaxation response , a state of restfulness that is the opposite of the fight or flight or mobilization stress response. As you learn and practice these techniques, your stress levels will decrease and your mind and body will become calm and centered.

In addition to regular exercise, there are other healthy lifestyle choices that can increase your resistance to stress.

Eat a healthy diet . Well-nourished bodies are better prepared to cope with stress, so be mindful of what you eat. Start your day right with breakfast, and keep your energy up and your mind clear with balanced, nutritious meals throughout the day.

Reduce caffeine and sugar. The temporary “highs” caffeine and sugar provide often end with a crash in mood and energy. By reducing the amount of coffee, soft drinks, chocolate, and sugar snacks in your diet , you’ll feel more relaxed and you’ll sleep better.

Avoid alcohol, cigarettes, and drugs. Self-medicating with alcohol or drugs may provide an easy escape from stress, but the relief is only temporary. Don’t avoid or mask the issue at hand; deal with problems head on and with a clear mind.

Get enough sleep. Adequate sleep fuels your mind, as well as your body. Feeling tired will increase your stress because it may cause you to think irrationally.

Tips for reducing stress in the moment

When you’re frazzled by your morning commute, stuck in a stressful meeting at work, or fried from another argument with your spouse, you need a way to manage your stress levels right now . That’s where quick stress relief comes in.

The fastest way to reduce stress is by taking a deep breath and using your senses—what you see, hear, taste, and touch—or through a soothing movement. By viewing a favorite photo, smelling a specific scent, listening to a favorite piece of music, tasting a piece of gum, or hugging a pet, for example, you can quickly relax and focus yourself.

[Read: Quick Stress Relief]

Of course, not everyone responds to each sensory experience in the same way. The key to quick stress relief is to experiment and discover the unique sensory experiences that work best for you.

More Information

• Special Health Report - Special Health Report from Harvard Medical School on Stress. (Harvard Health)
• Tolerating Distress - Workbook and information sheets to help you manage feelings of distress. (Centre for Clinical Interventions)
• How To Relax (Video) - Video to help you ease stress. (Mind)
• Trauma- and Stressor-Related Disorders. (2013). In Diagnostic and Statistical Manual of Mental Disorders . American Psychiatric Association. Link
• Can, Yekta Said, Heather Iles-Smith, Niaz Chalabianloo, Deniz Ekiz, Javier Fernández-Álvarez, Claudia Repetto, Giuseppe Riva, and Cem Ersoy. “How to Relax in Stressful Situations: A Smart Stress Reduction System.” Healthcare 8, no. 2 (April 16, 2020): 100. Link
• Norelli, Samantha K., Ashley Long, and Jeffrey M. Krepps. “Relaxation Techniques.” In StatPearls . Treasure Island (FL): StatPearls Publishing, 2021. Link
• Toussaint, Loren, Quang Anh Nguyen, Claire Roettger, Kiara Dixon, Martin Offenbächer, Niko Kohls, Jameson Hirsch, and Fuschia Sirois. “Effectiveness of Progressive Muscle Relaxation, Deep Breathing, and Guided Imagery in Promoting Psychological and Physiological States of Relaxation.” Evidence-Based Complementary and Alternative Medicine 2021 (July 3, 2021): e5924040. Link
• Unger, Cynthia A, David Busse, and Ilona S Yim. “The Effect of Guided Relaxation on Cortisol and Affect: Stress Reactivity as a Moderator.” Journal of Health Psychology 22, no. 1 (January 1, 2017): 29–38. Link
• Singh, Karuna. “Nutrient and Stress Management.” Journal of Nutrition & Food Sciences 6, no. 4 (2016). Link
• Katsarou, Alexia L., Marios M. Vryonis, Athanassios D. Protogerou, Evangelos C. Alexopoulos, Apostolos Achimastos, Dimitrios Papadogiannis, George P. Chrousos, and Christina Darviri. “Stress Management and Dietary Counseling in Hypertensive Patients: A Pilot Study of Additional Effect.” Primary Health Care Research & Development 15, no. 1 (January 2014): 38–45. Link
• Errisuriz, Vanessa L., Keryn E. Pasch, and Cheryl L. Perry. “Perceived Stress and Dietary Choices: The Moderating Role of Stress Management.” Eating Behaviors 22 (August 1, 2016): 211–16. Link
• Choi, Dong-Woo, Sung-Youn Chun, Sang Ah Lee, Kyu-Tae Han, and Eun-Cheol Park. “Association between Sleep Duration and Perceived Stress: Salaried Worker in Circumstances of High Workload.” International Journal of Environmental Research and Public Health 15, no. 4 (April 2018): 796. Link
• Blaxton, Jessica M., Cindy S. Bergeman, Brenda R. Whitehead, Marcia E. Braun, and Jessic D. Payne. “Relationships Among Nightly Sleep Quality, Daily Stress, and Daily Affect.” The Journals of Gerontology: Series B 72, no. 3 (May 1, 2017): 363–72. Link
• Saleh, Dalia, Nathalie Camart, Fouad Sbeira, and Lucia Romo. “Can We Learn to Manage Stress? A Randomized Controlled Trial Carried out on University Students.” PLOS ONE 13, no. 9 (September 5, 2018): e0200997. Link
• Loprinzi, Paul D., and Emily Frith. “Protective and Therapeutic Effects of Exercise on Stress-Induced Memory Impairment.” The Journal of Physiological Sciences: JPS 69, no. 1 (January 2019): 1–12. Link
• Salmon, P. “Effects of Physical Exercise on Anxiety, Depression, and Sensitivity to Stress: A Unifying Theory.” Clinical Psychology Review 21, no. 1 (February 2001): 33–61. Link

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Why stress happens and how to manage it

Stress is a natural reaction to specific demands and events, but ongoing stress can affect a person’s health and wellbeing. Tips for managing stress include exercise, setting priorities, counseling, and more.

These demands can come from work, relationships, financial pressures, and other situations, but anything that poses a real or perceived challenge or threat to a person’s well-being can cause stress.

Stress can be a motivator, and it can even be essential to survival. The body’s fight-or-flight mechanism tells a person when and how to respond to danger. However, when the body becomes triggered too easily, or there are too many stressors at one time, it can undermine a person’s mental and physical health and become harmful.

What is stress?

Stress is the body’s natural defense against predators and danger. It causes the body to flood with hormones that prepare its systems to evade or confront danger. People commonly refer to this as the fight-or-flight mechanism.

When humans face a challenge or threat, they have a partly physical response. The body activates resources that help people either stay and confront the challenge or get to safety as fast as possible.

The body produces larger quantities of the chemicals cortisol, epinephrine, and norepinephrine. These trigger the following physical reactions:

• increased blood pressure
• heightened muscle preparedness

These factors all improve a person’s ability to respond to a potentially hazardous or challenging situation. Norepinephrine and epinephrine also cause a faster heart rate.

Environmental factors that trigger this reaction are called stressors. Examples include noises, aggressive behavior, a speeding car, scary moments in movies, or even going out on a first date. Feelings of stress tend to increase in tandem with the number of stressors.

According to the American Psychological Association (APA)’s annual stress survey in 2018, average stress levels in the United States were 4.9 on a scale from 1 to 10. The survey found that the most common stressors were employment and money .

Mental health resources

Visit our dedicated hub for more research-backed information and resources on mental health and well-being.

Physical effects

Stress slows down some normal bodily functions, such as those that the digestive and immune systems perform. The body can then concentrate its resources on breathing, blood flow, alertness, and the preparation of the muscles for sudden use.

The body changes in the following ways during a stress reaction:

• blood pressure and pulse rise
• breathing speeds up
• digestive system slows down
• immune activity decreases
• muscles become more tense
• sleepiness decreases due to a heightened state of alertness

How a person reacts to a difficult situation will determine the effects of stress on overall health. Some people can experience several stressors in a row or at once without this leading a severe stress reaction. Others may have a stronger response to a single stressor.

An individual who feels as though they do not have enough resources to cope will probably have a stronger reaction that could trigger health problems. Stressors affect individuals in different ways.

Some experiences that people generally consider to be positive can lead to stress, such as having a baby, going on vacation, moving to a better home, and getting a promotion at work.

The reason for this is that they typically involve a significant change, extra effort, new responsibilities, and a need for adaptation. They also often require a person to take steps into the unknown.

A person may look forward to an increased salary following a promotion, for example, but wonder whether they can handle the extra responsibilities.

A persistently negative response to challenges can have an adverse effect on health and happiness.

For example, a 2018 review of studies found associations between work-related stress and coronary heart disease. Despite this, the authors could not confirm the exact mechanisms through which stress causes coronary heart disease.

Other literature has shown that people who perceive stress as having a negative effect on their health may be at higher risk for coronary heart disease than those who do not.

However, being more alert to the effects of stress may help a person manage it more effectively and cope better.

The National Institute of Mental Health (NIMH) recognize two types of stress: acute and chronic. These require different levels of management.

The NIMH also identify three examples of types of stressor:

• routine stress, such as childcare, homework, or financial responsibilities
• sudden, disruptive changes, such as a family bereavement or finding out about a job loss
• traumatic stress, which can occur due to extreme trauma as a result of a severe accident, an assault, an environmental disaster, or war

Acute stress

This type of stress is short-term and usually the more common form of stress. Acute stress often develops when people consider the pressures of events that have recently occurred or face upcoming challenges in the near future.

For example, a person may feel stressed about a recent argument or an upcoming deadline. However, the stress will reduce or disappear once a person resolves the argument or meets the deadline.

Acute stressors are often new and tend to have a clear and immediate solution. Even with the more difficult challenges that people face, there are possible ways to get out of the situation.

Acute stress does not cause the same amount of damage as long-term, chronic stress. Short-term effects include tension headaches and an upset stomach , as well as a moderate amount of distress.

However, repeated instances of acute stress over an extended period can become chronic and harmful.

Chronic stress

This type of stress develops over a long period and is more harmful.

Ongoing poverty, a dysfunctional family, or an unhappy marriage are examples of situations that can cause chronic stress. It occurs when a person can see no way to avoid their stressors and stops seeking solutions. A traumatic experience early in life may also contribute to chronic stress.

Chronic stress makes it difficult for the body to return to a normal level of stress hormone activity, which can contribute to problems in the following systems :

• cardiovascular
• respiratory
• reproductive

A constant state of stress can also increase a person’s risk of type 2 diabetes, high blood pressure, and heart disease. Depression, anxiety, and other mental health disorders, such as post-traumatic stress disorder (PTSD) , can develop when stress becomes chronic.

Chronic stress can continue unnoticed, as people can become used to feeling agitated and hopeless. It can become part of an individual’s personality, making them constantly prone to the effects of stress regardless of the scenarios that they encounter.

People with chronic stress are at risk of having a final breakdown that can lead to suicide, violent actions, a heart attack , or stroke .

People react differently to stressful situations. What is stressful for one person may not be stressful for another, and almost any event can potentially cause stress. For some people, just thinking about a trigger or several smaller triggers can cause stress.

There is no identifiable reason why one person may feel less stressed than another when facing the same stressor. Mental health conditions, such as depression , or a building sense of frustration, injustice, and anxiety can make some people feel stressed more easily than others.

Previous experiences may affect how a person reacts to stressors.

Common major life events that can trigger stress include:

• job issues or retirement
• lack of time or money
• bereavement
• family problems
• moving home
• relationships, marriage, and divorce

Other commonly reported causes of stress are:

• abortion or pregnancy loss
• driving in heavy traffic or fear of an accident
• fear of crime or problems with neighbors
• pregnancy and becoming a parent
• excessive noise, overcrowding, and pollution
• uncertainty or waiting for an important outcome

Some people experience ongoing stress after a traumatic event, such as an accident or some kind of abuse. Doctors will diagnose this as PTSD.

Those who work in stressful jobs, such as the military or the emergency services, will have a debriefing session following a major incident, and occupational healthcare services will monitor them for PTSD.

Symptoms and complications

The physical effects of stress can include:

• pain in the back or chest
• cramps or muscle spasms
• nervous twitches
• pins and needles sensations

A 2012 study found that the stressors that parents experience, such as financial troubles or managing a single-parent household, may also lead to obesity in their children.

Emotional reactions can include:

• concentration issues
• a feeling of insecurity
• forgetfulness
• irritability
• nail biting
• restlessness

Stress-associated behaviors include :

• food cravings and eating too much or too little
• sudden angry outbursts
• drug and alcohol misuse
• higher tobacco consumption
• social withdrawal
• frequent crying
• relationship problems

If stress becomes chronic, it can lead to several complications, including

• heart disease
• high blood pressure
• lower immunity against diseases
• muscular aches
• sleeping difficulties
• stomach upset
• erectile dysfunction (impotence) and loss of libido

A doctor will typically diagnose stress by asking an individual about their symptoms and life events.

Diagnosing stress can be challenging because it depends on many factors. Doctors have used questionnaires, biochemical measures, and physiological techniques to identify stress. However, these may not be objective or effective.

The most direct way to diagnose stress and its effects on a person is through a comprehensive, stress-oriented, face-to-face interview.

Treatment includes self-help and, when an underlying condition is causing stress, certain medications.

Therapies that may help a person relax include aromatherapy and reflexology.

Some insurance providers cover this type of treatment. However, it is important for people to check coverage with their provider before pursuing this treatment. Knowing the details about a potential treatment can help prevent it from adding to any ongoing stress.

Doctors will not usually prescribe medications for coping with stress, unless they are treating an underlying illness, such as depression or an anxiety disorder.

In such cases, they may prescribe an antidepressant . However, there is a risk that the medication will only mask the stress, rather than help the person deal with it. Antidepressants can also have adverse effects, and they may worsen some complications of stress, such as low libido .

Developing coping strategies before stress becomes chronic or severe can help an individual manage new situations and maintain their physical and mental health.

People who are already experiencing overwhelming stress should seek medical assistance.

People may find that the following lifestyle measures can help them manage or prevent stress-induced feelings of being overwhelmed.

• Exercise: A 2018 systematic review of animal studies found that exercise can reduce memory impairment in subjects with stress, although studies on humans are necessary to confirm this.
• Reducing the intake of alcohol, drugs, and caffeine: These substances will not help prevent stress, and they can make it worse.
• Nutrition: A healthful, balanced diet containing plenty of fruit and vegetables can help maintain the immune system at times of stress. A poor diet can lead to ill health and additional stress.
• Priority management: It may help to spend a little time organizing a daily to-do list and focusing on urgent or time sensitive tasks. People can then focus on what they have completed or accomplished for the day, rather than on the tasks they have yet to complete.
• Time: People should set aside some time to organize their schedules, relax, and pursue their own interests.
• Breathing and relaxation: Meditation, massage, and yoga can help. Breathing and relaxation techniques can slow down the heart rate and promote relaxation. Deep breathing is also a central part of mindfulness meditation.
• Talking: Sharing feelings and concerns with family, friends, and work colleagues may help a person “let off steam” and reduce feelings of isolation. Other people may be able to suggest unexpected, workable solutions to the stressor.
• Acknowledging the signs: A person can be so anxious about the problem causing the stress that they do not notice the effects on their body. It is important to be mindful of any changes.

Noticing signs and symptoms is the first step to taking action. People who experience work stress due to long hours may need to “take a step back.” It may be time for them to review their working practices or talk to a supervisor about finding ways to reduce the load.

Most people have an activity that helps them relax, such as reading a book, going for a walk, listening to music, or spending time with a friend, loved one, or pet. Joining a choir or a gym also helps some people relax.

The APA encourage people to develop networks of social support, for example, by talking to neighbors and others in the local community or joining a club, charity, or religious organization.

Those who often feel as though they do not have the time or energy for hobbies should try some enjoyable new activities that make them feel good. People can turn to their support network if they need ideas.

Being part of a group can reduce the risk of stress developing and provide support and practical help when challenging circumstances develop.

People who find that stress is affecting their daily life should seek professional help. A doctor or psychiatric specialist can often help, for example, through stress management training.

Stress management techniques

Stress management can help by:

• removing or changing the source of stress
• altering how a person views a stressful event
• lowering the effects that stress might have on the body
• learning alternative ways of coping

Stress management therapy pursues one or more of these approaches.

People can develop their stress management techniques by using self-help books or online resources. Alternatively, they can attend a stress management course.

A counselor or psychotherapist can connect an individual who has stress with personal development courses or individual and group therapy sessions.

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• Mental Health
• Anxiety / Stress
• Psychology / Psychiatry

How we reviewed this article:

• 5 things you should know about stress. (n.d.). https://www.nimh.nih.gov/health/publications/stress/index.shtml
• American Psychological Association. (2018). APA Stress in America™ survey: Generation Z stressed about issues in the news but least likely to vote [Press release]. https://www.apa.org/news/press/releases/2018/10/generation-z-stressed
• Cartwright, C., et al.  (2016). Long-term antidepressant use: Patient perspectives of benefits and adverse effects. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4970636/
• Loprinzi, P. D., & Frith, E. (2019). Protective and therapeutic effects of exercise on stress-induced memory impairment [Abstract]. https://www.ncbi.nlm.nih.gov/pubmed/30203315
• Manage stress: Strengthen your support network. (n.d.). http://www.apa.org/helpcenter/emotional-support.aspx
• Nabi, H., et al. (2013). Increased risk of coronary heart disease among individuals reporting adverse impact of stress on their health: the Whitehall II prospective cohort study. https://academic.oup.com/eurheartj/article/34/34/2697/617400
• Parks, E. P., et al. (2012). Influence of stress in parents on child obesity and related behaviors. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3483892/
• Robinson, L., et al. (2019). Relaxation techniques for stress relief. https://www.helpguide.org/articles/stress/relaxation-techniques-for-stress-relief.htm
• Sara, J. D., et al. (2018). Association between work‐related stress and coronary heart disease: A review of prospective studies through the job strain, effort‐reward balance, and organizational justice models. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6015274/
• Stress effects on the body. (n.d.). http://www.apa.org/helpcenter/stress.aspx
• Student guide to surviving stress and anxiety in college & beyond. https://www.learnpsychology.org/student-stress-anxiety-guide/

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What is the psychology of stress (a definition)​, video: the psychology of stress.

Why Is the Psychology of Stress Important?​

• Health and Well-being: Chronic stress can lead to health problems, such as cardiovascular issues, weakened immune systems, cancer, gastrointestinal disorders, and mental health disorders like anxiety and depression (Mariotti, 2015). Understanding the psychological aspects of stress helps identify its triggers , effects, and coping mechanisms, ultimately promoting better overall health and well-being . 
• Coping Strategies: By studying stress psychology, researchers can identify effective coping strategies that help us manage stress in healthy ways. 
• Resilience: Understanding the psychology of stress can help us build resilience . Resilience is the ability to bounce back from adversity, and it plays a crucial role in how individuals handle stressors. 
• Workplace Productivity: Stress affects work performance, job satisfaction, and employee well-being. Employers can benefit from understanding stress psychology to create supportive work environments, reduce stressors, and implement effective stress management programs (Bickford, 2005).
• Relationships: Stress can strain personal relationships, impacting communication and emotional connections. By understanding the psychological aspects of stress, we can develop empathy , communication skills , and support strategies to maintain healthier relationships.
• Public Health: Stress-related health issues can have a significant impact on public health systems and costs. Understanding the psychology of stress helps guide the design of targeted interventions and public health campaigns to address stress-related health concerns.
• Performance and Learning: Stress can affect cognitive functioning and academic performance. Understanding stress psychology in educational settings can lead to the development of better learning environments and support systems for students.
• Preventive Medicine: By studying the potential psychological impact of stress, individuals and healthcare providers can take proactive steps to prevent stress-related health issues from escalating.
• Self-awareness and Self-care: Understanding stress psychology enables us to be more self-aware, recognizing our stress triggers and patterns. This awareness empowers us to engage in self-care practices and seek support when needed.

Psychology of Stress & the Lazarus Theory

• Primary appraisal: During primary appraisal, we assess the significance of the stressor. We determine whether the stressor is irrelevant, benign, or stressful. If the stressor is perceived as stressful, it moves on to the secondary appraisal.
• Secondary appraisal: After identifying a situation as stressful, we evaluate our coping resources and options for dealing with the stressor. We assess our ability to handle the situation and the potential strategies we can employ. Coping strategies can be problem-focused (aimed at directly addressing the stressor) or emotion-focused (aimed at managing emotional reactions to the stressor).  ​
• Irrelevant: An irrelevant appraisal might be that missing the deadline doesn’t matter since it won’t impact your career, so you don’t feel stressed. 
• Benign: With a benign appraisal, you might see the deadline as a challenge but also as an opportunity to show off your skills. So, it doesn’t feel particularly stressful. 
• Stressful: If you’re worried about not meeting expectations , potential consequences, or the workload required, then you’ll view the situation as stressful. Since you’ve evaluated the situation as stressful, this brings you to the secondary appraisal where you consider coping strategies.
• Problem-focused: You break the project into smaller tasks and create a detailed plan. You allocate specific time blocks for each task and set priorities .
• Emotion-focused: You might also engage in emotion-focused coping, such as taking short breaks to manage your stress levels, practicing relaxation techniques , or venting to a friend.  ​

Psychological Stress Causes

• Work & family: We often experience stress when we feel like we can’t handle all the demands placed on us. This type of pressure typically comes from a demanding job or feeling overwhelmed trying to meet the needs of friends and family members.
• Finances : Common financial stressors include, struggling with debt, not making enough money to live comfortably, and unexpected expenses.
• Health issues: This includes dealing with a chronic condition of your own or worrying about the health of a loved one.
• Major life events: The Holmes and Rahe Stress Scale is a well-known measure of how much stress we typically feel from different life events. It ranks these events on a scale from 1 to 100, with the death of a spouse topping the list at 100. Of course, we can experience plenty of stress from other less dramatic events like moving, getting married, or having a baby.  
• Academic pressure : Stress among students is common due to academic performance expectations, exams, and assignments.
• Social pressures: This includes societal expectations, discrimination, or feeling the need to conform to certain norms.
• Technology and information overload: Constant exposure to technology, social media, and the 24/7 news cycle can lead to overwhelm.
• Uncertainty about the future: Fear of the unknown, whether it's related to personal or global events, can cause stress and anxiety.

Psychological Stress Factors

• Health behaviors: Smoking, alcohol or drug use, overeating (Cheon et al., 2020).
• Poor sleep : Both sleeping too little and too much are associated with increased stress. (Cheon et al., 2020)
• Loneliness: Studies show loneliness increases your level of perceived stress (Cacioppo et al., 2006). In addition, not having strong social support makes it harder to cope with stress. 
• Poor body image: A study showed that having a poor body image creates psychological stress. Interestingly, the image you have of your body has a greater effect on stress than being over (or under) weight (Cheon et al., 2020). This is an example of how our interpretations of ourselves and the world can affect stress levels.
• Genetics: Certain personality types may be more prone to experiencing stress such as those of us that tend toward perfectionism and pessimism , or have difficulty coping with change. These traits are partially linked to genetics (Luo et al., 2017).
• Trauma and abuse: Past traumatic experiences, such as physical or emotional abuse, can have long-lasting effects on a person's stress levels. 
• Environmental stressors : It’s pretty easy to imagine how things like living in a high-crime area or dealing with natural disasters would be huge contributors to stress.  ​

Psychological Stress Reactions​

• Fight-or-flight response : Most of us have heard of this traditional view of the body's stress response, where the body prepares itself to confront a threat or flee from it. During this response, stress hormones like adrenaline and cortisol are released, heart rate increases, and energy is diverted to essential functions.
• Challenge response: Stress can be perceived in a positive light when viewed as a challenge rather than a threat. When people see a stressful situation as an opportunity to grow and rise to the occasion, their body's physiological response can become more adaptive. This can lead to increased focus, motivation , and resilience.
• Tend-and-befriend response: In addition to fight-or-flight, McGonigal proposes that there is another stress response that is more common in women and some men. The "tend-and-befriend" response involves seeking social support and connection during times of stress. This response can lead to the release of oxytocin, a hormone that promotes bonding and reduces stress. You may have heard it referred to as the “cuddle hormone” because it’s released when we’re affectionate. 
• Freeze or tonic immobility: In some situations, people may experience a state of immobility or "freezing" when faced with overwhelming stress or trauma. This response is observed in animals when they play dead in response to predators. In humans, it might manifest as feeling paralyzed or unable to take action during highly stressful events.

Psychological Stress Physical Symptoms

• Muscle tension and pain: When we’re under stress, we automatically tense muscles. When the stress is chronic, it can lead to tension headaches, neck pain, back pain, and overall muscle aches (American Psychological Association, 2023).
• Sleep disturbances:   When under stress, many people have trouble falling asleep or staying asleep. Or at the other end of the spectrum, some sleep too much.
• Difficulty breathing: Shortness of breath and rapid breathing are signs of stress (Chu et al., 2022). This is especially true if stress rises to the level that it triggers a panic attack.
• Heart Palpitations and Chest Pain: Stress can cause the heart to beat faster or irregularly, leading to palpitations and chest discomfort. I know someone who thought she was having a heart attack and went to the hospital only to be told it was a panic attack.
• Digestion troubles: Stress can disrupt the normal functioning of the digestive system leading to symptoms such as stomach pain, bloating, and nausea. It’s also associated with changes in gut bacteria which can influence mood (American Psychological Association, 2023).
• Headaches and Migraines: Stress can trigger or worsen headaches in people who are susceptible (American Psychological Association, 2023). 
• Cardiovascular disease: Chronic stress is associated with an increased risk of hypertension, heart attacks, and stroke (American Psychological Association, 2023).
• Compromised immune system: Prolonged stress can weaken the immune system, making you more susceptible to infections and illnesses (American Psychological Association, 2023).

Video: Stress and Your Body: Psychology of Stress

The Psychological Stress Scale

Psychological stress and the coping process, psychological stress management techniques.

• If possible, find a quiet place to sit or lie down.
• Keep your spine upright if sitting or straight if lying down. 
• Close your eyes or keep your gaze soft and still.
• Direct your attention to your breath. Breathe normally, taking soft smooth inhalations and exhalations.
• When your attention drifts away from your breath and to whatever is stressing you out, notice that, and gently move your attention back to the breath.
• Repeat. Do this for at least 10 minutes or longer if possible, but even a couple of minutes can help.
• Regular Exercise: A study found that people who exercise regularly are less affected by stressful situations than people who don’t exercise. It makes us more resilient to stress (Childs & de Wit, 2014).
• Healthy Diet: Eating a balanced, clean diet with plenty of fruits, vegetables, and whole grains can support your body in dealing with stress.
• Adequate Sleep: Ensuring you get enough quality sleep is vital for stress management . Sleep allows the body and mind to recharge and recover. If you have trouble getting to sleep or staying asleep, there are lots of resources that advise on “sleep hygiene”. Some of this advice includes keeping a consistent sleep schedule, staying off devices before bedtime, avoiding large meals, establishing a relaxing bedtime routine, and exercising regularly (AASM, 2021).
• If possible, find a quiet place to sit or lie down. 
• First, take a normal breath. 
• Then take a slow, smooth inhalation, through your nose, allowing your chest and abdomen to expand as you feel your lungs fill with air. 
• When you reach the top, exhale slowly and smoothly through your mouth (or your nose if that feels more natural). 
• You can do several in a row, or take a normal breath in between. 
• Social Support: Talking to friends, family, or a support group can help you share your feelings and reduce emotional stress. And having strong social support can make you more resilient against the negative effects of stress (Ozbay et al., 2007).
• Time Management: Organizing your time and setting realistic goals can reduce feelings of being overwhelmed.
• Stress Journaling: Keeping a journal can help you identify sources of stress and develop healthier coping mechanisms. At the least, you get it out there instead of continually internalizing it.
• Limiting Caffeine and Alcohol : High caffeine and alcohol intake can exacerbate stress and anxiety.
• Relaxation Techniques : Engaging in activities like reading, listening to music, taking a warm bath, or spending time in nature can help you relax and unwind.
• Progressive Muscle Relaxation: This technique involves tensing and relaxing muscle groups to promote physical and mental relaxation. Numerous studies suggest this is a useful way to reduce stress (Toussaint et al., 2021).
• Mindful Walking : Taking a walk while staying aware of your surroundings can be a meditative and calming experience. A study showed participants who participated in a mindful walking program had reduced psychological stress symptoms and improved quality of life compared to the control group who didn’t participate in the program (Teut et al., 2013).

Psychological Stress Treatment

• Psychotherapy: If stress becomes overwhelming or chronic, seeking guidance from a mental health professional, such as a therapist or counselor, can be beneficial. Talking to a supportive and understanding therapist can provide a safe space to express feelings and gain insights into stress triggers and coping strategies.
• Cognitive-Behavioral Therapy (CBT): CBT is a widely used form of therapy that helps individuals identify and change negative thought patterns and behaviors contributing to stress. It aims to replace unhealthy coping strategies with healthier ones.
• Mindfulness-Based Stress Reduction (MBSR): MBSR combines mindfulness meditation and yoga techniques to help individuals become more aware of their thoughts and emotions and learn to manage stress in a non-judgmental way.
• Medication: In some cases, healthcare professionals may prescribe medications such as antidepressants or anti-anxiety drugs to help manage stress and related symptoms. However, medication is usually used in conjunction with therapy .
• Therapeutic yoga: Many studies demonstrate the potential benefits of yoga for stress management (Woodyard, 2011). When I became a yoga teacher, I learned about specific sequences of poses that promote calm . In most of the poses, the head is below your heart, which reduces blood pressure and triggers a relaxation response. In addition, paying close attention to what is going on in your body when practicing yoga can serve to disrupt stressful thought patterns.
• Biofeedback: This technique involves using electronic devices to monitor and gain control over certain bodily functions (e.g., heart rate, muscle tension) to promote relaxation.
• Acupuncture: While not conclusive, there is some evidence suggesting acupuncture may help reduce stress. Some studies indicate it does this by reducing the levels of stress hormones and increasing the release of endorphins, which are the body’s natural painkillers and mood enhancers. It’s now even covered by some insurance policies.

The Psychological Stress Performance Curve

Articles Related to  The Psychology of Stress

• Eustress: Definition, Causes, & Characteristics
• Stressing Out: Definition, Symptoms, & How to Stop
• Stress Relief: Activities, Exercises, & Tips ​​ ​​ ​​ ​​​​ ​​ ​

Books Related to The Psychology of Stress

• The Upside of Stress: Why Stress Is Good for You, and How to Get Good at It
• Stress The Psychology of Managing Pressure: Practical Strategies to turn Pressure into Positive Energy
• Practical Police Psychology: Stress Management And Crisis Intervention for Law Enforcement

Final Thoughts on The Psychology of Stress​

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• AASM. (2021, April 2). Healthy sleep habits . Sleep Education. https://sleepeducation.org/healthy-sleep/healthy-sleep-habits/ 
• American Psychological Association. (2023, March 8). Stress effects on the body.  
• Algorani, E. B., & Gupta, V. (2023, April 24). Coping mechanisms - statpearls - NCBI bookshelf . Coping Mechanisms. https://www.ncbi.nlm.nih.gov/books/NBK559031/ 
• Bickford, M. (2005). Stress in the Workplace: A General Overview of the Causes, the Effects, and the Solutions. Canadian Mental Health Association Newfoundland and Labrador Division , 44 .
• Cacioppo, J. T., Hughes, M. E., Waite, L. J., Hawkley, L. C., & Thisted, R. A. (2006). Loneliness as a specific risk factor for depressive symptoms: cross-sectional and longitudinal analyses. Psychology and aging , 21 (1), 140.
• Cheon, Y., Park, J., Jeong, B. Y., Park, E. Y., Oh, J. K., Yun, E. H., & Lim, M. K. (2020). Factors associated with psychological stress and distress among Korean adults: the results from Korea National Health and Nutrition Examination Survey. Scientific reports , 10 (1), 15134.
• Childs, E., & De Wit, H. (2014). Regular exercise is associated with emotional resilience to acute stress in healthy adults. Frontiers in physiology , 161.
• Lazarus, R. S., & Folkman, S. (1987). Transactional theory and research on emotions and coping. European Journal of personality , 1 (3), 141-169.
• Luo, J., Derringer, J., Briley, D. A., & Roberts, B. W. (2017). Genetic and environmental pathways underlying personality traits and perceived stress: Concurrent and longitudinal twin studies. European Journal of Personality , 31 (6), 614-629.
• Chu, B., Marwaha, K., Sanvictores, T., & Ayers, D. (2022, September 12). Physiology, stress reaction - statpearls - NCBI bookshelf . National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK541120/ 
• Mariotti, A. (2015). The effects of chronic stress on health: new insights into the molecular mechanisms of brain–body communication. Future science OA , 1 (3).
• McGonigal, K. (2016). The upside of stress: Why stress is good for you, and how to get good at it . Penguin.
• Ozbay, F., Johnson, D. C., Dimoulas, E., Morgan Iii, C. A., Charney, D., & Southwick, S. (2007). Social support and resilience to stress: from neurobiology to clinical practice. Psychiatry (edgmont) , 4 (5), 35.
• Teut, M., Roesner, E. J., Ortiz, M., Reese, F., Binting, S., Roll, S., ... & Brinkhaus, B. (2013). Mindful walking in psychologically distressed individuals: A randomized controlled trial. Evidence-Based Complementary and Alternative Medicine , 2013 .
• Toussaint, L., Nguyen, Q. A., Roettger, C., Dixon, K., Offenbächer, M., Kohls, N., ... & Sirois, F. (2021). Effectiveness of progressive muscle relaxation, deep breathing, and guided imagery in promoting psychological and physiological states of relaxation. Evidence-Based Complementary and Alternative Medicine , 2021 .
• Woodyard, C. (2011). Exploring the therapeutic effects of yoga and its ability to increase quality of life. International journal of yoga , 4 (2), 49.
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Managing Anxiety, Assignment & Exam Stress

Let’s start with the good news - experiencing some amount of stress or anxiety is an indication that you’re human. It’s how your body reacts to the demands and challenges it faces. It is natural to feel anxious prior to an exam or stressed while juggling assignment prep. 

While stress and anxiety can sometimes be overwhelming,  they can also be an energising and healthy pressure that encourages you to grow your capabilities and take control of your situation.

So how can you strike a balance between too little an too much stress? This blog will cover some techniques you can utilise to help reduce and manage your stress and anxiety levels during assignment periods and leading up to your exams. 

Slow Down to Speed Up 

When you're feeling overwhelmed, it's easy to fall into the trap of thinking that working harder and longer is the only solution. However, this can actually lead to burnout and a decline in your performance. By taking the time to slow down and prioritize your health, you can recharge your batteries and approach your work with renewed focus and energy.

There are many ways to slow down and take care of yourself, such as practising mindfulness, exercising regularly, getting enough sleep, and eating a healthy diet. These activities may seem like luxuries when you're under the pressure of exams and assignments, but they are essential for maintaining your mental and physical health.

Remember that your grades or your academic achievements do not define you. Taking care of yourself is a crucial part of your journey as a student, and it will ultimately help you achieve your goals in a more sustainable and fulfilling way. So, take a deep breath, slow down, and prioritize your health and well-being - it's the best investment you can make in your academic and personal success.

Early Bird or Night Owl?

Not everyone is the same, and no one size fits all when it comes to the best time of day for productivity.  And it’s unproductive to try and force yourself to study when your focus and productivity levels are low.  You are better off trying to try and use those times as your downtime to relax,  catch up with friends,  exercise,  or do something you enjoy, and then make use of the times that work best for you.

Ask yourself these two questions:

• When during the day do I have the greatest amount of energy and concentration?
• When do I have the fewest interruptions and distractions?

For some, that might be first thing in the morning. For others, they might find the mornings challenging and have a habit of procrastinating until midday anyway. So rather than making yourself feel guilty for procrastinating, schedule in that time as downtime and kick off your studying session at midday.

Messy Workspace, Messy Headspace

The physical environment of your workplace has a  significant effect on the way that you work. Cluttered spaces can have negative effects on our stress and anxiety levels,  as well as our ability to focus, our eating choices, and even our sleep.

A Good Routine

Hopefully, you already have a good routine in place, but if not, there has never been a better time to start. Self-care doesn’t have to cost a lot of money or take up heaps of time. Start with the basics, making sure you get enough sleep,  drink enough water, eat regular meals and snacks,  and get in some movement or time outdoors. Then look to build on this through self-care that helps you to relax. Remember - relaxing is not one activity. It’s the outcome of that activity and how it makes you feel. And what works for your friends may not work for you. Experiment and see what works best for you!  From journaling,  reading,  different types of exercise,  stretching, and meditating, the options are endless.  Pay attention to how you feel after each activity. Ask yourself, does this make me feel grounded and at ease? If so, schedule some time each day to help you shake off the tension of studying or to unwind after an exam.

Sleep! 

Not only can sleep deprivation worsens anxiety, but getting enough sleep is vital to feeling and performing your best,  which is particularly important around exam time. Don’t stay up late the night before or get up too early on the morning of. A good night’s sleep is more valuable than a few hours of revision.

Write Down Worries  

It’s been proven that if you take a few moments to write about your fears just before you take an exam, it will help to reduce your anxiety and improve your performance. Write down what you are stressed about, why you are stressed, and what the outcome would be if those  worries were realised.  By writing down your worries,  it can help you to put everything into perspective and help you to feel lighter and less tense by emptying your worries from your mind and onto the paper.

Move your Body  

You don’t need to run a marathon every day, but the movement is just as key to a healthy mind as it is to a healthy body. Exercise is considered healthy stress on the body,  which  can actually help your body fight off the effects of stress. Exercise in almost any form can act as a stress reliever.

Reach Out for Support 

Having people to lean on is great for your mental health. Make sure you let those close to you know if you are feeling overwhelmed or preparing for an upcoming exam. Not only can they help to support you emotionally, but they can also be on hand to help you in other ways (healthy study snacks, anyone!). If you don’t feel as though you have people in your life that understand your stress and anxiety,  that’s what  TalkCampus is for!  Jump onto their global community and chat with other students that get it.

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16 Effective Stress-Management Activities and Worksheets

The interview is in 10 minutes, yet I want to run away.

Sound familiar?

Fear and anxiety lead to stress responses – cognitive, physical, and behavioral.

Deeply embedded and automatic, they evolved to provide humans with warnings, guiding present and future behavior while attempting to maintain a relatively stable internal state known as homeostasis (Brosschot, Verkuil, & Thayer, 2016; Varvogli & Darviri, 2011).

However innate these responses may be, there are ways to manage the stress you perceive.

This article offers our favorite stress-management activities and worksheets to help you deal with whatever challenge lies in your path.

Before you continue, we thought you might like to download our three Stress & Burnout Prevention Exercises (PDF) for free . These science-based exercises will equip you and those you work with, with tools to manage stress better and find a healthier balance in your life.

This Article Contains:

A note on stress-management approaches, keeping a digital stress diary with quenza, our 3 favorite stress-management worksheets, 3 activities to help manage stress, stress management within therapy sessions.

• Worksheets for Your CBT Sessions

3 Printable Tools for Children

Top 3 exercises for helping students, for group therapy sessions, a take-home message.

Stress, or rather the perception of stressors, can be managed, and there are ways to do so:

• Preparation increases our sense of control and improves confidence.
• Relaxation reduces anxiety and restores focus.
• Maintaining physical health via a healthy lifestyle, balanced diet, and exercise underpins overall mental wellbeing.

Another way to manage stress is to reframe our perception of it.

Rather than see it as unwelcome and to be avoided, pressure can provide an essential opportunity for development and learning. Viewed as an opportunity to thrive, stress can be the motivation to perform at our very best and adopt a growth mindset (Lee, Park, & Hwang, 2016).

In what follows, we will point you toward a range of useful worksheets and tools you can use to help your clients better manage stress. Most are free, but some of these come from our own Positive Psychology Toolkit© , which is a comprehensive subscription-based resource containing more than 400 exercises, activities, interventions, questionnaires, and assessments you can use to support your clients.

If you’re looking for more ways to grow your coaching or therapy practice using engaging, science-backed tools, be sure to check it out.

Despite the dangers of experiencing prolonged stress, many of us are likely to be tuned out to our body’s signals that we are experiencing stress.

Likewise, we may not have stopped to consider the factors in our lives that are most responsible for causing us stress.

To help strengthen your clients’ awareness of the drivers and experience of stress, consider inviting them to complete a one-week stress diary.

The purpose of a stress diary is to help them look for patterns and insights into the most common causes of stress in their life and their reactions to stressful events. From here, you can help your clients find effective ways of dealing with stress in the future.

For a great, easy-to-administer tool, consider taking a look at the Stress Diary tool available via the blended care app Quenza .

The platform features a growing library of pre-programmed psychoeducational activities, within which is the Stress Diary Pathway. This pathway invites clients to reflect on the day’s stressful experiences for eight days and culminates in an in-depth reflection into the patterns of stressors, as well as the client’s reactions to these across the eight days.

Download 3 Free Stress & Burnout Prevention Exercises (PDF)

These detailed, science-based exercises will equip you or your clients with tools to manage stress better and find a healthier balance in their life.

Download 3 Stress & Burnout Prevention Exercises Pack (PDF)

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A 2022 report found that in the UK alone, 17 million working days were lost due to stress, depression, and anxiety.

But help is at hand.

Multiple, evidence-based stress reduction techniques have been shown to lower stress levels, “ resulting in a reduction of disease symptoms, lowering of biological indicators of disease, prevention of disease and improvement of patient’s quality of life ” (Varvogli & Darviri, 2011).

Many of these techniques are described below and will help you to manage stress in your life.

1. Breath Awareness

Breathing exercises can be a powerful way to place your body in a relaxed state. Sitting in a comfortable position and drawing your attention to your breath can release tension and offer a method for ongoing relaxation and a tool to use for times of stress.

Breath Awareness was created to help individuals cultivate a mindful awareness of their breathing and the present moment rather than get caught up in their thoughts.

Once comfortable, clients are asked to release any unnecessary tension and tune in to their breath. They are invited to observe the movements and sensations in their body with each inhale and exhale, without trying to change anything.

The exercise can be useful during moments of distress to unhook someone from their thoughts or as a mindfulness exercise.

Try out the Breath Awareness worksheet and practice it daily.

2. Anchor Breathing

Similar to the last activity, anchor breathing involves inhaling and exhaling consciously while focusing on the physical experience. In this exercise, clients are also instructed to imagine a peaceful scene – being on a boat, feeling calm and safe.

Deep breathing techniques have been shown to lead to decreased oxygen consumption and heightened alertness. EEG recordings have also recorded increases in theta wave amplitude when participants engage in certain deep breathing exercises, which is associated with reduced symptoms of generalized anxiety disorder (Jerath, Edry, Barnes, & Jerath, 2006).

By showing patients how combine mindful breathing with calming, peaceful visualization, Anchor Breathing  provides an effective relaxation technique, reducing residual stress levels and providing support during acute episodes of stress (Varvogli & Darviri, 2011).

3. The Five Senses Worksheet

Mindfulness can be cultivated by paying attention to what we observe and feel while using our different senses one at a time. During mindfulness practice, distractions are observed, and attention is gently returned to the body part receiving focus.

This exercise works in a similar way to the Body Scan exercise, which helps clients cultivate a mindful awareness of different body parts. Evidence from functional magnetic resonance imagining found that body scan meditation heightens brain activity linked to increased awareness of the present moment, focus, and stress reduction (Sevinc et al., 2018).

To read more about the steps involved, you can view or download The Five Senses worksheet .

If you’re looking for more tools, our free Mindfulness Exercises Pack  includes the popular Leaves on a Stream tool and audio meditation, as well as two other mindfulness tools and audio files that you can download for free.

1. Nature effect

The powerful effect of being outdoors has been validated many times and should not be underestimated.

Visitors to a park in Zurich were found to have significantly lower levels of stress, a reduced number of headaches, and a 40% increase in feelings of wellbeing. These positive effects were further elevated in those taking part in sports (Hansmann, Hug, & Seeland, 2007).

While drugs and therapy are often used as treatments for soldiers returning home with post-traumatic stress disorder, the medications and treatment frequently have to be continued for many years without providing a lasting cure. In response, nature-based therapy has begun to receive increased scientific attention.

In a 2016 study, veterans reported that merely being in the garden, often performing mindfulness activities, could improve the symptoms of their post-traumatic stress disorder (Poulsen, Stigsdotter, Djernis, & Sidenius, 2016).

The simple act of getting out into an open space can provide stress relief. We delve deeper into this in our post on Environmental Psychology .

2. Exercise

We are all aware of the physiological rewards of exercise, but the psychological benefits are equally impressive and backed up by research.

A seven-week exercise program was found to improve people’s moods ; reduce perceived stress; and increase optimism, self-belief , resilience, and a growth mindset (Cassidy, 2016).

Exercise regimes need not be extreme to be effective. Even modest levels of physical activity if performed regularly provide ongoing support for mental wellbeing, a growth mindset, and reduced levels of stress.

A great way to inspire you to start exercising may be found in our article on Mindful Running and Exercises .

3. Mindful movement

By replacing or combining some of our everyday car journeys with walking, we can become fully present in our day-to-day lives and improve mental health.

Indeed, a trial in 2017 found that combining walking with relaxation techniques is a great way to reduce levels of stress (Matzer, Nagele, Lerch, Vajda, & Fazekas, 2017).

Mindful walking combines the benefits of exercise, nature, and mindfulness.

Its goal is not to reach a destination, but to build an awareness of the moment, using the feet to anchor in the present. Pleasant and unpleasant bodily sensations such as muscle soreness are merely observed without opinion and let go.

3-Minute stress management: reduce stress with this short activity – Therapy in a Nutshell

Many people seek help when stress makes healthy living difficult. Therapy can help address immediate difficulties and work on the underlying causes (Strauss et al., 2018).

1. Anxiety Record

We often feel more vulnerable when we are asked to share what is making us anxious. The Anxiety Record worksheet helps individuals to understand what is causing their anxiety and learn appropriate coping skills.

Using this worksheet, clients can record their anxieties, triggers, and their effects. Afterward, they are guided through a breathing exercise and asked to revisit their answers to the questions.

A few prompts from this exercise are listed below:

• When do you feel anxious?
• What thoughts are you having before or during feeling anxious?
• Do you think these thoughts are realistic?
• What thoughts could you replace them with?

Click to download the Anxiety Record worksheet and give it a try.

2. Biofeedback training

Biofeedback builds on the concept of homeostasis introduced earlier. Using technology to measure and report brainwaves, skin temperature, breathing, and heart rate, the individual learns how to gain self-control over apparently involuntary bodily functions.

A recent meta-analysis of 24 studies confirmed that biofeedback training led to improvements in coping and offers a promising approach for treating stress and anxiety (Goessl, Curtiss, & Hofmann, 2017).

Individuals can ultimately learn to control their heart rate and blood pressure, reduce levels of stress, and even successfully treat high blood pressure and cardiac disease. Performed with a qualified therapist, these changes ultimately persist beyond the therapy (Varvogli & Darviri, 2011).

Worksheet Suggestions for Your CBT Sessions

Many of us experience spontaneous thoughts as images rather than individual words or an internal conversation (Beck & Beck, 2011).

A child pictures an angry parent, and an employee imagines a demanding boss. They can be powerful, representing moments of fear or anxiety, and can be used in Cognitive-Behavioral Therapy (CBT) sessions.

The following questions can form the basis of a conversation to explore a mental image and the individual’s relationship with it, cognitively restructuring its interpretation.

Imagery can feel as real to the mind as being in the situation, so playing through images in advance can restructure thoughts and emotions and reframe the stress.

2. Daily Exceptions Journal

A journal can be a fruitful way to track life’s ups and downs. Positive CBT encourages monitoring the client’s strengths and the positive outcomes of life rather than focusing on the negatives.

By capturing what went well in a Daily Exceptions Journal, it is possible to identify and record the skills and talents for reuse in other areas of your life.

Subsequently, walking through the journal during therapy reinforces successes, provides praise, and encourages discussion of the problems overcome.

Sensory awareness involves paying attention to a specific sensory aspect of the body. It can be a great way to teach mindfulness to children.

Such activities can also improve focus, increase self-awareness , help regulate emotions , and reduce anxiety.

1. The Raisin Meditation

The following exercise is a fun, palpable way for a child to develop mindfulness as a skill and notice the present.

Work through the Raisin Meditation worksheet following the steps with the child, paying attention to each sense in turn.

Children paying increased attention to their senses can learn to improve their focus and feel calmer.

2. Nature Play

Ongoing research has recognized the importance of playing and spending time outdoors on children’s mental wellbeing (Dankiw, Tsiros, Baldock, & Kumar, 2020).

Practicing underused senses such as sound can heighten a sense of awareness and promote mindfulness. This can be especially true in an unfamiliar environment, including walking through the countryside with family.

The questions can be tailored to the environment. Starting or pausing somewhere relatively quiet may assist the child’s focus more at the start.

Print the Nature Play worksheet here.

3. Anchor Breathing

Anchor breathing can be quickly learned and helps a child to focus their mind on one point.

Such mental training offers a valuable method for gaining perceived self-control and reducing stress.

The Anchor Breathing method also works with hands placed gently on the belly or in front of the nose.

The following three examples, along with the activities described above, can be learned quickly and implemented into a student’s daily routine to help manage both acute and chronic stress.

1. Urge Surfing

Coping with (often self-destructive) urges can be difficult, especially in times of stress. Such behavior can become a crutch, making us feel like we are taking control, when in reality, we are relinquishing it.

The Urge Surfing worksheet is available with a subscription to the Positive Psychology Toolkit© . Backed up by scientific research, mindful self-acceptance can teach individuals to observe their cravings rather than act upon them.

2. Meditation on the Soles of the Feet

Meditation on the Soles of the Feet  provides a safe space to work on managing strong emotions and regulating the urge to be aggressive , often a byproduct of stressful situations (Kruk, Halász, Meelis, & Haller, 2004).

The individual is not asked to stop angry thoughts – anger does serve a useful purpose at times – but rather to bring them under control through a shift of focus.

The client, standing or sitting with their feet on the ground, is asked to cast their mind back to a time that caused them to react very angrily. Then they are told to stick with those angry thoughts, letting them flow without hindrance. After that, they shift their attention to the soles of their feet.

Stretching and moving their toes, they feel the texture of their socks, the surface of the ground, or the insole in their shoes. They maintain focus, breathing naturally until feeling calm and in control.

Learning to manage anger more effectively reduces stress and anxiety, and increases feelings of control.

The full exercise is accessible with a subscription to the Positive Psychology Toolkit© .

3. Mindfulness

Working through the Leaves on a Stream and anchor breathing techniques, which are part of our free Mindfulness Exercises Pack , will help students focus awareness on the present moment and acknowledge and accept their feelings, thoughts, and emotions.

Research has identified the benefits of combining mindfulness and group therapy to help manage stress and increase resilience and positivity (Seyyed Moharrami, Pashib, Tatari, & Mohammadi; Babakhani, 2017).

Here is an example of a group exercise in mindfulness.

Walking Down the Street

The ability to observe, rather than react to, thoughts, emotions, and sensations is central to positive psychology.

The challenge is that the event and our thoughts about it are far from being the same.

The steps involved in the following exercise can be performed individually or in a group exercise, where everyone benefits from hearing one another’s thoughts.

Walking through the scene and discussing it in the group can help to develop positive behavioral change by separating thoughts and feelings from impulses and actions and, importantly, shape feelings while breaking a negative cycle of thinking.

17 Exercises To Reduce Stress & Burnout

Help your clients prevent burnout, handle stressors, and achieve a healthy, sustainable work-life balance with these 17 Stress & Burnout Prevention Exercises [PDF].

Created by Experts. 100% Science-based.

Resources from PositivePsychology.com

Building resilience helps clients bounce back from stressful situations and use coping mechanisms to turn them into opportunities for growth.

The Realizing Resilience Masterclass© provides guidance, along with a set of practical tools, to build a more resilient mindset.

If you’re looking for more science-based ways to help others manage stress without spending hours on research and session prep, this collection contains 17 validated stress management tools for practitioners. Use them to help others identify signs of burnout and create more balance in their lives.

Stress does not have to rule us. Stress should not be allowed to prevent us from doing what we want or need to do.

Instead, stress should be an enabler and drive us forward to build what we want and take on challenges that will allow us to grow.

There should be no excuse to hide from stress or become overwhelmed by it.

By using tools for coping and taking control, we can see stress as something natural that can invigorate and motivate us to overcome both planned and unexpected challenges.

These activities we shared will definitely help you manage stress. However, there are many other stress-management techniques to try out too. Identify those that work for you and implement them into your life. You will reap the benefits, especially before the next job interview or presentation.

Thank you for reading!

We hope you enjoyed reading this article. Don’t forget to download our three Stress & Burnout Prevention Exercises (PDF) for free .

• Arch, J. J., & Mitchell, J. L. (2015). An Acceptance and Commitment Therapy (ACT) group intervention for cancer survivors experiencing anxiety at re-entry. Psycho-Oncology, 25 (5), 610–615.
• Beck, J., & Beck, A. (2011). Cognitive behavior therapy: Basics and beyond. Guilford Press.
• Bergstrom, C. (2018). Ultimate mindfulness activity book: 150 mindfulness activities for kids and teens (and grown-ups too!). Blissful Kids.
• Babakhani, K. (2017). The effectiveness of cognitive-behavioral therapy group on self-efficacy and quality of life of women with breast cancer. Multidisciplinary Cancer Investigation , 1 (1).
• Brosschot, J. F., Verkuil, B., & Thayer, J. F. (2016). The default response to uncertainty and the importance of perceived safety in anxiety and stress: An evolution-theoretical perspective. Journal of Anxiety Disorders, 41 , 22–34.
• Cassidy, T. (2016). Psychological benefits of adhering to a programme of aerobic exercise. Clinical and Experimental Psychology, 2 (2).
• Dankiw, K. A., Tsiros, M. D., Baldock, K. L., & Kumar, S. (2020). The impacts of unstructured nature play on health in early childhood development: A systematic review. PLoS One, 15 (2).
• De Vibe, M., Solhaug, I., Tyssen, R., Friborg, O., Rosenvinge, J. H., Sørlie, T., & Bjørndal, A. (2013). Mindfulness training for stress management: A randomized controlled study of medical and psychology students. BMC Medical Education, 13 (107).
• Goessl, V. C., Curtiss, J. E., & Hofmann, S. G. (2017). The effect of heart rate variability biofeedback training on stress and anxiety: A meta-analysis. Psychological Medicine, 47 (15), 2578–2586.
• Hansmann, R., Hug, S., & Seeland, K. (2007). Restoration and stress relief through physical activities in forests and parks. Urban Forestry & Urban Greening, 6 (4), 213–225.
• Jerath, R., Edry, J. W., Barnes, V. A., & Jerath V. (2006). Physiology of long pranayamic breathing: Neural respiratory elements may provide a mechanism that explains how slow deep breathing shifts the autonomic nervous system. Medical Hypotheses ,  67 (3), 566–571.
• Kruk, M. R., Halász, J., Meelis, W., & Haller, J. (2004). Fast positive feedback between the adrenocortical stress response and a brain mechanism involved in aggressive behavior. Behavioral Neuroscience, 118 (5), 1062–1070.
• Lee, C. S., Park, S. U., & Hwang, Y. K. (2016). The structural relationship between mother’s parenting stress and child’s wellbeing: The mediating effects of mother’s growth mindset and hope. Indian Journal of Science and Technology, 9 (36).
• Matzer, F., Nagele, E., Lerch, N., Vajda, C., & Fazekas, C. (2017). Combining walking and relaxation for stress reduction: A randomized cross-over trial in healthy adults. Stress and Health , 34 (2), 266–27.
• Poulsen, D. V., Stigsdotter, U. K., Djernis, D., & Sidenius, U. (2016). ‘Everything just seems much more right in nature’: How veterans with post-traumatic stress disorder experience nature-based activities in a forest therapy garden. Health Psychology Open, 3 (1).
• Sevinc, G., Hölzel, B. K., Hashmi, J., Greenberg, J., McCallister, A., Treadway, M., … Lazar, S. W. (2018). Common and dissociable neural activity after mindfulness-based stress reduction and relaxation response programs. Psychosomatic Medicine , 80 (5), 439–451.
• Seyyed Moharrami, I., Pashib, M., Tatari, M., & Mohammadi, S. (2017). The efficiency of stress management group therapy in job‌ stress and self-efficacy of nurses. Journal of Torbat Heydariyeh University of Medical Sciences, 5 (1), 42–49
• Strauss, C., Gu, J., Pitman, N., Chapman, C., Kuyken, W., & Whittington, A. (2018). Evaluation of mindfulness-based cognitive therapy for life and a cognitive behavioral therapy stress-management workshop to improve healthcare staff stress: Study protocol for two randomized controlled trials. Trials , 19 (209).
• Varvogli, L. & Darviri, C. (2011). Stress management techniques: Evidence-based procedures that reduce stress and promote health. Health Science Journal , 5 , 74–89.

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What our readers think.

The resources was very helpful. thanks.

Interesting article although I wasn‘t able to open the links as it sent me to a site saying I had to purchase a toolkit in order to access them! I don‘t know why I get sent emails with resources that I‘m unable to access. Shame!

Glad you found the article interesting, and I’m sorry our distinction between the free and paid resources here is not as clear as it could be — I’ll flag this with our editor. Yes, some of the resources listed are freely available while others are available to subscribers of the Positive Psychology Toolkit . However, the three resilience exercises mentioned at the beginning are free and should instantly arrive in your inbox and be available to use.

– Nicole | Community Manager

These will be most helpful with the Native American population I serve

Very practical exercises of relaxation. True we have to rule ourselves not left to unnecessary stress which consequently results in low well being and reduce quality of life. Thank you Jeremy

Very helpful and easy to understand and practice documents. Grateful.

The article was more helpful and am looking forward to read more of this kind.

Hi Moses, So glad you found the resources helpful. Another great tool for dealing with stress is journaling, which you can read up about in our dedicated article here. – Nicole | Community Manager

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What Is Stress and How Can I Recognize It?

Risk factors.

• Health Consequences
• When to Seek Help

Stress is your body's natural response to physical and psychological challenges or threats. During moments of stress, the body releases two hormones called epinephrine (adrenaline) and cortisol that trigger a chain of events to help you better cope with stressful situations.

Stress can be a positive thing, helping you overcome obstacles and push yourself to new levels of personal growth.

But when stress is persistent, it can be damaging to your health, reducing your immune response, increasing your risk of certain infections, raising your blood pressure and risk of heart disease, and sapping your concentration, energy levels, and overall sense of well-being.

The article describes the different types of stress and how they impact you physically and emotionally. It also looks at some of the complications of stress and ways to reduce stress if it is affecting your health and quality of life.

Illustration by Laura Porter for Verywell Health

Types of Stress

Stress can be short-lasting, long-lasting, or come and go. While stress is often considered "bad" and something you need to manage, it can be beneficial in certain situations.

Stress can be broadly described as:

• Acute stress : This is stress that comes on abruptly and resolves once the perceived or actual threat is resolved. Acute stress can occur when faced with a traumatic situation but can also be something that gradually builds over time and suddenly comes to a head.
• Chronic stress : This is stress that is persistent or recurrent. It can be triggered by ongoing emotional distress or an illness or medical condition that you are managing. If left unchecked, chronic stress can have serious health consequences.
• Episodic acute stress : This is when someone experiences intense stress on a routine basis. It is common in people who face high-stress situations, such as law enforcement officers, firefighters, and soldiers on wartime duty.
• Eustress : This is the term for beneficial stress. Eustress is associated with excitement or motivation, such as riding a rollercoaster or starting a new job. Once the immediate stress eases, there is often a feeling of accomplishment.

Signs of Stress

Stress is regulated by the autonomic nervous system . This is a part of the nervous system that oversees involuntary functions like heart rate, respiration, blood pressure, and digestion. During moments of extreme stress, it also triggers the "fight-or-flight" response.

The fight-or-flight response is characterized by the spontaneous release of epinephrine and cortisol. These hormones trigger physiological and psychological changes to prepare you to either face or flee from the threat, whether real or perceived.

It does so by temporarily redirecting the body's resources—like blood, oxygen, and glucose (blood sugar)—away from non-essential organs (like the stomach, intestines, and bladder) to essential ones (like the muscles and eyes). These changes are responsible for the functional signs of stress.

Common signs of stress include:

• Rapid heartbeat
• Rapid breathing
• Muscle tension
• Flush or pale skin
• Dilated pupils
• Agitation or feeling on edge
• Trembling or shaking
• Sudden sweating (including sweaty palms)
• Queasy stomach
• Weak bladder or a sudden urge to pee

Once the threat is gone, the body will release other hormones, such as oxytocin , to bring epinephrine and cortisol back in check.

Symptoms of Too Much Stress

If stress is chronic, it can lead to a broader range of potentially disruptive symptoms. This is because the overload of cortisol and epinephrine can not only amplify the physiological symptoms of stress but also start to affect the brain, triggering psychological symptoms.

Symptoms of chronic stress may include:

• A pounding headache
• Heart palpitations
• Chest pains
• Muscle spasms and cramps
• Back and shoulder pain
• Nausea and vomiting
• Shortness of breath
• Forgetfulness
• Loss of concentration
• Daytime sleepiness
• Disorganized or racing thoughts
• Emotional outbursts
• Panicky feelings
• Ringing in the ears
• Numbness in the fingers and toes
• Changes in appetite (eating too much or not at all)
• Depression and anxiety

Many of these symptoms can also occur when acute stress is severe, such as during a panic attack . Sometimes, the symptoms come on so quickly and profoundly that it may seem like you're having a heart attack .

It is also possible to get a "stress rash" when the body is spontaneously flooded with cortisol and epinephrine. This can trigger an inflammatory reaction and the release of a chemical called histamine that instigates allergic reactions, In some people with extreme stress, this can lead to itching and hives ( urticaria ).

Causes of Stress

The body's stress response system is called the hypothalamic-pituitary-adrenal axis (HPA axis) . When faced with a stressor (a situation that causes stress), a part of the brain called the  hypothalamus sends a chemical message to the pituitary gland which, in turn, instructs the  adrenal glands to start secreting cortisol and epinephrine.

There are two broad categories of stressors: physiological stressors and psychological stressors.

Physiological and psychological stressors can also overlap. For instance, a physiological stressor such as a chronic illness can cause psychological stress, further amplifying symptoms.

Examples of stressors include;

Extreme temperatures

Strenuous physical activity

Injury or pain

Chronic illness

Acute infections

Being overworked

A noisy or chaotic environment

Relationship problems

Financial problems

Trouble at work or school

Loss and grief

Worry about the future

Heavy traffic

We are all wired to feel stress, but certain factors can predispose you to unhealthy levels of stress, including:

• Being over 50
• Being a caregiver to an ill family member
• Living with depression
• Being raised in a stressful family environment
• Being a victim of crime or abuse
• Living in a high-crime neighborhood
• Living with chronic illness
• Living in poverty
• Having financial problems
• Being socially isolated
• Have an alcohol or substance abuse problem

Related Conditions and Complications

The long-term effects of uncontrolled stress can take a toll on your health. Chronic stress is characterized by sustained high blood pressure , which not only affects your heart but all other organs connected to the circulatory system.

Chronic stress can also affect your sense of well-being, which also has health consequences.

Over time, uncontrolled stress can contribute to:

• Atherosclerosis (hardening of the arteries)
• Coronary artery disease (which increases the risk of heart attack or stroke)
• Type 2 diabetes
• Stomach ulcers
• Major depression
• Anxiety disorders

Is Stress a Mental Illness?

Stress is not a mental illness, but it can contribute to mental illness. Persistently high levels of cortisone—referred to as hyperadrenocorticism —have been independently linked to an increased risk of anxiety disorders, bipolar disorder , and major depressive disorder (MDD) .

Treatments and Ways to Cope With Stress

Managing stress is key to avoiding long-term health problems. Depending on your levels of stress and general coping skills, you may be able to manage on your own. In other instances, you may benefit from working with a healthcare provider or mental health specialist.

You can’t always avoid stress, but you can manage it by making healthy lifestyle choices, including:

• Exercising regularly : Exercise not only makes you feel better but also boosts "feel-good" hormones called endorphins . Just 30 minutes of walking per day can lift your spirits and improve your cardiovascular health.
• Setting goals : Establish what you intend to achieve for your day, week, and month. Setting priorities will help you feel more in control.
• Being practical : Be realistic about what you can achieve. While stress can be beneficial within limits, overtaxing yourself can undermine your health. Focus on what is truly important to you and adjust your goals to maintain a healthy work-life balance.
• Staying positive : At the end of a stressful day, don't just drop into bed and try to forget about it. Take a moment to think about what you’ve accomplished and not what you didn’t get done.
• Staying connected : Keep in touch with people who can provide emotional support and practical help. Ask for help from friends, family, and community or religious organizations if you are feeling overtaxed and stressed.

Mind-Body Therapies

There are many stress management tools you can turn to if you live a hectic lifestyle. Many of these approaches are endorsed by healthcare providers who understand how the mind influences the body and your overall health.

Some effective mind-body therapies for stress include:

• Deep breathing exercises
• Guided imagery
• Progressive muscle relaxation (PMR)
• Biofeedback

Psychotherapy

Psychotherapy (talk therapy) involves working with a therapist who can help you identify your sources of stress so you can better manage them. Although therapy is typically done in person, you can also have online sessions with a therapist who can see you regularly.

Different approaches may help depending on the source of your stress:

• Cognitive behavioral therapy (CBT) : This involves identifying problematic behaviors or thought patterns so you can build strategies to change them.
• Dialectical behavioral therapy (DBT) : This is a form of therapy intended for people who experience emotions very intensely.
• Family therapy
• Couples therapy

Prescription Medications

Sometimes medications are needed to help you through a stressful time. In such cases, you would need to get a prescription from your healthcare provider or a psychiatrist (rather than a therapist who cannot prescribe medications).

Some medications commonly prescribed for stress and anxiety include:

• Benzodiazepines : These are sedatives that include Valium (diazepam), Xanax (alprazolam), Klonopin (clonazepam), and Ativan (lorazepam).
• Selective serotonin reuptake inhibitors (SSRIs) : These are antidepressants that include Paxil (paroxetine), Prozac (fluoxetine), Zoloft (sertraline), and Lexapro (escitalopram).
• Serotonin-norepinephrine reuptake inhibitors (SNRIs) : These are antidepressants that include Effexor (venlafaxine), Cymbalta (duloxetine), and Pristiq (desvenlafaxine).
• Tricyclic antidepressants : These are a class of antidepressants that include Elavil (amitriptyline), Norpramin (desipramine), and Sinequan (doxepin).

When to Contact a Healthcare Provider

It can be easy to miss the signs of stress, particularly if you live a hectic lifestyle or are managing a heavy workload at work. Even so, it's important to notice the signs and take appropriate action if stress is interfering with your relationships, health, quality of life, and ability to function normally.

It may be time to see if a therapist or healthcare provider if:

• You find yourself having regular outbursts for little or no reason.
• You have trouble sleeping and are sleep-deprived .
• You have gained a lot of weight because you are stress eating.
• You have lost a lot of weight because you are too stressed to eat .
• You are drinking, smoking, or taking drugs to deal with stress.
• You find it hard to get out of bed and feel persistently on the verge of tears.
• You have panic attacks .

Stress is a natural response to physiological or psychological threats or challenges. Stress can be beneficial, helping push you to achieve more, but it can affect your health if it is extreme or chronic. Left untreated, chronic stress can contribute to heart disease, mood disorders, stomach ulcers, and diabetes.

The best way to manage stress is to live a healthy, balanced lifestyle and practice relaxation techniques like yoga, meditation, or deep breathing exercises. Psychotherapy and prescription medications (like antidepressants) can help if self-help treatments are not enough.

Centre for Studies of Human Stress. Biology of stress .

Romano A, Tempesta B, Di Bonaventura MVM, Gaetani S.  From autism to eating disorders and more: the role of oxytocin in neuropsychiatric disorders . Front Neurosci. 2015;9:497. doi:10.3389/fnins.2015.00497

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Umbrella Review: Stress Levels, Sources of Stress, and Coping Mechanisms among Student Nurses

Prelicensure nursing students face significant stress from their education and clinical placements, highlighting the crucial need for the development of effective coping mechanisms with which to manage both academic and clinical responsibilities, ultimately enhancing the wellbeing and academic performance of these students. This umbrella review aims to evaluate and synthesize existing review articles that examine stress levels and coping mechanisms among student nurses during their education and training. Five databases (PsycINFO, PubMed, CINAHL, Scopus and Web of Science) were searched for review articles published from 2010 onwards. This review includes twelve articles, encompassing 189 studies. The review findings demonstrate that student nurses experience moderate-to-high levels of stress during their nurse education. Major sources of stress include academic demands, patient care responsibilities, and interactions with nursing staff and faculty. Commonly utilized coping skills involve problem-solving behaviors, transference, and maintaining an optimistic outlook. Given the adverse consequences of stress, nurse educators play a critical role in the development of strategies with which to reduce stress and enhance coping skills among student nurses. This study was not registered.

1. Introduction

Stress and coping during nurse education and training are widely recognized as important areas of research, as nursing students often experience high levels of stress due to academic demands, clinical placements, and personal life stressors [ 1 , 2 ]. Stress, universally defined, is a physiological and psychological response to a perceived threat or challenge. It involves the body’s adaptive reactions aimed at mobilizing resources to cope with the demands of a situation. Stress can manifest as a complex interplay of physical, emotional, and behavioral changes, and its intensity varies based on individual perceptions and coping mechanisms [ 3 , 4 ]. Although stress in general is often considered harmful, when maintained at manageable levels, it can potentially offer benefits by serving as a motivational force for students, fostering resilience, and encouraging the development of effective coping strategies [ 5 ].

Numerous studies have identified common stressors in nursing students, including heavy academic workloads, time pressures, clinical placements, and personal life challenges such as financial problems and family issues [ 4 , 6 ]. Prolonged exposure to excessively high stress levels can have detrimental effects on the psychological health, academic performance, and overall wellbeing of student nurses [ 5 , 6 ]. Therefore, effective coping strategies are essential for reducing stress, promoting wellbeing, and fostering academic success among nursing students.

When faced with stress, nursing students commonly employ a combination of problem-centered coping strategies and emotion-centered coping mechanisms [ 7 , 8 ]. Problem-centered coping mechanisms involve seeking social support, managing time effectively, and engaging in active problem-solving. These strategies target the root causes of stress and provide long-term stress relief [ 8 , 9 ]. On the other hand, emotion-focused coping strategies encompass positive reinterpretation, acceptance, and mindfulness. While these strategies may help mitigate and manage the behavioral responses to stress, they offer only short-term stress reduction as they do not directly address the underlying causes of stress [ 9 , 10 ].

This umbrella review is guided by Lazarus and Folkman’s transactional model of stress and coping [ 9 ]. This influential framework emphasizes that individuals engage in coping strategies based on their appraisal of stressors, employing both problem-centered and emotion-centered mechanisms [ 9 ]. In the context of nursing students, the model provides a comprehensive lens through which to understand how they navigate stress, addressing not only the identification of stress levels and sources but also shedding light on the effectiveness of the coping mechanisms employed. By utilizing this theoretical foundation, the research aims to explore the dynamic interplay between stressors and coping strategies, offering insights applicable to the development of targeted interventions in nursing education and practice.

Over the past three decades, stress and coping in student nurses have been extensively researched, resulting in a substantial volume of individual studies and literature reviews [ 11 , 12 ]. Guided by the Joanna Briggs Institute (JBI) methodology, this umbrella review aims to examine the current state of knowledge on stress and coping in student nurses during their prelicensure programs [ 13 , 14 ].

In the context of nurse education and training, the results of this umbrella review are crucial for several reasons in the context of nursing practice for students. Firstly, understanding the specific stressors encountered by student nurses and the sources of their stress is essential for the development of targeted interventions by which to promote mental wellbeing during their education. By comprehensively synthesizing existing literature, this review aims to identify common stressors, such as academic pressures, clinical demands, and interpersonal challenges, and thus provide valuable insights for educators and institutions to tailor support mechanisms. Moreover, a detailed examination of coping mechanisms utilized by student nurses is vital for informing evidence-based strategies that can be incorporated into nursing education programs. Identifying effective coping strategies is not only beneficial for students’ mental health but also crucial for enhancing their resilience and their ability to manage stressors in their future nursing careers. This review aims to contribute to the ongoing efforts in nursing education to create environments that foster student wellbeing, reduce burnout, and ultimately cultivate a workforce that is better equipped to provide high-quality and compassionate patient care. The findings from this umbrella review have the potential to guide policy decisions, curriculum development, and support services, ultimately shaping the landscape of nursing education and practice. Despite the abundance of literature reviews examining stress and coping in students, no umbrella review synthesizing findings from previous reviews has been found to date.

The aim of this research was to conduct an umbrella review to systematically synthesize and analyze existing literature on stress levels, sources of stress, and coping mechanisms among student nurses. This overarching review seeks to provide a comprehensive understanding of the multifaceted aspects of stress experienced by student nurses during their education. Specifically, the research aimed to identify common stressors, explore variations in stress levels across different educational settings, and critically evaluate the effectiveness of coping mechanisms employed by students.

2. Materials and Methods

2.1. design.

An umbrella review is a systematic review that summarizes and evaluates the findings of multiple systematic reviews and research syntheses on a specific topic [ 15 ]. An umbrella review synthesizes and evaluates the quality, quantity, and consistency of evidence from multiple reviews, providing a broader and more reliable understanding of a specific research question or topic [ 13 ]. By integrating and summarizing the findings from various reviews, an umbrella review offers a more comprehensive and nuanced perspective on a particular field of study [ 16 ]. This type of review can be particularly valuable when guiding clinical practice and decision-making, informing clinical guidelines, public health policies, and future research directions [ 15 , 17 ].

Belbasis et al. [ 15 ] have provided a guideline for conducting an umbrella review. Their guideline includes steps such as clearly defining the research question, establishing inclusion and exclusion criteria, conducting a literature search, extracting, and analyzing data, evaluating the strength of evidence, and summarizing and presenting the data. Their result was presented using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).

2.2. Sources of Data and Search Strategy

To locate relevant literature reviews, five databases (SCOPUS, Web of Science, PubMed, CINAHL and PsychINFO) were searched using the following search terms: “student nurses” OR “prelicensure student nurses” AND “stress” OR “psychological distress” AND “coping mechanisms” OR “coping skills” AND “nurse education” OR “clinical practice” AND “integrative review” OR “systematic review” OR “scoping review” OR “literature review”. The inclusion criteria for articles were as follows: (a) peer-reviewed quantitative reviews of original studies assessing stress and coping among prelicensure nursing students, (b) published in the English language and (c) published from 2010 onwards. For the purpose of homogeneity, this review was limited to quantitative reviews. Focusing exclusively on quantitative studies in this umbrella review ensures a rigorous and systematic analysis of objective, numerical data related to stress levels, sources of stress, and coping mechanisms among student nurses. This approach allows for a standardized synthesis of evidence, enabling the identification of patterns, trends, and statistically significant associations that contribute to a more robust and generalizable understanding of the topic.

2.3. Search Outcomes

The initial search identified a total of 189 articles examining stress and coping in student nurses. These studies were then screened and filtered for duplicates, resulting in the removal of 91 reviews. The remaining 98 articles were further evaluated based on the inclusion criteria, leading to the exclusion of an additional 71 articles. The full texts of the remaining 27 articles were read, and 12 articles were found to be relevant for the review ( Figure 1 ).

Diagram of the process used to identify references for the review.

2.4. Quality Appraisal

The JBI Critical Appraisal Checklist for Systematic Review and Research Syntheses was used to assess the quality of the gathered evidence. This checklist consists of 11 items that can be answered with yes (1), no (0) or unclear (0), with a maximum score of 11. The quality of each review was categorized as low (<5.5), moderate (5.5–8), or high (9–11).

2.5. Data Extraction and Synthesis

Data extraction and synthesis were conducted by two researchers. The primary researcher, who was also the author of the study, worked alongside a second independent researcher not affiliated with the study to enhance objectivity and reliability in the process. This dual-researcher approach aimed to enhance the robustness and validity of the data extraction and synthesis process, contributing to the comprehensive analysis of stress levels, sources, and coping mechanisms among student nurses. To facilitate result comparison, a matrix table was created, and the following information was extracted: author, country, review type, databases used, number of studies included, key findings, and the quality appraisal checklist employed. The results of each review were synthesized based on the formulated research questions.

3.1. Characteristics of the Included Review Articles

Twelve reviews were included in this umbrella review. Among these, six utilized an integrative review design [ 3 , 8 , 18 , 19 , 20 , 21 ], three employed a systematic review design [ 5 , 22 , 23 ], two used a scoping review design [ 24 , 25 ], and one conducted a systematic review with a meta-analysis [ 11 ]. The number of studies included in each review ranged from 8 to 27, resulting in a total of 189 studies ( Table 1 ). The most commonly used databases for retrieving relevant articles were CINAHL, MEDLINE, Scopus and PubMed. Seven studies reported the quality appraisal checklist used to assess the methodological rigor of the reviews, with the Critical Appraisal Skills Programme (CASP) being employed in three of them. Among the 12 reviews, 2 were deemed to have moderate quality, while the remaining 10 were rated as high quality ( Table 2 ).

Summary of studies included.

NR = not reported.

JBI Critical Appraisal Checklist Criteria for Systematic Review and Research Syntheses.

Note: yes = 1; no/unclear = 0; 1 = is the review question clearly and explicitly stated?; 2 = were the inclusion criteria appropriate for the review question?; 3 = was the search strategy appropriate?; 4 = were the sources and resources used to search for studies adequate?; 5 = were the criteria for appraising studies appropriate?; 6 = was critical appraisal conducted by two or more reviewers independently?; 7 = were there methods to minimize errors in data extraction?; 8 = were the methods used to combine studies appropriate?; 9 = was the likelihood of publication bias assessed?; 10 = were recommendations for policy and/or practice supported by the reported data?; 11 = were the specific directives for new research appropriate?

3.2. Major Findings

The results of the data synthesis were categorized into four themes: (a) moderate-to-severe stress levels, (b) sources of stress, (c) frequently used coping skills, and (d) stress in relation to academic levels.

3.2.1. Moderate-to-Severe Stress Levels

Seven reviews reported stress levels in student nurses ranging from moderate [ 3 , 20 ] to severe [ 5 , 11 , 21 , 22 , 24 ]. Three of these reviews utilized an integrative design, two employed a systematic design, one used a scoping review, and one conducted a systematic review with a meta-analysis. All reviews analyzed articles on stress among students from various countries, except for the work of Labrague et al. [ 22 ], which focused specifically on Saudi Arabian student nurses, and the work of Younas [ 20 ], which included studies conducted only in Asia. Qualitative synthesis of the review results was conducted in all reviews except for that of Zheng et al. [ 11 ], who performed a meta-analysis to estimate the prevalence of psychological stress in practicing student nurses. The meta-analysis revealed a prevalence rate of 61.97%, indicating a higher prevalence of psychological stress among pre-licensure nursing students.

3.2.2. Sources of Stress

Under this theme, stress in the context of nursing education is defined as the psychological and emotional strain [ 9 ] experienced by students due to the demanding nature of academic coursework, clinical training, and interpersonal dynamics within educational settings, potentially impacting their overall wellbeing and academic performance. The top sources of stress identified in student nurses during nurse education and training were ‘academic demands’, ‘caring for patients’ and ‘interaction with nursing staff and faculty’.

Academic Stress

This subtheme pertains to the psychological strain experienced by nursing students in response to the demanding nature of their coursework, examinations, and high academic expectations, collectively referred to as academic stress [ 9 ]. Seven reviews identified ‘academic demands’ as the primary source of stress for student nurses during their education and training. Three integrative reviews identified heavy academic workloads [ 3 , 18 , 19 ] as the main stressor, while two systematic reviews [ 23 , 24 ] reported unreasonable assignments, tests, and examinations as major stressors for students. Similar findings were observed in reviews assessing stress and coping among Saudi Arabian student nurses [ 22 ] and in select Asian countries [ 20 ]. A scoping review examining stress and coping during the height of the pandemic identified academic demands and virtual learning as major stressors [ 25 ].

Stress from Caring for Patient

This subtheme encompasses the emotional and psychological strain experienced by nursing students, due to the challenges and responsibilities associated with providing care to individuals who are ill or in need of medical attention—referred to as stress from caring for patients [ 10 ]. Six reviews identified ‘caring for patients’ as the second most common source of stress for student nurses. Three integrative reviews identified caring for ill patients and dealing with families as the main sources of stress [ 8 , 18 , 19 ]. This finding was supported by a systematic review by Labrague et al. [ 22 ], in which Saudi Arabian students reported heightened psychological stress levels when caring for patients. Two scoping reviews, one conducted before the pandemic [ 24 ] and one during the pandemic crisis [ 25 ], examined clinical sources of stress among pre-licensure students. Both reviews identified stress associated with patient care as a common challenge during their clinical placements.

Stress from Interaction with Staff and Faculty

Under this subtheme, stress from interactions with staff and faculty in the context of nursing education is characterized by the emotional and psychological strain experienced by students due to challenging or negative encounters, expectations, or dynamics with nursing faculty and staff members during their academic and clinical training [ 9 ]. ‘Interaction with nursing staff and faculty’ was reported as the third most common source of stress for students during their nursing program. This stressor was identified in three integrative reviews and one scoping review. In a scoping review of 13 studies, in addition to unreasonable academic workloads, many pre-licensure students reported elevated levels of stress when interacting with nursing staff and clinical instructors [ 24 ]. This finding was supported by three integrative reviews, where interaction with nursing staff and faculty was regarded as one of the top stressors for students [ 8 , 19 , 21 ].

3.2.3. Frequently Used Coping Skills

Coping skills in the context of nursing education refer to the adaptive strategies and mechanisms employed by students to effectively manage and navigate the various stressors, challenges, and demands inherent in their academic coursework, clinical training, and interactions with faculty and staff [ 10 ]. Three distinct coping strategies were identified: problem-solving behaviors, transference, and staying optimistic.

Problem Solving Behaviors

Under this subtheme, problem-solving behaviors, as a coping strategy in nursing education, refer to the deliberate and systematic approach employed by nursing students to identify, analyze, and resolve challenges or stressors encountered during their academic and clinical training [ 9 ]. Seven review articles reported ‘problem-solving behaviors’ as the top coping strategy employed by student nurses to deal with and manage their stressors. Three of these were integrative reviews, one was a systematic review, and the remaining three were scoping reviews. These reviews, which analyzed global studies, consistently identified problem-solving behaviors as the most frequently used coping skill among nursing students [ 3 , 8 , 21 ]. A systematic review focusing on stress and coping among nursing and midwifery students found that both groups were more inclined to use desirable coping skills, including problem-solving [ 19 ]. Another systematic review conducted during the pandemic also identified seeking information, a problem-solving skill, as the most frequently used coping mechanism [ 25 ]. Two of these reviews had a narrower scope, one specific to Saudi students [ 22 ], and the work of Younas [ 20 ] focusing on Asian nursing students. In the systematic review of 13 studies conducted in Saudi Arabia, problem-solving behaviors were identified as the most frequently used coping skills, while avoidance was the least frequently used [ 22 ]. Younas [ 20 ] also found problem-solving behaviors to be the top-rated coping skills among Asian nursing students based on the analysis and appraisal of nine studies.

Transference

Transference as a coping strategy in nursing education involves the unconscious redirection of feelings, attitudes, and expectations from past experiences or relationships onto current interactions with faculty, staff, or peers [ 10 ]. Four review articles identified ‘transference’ as the second most frequently used coping strategy among student nurses. Bhurtun et al. [ 21 ] appraised and synthesized 13 studies, identifying transference as the second most frequently used coping strategy after problem-solving behaviors. Younas [ 20 ], in a study analyzing stress and coping studies in an Asian context, found that student nurses used problem-solving behaviors and transference as coping skills. McCarthy et al. [ 19 ], analyzing 25 studies, found that both midwifery and nursing students utilized transference as a way of managing academic and clinical stress. A scoping review of 13 studies conducted during the pandemic [ 25 ] also identified transference as frequently used coping during the height of the pandemic crisis.

Staying Optimistic

Staying optimistic as a coping skill involves maintaining a positive and hopeful outlook, even in the face of challenges or stressful situations [ 9 ]. This includes adopting a mindset that focuses on positive possibilities, finding silver linings, and cultivating resilience to navigate difficulties with a hopeful attitude. Three review articles reported ‘being optimistic’ as the third most frequently used coping skill when confronted with stressors during clinical placements. Staying optimistic was identified as one of the main coping skills utilized by Asian students in an integrative review by Younas [ 20 ]. Similar results were obtained in a literature review of 25 studies that measured stress and coping in nursing and midwifery students [ 19 ]. In a study examining stress and coping among student nurses during the height of the COVID-19 crisis, Majrashi et al. [ 25 ] identified staying optimistic as one of the most frequently used coping skills, alongside seeking information.

3.2.4. Stress in Relation to Academic Year Level

Three review articles assessed how stress levels change according to academic year levels. Two reviews found no apparent changes in stress levels across academic year levels [ 18 , 23 ], while one review [ 22 ] found that academic year levels were associated with heightened stress levels in students. A systematic review of 23 studies found no apparent changes in stress levels as student nurses progressed to higher academic year levels [ 23 ]. Similarly, an integrative review by Alzayyat et al. [ 18 ] found no statistical difference in stress levels among student nurses across different year levels. In contrast, a systematic review of stress and coping studies in Saudi Arabia showed higher stress levels in student nurses in higher academic year levels compared with those in lower year levels [ 22 ].

4. Discussion

4.1. key findings.

The literature has consistently identified stress as a common experience among health-related professions, with studies indicating a high prevalence of stress among this population. Earlier studies have reported that up to 80% of health profession students experience a high amount of stress during their academic years, which is supported by the findings of Liu et al. [ 1 ] and Ayaz-Alkaya and Simones [ 2 ]. Nursing students, in particular, face personal life challenges during their adolescent stage, and the nursing program itself exposes them to various stressors throughout their pre-licensure program [ 4 , 6 ]. Balancing academic studies with clinical rotations, which often involve long hours and unpredictable schedules, further contributes to the higher stress experience in student nurses. Across countries, the umbrella review reveals a relatively uniform intensity of stress, consistent sources of stress, and common coping mechanisms among student nurses. These findings underscore the global nature of challenges faced by nursing students during education and clinical training. In light of this, the implications for nursing education globally are significant, necessitating collaborative efforts to establish standardized support measures, culturally sensitive interventions, and the integration of flexible learning technologies with which to address the shared stressors experienced by nursing students worldwide.

This review identified the top stressors in student nurses, including academic demands, caring for patients, and interactions with nursing staff and faculty. Academic demands are expected to be the top stressor in nursing students due to the heavy workload of lectures, labs, clinical rotations, and assignments [ 5 ]. Clinical experiences, including caring for patients, can be emotionally and physically demanding, especially for students and new nurses. The responsibility of caring for sick and dying patients and the emotional toll of witnessing patients’ suffering can overwhelm nursing students [ 26 ]. Interactions with nursing staff and faculty can also be a potential source of stress if students feel unsupported and lack guidance in their clinical training [ 5 , 21 ]. Nursing students may feel intimidated, particularly when faced with experienced staff nurses [ 27 ]. Student nurses may perceive interactions with faculty and nursing staff as stressful due to a variety of reasons. Firstly, a lack of clear communication and expectations can create uncertainty, leading to heightened anxiety among students [ 7 ]. Additionally, disparities in power dynamics, with students often perceiving faculty and staff as authority figures, may contribute to feelings of intimidation and hinder open communication [ 8 , 9 ]. Moreover, inadequate feedback and support in clinical settings can exacerbate stress, as students may struggle to navigate challenges without sufficient guidance [ 10 ]. Addressing these issues through clear communication, supportive mentorship, and constructive feedback can help alleviate stress and enhance the overall learning experience for student nurses. This result provides support to earlier research that has identified academic demands, caring for patients, and interactions with nursing staff and faculty as top sources of stress [ 9 , 18 , 20 ].

To effectively manage and deal with these stressors, individuals should utilize coping skills that provide long-term resolutions to stress, such as problem-solving behaviors rather than emotion-focused strategies [ 28 ]. This review identified three coping strategies frequently used by student nurses: problem-solving behaviors, staying optimistic, and transference. Problem-solving behaviors and staying optimistic have been shown to be effective coping mechanisms in managing stress and challenging circumstances [ 9 , 10 ]. Optimism, which involves maintaining a positive outlook on life, helps student nurses remain motivated and resilient in difficult circumstances [ 10 , 28 ]. Problem-solving involves identifying issues, developing action plans, and implementing them, in turn enabling individuals to reduce stress and regain control [ 9 ]. These findings support prior reports that have identified problem-solving behaviors and optimism as important coping strategies for nursing and non-nursing students [ 4 , 6 ]. These findings coincide with earlier research, wherein student nurses identified these coping mechanisms as useful for dealing with and managing their stressors during nursing education and training [ 18 , 21 , 24 ]

In addition to problem-focused coping strategies, an emotion-focused strategy, including transference, was also identified as a coping mechanism used by students to deal with stressors. Transference is a psychological phenomenon that occurs when individuals unconsciously transfer feelings, attitudes, and expectations from one person or situation to another. Transference, however, is considered an undesirable coping mechanism as it can prevent individuals from developing healthy coping skills and addressing the root causes of stress [ 9 , 10 ]. Overreliance on transference can be counterproductive [ 25 ]. In nursing education, students often face demanding academic and clinical challenges that may be beyond their immediate control. Emotion-focused coping strategies become crucial as they navigate stressors like heavy workloads and high-pressure situations in healthcare settings. By teaching nursing students techniques such as mindfulness, self-care, and seeking peer support, educators can help them effectively manage their emotional responses, promoting resilience and wellbeing in the demanding context of nursing education.

Nurse faculty can promote problem-solving behaviors in nursing students by providing constructive feedback, encouragement, and modeling the use of problem-solving skills. By assisting students in identifying the root causes of their stress and brainstorming potential solutions, nurse faculty can help them effectively handle their stressors instead of projecting their emotions onto others or situations.

4.2. Limitations of the Study

A limitation of this study is that it exclusively focused on quantitative studies, thereby excluding valuable qualitative insights that could provide a deeper understanding of the subjective experiences related to stress, sources of stress, and coping mechanisms among nursing students. Additionally, the decision to restrict the review to studies published in the English language may introduce language bias, potentially omitting relevant findings from non-English literature that could offer diverse perspectives on the topic. Another limitation lies in the exclusion of articles published before 2010, which may overlook earlier research that could contribute historical context and highlight potential changes or trends in stress among nursing students over time. These limitations collectively underscore the need for future research to adopt a more inclusive approach, considering both qualitative and non-English literature, and exploring a broader timeframe to ensure a comprehensive understanding of stress in nursing education.

4.3. Future Research Directions

This umbrella review identified several critical points that can guide future literature reviews. Firstly, of the 12 reviews analyzed, 5 did not evaluate the methodological rigor of the included studies. Assessing the quality of evidence is crucial for determining the reliability and validity of research findings [ 29 ]. Without analyzing the quality of the studies, it becomes challenging to make informed decisions based on the review findings.

Meta-analysis is a powerful tool that can improve the reliability and quality of research findings, informing evidence-based practice and policy decisions [ 30 ]. In this umbrella review, only one review utilized meta-analysis to analyze the data, partly due to the heterogeneity of the included studies, such as variations in scales used. Future research synthesis should consider statistical pooling or meta-analysis for a comprehensive evaluation of the evidence.

Although this umbrella review provides evidence regarding the prevalence of stress among nursing students across countries, the studies included often lack in-depth discussions considering specific contextual nuances related to each country. Consequently, due to this limited contextual analysis, comparing differences across countries that might affect stress and coping in students becomes challenging. Recognizing the influence of varying cultural, educational, and healthcare system factors on student experiences is crucial for a comprehensive understanding of stress in nursing education, emphasizing the need for future studies to adopt a more nuanced approach in exploring and reporting results within diverse international contexts. Therefore, to advance our understanding of the nuanced factors contributing to stress among nursing students, future studies should delve into the specific contextual nuances, considering the diverse educational, cultural, and healthcare landscapes across countries, to facilitate more meaningful cross-cultural comparisons and inform tailored interventions.

Furthermore, there is a need for reviews examining the interaction between stress and coping, specifically identifying which coping skills are most effective for nursing students in dealing with their stressors. Different coping strategies may be effective depending on the situation and individual characteristics and resources [ 9 , 10 , 28 ]. This knowledge is essential to assist nurse educators in identifying potential coping strategies that could effectively reduce stress in students. Overall, enhancing the methodological rigor of reviews, conducting meta-analyses when appropriate, and exploring the specific coping skills that best assist nursing students in managing their stressors will contribute to a deeper understanding of stress and coping in this population and inform evidence-based interventions and support strategies.

5. Relevance to Nurse Education

Stress during nurse education and clinical training can potentially exacerbate the current shortage experienced by healthcare institutions worldwide. Consequently, nurse educators play a crucial role in the development of stress reduction measures and enhancing coping skills in nursing students. Given that academic demands have been identified as the primary stressor among student nurses, it is vital for nurse educators to implement measures that assist students in effectively managing their workloads and reducing stress [ 31 ]. This may involve prioritizing essential coursework and assignments, increasing flexibility, and providing academic support [ 31 ]. By strengthening coping and social support, engaging in stress-reducing activities, and seeking professional help when needed, student nurses can effectively deal with stress related to patient care and improve their overall health and wellbeing [ 18 , 23 ]. The literature has identified several theoretically based interventions that are equally effective in reducing stress among students, including mindfulness-based interventions [ 32 ], behavioral-based stress management programs [ 33 ], and evidence-based resilience interventions [ 34 ].

To strengthen positive coping skills, nurse educators should focus on building and fostering problem-focused coping strategies in students to help them effectively deal with their stressors. Evidence has shown the importance of structured orientation programs for new students and structured faculty–student mentoring programs to assist students in developing active coping skills [ 35 , 36 ]. Social support, derived from family, relatives, and friends, should be strengthened as it has been found to be helpful in protecting students from the long-term effects of stress [ 36 ]. Additionally, nurse educators can model positive coping behaviors and share their own experiences of managing stress in a healthy way, leading to improved wellbeing and increased retention [ 37 ]. Collectively, these strategies can assist student nurses in bolstering their coping abilities and effectively managing the numerous stressors encountered during nurse education and training.

6. Conclusions

This umbrella review provides a new understanding of stress in nurse education by synthesizing evidence from multiple reviews and research syntheses. Globally, the intensity of stress and coping mechanisms among student nurses exhibits variation, yet the identified sources of stress remain remarkably consistent. While stress levels range from moderate to severe across different regions, the overarching themes of academic demands, patient care responsibilities, and interactions with nursing staff and faculty persist as primary stressors for students worldwide. Commonly used coping strategies included problem-solving behaviors, transference, and maintaining optimism. This review did not establish a relationship between academic levels and stress experience among pre-licensure nursing students. This suggests a universal need for targeted interventions and support strategies to address common stressors and enhance coping mechanisms among student nurses on a global scale.

Funding Statement

This research received no external funding.

Institutional Review Board Statement

Not applicable.

Informed Consent Statement

Public involvement statement.

No public involvement in any aspect of this research.

Guidelines and Standards Statement

This manuscript was drafted against the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.

Conflicts of Interest

The author declare no conflict of interest.

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How students leverage assignment submission flexibility — a case study.

Description.

Raw data used for generating each corresponding figure from the manuscript entitled "How students leverage assignment submission flexibility — a case study." Manuscript Abstract: Recent pedagogical trends in post-secondary education focus on how providing students with greater autonomy through assignment submission flexibility offers benefits ranging from increased learning to stress reduction. Unfortunately, the relationship between submission flexibility and any specific benefit is not firmly established. One explanation for this is a potential misalignment between anticipated benefits and an understanding of how most students leverage extended opportunities for assignment completion. The goal of this study was to investigate the relationship between assignment submission flexibility and how students used the opportunity. Quantitative evidence reveals that most students routinely maximized the time taken before submitting assignments. This occurred independent of assignment type, teaching modality, or the duration assignment availability. The results support a conclusion that most students do not capitalize on increased flexibility to meet the demands of their unique schedules. Instead, they appear to adapt their schedules to submit assignments shortly before a perceived deadline. Calculations: Elapsed opportunity window — Filemaker was used to calculate an elapsed opportunity window (EOW) for each assignment type. To do so, the difference between the assignment submission and the due timestamps was divided by the difference between the availability and due timestamps. Filemaker was then used to format and export data for histogram generation using ggplot2 (https://ggplot2.tidyverse.org/), a data visualization package for the open source R programming language (https://www.r-project.org/). All statistical analysis was performed with rstatix (https://cran.r-project.org/web/packages/rstatix/index.html), a framework for basic statistical tests.

Steps to reproduce

All assignment data was collected using the Canvas LMS REST API for Quiz Submissions (https://canvas.instructure.com/doc/api/quiz_submissions.html). These datasets included information related to each assignment type (practice questions, quiz, or exam) and the time of submission. Course activity data were collected from the Canvas LMS using the New Analytics reports and course activity features. Video access activity was obtained through Kaltura using the LTI-based integration with Canvas by downloading ‘User Engagement’ data. Downloaded datasets were then automatically parsed to capture content type and access time before import into a Filemaker (https://www.claris.com/) database for storage and further analysis. In total, assignment and activity data was collected from two in-person and 5 online sections of a Introductory Cell Biology course between the Springs of 2021-2023.

Institutions

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For first-year architecture students, an assignment of consequence.

For decades, the Jim Vlock First Year Building Project has offered students at the Yale School of Architecture the opportunity to design and build a house in New Haven, creating badly needed homes for individuals and families who would otherwise struggle to afford one.

The project recently launched a multi-year partnership with the Friends Center for Children, an early-childhood care and education in New Haven, offering to design and build five adjacent houses for two of the center’s educators and their families by 2027. The partnership is part of the Friends Center’s Teacher Housing Initiative, which addresses both the crisis in childcare and affordable housing by providing 20% of the center’s educators with rent-free homes, substantially increasing their take-home pay.

Last year, Yale students designed and built the first duplex dwelling, in the Fair Haven Heights neighborhood of New Haven. In this video, we follow the Yale students throughout the year-long process, from the first site visits, through design and construction, and ultimately to the celebration of the newly completed home.

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The project, a key facet of the curriculum in the school’s professional architecture degree program, was established in 1967 when the late Charles Moore, who directed Yale’s Department of Architecture from 1965 to 1971, sought to address students’ desire to pursue architecture committed to social action. The first-of-its-kind program is now emulated by many other architecture schools.

In its early years, students traveled to sites in Appalachia to build community centers and medical facilities. Since 1989, when the project switched its focus to building affordable housing in New Haven, first-year students have designed and built more than 50 homes in the city’s economically challenged neighborhoods.

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