- Does Stress Affect Your Cholesterol?
- How Does Stress Contribute to Cholesterol?
- Can Stress impact Your Cholesterol?
- Too much worrying and stress can increase your cholesterol and your heart risk
- How does stress increase my cholesterol?
- Breaking the Chain of Stress-Related Cholesterol
- Tips to Get A Heart Healthy Handle On Stress
- Medical memo: Stress and cholesterol
- Stress and cholesterol
- A stressful study
- 4 Ways You Can Lower Your Cholesterol
- Job stress may raise our ‘bad cholesterol’ levels
- Where did the story come from?
- What kind of research was this?
- What did the research involve?
- What were the basic results?
- How did the researchers interpret the results?
- Links to the headlines
- Links to the science
- Stress and Your Heart
- Can managing stress reduce or prevent heart disease?
- What can you do about stress?
Does Stress Affect Your Cholesterol?
Coping with stress
Since there is a correlation between stress and cholesterol, preventing stress may help to prevent high cholesterol caused by it.
Long-term chronic stress is more damaging to your health and cholesterol than brief, short-term periods of stress. Lowering stress over time can help to prevent cholesterol problems. Even if you can’t cut any stress from your life, there’s options available to help manage it.
Coping with stress, whether brief or ongoing, can be difficult for many people. Coping with stress can be as simple as cutting out a few responsibilities or exercising more. Therapy with a trained psychologist can also provide new techniques to help patients manage stress.
One of the best things you can do for both stress and cholesterol is to get regular exercise. The American Heart Association recommends walking for about 30 minutes a day, but they also point out that you can get a similar level of exercise just by cleaning your house!
Of course, going to the gym is also recommended, but don’t put too much pressure on yourself to get in Olympic shape overnight. Start with simple goals, even short workouts, and increase activity over time.
Know what kind of exercise routine suits your personality. If you’re more motivated to do the same exercise at a regular time, stick with a schedule. If you get bored easily, then challenge yourself with new activities.
You can also significantly affect your cholesterol levels by eating more healthfully.
Start by reducing the saturated and trans fats in your grocery cart. Instead of red meats and processed lunch meats, choose leaner proteins like skinless poultry and fish. Replace full-fat dairy products with low- or nonfat versions. Eat plenty of whole grains and fresh produce, and avoid simple carbohydrates (sugar and white flour-based foods).
Avoid dieting and focus on simple, incremental changes. One study showed that diets and severely reduced calorie intake were actually associated with increased cortisol production, which raises your cholesterol.
Medications and alternative supplements
If reducing stress hasn’t sufficiently reduced high cholesterol, there are medications and alternative remedies that you can try.
These medications and remedies include:
- omega-3 fatty acids
Whether using prescription medications or alternative supplements, always consult your doctor before making any changes to your treatment plan. Even if they’re natural, small changes in a treatment plan can interfere with medications or supplements you’re already taking.
How Does Stress Contribute to Cholesterol?
Everyday Health: How does stress contribute to cholesterol?
Dr. Stuart Seale: Studies have shown that stress increases cholesterol not only in the short-term but can also affect cholesterol levels even years down the road. The cause for this isn’t exactly known. Other studies have shown that stress itself isn’t really the only culprit but that how an individual reacts to and manages stress is also important. Those who manage stress in unhealthy ways (via hostility, social isolation, or self-blame, for example) tend to have lower levels of HDL (good) cholesterol.
Dr. Lisa Matzer: Stress is known to increase cholesterol levels and in particular the bad LDL cholesterol. The amount of stress in your life isn’t as important as how you deal with it. The more anger and hostility that stress produces in you, the higher (and worse) your LDL and triglyceride levels tend to be. Stress encourages the body to produce more energy in the form of metabolic fuels, which cause the liver to produce and secrete more of the bad cholesterol, LDL. Also, stress may interfere with the body’s ability to clear lipids.
Dr. Jacob DeLaRosa: One theory is that stress hormones’ function is to provide fuel for a potential fight-or-flight situation. But if this energy is not used, it gradually accumulates as fat tissue. In addition, sugars that are produced with stress are repeatedly left unused and are eventually converted into triglycerides or other fatty acids.
Jeanette Bronée, CHHC, AADP: Stress not only increases inflammation in the body but also causes poor eating habits and poor food choices – all of which affect cholesterol levels. But cholesterol can also be regarded as a stress response from the body.
Pamela Warren, MS, CHN: Staying calm and cool helps manage cholesterol. Here’s how: When you’re under mental stress, your body is preparing to protect you and assumes a primitive response, called the fight-or-flight response. During such a situation, the brain produces the hormones cortisol and adrenaline. The release of these hormones sends signals that increase blood flow to the brain and eventually produces more energy for the body. When cortisol and adrenaline are released, it raises your cholesterol level. Specifically, the release of cortisol raises blood-sugar levels for the body’s use as energy, as it locks away fat so it’s not used during this state as energy. Therefore, as cortisol is released, it raises the body’s blood-glucose level, which in turn creates more triglyceride production. Higher triglycerides create higher cholesterol levels. Keeping your stress response under control is a great way to manage cholesterol levels for the long term.
Inna Topiler, MS, CNS: Stress will increase your cortisol levels. (Cortisol is a hormone produced by your adrenal glands when you are stressed.) Under stress, cortisol delivers glucose to the body to help the fight-or-flight mechanism function properly. If cortisol is consistently doing this, blood-sugar levels remain constantly high, which can lead to not only hypo/hyperglycemia and diabetes but also elevated cholesterol levels.
Dr. Raja R. Gopaldas: In modern-day life, stress is inevitable. Job stress, getting to work, and taking care of the family all contribute to stress. How we manage stress is important. There is no doubt that a constant state of emotional stress is directly linked with high cholesterol levels. Being happy is a fundamental requirement for every human being – so avoid circumstances that make you unhappy! A daily meditation schedule of 15 to 20 minutes will help relieve stress, and 45 minutes of vigorous exercises (get your heart rate over 120) three times a week will help lower anxiety levels and stress. Ensuring that you get adequate sleep – about six to eight hours daily (no more or no less – both are detrimental) is important for everyone.
Can Stress impact Your Cholesterol?
Too much worrying and stress can increase your cholesterol and your heart risk
You order grilled fish and salad at your favorite restaurant instead of the fried combo platter. You are truly making efforts to lower your cholesterol. In fact, you are so concerned about it, it’s stressing you out. What you might not realize is that stress (whatever its source) can actually increase your cholesterol. This, in turn, raises your risk of heart disease.
How does stress increase my cholesterol?
Stress –> Cortisol –> High Cholesterol
You’ve probably heard the term “fight-or-flight response.” This is the physical reaction the body has when faced with a stressful situation. Your systems spring into action, preparing you to stay and fight the threat, or run away. The more often you feel stressed, the more often your body goes through this process. If you are constantly stressed, your systems are constantly on alert, thinking they need to be ready to fight or flee at all times.On the surface, you may notice sweating or increased heart rate as your body prepares for action. What you can’t see are the hormones being produced and pumped through your system as it prepares to respond.
One of these hormones is cortisol. Cortisol helps in the fight-or-flight function by delivering glucose to the body. What happens when your body is constantly under stress and in this fight-or-flight condition? The cortisol works overtime and keeps your blood-sugar levels high. This results in elevated cholesterol levels.
Metabolic Fuels –> Liver Production of LDL –> High Cholesterol
LDL is the “bad cholesterol.” When stress triggers cortisol, which triggers the production of metabolic fuels (such as glucose,) the liver also springs into action. It begins to produce more of the bad cholesterol LDL in response to the increased levels of glucose and fatty acids.
High Cholesterol –> Hardening of the Arteries –> Heart Disease/Heart Attack
Too much cholesterol in your blood causes damage to your arteries. The cholesterol builds up on your arterial walls. This eventually causes your arteries to “harden,” becoming narrow. When this happens, blood flow is restricted or blocked altogether. If blood can’t get to your heart, you suffer a heart attack.
Breaking the Chain of Stress-Related Cholesterol
Reversing this chain reaction, we see that stress is an unhealthy trigger that results in raised cholesterol levels. It is important to break this chain, which can lead to high blood pressure and heart risk.
Change Your Habitual Response To Stress
We’ve covered how your body responds internally to stress. We see how this can cause an increase in cholesterol. Your external response can do the same.Often, we develop unhealthy habits to try to handle stress. We turn to food to soothe our souls. We light up a cigarette. We try to escape out our troubles by vegging out in front of the TV. We end up developing the unhealthy habits of overeating, smoking, and failing to exercise. These all contribute to raising your cholesterol.It is important to find healthy ways to handle stress. By coping with stress in better ways, you can avoid increasing your chances of high cholesterol levels and risk of heart disease.
Lessen the Intensity of Your Reaction To Stress
A study conducted by University of College London researches found that “individuals with larger initial stress responses had substantially greater rises in cholesterol than those with small stress responses.” In fact, those in the top third of stress responders were three times more likely to have high cholesterol. Based on this study, researchers concluded, “It appears that a person’s reaction to stress is one mechanism through which higher lipid levels may develop.”
Clearly, decreasing your reaction to stress will increase your health. Because stress is a key factor affecting your health on multiple levels, it is essential to find ways to manage stress in the best way possible. This will help reduce your risk of high cholesterol, which leads to greater risk of heart disease.
Tips to Get A Heart Healthy Handle On Stress
If stress increases your cholesterol and leads to heart risks, how can you go about reducing these risks? Healthy responses to stress, healthy stress relievers, and healthy living that stops stress before it starts are all steps in the right direction. Try the following stress-reducing techniques.
8 Ways to Reduce Stress
- Just…Relax – Your schedule is hectic. You have no down time. Every second is filled with one task after another. How stressful. Take a break. You may think you don’t have the time, but make the time. You’re surfing the net right now, so you do have at least a few minutes to spare. Take just seven minutes each day to stop. Sit quietly. Do some stretches. Take deep breaths. Meditate. Pray. Do whatever gets your mind to slow down so your body does too.
- LOL – Laughter is a great tension reliever. Watch a funny movie. Listen to a comedian. Treat yourself to some smiles and laughter to release the stress and help your heart.
- Eat sress-fighting foods – Choosing the right foods can help reduce your stress. Hello Heart offers a list of Foods That Fight Stress. Don’t worry, they aren’t things you’ll hate. One of them is chocolate!
- Be social – Make time for family and friends. Depending on your family and friends, this may sound stressful. Generally, though, it’s a good idea. You need to set aside the stress for a while and just kick back and have a good time.
- Learn to say NO – Just because you’re asked to serve on yet another committee doesn’t mean you have to. You don’t have to attend every single game your kids or grandkids participate in. Someone else can cover that extra work shift. It doesn’t always have to be you. It’s ok to say no, especially when you are feeling stretched too thin. Say no to over scheduling and stress. Say yes to heart health.
- EZ Exercise – A good workout is a great stress reliever. In order to ensure you make time for exercise, make it easy. Don’t join the gym if you know you’ll never go. Don’t take up running if you hate to run. Pick something you enjoy and is the most convenient for you.
- Pet your dog – Petting your dog or cat helps your body release the hormone oxytocin that is known to reduce stress. This is no small thing to heart health when you consider the toll that stress takes on the body.
- Track Stress Level Changes – As you take steps to monitor and reduce your stress level, another helpful step is to see if what you are doing is truly affecting your cardiovascular system. The most reliable way to do this is by monitoring your blood pressure at home.
With the use of a home blood pressure measuring device, you can track your heart health. As you make changes in your lifestyle, you can track changes in your blood pressure. This will help you see what is working best, and know what additional changes should be made. Making healthy choices will result in healthy blood pressure numbers and reduced risk of heart disease.Tracking changes in your blood pressure is easy with Hello Heart (iOS, Android), a free app that works with all blood pressure monitoring devices. There is no added stress of difficult records or processes. You can download the Hello Heart (iOS, Android) app now to start tracking your stress levels today.
You know your best stress relievers better than anyone. If there is an activity you know relaxes you or relieves stress, take the time to do it. Maybe it’s a long walk, or painting, or wood working. Whatever works for you, do it! It’s important to keep your heart health a priority, and this includes bringing down your stress levels. This will, in turn, help your cholesterol levels and lower your risk of heart disease.
Medical memo: Stress and cholesterol
Stress and cholesterol
Published: February, 2007
The body’s metabolism is complex “” and despite major scientific advances, its fine print is still a bit hard to read. That’s true even for a molecule as important as cholesterol. Researchers have learned that a man’s blood cholesterol profile results from the interplay of many influences, including genetics, hormones, diet, body fat, exercise, and exposure to alcohol, tobacco, supplements, and medication. And a study from England suggests that this formidable list should be expanded further by adding stress.
A stressful study
The subjects were 106 male and 93 female British civil servants between the ages of 45 and 59. None had coronary artery disease or hypertension, and none was taking drugs for cholesterol or blood pressure. At the beginning of the study, each volunteer was weighed and measured, and each filled out a medical questionnaire. After blood samples were obtained, each subject was asked to perform a series of mentally stressful tasks while being monitored to evaluate their psychological and chemical responses. A final blood sample was obtained at the end of each experimental session.
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4 Ways You Can Lower Your Cholesterol
You’ve probably heard that high levels of cholesterol are harmful to your health, but that’s only partially correct. Your body requires cholesterol to create hormones, produce bile in your liver, and protect your cells. There are two basic types of cholesterol: LDL (the bad stuff) and HDL (the good stuff). They both complete the jobs listed; however, the LDL cholesterol can be dangerous because the unused portion stores up in your arteries and can create blockages that lead to heart attacks and strokes.
Learn about a few simple changes you can make in your lifestyle to build up your HDL levels and say goodbye to excess LDL.
1. Eat Up!
When picking out your meals, choose foods with healthier fats. Avoid foods with trans fat and saturated fat because these are sources of LDL cholesterol. Instead, opt for foods with unsaturated fat, which will boost your HDL levels. Try incorporating fish, nuts, seeds, beans, and avocados into your diet. Fried and processed foods tend to have a lot of unhealthy fat, so enjoy these in moderation. Additionally, whole grains (like oats and barley) and other sources of soluble fiber (like fruits and veggies) help prevent cholesterol from entering your bloodstream.
2. Get the Heart Pumping
Any type of exercise that gets the blood coursing through your veins is great for getting rid of some of that stored LDL, and regular activity can even increase levels of HDL! Try dancing, jogging, or biking as a fun way to improve your cardiovascular health.
3. Stay Smoke-Free
Smoking is detrimental to your health. It increases your risk of developing cancer, damages your lungs, and makes it far more difficult for HDL cholesterol to transport stored LDL to your liver for removal. Quitting smoking is in your best interest, and if you need help doing so, here are three helpful tips.
4. Stress Less
Higher stress levels correlate to higher cholesterol levels. This could be indirectly due to the use of unhealthy coping mechanisms when we’re stressed or directly related through the long-term effects that stress hormones have on our bodies. Learn about healthy ways to handle stress to prevent spikes in cholesterol and blood pressure.
With a few simple changes to your lifestyle, you can make strides in improving your HDL levels and decreasing the amount of LDL stored up in your arteries. Your Baylor St. Luke’s Medical Group primary care physician can check your cholesterol levels and work with you to develop a healthy diet and fitness plan to get you on the right track. If you have high levels of cholesterol (over 200 mg/dL), schedule an appointment with a Baylor St. Luke’s Medical Group cardiologist to talk about additional ways you can lower your cholesterol and move toward better health.
Healthline | 10 Natural Ways to Lower Your Cholesterol Levels
MedlinePlus | How to Lower Cholesterol
Harvard Health Publishing | 11 Foods That Lower Cholesterol
Healthline | The Effects of High Cholesterol on the Body
Medical News Today | Foods with high cholesterol to avoid and include
Harvard Health Publishing | Elevating Your HDL Game
NCBI | Acute cholesterol responses to mental stress and change in posture.
Healthline | Does Stress Affect Your Cholesterol?
MedlinePlus | LDL: The “Bad” Cholesterol
American Heart Association | HDL (Good), LDL (Bad) Cholesterol and Triglycerides
Healthline | Why Is Cholesterol Needed by the Body?
LiveStrong | What Is the Function of Cholesterol in the Body?
Job stress may raise our ‘bad cholesterol’ levels
‘A stressful job really can kill you – by raising your cholesterol,’ reports the Mail Online website. This headline is based on Spanish research that looked at the relationship between job stress and lipid (fat) levels in the blood of more than 90,000 people.
The research found that people who reported difficulties coping with their job had higher levels of what has been dubbed “bad cholesterol” (LDL cholesterol) and lower levels of “good cholesterol” (HDL cholesterol). High levels of LDL cholesterol can clog up the arteries, increasing an individual’s risk of developing cardiovascular diseases such as coronary heart disease.
A significant strength of this study is its size – an impressive 90,000 people participated. But the study did not look at diet, which can also affect cholesterol levels. It could well be the case that people in stressful jobs tend to have unhealthy diets and it is this, rather than stress itself, that is to blame for their higher “bad” cholesterol rates.
While increased LDL levels are a risk factor for cardiovascular diseases, this study did not explore the effect this would have on people’s long-term health. The Mail Online’s claim that a stressful job will kill you is therefore not supported by this study.
Where did the story come from?
The study was carried out by researchers from Ibermutuamur – a mutual insurance company dealing with work-related accidents and occupational illnesses – and two universities in Spain. There were no external sources of funding for the study.
It was published in the peer-reviewed Scandinavian Journal of Public Health.
The Mail Online’s headline over-interprets the research, as the study did not assess whether people in stressful jobs were more likely to die. The body of the story was reasonably accurate, but it did not highlight that this type of study cannot prove that one factor is definitely causing another.
What kind of research was this?
This was a cross-sectional study that explored whether there is a link between job stress and abnormal levels of fats (lipids) in the blood.
Some studies have found a link between job stress and an increased risk of coronary disease. There are various theories about how this link might come about – for example, by stress increasing the likelihood of unhealthy habits such as smoking.
Some studies have also suggested that stress could directly influence levels of lipids in the blood by possibly adversely affecting the body’s metabolism. However, these studies have been small and in selected populations, and have had mixed results.
In the current study, researchers wanted to assess stress and lipid levels in a large representative sample of workers. As this study is cross-sectional, both stress and lipid levels were assessed at the same time. This means the study cannot establish whether participants’ lipid levels were directly influenced by their stress levels.
What did the research involve?
The study involved workers covered by the Ibermutuamur insurance company who had yearly medical check-ups. More than 430,000 participants were recruited between 2005 and 2007, and a study questionnaire was sent out to more than 100,000 randomly selected individuals. Completed questionnaires were returned by 91,593 of these people.
The questionnaire included the question, “During the last year, have you frequently felt that you cannot cope with your usual job?”. Participants who answered “yes” were considered to have job stress.
The questionnaire also included 11 questions relating to anxiety and depression symptoms, such as “Have you felt keyed up, on edge?” and “Have you had difficulty relaxing?”.
The researchers took fasting blood samples from participants and measured levels of total cholesterol, HDL cholesterol (so-called “good” cholesterol), and levels of a type of lipid called triglycerides. The levels of so-called “bad” cholesterol were calculated based on these measurements.
Participants were classed as having abnormal lipid levels based on pre-specified levels if they reported taking lipid-lowering medication or had been diagnosed as having abnormal lipid levels.
The researchers then looked at whether abnormal lipid levels are linked to job stress. They took into account the following confounders:
- basic measures of alcohol consumption and physical leisure activity
- type of job (“blue collar” or “white collar”)
What were the basic results?
Job stress was reported by 8.7% of participants. Participants reporting job stress also had higher levels of anxiety and depression symptoms.
After the researchers took into account factors that could affect the results and adjusted them accordingly, people who reported job stress were found to have 10% higher odds of having abnormal lipid levels (odds ratio 1.1, 95% confidence interval 1.04 to 1.17).
They also had increased odds of:
- high levels of “bad” cholesterol (LDL)
- low levels of “good” cholesterol (HDL)
- a high total cholesterol to “good” cholesterol ratio
- a high “bad” cholesterol to “good” cholesterol ratio
How did the researchers interpret the results?
The researchers concluded that their results support an association between job stress and abnormal lipid levels in the blood.
This study has found an association between job stress and abnormal lipid levels in the blood. Its strengths include the large number of workers assessed (more than 40,000) and the use of the same methods to assess all of the participants.
However, the fact that both job stress and lipid levels were assessed at the same time means it is not possible to say for certain whether job stress might have directly caused changes in blood lipid levels.
There are also other limitations and points to note:
- The study did not assess diet. People with job stress may have less healthy diets, which could account for the differences seen in the blood lipid levels, rather than these differences being a direct impact of job stress.
- Job stress was assessed by a single question, which may not fully capture all aspects of job stress. Also, different people may consider different things stressful, and the question did not disentangle the exact stressful workplace situations and an individual’s ability to cope with them.
- Workers who were off sick would not have had the routine medical check-up. This means the sample may have missed some people with more serious health problems with stress.
- The authors acknowledge that the effect of job stress seen is relatively small – a 10% increase in the odds of having abnormal lipid levels.
Overall, it is not clear from this study whether stress is a direct cause of the increased lipid levels seen. Studies looking at whether interventions to reduce work stress can reduce lipid levels in the blood would provide an indication if this is in fact the case.
Despite these limitations, there is a wide range of good quality evidence that workplace stress can have a harmful effect on your physical and mental health.
While some people may thrive on pressure, persistent high levels of stress are likely to be harmful.
Read more about what you can do to reduce your levels of workplace stress.
Analysis by Bazian
Edited by NHS Website
Links to the headlines
A stressful job really CAN kill you – by raising your cholesterol
Mail Online, 17 May 2013
Links to the science
Catalina-Romero C, Calvo E, Sánchez-Chaparro MA, et al.
The relationship between job stress and dyslipidemia
The Scandinavian Journal of Public Health. Published online January 2 2013
When you’ve got an unexpected bill, a dead car battery or family trouble on your hands, are you like a cartoon character with steam shooting out of your ears? Or a cool cat who manages your stress?
Everyone feels stress in different ways and reacts to it in different ways. How much stress you experience and how you react to it can lead to a wide variety of health problems — and that’s why it’s critical to know what you can do about it.
“When stress is excessive, it can contribute to everything from high blood pressure, also called hypertension, to asthma to ulcers to irritable bowel syndrome ,” said Ernesto L. Schiffrin, M.D., Ph.D., physician-in-chief at Sir Mortimer B. Davis-Jewish General Hospital, and professor and vice chair of research for the Department of Medicine at McGill University in Montreal.
Stress and Your Heart
More research is needed to determine how stress contributes to heart disease — the leading killer of Americans. But stress may affect behaviors and factors that increase heart disease risk: high blood pressure and cholesterol levels, smoking, physical inactivity and overeating. Some people may choose to drink too much alcohol or smoke cigarettes to “manage” their chronic stress, however these habits can increase blood pressure and may damage artery walls.
And your body’s response to stress may be a headache, back strain, or stomach pains. Stress can also zap your energy, wreak havoc on your sleep and make you feel cranky, forgetful and out of control.
A stressful situation sets off a chain of events. Your body releases adrenaline, a hormone that temporarily causes your breathing and heart rate to speed up and your blood pressure to rise. These reactions prepare you to deal with the situation — the “fight or flight” response.
When stress is constant, your body remains in high gear off and on for days or weeks at a time. Although the link between stress and heart disease isn’t clear, chronic stress may cause some people to drink too much alcohol which can increase your blood pressure and may damage the artery walls.
Can managing stress reduce or prevent heart disease?
Managing stress is a good idea for your overall health, and researchers are currently studying whether managing stress is effective for heart disease. A few studies have examined how well treatment or therapies work in reducing the effects of stress on cardiovascular disease. Studies using psychosocial therapies – involving both psychological and social aspects – are promising in the prevention of second heart attacks. After a heart attack or stroke, people who feel depressed, anxious or overwhelmed by stress should talk to their doctor or other healthcare professionals.
What can you do about stress?
Exercising, maintaining a positive attitude, not smoking, not drinking too much coffee, enjoying a healthy diet and maintaining a healthy weight are good ways to deal with stress, said Schiffrin, who is also the Canada research chair in hypertension and vascular research at Lady Davis Institute for Medical Research. “All those people are doing the right thing,” said Schiffrin, a volunteer with the American Heart Association.
Medicines are helpful for many things, but usually not for stress. Some people take tranquilizers to calm them down immediately, but it’s far better in the long term to learn to manage your stress through relaxation or stress management techniques. Be careful not to confuse stress with anxiety. If you suffer from anxiety, speak with your doctor a treatment or management plan including whether you need medication. Figuring out how stress pushes your buttons is an important step in dealing with it.
When you’re under stress, do you:
- eat to calm down?
- speak and eat very fast?
- drink alcohol or smoke?
- rush around but do not get much done?
- work too much?
- sleep too little, too much or both?
- slow down?
- try to do too many things at once?
Engaging in even one of these behaviors may mean that you are not dealing with stress as well as you could.
If your stress is nonstop, stress management classes can also help. Look for them at community colleges, rehab programs, in hospitals or by calling a therapist in your community.