“Do you think it’s stress?” I’ve been asked that question many times over the years. In nearly every instance, the person asking the question was concerned that pressure at home or on the job was responsible for the symptoms that he or she was experiencing at the time. My answer has always been the same: “Stress causes nothing, but aggravates everything.”

Before discussing stress it is important to define what it is. Stress is simply a challenge given to the adaptive abilities of the body, mind, and spirit. If the body, mind, and spirit are capable of rising to the challenge, stress can carry an individual to new levels of accomplishment. If they are not, and adaptive mechanisms fail, illness will ultimately appear.

Stress can be physical, as sustaining a burn or undergoing a surgical procedure, mental, as in dealing with a strained relationship or taking on additional responsibilities at work, or spiritual, as in having goals or dreams ridiculed or challenged. Stress can be either beneficial, taking us to new heights, or harmful, resulting in a mental or physical breakdown. It is not so much what happens to us, as it is how we respond that determines the outcome. The question is not, “Am I stressed?” but rather, “Am I up to the challenge?”

Stress, no matter how intense or what the source, is incapable of causing any illness of its own accord. Another predisposing factor must be present. For example, if there is no plaque buildup in the coronary arteries, a heart attack will not occur no matter how stressful the situation.

It must also be recognized, however, that stress is often the trigger that accounts for the appearance of a disease and that it contributes greatly to the severity of the symptoms that are present. If plaque is present in the coronary arteries, the body’s response to stress may destabilize the condition and trigger a heart attack.

When adaptive mechanisms fail, the breakdown generally appears at the weakest point. If an individual has a predisposition to an ulcer due to the presence of an organism called H-pylori in the stomach, abdominal pain or bleeding may appear. If, on the other hand, an individual has narrowed coronary arteries, he or she may experience chest pain. That is why I say, “Stress causes nothing, but aggravates everything.”

In 1967 Dr. Thomas H. Holmes and Dr. Richard H. Rahe of the University of Washington published the results of their work on the relationship between social stress and illness in the Journal of Psychosomatic Research. By assigning “Life Change Units” to a number of life events (See Table 1), they were able to predict the likelihood of the appearance of a significant illness or injury in the life of an individual experiencing them. They found that someone that accrued more than 300 life change units over a 12 month period had an 80% chance of experiencing a serious illness or injury within the next two years. In contrast, an individual who experienced 150 life change units or less had only a 37 % chance of developing a serious illness within the same time frame.

While the Holmes/Rahe scale is a general indicator of the effect of various life events on the health of an individual, it is important to recognize that some people are far more resilient than others. One of five individuals with over 300 life change units did not experience any recognizable ill effect from the stress, while a third of those evaluated were affected with fewer than 150 life change units.

Since stress in an inevitable part of life, each of us should seek to become one of those adaptable individuals who continue to do well regardless of external circumstances. One of the keys to successfully managing stress is advance preparation. If our body, soul, and spirit have been given consistent support and nourishment we will almost certainly be able to withstand the challenges of life. If, however, one or more of these aspects has have been neglected we are likely to fail the test when it comes.

The most important element in stress management is developing and cultivating a relationship with the Creator. That this is possible is one of the greatest mysteries of life. That so many fail to avail themselves of the opportunity is even more bewildering. When that relationship is strong, based upon a moment-by-moment and day-by-day interaction no amount of stress can quench our spirit.

The Apostle Paul withstood stresses most cannot imagine. J. B. Phillips translated Paul’s stress list as follows: “In my travels I have been in constant danger from rivers and floods, from bandits, from my own countrymen, and from pagans. I have faced danger in city streets, danger in the desert, danger on the high seas, danger among false Christians. I have known exhaustion, pain, long vigils, hunger and thirst, doing without meals, cold and lack of clothing.” Paul should have been a nervous wreck, yet he never wavered.

He explained his unshakable faith and unflappable spirit in these words: “I am persuaded that neither death nor life, nor angels nor principalities nor powers, nor things present nor things to come, nor height nor depth, nor any other created thing, shall be able to separate us from the love of God which is in Christ Jesus our Lord.”

It is clear that Paul was constantly aware of God’s presence. This is the sort of relationship described by Brother Lawrence, a humble kitchen worker, in The Practice of the Presence of God. When one walks with God in the sunshine His presence in the shadow is unmistakable.

A good deal of stress is self-inflicted. Worry and frustration extract a tremendous toll. For many years I have taught a simple, but effective, technique for reducing or eliminating the stress of worry and the feeling of being overwhelmed by the tasks at hand.

I encourage anyone who is anxious or worried to purchase a small, pocket-sized, notebook that can easily be carried at all times. Any time a concern arises or one discovers something that needs to be done the concern or task is immediately written down in the notebook. This immediately removes the stress that results from trying to remember the item.

Once a day, at a convenient time, take out a blank sheet of paper. Draw a line down the center. On the left side write “can do” and on the right side “can’t do” (Figure 1) . Go through the notebook item by item placing each in the appropriate column.

                                                    Figure 1: Items of Concern

                                          Can Do                                       Can’t Do

                                      Wash clothes                  Make slow drivers move over

                                    Get oil changed                 Get troops out of Afghanistan

                                Complete job estimate                    Stop terrorist attacks

Tasks such as “Wash clothes” or “Get the oil changed” are placed in the “can do” column because, given adequate time and resources, you could personally wash the clothes and take the car in for servicing. Items such as “Slow drivers need to stay in the right lane” and “We need to get out of Afghanistan” are listed on the right side because no matter how much time you personally spend fussing or worrying about them the situation is unlikely to change.

Items in the “can do” list are then prioritized. This may be done simply by numbering them, but it is often more effective to take out a second sheet of paper and divide it into four quadrants by drawing lines down and across the page (Figure 2). Items are placed in the quadrants based upon two criteria: importance and urgency. Each item is then placed in the most appropriate quadrant, high importance-high urgency, high importance-low urgency, low importance-high urgency, and low importance-low priority.

                       Complete job estimate                           Answer the phone

                               Get oil changed                                 Sweep the garage

                                 Wash clothes                               Organize the hall closet

In prioritizing, you will find that you become much more productive and satisfied if you concentrate on the items you have designated of high importance, even if they are of low urgency.

Much of the stress we experience is the result of responding to the countless number of “urgent” demands upon our time, regardless of their importance. It is very easy to become distracted by the ringing of the phone or a box full of e-mails and fail to accomplish a very important task because it does not carry the same sense of urgency. It is better to accomplish the important task and subsequently respond to important messages than to accept all interruptions and leave the truly rewarding work undone.

A helpful phrase to remember is “Life is an unfinishedness.” If you are consistently writing things down as you think of them, you will never complete every item on your “can do” list. This is a perfectly normal situation. Having prepared for the day by organizing and prioritizing your tasks, however, you will experience the satisfaction that you have completed what was most necessary, given the time that was available.

After prioritizing the “can do” items turn your attention to the “can’t do” entries. Rather than continuing to invest time and energy into them, turn them over to God, trusting that He will bring them to a suitable conclusion in His time.

An additional step to reduce mental or emotional stress is to break the news habit. Newspapers, newsmagazines, broadcast news programs, and radio and television talk shows are incredibly rich sources of “can’t do” items that do little but drain our emotional energy. It is far more helpful to read and listen to encouraging and uplifting books, tapes, and CDs, which build rather than drain one’s emotional bank account.

Support of the body is also important. As with the spirit and the mind this should be an ongoing process, not something that is begun when the stressful event appears.

Regular physical activity, which keeps the body conditioned, enables the body to respond to stress efficiently. Getting the body moving and keeping it moving for twenty to thirty minutes three to five times weekly is ideal for most people. Those with conditions such as diabetes are encouraged to do so on a daily basis.

A comprehensive that provides optimum levels of all vitamins, minerals, and essential amino acids should be taken daily. Essential fatty acids, which are critical for proper brain function, should also be provided. These are commonly found in vegetable oils such as flax oil, borage oil, or evening primrose oil and in oils derived from the belly fat of cold-water fishes. These are not fish liver oils, but those commonly referred to as Omega-3 oils or Marine Lipids.

In times of stress the body’s demand for B vitamins increases. This may explain why many people develop a craving for carbohydrates during times of stress. B vitamins are found in complex carbohydrates such as whole grains, but are stripped away during the refining process. Ironically, increasing one’s intake of refined carbohydrates further increases the demand for B vitamins and decreases the body’s ability to cope with the challenge that is present.

Vitamin B-5, pantothenic acid, is particularly critical during times of stress because the body needs it to produce a critical substance called Coenzyme A. Coenzyme A is required for energy production and is also essential in the manufacture of stress hormones such as cortisol and adrenaline. Low levels of Coenzyme A will severely limit the body’s ability to withstand stress and can lead to extreme tiredness and fatigue.

Because B vitamins are water-soluble they cannot be stored in the body. They must be administered at least twice daily. Another water-soluble nutrient is vitamin C. The demand for vitamin C increases dramatically during times of stress and it, like the B vitamins, must be taken at least twice daily for optimum benefit.

A number of herbal substances are capable of enhancing the body’s ability to respond to stress by modulating the activity of the nervous system. Many have been demonstrated to calm anxiety and enhance relaxation while actually increasing the ability to concentrate and react appropriately to stimuli.

Some of the herbs commonly used in stress management include valerian, skullcap, chamomile, and hops. I prefer combinations rather than single herb preparations. In my experience, herbal combinations, which typically contain lower amounts of each ingredient than when they are used as single agents, work more smoothly and effectively and have a very low incidence of side effects.

Stress is unavoidable. It is as much a part of life as eating, breathing, or sleeping. You will always experience challenges. Stress need not be feared, however. If you are diligent in supporting your physical, emotional, and spiritual needs you will be up to the challenge, whenever or however it comes.

When you are adequately prepared, you will welcome stress, for you will find yourself energized and driven to new levels of achievement by its presence. Once you are able to embrace stress as a friend you will find that it is really nothing but an additional source of energy. You will be able to say with Helen Keller, “Life is either a grand adventure or it is nothing at all.”