Posts tagged with "mindfulness"

Journey to Better Stress Management

Journey to Better Stress Management

Stress! This one word may set your nerves on edge. Everyone feels stressed from time to time. Some people cope with stress more effectively than others. You have the power to prevent and effectively manage stress. By doing so, you can help lower your risk for serious conditions like heart disease, obesity, high blood pressure, and depression.

What is stress?

Stress is the brain’s response to change. Stress is different for everyone. Many things can cause stress and may be recurring, short-term, long-term and for example, may include your commute to work, searching for a job, or moving to a new home. Some changes are more serious than others, and for example, can include serious illness, loss of a loved one, marriage, or divorce.

How does stress affect the body?

Not all stress is bad. “Stress can motivate people to prepare or perform, like when they need to take a test or interview for a new job. Stress can even be life-saving in some situations. In response to danger, your body prepares to face a threat or flee to safety. In these situations, your pulse quickens, you breathe faster, your muscles tense, your brain uses more oxygen and increases activity—all functions aimed at survival.”1 

Different people may feel stress in different ways. Some people experience digestive symptoms, while others may have headaches, sleeplessness, sadness, anger or irritability. People under chronic stress are prone to more frequent and severe viral infections, such as the flu or common cold.

When under stress you may feel:2

  • Worried
  • Angry
  • Irritable
  • Depressed
  • Unable to focus

Physical signs of stress include: 

  • Headaches
  • Back pain
  • Problems sleeping
  • Upset stomach
  • Weight gain or loss
  • Tense muscles
  • Frequent or more serious colds

What are the benefits of lower stress? 

Over time, chronic stress can lead to health problems and lead to chronic disease. Managing stress can help you:

  • Sleep better
  • Control your weight
  • Get sick less often and feel better faster when you are sick
  • Have less neck and back pain
  • Be in a better mood
  • Get along better with family and friends

How can I cope with stress?

The effects of stress tend to build up over time. Taking practical steps to maintain your health and outlook can reduce or prevent these effects. The following are some tips that may help you to cope with stress.

  • Seek help from a qualified mental health care provider if you are overwhelmed, feel you cannot cope, have suicidal thoughts, or are using drugs or alcohol to cope.
  • Get proper health care for existing or new health problems.
  • Stay in touch with people who can provide emotional and other support. Ask for help from friends, family, and community or religious organizations to reduce stress due to work burdens or family issues, such as caring for a loved one.
  • Recognize signs of your body’s response to stress, such as difficulty sleeping, increased alcohol and other substance use, being easily angered, feeling depressed, and having low energy.
  • Set priorities—decide what must get done and what can wait, and learn to say no to new tasks if they are putting you into overload.
  • Note what you have accomplished at the end of the day, not what you have been unable to do.
  • Avoid dwelling on problems. If you can’t do this on your own, seek help from a qualified mental health professional who can guide you.
  • Exercise regularly—just 30 minutes per day of gentle walking can help boost mood and reduce stress. Schedule regular times for healthy and relaxing activities.
  • Explore stress coping programs, which may incorporate meditation, yoga, tai chi, or other gentle exercises.

If you or someone you know is overwhelmed by stress, ask for help from a health professional. If you or someone close to you is in crisis, call the toll-free, 24-hour National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) available 24 hours a day, 7 days a week. The service is available to anyone. All calls are confidential.


1.National Institute of Mental Health:

2. U.S. Department of Health and Human Services:

Reducing Stress With Online Mindfulness Program

Reducing Stress with Online Mindfulness Programs – At a Fraction of the Cost of Traditional Programs

Thomas J. Morledge, MD, Didier Allexandre, PhD, Emily Fox, MBA, MSSA, LSW, et al. “Feasibility of an Online Mindfulness Program for Stress Management – A Randomized, Controlled Trial.” JOEM. Volume 58: Number 3, March 2016.


  • Purpose: This study aims to determine feasibility of an 8-week Internet-based stress management program (ISM) based on mindfulness principles in reducing stress in a 12-week, parallel, randomized, controlled trial.
  • Methods: Participants were randomly allocated to ISM, ISM plus online message board (ISM+), or control groups. Perceived stress, mindfulness, self-transcendence, psychological well-being, vitality, and quality of life were measured at baseline, week 8, and week 12 using standard validated questionnaires.
  • Results: ISM and ISM+ groups demonstrated statistically significant improvements compared with control on all measures except vitality and physical health.
  • Conclusions: The ISM program effectively and sustainably reduced measures of stress. The magnitude of improvement is comparable to traditional mindfulness programs, although fewer participants were engaged. This feasibility study provides strong support for online stress management programs, which increase access at a fraction of the cost of traditional programs.

Chronic stress affects many Americans – approximately 35% of North Americans are affected by severe psychological stress.1 Stress is a major public health issue, and calls have been made for better access to stress management programs to prevent and manage chronic diseases. Stress can be reduced by “cultivating mindfulness, a state of consciousness that focuses on individual’s attention and awareness on the present moment and developing a nonjudgmental, conscious awareness of the moment-to-moment experience of one’s environment, thoughts, feelings, and actions.”2, 3, 4

However, stress management programs may be expensive or have limited access. The purpose of this study was to determine the feasibility of an 8-week Internet-based stress management program (ISM) based on mindfulness principles in reducing stress in a 12-week, parallel, randomized, controlled trial.

The 12-week, randomized, parallel, controlled trial was administered entirely online at the program Website. Participants provided their name and e-mail address and were automatically randomized (using a computer-generated list with a block size of three) into one of three groups: ISM, ISM plus online message board (ISM+), or control. All participants were asked to complete online questionnaires at 0 (baseline), 8, and 12 weeks and to fill out weekly activity logs for weeks 1-8. ISM+ group was asked to participate in an online message board hosted by

Since high dropout rates are expected for online studies 5, 6, 7, the study enrolled approximately 700 people to obtain the target sample size.

  • 1,204 people received the study description, and 684 (57%) people enrolled in the study between September 2010 and August 2011.
  • The study ended in November 2011. Of those enrolled, 133 (19%) were lost prior to providing baseline data.
  • Of the remaining (81%) who enrolled and completed the baseline questionnaire (n=551), more than half (57%) also completed one or both follow-up questionnaires (n=312).
  • The 8- and 12-week completion rates differed across treatment groups: 41 and 33% for ISM, 44 and 38% for ISM+, and 67 and 65% for the control group at weeks 8 and 12, respectively.

This study demonstrates that Internet-based stress management program (ISM) participants experienced significant reductions in stress. The study found that a person who practices meditation techniques an average of 5 times/week will experience a 6.12 decrease (1.53 times 4) in Perceived Stress Scale (PSS) score versus practicing once per week.

Feedback about the ISM program and message board was provided by 78 ISM and 68 ISM+ participants who practiced the relaxation exercise at least once. Of those respondents, 45% found the overall program to be very or extremely helpful, 35% somewhat helpful and 19% little or not at all helpful.

Approximately one third (35%) of all ISM and ISM+ enrollees showed online program activity for 6–8 weeks, and 42% completed the questionnaires at 8 weeks. Program and study retention may be lower than most small-sample size studies of Web-based programs for psychological disorders, which range from 17 to 98% with an average of about 70%6 ; the rates are comparable to larger effectiveness studies5,7 and may be more reflective of real-world settings.

When asked about how helpful and beneficial specific components were, 53% found the meditation techniques, 43% the weekly audio lesson and 48% the articles to be very or extremely helpful.

This study demonstrated an 8-week ISM program could feasibly and effectively reduce stress. Benefits were sustained through week 12 for a well-educated, mostly female and computer savvy self-selected population. Although the participant completion rate was low, the magnitude of improvement was significant for those who completed the online program. This study provides support for online stress management programs that are publicly accessible and not cost prohibitive.

About USPM and Cleveland Clinic

U.S. Preventive Medicine (USPM) partnered with the Cleveland Clinic Wellness Institute in an innovative strategic partnership to integrate their next generation information technology platform and population health management services with their best-of-class wellness programs and e-Coaching services. Cleveland Clinic Wellness focuses on changing behavior in the “Big 4” causes of chronic diseases (food choices, tobacco, physical inactivity, and stress) through programs such as Healthy Performance with Stress Free Now, Cleveland Clinic Wellness e-Coaching, and interactive online programs Stress Free Now, Go! Foods, and Go! to Sleep. Cleveland Clinic’s Healthy Performance with Stress Free Now and CC e-Coaching have driven remarkable results across a wide variety of industries. Cleveland Clinic has led numerous successful community and institutional campaigns committed to improving the lives of children and adults. Also, in 2005 they were the first hospital to become a smoke-free workplace.


  1. Yusuf S, Hawken S, Ounpuu S, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): Case–control study. Lancet. 2004;364(9438):937-952. doi:10.1016/S01406736(04)17018-9.
  2. Baer RA.Mindfulness training as a clinical intervention: A conceptual and empirical review. Clin Psychol Sci Pract. 2003;10(2):125-143.
  3. Shapiro SL, Oman D, Thoresen CE, Plante TG, Flinders T. Cultivating mindfulness: Effects on well-being. J Clin Psychol. 2008;64(7):840-862.
  4. Chiesa A, Serretti A. Mindfulness-based stress reduction for stress management in healthy people: A review and meta-analysis. J Altern Complement Med. 2009;15(5):593-600.
  5. Meyer B, Berger T, Caspar F, Beevers CG, Andersson G,Weiss M. Effectiveness of a novel integrative online treatment for depression (Deprexis): Randomized controlled trial. J Med Internet Res. 2009;11(2):e15.
  6. Melville KM, Casey LM, Kavanagh DJ. Dropout from Internet based treatment for psychological disorders. Br J Clin Psychol. 2010;49(Pt 4):455-471.
  7. Verheijden MW, Jans MP, Hildebrandt VH, Hopman-Rock M. Rates and determinants of repeated participation in a Web-based behavior change program for healthy body weight and healthy lifestyle. J Med Internet Res. 2007;9(1):e1.

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