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Mental Health, Stress

How Can Relaxation Strategies Help Manage My Chronic Condition?

It's impossible to avoid all stress-inducing situations but we can learn adaptive ways of responding to them and one way is through relaxation strategies.
Relaxation Strategies
Author
Ashleigh Golden, PsyD

Dr. Ashleigh Golden is a licensed psychologist and an expert in cognitive-behavioral treatments for anxiety, depression, obsessive-compulsive disorders, and sleep disorders. Dr. Golden completed a 2-year sub-specialized postdoctoral fellowship at the Center for OCD and Anxiety-Related Disorders at the Saint Louis Behavioral Medicine Institute. Dr. Golden has supervised teams of clinicians across the country in intensive outpatient and partial hospital settings. She has a special interest for working with people who are ambivalent about accessing or participating in evidence-based therapy.

What Is Stress, And Why Is It Important To Manage It?


Harvard Health explains that the body experiences a stress response, or ‘fight or flight response,’ when it is preparing to face or avoid danger. The stress response can be useful when we encounter challenging situations, but can contribute to anxiety and depression when triggered by mundane concerns about our jobs, money, and relationships, or the demands of managing a chronic condition. Overactive stress responses can contribute to health problems, including high blood pressure, heart disease, obesity, and diabetes. While it would be impossible to avoid all stress-inducing situations, we can learn healthy, adaptive ways of responding to them and one way is through relaxation strategies.

Mayo Clinic outlines some common effects of stress on the body, mood, and behavior:

Common effects of stress

What Are The Benefits Of Relaxation Strategies?


Relaxation strategies carry many benefits when it comes to managing stress symptoms, including: 

  • Slowed heart rate and breathing rate
  • Lowered blood pressure and fatigue
  • Reduced chronic pain; muscle tension; and stress hormone activity
  • Improved digestion and blood flow to major muscles
  • Better mood and focus; sleep quality; and confidence to cope with problems
  • Less frustration and anger

Relaxation strategies can be helpful in managing a range of chronic health conditions, including anxiety or stress associated with these conditions. With respect to diabetes, there are studies showing that relaxation techniques can have an overall positive effect on glucose control.

Thankfully, relaxation strategies are portable, free, and pose minimal risk, although you should talk with your doctor if you are unsure of whether they are right for you. These strategies are more than just a way to experience temporary peace of mind; when practiced intentionally and consistently over time, they are an effective way to help manage everyday stress along with stress linked to managing health issues, and to dial down the intensity of physical sensations related to stress in the body.

How Do Relaxation Strategies Help Me Manage Stress?


The basic goal of relaxation strategies is to induce the body’s natural relaxation response, which is characterized by lower blood pressure, slower breathing, and a feeling of enhanced well-being. According to the National Institutes of Health, relaxation strategies include a number of techniques like deep breathing, visualization or guided imagery, and progressive muscle relaxation (PMR.)

What Is Deep Breathing?


Our breathing can change pace when we are feeling stressed or anxious. We might engage in overbreathing or hyperventilating, taking short, shallow, quick breaths. This can actually drive physical, panic-like symptoms such as shortness of breath, lightheadedness, and chest pain, which are harmless but can be scary. 

Deep breathing, or taking regular, slow, smooth breaths, is a relaxation strategy that can dial down unwanted physical symptoms as well as anxious feelings. Like any new skill, though, it can take practice.

How Do I Practice Deep Breathing?

Anxiety Canada recommends the following step-wise process to practice deep breathing:

  • Find a comfortable place to sit.
  • Plant your feet flat on the ground.
  • Gently close your eyes, or lower your gaze to a comfortable distance.
  • Let your shoulders drop down, away from your ears, and try to loosen and relax your posture.
  • Focus on your breathing and allow yourself to continue breathing naturally.
  • Gently rest your hands on your belly, lightly touching your fingertips together.
  • Breathe in through your nose
  • As your lower lungs fill with air, observe your belly pushing your fingertips slightly apart.
  • Slowly exhale through your mouth, observing your belly moving back towards your spine.
  • Imagine your belly as a balloon. Fill it with air and notice it deflate.
  • Inhale smoothly through your nose for 4 counts (count ‘1-2-3-4’ in your mind) and hold your breath.
  • Exhale through your mouth for 4 counts and hold your breath .
  • Repeat this sequence, inhaling through your nose and out through your mouth 5 more times.
  • Observe any tension or tightness melting away.
  • Let your breathing return to normal.

What Is Visualization?


Visualization, or guided imagery, is a technique that involves imagining a detailed picture of a calming environment in your mind for a few minutes, which can help lower stress. You can think of it as a ‘mental vacation.’ Visualization can work through distraction, redirecting your attention from a stressful situation or thought to a different point of focus. This relaxation strategy can help you act ‘as if’ you are in a safe, peaceful setting. You can think of visualization as a form of mindfulness meditation, with the goal being a detached, curious observation of your moment-to-moment thoughts, sensations, and feelings. The images that you can focus on during your visualization practice can also become a cue or trigger for relaxing in real stressful contexts — think of your calm environment, and you can bring about a calmer state.

How Do I Practice Visualization?

To try your hand at visualization, give the following steps from the Mayo Clinic a go:

  • Close your eyes and picture yourself in a relaxing, comfortable, safe place like a forest, lake, or beach
  • Immerse yourself in your surroundings by leveraging all five of your senses (smell, sight, sound, touch, taste)
  • Picture yourself exploring this place through your senses for several minutes
  • Gently bring yourself back when you’re ready.

What Is Progressive Muscle Relaxation?


People who experience stress and anxiety often experience muscle tension during that day, to the point that it can be tough to know what relaxation actually feels like. By practicing tensing and releasing your muscles, you can learn to tell the difference between muscle tension and relaxation, and how to observe when tension is building up for you.

Progressive muscle relaxation (PMR) is a relaxation strategy that guides you through tensing and releasing certain muscle groups through two steps, first tensing up groups of muscles in your body, then releasing the tension and observing the feeling of relaxation. Consult with your doctor first before practicing PMR, and do not continue any movement that causes pain. Be careful about tensing any parts of your body that have caused concerns in the past. 

How Can I Practice Progressive Muscle Relaxation?

The Department of Veterans Affairs provides an outline for PMR practice: 

  1. Find a quiet, comfortable place, either lying down or in a chair. If you are comfortable, close your eyes.
  2. Start the exercise with a few counts of deep breathing (see above.)
  3. Continue to breathe deeply as you move in the tension and relaxation part of the exercise. Start with your feet and work your way up. As you breathe in, tense and hold each muscle for a count of 4. Relax that muscle group as you exhale. Take several breaths before you move on to the next part of your body, allowing some time to experience the relaxation.
  4. Point your toes and tighten your feet and hold momentarily as you inhale to tense the muscles in your feet. Breathe out, imagining the tension flowing out of you as you relax your toes and feet. Observe the difference between tension and relaxation.
  5. Allow your calf muscles to contract as you press the balls of your feet into the floor and raise your heels. Experience the tension in your calves for a moment, then release and observe your muscles relaxing. Tighten your knees and allow your legs to straighten and experience the tightness in the front of your legs. As you breathe in, observe the sense of tension. Allow your legs to bend and relax back on onto the floor as you release on the exhale.
  6. Squeeze the muscles in your buttocks, inhale, and observe the feeling of tension. Hold for a moment, then exhale, releasing your muscles into relaxation, allowing the tension to melt away.
  7. Moving up through your body, focusing on your belly. Contract your stomach and continue breathing. Hold the tension and count to 4, then inhale deeply. Let your stomach relax as you inhale deeply. Observe the difference between tension and relaxation.
  8. Now move your focus to your hands, curling your fingers into a tight fist in each hand. Keep your fists tight and observe the sensation of tension as you continue breathing. Let your hands relax into a natural position as you release your fists. Observe the difference between the feeling of tension and relaxation in your hands.
  9. Bend both your arms now at the elbow, flexing both your arms by making fists and pulling them up tightly to your shoulders. Observe the feeling in the tensed muscles of your upper arms. Breathe in again, and as you exhale, relax your arms down to your sides. Observe any changes as you go from a state of tension to relaxation.
  10. Raise your shoulders up to your ears, holding your position for a moment. Experience the tension in your shoulder and neck muscles, then feeling the tension melt away as your shoulders relax back down. Keep breathing in and out.
  11. Tense the muscles in your face, scrunching up your face and feeling your eyebrows pull together. Tightly pinch your eyes shut, purse your lips, and observe the sensation of tension in your face for a moment. Allow your face to relax, experiencing the release from your eyes, forehead, cheeks, jaw, and mouth.
  12. Be still for a few moments, noticing the relaxation in your muscles. Keep breathing deeply and slowly, observing any tension melting away. 
  13. Bring your focus back to your breathing when you’re ready, observing how your body feels. 

For guided audio PMR practice, check out these clips from Anxiety Canada.

Relaxation Strategies Take-Aways


Remember that practice is key when it comes to relaxation strategies — do not expect yourself to be able to relax perfectly the first time that you try deep breathing, visualization, or progressive muscle relaxation! To experience a difference in your baseline stress levels, and to increase your comfort level with these techniques, it is best to schedule a few minutes several times during the week to practice one or several of these strategies. Enjoy the feeling of relaxation in the moment that you get from these practices, as well as the long-term health benefits that accompany them.