What I've learned about stress and how I manage it condensed into actionable form: Becoming aware of stress levels required some awareness practice, the lower grade stressors that just keeping going indefinitely weren't as obvious. I found the [Lief device](https://lief.ai/) helpful for telling me as soon as stress was rising. Some smart watches function similarly but less precise. Signs of stress to look for: - Hands feeling extra cold: [stress often constricts veins](https://www.ahajournals.org/doi/full/10.1161/JAHA.119.015697) (they are usually easily visible on the back of the hand when relaxed. The distinction isn't useful when hot out.) - Feeling frozen in place unable to move - Sweating when not hot - Shivering - Pain from tight/clenched muscles, often in shoulders, neck, chest, or throat - Bloody nose from blood pressure spike - Biting lip/skin near lips inside of mouth ## Intensity of stress determines the most effective response: ### High (7+/10): 1) Physiological sigh, quick and can be done anytime. [explanation](https://www.youtube.com/watch?v=rBdhqBGqiMc) 2) Get enough space from the trigger to assess the situation. 3) Dunk head in water cool enough to feel a bit of shock. Triggers the mammalian diving response which drops heart rate and automatically relaxes the body. I keep a bin a bit bigger than my head available to fill up on demand. Cold showers focused on the face and neck or quick dunk in a lake/river can act as alternatives. ### Medium(4-7): 1) Box breathing: inhale, hold, exhale, hold for 5 seconds each. Repeat. 2) Find a stressor the body is adapted for like cold, heat (sauna), exercise, etc. This seems counterintuitive but reduces mental stressors and there is research replicating this. I would use the sauna after long stressful days at work and come out consistently relaxed. 1) [Study on exercise for stress](https://www.nature.com/articles/s41598-023-35987-8): "On stressful days, physical activity may buffer the negative association between stress and affective wellbeing." 3) [Float tanks](https://en.wikipedia.org/wiki/Isolation_tank): when time and location allows float tanks have helped greatly. Especially when tired for the mental rest or when there is a decision or challenge that needs space to be processed. The magnesium in the water likely helps enhance the relaxation. 4) Yoga classes: Yin, Hatha, or any with a particular focus on breathing, meditation, and the mind body connection. ### Low(1-4): 1) Practice emotional fitness https://nickwignall.com/the-case-for-emotional-fitness/ What this looks like concretely for me is a series of habits to respond to emotions: awareness in body of feelings arising, labeling the emotion in simple terms like fear, sadness, anger, joy. validating the emotion and accepting it, tolerating the emotion and watching it for a while before responding, listening to the message the emotion has (they usually correspond to instincts), etc. 2) There are more stress responses beyond fight, flight, and freeze. Seeking social support is another. If you don't feel you have someone to go to, there are resources like [warmlines](https://www.warmline.org/directory/washington-warm-line-crisis-connections/) which will connect you to someone who is willing to be there with you. 3) Journaling: writing out on physical paper helps process feelings better. Slows down thinking which reduces panic/anxiety spiraling upward. [[Attribution retraining]] is the one I'm most impressed by, a couple other helpful ones are CBT thought records focused on perceiving safety wherever reasonable and Activinsight (from a helpful book called The Myth of Stress) 4) 4-7-8 breathing: inhale four seconds, hold seven, exhale eight, repeat. ## What to do when the stress doesn't go away Sometimes issues persist long after the stress is gone. An extreme version is PTSD, I see a continuum of more mild and moderate variations that also exist and have experienced. Once the threat is past then longer term healing becomes viable. What I found to be the case is if something has scientific evidence to work for PTSD it will be more than up to handling and healing less extreme stressors. 1) MDMA is the most effective modality I have seen research for when it comes to PTSD. The best way I can describe it is elevating safety and emotional intelligence to the maximum. I found the book [Trust Surrender Receive](https://www.goodreads.com/book/show/36234395-trust-surrender-receive) quite helpful in understanding what this is about. 2) Exposure therapy [compares favorably with alternatives when tested](https://www.sciencedirect.com/science/article/abs/pii/S0272735821001586) What I'm curious about is the combination of MDMA with exposure therapy because one of the most consistent effects of MDMA is a feeling of safety and safety learning core to exposure therapy. 3) Holotropic breathwork [shows great promise](https://maps.org/news/bulletin/a-clinical-report-of-holotropic-breathwork-in-11000-psychiatric-inpatients-in-a-community-hospital-setting/) The cost is far lower than therapies like psychedelics and bypasses the legal issues with substance ingestion. I find breathwork a better place to start as it provides an experience that can be both powerful and stopped quickly if problems arise. 4) Cuddling/massage are remarkably good at creating feel good chemicals and a space where people feel safe. There are many ways to get benefits from petting an animal to hugging a friend to getting a massage. [Some cities have cuddling events](https://www.seattlemetromagazine.com/entertainment/cuddle-events-hugz-cuddlez-erez-benari/) built around [platonic](https://cuddleparty.com/what-is-a-cuddle-party/) physical touch and supportive community. Does it seem weird at first? Yes, I felt that too; I consistently hear people saying the experience they are glad they went. 5) EMDR: I was initially impressed by it and found the sessions I did somewhat helpful. A recent meta analysis shows [no significant difference compared to other PTSD treatments.](https://www.cambridge.org/core/journals/psychological-medicine/article/emdr-v-other-psychological-therapies-for-ptsd-a-systematic-review-and-individual-participant-data-metaanalysis/903183C014DD518979569C26525588E1)