We live in a time of abundance where our access to information has never been greater. This, however, has not correlated with improved psychological well-being as stress, burnout, substance abuse, and mental health disorders are on the rise. Early intervention in imperative in preventing burnout or long term consequences of stress. Everyone experiences stress. How we manage it, however, varies significantly. This article provides a foundation and nine tactical strategies to help effectively manage the internal experience of stress, ultimately allowing for a more fulfilling life.

Defense employees can be prone to stress

People who choose to serve the United States military are generally hard working, altruistic, and adept at problem solving. Ironically, these positive qualities can also contribute to an increased risk of stress injuries, notably burnout. Occupational stress, contributing to burnout, causes disruptions in personal life, professional work, and job turnover (Delaney et al, 2022). Burnout is a syndrome of emotional exhaustion, depersonalization, and reduced personal accomplishment that can lead to deterioration (Maslach and Schaufeli, 1993). The Global War on Terrorism and consequential impact on service members, their families, and military mental health led DOD leadership to create the Defense Task Force on Mental Health in 2006. This led to the creation of the Stress Continuum (Ram et al, 2023).

Your stress falls on a continuum

The Stress Continuum (Figure 1) is a classification system developed by the Navy and Marine Corps to help individuals recognize when they or others have been injured by stress and may benefit from support or intervention (Nash et al, 2011).

The basic assumption underlying the Stress Continuum is that acute and chronic responses to stressors lie along a spectrum from wellness and thriving to illness and disability that can change over time. Placing stress responses on a continuum counters the belief that a stress response is dichotomous — either normal or pathological (Nash et al, 2011). The Stress Continuum model identifies and codifies the spectrum of stress responses through four color-coded stress response zones. The green “ready” zone encompasses adaptive coping and effective/optimal functioning. This does not suggest the absence of stress, but rather control over the stress response (Litz, 2014; Nash et al, 2011). The yellow “reacting” zone encompasses mild distress and promotes resilience when reactions are reversed. The orange “injured” zone encompasses more severe or persistent distress from wear and tear (burnout), inner conflict, loss, or trauma. Injuries result from stressors that exceed (in intensity or duration) an individual’s biological, psychological, social, or spiritual coping capacities. The red “ill” zone includes stress illnesses that do not heal without professional help and include various types of mental health illnesses (Nash et al, 2011).

To cope, separate your stress from the stressor

After identifying we are stressed using the relevant features from the continuum, we can then intervene with the intent to return to optimal functioning. The first step is to differentiate the stress response from the stressor, the associated external or internal events causing the response. People often focus efforts on modifying or eliminating stressors in their lives. It can be very helpful to lay out the stressor or cause of one’s stress (e.g., poor work/life balance) and the stress response (e.g., feelings of inadequacy or guilt).

Separating stress from stressor can allow one to then distinguish things that are controllable versus things outside of one’s control. For example, communication is always in our control. Depending on the stressor, seeking clarification or explaining what we are experiencing can improve a situation. When communicating with someone who is the stressor, however, it’s important to be rational and maintain composure. If you’re emotionally responding to stress, withholding communication until emotions settle can prevent saying or doing anything unintended. Outside of communication, acceptance or avoidance of stressors are often the only other things within our control. We ultimately have two options: accept and optimize within the stressor or avoid it.

Following acceptance, we can allow the passage of time and use of our support systems and coping strategies to improve function. Coping strategies can either add or remove value from our lives. Negative coping strategies such as binge drinking or substance abuse will never provide sustainable benefits. Exercise is a culturally accepted, promoted form of coping for good reason. However, if one exercises in excess or uses it to escape controllable solutions to resolve a problem, it can become negative. Setting intention and moderation behind a coping strategy makes it positive rather than negative.

We have the most control over our own stress, and therefore, should develop individual solutions that are most effective in reversing negative impacts of stress. Recommended strategies to manage stress are mainly focused on adjusting perspective. Awareness of our mood promotes rational brain support.

Our thoughts have power. Thoughts lead to emotions. Emotions lead to our attitude, words, and actions. Over time, this pattern develops habits and habits influence our personality and character. Eventually, our habits become our legacy. One’s attitude is a decision based on permitted thoughts.

Without intention, our subconscious, and often our conscious, thoughts are habitual. With intention, we can transform our thoughts into productive patterns to handle stress and instill beneficial habits over time.

Nine science-based tips to approach stress tactically

Here are nine researched-backed tactics to manage stress:

1. Challenge Negative Thinking Patterns (Neff et al, 2020; Neff and Germer, 2017; Thorn, 2019; Greenberg, 2017):

To prevent an automatic emotional response to a stressor, challenge your negative thinking pattern. What advice would you give a friend in the same situation? Consider it for yourself. Simply considering the advice may shift your perspective and improve an emotional response. Furthermore, you can view stressors as a challenge or opportunity rather than something negative. Resilient individuals use this reframing technique as another way to shift perspective.

2. Intentional Breathing (Ashhad, 2022; Fincham, 2023; Grossman and Christensen, 2007; Zelano et al, 2016):

Breathing is a subconscious function of the brainstem, and stress may cause altered breathing. Consciously taking control of our autonomic system with intentional breathing may change a physiological response to stress while promoting the rational brain. Some well-researched intentional breathing strategies are:

Boxed breathing: cycles of inhaling, holding, exhaling, and holding for the same number of seconds per cycle
Physiologic sigh: cycles of two inhales through the nose following by extended exhale through the mouth
Nasal breathing

3. Detach Emotionally (Kubala and Jennings, 2023; Meredith, 2019; Thorn, 2019):

Temporary distractions or breaks from responding to our stress allows the power of time and our parasympathetic nervous system to improve a negative stress response. Tabling concern about a stressor can allow our rational brain to focus on and positively respond to something else before returning to the issue at hand.

4. Positive Affirmation (Cascio, 2016; Rasmussen et al, 2006):

Say a positive affirmation or word to yourself in response to a difficult event or common stressors like “I can do hard things” or, “I’m resilient.” Watch the video on YouTube titled, “Good” by Jocko Willink for a quick example on the power of one word in forging an improved perspective despite challenging circumstances. Note: this strategy is appropriate for common stressors, not necessarily for orange zone injuries like loss of a loved one.

5. Realistic Optimism (Rasmussen et al, 2006; Strutton and Lumpkin, 1992; Nes and Segerstrom, 2006):

Realistic optimism is the belief that there is a silver lining in all events. For significant events, this strategy requires a habit of using internal optimism and positive thinking patterns in response to stressors. For example, the loss of a job can offer opportunity, or breakups may lead to a better understanding of what you’re looking for in a partner. This strategy is best developed and utilized internally rather than recommended to others. It is also best honed with less significant or indirect stressors to prepare oneself for inevitable orange zone injury in the future.

6. Goal Setting (Rasmussen et al, 2006; Doerr, 2018):

Goals setting gives direction to the immediate and distant future and is an empowering way to shift perspective. It is important, however, to avoid creating vague goals that are difficult to track or determine success with. Specific, Measurable, Attainable, Realistic, and Time-Sensitive—or SMART—goals provide a system to assist with goal creation. Adding ‘stretch’ goals, which may not be attainable, allows one set optimistic goals providing the opportunity to “fail up” which leads to improvement and healthy perspectives on failure.

7. Don’t Expect Yourself Out of Others (Robson, 2022):

This is a powerful perspective-setter to use whenever your stressor is another person. Personal and professional conflicts often happen due to differences in perspective. The world would suffer without diversity and approaching problems from a different perspective potentiates progress. Acceptance and gratitude that not everyone thinks like us is a great way to decrease emotional reactions to conflicts with other people.

8. Practice Empathy (Riess, 2017; Ciaramicoli, 2016; Ciaramicoli and Ketcham, 2000):

Empathy, or talking on another person’s perspective, is an important and useful skill. Stressors in the occupational setting along with other life stressors may contribute to professional burnout and lack of empathy. To avoid burnout, consider every encounter as a new opportunity to practice empathy. There is the old adage that you never step in the same river twice because it is no longer the same river, and you are no longer the same person.

Everyone has a unique perspective that changes throughout their life; so do you. Practice empathy.

9. Most Charitable Interpretation (Brown, 2017; Kennedy, 2022):

Using most charitable interpretation in response to stressful events or people is essentially exercising extreme empathy. Intentionally trying to think of the most generous reason a person is behaving a certain way, may allow for a lessened emotional response to a stressor. Someone may cut you off on the highway because of ego or it may be a parent who just received a concerning call about a child. Regardless of the reason, using the most charitable interpretation to consider the reasons behind a stressor will decrease the emotional response.

Stress is part of the human experience

The physiology of stress is one of the original functions of our central nervous system. The emotional brain, or limbic system, houses our sympathetic nervous system which is responsible for activating the fight-flight-or-freeze response. This automatic reaction to perceived stressors was designed to help us survive dangerous situations. When activated, heart rate and blood pressure increase, breathing rate changes, and pupils dilate. Following stress, the parasympathetic nervous system then works to restore everything to baseline (Cleveland Clinic, 2019). After millions of years of evolution, the rational brain (i.e., neocortex) evolved from the limbic system to create the modern human brain (Goleman, 2007; Salovey et al, 2004). To this day, physiological stress responses still play out the same, regardless of the trigger. Physical, social, cognitive/emotional or spiritual roots of stress all induce the same reaction. The only factors that differ are the intensity and duration of the response (Cleveland Clinic, 2019).

Rewiring your brain for an improved stress response

Neuroplasticity is the ability of the nervous system to change its activity in response to intrinsic or extrinsic stimuli by reorganizing its structure, functions, or connections (Mateos-Aparicio and Rodríguez-Moreno, 2019). Our brain has the incredible ability to strengthen or weaken neural connections based on inputs. This applies to everything we do. Our thoughts, habits and skills are all products of neuroplasticity and prone to further adaptation. With practice, we can intentionally cause plasticity in our stress physiology (Kays, 2012; Greenberg, 2017).

The previously mentioned strategies can be excellent tools to recover from negative effects of stress. They are skills that we can use to become competent in over time. Noel Burch developed the four stages of competence model, stating we fall into one of four stages for all potential skills in life (Adams, 2021):

Unconsciously incompetent: We don’t know what we don’t know. We are inept and unaware of it.

Consciously incompetent: We know what we don’t know. We start to learn at this level when awareness of how inept we are shows how much we need to improve.

Consciously competent: Try the skill out, actively experiment, and practice it. We now know how to do the skill the right way, but we need to think and work hard to do it.

Unconsciously competent: If we continue to practice and apply the new skills, eventually we arrive at a stage where they become easier, and given time, even natural.

The best way to develop a skill is to practice using it in response to a self-created stressor. Deliberate discomfort causes neuroplasticity to improve resilience over time. Intentionally inducing stress in some capacity, with proper use of coping strategies, trains the mind and body to effectively respond to future stressors. Whether it’s a sauna, cold showers, exercise, public speaking, meditation, a difficult conversation you’ve been putting off, driving in traffic, fasting, dedicated time without technology, or something uniquely beneficial to you that delays gratification, your self-created stressor will begin to cause beneficial neuroplasticity in your stress response. Entering into a situation that typically causes emotional distress with a prepared, rational mind changes how you respond to adversity. Setting aside time to gradually challenge yourself is both self-care and resilience training that will lead to fulfillment and prevention of stress injuries.

In summary, stressors are inevitable. However, everyone can become more aware of stress and push themselves by practicing intentional stress while utilizing a management strategy to build resilience over time.

You can’t be brave without experiencing fear, and you can’t be resilient without experiencing stress.

More on NAWCAD’s Lt. Cmdr. Kyle Shepard
Lt. Cmdr. Kyle Shepard, Au.D, is an audiologist for the United States Navy. Shepard has been a stress management and resilience instructor for the Navy for seven years, and ran the stress management program for Naval Hospital Guam for two and a half years. The program was recognized for several best practices and designated the top program in Navy medicine at the time.

What stresses Shepard out? The most common source of stress in Shepard’s life is the never-ending attempt at balance between work and family. Shepard is married with three younger children—trying to do right by them, along with giving his best effort to the military is a daily challenge.

How does he cope? By focusing on consistent communication with his family and teammates about daily tasking and priorities so everyone understands what he is doing and why. For Shepard, intentional breathing also helps. Once his initial stress response improves through intentional breathing (usually nasal so it is hard for anyone to notice), his favorite strategy becomes his most charitable interpretation. There are many reasons a person is behaving or a situation is happening a given way. Considering the most generous perspective is his surefire way to get out of his own head and ensure his actions are rational rather than emotional. To build resilience overtime, Shepard pursues intentional stress daily using various breathing techniques. His favorite stress inducing activities include exercise, sauna, cold showers, intermittent fasting, and mixed martial arts/jiu jitsu.

Disclaimer:

The content provided is intended for general knowledge and informational purposes only and is not a replacement for medical advice. Always consult with a qualified healthcare professional prior to making any decisions or changes relating to your health. Kyle Shepard is not responsible for any adverse effects resulting from the use of information in this publication.

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Resilient Mental State

Stress Management 101