Daily Stress Management Reduces Risk of Symptom Relapse

We all get stressed.

Everyone. That includes adults, teenagers, and children: it’s part of being human. Most of the time, stress is a negative experience for the person experiencing it.

But we should all understand that not all stress is bad. Sometimes, it helps – but not always.

Experts identify two types of stress.

First, there’s acute stress.

Acute stress can be helpful, but it rarely feels good while it happens.  It’s your innate, neurochemical reaction to external threats. When you go to cross the street, but have to jump back at the last second because you see a car speeding toward you, the adrenaline rush you feel is acute stress. Most of us understand this as our fight-or-flight mechanism. After the threat is gone – in this example, the speeding car – the stress goes away, too. We’re on edge for a little while, then we relax: that’s how it works.

Second, there’s chronic stress.

Chronic stress lasts much longer than acute stress. It stays even when the threat is no longer present. One thing to understand about chronic stress is that it’s not always caused by something external. Emotional or psychological pain or discomfort can trigger chronic stress. If you’re a teenager, think about going to a school you don’t like surrounded by people you don’t get along with for an entire school year. Then add being bullied by all the mean kids every day: that would be a taste of chronic stress.

The thing about exposure to chronic is that to your body and mind, it’s the same thing as acute stress. Your brain can’t tell the difference. That’s why it can cause problems, especially for teens in a treatment program for a mental health, behavioral, or alcohol/substance use disorder.

Why Should Teens in Treatment Learn To Manage Stress?

The short answer: stress can lead to relapse.

Here’s the long answer.

The difficult emotions associated with the symptoms of mental health disorders such as anxiety, depression, bipolar disorder, or addiction are significant sources of stress. When that stress is untreated, it becomes chronic.

Symptoms of chronic stress that manifest in daily behavior include:

• Withdrawing from loved ones and friends
• Eating too much or eating too little
• Alcohol or drug use
• Smoking cigarettes
• Becoming sedentary

Symptoms of chronic stress that manifest in emotions include:

• Low or sad mood
• Feeling anxious
• Hostility/anger
• Feeling overwhelmed
• Confusion/lack of focus

Symptoms of chronic stress that manifest in the body include:

• Feeling tired all the time
• Poor sleep
• Nausea
• Headaches
• Stiffness and pain in muscles and joints

Teenagers in treatment for mental health, behavioral, or addiction disorders quickly learn what we mention above: stress can lead to patterns of thought and behavior that increase the chance of returning to drug or alcohol use. This applies to mental health and behavioral disorders as well as for addiction disorders. And that means it’s critical for teenagers in treatment and recovery to know what stress looks like and feels like. What’s more important, though, is that they learn and practice ways to manage stress so that when it arrives, they know exactly how to handle it.

Stress Management for Teens During Treatment

When teens enter treatment for a mental health, behavioral, or addiction disorder, they participate in a range of evidence-based therapeutic approaches, complementary modalities, and experiential activities that all work toward their overall health and well-being.

One thing these treatments have in common is that on some level, they all work to help teens manage difficult emotions, which often either cause stress or are themselves stressful in the moment. We’ll review how stress management appears in the various therapies common to treatment and recovery for mental health and addiction issues:

Dialectical Behavior Therapy (DBT)

Four of the five core modules of adolescent DBT – mindfulness, emotion regulation, distress tolerance, and walking the middle path – are directly related to process of managing difficult feelings. DBT helps teens find balance. When they find balance, they decrease the stress associated with their symptoms. And when they do that, they reduce the overall load that chronic stress places on their mind and body.

Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy helps teens understand that specific patterns of thought lead to specific patterns of behavior. CBT therapists help teens identify which patterns of thought are life-interrupting and lead to life-interrupting behaviors, and replace those patterns of thought with those that aren’t life-interrupting, and therefore have less chance of leading to life-interrupting behavior. When teens learn to identify and rectify these maladaptive patterns of thought, their overall stress levels decrease – and their overall state of health and well-being improves.

Mindfulness-Based Cognitive Behavioral Therapy (MBCBT)

We describe the core CBT process above. Mindfulness-based CBT takes this process and adds a foundational principle of mindfulness: observation without judgment. Although teens learn to identify which thought processes help them and which processes derail them, they also learn not to label those processes as inherently bad: they simply learn they’re not helpful in their lives, and may be counter-productive to the process of recovery. When teens learn how to apply this skill to the symptoms of a mental health or addiction disorder, they can then transfer the same skill to stressful thoughts and circumstances they encounter at school at home, and with friend, which helps reduce the overall amount of stress in their lives, and reduces exposure to chronic stress.

How to Apply Treatment-Related Stress Management Techniques to Every Day Life

Implementing stress management in your life is not always easy. can be tricky. However, almost all the tried and true approaches to stress management are relatively simple. The key is recognizing when you need them and then using them right away, rather than waiting for acute stress to become chronic. Here’s a helpful suggestion:

Make the fundamental techniques part of your daily routine. That way, you reduce stress before it causes problems.

Here are the top five quick and simple tips for beating stress – and they’re all derived from things teens learn while in treatment.

Five Tips to Beat Stress: Teens in Treatment

1. Do Fun Things

Practice hobbies like reading, playing and listening to music, creating art, or doing anything you love that supports your treatment and recovery plan. In the language of treatment, doing things you love involves the putting the lifestyle modifications learned in treatment to life at home.

2. Live an Active Lifestyle

Your exercise routine can be simple or complex: whatever you like, do that. You can keep it mellow with simple things such as walking, yoga, or casual bike riding. Or you can go all in and take up running, workout classes like cardio kickboxing, or check out martial arts classes. Whatever you do, make sure it reduces stress. Don’t cause more stress by putting pressure on yourself to exercise like a pro athlete. Instead, find a routine that fills you with energy and enhances your life: this is the role of exercise during treatment, and it’s also a healthy role for exercise in life after treatment.

3. Study Mindfulness

The very best thing about mindfulness techniques is their simplicity. Once you learn them, they’re yours forever. Most mindfulness techniques take no special equipment, no special location, and very little time. That means you can do them anywhere, anytime, and experience their benefits. Mindfulness techniques learned during treatment encourage independence, increase personal agency, and enhance self-esteem, all while reducing stress. That’s a powerful combination, and makes learning mindfulness techniques well worth the effort.

4. Spend Time With People You Love

One thing many of us want to do when we’re stressed is curl up in a ball and hide from the world. That can work – for maybe a few minutes. But it’s not sustainable. Once you have your alone time, it’s important to reach out to friends and family. You may want to talk through what’s bothering you, because talking helps. Or you may just want to hang out and not talk about things, but rather simply enjoy being with people who make you laugh and feel good. That’s therapeutic, too. Our friends can be a sounding board, or they can be a short, rejuvenating escape: both are equally valid – in moderation, of course. During treatment, workshops and educational classes that focus on rebuilding and repairing relationships help make reaching out more realistic and achievable during life after treatment.

5. Eat a Healthy Diet

This is easier than you think: the secret is avoiding prepackaged foods, processed foods, and candy/junk/fast food as much as possible. Once in a while? Sure. But your daily diet should consist of the common-sense healthy foods we all know about: fresh fruits and vegetables, whole grains, and lean protein. Some teens learn good eating habits for the first time during treatment. When they carry these habits into life after treatment, they increase their chances of avoiding stress related to poor health related to inadequate or sub-par nutrition.

Practice Makes It Work

The secret to beating stress is not a secret.

The foundation of practical, real world stress management is making all five things on the list above the rule, rather than the exception to the rule.  You need to make them habits, and that requires daily diligence and practice. The best way is to start small and stay consistent. Changing everything all at once overnight rarely works. It’s better to take a measured, consistent approach. You start in treatment, and continue when you get home. Gradually, stress management becomes a default part of your routine. When these positive actions become regular, daily habits, an increase in stress doesn’t throw everything in your life askew, because you’ve got effective stress management skills ready and waiting.