6 Pillars of Good Health: A Calm Mind and Balance in Stress Management

Stress is a state of anxiety or mental discomfort that arises when facing difficulties. It is a natural human response to the challenges and threats encountered in everyday life. While the level of stress experienced varies among individuals, chronic stress can exacerbate health problems, including cardiovascular disease, depressive disorders, insulin resistance, and many other conditions. Therefore, stress management is recognized as the fifth pillar of Lifestyle Medicine and plays a crucial role in holistic healthcare.

In addition to its direct impact on health and well-being, stress also affects other health-related behaviors, including:

• Sleeping behaviors - Stressful situations, such as high-pressure work or exposure to violent media content, can alter brain wave patterns during sleep, and lead to frequent awakenings throughout the night.
• Exercise behaviors - Although exercise can help relieve stress, individuals experiencing stress often become less physically active. This is particularly common among those under chronic stress, such as medical students, new mothers, and cancer survivors, who tend to engage in less physical activity than average.

o   Alcohol consumption and smoking behaviors - Much of everyday stress arises from common issues, such as financial problems, work demands, or health concerns. These stressors can lead to maladaptive coping strategies, including drinking alcohol and smoking. Other behaviors, such as watching television, internet browsing, napping, or overeating, are also common ways that people cope with stress.

Guidelines for Stress Management: Strategies for a Resilient Mind

There are several approaches to stress management, as follows:

1. Relaxation – The breathing technique is an effective way to relax. Begin by inhaling through the nose for 4 seconds, holding the breath for 7 seconds, and then exhaling through the mouth for 8 seconds. Repeat this cycle three times until a steady and rhythmic breathing pattern is achieved.
2. Behavioral strategies- Distraction techniques can help manage stress. Listening to music, chewing gum, and avoiding stress-inducing stimuli are some of examples. Time management is another effective behavioral strategy for coping with stress.
3. Cognitive strategies - Avoiding extreme or black-and-white thinking (Dichotomous thinking) and practicing positive self-affirmations can help reinforce one’s sense of self-worth and potential, promoting a more balanced and realistic perspective on life.

There is no single perfect approach to stress management; multiple strategies can be combined or adapted to suit different situations. The key to effective stress management is consistent practice, which allows an individual to cope with stress more efficiently.

Mindfulness: A Practice for Balanced Well-Being

Mindfulness practice is a non-pharmacological approach to stress reduction and is considered an effective method in Lifestyle Medicine. The key to mindfulness lies in cultivating awareness of one’s state—whether thoughts, emotions, or present experiences. With this awareness, individuals can adapt more effectively and manage stress more efficiently.

Practicing mindfulness has been developed into stress management programs that help patients gain greater control over stress, anxiety, pain, and depression, while enhancing their ability to care for themselves. Numerous studies have highlighted its benefits for both physical and mental health. These include improved concentration, increased adaptability to challenges, enhanced self-esteem, overall well-being, and reductions in inflammation and stress-related pain.

With consistent practice over time, mindfulness enhances activity in the left prefrontal cortex, increases gray matter density in the hippocampus, and reduces gray matter in the amygdala. These brain regions plays key roles in planning, personality, learning, memory, emotions, problem solving, self-awareness, and empathy. Therefore, mindfulness can be seen as the practical application of awareness to effectively respond to life’s challenges.

Stress management does not mean avoiding problems. It involves developing skills and attitudes that enable individuals to face their challenges with resilience. Calmness does not come from a problem-free world, but from being well-prepared to handle whatever comes our way without letting it affect physical or mental health, while also supporting a holistic approach consistent with Lifestyle Medicine.

Refer

1. Braun C, Foreyt JP, Johnston CA. Stress: a core lifestyle issue. Am J Lifestyle Med. 2016 Jun 22;10(4):235-8.
2. Shurney D. Employing mindfulness in lifestyle medicine. Am J Lifestyle Med. 2019 Nov;13(6):561-4.
3. World Health Organization. Stress [Internet]. 2023 Feb 21 [cited 2025 Sep 2]. Available from: https://www.who.int/news-room/questions-and-answers/item/stress