Stress: Consequences and Management (Part 2)

Management of stress

Pharmacological

Short-term use of benzodiazepine in low dose is useful in helping the person struggling with a stressor. 

Cognitive-behavioural approaches

"The greatest weapon against stress is one's ability to choose one thought over another":- William James

Nowadays, CBT is increasingly used to manage stress response. It is based primarily upon the understanding that cognitive appraisal about the stressful event and the coping mechanism used to these appraisals determine the stress response. 

These cognitive appraisals are of two type

First, Primary Appraisal: This refers to the way in which individual evaluate the importance or meaning of the stressor or event, e.g. a person diagnosed with a chronic illness and he appraises it as a harmful, a loss or threatening one and start thinking that I will never able to do anything, and I really will care about it. Which, in turn, leads him anxious, depressed and withdrawn.  Consider a different scenario; if he takes it as a challenging and starts thinking that although he is not able to do some activities, still there are many others that he can do and enjoy. In this, there are more chances of a positive outcome. 

Second, Secondary Appraisal: This refers to the process of evaluating the event and thinking about what next can be done and whether it will work or not. Here many factors influence this like their learning history, mastery of coping skill etc.

There are three main aims of CBT:

First, to make the person more aware of his/her cognitive appraisal

Second, to make them understand their appraisal and how it affects their negative emotions and behavioural responses and help them to reconceptualise their cognitive appraisal.

Third, to train them to use and develops other cognitive and behavioural techniques. 

CBT is efficacious in the management of stress. There is ample research showing its effectiveness.  Most of the time it combined with stress management skills like self-observation, cognitive restructuring, relaxation training, time management and problem-solving.