Get $15 off your first month of ED treatment (if prescribed). Start now.

Aug 10, 2021
14 min read

How to relieve stress: proven tips and techniques

Hundreds of apps, programs, and claims circulate daily about the best ways to alleviate stress. What works for some may not work for others. Fortunately, there are a variety of approaches, tips, and techniques that are backed up by research.

Disclaimer

If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.

    We all experience stress from time to time. We may be late for work, anxious about a project, or worried about a family member or friend with health problems. Stress levels may range from minor to extreme, but how the body responds relies on the same chemical cascade. 

    The body’s stress response sends adrenaline and cortisol through the body to activate the muscles, heart, and other systems required for a physical reaction, also known as the classic fight-or-flight response (Chu, 2020).

    The problem is we typically don’t need a physical response when we react to everyday stressors. In the long run, stress hormones can boost the risk for anxiety, depression, and many diseases such as heart disease and cancer (Mariotti, 2015, Yaribeygi, 2017). That’s why de-stressing has become a constant goal for many. 

    The good news: there are some fun ways to turn off the stress response.

    Identify what causes stress

    To lower stress, it’s helpful to start making a list and ask yourself which stressors you can control and which ones you can’t. 

    Before letting a stressor take over your thoughts, healthcare professionals suggest asking the following: Is the cause of stress based on a fact or perception? Is this thought helpful? 

    For instance, if you don’t hear from a friend for a while, you may assume they don’t like you anymore. In reality, they may be managing a family crisis you don’t know about. Some thoughts are not true and not helpful and can lead to a vicious cycle that can be draining. Experts point out that analyzing a stressor or negative thought can help you determine if it’s worth the stress (Miller, 2001).

    Choose your coping style

    If you have some control over a stressor, taking action may help lower stress by solving the issue that’s generating the stress to begin with. This is called problem-focused coping. For example, if you’re worried about a test, spend extra time studying for it (APA, 2020a; Sirois, 2016).

    If a stressor is out of your control, experts suggest emotion-focused coping. This is changing your emotional reaction to a stressor. An example would be tuning out a negative colleague to take a meditation break (APA, 2020b).

    Pick a stress-reducing technique

    Whatever coping style you use, there are many stress-reducing techniques to try. Some can bring down your cortisol levels quickly. The following approaches have been shown to reduce stress and, in many cases, boost mood:  

    Reframe and reach out

    ‘Glass half full’ thinking, laughing, and connecting with people and pets have all been shown to alleviate stress. 

    Embrace positive thinking

    If something doesn’t go well, how do you react? Positive reframing steers away from self-blame. It involves thinking of a situation more positively and can improve mood and self-esteem (Stoeber, 2011). 

    Re-thinking negative thought patterns is a mainstay of cognitive-behavioral therapy (CBT), which has been shown to be effective for reducing stress. CBT is a proven approach you can combine with relaxation techniques (Hofmann, 2012).

    Try gratitude journaling

    Keeping a gratitude journal can be an effective way to stay positive (Kelly, 2016). Gratitude journaling—jotting down what you are grateful for each day—has been shown to improve mood, happiness, and life satisfaction, while reducing depression symptoms (Cunha, 2019). 

    Laugh away stress

    Laughter has been shown to reduce blood pressure and the stress hormones cortisol and epinephrine while boosting dopamine—the chemical that makes us feel happier. Laughter also helps form social bonds and may help boost immunity (Savage, 2017; Louie, 2016; Bennett, 2003).

    Boost social bonds

    Spending time with a loved one and expanding social connections can be one of the best ways to reduce stress. Studies show that perceived social support and hugs lower the risk of infections, even if there are conflicts between people (Cohen, 2015). The hormone oxytocin increases when couples kiss or hug. Oxytocin reduces the stress hormone cortisol, lowers blood pressure, and protects brain cells during stress (Moberg, 2020; Matsushita, 2019). 

    Seek pet support

    Human-animal bonding has been shown to reduce cortisol, heart rate, and blood pressure while improving mood and interactions with people (Beetz, 2012). A broad review of various studies concludes that pet therapy is an effective stress buffer (Ein, 2018). 

    Build daily stress resilience

    Have you ever woken up after a great night of sleep and felt like you could take on the world? Sleep, exercise, and diet help boost resiliency by keeping your body and brain in peak shape. Here are daily activities that can help you set the stage for stress resistance:

    Exercise regularly 

    You don’t have to be at the gym every day to reap the benefits of exercise. Even a moderate amount of daily physical activity can improve physical and mental well-being, including lowering stress levels. Researchers say you can reduce stress within hours of exercise and that exercise can break the cycle’ of inactivity, stress, and negative emotions (Schultchen, 2019). 

    Exercise ultimately has several beneficial effects on the body. It helps you sleep better. Sleep boosts endorphins—the body’s natural pain killers. Endorphins, in turn, boost dopamine levels, which increase feelings of pleasure (Anderson, 2013).

    Sleep to recharge

    Stress and worrying can lead to sleep problems like insomnia (Kalmbach, 2018). A lack of sleep can make it harder to cope with daily life stressors, making bigger stressors extremely challenging (Han, 2012). Healthcare providers suggest creating good sleep habits that involve regular sleep times, exercise, and reduced caffeine intake, and seeking help if you’re struggling with sleep (Karna, 2021). 

    Eat to boost mood

    Data consistently shows the importance of a balanced diet for peak mental health (Muscaritoli, 2021). Eating five servings of fruit and vegetables a day has been linked to lower psychological distress, and some studies link higher antioxidant levels with lower levels of depression and anxiety (Abshirini, 2019; Guatam, 2012). Additional research is underway. 

    Tap the mind-body connection

    Mind-body approaches to wellness have been shown to help alleviate stress, improve mood and sleep, and have other benefits. Meditation and mindfulness often go hand-in-hand but can also be done separately.  

    Change your breathing

    Deep breathing exercises can serve as an antidote to the rapid breathing the stress response triggers. Long deep breaths signal to the body’s nervous system that it’s time to reverse the fight-or-flight response and move to what is referred to as the rest-and-digest mode (Perciavalle, 2017; Zaccaro, 2018). Some deep breathing techniques have been shown to reduce cortisol and improve cognition (Ma, 2017). 

    A practice known as 2:1 breathing is among those used to reverse the stress response. It involves exhaling and inhaling through your nose using a 2-to-1 ratio. For example, you would count to two while inhaling and four while exhaling (Adhana, 2013). 

    Meditate and let go

    Letting go of stressful thoughts is not easy. Letting go of racing thoughts is the goal of many forms of meditation and takes some practice. Studies show meditation has a number of health benefits, including reduced blood pressure and stress hormones (Pascoe, 2017). Serious practitioners can even increase the size of some parts of their brains (Kang, 2012). There are a wide variety of meditations to try. Many involve focusing on a word or image to keep daily thoughts from entering the mind. Some are as simple as counting your breaths (Roca, 2021).

    Try moving meditation

    Countless practices combine movement and meditation. Among the most popular: yoga, Tai Chi, Qi Gong, and walking meditation. All have shown benefits in reducing stress and have the added bonus of improving balance and flexibility (Maddux, 2018; Zheng, 2018; Wang, 2014; Polsgrove, 2018; Huang, 2015; Stahl, 2020).

    Practice mindfulness

    A core element of many meditations is the concept of mindfulness. Mindfulness involves focusing on the present moment. Like meditation, the practice pushes away daily thoughts that can create stress. Studies show it reduces stress and anxiety. Mindfulness is frequently a component of meditation, stress management programs, and some cognitive behavioral therapy approaches (Worthen, 2020).  

    Relax through repetition

    Repetitive tasks like coloring mandalas can be calming. A study showed coloring a complex geometric pattern rather than a blank sheet of paper induced a meditative state and led to lower anxiety levels. Researchers theorize that repetitive, structured tasks or movements that don’t take a lot of thought can let the mind relax (Curry, 2005). 

    Engage the senses

    Want to get out in nature? It can help reduce stress, even if you visualize it with the help of a recording. Many stress relievers rely on our senses: 

    Guided imagery

    Hearing a calming voice navigating you through amazing terrain is a stress-reducing option that can be done seated at your desk. Guided imagery means taking a short vacation in your mind. It typically involves a recording that walks you through a relaxing scene. You can also practice guided imagery on your own. The key is to imagine all the sensory experiences you would feel if you were there. Research supports using guided imagery to reduce stress and anxiety, boost the immune system and enhance well-being (Giacobbi, 2017; Krau, 2020). 

    Aromatherapy

    Various studies show aromatherapy can improve sleep and reduce anxiety (Freeman, 2019; Ramsey, 2020a). Aromatherapy involves inhaling essential oils that are heated to form vapors. Essential oils are plant-based oils that come in a variety of types, have different properties, and can be either inhaled or placed on the skin. Some types can be ingested. Essential oils have been used for thousands of years, and studies show a range of health benefits if used correctly (Elshafie, 2017; Peterfalvi, 2019).

    Caution: There have been adverse effects linked to essential oils, including allergic reactions, burns to the skin, and some essential oils contain endocrine disruptors (Ramsey, 2019; Henley, 2007). Research showing hormone disruption in adolescents has prompted a government warning about using products containing lavender and tea tree oils. If trying aromatherapy, review instructions and precautionary materials, and keep essential oils out of the reach of children. It’s best to check with your healthcare provider if you have any questions (Posadzki, 2012).  

    Calm stress with water

    For those who enjoy a hot or warm bath to de-stress, there may be a reason. Hot baths may reduce cortisol levels (An, 2019; Kojima, 2018). Even the sound of water has a relaxing effect. Rippling water sounds are also shown to reduce levels of cortisol (Thoma, 2013). 

    Find a forest

    If you’re sensing a ‘back to nature’ theme, there’s more. Forest bathing—getting out into nature—has been linked to a broad range of positive health benefits and can help ease stress. Studies show leaving an urban area and relaxing and exploring in a forested natural area lowers cortisol, adrenaline, and heart rate while improving mood (Wen, 2019; Ochiai, 2015a, Ochiai, 2015b; Jia, 2016; Li, 2016).

    References

    1. Abshirini, M., Siassi, F., Koohdani, F., Qorbani, M., Mozaffari, H., Aslani, Z., et al. (2019). Dietary total antioxidant capacity is inversely associated with depression, anxiety and some oxidative stress biomarkers in postmenopausal women: a cross-sectional study. Annals of General Psychiatry, 18(1). doi: 10.1186/s12991-019-0225-7. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6423824/
    2. Adhana, R., Gupta, R., Dvivedii, J., & Ahmad, S. (2013). The influence of the 2:1 yogic breathing technique on essential hypertension. Indian Journal of Physiology and Pharmacology, 57(1), 38–44. Retrieved from https://pubmed.ncbi.nlm.nih.gov/24020097/
    3. American Psychological Association. (n.d.). Emotion-focused coping. APA Dictionary of Psychology. Retrieved from https://dictionary.apa.org/emotion-focused-coping
    4. American Psychological Association. (n.d.). Problem-focused coping. APA Dictionary of Psychology. Retrieved from https://dictionary.apa.org/problem-focused-coping
    5. An, J., Lee, I., & Yi, Y. (2019). The thermal effects of water immersion on health outcomes: An integrative review. International Journal of Environmental Research and Public Health, 16(7), 1280. doi: 10.3390/ijerph16071280. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6479732/
    6. Anderson, E., & Shivakumar, G. (2013). Effects of exercise and physical activity on anxiety. Frontiers in Psychiatry, 4. doi: 10.3389/fpsyt.2013.00027. Retrieved from https://www.frontiersin.org/articles/10.3389/fpsyt.2013.00027/full
    7. Beetz, A., Uvnäs-Moberg, K., Julius, H., & Kotrschal, K. (2012). Psychosocial and psychophysiological effects of human-animal interactions: The possible role of oxytocin. Frontiers in Psychology, 3. doi:10.3389/fpsyg.2012.00234. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3408111/
    8. Bennett, M. P., Zeller, J. M., Rosenberg, L., & McCann, J. (2003). The effect of mirthful laughter on stress and natural killer cell activity. Alternative Therapies in Health and Medicine, 9(2), 38–45. Retrieved from https://pubmed.ncbi.nlm.nih.gov/12652882/
    9. Chu, B. (2021). Physiology, stress reaction. In: StatPearls [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK541120/
    10. Cohen, S., Janicki-Deverts, D., Turner, R. B., & Doyle, W. J. (2014). Does hugging provide stress-buffering social support? A study of susceptibility to upper respiratory infection and illness. Psychological Science, 26(2), 135–147. doi: 10.1177/0956797614559284. Retrieved from https://pubmed.ncbi.nlm.nih.gov/25526910/
    11. Cunha, L. F., Pellanda, L. C., & Reppold, C. T. (2019). Positive psychology and gratitude interventions: A randomized clinical trial. Frontiers in Psychology, 10. doi: 10.3389/fpsyg.2019.00584. Retrieved from https://pubmed.ncbi.nlm.nih.gov/30949102/
    12. Curry, N. A., & Kasser, T. (2005). Can coloring mandalas reduce anxiety? Art Therapy, 22(2), 81–85. doi: 10.1080/07421656.2005.10129441. Retrieved from https://www.tandfonline.com/doi/abs/10.1080/07421656.2005.10129441
    13. Ein, N., Li, L., & Vickers, K. (2018). The effect of pet therapy on the physiological and subjective stress response: A meta-analysis. Stress and Health, 34(4), 477–489. doi: 10.1002/smi.2812. Retrieved from https://pubmed.ncbi.nlm.nih.gov/29882342/
    14. Elshafie, H. S., & Camele, I. (2017). An overview of the biological effects of some Mediterranean essential oils on human health. BioMed Research International, 2017, 1–14. doi: 10.1155/2017/9268468. Retrieved from https://pubmed.ncbi.nlm.nih.gov/29230418/
    15. Freeman, M. (2019). Aromatherapy and essential oils: A map of the evidence. National Center for Biotechnology Information. Retrieved from https://pubmed.ncbi.nlm.nih.gov/31851445/
    16. Gautam, M., Agrawal, M., Gautam, M., Sharma, P., Gautam, A. S., & Gautam, S. (2012). Role of antioxidants in generalised anxiety disorder and depression. Indian Journal of Psychiatry, 54(3), 244. doi:10.4103/0019-5545.102424. Retrieved from https://pubmed.ncbi.nlm.nih.gov/23226848/
    17. Giacobbi, P. R., Stewart, J., Chaffee, K., Jaeschke, A.-M., Stabler, M., & Kelley, G. A. (2017). A scoping review of health outcomes examined in randomized controlled trials using guided imagery. Progress in Preventive Medicine, 2(7). doi: 10.1097/pp9.0000000000000010. Retrieved from https://pubmed.ncbi.nlm.nih.gov/29457147/
    18. Han, K. S., Kim, L., & Shim, I. (2012). Stress and sleep disorder. Experimental Neurobiology, 21(4), 141–150. doi: 10.5607/en.2012.21.4.141. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3538178/
    19. Henley, D. V., Lipson, N., Korach, K. S., & Bloch, C. A. (2007). Prepubertal gynecomastia linked to lavender and tea tree oils. New England Journal of Medicine, 356(5), 479–485. doi: 10.1056/nejmoa064725. Retrieved from https://pubmed.ncbi.nlm.nih.gov/17267908/
    20. Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognitive Therapy and Research, 36(5), 427–440. doi: 10.1007/s10608-012-9476-1. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3584580/
    21. Huang, Y., & Liu, X. (2015). Improvement of balance control ability and flexibility in the elderly Tai Chi Chuan (TCC) practitioners: A systematic review and meta-analysis. Archives of Gerontology and Geriatrics, 60(2), 233–238. doi: 10.1016/j.archger.2014.10.016. Retrieved from https://pubmed.ncbi.nlm.nih.gov/25497683/
    22. Jia et al., B. B. (2016). Health effect of forest bathing trip on elderly patients with chronic obstructive pulmonary disease. Biomedical and Environmental Sciences: BES; 29(3), 212–218. doi: 10.3967/bes2016.026. Retrieved from https://pubmed.ncbi.nlm.nih.gov/27109132/
    23. Kalmbach, D. A., Anderson, J. R., & Drake, C. L. (2018). The impact of stress on sleep: Pathogenic sleep reactivity as a vulnerability to insomnia and circadian disorders. Journal of Sleep Research, 27(6). doi: 10.1111/jsr.12710. Retrieved from https://pubmed.ncbi.nlm.nih.gov/29797753/
    24. Kang, D.H., Jo, H.J., Jung, W.H., Kim, S.H., Jung, Y.H., Choi, C.H., et al. (2012). The effect of meditation on brain structure: cortical thickness mapping and diffusion tensor imaging. Social Cognitive and Affective Neuroscience, 8(1), 27–33. doi: 10.1093/scan/nss056. Retrieved from https://pubmed.ncbi.nlm.nih.gov/22569185/
    25. Karna, B. (2021). Sleep disorder. In: StatPearls [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK560720/
    26. Kelly, J. D. (2016). Your best life: Breaking the cycle: The power of gratitude. Clinical Orthopaedics & Related Research, 474(12), 2594–2597. doi: 10.1007/s11999-016-5100-0. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5085955/
    27. Kojima, D., Nakamura, T., Banno, M., Umemoto, Y., Kinoshita, T., Ishida, Y., & Tajima, F. (2017). Head-out immersion in hot water increases serum BDNF in healthy males. International Journal of Hyperthermia, 34(6), 834–839. doi: 10.1080/02656736.2017.1394502. Retrieved from https://pubmed.ncbi.nlm.nih.gov/29157042/
    28. Krau, S. D. (2020). The multiple uses of guided imagery. Nursing Clinics of North America, 55(4), 467–474. doi: 10.1016/j.cnur.2020.06.013. Retrieved from https://pubmed.ncbi.nlm.nih.gov/33131625/
    29. Li, Q., Kobayashi, M., Kumeda, S., Ochiai, T., Miura, T., Kagawa, T., et al. (2016). Effects of forest bathing on cardiovascular and metabolic parameters in middle-aged males. Evidence-Based Complementary and Alternative Medicine, 2016, 1–7. doi: 10.1155/2016/2587381. Retrieved from https://pubmed.ncbi.nlm.nih.gov/27493670/
    30. Louie, D., Brook, K., & Frates, E. (2016). The laughter prescription. American Journal of Lifestyle Medicine, 10(4), 262–267. doi: 10.1177/1559827614550279. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6125057/
    31. Ma, X., Yue, Z.Q., Gong, Z.Q., Zhang, H., Duan, N.Y., Shi, Y.T., et al. (2017). The effect of diaphragmatic breathing on attention, negative affect and stress in healthy adults. Frontiers in Psychology, 8. doi: 10.3389/fpsyg.2017.00874. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5455070/
    32. Maddux, R. E., Daukantaité, D., & Tellhed, U. (2017). The effects of yoga on stress and psychological health among employees: an 8- and 16-week intervention study. Anxiety, Stress, & Coping, 31(2), 121–134. doi: 10.1080/10615806.2017.1405261. Retrieved from https://pubmed.ncbi.nlm.nih.gov/29166771/
    33. Mariotti, A. (2015). The effects of chronic stress on health: new insights into the molecular mechanisms of brain–body communication. Future Science OA, 1(3). doi: 10.4155/fso.15.21. Retrieved from https://pubmed.ncbi.nlm.nih.gov/28031896/
    34. Matsushita, H., Latt, H. M., Koga, Y., Nishiki, T., & Matsui, H. (2019). Oxytocin and stress: Neural mechanisms, stress-related disorders, and therapeutic approaches. Neuroscience, 417, 1–10. doi: 10.1016/j.neuroscience.2019.07.046. Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S0306452219305378?via%3Dihub
    35. Miller, F. E. (2001). Challenging and changing stress-producing thinking. Western Journal of Medicine, 174(1), 49–50. doi: 10.1136/ewjm.174.1.49. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1071234/
    36. Moberg, K. U., Handlin, L., & Petersson, M. (2020). Neuroendocrine mechanisms involved in the physiological effects caused by skin-to-skin contact – With a particular focus on the oxytocinergic system. Infant Behavior and Development, 61, 101482. doi: 10.1016/j.infbeh.2020.101482. Retrieved from https://pubmed.ncbi.nlm.nih.gov/32919112/
    37. Muscaritoli, M. (2021). The impact of nutrients on mental health and well-being: Insights from the literature. Frontiers in Nutrition, 8. doi: 10.3389/fnut.2021.656290. Retrieved from https://pubmed.ncbi.nlm.nih.gov/33763446/
    38. Ochiai, H., Ikei, H., Song, C., Kobayashi, M., Takamatsu, A., Miura, T., et al. (2015). Physiological and psychological effects of forest therapy on middle-aged males with high-normal blood pressure. International Journal of Environmental Research and Public Health, 12(3), 2532–2542. doi: 10.3390/ijerph120302532. Retrieved from https://pubmed.ncbi.nlm.nih.gov/25809507/
    39. Ochiai, H., Ikei, H., Song, C., Kobayashi, M., Miura, T., Kagawa, T., et al. (2015). Physiological and psychological effects of a forest therapy program on middle-aged females. International Journal of Environmental Research and Public Health, 12(12), 15222–15232. doi: 10.3390/ijerph121214984. Retrieved from https://pubmed.ncbi.nlm.nih.gov/26633447/
    40. Pascoe, M. C., Thompson, D. R., Jenkins, Z. M., & Ski, C. F. (2017). Mindfulness mediates the physiological markers of stress: Systematic review and meta-analysis. Journal of Psychiatric Research, 95, 156–178. doi: 10.1016/j.jpsychires.2017.08.004. Retrieved from https://pubmed.ncbi.nlm.nih.gov/28863392/
    41. Perciavalle, V., Blandini, M., Fecarotta, P., Buscemi, A., Di Corrado, D., Bertolo, L., Fichera, F., & Coco, M. (2016). The role of deep breathing on stress. Neurological Sciences, 38(3), 451–458. doi: 10.1007/s10072-016-2790-8. Retrieved from https://pubmed.ncbi.nlm.nih.gov/27995346/
    42. Peterfalvi, A., Miko, E., Nagy, T., Reger, B., Simon, D., Miseta, A., et al. (2019). Much more than a pleasant scent: A review on essential oils supporting the immune system. Molecules, 24(24), 4530. doi: 10.3390/molecules24244530. Retrieved from https://pubmed.ncbi.nlm.nih.gov/31835699/
    43. Polsgrove, M. J., Eggleston, B. M., & Lockyer, R. J. (2016). Impact of 10-weeks of yoga practice on flexibility and balance of college athletes. International Journal of Yoga, 9(1), 27. doi: 10.4103/0973-6131.171710. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4728955/
    44. Posadzki, P., Alotaibi, A., & Ernst, E. (2012). Adverse effects of aromatherapy: A systematic review of case reports and case series. International Journal of Risk & Safety in Medicine, 24(3), 147–161. doi: 10.3233/jrs-2012-0568. Retrieved from https://pubmed.ncbi.nlm.nih.gov/22936057/
    45. Ramsey, J. T., Shropshire, B. C., Nagy, T. R., Chambers, K. D., Li, Y., & Korach, K. S. (2020). Essential oils and health. The Yale journal of biology and medicine, 93(2), 291–305. Retrieved from https://pubmed.ncbi.nlm.nih.gov/32607090/
    46. Ramsey, J.T., Li, Y., Arao, Y., Naidu, A., Coons, L. A., Diaz, A., & Korach, K. S. (2019). Lavender products associated with premature thelarche and prepubertal gynecomastia: Case reports and endocrine-disrupting chemical activities. The Journal of Clinical Endocrinology & Metabolism, 104(11), 5393–5405. doi: 10.1210/jc.2018-01880. Retrieved from https://pubmed.ncbi.nlm.nih.gov/31393563/
    47. Roca, P., Vazquez, C., Diez, G., Brito-Pons, G., & McNally, R. J. (2021). Not all types of meditation are the same: Mediators of change in mindfulness and compassion meditation interventions. Journal of Affective Disorders, 283, 354–362. doi: 10.1016/j.jad.2021.01.070. Retrieved from https://pubmed.ncbi.nlm.nih.gov/33578349/
    48. Savage, B. M., Lujan, H. L., Thipparthi, R. R., & DiCarlo, S. E. (2017). Humor, laughter, learning, and health! A brief review. Advances in Physiology Education, 41(3), 341–347. doi: 10.1152/advan.00030.2017. Retrieved from https://journals.physiology.org/doi/full/10.1152/advan.00030.2017
    49. Schultchen, D., Reichenberger, J., Mittl, T., Weh, T. R., Smyth, J. M., Blechert, J., & Pollatos, O. (2019). Bidirectional relationship of stress and affect with physical activity and healthy eating. British Journal of Health Psychology, 24(2), 315–333. doi: 10.1111/bjhp.12355. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6767465/
    50. Sirois, F. M. (2016). Procrastination, stress, and chronic health conditions: A temporal perspective. Procrastination, Health, and Well-Being, 67–92. doi: 10.1016/b978-0-12-802862-9.00004-9. Retrieved from https://www.sciencedirect.com/science/article/pii/B9780128028629000049
    51. Stoeber, J., & Janssen, D. P. (2011). Perfectionism and coping with daily failures: positive reframing helps achieve satisfaction at the end of the day. Anxiety, Stress & Coping, 24(5), 477–497. doi: 10.1080/10615806.2011.562977. Retrieved from https://pubmed.ncbi.nlm.nih.gov/21424944/
    52. Thoma, M. V., La Marca, R., Brönnimann, R., Finkel, L., Ehlert, U., & Nater, U. M. (2013). The effect of music on the human stress response. PLoS ONE, 8(8). doi: 10.1371/journal.pone.0070156. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3734071/
    53. Tsigos, C. (2020). Stress: endocrine physiology and pathophysiology. In: Endotext [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK278995/
    54. U.S. Department of Health and Human Services. (n.d.). Lavender oil linked to early breast growth in girls (Environmental Factor, September 2019). National Institute of Environmental Health Sciences. Retrieved from https://factor.niehs.nih.gov/2019/9/feature/3-feature-lavender/index.htm
    55. Wang, C.W., Chan, C.H.Y., Ho, R.T.H., Chan, J.S.M., Ng, S.M., & Chan, C.L.W. (2014). Managing stress and anxiety through qigong exercise in healthy adults: a systematic review and meta-analysis of randomized controlled trials. BMC Complementary and Alternative Medicine, 14(1). doi: 10.1186/1472-6882-14-8. Retrieved from https://pubmed.ncbi.nlm.nih.gov/24400778/
    56. Wen, Y., Yan, Q., Pan, Y., Gu, X., & Liu, Y. (2019). Medical empirical research on forest bathing (Shinrin-yoku): a systematic review. Environmental Health and Preventive Medicine, 24(1). doi: 10.1186/s12199-019-0822-8. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6886167/#!po=83.3333
    57. Worthen, M. (2020). Stress management. In: StatPearls [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK513300/
    58. Yaribeygi, H., Panahi, Y., Sahraei, H., Johnston, T. P., & Sahebkar, A. (2017). The impact of stress on body function: A review. EXCLI journal, 16, 1057–1072. doi: 10.17179/excli2017-480. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5579396/
    59. Zaccaro, A., Piarulli, A., Laurino, M., Garbella, E., Menicucci, D., Neri, B., & Gemignani, A. (2018). How breath-control can change your life: A systematic review on psycho-physiological correlates of slow breathing. Frontiers in Human Neuroscience, 12. doi: 10.3389/fnhum.2018.00353. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6137615/
    60. Zheng, S., Kim, C., Lal, S., Meier, P., Sibbritt, D., & Zaslawski, C. (2017). The effects of twelve weeks of Tai Chi practice on anxiety in stressed but healthy people compared to exercise and wait-list groups-A randomized controlled trial. Journal of Clinical Psychology, 74(1), 83–92. doi:10.1002/jclp.22482. Retrieved from https://pubmed.ncbi.nlm.nih.gov/286085