Stress Management

Reviewed by: HU Medical Review Board | Last reviewed: February 2019 | Last updated: August 2020

While stress doesn’t cause ankylosing spondylitis (AS), stress can worsen symptoms like inflammation and chronic pain. Chronic stress can also contribute to mood disorders like anxiety and depression, and stress management approaches can reduce the negative effects of stress and improve overall well-being. Stress management includes learning why a person feels stress and learning how to develop healthy coping strategies to reduce that stress.

Understanding the stress response

Stress is natural reaction of the body to the demands of life, and the stress response can occur to a physical or emotional stimulus. The stress response, also called “fight-or-flight” response, prepares the body to cope with a threat. When faced with a stressor, hormones are released into the body to mobilize energy to fuel a response. Common signs of this state are increased rate of breathing, increased heart rate, anxiety, and a shift of blood flow to the larger muscles in the body. These biological changes ready the body to fight or flee from a threat. In some cases, the body may also have a “freeze” response to a stressor. In this case, the muscles are tensed and poised for action but are not used.1,2

The stress response begins in the brain, as sensory information is sent to the amygdala, the portion of the brain responsible for emotional processing. The amygdala sounds the alarm when it perceives a threat. However, the amygdala can’t tell the difference between real or perceived stressors, causing the same physical reactions in the body for both. Once the threat is gone, the body is supposed to return to a relaxed state. However, with the nonstop pace and rapidly changing environment of modern life, this alarm system rarely shuts off. Chronic stress that continues for weeks or months can lead to health problems.1-3

Strategies for relieving stress

Stress can have a negative impact on a person’s immune response, but not everyone experiences the effects of stress the same way. Studies have demonstrated that people’s cardiovascular and endocrine responses to stressful experiences are dependent on their appraisal of the situation and their thoughts about it. Optimism and coping have shown to moderate the effect of stress on the immune system.4

Just as stress impacts each person uniquely, the ways to manage it are also individualized. There are many techniques for managing stress, including:

  • Identifying and avoiding triggers – Recognize what triggers your stress and take steps to avoid those situations when possible.
  • Using physical activity – Exercise helps the body relieve muscle tension and deepen the breath. Some types of exercise also combine movement and breath, like yoga or Tai chi, and can be helpful in calming the mind.
  • Engaging in breathing techniques – Breathing exercises can help the body relax, as the mind focuses on the intake and outtake of breath.
  • Getting social support – From leaning on family and friends to reaching out to other people with AS, talking with others can help reduce stress and help someone feel less alone.
  • Receiving acupuncture – Acupuncture is a type of complementary medicine that can help some people with stress relief.
  • Meditating – Whether using a patterned breath, a mantra, or a guided meditation, taking time to clear the mind can help reduce stress.
  • Trying biofeedback – Biofeedback can help someone learn ways to reduce stress by providing information on how the body responds.
  • Take care of yourself – During times of stress, it may be tempting to reach for junk food or alcohol, but it’s best to fuel your body with good nutrition and proper sleep to help manage the effects of stress.
  • Asking for help – If you need extra support and aren’t finding relief from other stress management techniques, seek professional help by talking about your stress to your doctor or a counselor.

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