🧠Pillar 4: Stress Management — Not All Stress Is Created Equal
- Ashlyn Smith
- 4 days ago
- 4 min read
By Ashlyn Smith, MMS, PA-C, DipACLM, BC-ADM, DFAAPA, LSC
ELM Endocrinology & Lifestyle Medicine
Stress gets a bad reputation, but not all stress is harmful.
In fact, some stress can be motivating, energizing, even inspiring, like starting a new project or learning a new skill. This is called eustress.
There’s also neustress, the kind of stress that’s neutral or inconsequential. For example, hearing about a news event that doesn’t directly affect you.
But when most of us say “stress,” we’re talking about distress, the kind that feels overwhelming, draining, or heavy.
What Does Stress Look Like in the Body?
Stress isn’t just “in your head.” It can come from many sources:
Psychological: deadlines, exams, waiting on important news
Physiological: pain, illness, hunger, lack of sleep
Social: tension at work or home, social isolation (Remember Week 3?)
Biochemical: blood sugar changes, cigarette smoke, pollution
Distress can be:
Acute → quick on, quick off
Chronic → lingers, keeping your body in a constant state of alert
Think about that for a moment.
During distress, your body responds as if you’re facing a physical threat, like being chased by an aggressive animal or standing in the path of an oncoming car.
Your heart rate increases. Cortisol and epinephrine surge. Systems shift into survival mode.
That response is helpful in true danger, but when it stays “on,” it can take a toll.
Why This Matters
Chronic distress doesn’t just affect how you feel. It affects your health.
In fact, depression carries a health risk comparable to smoking.
This is one reason why phrases like “it’s all in your head” are not only inaccurate but can be harmful.
Stress, anxiety, and depression are real, measurable, and treatable health conditions. Just like blood pressure or cholesterol, they can (and should) be evaluated by a healthcare professional.
What Can You Do About It?
The good news: there are effective, evidence-based tools that support both mental and physical health.
Mindfulness & Meditation
Mindfulness helps you observe thoughts and experiences with curiosity, not judgment.
It has been shown to:
Improve psychological resilience
Reduce symptoms of anxiety and depression
Decrease inflammation
Reduce perception of pain
For a more structured approach, Mindfulness-Based Stress Reduction (MBSR) programs offer guided practices over 8 weeks to help build sustainable habits.
Therapy & Medication
For clinical depression and anxiety:
Medications remain the gold standard for safety and stabilization
Cognitive Behavioral Therapy (CBT) combined with medication is more effective than medication alone
Physical Activity
Physical activity is one of the most powerful tools for mental health.
It can:
Help treat depression, anxiety, ADHD, and even psychotic disorders
Be protective against developing bipolar disorder
Among lifestyle interventions, physical activity shows the strongest evidence as an addition to therapy and medication for depression.
Sleep
Restorative sleep is foundational.
It is protective against anxiety, ADHD, and bipolar disorder. And it may help improve depression symptoms.
Remember Week 2? You can revisit sleep strategies on the ELM blog here.
Avoid Smoking
Avoiding cigarette smoking supports both mental and physical health.
It is protective against:
Depression
ADHD
Bipolar disorder
Psychotic disorders
Nutrition Patterns Matter
When it comes to mental health, your overall dietary pattern matters more than individual nutrients or supplements.
Protective patterns include:
Fruits and veggies
Whole grains
Fish
Olive oil
Low-fat dairy
Antioxidant-rich foods
Patterns associated with increased risk:
Red and processed meats
Refined grains
Sweets
High-fat dairy and butter
Fast food
In fact, frequent fast food is associated with up to a 40% higher risk of developing depression.
This isn’t about perfection, it’s about patterns over time.
(We’ll go deeper into nutrition next week.)
Your Invitation This Week (Pick One)
Choose one small step that feels realistic:
Build awareness
Notice moments of distress, eustress, and neustress throughout your day with curiosity, not judgment
Try mindfulness
Spend 5–15 minutes in mindful meditation (YouTube, podcasts, and even Netflix have guided options)
Pick one day to add physical activity
Choose something you enjoy, at a level that fits where you are
Support your sleep
Revisit “Simple Habits That Supports Better Sleep” from Week 2
Shift one nutrition habit
Add or reduce one food type based on the patterns above
Final Thought
Stress can't be eliminated, but it can be understood. When you begin to recognize how stress shows up in your life, you create the opportunity to respond differently.
And small, consistent changes can have a powerful impact over time.
Important Note
If you have a diagnosed mental health condition, it’s important to continue following the guidance of your mental health care team.
If you are experiencing thoughts of harming yourself or others:
Call 911, or
Contact the 988 Suicide & Crisis Lifeline
You are not alone, and support is available.
If you missed Week 1 (Introduction), Week 2 (Sleep), Week 3 (Social Connectedness), or Week 4 (Physical activity), you can catch up on the blog here.
Looking to strengthen your psychological resilience or incorporate a lifestyle medicine approach to mental health prevention or treatment? I am here to help—let’s connect on a free consultation to discuss further!
Disclaimer:
The content on this blog is for informational purposes only and is not intended to provide medical diagnosis, treatment, or replace professional medical advice, diagnosis, or care. Always consult a qualified healthcare provider with any questions regarding a medical condition or treatment.
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