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Your doctor said "reduce stress". But how do you do that? Therapy-based input

Updated: Nov 24, 2023


Have you ever gone for a medical checkup where the conclusion and recommendation is that you need to "reduce stress"? You're sitting there thinking you could have said this yourself, and you didn't really need a medical checkup to know so. And what exactly does "reduce stress" mean? How does one do that, in today's busy world?

This article is designed to provide a perspective on stress – what it is, its causes, its effects, and how to manage it effectively in our daily lives.

Understanding Stress

Stress is our body's natural reaction to challenges or demands. It's akin to a built-in alarm system that gets triggered when we're faced with a situation that requires attention or action.

It's worth noting that stress is a response, not an event. So a job loss, relationship breakdown, etc. is a stressor, not stress itself. How we respond to it determines how much stress we experience. This response can be helpful in short bursts, but when it becomes chronic, it can lead to various health issues.

Responses to Stress - The Water Tank

diathesis stress model - water tank

The diathesis-stress model provides a useful framework for understanding stress. It suggests that stress results from the interaction between a person's predisposition (diathesis) and life stressors. So our genetic makeup, personality traits, and early life experiences can influence our thoughts and perceptions of the world and events, and therefore impact susceptibility to stress. You can think of it as a water tank - the stronger a person's genetic makeup is and more favourable their childhood experiences were, the bigger the size of their tank. The more stressors they have in their life at present, the more water in the tank. When there's too much water in a tank that can't contain it, the tank overflows.

The triggers of stress (stressors) are well known:

  1. Work and Life Pressures: From demanding jobs to personal responsibilities, various factors can contribute to stress.

  2. Life's Challenges: Financial difficulties, relationship issues, and health concerns are typical triggers.

  3. Global and Societal Changes: Larger events, like the COVID-19 pandemic, have introduced new stressors into our lives, impacting mental well-being on a broad scale.

However, as the water tank model suggests, different people may respond to the same life events in different ways, depending on their perceptions of those events. While we can't control our past, understanding our thoughts, feelings and reactions and making peace with our past is the first step towards dealing with stress.

The Impact of Stress

Short-term stress prepares the body for action, increasing heart rate, blood pressure, and energy levels. However, chronic stress can have detrimental effects on health, including heart disease, diabetes, weakened immune function, and mental health issues like depression and anxiety. Stress can also lead to unhealthy behaviors such as poor diet and lack of exercise, exacerbating its negative impact on health.

Stress in the Digital Age

stress in the digital age

Our increasing reliance on technology, while beneficial in many ways, has also introduced new sources of stress. Here's how notifications effect our health:

Multitasking is a myth

For 97.5% of us, our brain can really focus only on one thing at a time. That means that every time we pause to answer a new notification, we get interrupted, & pay a price called the “switch cost”. Brain scientists (David Meyer, Robert Lustig, Hyung Suk Seo) have shown that this constant switching affects our brain’s efficiency by about 40%.

Releasing stress hormones

Constantly waiting for the next notification can put us on edge, meaning when it comes, our body releases cortisol, causing our heart rate to jump.

Stuck in a reward-seeking loop

Notifications such as people liking your post can produce the feel-good chemical, dopamine. But when the notifications don’t come through, we start to feel anxious and wonder if we’ve said something wrong.

At work too

This effect applies to work-related notifications too. A 2019 study in China showed that smartphone dependence at work led to higher anxiety, and after a point, lower job performance.

5 things you can do today to reduce the impact of notifications
  1. Turn off notifications from “non essential“ apps

  2. Set clear working hours for yourself, during which you can respond to work related notifications

  3. Limit your in-between screen time: in between work, in between meetings, a date etc.

  4. Replace in-between screen time with helpful pleasurable activities

  5. Practice evidence-based techniques to deal with anxiety.

Therapy-Recommended Strategies for Managing Stress

You would probably be aware of most of these interventions. The trick is in making them a part of your routine. Keep scrolling down to see a self care calendar for you.

1. Cognitive-Behavioral Therapy (CBT):

  • CBT is an effective approach for managing stress. It involves identifying and modifying negative thought patterns and behaviors, promoting a healthier mindset. Since how much stress impacts us depends on not just external factors but also our internal perceptions of events, understanding our thoughts better can help us respond better to stressful events.

2. Lifestyle Adjustments:

  • It sounds boring, but regular physical activity, balanced nutrition, and sufficient sleep play crucial roles in mitigating stress.

3. Mindfulness and Relaxation Techniques:

  • Practices like meditation, yoga, and deep breathing exercises can help in managing stress by calming the mind and reducing physiological stress responses.

4. Building a Support Network:

  • Strong relationships with family, friends, or support groups provide emotional support and a sense of belonging, crucial in managing stress. This is one of the strongest protective factors in dealing with stress and other mental health conditions. Going back to the water tank metaphor, a support network is like a hole in the tank that allows water to flow out gradually, so that the tank does not overflow.

Professional Help:

  • There are times when professional assistance is needed to manage stress effectively. Mental health professionals can offer tailored strategies and support, providing a space for individuals to explore and address their stressors in a constructive manner.

5 ways to combat stress during the week:

Your self-care calendar

We know that calendars are more effective than to-do lists from research by Behavioural economists (e.g Dan Ariely). When an event is consistently scheduled on your calendar, it’s much more likely to become an unconscious habit. It helps us make time for the things that matter to us, ultimately helping us live a life that matters to us.

Here’s how we can make self care a core part of our lives too, protecting us from the harmful effects of stress.

stress self-care calendar

stress self-care calendar

The trick is in being specific: Specify what activity you’ll do from each of these types, and assign a time slot to it.


Stress, while a common experience, varies greatly in its impact and manifestation. Understanding its dynamics and learning effective management strategies are essential for maintaining both mental and physical well-being. Recognizing the signs of stress, understanding its sources for you (including the impact of your early life experiences on your thoughts and perceptions), and employing practical strategies that you can incorporate into your lifestyle are crucial steps in managing stress effectively.

Diya John - Tokyo based therapist

If you're new here, I'm Diya John, a counselor and psychotherapist with a Masters in Psychology and a Diploma in Counselling from Australia. I founded Therapy Garden to make evidence-based counseling more accessible to expatriates, immigrants and the international community. I am based in Tokyo, but I work with clients in different parts of the world via online therapy. You can book a free consultation or read more about my areas of specialisation and services.


  • O'Connor, D. B., Thayer, J. F., & Vedhara, K. (2021). Stress and Health: A Review of Psychobiological Processes. PubMed.

  • Nakao, M., Shirotsuki, K., & Sugaya, N. (2021, October 3). Cognitive–behavioral therapy for management of mental health and stress-related disorders: Recent advances in techniques and technologies. BioPsychoSocial Medicine.

  • Saleh, D., Camart, N., Sbeira, F., & Romo, L. (2018, September 5). Can we learn to manage stress? A randomized controlled trial carried out on university students. PLOS ONE.

  • Becker, L., Kaltenegger, H. C., Nowak, D., Weigl, M., & Rohleder, N. (2022, February 8). Physiological stress in response to multitasking and work interruptions: Study protocol. PLOS ONE.

  • Xiang, W., Yuan, Y., Li, Z., Yang, X., Xiong, Z., Li, Z., Li, X., Xiang, W., Yuan, Y., & Li, Z. (2020, December 4). Perceived psychological stress and associated factors in the early stages of the coronavirus disease 2019 (COVID-19) epidemic: Evidence from the general Chinese population. PLOS ONE.



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