Stress can come from physical, mental, or emotional sources. When experiencing stress, the body can respond in many ways. For example, the heart may feel like it is beating faster, or muscles may tense. Finding ways to manage stress can help improve your quality of life. 

This section on Managing Stress covers:

What Are the Typical Signs of Stress?

What Are Ways to Handle Stress?

When to Get Help

What Are the Typical Signs of Stress?

People experience stress in many ways.  The signs and symptoms of stress can usually be divided into four categories: physical, emotional, cognitive, and behavioral.1,2,3,4,5,6,7      

Physical
  • Headaches, Backaches, Stomach aches   

  • Dizziness, fainting   

  • Tight muscles, More sweating   

  • Fast heartbeat, Chest pain   

  • Weight gain or loss   

  • Skin breakouts (hives, eczema)   

  • More colds   

  • Cold hands, feet, or skin   

Emotional
  • Moodiness, Feeling unsettled   

  • Not feeling able to sit still    

  • Short temper   

  • Feeling depressed   

  • Not able to relax   

  • Feeling overwhelmed, Feeling tense   

  • Feeling lonely and alone   

Mental
  • Memory problems   

  • Trouble focusing  

  • A focus on the negative   

  • Racing thoughts   

  • Constant worrying   

  • Problems paying attention   

Behavioral
  • Eating or sleeping more or less   

  • Teeth grinding or jaw clenching   

  • Nervous habits (nail biting, twirling hair, pacing)   

  • Overdoing things (shopping, exercising)   

  • Overreacting to new problems   

  • Picking fights with others   

  • Not wanting to be around others   

What Are Ways to Handle Stress?

Not only do both the body and mind react to stress, but they also react to each other. To prevent and cope with stressors, you can follow the steps below: 

  • Identify the stressors 

  • Work on removing, reducing, or changing the stressors 

  • Think about and understand how stress impacts you 

  • Lessen stress by finding ways to cope 

You can manage stress through physical or mental activities or a combination of both. No one way is the best, so try some activities and see what works best for you. 

Here are a few ways to cope:  

Physical Activity
Both exercise and moving the body for fun will help to release tension and keep you healthy. Talk with your Hemophilia Treatment Center (HTC) physical therapist if you are trying a new activity.
Deep Breathing
 Inhale through your nose and push out your belly as you take in air. Hold your breath for a few seconds and then let the air out through your mouth. Repeat this several times until you feel more relaxed.
Muscle Relaxation
Start with the top of your body and work each major muscle group down your body. Tighten, hold, and then release each group of muscles as you work toward your toes.  
Relaxation Activities
Activities such as mindfulness, meditation, massage, or listening to music can help you relax and reduce stress. There are several helpful apps available.   If you want more information about two of these apps, Headspace and Calm, please go to Headspace or Calm
Yoga
Guided breathing, strengthening, and stretching through yoga poses can help strengthen muscles. Yoga can help you relax and reduce stress.  
Animals
Being with a pet can help you relax. Many people can lower their stress level by petting a cat or taking a dog for a walk. If you are unable to have a pet at home, volunteering at a local animal shelter can be an option. 
Positive Social Support
You will benefit from already existing supportive relationships through your family and friends, but you will also benefit from building new relationships through your local chapter or other organizations. 
Finding Gratitude
If you focus on things you are grateful for you won’t be able to think of stressful things at the same time. Gratitude also helps to focus on the positive parts of your daily life. You can also start a gratitude journal. 

Other ways to manage stress you can try: 

  • Talk with a trusted person. 

    • Let them know what’s going on. You’re not alone in whatever you are feeling. 

    • Be proactive. Talk about what is causing you stress. Express your needs clearly to family, friends, and your health care team. 

  • Get out and do something. 

    • Even if you just go to and sit in the mall, library, student center, or outside space. 

    • Do something fun and life-giving to take your mind off what you are going through. 

    • Balance social time with alone time. 

  • Focus on things that make you happy. 

    • Make time to do activities that bring you joy. 

    • Take on the challenge of trying a new hobby, learning a new language, or writing poetry. 

  • Eat healthy, well-balanced meals so your body receives the right nutrients. 

  • Practice sleep hygiene to allow for necessary rest. 

  • Work with your local Hemophilia Treatment Center (HTC) or local bleeding disorder chapter. 

    • They will have social events you can attend and connect with other people who understand what you’re going through. 

    • Think about becoming a volunteer at your local chapter or other organization. 

  • Talk to a mental health provider. They can offer support and resources to help you navigate what you’re feeling. 

When to Get Help

You may experience signs and symptoms that signal it is time to seek professional help. If you continue to feel chronic tension, confusion, emptiness, loss of control, or exhaustion and experience physical symptoms, it's time to speak to a health care provider as soon as possible. 

Other symptoms that signal the need for professional help include: 

  • Experiencing bad dreams and poor sleep 

  • Experiencing severe mood swings 

  • Eating too much or too little 

  • Not having anyone to share emotions with 

  • Feeling numb, empty, and unable to get up and face a new day 

  • Persistent sad, anxious, or "empty" mood 

  • Feeling hopeless or pessimistic 

  • Feeling irritable, easily frustrated‚ or restless 

  • Feeling guilty, worthless, or helpless 

  • Loss of interest or pleasure in hobbies and activities 

  • Decreased energy, fatigue, or feeling "slowed down" 

  • Difficulty concentrating, remembering, or making decisions 

  • Difficulty sleeping, waking up, or oversleeping 

  • Changes in appetite or weight 

  • Aches or pains, headaches, cramps, or digestive problems without a clear physical cause that do not ease even with treatment 

  • Suicide attempts or thoughts of self-harm 

References
  1. Al-Huniti, A., Reyes Hernandez, M., Ten Eyck, P., & Staber, J. M. (2020). Mental health disorders in haemophilia: Systematic literature review and meta-analysis. Haemophilia : the official journal of the World Federation of Hemophilia, 26(3), 431–442. https://doi.org/10.1111/hae.13960    

  2. Fan S, Guan J, Cao L, et al. Psychological effects caused by COVID-19 pandemic on pregnant women: A systematic review with meta-analysis. Asian J Psychiatr. 2021;56:102533. Doi:10.1016/j.ajp.2020.102533  

  3. Forsyth AL, Gregory M, Nugent D, et al. Haemophilia Experiences, Results and Opportunities (HERO) Study: survey methodology and population demographics. Haemophilia. 2014;20(1):44-51. Doi:10.1111/hae.12239  

  4. Kunzler AM, Röthke N, Günthner L, et al. Mental burden and its risk and protective factors during the early phase of the SARS-CoV-2 pandemic: systematic review and meta-analyses. Global Health. 2021;17(1):34. Published 2021 Mar 29. Doi:10.1186/s12992-021-00670-y  

  5. Pifarré I Arolas, H., Acosta, E., López-Casasnovas, G. et al. Years of life lost to COVID-19 in 81 countries. Sci Rep 11, 3504 (2021). https://doi.org/10.1038/s41598-021-83040-3  

  6. Racine N, McArthur BA, Cooke JE, Eirich R, Zhu J, Madigan S. Global Prevalence of Depressive and Anxiety Symptoms in Children and Adolescents During COVID-19: A Meta-analysis. JAMA Pediatr. 2021;175(11):1142-1150. Doi:10.1001/jamapediatrics.2021.2482  

  7. Zubin, J., & Spring, B. (1977). Vulnerability: A new view of schizophrenia. Journal of Abnormal Psychology, 86(2), 103–126. https://doi.org/10.1037/0021-843X.86.2.103