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Stress Reduction

You can reduce the effects of stressful situations by changing how you respond to them. This is often a gradual process, in which one set of habitual responses are replaced with new ones. 

Here are 12 strategies for reducing stress.



Physically relaxing activities counteract both the physical and the emotional aspects of stress. Through relaxation, you can reduce muscle tension and anxiety. (Relaxation is also very helpful for controlling pain.) 

Examples of relaxing activities include scheduled rest breaks, prayer and meditation, deep breathing, yoga, imagery, taking a bath, and playing with a pet. Many people with CFS and FM uses a daily stress reduction practice. 

For step-by-step instructions on five relaxation techniques, see the article Stress Reduction: Five Practical Techniques on the self-help program website. (The five are: watching the breath, the body scan, progressive muscle relaxation, the relaxation response, and guided imagery.)

Mental Adjustments

Your thoughts can be a source of stress. For example, you may have outdated expectations. You may think that as a “good mother” or “good wife,” you should keep the house as you did before becoming ill. Adjusting your standards to fit your new limits reduces stress and helps you avoid overdoing.

Another way in which thoughts can increase stress is through “self talk,” the internal dialogue we have with ourselves, especially about negative events. For example, you might respond to a crash by saying "Stupid me, I overdid it again. This is hopeless."

You can learn how to recognize and change habitual negative thoughts to be more realistic and more positive. For instructions, see the article Changing Self-Talk.

Replacing overly pessimistic thoughts reduces anxiety, sadness and feelings of helplessness.

Exercise and Movement

Exercise is a natural stress reducer, since it causes your body to produce endorphins and other soothing body chemicals. A similar effect can be obtained through other forms of movement, such as yoga and Tai Chi. If you are worried, just getting up and moving around can help break the spell.


Supportive Relationships

Good relations are a buffer against stress. Feeling connected to people who understand and respect you reduces anxiety and counteracts depression. Beyond that, talking to another person may help you clarify your situation. 

You may receive such support from a variety of sources, including family members, friends, other people with CFS and FM, and therapists. Support also includes practical assistance, such as help with shopping, cooking, bill paying or housecleaning. For more, see the Relationships section of this site.


Educating yourself about CFS and FM can be a great stress reducer, as you replace fears with facts. There are at least five other sources of information besides your doctors: patient organizations, the internet, support groups, books, and self-observation. 

We'll begi with the item. You are perhaps the most important source of information about your illness. You live with your condition and know it intimately.

You are probably aware of things that intensify symptoms and also things that help you feel better. We encourage you to keep records, but whether or not you log, you can use your knowledge of "what helps" and "what hurts" to increase your control.

As for other sources of information about CFS and FM, wWe suggest you consider the following four guidelines for educating yourself about CFS and/or FM.


1. Use multiple sources: No one person or organization has a monopoly on helpful ideas about CFS and FM. You can counteract the partial perspective of any one source by considering multiple sources.

2. Ask yourself whether the claims you hear about treatments are credible. Some people prey on the desperation of patients, so be skeptical of those who promise recovery.

3. Be willing to experiment, but ask what risks are associated with a treatment and whether the likely gains are consistent with the cost.

4. View education as an ongoing task, but put limits on your inquiry. New development occur from time to time, but breakthroughs are rare.

Pleasurable Activities

Enjoyable activities lessen frustration while distracting you from your symptoms. Examples include reading, exercise, watching TV, journaling, listening to music, playing games, doing art projects, pursuing a hobby, and talking to a supportive person.


Writing may be useful as a stress reducer. You might find it helpful to write out what’s bothering you as a way of venting frustration and lessening worry. Another use of journaling is to help you change perspective on your life. For ideas on how writing can improve your health, see the article Writing Is Good Medicine

Some people have told us they found it very helpful to keep a journal in which they note positive events every day. Over time, they found that their mental attitude toward their illness and their life changed in a positive direction.

For more, see the one person's story in the article The Healing Power of Gratitude and a review of research on gratitude in the article Counting Your Blessings: How Gratitude Improves Your Health.


Talking and Being Listened To 

It is not surprising that, in a survey, talking to a friend was rated as the number one way to combat worry. Talking to someone you trust provides reassurance and connectedness to dispel worry. Studies have shown that talking to another person changes what is happening in your brain at a physical level.


Laughter and Humor

This is another good stress reducer. Watching a funny movie, reading a humorous book, looking at favorite cartoons or laughing with friends can be a great release. 

Like exercise, laughter promotes the production of endorphins, brain chemicals that produce good feelings and reduce pain. Research suggests that it can strengthen the immune system, counteract depression and even provide a substitute for aerobic exercise.



For some people, just having time alone can be helpful. One person wrote, “I spend much of my time in quiet, relaxing activities such as reading, needlework, etc. If I have a day that does not allow me to participate in these activities to some minimal extent, I find myself extremely tense, stressed out and emotional.”


Assertiveness (Taking Control)

By speaking up for yourself, setting limits and saying “No,” you protect yourself and avoid doing things that intensify symptoms. By having a “voice,” you reduce the stress that results from keeping things inside. For more on assertiveness, including a success story, see the article Assertiveness: A Tool for Reducing Symptoms.



Prescription medications can be helpful as part of a stress management program. As one person said, "I resisted the idea of medications for a long time and now kick myself for having done so. Zoloft has helped me level off my reactions to everyday stress and evened out my mood. Medications are not for everyone, but I've learned to keep my mind open to treating all aspects of my life and not relying on solely one approach."


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