Stress: What You Need to Know

Your holiday stress relief primer

Stress: What You Need to Know | Johns Hopkins Medicine

For many, this can be a stressful time of year. The good news is there are things you can do to minimize the stress – and help you savor time spent with the ones you love during the holidays.

What is stress — and what causes holiday stress?

Stress is the feeling you get when you’re overloaded – you’re wondering how you can possibly get everything done. According to Medical News Today, we go into “fight or flight” mode and start breathing faster and our muscles tense.1

The holidays have been known to cause stress. You may feel spread too thin, overworked and underappreciated. From travel to school to baking and entertaining, the calendar entries and obligations abound.

Too much of a good thing?

Anxiety and stress – and in some cases, depression – can especially arise during the holidays. That’s because there’s usually more on your plate, from tasks to social events.

Your routine is often affected because you’re trying to fit more in your day. This can wreak havoc on your sleep schedule. You may not be eating healthy or exercising you usually do. And buying gifts can take a toll on your budget.2

The holidays aren’t necessarily a happy time for everyone, either. They can be a sad and emotional period if you’re unable to visit friends and family who live far away – or if you’re grieving the loss of a loved one.2

But take heart — there are things you can do to minimize the stress and enjoy the holidays, however you choose to celebrate them.

How can I prevent holiday stress?

If you know you perennially get stressed during the holidays, it’s key to take action to prevent yourself from getting stressed out in the first place.2

Manage your expectations — let go of what you think the holidays “should be” — things don’t have to be perfect!

Here are some useful tips you can work on before the holidays descend to help prevent stress from overtaking you:1

Tips for preventing mental and physical stress

  • Practice deep breathing
  • Learn how to relax through meditation or yoga
  • Recognize your physical signs of stress – so you know when to keep yourself calm
  • Identity what helps you de-stress – so you can take action at the first sign of stress ( take a walk or listen to music)

Tips for preventing financial stress

  • Stick to a holiday budget. Live within your means. And try cutting back on the number of gifts you give or do a gift exchange. Remember, it’s the thought that counts, not the amount of money you spend.
  • Don’t rely too heavily on credit cards. What may bring you joy now, will not be so joyful when the monthly bill rolls around in January.
  • Forgo gift giving altogether and donate those funds to a family in need or favorite non-profit.
  • Instead of serving family or friends a three-course meal, save on your food and beverage budget and host a potluck.

How can I manage holiday stress once it hits?

Particularly during the holiday season, you can manage stress by learning to say no.3 You don’t have to take on everything yourself. Maybe you tell your child’s school you can’t make the costumes this year. Or ask another friend or family member to host Christmas Eve dinner instead.

It’s also important to take time for yourself to unwind. Don’t short-change yourself and cut out things in your life that make you happy or help you de-stress. Keep up your workouts. Take that bubble bath. Watch that football game. Get a babysitter and go shopping on a weeknight.

Changing your perspective about the holidays can also help. If something doesn’t get done, what would happen? Would a crisis ensue? Probably not. So be realistic.

The Mayo Clinic also says it can be helpful to set aside differences during this time and get professional help if you need to.3

Tips for enjoying the holidays

Johns Hopkins Medicine offers some simple things you can do to make your holiday less stressful. If you apply these to your life, this can be a season of enjoyment. And you can take pleasure in creating new holiday memories with friends and family:4

  1. Think about what makes the season meaningful for you — That way you can be intentional about who you spend your time with – and how you spend your time during the holidays. 
  2. Make a plan early on — Do at least one thing you enjoy during the holidays, attending a holiday concert or checking out local lights displays.
  3. Don’t do everything yourself — Accept help when people offer it and proactively ask for help. Also practice saying no.
  4. Stay healthy — Don’t skip your workouts and eat healthy when you can. This can be easier said than done, but can help you stay energized.  It’s easy to overindulge during the holidays, so eat and drink in moderation.
  5. Manage your expectations for family gatherings — When multiple generations and multiple families celebrate together, it can be challenging to feel heard and understood. Be clear about what you need the most and flexible about the rest.
  6. Recognize what worked for you during this holiday season — Pat yourself on the back for being less stressed this year! What could you improve on? Plan to make adjustments for next year, so your holiday is even more enjoyable.

Happy holidays to you and your family! May your days be merry and bright – and a little less stressful.


Public Safety Advisory: Beware of phone and internet scams

Stress: What You Need to Know | Johns Hopkins Medicine


Johns Hopkins Security is providing the following information for all Johns Hopkins employees and students:

Recently, federal and local law enforcement officials have noted increased reports of the following three scams. Further, some criminals have taken advantage of confusion surrounding the U.S. federal government shutdown to impersonate federal officials. Below, you will find information on how each of these fraud schemes works and how you should respond if you become a target.

1. IRS Scam

The scam: An individual claiming to be from the U.S. Internal Revenue Service calls and claims that you owe back taxes.

You are also told that if you fail to respond by a certain time, you will be arrested, and that if you are in the United States on a visa, you will be deported.

The caller typically asks for a wire transfer or pre-paid debit card to pay the alleged back taxes.

What you should know: U.S. government agencies do not make phone calls or send emails to inform people they are delinquent, they will not threaten people with imprisonment or deportation, and they do not accept wire transfers or pre-paid debit cards as a way of payment for any legitimate debt you may owe the U.S. government. You should ignore such calls or emails.

More information:

2. Kidnapping Scams

The scam: An individual or group uses various open sources, such as social media accounts, to compile information about you and your family. Typically, criminals will use this personal information in one of two ways. First, they may call you at either a work or a personal telephone number claiming to have kidnapped a family member—typically a child.

During the call, someone may be heard in the background calling for help; the caller will claim that it is the kidnapped family member.

In the second version of the scam, the individual committing the scam will try to convince you to go into hiding and cut off all contact with your family, and will then tell your family that you have been kidnapped and ask them to pay a ransom. 

What you should know:  At a moment of anxiety and stress, recipients of such calls may believe the background voice sounds the allegedly kidnapped family member.

Should you receive such a call, remain on the line to gather as much information as possible (see below for useful information) and use another phone line to call Johns Hopkins Security or your local police department. If you must hang up to call security or the police, do so immediately.

Do not agree to meet or wire money and do not agree to any other demands. Wait for the arrival of the security team or police and provide them with as much information as possible.

More information:

3. DEA Scam

The scam: An individual claiming to be from the U.S. Drug Enforcement Administration attempts to persuade drug prescribers to provide personal information and/or a DEA registration number over the phone or by email.

What you should know: Government officials will not call or email requesting any type of personal information. Should you receive such a call or email, do not respond. Contact Johns Hopkins Security and provide details.  

More information:

These are a small sample of the many fraud schemes or scams that criminals use to collect money from unsuspecting individuals. Please be cautious when dealing with unsolicited emails and phone calls. If you are not sure about the authenticity of a contact you have received, do not respond; instead, immediately contact your campus security office.

When reporting such an issue, it is helpful to provide as much information as you can, such as:

  • An incoming phone number;
  • The nature of the call, including specific requests or demands;
  • Any potentially identifying characteristics of the caller;
  • An original email or social media post, if the communication was received through one of those channels;
  • Information on the email address or social media account from which such a communication was received; and
  • The content and originating number of a text message, if the communication was received by text.

If you have any questions, do not hesitate to contact Johns Hopkins Security.


From our collaborators at Johns Hopkins Medicine International | How exercise helps you de-stress

Stress: What You Need to Know | Johns Hopkins Medicine
Posted August 4, 2017By Kerry Stewart, Ed.D., Professor of Medicine and Director of Clinical and Research Exercise Physiology, Johns Hopkins University School of Medicine

The physical and emotional demands of life often lead to high levels of stress.

A stressful situation at work, a divorce or separation, a death in the family or a diagnosis of a serious health problem may lead us to fall into poor eating habits or give up on exercise, making it even more difficult to cope with the challenges of life.

During challenging times, some of us might even start or resume destructive habits smoking, drinking too much alcohol or taking drugs. Yet, such physical or emotional problems are the very situations where maintaining healthy habits, especially exercise, can be the perfect prescription for what ails you, particularly for high levels of stress.

Conclusive research shows that 150 minutes of exercise per week — about a half hour five days per week — reduces stress by lowering blood pressure, relieving muscle tension and improving mood and concentration. Someone who is physically active has more vigor and is better able to tolerate fatigue, another factor that contributes to stress.

Consider fitness a first line of medication

Despite these proven rewards, many health care providers fail to recommend exercise as a first-line treatment for stress. Too often, stressed patients are offered medications instead. Yet, in many cases, increasing one’s level of physical activity can be one of the best treatment strategies for busting stress and improving stress-related high blood pressure or a racing heart rate.

For most otherwise healthy adults with mild high blood pressure, the guidelines from leading health organizations recommend a trial of several months of exercise and diet before starting to take blood pressure medications.

When a patient with cancer is suffering from the fatigue that most people experience when undergoing radiation or chemotherapy, many doctors still offer the misguided advice of resting as much as possible, even though maintaining an active lifestyle has been shown to be the best medicine for fighting physical fatigue and emotional stress in cancer survivors.

Many studies have shown that exercise, both in healthy people and in those with health problems, improves mild depression, anxiety and other psychological challenges.

Besides helping the body remain as physically fit as possible, exercise relieves nervous and muscle tension, and helps you to feel better about yourself.

This could be due to an increase in endorphins, a chemical produced in the brain with higher levels of activity that reduce pain and induce euphoria, or it could be due to taking your mind off your worries.

Fatigue from fitness can be beneficial for sense of self

Although exercising during difficult times might itself cause some fatigue, the fatigue from exercise, un the tiredness that results from feeling stressed, worried or being ill, also instills a sense of accomplishment and personal satisfaction from completing a workout.

In some of our work at Johns Hopkins, we have measured this sense of accomplishment in patients with serious heart problems.

After becoming more physically active, these individuals reported feeling greater confidence in their ability to be active, which in turn led to further increases in their activity levels and reaping the health benefits that naturally flow from exercising more. Increased confidence in your ability to perform at higher levels of physical activity is also a great stress buster.

Not only does exercise help people better manage and treat their health problems, it also helps them feel more in charge of their health because they are now being proactive rather than just living from one doctor visit to another, or going to the drugstore every month to stock up on pills. Taking an active role in your own health care is an excellent way to reduce anxiety, a major contributor to stress.

People who exercise regularly also tend to stop or decrease their smoking and eat better, both actions that further improve their ability to cope with life’s inevitable challenges, including stress.

Exercising in groups is motivating, offers new sources of support

The benefits of exercise for stress reduction can be further enhanced when exercising with someone else or in a group.

Working out with a buddy or in a group helps to maintain a consistent schedule, exposes you to a social and fun environment, and eliminates the boredom that sometimes occurs when exercising alone.

Being part of a social network that provides friendship and support is a great way to improve mood and reduce stress.

So regardless of the physical and emotional challenges that life may throw your way, staying as physically active as possible will get you through tough periods of stress, leading to a healthier and happier life.

Content courtesy of Kerry Stewart, Ed.D., professor of medicine and director of clinical and research exercise physiology at the Johns Hopkins University School of Medicine.

The content was reproduced with permission of the Office of Marketing and Communications for Johns Hopkins Medicine International. Additional reuse and reprinting is not allowed.

The information aims to educate readers and is not a substitute for consultation with a physician.


Protecting your mental health during the coronavirus pandemic – COVID-19 – Johns Hopkins Bloomberg School of Public Health

Stress: What You Need to Know | Johns Hopkins Medicine

The daily counts of COVID-19 cases and deaths tell the public story of the coronavirus outbreak. Privately, the effects of the pandemic aren’t as clear.

The new reality of social distancing and other safety measures is testing everyone, and those living with mental illness may find this time even more challenging if the support system they rely on is not in place.

Experts from the Department of Mental Health at the Johns Hopkins Bloomberg School of Public Health put together these tips and resources on how to protect your mental health during these trying times.

As the coronavirus pandemic has unfolded across the U.S., ordinary life has been put on pause. Lockdowns, travel restrictions, school closings, work closings, and social distancing have created a level of social isolation previously unseen across the globe.

Fears about finances and food shortages have placed additional stressors on an already anxious and sensitized population. The practices recommended by the Centers for Disease Control and Prevention and World Health Organization are necessary and designed to protect the community, particularly the most vulnerable individuals.

However, this pandemic and the associated changes, including serious financial implications for many households, can have profound consequences for our mental health.

Traumatic or stressful experiences put individuals at greater risk for not only poor physical health but poor mental health outcomes, such as depression, anxiety, and PTSD.

You may notice that yourself or others around you are more edgy, irritable, or angry; helpless; nervous or anxious; hopeless, sad, or depressed. Sleep may be disrupted and less refreshing.

Practicing social distancing may leave you feeling lonely or isolated. If you are at home with children, you may have less patience than before.

Those who are especially vulnerable to COVID-19—older individuals and people with medical comorbidities or immune-comprised systems—who need to be especially stringent in following guidelines from the health authorities, may be the very people whose mental health may suffer the most. Individuals with a pre-existing mental health condition, such as an anxiety disorder, are also at heightened risk for poor mental health outcomes as a result of coronavirus.

It is important that as a population, we learn how to protect our mental health during this stressful and ever-changing situation, while also following the guidelines set by health authorities to protect our physical health. Here are some strategies that can be used during these challenging times to protect your and others’ mental health.

Create structure

  • Create a daily schedule for you and your family. Feelings of uncertainty can lead to increased mental health symptoms.
  • Try to limit the amount of time you spend watching, reading, or listening to the news. Get your information on the coronavirus outbreak from a trusted source, such as the CDC or WHO, once or twice a day.
  • Make space for activities and conversations that have nothing to do with the outbreak.

Maintain your physical health

  • Protect your sleep. Good quality, sufficient sleep not only helps to support your immune system but also helps you to better manage stress and regulate emotions. Adults should aim for 7–9 hours, while children and teenagers need even more. [See recommendations by the National Sleep Foundation].
  • Try to eat at regular times and opt for nutritious foods whenever possible. Some people may crave junk food or sugary snacks and be tempted to snack mindlessly when stressed or bored, and others may skip meals altogether.
  • Maintain an exercise routine, even if you can’t go to your local gym.

    Exercise at home using an online workout video, or go for a walk, run, or bike ride in a sparsely populated area.

Support–and create–your community

  • Create a virtual support group and check in with those around you. There are many options for connecting, including video conferencing software, such as Google Hangouts and Facetime. During this time of isolation, connecting face-to-face (online) is more important than ever.

    If you can’t stream, then calling and texting is important. Check out some ideas at Wirecutter and Prokit for how to be social during the quarantine.

  • Crises offer a time for community cohesion and social solidarity, and volunteering is one way to not only help others, but yourself as well.

    Science has repeatedly shown that volunteering can improve mental health. Check out this article for a list of organizations to donate to and this article for other ways to help your neighbors and community.

  • If you have children, talk to them honestly about what is going on in an age-appropriate manner. Help kids express their feelings in a positive way, whether playing in the backyard, drawing, or journaling.

    Check out these guides by the Substance Abuse and Mental Health Services Administration, Child Mind Institute, or National Association of School Psychologists for tips on how to talk to your kids about coronavirus.

Take care of your spirit

  • Find a place of worship that is streaming or recording services. If prayer is an important part of your life, make time for it. Stay connected to your church community through phone calls, emails, and video chats.

  • Try meditation, deep breathing, progressive muscle relaxation, or another mindfulness or relaxation technique. Check out or phone apps such as Calm or Headspace for guided meditation exercises. Consider enlisting friends and family and practicing meditation together at least once a day.

    Mindfulness can help lower blood pressure, reduce stress, support your immune system, and protect brain health.

Continue or seek out mental health treatment

  • If you are currently in mental health treatment, continue with your current plan if possible, being mindful of approaches to minimize contact with others. Consider reaching out to a mental health professional even if you haven’t before. Make sure you have ongoing access to any medications you need.
  • Ask about video therapy or phone call appointments.

    Most states have already made emergency exemptions to insurance coverage for telehealth. Regulations have been temporarily relaxed to allow even non-medical software Skype, Facetime, and Zoom to be used for telehealth. Even if this option wasn't available with your provider previously, it may be now! Contact them to ask about remote services.

  • Avoid drugs and alcohol, particularly if you have a pre-existing mental health or substance use disorder. Check out online support groups and meetings, such as Alcoholics Anonymous, Smart Recovery, and In The Rooms.
  • The need for social distancing may make it difficult to see symptoms of depression in others.

    In “hunker-down” mode, the in-person opportunities that we usually have to notice that friends, family, and colleagues may be struggling with a problem are no longer there. One way to think about it is that child abuse or intimate partner violence is missed more often in winter because long clothes cover bruises.

    Conduct regular “check ins” with your network and stay attuned to symptoms of depression, such as persistent feelings of sadness, hopelessness, loss of interest or pleasure in activities, or changes in sleep and weight.


Remember that the emotions you may be experiencing are normal reactions to difficult circumstances. Accept that things are different right now and everyone is adjusting. Prioritize what’s most important and know that it’s okay to let some things go right now.

Be kind to yourself and others. Try to stay positive and use this time to spend more time with your children or spouse, try things you’ve been putting off, such as taking an online class, learning a new skill, or getting in touch with your creative side.

It can be hard to think past what is going on today, let alone in a week or in six months, but give yourself permission to daydream about the future and what is on the horizon. Remember that this is temporary, and things will return to normal.


Calliope Holingue, postdoctoral fellow in the Department of Mental Health and the Department of Neuropsychology at Kennedy Krieger Institute; M. Daniele Fallin, Mental Health chair; and Mental Health faculty Luke Kalb, Paul Nestadt, and Elizabeth Stuart co-authored this piece.

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