Stress is a common occurrence that affects everyone at some point. Some people feel stress daily, while others may have difficult circumstances that create stress. Stress in small doses allows us to transform and build resiliency and grit. However, chronic stress can lead to physiological, physical, and mental health issues. This article focuses on stress management techniques to help you manage and alleviate stress. 



I am a huge fan of connecting with our breath —after all, it is free and right under our noses. There are a plethora of breathing techniques one can choose from. I will highlight three common practices. If it feels right, I recommend picking one technique and practicing it daily for a month. Take inventory of how your body and mind feel during this time as you connect with your breath. Breath work allows one to relax in a low-stakes environment so that you can tap into the relaxation response when you are in a high-stakes situation. Breathwork is helpful because you can do it anytime, especially if you only have a few minutes to spare. 


4-7-8 Breath
    • Inhale for a count of 4. Hold for a count of 7. Exhale for a count of 8. 
    • Start gently and slowly. 
    • Notice how you feel in your body. 
    • Are there areas of tension you can release?
    • Do four rounds of this, especially first thing in the morning.
    • As you start feeling comfortable, increase to 8 rounds. 
    • Notice how you feel before and after the breath exercise.


Box Breathing
    • Inhale for a count of 4. Hold for a count of 4. 
    • Exhale for a count of 4. Hold for a count of 4.
    • Notice how you feel in your body. 
    • Are there areas of tension you can release?
    • Do four rounds of this.


Alternate nostril breathing
    • Press your thumb to the right nostril. Breathe in through your left nostril.
    • Close off the left nostril with your index finger. Breathe out through your right. 
    • Inhale right nostril. Exhale left nostril.
    • Repeat this six times.
    • Notice how you feel in your body. 
    • Are there areas of tension you can release?



I hear so often from my patients that they have a hard time getting into a meditation practice–that they can’t focus or don’t have the time. I am here to tell you that there are so many different types of practices that I encourage you to explore a practice that works for you. There is Zen meditation, heart-centered meditation, mindfulness meditation, walking meditation, etc. Meditation allows one to connect with oneself without judgment. Mindfulness-Based Stress Reduction (MBSR) is an eight-week course that meets in a group setting. Students can learn different meditation practices, including seated meditation, walking meditation, and body scans. 


I encourage you to look into an MBSR course or check out the available meditation apps (Insight Timer, Headspace, Calm, to name a few). Start with 5 minutes daily and work to 20-30 minutes, if available. Check out local meditation circles ( that are donation-based. Creating a community you can meditate with is a great way to get deeper into your practice. Notice how you feel after a meditation journey and how it changes over time! 



Movement is an excellent way to de-stress. Exercise increases endorphins—which help elevate our mood—and reduces cortisol and adrenaline. Find a movement practice that resonates with you, whether hiking, swimming, running, yoga, dance, biking, etc. Find a group class or go to the gym with a friend. When we engage in social interactions while exercising, stress levels naturally reduce (after all, we are social creatures!). 


Mental health 

It is so important to take care of your mental health. Chronic stress can lead to imbalances in your hypothalamic-pituitary-adrenal axis. If the techniques listed above are not working or you are going into a mental health crisis, please discuss with your healthcare provider about medical interventions that would be appropriate for you. For some, that may look like working with a mental health counselor. For others, discussing medication or herbal options or a combination of both. Know that your medical team at Integrative Family Medicine of Asheville is here for you to discuss ways of managing stress in a personalized way. 


In summary, I hope you find your unique way of alleviating stress. Stress is unavoidable, so work to create healthy habits of de-stressing. These stress management techniques are available at your fingertips! Feel free to explore each one to see which works best for you. Happy de-stressing!

This blog post was written by Dr. Aneela Cox, a physician at Integrative Family Medicine of Asheville.