You know the feeling. The butterflies fluttering in your stomach begin. Soon they persist and grow into giant eagles beating their wings inside your rib cage. You can't hear the people around you clearly and find yourself at a loss when they look at you waiting for a response. Soon the rushing in your ears is all you can hear. Decision-making is long gone, and all you can do is go through the motions. No one could understand what this feels like, so you keep it all inside. Next thing you know, you are sitting in the dark, eating another bowl of ice cream, all alone with your thoughts that keep circulating.

These are just some examples of people's feelings when they are stressed, have anxiety, or slip into depression. The first step in treating any of these conditions is recognizing that you are stressed, have anxiety, or could very well be depressed. You are not alone! There are professionals available to help treat all of these conditions. Please seek help from your primary care provider or a licensed mental health professional if these feelings persist. Seeking help from a qualified provider can assist you in talking through your issues. Many insurance carriers even cover remote mental health services, which in some cases are underutilized.

When a stressful situation occurs, your body may enter fight or flight mode. The body is flooded with hormones that are gearing you up for a fight or to run away. They cause the skin to flush, increase your heart rate, make your hands tremble, and increase shallow breathing. The hormones take 20 to 60 minutes to leave the body after the stressful event has passed. Repeated stressful situations keep the body pumping these chemicals into your system, leaving you exhausted.

Pay attention to your body. Learn to recognize when and what situations induce stress. When are you feeling the release of these hormones? What was the trigger that caused you to become stressed? Start taking deep breaths once you realize that you have been triggered. Take slow, deep breaths in through your nose and out through your mouth. Talk positively to yourself inside your head during the breathing. Repeatedly tell yourself that you are doing fine. No one is going to harm you physically. You can handle any situation. You are worthy. You are smart. You are a good person.

Exercise can reduce stress, too. Exercises can range from simple shoulder rolls and neck stretches to yoga to running to playing a sport. In the heat of a stressed-out moment, raise your shoulders to your ears and then drop them low. This movement will cue your brain to relax your shoulders. Find a friend to exercise with. An exercise buddy will keep you accountable and provide an opportunity to talk out the situation.

Schedule time for yourself. You may believe you are too busy to relax; however, if you take even 10 minutes doing something you enjoy, like working a puzzle, reading, playing with your kids, or talking to a friend on the phone, you will be recharged and ready to handle the day to come. Our calendars are full, and we often try to squeeze one more thing into the day. Look carefully at your long list of to-do items. What is the most important thing to get done? Do that thing, then give yourself a break. Take some time to reward yourself before moving on to the next item.

An alternative way to help control stress is to find time for thought and reflection.  Many people find religious congregations, worship services, yoga, or meditation in many forms to help keep them grounded and provide perspective in recognizing and handling stress. You don't have to be a regular "church-goer" to find benefits in organized religion. More importantly, the time before, during, and after structured meditation or religious services may provide you with time to think, sit, and reflect. In addition, many religious congregations provide emotional and other forms of support for those dealing with difficult situations.  At the very least, carving out time to be still and silent may center you for the week to come.

There are medications that can help reduce stress, anxiety, and depression; however, medical guidelines and criteria always recommend talking with a licensed health care professional either before or during the initiation of medication therapy. Many types of medications are used to treat anxiety disorders, including traditional anti-anxiety drugs such as benzodiazepines (typically prescribed for short-term use) and newer options like SSRI/SNRI medications that affect serotonin-norepinephrine levels in your body (often recommended as a long-term solution). These drugs can provide relief, but they also come with side effects and safety concerns—some significant. They are also not a cure or "silver bullet" – all medications used to treat stress, anxiety, or depression are more effective when a patient also seeks the services of licensed mental health professionals.