Linda made several suicide attempts between her 13th and 15th birthdays. "I was always telling myself how stupid, fat and ugly I was. I always felt I had to help my friends with their problems, and I had lots of family problems of my own," she says. "I just kept heaping tons and tons of stress on myself and that's probably why I got to be such a mess. I didn't realize until years later how stress had contributed to my decision to die."

Linda's situation is not an unusual one, though her response is extreme. Not knowing that she was causing herself unnecessary stress, Linda was unable to control its effects.

Stress is always present. For some people, even the smallest amount of stress seems unbearable, while others seem to be energized by it. To control the effects of stress in your life. you need to understand its sources.

Most people think stress is only caused by bad things, such as failing an exam or breaking up with a girlfriend or boyfriend. Stress, however, can be caused by good things as well.

Starting a new job, falling in love or moving to a new house can cause you to experience levels ol stress just as high as those caused by negative events. This is natural and is common to everyone.

How you feel about yourself can create stress. Vickie Gravila-Retich, a clinical psychologist in Milford, Michigan, works with adolescents who suffer from stress. "A young person, 17 years old, suffered from a kind of stress...not fitting in. He labeled himself as nerdy.

"We focused in therapy not on his feelings and behaviors being negative, but on how many could be viewed as positive, charming and insightful. We also looked at his appearance. Yes, he wore 'nerdy' glasses, so they were quickly replaced. He altered his hairstyle a bit, and we looked at different clothes options that made him feel great, yet be comfortable.

"He found new self-confidence and in turn saw that he didn't need to fit in, just be himself. He also found activities he enjoyed outside school which did reduce his anxieties."

The causes of stress can be divided into two categories: external and internal. Problems at school, conflicts with friends or family, and difficulties at work are prime examples of external stressors.

Internal stressors, experienced by the young man who saw himself as "nerdy," are pressures you put on yourself. This type of stress is generally due to either thoughts or feelings and can be the most damaging.

Doris Misiak, a therapist with Catholic Family Service in Midland, Michigan, works with teens. She feels that "common stressors...for teens involve uncertainty or impotence. Uncertainty is the fear of the unknown....If parents are divorcing, there can be fears about the permanence of love. Does it mean love is not forever? Is it better to stay out of love? Stress can also accompany choosing which parent to live with or other changes in the daily routine of life."

Misiak also feels that in peer relationships, there can be concerns about what others will think. Will others make fun of my clothes or hair? Will I say something stupid?

"Impotence, on the other hand, is a feeling of powerlessness or helplessness where an individual experiences a lack of control over life," Misiak explains. "For instance, in newly formed stepfamilies, there is a tug between the teen's need to be independent and the family's need to form a bond. In cases of poverty, violence and drug abuse, there is a lack of care and protection. Parents in such families may not be available to listen and to understand."

Fight, Flight, Freeze

You probably react to stress in one of three ways. Some people strike out at others, becoming angry or taking immediate action. "I just feel like blowing up," says Bob, who's 18. "I feel better if I can yell or scream or something. Sometimes physical work like mowing the lawn can help as well."

Unlike Bob, some people become passive when stressed. You may know someone who urges her friends to tell her what to do, or just follows along with whatever everyone else does.

While some people either strike out or withdraw, still others freeze. People who don't study for a test until the night before or put things off as long as they possibly can are good examples of freezing under stress.

Whether you respond to stressful situations by fighting, becoming passive or freezing, knowing how you react to stress will help you to know when you're experiencing it.

Track the Effects

In recent years, research has been pointing to a connection between stress and physical illness. Conditions such as heart disease, ulcers and high blood pressure are just a few of the possible physical outcomes of a high-stress lifestyle.

Gravila-Retich explains, "A 17-year-old recently came to me for help because her physician had diagnosed her as already having an ulcer. As she spoke of her daily activities, friends, family and self-perceptions, I came to see a need to control. She was unable to relax, was working two jobs, was very competitive, in college prep courses and was having boyfriend problems because she was too busy to see him (and the list continued).

"We attempted slowly to add positive stress-reducing activities to her life. It wasn't easy. For example, I asked her to take a bubble bath for one hour once a week, but she set a timer, kept watching the clock, and immediately jumped out and continued on her hectic schedule.

"After three months of therapy, she now is able to take two [long] baths a week. As for her relationship—once a week they [she and her boyfriend] have an appointment to watch a comedy, We are finding out that humor releases wonderful, healthy chemicals into the body to reduce stress as well as reduce physical illnesses."

Even more disturbing than the physical effects of stress are emotional disturbances that result. Depression, low self-esteem, irrational thinking and suicide are just some of the emotional outcomes of extreme stress.

Stress Analysis

If you are going to control stress in your life and stop its negative effects, then you must be aware of how it affects you.

Each person tends to hold stress in a different part of the body. Linda is well aware of how her body holds stress. "By the end of a hard day you can be sure to see me rubbing the back of my neck. Sometimes I'm aware of the stiffness in my neck before I'm aware of what's causing me the stress." Being aware of physical changes that take place in your body can alert you to the effects of stress.

Another way to enhance your awareness is to do a stress analysis. Make a written list of what events in your life are currently causing you stress and rate them from the most to least stress-producing. Pay attention to both internal and external sources.

A detailed journal that reflects an hour-by-hour account of your day will help you to analyze how you spend your time and what you're feeling in response to what's happening in your life. After a week of keeping this journal, you should be able to see a connection between your daily activities and the stress they cause.

A stress journal often helps people to see a connection between stress and eating. Kathy Reinert, a medical technologist at St. Joseph's Hospital in Flint, Michigan, was herself a victim of eating in response to stress. "I remember when I first learned that food was comforting. One day in school the teacher was talking about the crucifixion in detail, and I felt like I was going to pass out. It was the lecture before lunch and at lunch they served pumpkin pie. I remember it was warm and comforting, and I remember thinking that if I ever feel bad or depressed I know food makes me feel better....[Later] I started trying to identify the times I was eating with what was happening in my life, and I realized that I was eating in response to stress or pressure....Now...I walk and bike to relieve stress instead."

You Can Manage

Once you've gained an understanding of how much and what kinds of stress you have in your life, as well as how you experience it physically and emotionally, you can learn techniques to manage it. You must experiment with different methods to find out what works best for you.

1. Deep breathing is a very simple method of stress management. Often when you become stressed, you tense up and your breathing becomes shallow and sometimes rapid. Breathing deeply provides your body with the most oxygen and generally calms you. To avoid breathing too quickly, try counting to 10 as you inhale and again as you exhale.

2. Relaxation may seem like something that comes naturally, but many people don't know how to achieve total muscular relaxation. Following these simple steps can help: Tune in some soft music. Lie flat on your back in a dimly lit, quiet room. Beginning with your head and moving slowly down until you reach your toes, tense each of your muscles as strongly as possible and then relax. By the time you reach your toes, you should experience physical relaxation.

3. Patrol your thinking. If you're inclined to give yourself negative messages, or think upsetting thoughts, a thought-stopping technique may prove effective. Jessica was a victim of a serious car accident when she was 14, and had suffered a head injury as a result. Two years later she was still consumed with fears about being in another car accident. "My therapist told me to wear a rubber band on my wrist, and every time I had the scary thoughts, I'd snap my wrist. It really helped. I felt pretty stupid at first, but it worked."

By snapping her wrist each time she had a "scary" thought, Jessica began to associate certain thoughts with physical pain. Since people naturally tend to avoid pain and seek pleasure, Jessica eventually stopped herself from dwelling on certain negative thoughts.

4. Act. Doing something simply to stop yourself from thinking about what's bothering you, like saying the word stop aloud or shifting your focus to something else, can help you to control negative thoughts also. Whatever technique you choose to control internal stress, remember you are free to choose. While you may not be able to control external events in your life, you can choose how you react to them.

Ask God's Help

Your spiritual life is a major source of the peacefulness and the confidence that can conquer stress. This benefit of faith has long been overlooked by caregivers. Recently, however, more health-care professionals are acknowledging the usefulness of religious practices, including spiritual reading and meditation, volunteer service, spiritual counseling and prayer.

Reading is a quieting activity in itself. If stress troubles you, make a reading plan. List some of the biblical stories that soothe you. Some find that a few of the psalms work well for them. Others like to read Jesus' words to his friends at the Last Supper or after his resurrection. Be prepared with a list for the hard times so that you don't have to work too hard to find them when you're feeling low.

Peggy McCourtney, diocesan director of family/youth ministry in Saginaw, Michigan, says, "I believe that the Gospels have a lot to say about the whole human condition. The kinds of things that people went through are not really different from what people are still dealing with today."

McCourtney also suggests that teens read books such as Dreams Alive: Prayers by Teenagers by Carl Koch, Prayers for a New Generation by Joseph Moore and May I Have This Dance? by Joyce Rupp. "These types of books invite young people into a process of reflection," says McCourtney. "They can sit back and think with some guidance."

Helping others may also lower your stress level. While volunteer work may not directly provide the comfort that reading does, it can direct your focus toward the problems of others rather than your own. Seeing firsthand the difficulties that others face can put your own life in perspective, and perhaps provide the realization that the things you sometimes see as stressful really aren't as life-and-death as they may seem at times. (Activity works best for those whose response to stress is action.)

Sometimes, when stress becomes overwhelming, therapy may be needed. Along with therapy, however, spiritual counseling may be beneficial. The spiritual counselor can act as a sounding board for your concerns while helping to put you back in touch with your relationship with the Lord.

Perhaps most useful in the control and reduction of stress is prayer. Traditional prayers can soothe you with their repetitious and familiar message. Unstructured prayer gives you the opportunity to say whatever seems necessary. That in itself is good therapy. Faith reminds you that your prayer is heard by a loving God. This confidence also reduces stress. Prayer also has a physical effect, reducing your heart rate and slowing your breathing.

Gravila-Retich says, "My advice to teens is to understand that there will always be stressors in your life, but it is how you perceive them that matters. Ask yourself if you can change your goals, seek out assistance and make fewer demands on yourself. Simple and inexpensive activities are the best for reducing stress. A walk, a bubble bath, taking the time to rest, seeing a humorous movie, talking with a friend, meditating, exercising, watching the stars. So many things can be added to fit you and your needs that the list is endless."

Lynn Marie-Inner Klammer is a licensed clinical psychologist, college educator and author. This is her third Youth Update.

Cliff Woycke, high school CCD teacher at St. Catherine of Sienna Parish in Westwood, a Cincinnati, Ohio, neighborhood, gathered four teens together to consider this issue on stress. Though school was out, they were still stressed and they wanted more examples and help in coping. The critics were Almeria Decker, 15; Reine Decker, 17; Sarah Schmitt, 18; and Regan Thaler, 18.