Feeling stressed? We all experience it. A modest amount of stress - usually cyclical and offset by periods of relative calm and security - can be normal. But sustained high levels of stress can be hazardous to your health, leading to hypertension, strokes, heart attacks, diabetes, ulcers and neck or low-back pain.
In the workplace, stress can also affect work performance, personal and professional relationships, and even the employer's bottom line. According to the Centers for Disease Control and Prevention's National Institute for Occupational Safety and Health:
40 percent of job turnover is due to job stress;
60 percent to 80 percent of on-the-job accidents are stress related;
and health care costs are 50 percent greater for employees with high stress levels
Ohio residents apparently know a thing or two about being stressed. According to United Health Foundation's 2011 ''America's Health Rankings,'' Ohio ranks 41st among all 50 states when it comes to poor mental health days - days in which an employee is physically at work, but not fully productive due to stress and physical or mental health issues.
The good news is that stress is manageable. Consider the following four categories of stress relievers:
Biological Reactions: relaxation, meditation and improved diet, exercise and sleep habits;
Environmental Conditions: better time management, conflict management and delegating responsibilities at work and home;
Individual Actions: assertiveness training, accepting criticism without overreacting and avoiding substance abuse;
Workplace Changes: having a well-defined job, being clear about goals and priorities, being involved in worthwhile work and adequate staffing.
The goal of these practical steps is to create ''resilience'' in individuals and in the workplace, or having strength in the midst of change and stress, and the power to spring back and recover readily from adversity. Support from friends and colleagues is also important, while avoiding people and environments that drive negative attitudes also help.
Research has shown that humor is another very effective mechanism for coping with acute stress. Keeping a sense of humor during difficult situations is a common recommendation from stress-management experts. Laughter not only releases the tension of pent-up feelings and helps keep perspective, it appears to have actual physical effects that reduce stress hormone levels.
According to the American Cancer Society, laughter can increase breathing, oxygen use, and heart rate, and also cause short-term changes in hormones and certain neurotransmitters.
Psychologically, laughter also may act as a coping mechanism to reduce stress and psychological symptoms related to negative life events. In short, laughter can improve self-esteem and mental health while lowering levels of loneliness and depression.
So consider infusing some healthy, happy dose of laughter into your daily routine to reduce stress and improve your physical and mental health.
Merk is managing director of health strategies, United Healthcare of Ohio.

