The human body's stress reaction is referred to as the "fight or flight" response. To help you fight with your arms or run away from danger, the body increases its heart rate and sends blood to the outer extremities. When you are experiencing stress reaction, blood is taken away from your digestive tract. While you are under stress you are not absorbing nutrients effectively; they are instead excreted through your bodily wastes. Vitamin C is lost in large amounts to the stress response.

Under stress there is a tendency to limit the breath and the amount of fresh oxygen you take into your body. Shallow breathing also involves holding muscles of the trunk, abdomen, and often the shoulders and neck in constant, low-level exertion. For people with pulmonary limitations as a factor of their disability, stress only decreases their respiratory efficiency.

There are a number of unique stresses you might experience as a wheelchair user:

• The effort of pushing a wheelchair raises your body's metabolic processes in ways that mimic a continual stress response.
• Awkwardness in handling your body while wheeling, transferring, or performing daily tasks such as work or cooking that preclude the relaxed state.
• Some daily tasks such as dressing or using the bathroom could be strenuous for you.
• You might experience psychological stresses from worrying how others see you, particularly at stages of disability when you are adapting to your new identity as a chair rider.
• You might experience discrimination, such as being denied access to jobs or transportation.
• You might face stresses with bureaucracies such as Social Security, Vocational Rehabilitation, Medicare, or other systems which you must rely on for support.

The simple act of breathing is an extremely valuable stress manager. When you take a couple of deep breaths and close your eyes, you can discover where you are holding physical tension in your muscles. Breathing allows you to notice that your belly is tight, your shoulders slightly raised, or that you are holding your head in a limited range. If you don't have the use of your trunk muscles, keeping the area around the lungs relaxed is all the more important.

You already know how to breathe, of course, but you might be in the habit of breathing only in your chest. Even if your disability precludes the use of your abdominal muscles, you can imagine your breath starting from that lower part of your body. Imagine that the air you are breathing first goes all the way down to the very bottom of your lungs and out to the farthest small branches of the brachial "trees" that make up your lungs. As you practice this method, you will find that you are able to take in more air comfortably. This ability to breathe deeply will help you counteract the stress response.

Another important technique for stress management is your own thinking. When there are parts of your life that are upsetting, staying focused on those problems increases the negative impact of the resulting stress. In time, you lose perspective and the ability to think objectively. Certainly it is healthy to experience emotions about events and challenges in your life, but not to be continually overwhelmed by them. You can minimize the effect of stress by doing your best to relax, giving your attention to other activities and allowing your mind to have a rest from what is troubling you. When you come back to thinking about a problem you will likely have a fresh perspective, and your body will not suffer so much from the tension, loss of nutrients, and other detrimental effects of excessive stress.

Meditation might sound like something that only Buddhist monks or Californians do, but it is a simple and powerful tool available to anyone, anywhere. Meditation is not about going into a trance, nor is it about superhuman concentration. To meditate, all you do is sit comfortably and pay attention to your breath. That's all. Your thoughts will continue, but each time you notice getting caught up in a certain thought, just put your attention back to your breathing. Decide that for the fifteen minutes you will spend in meditation that any thought that comes to you will still be around later, and you don't have to stop and explore it. The simple act of observing the breath will allow you to gain a fresh perspective, and help to moderate physical tension and emotions. Try it once a day for a week, without judgment, and see what happens.