When you're stressed, the cause usually seems obvious: job insecurity, an aging parent's hospitalization, not enough money, a fight, a health scare. Try taking a second look. The real stressor is less likely to be the situation than the way you react to it.

No, I'm not saying that just thinking differently will make a sick parent better or wipe out your credit card debt. But your mental response can make or break how well you weather the storm. That's a valuable insight, considering that stress swamps the immune system, making existing symptoms worse and speeding disease. New research says stress also piles on abdominal fat, the least healthy kind.

Crack the code of what's really feeding your stress and you're on your way to taming the anxiety and tension -- before you need the coping crutches of booze, food, blood pressure meds, a day under the covers, or worse.

Here are the five top ultimate stressors -- and practical ways to tame them:

1. Lack of control

You sense: "I feel stuck." "I don't have any good options." "Nobody asks my opinion." "There's nothing I can do about this."

Remedy: Give input and exert influence in small ways, if not big ones – and whether or not your actions seem to make a difference. When our action-oriented brains feel like we're making progress, we feel more in control. It's the sense of being able to try that counts. So ask yourself:

• Can I do anything to change the situation? Sometimes we accept realities out of habit, even when they're not good for us. Have you turned over every stone?
• Can I assert myself more? Muster the chutzpah to say, "This is what I need."
• Can I flat-out say no? Natural-born caregivers tend to be big-hearted helpers. But they screw themselves over by taking on more than they can manage and then seething afterward, feeling overwhelmed. Look in the mirror and rehearse saying, "Gee I'm sorry, but I can't…".
• Am I moving toward a better situation, even if it's tough now? Consider the big picture. Sometimes it's easier to withstand a sense of stagnation if you know it's part of a bigger arc of progress.

2. Expectations or standards that are too high

You sense: ""Nobody can [fill in the blank] the way I do." "I'm the only one who understands." "I should have held my tongue." "I ought to be able to manage better."

Remedy: Draw – or redraw — what's acceptable to you. For starters:

• Erase the words **always and never from your vocabulary.* While you're at it, toss "ought" and "should," too – all red flag constructions of setting your personal bar too high.
• Aim for the B. Trying to do everything at A+ level is for college-bound crazoids, not human beings with houses to keep, relationships to tend, jobs to do, and sanity to uphold.
• Don't try to fit three errands into a two-errand time slot. Especially at rush hour. The math is against you.
• Hold yourself to your own standards, not anybody else's. Everybody has a different threshold. Maybe your sister grooves on talking to financial experts but you're terrified. Maybe your spouse maintains zen-like calm but you have a shorter fuse. Don't compare.
• Applaud yourself. Talking yourself down ("I'm fat," "I'm too slow") makes you your own worst enemy. Pep talk that's positive, even if it's inane ("Nice reply!" "Good hair day!") actually makes you feel physically better.

3. Uncertainty or fear

You sense: "I don't know what to expect." "How will we manage?" "What fresh disaster awaits today?" "Now what?" "I'm terrified x will happen."

Remedy: "Knowledge is power" isn't just a cliché, it's darn good advice. To wit:

• Collect all the facts you can. If it's a disease, troll the web for info, make lists of questions for doctors. If the fear is financial, research options in detail, find experts to consult. Take notes.
• Collect others' experiences. Don't be embarrassed or shy about asking around to finds friends of friends who've been there. Seek out support groups. You're not the only one who's ever been through anything.
• Accept that you can’t know (or control) everything. I've seen caregivers tear themselves up with anxiety over the fate of a sick relative. They want answers. They want restored health. They want crystal balls – and they don't exist.
• Break time into bearable bits. Get through today. Then tomorrow.

4. Too little self respect

You sense: "I don't have time for myself." "With all I put up with, I deserve this bag of chips/pint of ice cream." "When is it going to be my turn?" "I hate myself."

Remedy: Advocate for yourself and love yourself even more than everyone you love around you. Ask yourself:

• Am I doing things that make me feel better five minutes from now but will make me feel much worse in five hours? I'm talking that bag of chips here. Mindless eating fuels stress because we wind up feeling sluggish and remorseful. Tell yourself; "I deserve better" and do something that will fuel that feeling – exercise, one glass of wine, a chocolate-dipped strawberry (just not a dozen of 'em).

• Am I at least ranked in the top three on my priority list, most days? Granted, it's hard to make looking out for #1 your daily Job One, amid parent care, childcare, work, marriage, etc. But if you're not even sticking yourself in the list, it'll never happen.

• Do I feel likable and deserving? Everyone is! But if you can't honestly answer yes, it's time to find a counselor who can help you unlock this block.

5. Feeling isolated or unsupported

You sense: "Nobody understands." "Nobody asks about me." "I'm too embarrassed (or depressed or overwhelmed) to socialize."

Remedy: Push past the hurt and initiate. This stressor is huge for caregivers. When the situation is new or overwhelming, a natural inclination is to hibernate. To avoid this trap:

• Express yourself. A feeling bottled up is one more bit of pressure that will eventually explode. Say it to someone, write it down, even telling it to your dog gets it off your chest.
• Find yourself a fresh support network. Child going off to college? Mom moving into your spare bedroom? Maybe your old friends can't relate. You need some like-minded souls who are dealing with the exact same things; look online for abundant [supportive groups] (http://www.caring.com/community).
• Beware of stressors disguised as support. If your sister promises to help you but spends half the time criticizing your efforts, she's sapping your energy.