Virtually every disease, with a few genetic exceptions, can be caused by stress cautioned Dr. John Wakeman at the New Orleans Bar Association Inn of Court CLE Understanding the Medical Causes of Stress and How it Affects Professionalism. The somber truth was part of his thorough explanation of the many negative effects of stress that are both psychological and physical, which served as the introduction on how to best manage stress. The first step in stress management is indentifying it. Keeping a stress log can be a great way to figure out stress triggers, how one typically reacts, and feels so that they can move onto Dr. Wakeman’s four A’s of dealing with it: avoid, alter, adjust and accept. Lawyers and judges will admit that stress is a professional problem that all have experienced throughout their careers. Along with the four A strategy Dr. Wakeman explained that laughter, having fun, and even engaging in a hobby for twenty minutes day can really help with stress management. Exercising for thirty minutes three times a week, being in the sunlight, a healthy diet and breathing deeply are other ways to handle stress. Jacobsonian deep muscle relaxation is a method touted by many doctors for over 60 years, and that Dr. Wakeman himself finds useful. Employing this method is effective because anxiety and anger cannot coexist with deep muscle relaxation. Anger is a common response to stress, and most professionals express some level of anger due to stress. Angry people have higher blood pressure, heart rate, at higher risks for many diseases, and have been proven to die sooner. Dealing with stress, concluded Dr. Wakeman, is a matter of life and death, and therefore it is important to address it.