All managers in the English Premier League and Football League have been sent a 120-page survival guide by the League Managers Association, offering expert advice from clinical psychologists, cardiovascular specialists and even an addiction counsellor on how to handle the multiplying stresses and strains of their job. Managers are being instructed by the LMA to take a "20-minute nap" during the day, to eat "more broccoli, cauliflower and soy beans" and to "drink alcohol only in moderation", helping them avoid the "triggers" that increase match-day tension.The pressure is such that, of the first 54 managers tested by the LMA under its "Fit to Manage" programme, 25 revealed "significant cardiovascular and lifestyle-related health issues".The unforgiving nature of life in the technical area finds a similar reflection in the statistic that more than 50% of first-time managers in the top four divisions never work in the professional realm again.In such a febrile and results-driven industry, managers have always inhabited the compression chamber, but never have the forces on them been so numerous and so unremitting.Take Steve Bruce. Battling to keep Hull City in the Premier League, Bruce also has to deal with midfielder Jake Livermore's cocaine habit, owner Assem Allam's ridiculous desire to change the club's name and some petty refereeing accentuating Hull's travails.Officials refused to allow centre-half Michael Dawson back on quickly after he had been ordered to change a shirt slightly flecked with blood; during his absence, Danny Ings scored, Burnley won 1-0 and Bruce's men slumped into the relegation positions.Burdening Bruce further is that he is well aware of the impact of relegation on budgets, fans' self-esteem, local tourism and the brutal reality that backstage staff risk losing their livelihood. The stress is immense.The oft-stated fact that managers, certainly at Premier League level, are handsomely rewarded for pursuing a trade they love does not diminish the legitimacy of concern over the proliferating perils of their occupation. Some managers have received words of wise counsel from Jeremy Snape, a former England cricketer, sports psychologist and current LMA non-executive director credited with Alan Pardew's improved self-control following one-on-one sessions.Writing in the LMA booklet, Snape tells managers: "Whereas that perceived danger was once the sudden appearance of a sabre-toothed tiger, it is now a text from the club's owner, a misquote in the media or the persisting memory of a lost opportunity. While the dangers or stressors once came in short, sharp bursts, they are now often regular and sustained and our bodies were not designed to handle it."Snape identifies signs that stress has taken its toll as "indecisiveness, [being] suddenly verbally or physically aggressive, heart palpitations, disturbed sleep, excessive drinking, short fuse with loved ones and depression".Snape exhorts managers to focus calmly on the immediate issue, using an analytical head rather than a racing heart."The All Blacks have a number of cues to jolt them back into the present, such as looking at the stadium roof, wiping their brows and kicking the ground," Snape said.It is hard to imagine Bruce taking up yoga but he has to watch his health and stress levels. The LMA booklet arrives at the right time. ..