This document summarizes an expedition medicine conference presentation about expedition stress. It discusses an expedition in Malaysia in 2008, defines expedition stress as irritability, anxiety, and other changes in behavior from being outside one's comfort zone in an expedition setting. It notes that those particularly vulnerable include first timers, overconfident or inflexible individuals, and those with prior psychological or substance issues. The document outlines ways to counteract and prevent expedition stress through identifying vulnerable individuals, early recognition, stress-relieving activities, and proper selection, preparation, teamwork and leadership.