Stress

We all get stressed sometimes. This is perfectly normal. Although we tend to think of stress as a bad thing, stress can sometimes be very positive and motivating, spurring us to overcome hurdles and achieve our goals.

What is stress?

We all get stressed sometimes. This is perfectly normal. Although we tend to think of stress as a bad thing, stress can sometimes be very positive and motivating, spurring us to overcome hurdles and achieve our goals. For example, the stress of facing a tight deadline can encourage us to do better work in less time. Stress can keep us alert so that we avoid danger, such as when we are cycling on a busy road. Watching a scary movie or white water rafting can make us feel stressed, but in a good way.

Problems arise, though, when our stress feels overwhelming or goes on for too long, affecting relationships, work and home life. Your mood and behaviour might change, and you might notice physical clues within yourself that all is not well. Although stress itself isn’t a psychiatric diagnosis, it can have a harmful effect on our emotional and physical well-being. It can even lead to serious illness.

Common signs of stress

The following are just some of the signs that your stress has crossed the line from normal to problematic:

  • Feeling worried, anxious and afraid a lot
  • Irritability and hostility
  • Feeling tired, run down and/or burned out
  • Reduced self-esteem
  • Feeling tearful and crying more often
  • Feeling low, sad or depressed
  • Difficulty concentrating or remembering
  • Sleeping too much or too little
  • Aches and pains
  • Picking at your skin or biting your nails
  • Getting more colds and other illnesses
  • Taking drugs, smoking and/or drinking alcohol more than usual
  • Serious illness such as cardiovascular disease, diabetes, stroke, asthma and some types of cancer
  • Episodes of racing heart, high blood pressure, chest pains
  • Stomach and gastrointestinal problems including heartburn, indigestion, constipation and/or diarrhoea
  • Under or over-eating

How does stress work?

Evolution. Millions of years of evolution have given us amazing ways of dealing with threats and challenges. Our bodies are always primed to react to danger, real or imagined, whether it involves escaping a tiger or our boss at work!

Our biology. When we are stressed, the hypothalamus part of our brain tells our body to make more “stress hormones,” such as adrenaline and cortisol. These hormones give us an extra boost of energy so that we can deal better with any threats or pressure (also called our fight or flight response). Adrenaline, for example, increases our heart rate, raises our blood pressure and provides energy, and cortisol increases our energy by releasing glucose into our bloodstream so that we can run away. Our body usually controls our physical response to stress all by itself, so that when the stressful event is over, our hormone levels naturally fall. Problems occur, though, when our stress is too intense or goes on too long, because our bodies are forced to release stress hormones over a long period. This can cause the physical and psychological health problems mentioned above.

Mind and body connection. Our mind and body are very much connected. Our thoughts can affect how we physically respond to stress. Research has found that the part of the brain that deals with complex thought and movement (cerebral cortex) links to the part of our body that makes stress hormones (1). This means that just thinking stressful thoughts can cause our body to release stress hormones as it gets ready to face a threat.

Stress and our immune system. Stress hormones can dampen down our immune system (2) so that when we are stressed for long periods of time, our bodies can’t fight off colds and other illnesses or even heal wounds as quickly (3).

The extraordinary insight that follows from this is that the opposite is also true! Having calming thoughts and doing calming things can bring us back to a more relaxed state. This is why certain movement practices that include a meditation element (e.g. pilates, yoga and tai chi, etc.) can help calm us down. 

I’m feeling stressed. What can I do to help myself?

No two people will react to events in their lives the same way. How we deal with stress and stressful situations varies from person to person. Not only do we each handle situations in our lives differently, but things that we dealt with easily at one stage in our lives might make us feel stressed at other times.

One big thing can make us feel stressed – such as being under a lot of pressure, divorce/separation, moving house, facing a new challenge or change – or it can be a build up of lots of small situations. Even happy events, such as a new baby or getting married, can cause stress. Just being stressed can make us feel stressed, which often makes the original problem even more difficult to handle.

So what can we do to help ourselves when we feel stressed? Although we can’t always change our circumstances, we can change how we respond to them.

So what is the first thing we need to figure out? It may seem obvious, but the first thing to figure out is what exactly is making you feel stressed and to look honestly at how you are reacting in your mind, heart and body. It can help to sit down and write the answers to these questions:

  1. What makes me feel stressed? Think about large and small triggers, since even something that seems trivial can spark a stress spiral. Examples of small triggers might be misplacing your keys/wallet/glasses, being late for an appointment, or getting stuck behind a slow driver.
  2. What thoughts and emotions arise when I begin to feel stressed?
  3. What is happening in my body when I begin to feel stressed?

Stress management techniques

Once you have answered the above questions, you can start to think about what you can do about it. Although you might feel helpless and overwhelmed, there are numerous stress management techniques you can try that have helped many people. The ones we list here are just a few examples and they can be used separately or in combination.

It is important to note that while these techniques are suitable for most people, there might be psychological and/or physical reasons why you should not take part. You may wish to get advice from a doctor or health professional before trying any of these techniques. You should always listen to your own experience, do what works and leave what doesn’t.

Mindfulness

Mindfulness is a mental training technique that teaches us to be aware of our thoughts, feelings, moods and bodily sensations as they are in the present moment so that we can see things as they are they are, and not as we wish them to be. When we pay attention to how we are thinking and feeling right now, we become better at spotting the build up of stress – and uncomfortable emotions and thoughts – so that we can deal with them more effectively, instead of just reacting in ways that might not be good for us. We learn that thoughts are just thoughts. They are not facts and we can choose whether to give them power over our minds and hearts. Mindfulness practices include focusing on the breath and body as well as meditation, movement and the development of a more mindful attention to everyday activities. All of these approaches help us learn to recognise the feelings and patterns of thinking that cause unhappiness.

There are many resources, such as books and CDs, that you can use as a starting point to learning mindfulness. One highly-recommended book is Mindfulness: A Practical Guide to Finding Peace in a Frantic World, written by Mark Williams and Danny Penman.

Some people choose to join an eight-week Mindfulness-based Stress Reduction (MBSR) course. MBSR is a group-based class where you can get the benefit of guidance and support from an experienced mindfulness teacher. MBSR was originally developed by Jon Kabat-Zinn (Center for Mindfulness, University of Massachusetts Medical School, USA), who has produced a wide range of excellent books, downloads and guided meditation CDs.

Progressive muscle relaxation

When we are stressed, our bodies often tense up. The classic place to feel this sort of tension is in our backs and necks, but tension can be experienced anywhere in our bodies.

Progressive muscle relaxation involves working through the muscle groups in your body, first deliberately clenching and holding and then relaxing. Start by tensing and relaxing the muscles in your toes, then your feet, calves, upper legs and so on. Gradually work your way up to your neck and head; pay particular attention to parts of the body where you notice tension; don’t forget your fingers, hands and arms. Or you can start with your head and neck, and work down. While breathing in, tense your muscles for at least five seconds and then relax for 30 seconds as you breathe out. Repeat this as you move to a different part of your body. Over time, this training can help you recognise tension in parts of your body so that you can relieve it yourself.

Guided imagery technique

Guided imagery technique is a form of meditation that teaches us to focus on pleasant images to replace negative or stressful ones. Based on the concept that our minds and bodies are connected, the idea behind it is that the images that we create in our minds can seem almost as real as actual events, and that our bodies react as though the events are real. When we picture stressful events, for example, our bodies can have a stress reaction such as increasing our blood pressure and heart rate. When we picture more peaceful things, such as strolling on the beach at sunset, our bodies and minds become calmer. Engaging all of our senses – smell, touch, taste, hearing, sight – can make us feel that we are actually there. As we connect fully with the peaceful image, our minds and bodies become calmer and we don’t feel as stressed.

You can practise the guided imagery technique using a CD, written script, or with the help of an instructor. The key is to find imagery that makes you feel safe, relaxed and happy.

Physical exercise

Many research studies have shown that physical exercise really does make us feel better because our bodies create more “feel-good” endorphins when we are active. Regular exercise not only can make us feel happier, but it can also boost our self-confidence, improve our sleep and lower the risk of major illnesses, such as heart disease, stroke and cancer. How much exercise you choose to do depends on your lifestyle, interests and physical abilities.

Other mind and body practices

As we mentioned before, there are many things that you can do to help yourself deal with the stress you are feeling. In addition to mindfulness, for example, there are other mind and body practices that combine meditation with movement such as tai chi, yoga and pilates. A growing body of research is exploring how these mind-body practices trigger beneficial physiological changes in our bodies – such as slowing our heart and breathing rates, and increasing the blood flow – that help us cope with stress (4).

Cognitive Behavioural Therapy

Cognitive Behavioural Therapy (CBT) is a short-term, goal-oriented treatment and is one of the most widely used evidenced-based therapies for stress and emotional problems. It is used to treat a variety of mental and physical health problems, including managing stress. Under the guidance of a skilled mental health practitioner, such as a clinical psychologist, it focuses on changing unhelpful patterns of thinking and behaviour, so that you learn new ways to deal with difficult situations.

When to see your doctor

As we’ve discussed, stress can have a very serious impact on our mental and physical health. You may have tried some of the self-help techniques listed above, or feel that they are not right for you. You, and/or your friends and family, may notice major changes in how you behave, think and feel. At this point, it might be wise to discuss what’s going on with your family doctor so that you can receive the most suitable help.

Preventing stress and getting stronger

There are lots of positive things that you can do that will give you the strength and wisdom to deal with challenges that come up. The following suggestions will make you feel stronger and more in control on a day-to-day level so that you are prepared to face the large and small stresses in your life.

Learn what supports and sustains you

Many people lead life on automatic pilot, rarely stopping to ask themselves what supports and sustains them. Make a list of all the things you do in a typical day and then highlight those that support and sustain you and those that deplete and exhaust you. Are there any changes you need to make? Because our minds tend to focus on threats and problems, we often ignore all the good things in our lives. It can be helpful to pause regularly to think about three things that you enjoyed, that went well, or that you are simply grateful for. Writing them down can be a good reminder that it’s “not all bad” when you start to feel stressed. It can also highlight what is important to you and what you enjoy.

Take control: planning, problem solving and time management

Being passive can make our problems seem worse. Managing your time better in your work and personal life can be very empowering and make you feel more relaxed and focused. Managing your time can include:

  • figuring out your short, medium and long-term goals so that you have a road map for the future.
  • writing a single daily to-do list (not multiple lists which can get confusing) can help you remember large and small tasks, and when you need to do them. Having a to-do list makes your more efficient. It frees the mind up from the stress of always worrying that you are forgetting things.
  • scheduling in time for breaks, exercise, meals and leisure activities so that you give yourself the best chance of staying refreshed, happy and healthy.
  • working “smart” not more. Working an extra hour when you are too exhausted to focus, for example, might not be a good way to manage your time.
  • prioritising important tasks that will fulfil your goals. It is all too tempting to “clear the decks” by doing small tasks that are not important, such as clearing non-urgent emails. It can be liberating to just accept the fact that your in-tray won’t be empty at the end of the day.

Socialising and communicating with others

Having a good support system of family, friends and colleagues already in place during the good times means that we will have people to turn to in the bad times. They can provide a listening ear, give us a new perspective to our problems, and encourage us to try new things and get out more.

Identify and avoid unhealthy habits

We can all have habits that we do for good reason, but some of them probably make things worse. Comfort eating is a classic way of reacting to stress, but turning to caffeine, alcohol, smoking, irritability with others and/or drugs are also common ways of coping. None of these strategies will solve our problems, of course, and most will cause additional ones. It’s definitely better to find more effective methods of handling stress that help, not hurt, your well-being.

 

You can’t stop the waves, but you can learn how to surf.

– Jon Kabat-Zinn

 

Dealing with stressful situations can sometimes feel like we are bracing ourselves against powerful ocean waves that just keep coming and coming. While we can’t stop the waves, we can alter our stance to meet them differently so that they don’t knock us down quite so often. What seemed scary can suddenly be fun and thrilling. In the same way, we can alter how we face stress, turning to meet it with a new understanding of its impact on our minds, hearts and bodies. There will always be a certain amount of stress in our lives, but we can choose to respond in skilful ways that give us the best chance of being happy and healthy.

 

References

(1). Richard P. Dum, David J. Levinthal, Peter L. Strick. Motor, cognitive, and affective areas of the cerebral cortex influence the adrenal medulla. Proceedings of the National Academy of Sciences, 2016; 201605044 DOI:10.1073/pnas.1605044113)

(2) Sternberg, E.M., & Gold, P.W. (2002). The mind-body interaction in disease. Scientific American, 12, 82-89.

(3) Cohen S, Janicki-Deverts D, Doyle WJ, et al. Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk. Proceedings of the National Academy of Sciences. 2012.

(4) Dusek, J.A & Benson, H., Mind-Body Medicine A Model of the Comparative Clinical Impact of the Acute Stress and Relaxation Responses. Minn Med. 2009 May; 92(5): 47–50.