How to manage and reduce stress

Stress affects us in a number of ways, both physically and emotionally, and in varying intensities.1

Research has shown that stress can sometimes be positive. It makes us more alert and helps us perform better in certain situations.2 However, stress has only been found as beneficial if it is short-lived. Excessive or prolonged stress can contribute to illness such as heart disease3 and mental health problems such as anxiety and depression.4

How do you define stress?

In brief, stress is a feeling of being under abnormal pressure, whether it is an increased workload, an argument with a family member or financial worries.

During situations that make you feel threatened or upset, your body creates a stress response. This can cause a variety of physical symptoms, change the way you behave, and lead you to experience more intense emotions.5

Physical symptoms

People react differently to stress. Some common symptoms of stress include sleeping problems, sweating or a change in appetite.6,7

Symptoms like these are triggered by a rush of stress hormones in your body which, when released, allow you to deal with pressures or threats. This is known as the 'fight or flight' response.

Hormones called adrenaline and noradrenaline raise your blood pressure, increase your heart rate and increase the rate at which you perspire. This prepares your body for an emergency response.8 These hormones can also reduce blood flow to your skin and reduce your stomach activity. Cortisol, another stress hormone, releases fat and sugar into your system to boost your energy.9

As a result, you may experience headaches, muscle tension, pain, nausea, indigestion and dizziness. You may also breathe more quickly, have palpitations or suffer from various aches and pains. In the long-term, you may be putting yourself at risk from heart attacks and stroke.10

All these changes are your body’s way of making it easier for you to fight or run away and once the pressure or threat has passed, your stress hormone levels will usually return to normal.11 However, if you’re constantly under stress, these hormones remain in your body, leading to the symptoms of stress. If you’re stuck in a busy office or on an overcrowded train, you can’t fight or run away, so you can’t use up the chemicals your own body makes to protect you. Over time, the build-up of these chemicals and the changes they produce can be damaging for your health.12

Behavioural and emotional effects

When you are stressed you may experience many different feelings, including anxiety, irritability or low self-esteem, which can lead to becoming withdrawn, indecisive and tearful.13

You may experience periods of constant worry, racing thoughts, or repeatedly go over the same things in your head. Some people experience changes in their behaviour. They may lose their temper more easily, act irrationally or become more verbally or physically aggressive.14 These feelings can feed on each other and produce physical symptoms, which can make you feel even worse. For example, extreme anxiety can make you feel so unwell, that you then worry you have a serious physical condition.

Identifying the signs of stress

Everyone experiences stress. However, when it is affecting your life, health and wellbeing, it is important to tackle it as soon as possible.

While stress affects everyone differently, there are common signs and symptoms you can look out for:15

  • feelings of constant worry or anxiety
  • feelings of being overwhelmed
  • difficulty concentrating
  • mood swings or changes in your mood
  • irritability or having a short temper
  • difficulty relaxing
  • depression
  • low self-esteem
  • eating more or less than usual
  • changes in your sleeping habits
  • using alcohol, tobacco or illegal drugs to relax
  • aches and pains, particularly muscle tension
  • diarrhoea and constipation
  • feelings of nausea or dizziness
  • loss of sex drive.

If you are experiencing these symptoms for a prolonged period, and feel they are affecting your everyday life or are making you feel unwell, you should speak to your GP. You should ask for information about the support services and treatments available to you.

What causes stress

All sorts of situations can cause stress. The most common involve work, money matters and relationships with partners, children or other family members.

Stress may be caused either by major upheavals and life events such as divorce, unemployment, moving house and bereavement, or by a series of minor irritations such as feeling undervalued at work or arguing with a family member.16 Sometimes, there are no obvious causes.

Relationships

Relationships are a great support in times when we feel stressed. However, from time to time the people close to you, be it a partner, parent, child, friend or colleague, can increase your stress levels.17

Relationships, the missing piece of the wellbeing puzzle

We explored relationships for Mental Health Awareness Week 2016 and how good relationships are vital for our mental health. Watch our animation now:

Events such as ongoing minor arguments and disagreements, to larger family crises, such as an affair, illness or bereavement are likely to affect the way you think, feel and behave. This may consequently have an impact on your stress levels.

Work-life balance

The pressure of an increasingly demanding work culture in the UK is one of the biggest contributors to stress among the general population.18

While traditional working hours are 37 hours a week, the recent and dramatic rise in Britain’s working hours suggests this is likely to increase. 20.1% of the UK working population work 45 hours or more per week.19

The human costs of unmanaged work related stress is extensive. Feeling unhappy about the amount of time you spend at work and neglecting other aspects of life because of work may increase your vulnerability to stress. Increased levels of stress can, if not addressed early enough, lead to burn-out or more severe mental health problems.

Mental health issues such as anxiety and depression, are thought to be the leading cause of work absences, accounting for up to 40% of sickness leave.20 In 2008, mental health accounted for 442,000 cases of work-related illnesses and has had an estimated cost of 13.5 million.21 As a result, mental ill health now accounts for a significant proportion of long-term sickness and early retirement, cited as the leading cause of illness for 20% of NHS employees.22

Money

Money and debt concerns place huge pressure on us, so it comes as no surprise that they have a marked effect on our stress levels.

The effects of the economic crisis have affected everyone in some capacity. Recent statistics from StepChange Debt Charity found an increased demand of 56% for debt advice and support from 2012-2014.23 Citizens Advice have seen a similar increase in the number of people experiencing stress about finances, dealing with 6,407 debt problems every working day.24

A survey conducted in 2013 found that 42% of those seeking debt help had been prescribed medication by their GP to help them cope, while 76% of those in a couple said debt had affected their relationship.25

The combination of chronic stress and debt can result in depression and anxiety,26 and has been highlighted as a factor linked to suicidal thoughts and attempts.27

Helpful organisations

It is important if you are worried about your finances and debts that you do not try to deal with them alone. There is a lot of help and support available to you through organisations such as Step Change and Citizens Advice.

You should also talk to your GP or a trusted health professional if you are worried about how debt is affecting your mental and physical health.

Smoking, drinking and drug use

Some people smoke, drink alcohol and use recreational drugs to reduce stress. However, this often makes problems worse.28

Research shows that smoking may increase feelings of anxiety.29 Nicotine creates an immediate, temporary, sense of relaxation, which can then lead to withdrawal symptoms and cravings.

Similarly, people may use alcohol as a means to manage and cope with difficult feelings, and to temporarily reduce feelings of anxiety.  However, alcohol may make existing mental health problems worse. It can make you feel more anxious and depressed in the long run.30 It is important to know the recommended limits31 and drink responsibly.

Prescription drugs, such as tranquillisers and sleeping tablets, which may have been prescribed for very good reasons, can also cause mental and physical health problems if used for long periods of time.32 Street drugs, such as cannabis or ecstasy, are usually taken for recreational purposes. For some people, problems start as their bodies get used to repeated use of the drug. This leads to the need for increased doses to maintain the same effect.33

How can you help yourself?

Stress is a natural reaction to many situations in life, such as work, family, relationships and money problems.

We mentioned earlier on that a moderate amount of stress can help us perform better in challenging situations,34 but too much or prolonged stress can lead to physical problems. This can include lower immunity levels,35 digestive and intestinal difficulties, e.g. irritable bowel syndrome (IBS),36 or mental health problems such as depression.37 It is therefore important that we manage our stress and keep it at a healthy level to prevent long-term damage to our bodies and minds.

Steps to take when feeling stressed

1. Realise when it is causing you a problem

You need to make the connection between feeling tired or ill, with the pressures you are faced with. Do not ignore physical warnings such as tense muscles, over-tiredness, headaches or migraines.38

2. Identify the causes

Try to identify the underlying causes. Sort the possible reasons for your stress into those with a practical solution, those that will get better anyway given time, and those you can’t do anything about. Try to let go of those in the second and third groups – there is no point in worrying about things you can’t change or things that will sort themselves out.

3. Review your lifestyle

Are you taking on too much? Are there things you are doing which could be handed over to someone else? Can you do things in a more leisurely way? You may need to prioritise things you are trying to achieve and reorganise your life so that you are not trying to do everything at once.

Seven steps to help protect yourself from stress

1. Eat healthily

A healthy diet will reduce the risks of diet-related diseases.39 Also, there is a growing amount of evidence showing how food affects our mood.40 Feelings of wellbeing can be protected by ensuring that our diet provides adequate amounts of brain nutrients such as essential vitamins and minerals, as well as water.41

2. Be aware of your smoking and drinking

Even though they may seem to reduce tension, this is misleading as they often make problems worse.42

3. Exercise

Physical exercise can be very effective in relieving stress. Even going out to get some fresh air and taking some light physical exercise, like walking to the shops, can help.43

4. Take time out

Take time to relax. Saying ‘I just can’t take the time off’ is no use if you are forced to take time off later through ill health. Striking a balance between responsibility to others and responsibility to yourself is vital in reducing stress levels.

Read more on how taking a break is important for good mental health.

5. Be mindful

Mindfulness meditation can be practiced anywhere at any time. Research has suggested that it can reduce the effects of stress, anxiety and related problems such as insomnia, poor concentration and low moods, in some people.44 Our Be Mindful website features a specially developed online course in mindfulness, as well as details of local courses in your area.

6. Get some restful sleep

Sleeping problems are common when you’re stressed.45 Try to ensure you get enough rest. For more tips on getting a good night’s sleep read our guide How to sleep better.

7. Don’t be too hard on yourself

Try to keep things in perspective. After all, we all have bad days.

Seeking help 

It is okay to ask for professional help if you feel that you are struggling to manage on your own. It is important to get help as soon as possible so you can begin to get better.

The first person to approach is your family doctor. He or she should be able to give advice about treatment, and may refer you to another local professional. Cognitive Behavioural Therapy and Mindfulness based approaches are known to help reduce stress. There are also a number of voluntary organisations which can help you to tackle the causes of stress and advise you about ways to get better. 

Anxiety UK 

Anxiety UK runs a helpline staffed by volunteers with personal experience of anxiety from 9:30-5:30, Monday to Friday. Call 08444 775 774. 

Citizens Advice

Citizens Advice provides free, independent and confidential advice for a range of problems as well as providing information on your rights and responsibilities.

StepChange

StepChange provides help and information for people dealing with a range of debt problems. Freephone (including from mobiles) 0800 138 1111.

Mind Infoline 

Mind provides information on a range of mental health topics to support people in their own area from 9.00am to 6.00pm, Monday to Friday. Call 0300 123 3393 or email info@mind.org.uk.

Rethink Advice and Information Service 

Rethink provide specific solution-based guidance - 0300 5000927 Fax: 020 7820 1149 email advice@rethink.org.

Samaritans

Samaritans offer emotional support 24 hours a day - in full confidence. Call 116 123 or email jo@samaritans.org.

Specialist mental health services

There are a number of specialist services that provide various treatments, including counselling and other talking treatments. Often these different services are coordinated by a community mental health team (CMHT), which is usually based either at a hospital or a local community mental health centre. Some teams provide 24-hour services so that you can contact them in a crisis. You should be able to contact your local CMHT through your local social services or social work team.


References

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