What is stress?
Stress is a modern, widely-used word that's used to describe the feelings of "distress" experienced when tension (or boredom) become unbearably high. In fact, a moderate level of stress is important and beneficial — it's a key element that enables you to deal positively with the physical and emotional challenges of life.
What are the main symptoms?
When stress increases, you soon feel the effects as symptoms show up in all vital systems.
The most noticeable are physical symptoms because they often cause severe discomfort. They include:
- back ache
- a dry mouth
- sexual problems
- disturbed sleep
- panic attacks
Stress affects the mind as well as the body. Common mental symptoms include:
- poor concentration
- short-term memory loss
- feeling cut off from the world
- feelings of frustration
Prolonged stress can cause a range of negative feelings and behaviour and the resulting symptoms may seriously affect mental output. As problems mount up it becomes more difficult to cope.
Stress affects your whole body, lowering immunity and increasing the risk of disease. For example, there's good evidence that stress increases susceptibility to a wide range of illnesses, from the common cold to cancer.
Stress may also aggravate a range of conditions, including:
- Irritable bowel syndrome
- Heart disease
- High blood pressure
- Hair loss
- Sexual problems, including erectile dysfunction (impotence)
What's the risk? Problems relating to increased stress are very common. According to research commissioned by the Health and Safety Executive, up to five million people in the UK feel 'very' or 'extremely' stressed by work, with half a million feeling that stress is making them ill. Work-related stress costs the country nearly £4 billion a year - maybe more - in terms of absence and lost productivity.
What causes it?
The biochemistry of stress
The physical and mental symptoms of stress are triggered by an ancient survival mechanism, known as the fight-or-flight reaction. At the first hint of danger (perceived stressful situation), your body produces large quantities of the hormone adrenaline. This hormone floods the blood stream to instigate action. The response is instantaneous, and includes rapid pulse rate, sweat gland action, faster breathing, tenser muscles, release of stored-up blood sugar, dilated pupils, urgent bowel and bladder action and the drawing up of your testicles — all designed to make you run faster or punch harder.
Nowadays, of course, the need for true combat or a speedy retreat is rarely necessary, so instead of burning off energy generated for self-protection, it remains stagnant and your body must adjust to a continual state of tension. Unfortunately, this unnatural state quickly leads to feelings of chronic stress.
Sources of stress
Psychologists refer to sources of stress as "life events" and the list ranges widely from major upheavals to everyday situations. These everyday life events are neither special nor rare, just things that happen to most people at various times in their lives: retirement, divorce, exams, new relationships and holidays all count.
Research has shown that if a string of life events follow hard on each other, without giving the body time to recover, the effects are always more intense. The vital point to note is that it is the accumulation of events close together that increases the stress, rather than the severity of individual problems.
Stress-inducing life events include:
- Workplace problems: increased workload, recent accident, time off sick, irrational demands made by colleagues, unpleasant atmosphere, poor environment, no access to natural light, uncomfortable chair, on your feet for many hours, exposed to noise stress or VDU screen glare, lack of privacy, work in isolation, unsocial/shift hours, job insecurity, no time for a proper break, introduction of new technology, skills underused, unclear job description, conflict between home and work, victim of harassment or prejudice (racial, sexual, bullying or ageism), over/under supervised.
- Travel factors: uncomfortable conditions, repetitive journeys, long distances, confused body clock (jet-lag), time wasted in traffic jams.
- Home/environmental: difficult neighbourhood, live close to sources of pollution (air, smell or noise), live in non-ideal conditions (cramped flat or high rise block).
- Substance intake (too much or unhealthy): caffeine, alcohol, drugs, tobacco.
- Relationship problems: break-up with partner/spouse, difficult marriage, feelings of jealousy, undergoing separation or divorce.
- Difficulties with children: trouble at school, teenage problems, drug/alcohol abuse, poor discipline, breaking the law, contact/child support problems.
- Concerns about parents: shared accommodation, caring problems, live far apart, deteriorating physical/mental health, financially dependent.
- Financial worries: low salary, threat of/recent redundancy, debts and gambling problems.
- Health conditions: recent illness, ongoing problem (high blood pressure), waiting for surgery, early retirement on health grounds, too little exercise, mental ill-health.
How can I prevent it?
A moderate amount of stress is inevitable and a bonus; it is neither desirable nor possible to eliminate all stress from your life. On bad days you may crave to be stress-free, but too little action can have the opposite effect. Remember: without challenges "Jack would become a very dull boy".
Everyone reacts to stress in the same physical way — with a fight-or-flight response — but the intensity of each person's reaction is an individual matter. Several factors influence the strength of your reaction and your ability to respond effectively, including:
- Your recent "stress history" — your list of accumulated life-events.
- Your current emotional state — whether you feel calm and in control or ready to explode.
- Your coping skills — what lessons you have learned from dealing with problems in the past.
- Your inherent personality type — Type A people are "go-getters" who frequently experience and display prominent signs of stress and insecurity; Type B people are more relaxed and self assured. Type Bs are no less ambitious than Type As, but achieve their goals with less aggression.
Your best bet is to prevent stress getting out of control by finding ways both to tackle the causes of stress and to improve your coping strategies.
Should I see a doctor?
Deciding whether to consult someone about stress depends on how you feel. If symptoms of distress are making you unwell it would be advisable to seek help without delay. You could speak to your GP, the practice nurse at the surgery, the occupational health nurse at your workplace (if there is one) or a stress counsellor.
There is no single test that diagnoses stress. The main investigations will include a physical examination to eliminate other possible diseases and a discussion that helps the doctor pinpoint evidence of stress-inducing problems.
You should certainly consult a health professional if you are depressed because of stress, or if stress is causing you anxiety or leading to panic attacks.
What are the main treatments?
Most cases of stress can be dealt with through self-help measures — see "How can I help myself?". Treatment by a health professional should be needed only in severe cases. If every person with stress saw their GP, the NHS would quickly grind to a halt.
A range of therapies and medication can help reduce the worst symptoms of stress:
- Drugs (tranquillisers) such as chlordiazepoxide (Librium) offer short-term relief from anxiety symptoms and induce feelings of calm; however, long-term use is not recommended as the beneficial effects quickly diminish and side-effects, including psychological dependency, may develop.
- Beta-blockers (drugs that block the effects of adrenaline) can be prescribed for severe anxiety attacks or for use as a preventative measure when you need to be particularly calm.
- Over-the-counter medication and herbal remedies can be purchased at pharmacies and health-food stores. It would be wise to obtain professional advice before taking long-term alternative remedies — a pharmacist can help.
- Specific stress-related diseases require individual medical examination and treatment.
- A range of behavioural therapies, such as anxiety management, can produce good results. Some specialise in individual support while others use group therapy. Your GP can advise and refer you to a therapist; however, unless the treatment is available through the NHS, you will have to pay.
- A stress management counsellor can help you talk about your problems and work out your own solutions.
How can I help myself?
Most cases of stress can be dealt with by self-help measures.
Keep a stress diary for a few days to note your sources of stress and how you reacted.
Example of a stress diary entry:
Use the information in your diary to spot your stress triggers and to help you think about how you could tackle the cause and find ways to cope better.
- Guard against relying on strategies that mask the anxiety but do not solve the problem, for example:
- disordered eating (e.g. comfort eating)
- excessive use of alcohol
- abusing illegal drugs
- Share your worries with a reliable friend or partner — not the whole office! Genuine friends offer positive support and advice. Uninterested colleagues may be negative, unhelpful and prone to gossip.
- Aim for a balanced, healthy lifestyle that includes:
- a nutritious diet with plenty of fruit and vegetables
- regular exercise that gets your heart pumping
- adequate sleep most nights of the week
- plenty of relaxation that restores and heals sensitive nerves
- lots of non-competitive leisure.
- Reduce your tension using complementary therapies and relaxation techniques (some require treatment/tuition from a qualified practitioner, others can be learned from a book). There are many to choose from, including:
- flotation therapy
- whole body relaxation
- Learn coping strategies to see you through the difficult periods.
- Tackle the causes of your stress. The most permanent solution — but often the hardest — is to eliminate whatever's causing the problem. If your computer keeps crashing, for example, consider dumping it or buying new software. If your neighbours' loud music winds you up when you're trying to relax in the evening, ask them to turn it down and, if they keep refusing, take them to court. If you can't cope with the amount of work your boss gives you, say "No" next time you're asked to produce another major report in two days.
What's the outlook?
This depends largely on how well you manage your stress. Short-term self-help or (if necessary) professionally-managed therapies can work well. But there can be health risks if stress is not successfully reduced in the long term. Your aim should be to achieve and maintain an equilibrium that feels comfortable for you.
Who else can help?
- International Stress Management Association
Tel: 07000 780430
- Centre for Stress Management
- Sort Out Stress
Developed by the local Primary Care Trust with men from Camden, London, it offers ideas and advice for dealing with stress
Suggested reading list (compiled 2005)
- Toni Battison, Beating Stress (Marshall Publishing)
- Sarah Brewer/Good Housekeeping, The Ultimate Stress Buster: A Complete Guide to Help You Relax and Enjoy Life to the Full (Ebury Press)
- Reader's Digest Association, Health and Healing the Natural Way: The Stress Factor (Readers Digest)
- Thomas Stuttaford, In Your Right Mind: Everyday Psychological Problems and Psychiatric Conditions Explored and Explained (Faber and Faber)
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Date of last review 08/04/14
Date of next review 08/04/17