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Stress

Stress – how to identify the signs, and how to deal with it

It is National Stress Awareness Day today and this is a great opportunity for you to reflect on your well being and recognize when you may be stressed. Even for those of us who feel we cope well with stress, this past year with COVID-19 has really challenged us with many things that we haven’t experienced before.

But what is stress? How can you identify if you or others around you are stressed? What does it do to our mind and body and how can we look after ourselves, and others when it could potentially become a problem? We asked our Supervising First Aid for Mental Health Trainer, Su, to give you tips on how to identify the signs of stress, and how to deal with it when it arises.

Although there is no true medical definition of stress, it is defined by the Health and Safety Executive (HSE) as the, “adverse reaction people have to excessive pressure or other types demand place on them”. It is likely that most people agree that stress is experienced as a sense of physical or mental tension, but what might be ‘excessive’ pressure to one person may be very different for another.

Everyone experiences stress in different ways and each individual has varying degrees of ability to cope with it. Our ability to cope with stress and how it affects us might be defined as our level of emotional resilience. You could argue that how much emotional resilience, or ability to ‘bounce back’ and cope with adversity we have might be down to our genetic make up, or our upbringing, however, it is also a skill that can be learnt and developed over time.

In order to best cope with stress we need to first recognise when it might be becoming a problem. To do this, it might be helpful to have an understanding of what is going on in our bodies at times of stress. When we feel anxious about an actual (or perceived) physical danger or psychological threat, we go into a primal survival state sometimes known as the ‘fight, flight, freeze response’. This means that we produce hormones, such as adrenaline, which speeds up our heart rate and increases blood pressure, and cortisol, which raises glucose levels in the blood. In short bursts and in true ‘survival’ situations, this can be extremely helpful, as it gives us the strength and energy to escape from, or fend off, the threat. Even though we no longer need to flee from, or fight, woolly mammoths, it still serves a purpose for keeping us safe should we need to run from an attacker or jump out of the way of an oncoming vehicle, for example. To a certain degree, this response can help us to perform at an optimum level say, when we have a presentation to deliver, a deadline to meet or an interview or sports trial to attend. Where it gets problematic, though, is when it is constantly getting triggered by non-threatening situations, which aren’t truly dangerous, but our bodies are reacting to them as though they were.

Chronic, long-term stress can lead to:

  • Mental health conditions, such as depression, anxiety and personality disorders,
  • Cardiovascular problems,
  • Immune system, infection and skin issues,
  • Digestive problems/conditions such as Irritable Bowel Syndrome,
  • Changes in behaviour such as excessive alcohol use and substance misuse.

Signs and symptoms of Stress

So what are some of the signs and symptoms of stress that you need to be aware of?

Physically we may experience:

  • Headaches,
  • Fatigue,
  • Muscle aches and tension,
  • Chest pain,
  • Nausea or dizziness.

Emotionally we may feel:

  • Anxious,
  • Lacking in self-esteem,
  • Angry,
  • Irritable,
  • Sad,
  • Unable to concentrate or make decisions; like we are constantly worrying and that our thoughts are racing,
  • Frustrated,
  • Overwhelmed.

In terms of behaviour we may experience:

  • Outbursts of anger,
  • A tendency to under, or over, eat,
  • Restlessness,
  • Changes in libido,
  • A need to socially withdraw,
  • A desire to exercise more, or less, often than usual,
  • An increased use of alcohol, cigarettes or drugs.

Take a moment to think about what symptoms you think you most commonly experience at times of stress, so you can act accordingly to reduce their effects, when you first start to notice them. You can look out for these signs in friends and colleagues and check in with them and listen in a supportive and non-judgemental manner. Interestingly, oxytocin, another hormone which gets released at times of stress, in an attempt to reverse the negative effects, is the hormone associated with physical and emotional intimacy and social bonding. Some researchers believe that due to the greater influence of oxytocin in women, they are less likely to fight or flee when faced with stressors but instead turn to the nurturing and connecting behaviours of ‘tending and befriending’. So, something it might be worth bearing in mind, particularly if you have a tendency to withdraw at stressful times, is that there may be a strong scientific reason why seeking out (or indeed offering) social connection and support could help with reducing the more damaging effects. Obviously during COVID-19 this is difficult, however we still have video call and phone calls. As Stanford University psychologist Kelly McGonigal says in her TED Talk, “How To Make Stress Your Friend”,

When oxytocin is released in the stress response ..(it) is nudging you to tell someone how you feel instead of bottling it up. Your stress response wants to make sure you notice when someone else in your life is struggling so that you can support each other. When life is difficult, your stress response wants you to be surrounded by people who care about you.

How to deal with stress

So when you identify your own signs or symptoms of stress, what do you do next?

  1. Firstly, try to recognise when stress is becoming a problem and do a bit of thinking about what the underlying causes might be.
  2. Then go on to think about which of these you can change and which you can’t. This is sometimes known as the circle of influence/control.
  3. Ask yourself whether there are some practical changes you can make to reduce your levels of stress, such as asking for a deadline to be extended, writing a plan, getting help with a task, requesting extra training or flexible working hours to meet caring responsibilities.

If you are an employer perhaps these are the sort of things you can consider offering or supporting and you could also carry out a stress risk assessment in your workplace.

If there are stressors that are beyond your control, then try to look at ways to control your emotional reactions around the situation. This could be by:

  • Reframing the situation in your mind in terms of importance and long term impact,
  • Challenging your own negative thoughts,
  • Using humour or confiding in someone and seeking emotional support. It may be that using a combination of both emotion-focused and problem-focused solutions may be the best approach. Try breaking down a task which seems overwhelming into more manageable chunks and then give yourself some credit for completing each of them.

What other ways can help you cope with stress?

  • Looking after your physical health,
  • Making lifestyle changes,
  • Setting achievable goals,
  • Growing your self-esteem,
  • Being kinder to yourself,
  • Focusing on being optimistic,
  • Gratitude,
  • Developing a strong support network.

The Mind website has some good advice and information on stress in general but also on developing emotional resilience.

The tips above are well known and documented for coping with stress, but often we forget about them, or push them to one side when we feel under a lot of pressure, feeling that the ‘best’ way forward is to push on and ‘work’ even harder, which tends to just exacerbate our physical and emotional symptoms.

It may be useful to remind ourselves of the need to go ‘back to basics’ and to ensure we are finding time to relax, pay attention to our sleeping habits, to socialise and connect with friends and family, to eat healthily without skipping meals, to avoid unhealthy habits and to set some realistic and achievable goals. It might also help to spend time exercising or just getting outdoors in nature, which has been shown to trigger positive chemical changes in the mind or body. Giving to others, whether it’s just a smile or an expression of gratitude, or a larger act such as volunteering for a charity can also improve mental well being. Getting thoughts out of your mind and down on to paper can also be useful – whether it’s writing down your worries, or making a plan before you sleep, or journaling the positive things that have happened that day or which you are grateful for.

The stress container model may also be a useful concept to look at. The size of the container relates to our personal resilience at any given time and may, or may not, have plenty of room for pressure, depending on how vulnerable we may be feeling. Used in its simplest form, you could draw a container, or bucket, on a piece of paper and write inside all things in your life that are causing you stress. The crucial part is that, having identified your stressors, you then add a tap at the bottom and think about how you will relieve the pressure. This could be by using some of the strategies mentioned above or by, for example, reading, listening to an audio book, practicing some meditation and mindfulness techniques, playing some music or learning a new skill. You can find some more information on the stress container model on YouTube.

Whilst we can’t totally escape from the stresses and strains of life, especially in the current circumstances, there are definitely things we can do help ourselves. Although we can’t always control the things that happen to us and the situations that we find ourselves in, it’s important to remember that we can choose how we respond.

If you are distressed and feel that stress is affecting your daily life, you should call your GP or NHS 111. If you feel unsafe and unable to wait to see a doctor, it’s important to tell someone. You can call the Samaritans on 116 123 or Text “SHOUT” to 85258 (Shout Crisis Text Line).  In a life threatening emergency call 999.

If you or your workplace need mental health first aid training, see our Supervising First Aid for Mental Health page.

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