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Stress Awareness Month - Manchester Mind

What is stress? We all know what it's like to feel stressed, but it's not easy to pin down exactly what stress means. When we say things like "this is stressful" or "I'm stressed", we might be talking about:

  • Situations or events that put pressure on us – for example, times where we have lots to do and think about, or don't have much control over what happens.

  • Our reaction to being placed under pressure – the feelings we get when we have demands placed on us that we find difficult to cope with.

It's overwhelming. Sometimes you can't see beyond the thick fog of stress.

There's no medical definition of stress, and health care professionals often disagree over whether stress is the cause of problems or the result of them. This can make it difficult for you to work out what causes your feelings of stress, or how to deal with them. But whatever your personal definition of stress is, it's likely that you can learn to manage your stress better by: • managing external pressures, so stressful situations don't seem to happen to you quite so often. • developing your emotional resilience, so you're better at coping with tough situations when they do happen.

Is stress a mental health problem? Being under pressure is a normal part of life. It can be a useful drive that helps you take action, feel more energised and get results. But if you often become overwhelmed by stress, these feelings could start to be a problem for you. Stress isn't a psychiatric diagnosis, but it's closely linked to your mental health in two important ways:

  • Stress can cause mental health problems, and make existing problems worse. For example, if you often struggle to manage feelings of stress, you might develop a mental health problem like anxiety or depression.

  • Mental health problems can cause stress. You might find coping with the day-to-day symptoms of your mental health problem, as well as potentially needing to manage medication, heath care appointments or treatments, can become extra sources of stress.

This can start to feel like a vicious circle, and it might be hard to see where stress ends and your mental health problem begins.

[When I’m stressed] I feel like I’m on the verge of a breakdown.

Why does stress affect me physically? You might find that your first clues about being stressed are physical signs, like tiredness, headaches or an upset stomach. This could be because when we feel stressed emotionally, our bodies release hormones called cortisol and adrenaline. This is the body’s automatic way of preparing to respond to a threat (sometimes called the 'fight or flight' response). If you’re often stressed then you’re probably producing high levels of these hormones, which can make you feel physically unwell and could affect your health in the longer term.

[I] can't sleep. [I’m] always on edge. Small things make [me] angry or tearful.

What are the signs of stress? We all experience stress differently in different situations. Sometimes you might be able to tell right away when you're feeling under stress, but other times you might keep going without recognising the signs. Stress can affect you both emotionally and physically, and it can affect the way you behave.

My head is tight and all my thoughts are whizzing round in different directions and I can't catch them.

[It feels like] the world is closing in on me, I can't breathe and I'm running out of time.

What causes stress? Feelings of stress are normally triggered by things happening in your life which involve: • being under lots of pressure • facing big changes • worrying about something • not having much or any control over the outcome of a situation • having responsibilities that you're finding overwhelming • not having enough work, activities or change in your life. There might be one big thing causing you stress, but stress can also be caused by a build-up of small challenges. This might make it harder for you to identify what's making you feel stressed, or to explain it to other people.

Lots of things stress me at the moment, mainly worries about my memory, as I'm a pensioner with nothing to do all day. Trying to fill my day is hard as I have arthritis so can’t walk too far.

Why do certain things make me feel stressed? The amount of stress we feel in different situations can depend on:

  • our perception of the situation – this might be connected to our past experiences, our self-esteem, and how our thought processes work (for example, if we tend to interpret things positively or negatively)

  • how skilled we are at dealing with pressure (see p.10)

  • our emotional resilience to stressful situations (see p.12). We're all different, so a situation that doesn't bother you at all might cause someone else a lot of stress. For example, if you're feeling confident or usually enjoy public speaking, you might find that giving a speech in front of a room of people feels comfortable and fun. But if you're feeling low or usually prefer not to be the centre of attention, this situation might cause you to experience signs of stress.

I get stressed when things get out of perspective – too much work, thinking too far ahead.

What kind of situations can cause stress?

Some common life events which often cause a lot of stress are listed below.

Personal issues

  • illness or injury

  • pregnancy and becoming a parent

  • bereavement

  • long-term health problems

  • organising a complicated event, like a family holiday

Friends and family

  • getting married or civil partnered

  • going through a break-up or getting divorced

  • difficult relationships with parents, siblings, friends or children • being a carer for a friend or relative who needs lots of support

Employment and study • losing your job • long-term unemployment • retiring • exams and deadlines • difficult issues at work • starting a new job Housing • poor housing conditions • moving house • problems with neighbours Money • worries about money or benefits • poverty • debt

My breakdown [...] was due to having a stressful job as a project manager and dealing with a marriage break-up and subsequent divorce.

Can happy events cause stress? Some of the situations listed above are often thought of as happy events – for example, you might feel expected to be happy or excited about getting married or having a baby. But because they can bring big changes or make unusual demands on you, they can still be very stressful. This can be particularly difficult to deal with, because you might feel there's additional pressure on you to be positive.

I've never been more stressed in my life than the 6 months leading up to my wedding... everyone kept asking me if I was happy and expecting me to be excited all the time, but I just couldn't feel it. I ended up getting really ill.

How can I deal with pressure? Even though there are likely to be some things happening in your life that you can't control, there are still lots of practical things you can do to manage the amount of pressure you're under day to day.

Identify your triggers Working out what triggers stress for you can help you anticipate problems and think of ways to solve them. Even if you can't avoid these situations, being prepared can help. Take some time to reflect on events and feelings that could be contributing to your stress (you might want to do this with a friend or family member). You could consider:

  • issues that come up regularly, and that you worry about, for example paying a bill or attending an appointment

  • one-off events that are on your mind a lot, such as moving house or taking an exam

  • ongoing stressful events, like being a carer or having problems at work. You might be surprised to find out just how much you're coping with at once. Remember that not having enough work, activities or change in your life can be just as stressful a situation as having too much to deal with.

Organise your time Making some adjustments to the way you organise your time could help you feel more in control of any tasks you're facing, and more able to handle pressure.

  • Identify your best time of day, and do the important tasks that need the most energy and concentration at that time. For example, you might be a morning person or an evening person.

  • Make a list of things you have to do. Arrange them in order of importance, and try to focus on the most urgent first. If your tasks are work related, ask a manager or colleague to help you prioritise. You may be able to push back some tasks until you're feeling less stressed.

  • Vary your activities. Balance interesting tasks with more mundane ones, and stressful tasks with those you find easier or can do more calmly.

  • Try not to do too much at once. If you take on too much, you might find it harder to do any individual task well. This can make you feel like you have even more pressure on you.

  • Take breaks and take things slowly. It might be difficult to do this when you're stressed, but it can make you more productive.

I try and reassure myself by breaking things down into small achievable tasks.

Address some of the causes of stress Although there will probably lots of things in your life that you can't do anything about, there might still be some practical ways you could to resolve or improve some of the issues that are putting pressure on you. You might find it helpful to read some of our other booklets on issues around mental health, family and personal life, work life, student life, finances, housing and legal rights.

Accept the things you can't change It's not easy, but accepting that there are some things happening to you that you probably can't do anything about will help you focus your time and energy more productively.

Sometimes I take a minute to 'reply' to my stressy thoughts... it's hard to be stressed when you've got things in perspective! Most of the things I worry about are either things I can't change or things which aren't earth-shatteringly important.

How can I become more emotionally resilient? Taking steps to look after your wellbeing can help you deal with pressure, and reduce the impact that stress has on your life. This is sometimes called developing emotional resilience – the ability to adapt and bounce back when something difficult happens in your life.

d Make some lifestyle changes There are some general changes that you can make to your lifestyle that could help you feel more able to cope with pressure and stressful situations. You can:

  • Practice being straightforward and assertive in communicating with others. If people are making unreasonable or unrealistic demands on you, be prepared to tell them how you feel and say no.

  • Use relaxation techniques. You may already know what helps you relax, like having a bath, listening to music or taking your dog for a walk. If you know that a certain activity helps you feel more relaxed, make sure you set aside time to do it. (See our web pages on relaxation for lots more ideas.)

  • Develop your interests and hobbies. Finding an activity that's completely different from the things causing you stress is a great way to get away from everyday pressures. If stress is making you feel lonely or isolated, shared hobbies can also be a good way to meet new people.

  • Make time for your friends. When you've got a lot on this might seem hard, but it can help you feel more positive and less isolated. Chatting to friends about the things you find difficult can help you keep things in perspective – and you can do the same for them. Laughing and smiling with them will also produce hormones that help you to relax.

  • Find balance in your life. You may find that one part of your life, such as your job or taking care of young children, is taking up almost all of your time and energy. Try making a decision to focus some of your energy on other parts of your life, like family, friends or hobbies. It's not easy, but this can help spread the weight of pressures in your life, and make everything feel lighter.

When I'm stressed, I take myself away from everyone, into another room or somewhere quiet – even just for five minutes – and sing to myself. Not full on belting out a tune, but just quietly or even humming to myself really calms me down.

Give yourself a break Learning to be kinder to yourself in general can help you control the amount of pressure you feel in different situations, which can help you feel less stressed.

  • Reward yourself for achievements – even small things like finishing a piece of work or making a decision. You could take a walk, read a book, treat yourself to food you enjoy, or simply tell yourself "well done".

  • Get a change of scenery. You might want to go outside, go to a friend’s house or go to a café for a break – even if it's just for a short time.

  • Take a break or holiday. Time away from your normal routine can help you relax and feel refreshed. Even spending a day in a different place can help you feel more able to face stress.

  • Resolve conflicts, if you can. Although this can sometimes be hard, speaking to a manager, colleague or family member about problems in your relationship with them can help you find ways to move forward.

  • Forgive yourself when you make a mistake, or don't achieve something you hoped for. Try to remember that nobody's perfect, and putting extra pressure on yourself doesn't help.

I distract myself from my [...] worry by doing a puzzle or playing a game.

  1. Use your support network Remember that whatever you're going through that's causing you stress, you don't have to cope with it alone.

• Friends and family. Sometimes just telling the people close to you how you're feeling can make a big difference – and they might be able to help you out in other ways too.

How can I become more emotionally resilient?

  • Support at work, such as your line manager, human resources (HR) department, union representatives, or employee assistance schemes. Try not to worry that talking to your manager or colleagues about stress will be seen as a sign of weakness – your wellbeing is important and responsible employers will take it seriously. If you're worried that the culture in your workplace might not be very supportive, you might find it helpful to take a look at Time to Change's resources on mental health support at work, and also the Health and Safety Executive’s information on work-related stress (see 'Useful contacts' on pp.20–21.)

  • Support at university or college, such as your tutors, student union or student services. (See our booklet How to cope with student life for more tips on accessing support as a student.)

  • Online peer support. Sometimes sharing your experiences with people who've been through something similar can help you feel less alone. Elefriends and Big White Wall both offer supportive online communities where you can talk openly about stress and your mental health.

Specialist websites and organisations. For example:

  • The Stressbusting website and the Stress Management Society both offer information about stress and provide techniques for coping.

  • The Mind Tools website can help you with stress management and assertiveness techniques.

  • The International Stress Management Association can help you find a specialist stress practitioner in your local area.

  • Mind's Infoline can provide information about support groups and mental health services in your local area.

  • Your GP. If you feel like you need some professional support, you can speak to your doctor. They can check your overall health, and help you access treatments. They could also recommend that you take some time off work, university or college, and sign a medical note for you.

What treatments are there for stress? Stress isn't a medical diagnosis, so there's no specific treatment for it. However, if you're finding it very hard to cope with things going on in your life and are experiencing lots of signs of stress, there are treatments available that could help. To access most treatments, the first step is usually to talk to your GP. (See our booklet The Mind guide to seeking help for a mental health problem for tips on how to talk to your doctor about your mental health.)

Talking treatments Talking with a trained professional can help you learn to deal with stress and become more aware of your own thoughts and feelings. Common types of talking treatments which can help with stress are:

  • Cognitive behavioural therapy (CBT), which helps you understand your thought patterns, recognise your trigger points and identify positive actions you can take. (See our online booklet Making sense of cognitive behavioural therapy for more information.)

  • Mindfulness based stress reduction (MBSR), which combines mindfulness, meditation and yoga with a particular focus on reducing stress. The Be Mindful website provides more guidance on mindfulness, including how to find a mindfulness-based stress reduction (MBSR) course

Using mindfulness [helps me] to just allow some space to breathe and focus on the present moment.

Medication Feelings of stress are a reaction to things happening in your life, not a mental health problem, so there's no specific medication for stress. However, there are various medications available which can help to reduce or manage some of the signs of stress. For example, your doctor might offer to prescribe:

  • sleeping pills or minor tranquillisers if you're having trouble sleeping

  • antidepressants if you're experiencing depression or anxiety

  • medication to treat any physical symptoms of stress, such as irritable bowel syndrome (IBS), or high blood pressure.

Before you are prescribed any medication, your doctor should explain to you what the medication is for, and discuss any possible side effects and alternative treatment options.

Ecotherapy Ecotherapy is a way of improving your wellbeing and self-esteem by spending time in nature. This can include physical exercise in green spaces or taking part in a gardening or conservation project.

Complementary and alternative therapies You may find certain alternative therapies help you manage feelings of stress. These might include acupuncture, aromatherapy, massage or Traditional Chinese Medicine.

How can friends and family help? This section is for friends and family of someone who is experiencing stress, who want to support them. If someone you're close to is stressed there are lots of practical things you can do to support them – even though you probably can't change the situation they're in.

  • Help them reflect on whether they are stressed. Often, people don’t notice that some physical symptoms and behaviour (such as not being able to get to sleep, or drinking more than usual) are actually signs of stress. Sometimes you may be able to see it before they recognise it themselves. If you've noticed that someone seems particularly busy, anxious or unwell, you could gently let them know, and ask how you can help.

  • Listen to how they are feeling. Having a chance to talk openly could help someone to feel calmer and more able to move forward. Just being there for them will probably help lots.

  • Reassure them that stressful situations can pass. For someone who is in the middle of a stressful time, it can be hard to see an end point. Let them know that situations change and can get better.

  • Help them identify their triggers. You can be specific about things you've observed, but try to stay open-minded and non-judgemental. Your perspective might be valuable, but your friend or family member could find this conversation stressful, and being patient will help.

  • Help them address some causes of stress, if you can. You might be able to help your friend or family member look for support around issues like debt, housing problems or difficulties at work.

  • Help them learn and practise relaxation techniques. You could help them research good relaxation techniques and find ways to practise them, such as a weekly yoga class, or setting aside time for breathing exercises at home. This might become something that you could do together.

[When I'm stressed I need friends to] hug me. It's amazing how good a single hug can feel.

  • Support them to seek professional help. For example, you could help them contact their GP, go with them to an appointment or do some research on mental health and wellbeing. (See our booklet The Mind guide to seeking help for a mental health problem for more ideas).

  • Look after yourself. If someone around you is very stressed, you might become stressed too. If this happens, try to take a step back and look after your own wellbeing. Being calm and relaxed will make you more able to help someone else. (See our booklet How to cope as a carer for more information.)

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