This information is for anyone who is feeling stressed - or anyone who knows someone who is feeling stressed.
We all feel stressed from time to time. It's part of life - usually an understandable reaction to something happening in our life. But, if it goes on for too long, it can be uncomfortable, even overwhelming, and can affect your physical health.
This information looks at:
- What stress is;
- The things that can make us stressed;
- How stress feels to different people - physically and mentally;
- How your body can react to stress;
- How to deal with stress.
This leaflet provides information, not advice.
The content in this leaflet is provided for general information only. It is not intended to, and does not, mount to advice which you should rely on. It is not in any way an alternative to specific advice.
You must therefore obtain the relevant professional or specialist advice before taking, or refraining from, any action based on the information in this leaflet.
If you have questions about any medical matter, you should consult your doctor or other professional healthcare provider without delay.
If you think you are experiencing any medical condition you should seek immediate medical attention from a doctor or other professional healthcare provider.
Although we make reasonable efforts to compile accurate information in our leaflets and to update the information in our leaflets, we make no representations, warranties or guarantees, whether express or implied, that the content in this leaflet is accurate, complete or up to date.
What is stress?
Most of us will know the feeling of struggling to cope with the demands of everyday life, an important or distressing event or a big change in our life. We worry, get irritable with other people and just can't relax.
"Stress" is the way that our bodies and minds react when this is happening. It includes emotional feelings, physical symptoms and changes in how our bodies work.
What can cause stress?
Almost anything that affects your daily life, work or relationships. Important events in your life are often stressful.
These include the death or serious illness of a loved on, divorce or separation from a partner, changes in work circumstances or financial problems. But we are all individual.
What will stress one person won't stress another. And even an apparently minor problem can become stressful if it goes on for a long time.
Even events that might seem positive - such as marriage or the arrival of a new baby - can be very stressful. Someone feeling stressed in these situations might struggle to understand this and perhaps feel guilty for feeling that way, but it is very common.
It can feel quite different for different people.
The physical feelings include:
- feeling tired or lethargic
- having trouble sleeping
- going off food or eating more than normal
- nausea, stomach aches and changes in bowel habit
- aches and pains
Of course, many physical illnesses can produce these symptoms. If you are worried about any symptoms, ask your GP about them.
Sometimes when you get suddenly stressed or anxious, you may notice how your body is working.
You breathe fast (but shallow), notice that your heart is racing, your mouth is dry and your palms are sweaty.
These seem to be part of a "fight or flight" response that is "built in" and which helps us to cope with dangerous situations.
They are produced by stress hormones hat the body releases when we feel threatened. This can become a problem if it happens too much, too often or when you are not actually under threat.
There are also things you tend to feel and think when under stress. You may feel:
- angry or irritable
- sad or tearful
- that your situation is hopeless or overwhelming
- unable to concentrate
- that you've lost your sense of humour
- more likely to blame ourselves or others for a situation
- unable to unwind and enjoy thing
- worried or apprehensive.
So, other people may notice that you are stressed before you do.
Recognising that you are stressed is the first step. You may be able to make adjustments to your life or do other things to control your feelings of stress.
- Talk to friends or family about how you are feeling. This can be very helpful, although it can be difficult to do. You may find that stress affects how you get on with other people, so it's important for your family and friends to know what you are going through. They may also be able to make allowances for you or give you help and support.
- Break down big tasks or problems into smaller parts that are easier to deal with. This can really reduce your sense of being overwhelmed by a situation. You can:
- make lists of problems and what you need to do about each one;
- make a timetable to deal with demanding work or personal commitments;
- set yourself a number of small goals that you can reach, one by one.
- Look after your physical health. It's easy to forget to do this when you feel stressed. Simple things like making time to eat regular meals helps avoid low sugar levels caused by skipping meals which can affect how you feel mentally as well as physically.
- Watch your drinking and smoking. It's easy to drink and smoke more when you feel stressed - it takes the edge off for a short while. But, in the long run, it can stop you sleeping properly and actually make you feel more anxious.
- Find practical help. Depending on your situation, you may be able to get help from occupational health at work, or from your local Citizens Advice Bureau.
- Set time aside. Put some regular time aside to do something you enjoy.
There are also a range of more structured approaches to dealing with stress which focus on, for example, ways of changing the unhelpful thought patterns that can sometimes emerge when under stress, or addressing the more bodily feelings of stress.
Many lend themselves to the 'self-help' approach and can be widely accessed online or through books or courses. Examples include:
- Cognitive behavioural therapy (CBT)
- Progressive muscular relaxation
- Diaphragmatic breathing exercises.
Physical exercise seems to make you feel better. It affects some brain circuits linked to mood, and it may help in depression.
It's good for your sleep and can help you to feel less tired in the course of a normal day. It can also be a good way to find a new interest and to spend time with other people. These will all increase your sense of well-being and your ability to cope with stress.
If you do these things, but they don't help, see your GP. He or she might suggest a psychological treatment ('talking therapies'). This is most likely to be cognitive behavioural therapy (CBT), although other types of therapy may be available locally.
You may be able to get enough support from friends, family and work. You may need to see a health professional such as your GP:
- if your ability to do things is being affected. You might stop looking after yourself, take more time off sick, avoid doing things you need to do, either for yourself or your family.
- if you feel so stressed that you have thought that life is not worth living or have had thoughts of harming yourself.
- If you are using alcohol or drugs to cope with the stress.
- If you have constantly felt down and hopeless and been unable to enjoy anything, with no lifting of your mood for more than two weeks.
- If you are struggling with attacks of extreme anxiety or panic.
In these cases, it is helpful for a doctor to discuss your symptoms and difficulties with you to see whether you have depression or an anxiety disorder.
Active Places: Be Inspired: sports and fitness finder.
Anxiety UK: a user-led mental health charity that provides direct support services (including psychological therapies) to individuals affected by a range of anxiety disorders. Helpline: 0844 775 774.
Citizens Advice: Online self-help from Citizens Advice. The site contains advice to help people solve their problems, research to explain why they have problems.
Free debt advice: Step to change debt charity: Helpline 0800 138 111.
Stress Management Society: a not for profit organization dedicated to helping
people tackle stress.
Reading Well Agency: Books on Prescription
Cavanagh K, Strauss C, Forder L and Jones F (2014) Can mindfulness and acceptance be learnt by self-help? A systematic review and meta-analysis of mindfulness and acceptance-based self-help interventions. Clin Psychol Rev 34(2):118-20.
Cooney GM, Dwan K, Greig CA, Lawlor DA et al. (2013) Exercise for depression. Cochrane Database Syst Rev 9:CD004366.
Cohen S, Janicki-Deverts D and Miller GE (2007) Psychological stress and disease. JAMA298(14):1685-7.
EschT, Stefano GB (2010) Endogenous reward mechanisms and their importance in stress reduction, exercise and the brain. Arch Med Sci 6(3):447-55.
Grossman P, Niemann L, Schmidt S and Walach H (2004) Mindfulness-based stress reduction and health benefits. A meta-analysis. J Psychosom Res 57(1):35-43.
Hammen C (2005) Stress and Depression. Annu Rev Clin Psychol 1:293-319.
Holmes TH and Rahe RH (1967) The Social Readjustment Rating Scale. J Psychosom Res11(2):213-8.
Marin MF, Lord C, Andrews J, Juster RP et al. (2011) Chronic stress, cognitive functioning and mental health. Neurobiol Learn Mem 96(4):583-95.
Varvogli L and Darviri C (2011) Stress Management Techniques: evidence-based procedures that reduce stress and promote health. Health Sciences Journal 5(2):74-89.
This leaflet had been produced by the Royal College of Psychiatrists' Public Engagement Editorial Board.
- Series editor: Dr Philip Timms
- Original author: Dr Daniel Whiting
- Service user and carer input: members of the Public Engagement Editorial Board.