1. What is stress?
Most people have at some stage talked about feeling stressed during their life and stress is a common feeling in today’s society. When someone refers to themselves as stressed or explains that a situation is stressful, what they are normally referring to is that the event or situation they are faced with is putting pressure on them, or that they are finding it difficult to manage being placed under pressure. Stress is considered to be a normal physical response to situations or events that cause us to feel vulnerable or upsets our life balance.
2. Causes, signs and symptoms
When we feel threatened, regardless of whether the threat is real or not, our body activates an automatic process known as the “fight-or-flight” response. This reaction is the body’s way of protecting us. When working accurately, it assists us in feeling alert, focused and energetic. If we are faced with danger or an emergency situation then stress and the activation of the ‘fight-or-flight” response can save our life by providing extra strength to defend ourselves or increased focus and alertness to avoid having an accident on the motorway. Stress can be helpful for us to develop, succeed and meet challenges, for instance by sharpening our attention when we are about to complete the game winning penalty shot or by keeping us on our toes during a presentation at school or work. However, beyond a certain point, stress stops being helpful and instead it causes distress, deterioration in your mood, damages your health, your relationships, your productivity and potentially even your quality of life. Typical causes of too much stress include facing big changes, financial difficulties, being under a lot of pressure, not having enough change or activities in your life, repeated worrying, relationship difficulties, children and family, a lack of control of the outcome of a situation and feeling overwhelmed as a result of increased responsibility. A number of factors might cause someone to feel stressed, but the three most common factors that contribute to distress is our emotional resilience to stress, how we deal with pressure and our perception of the stress-inducing situation. Cognitive signs and symptoms to look out for include memory problems, anxious or racing thoughts, poor judgment, an inability to concentrate, and seeing only the negative. Stress can cause emotional symptoms of irritability or short temper, agitation, depression, isolation or a sense of loneliness, and feeling overwhelmed. Typical physical symptoms seen in people who experience distress include; chest pain and rapid heartbeat, frequent colds, aches and pains, nausea, dizziness, loss of sex drive and diarrhoea or constipation. Stress may also influence the way people behave; for instance by causing them to eat more or less, procrastinate and neglect responsibilities, isolate themselves, sleep too little or too much, increase substance use, or develop nervous habits such as nail biting or pacing.
As indicated above stress can lead to a number of cognitive, emotional, physical and behavioural symptoms and at least some of these symptoms need to be present for someone to be diagnosed with stress. At present stress is not seen as a separate mental health disorder, but can instead be viewed as an umbrella term for physical and mental strain not otherwise specified in an alternative mental health diagnosis. Here, stress referrers to exposure to a catastrophic stressor, for instance stress related to employment or unemployment, followed by marked symptoms of anxiety or increased arousal. This could include difficulties sleeping, poor concentration, irritability, or motor restlessness. The disturbance must cause significant distress or impairment over a prolonged period of time and it must not be caused by substance use, an alternative mental health condition or a medical condition.
Stress is normally treated with psychotherapy, medication, or both. Choice of treatment depends on the severity of the disorder, and individual choice. In some cases, self-help books or relaxation training may be helpful. Psychologists provide different techniques and therapies. Psychological therapies such as Cognitive Behavioural Therapy (CBT) are commonly used when working with stress. CBT is a type of therapy that focuses on the connection between thoughts, emotions and behaviour and teaches the person new ways of thinking and behaving that may help strengthen a person’s resilience to dealing with stress. This kind of therapeutic approach will focus on identifying triggers for stress, reframing situations and developing healthy and constructive coping mechanisms. Typical changes that can help with stress include setting time aside to relax, eating healthy and making sure one gets plenty of sleep. When stress occurs alongside depression, anxiety or other mental health difficulties then it can also be treated through the use of medication and your GP will be able to provide you with guidance on what medication to take. At present two types of medications are commonly used to treat stress – antidepressants and anti-anxiety medications. Some of these medications start working immediately whilst others take several weeks to start working. Common to all medication is that it may cause side effects and some medication should not be taken for prolonged periods of time.