Stress - A Self Help Guide

What is stress?

Here are the thoughts of some people who are experiencing stress.

“I just don’t get a task finished any more before I move on to the next thing. I keep forgetting where I’m up to, I have 20 things on the go at once and I’m not getting anywhere with any of them ...”

“I keep meaning to get a little time for myself but I never manage to. Someone always asks me to help out and I never have the heart to say no, but I end up feeling really tired and irritable ...”

“It just seems to be one crisis after the next in my life. I’ve got a constant headache and stomach problems, I keep expecting something else to go wrong, I’m at the end of my tether ...”

Stress is the word that many people use when they are describing how the demands of their life seem to be becoming too great for them to cope with. This ability to cope varies from person to person and what one person finds stressful may not be a problem for another. Whilst many of us suffer with stress at times in our day to day lives, long term stress is known to be bad for our health and many of us would like to find ways to gain some control over it.

How can this leaflet help me?

This leaflet will tell you more about stress, it will help you to see whether stress is a problem for you. It makes simple suggestions about how to overcome stress and what other help may be available.

What are the signs of stress?

The signs of stress vary from person to person but here are some of the most common ones. Do you recognise any of them in yourself?

Physical signs (please tick if appropriate)
— Headaches
— Muscle tension or pain
— Stomach problems
— Sweating
— Feeling dizzy
— Bowel or bladder problems
— Breathlessness or palpitations
— Dry mouth
— Tingling in body
— Sexual problems

Emotions
— Feeling irritable
— Feeling anxious or tense
— Feeling in low mood
— Feeling of apathy
— Feeling low in self esteem

Effects on what you do
— Temper outbursts
— Drinking or smoking too much
— Changes in eating habits
— Withdrawing from usual activities
— Becoming unreasonable
— Being forgetful or clumsy
— Rushing around

If you have some of these signs it may be you are experiencing stress. These are some of the short term signs but long term health risks from stress are serious and include heart disease, high blood pressure, severe depression, stroke, migraine, severe anxiety, asthma, low resistance to infection, bowel problems, stomach problems especially ulcers, fatigue and sleep problems.

Can life events cause stress?

Some things that happen in your life can be stressful particularly life changes. If you have had one or more of the following life events occurring over the last year you will probably be more likely to be stressed and should take care to avoid further stressors, and try to take ‘extra care‘ of yourself.

(Please tick if appropriate)
— Death of partner
— Divorce or relationship breakdown
— Jail term
— Death of close family member
— Getting married
— Loss of employment
— Health problems
— Pregnancy
— New employment
— High financial commitments
— Serious debts
— Major changes at work
— Partner stops or begins work
— Death of close friend
— Change in living conditions
— Disagreement with friends
— Problems at work, eg lack of job security, several jobs, no satisfaction at work
— Change in leisure activities
— Change in church/spiritual habits
— Minor legal problems
— Problems with neighbours/noise
— Holidays
— Family gatherings such as for Christmas

Is there a type of person who is more likely to experience stress?

Studies have shown that some people are more likely to experience stress than others. These people are know as ‘type A' personalities. They tend to be more competitive and impatient and have tight time schedules compared to ‘type B' personalities who are more relaxed and ‘laid back' in their style. If you would like to know which type you are then tick next to each of the following that apply to you:

If most of your ticks are on the A side then you will be more prone to stress, if both As and Bs then you are a little prone to stress, if mainly Bs then you are less likely to suffer from stress! Those people who are more prone to stress may have to try harder to use some of the stress management approaches suggested here to tackle their natural tendency to stress.

How can I help myself to cope with stress?

Studies have told us that the first step in tackling stress is to become aware that it is a problem for you. The next stage is to make a plan to take control of the causes and effects of stress. Here are some practical ways to take control of stress.

Holiday – try to plan at least one each year with a change in activities and surrounding.
Open up – if your relationship is part of the problem. Communication is very important.
Work – is that the problem? What are your options? Could you retrain? What aspects are stressful? Could you delegate? Could you get more support?

Try to concentrate on the present. Don’t dwell on the past or future worries.
Own up to yourself that you are feeling stressed – half the battle is admitting it!

Be realistic about what you can achieve. Don’t take too much on.
Eat a balanced diet. Eat slowly and sit down, allowing at least half an hour for each meal.
Action plans – try to write down the problems in your life that may be causing stress, and as many possible solutions as you can. Make a plan to deal with each problem.
Time management – plan your time, doing one thing at a time and building in breaks. Don’t make too many changes at once in your life.

Set priorities – if you could only do one thing, what would it be?
Talk things over with a friend or family member or someone else you can trust and share your feelings with.
Relaxation or leisure time each day is important. Try new ways to relax such as aromatherapy, reflexology or yoga. Relaxation exercises are described more fully below.
Exercise regularly – at least 20 minutes two or three times a week. This is excellent for stress control. Walking is good – appreciate the countryside.
Say no and don’t feel guilty.
Seek professional help if you have tried these things and still your stress is a problem.

Can I learn to be more relaxed?

Relaxation is a skill like any other which needs to be learned and takes time. The following exercise teaches deep muscle relaxation, and many people find it very helpful in reducing overall levels of tension.

Deep muscle relaxation

It is helpful to read the instructions first and eventually to learn them by heart. Start by selecting a quiet, warm, comfortable place where you won’t be disturbed. Choose a time of day when you feel most relaxed to begin, then lie down and get comfortable. Close your eyes and concentrate on your breathing for a few minutes, breathing slowly and calmly - in-two-three and out-two-three. Say the word “calm” or “relax” to yourself as you breath out. The relaxation exercise takes you through different muscle groups, teaching you firstly to tense, then relax. You should breathe in when tensing and breathe out when you relax.

Start with your hands. Clench one fist tightly, and think about the tension this produces in the muscles of your hand and forearm.

Study the tension for a few seconds then relax your hand. Notice the difference between the tension and the relaxation. You might feel a slight tingling, this is the relaxation beginning to develop. Do the same with the other hand.

Each time you relax a group of muscles think how they feel when they are relaxed. Don’t try to relax but just let go of the tension. Allow your muscles to relax as much as you can. Think about the difference in the way they feel when they are relaxed and when they’re tense. Now do the same for the other muscles of your body. Each time tense them for a few seconds and then relax. Study the way they feel and then let go of the tension in them.

It is useful to stick to the same order as you work through the muscle groups:

Hands - clench fists, then relax.
Arms - bend your elbows and tense your arms. Feel the tension especially in your upper arms. Remember, do this for a few seconds and then relax.
Neck - press your head back and roll it from side to side slowly. Feel how the tension moves. Then bring your head forward into a comfortable position.
Face - there are severe muscles here, but it is enough to think about your forehead and jaw, first lower your eyebrows in a frown. Relax your forehead. You can also raise your eyebrows, and then relax. Now, clench your jaw, notice the difference when you relax.
Shoulders - shrug your shoulders up - then relax them.
Chest - take a deep breath, hold it in for a few seconds, notice the tension, then relax. Let your breathing return to normal.
Stomach - tense your stomach muscles as tightly as you can and relax.
Buttocks - squeeze your buttocks together and relax.
Legs - straighten your legs and bend your feet towards your face then relax.

You may find it helpful to get a friend to read the instructions to you. Don’t try too hard, just let it happen.

To make best use of relaxation you need to:

• Practise daily.
• Start to use relaxation in everyday situations.
• Learn to relax without having to tense your muscles first.
• Use parts of relaxation to help in difficult situations, eg breathing slowly.
• Develop a more relaxed lifestyle.
• Practise in public situations (on bus, in queue etc).

What further help is available?

Sometimes a good source of help is to talk to family or close friends, but there are also other ways you may get help. Your family doctor is probably the best person to discuss your difficulties with in the first instance. This is particularly important if your problem is not going away or is getting worse. You may be offered counselling or if your problem seems to becoming more severe you may be referred to a mental health worker. If you feel your stress problem may now be a more serious anxiety or depression, talk to your family doctor. Try to get help sooner rather the later.

The following organisations and help lines may also be useful:

Cruse Bereavement Care - for bereaved people and those caring for bereaved people.
Tel: 0844 477 9400

Mind InfoLine
Tel: 0845 766 0163

National Debt Line. Help for anyone in debt or concerned they may fall into debt.
Tel: 0808 808 4000

Relate - help with marital or relationship problems
Tel: 0845 456 1310

Samaritans
Confidential support for anyone in a crisis
Tel: 08457 90 90 90

NHS Direct. A free 24 hour helpline.
Calls charged at local rate: 0845 4647

Some useful books to buy or borrow from your local library:

Burns, D 1980. Feeling good the new mood therapy. New American Library, New York.
Cooper, C. 1981. The stress check. Prentice Hall.
Charlesworth, E. 1986. Stress Management: A comprehensive guide to your well-being. Corgi.
Greenberger, D and Padesky, C. 1995. Mind over Mood, Guilford.
Gutmann, J. 1998. The Stress Workbook. Sheldon.

This guide was written by Lesley Maunder and Lorna Cameron, Northumberland Department of Psychological Services and Research, Newcastle, North Tyneside & Northumberland Mental Health NHS Trust, St George’s Hospital. With contributions from healthcare staff and service users in Northumberland.
Designed by the Communications Department
© 2003, Northumberland, Tyne and Wear NHS Trust (Revised March 2006)

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