How to deal with stress

Often, stressful periods come and go, but experiencing long-term stress can take its toll on the body. It can cause physical symptoms such as muscle tension in the back and shoulders, headaches and problems with our mental health including anxiety and poor self-esteem.

If you’re suffering the effects of stress, then taking steps to proactively reduce your stress will be helpful.

In this article, King Edward VII’s Hospital GP Dr Ruth Whitby discusses what stress is, how it impacts on our health and what we can do ourselves to help manage it.

What is stress?

Stress isn’t always a bad thing. The human body is designed to experience and react to stress. Without it, the human race wouldn’t have made it out of prehistoric times. Our ancestors relied on our ‘fight or flight’ stress reaction to decide whether to fight a dangerous situation or flee from it.

We’ve evolved to keep the same fight or flight reaction, even though the dangers we face now are different. When we feel stressed, the body reacts physically by releasing hormones to help ready us for a particular situation.

The stress-response system

When you encounter a stressor, the body triggers a combination of nerve and hormonal signals that release a surge of hormones, including adrenaline and cortisol.

Adrenaline increases your heart rate, blood pressure and energy supplies. Cortisol, the primary stress hormone, increases sugars (glucose) in the bloodstream and improves the way your brain uses those sugars.

Cortisol alters your immune system response and reduces the activity of the digestive and reproductive systems and will also slow the growth processes.

The stress-response system also influences the brain regions that control mood, motivation and fear.

If the fear is short lived, such as avoiding a fast car as you’re crossing the road, your hormone levels will drop after the stressor has gone, and your heart rate and blood pressure return to normal.

If stress is prolonged, the hormone mechanism in the body persists. Long term, these hormones can disrupt almost all your body systems. This in turn, leads to health problems.

Long-term stress

So some stress is good for us. It can be positive and help us stay alert, say in the workplace when facing something like a job promotion. It can help you stay on top of your game.

But commonly, stress is negative. When a person faces continuous challenges without relief or relaxation, stress-related tension builds. In our current environment, you may feel as if you’re constantly under attack with so many demands each day: answering emails, meeting deadlines at work, paying bills, looking after family.

Learning how to be aware of stress, and when it’s affecting you physically and emotionally, is important. Once you know the symptoms of stress, you’ll be better equipped to take steps to deal with it.

How does stress affect the body?

Experiencing long-term stress can cause the following physical symptoms:

• A racing heart or palpitations
• A faster breathing rate
• Sweating
• Indigestion
• Aching and tense muscles, particularly in the neck, shoulders and back
• An upset stomach
• Headaches
• Dizziness
• Difficulty falling, or staying asleep, or staying in bed longer than usual

And more seriously:

• High blood pressure
• Chest pain (which could be a medical emergency and require urgent medical attention)

How does long-term stress affect mood and behaviour?

As well as physical symptoms, long-term stress can cause the following mental, emotional and behavioural symptoms:

• Low mood, anxiety or depression
• Irritability
• Racing, panicky, fearful thoughts
• A feeling of overwhelm and an inability to cope
• Difficulty concentrating, focusing, remembering or making decisions
• A lack of self-esteem
• An inability to finish any tasks, yet starting many
• Feeling demotivated or not good enough
• Isolating yourself and avoiding social situations
• An inability to find enjoyment in things you used to enjoy
• Lack of interest in sex
• Eating more or less than normal
• An increasing dependence on caffeine, alcohol, cigarettes or drugs

Stress management tips

We can’t always control stress, but we can learn how to react to a stressful situation better. Understanding what causes our own stress, building up a resilience and having strategies in place to manage stress are all important to staying well, both physically and emotionally.

Here are some tips for helping to manage stress better. They’re all things you can do yourself at home or in your own time. Some may work well for you, while others might not seem to have much of an effect. Try the ones that appeal to you, to see which ones you benefit from.

1. Relaxing exercise — Practicing yoga or taking part in pilates or tai chi can be incredibly relaxing. These kinds of exercises combine stretching and gentle flowing movements with purposeful breathing. Join a class or download an app so that you can practice at home in your own space. The Yoga Studio app is free (with some paid for classes) and easy to follow for all levels.
2. Exercise — Doing any kind of exercise produces feel-good endorphins and even if you struggle to get started, you’ll finish on a high. Find an exercise that you enjoy, be that running, playing tennis, rock climbing or dance classes. Most local authorities run classes, or you could join a private gym. Running is free and can be done completely at your own pace. Use a couch to 5km app and you could be running 5km in 12 weeks.
3. Eat a healthy diet — When you’re feeling stressed, it’s easy to reach for the comforting junk food, but you’ll feel healthier and have more energy if you eat a diet rich in wholegrains, fibre, lean protein, fruit and vegetables. Keep the treats for the weekend.
4. Spend time in the kitchen — Whether you’re a novice or a keen home cook who doesn’t get much spare time to spend in the kitchen, preparing and cooking a meal from scratch creates a sense of accomplishment. The BBC Good Food website has lots of recipes to choose from, whatever your dietary preferences, budget, time allowance and skill level.
5. Meditation and mindfulness — Taking time out to focus on the here and now helps to manage stress levels. Mindfulness helps you relax, accept the things you can’t control, let go and think positively. Avoid thinking you’ll be able to completely clear your mind, as that’s not the aim. The aim is to acknowledge when your mind drifts when you’re being mindful, and simply bring your thoughts back to the present, how ever many times that is. Guided meditations from apps such as Calm and Headspace can be used at home, on your commute, while out and about or before bed.
6. Calm your breathing — Many mindfulness apps have reminders that you can set during the day to remind you to just take a moment to breathe deeply for a moment.
7. Go for a walk — The power of a head-clearing walk should never be underestimated, even if the weather is bad. Take as long as you can, even if only ten minutes, to break away if you feel your stress levels rising, to get some fresh air and exercise. Use a mindfulness walking meditation too if that helps you to switch off. You could also use this on the walk between your workplace and the station or home to help separate work life from home life. (Don’t be tempted to use mindfulness apps if you’re driving.)
8. Be kind to yourself — Being gentle with yourself and allowing for mistakes is crucial for good mental health. Treat yourself in the same way as you’d treat a loved one if they needed support or reassurance. Being positive and compassionate and celebrating the things you’ve achieved is great for boosting self-belief and confidence.
9. Me time — Schedule in time to spend on yourself at least once a week. This could mean going for a massage, getting lost in a book or catching up on your favourite box set.
10. Get enough sleep — Consistently getting less than seven- or eight-hours sleep can mean that you’re unproductive, irritable and lethargic, which makes stress feel worse. It can also lead to a weakened immune system, meaning that you’re more susceptible to illness, and mental health problems such as depression and anxiety. The UK’s Mental Health Foundation has a downloadable guide full of useful tips on improving your ‘sleep hygiene’.
11. Rest and recovery — Living a stressful life, for whatever reason, means that you need to allow yourself enough time to rest and recuperate from a busy day or week. Sleep is important, but it isn’t the whole story. Resting in the evenings or at weekends is just as vital. Short periods of rest and taking breaks can make you more productive than powering through.
12. Acceptance — Being reactionary to stressful events often makes situations worse, especially if you regret how you’ve reacted. It can be difficult but walking away from a situation or allowing yourself time to react in a way you’d feel better about can help you accept a situation. If something is deeply personal, this may not be possible, but taking a deep breath can help give a different perspective on things, ultimately causing less stress.
13. Caffeine, alcohol, drugs and smoking — Stimulants such as these might temporarily mask stress, but if the causes are still present, having a caffeine comedown or hangover will only make things worse. Try to limit caffeine to the mornings only (late into the afternoon and it could interrupt your sleep) and limit alcohol to 14 units a week, making sure you have several alcohol-free days. Try to take note of situations that force you into compulsive behaviours and if you need to, seek help for addiction. The Samaritans is a good place to start. As well as treating you, seeking help can feel incredibly empowering.
14. Screen time — Electronic devices such as mobile phones, laptops and tablets might be convenient, but the blue light they emit disrupts sleeping patterns if used late at night, by tricking the eyes into thinking it’s daytime. Try to avoid using these devices before bed. Also, if social media and news channels cause you to feel stressed or lower your self-esteem, try to limit how much time you spend on them.
15. Talk to your manager — If your job is causing you to feel stressed, then speak to your manager about how they could help make things feel better. Speaking up might even make you realise that other colleagues feel the same way.
16. Keep a diary or journal — This doesn’t have to be daily but writing down how you feel on a semi-regular basis can be very cathartic. Write down the good things as well as the bad things. You may notice patterns develop, such as feeling worse stress on a particular day each week that coincides with a particular meeting or working with a particular colleague. You may then be able to take steps to change the things that stress you.
17. The great outdoors — Spending time in nature is scientifically proven to help make us feel happier and less stressed. It can even improve memory, lower blood pressure and boost focus and creativity. Make time to do some gardening, go for a hike or simply sit in the local park.
18. Music, singing and dancing — These might all sound like nursery activities, but they can all make you feel happy, alive and free. Put on your favourite music, sing along and dance!
19. Assertiveness — Confidence doesn’t come easy to all of us, but learning to be more assertive, saying no to social engagements or commitments that cause stress and speaking up when you feel wronged are good skills to learn. Here’s some tips on learning how to be more assertive.
20. Time management — Rushing from one task to the next, always being late and taking on too much can all be overwhelming and feed our stress levels. Working smart, not hard, setting goals and prioritising urgent tasks over non-urgent tasks can all seem like difficult things to learn but time management apps such as Way of Life can help you take control.
21. Be productive — The power of being productive and ticking off tasks is enormous. Understand when you’re at your most productive and aim to get important or difficult tasks completed then. This could mean getting up earlier to fit in exercise when you’re feeling the most energetic or knowing that the evening is the best time for you to sit down to concentrate on filling in your tax return. Listening to your body and mind is important too, to allow you to take breaks when you need them.
22. Take control — Being positive and telling yourself that you can deal with a problem and that there is a solution is empowering and will better arm you for finding a solution.
23. Avoid self-sabotage — Don’t be negative about yourself and send yourself into a spiral of negativity and self-doubt. Equally, avoid comparing yourself to others. We all have different goals and aspirations, and our paths to them are also different. Life isn’t a race.
24. Laugh — Put a comedy on, spend time with people who make you laugh or go to a comedy show — and laugh!
25. Avoid stressful people — Sometimes we have relationships with people that cause us to feel stressed. Avoiding these people can be hard, but if you’re able to gradually break away from a non-fulfilling friendship then all the better for your stress levels.
26. Spend time with animals — Having a pet, borrowing someone else’s, offering to walk a neighbour’s dog or visiting a petting zoo can all work wonders for stress.
27. Gratitude — Taking a step back and feeling thankful for all the things in your life that you might take for granted is a simple way of feeling gratitude. Reframe how you feel about life by using a gratitude app such as My Gratitude Journal.
28. Hobbies — Doing something you really love or enjoy can take your mind off worries and problems, reducing your stress levels. Try learning something new too, such as playing an instrument or a new sport, taking up sewing or learning a language, to stimulate the brain.
29. Volunteer — Being an active member of your local community by volunteering your time to those in need, organising litter picks or helping a charity allows you to build more social relationships and provides a sense of wellbeing.
30. Take a break — Booking a holiday or a weekend away to remove yourself from your everyday life is something to focus on and enjoy and could allow you to return feeling refreshed and more positive.
31. Know that things will pass — Most stressful events come and go, so hold onto the belief that a current stressful episode will pass too. Much like managing a panic attack, take deep, slow but gentle breaths and repeat to yourself that soon, you’ll be feeling much more in control.
32. Ask for help — Talking to a loved one, friend, family member or colleague may reveal that you’re feeling just the same as someone else. Knowing that you’re not alone is a powerful realisation.

More information and help

• If stress is impacting on your quality of life and none of these tips seem to be helping, make an appointment to speak to you GP. They can arrange a referral to a psychological therapy specialist. (Don’t have a GP?)
• You can also refer yourself to a psychological therapist for therapies such as cognitive behavioural therapy (CBT), a talking therapy that can help you change your mindset and behaviours to help you cope better.
• The psychology department here at King Edward VII’s Hospital offers an exceptional level of highly focussed psychological care from experts in the field.
• Our psychiatry department is also available, to expertly diagnose and treat mental health problems using the latest techniques and therapies.