Stress is one of those words that has become intrinsic in our everyday vocabulary: we’ve all heard ourselves moaning “I’m so stressed!” What is it and how can we manage it?
Stress is defined in different ways by different organisations, but the common thread seems to be that stress is “feeling under pressure”. A small amount of stress is good for us: it keeps us motivated and helps us to do our best. However, when we are living with stress all the time, it can lead to a myriad of unpleasant feelings and physical symptoms can follow.
Often we are quick to identify stress in others, but would we recognise it in ourselves? Symptoms associated with stress are wide ranging and initially we might not associate the physical symptoms as related to our mental wellbeing. There has been a tradition to separate mental and physical health, but evidence shows the link is greater than we previously may have understood. The jury is still out as to whether stress itself causes disease, but there’s lots of evidence to show that the unhealthy habits we rely on when we’re stressed contribute to many conditions.
Physical symptoms can include:
- Sleep problems
- Chest pain, palpitations
- Dry mouth, lump in the throat, shaky hands
- Lack of appetite, or conversely, comfort eating
- Repetitive tic
- Diarrhoea or constipation
- Loss of libido
- Worsening symptoms of long term conditions
- Poor concentration
- Difficulty making decisions
- A feeling that things are hanging over you
- Excessive intake of caffeine, cigarettes or alcohol
- Low self esteem/lack of confidence
This list is not exhaustive!
What causes stress?
Here’s the tricky bit. We’re all different, so we all have different triggers. For example, one nurse would struggle to cope with the incessant physical and emotional demands of working in the Emergency Department, whereas that environment is perfect for a different nurse.
Acknowledged triggers of stress are as follows:
- Work pressures, job instability, fear of redundancy
- Parenting, family and relationship difficulties
- Financial pressures
- Bullying and discrimination
- Loneliness and isolation
- Living with a long term condition
- Caring responsibilities
And one more for us workaholics:
- Taking on too much responsibility and feeling you don’t have enough time to do everything!
OK, so it looks like life itself is stressful.
If you’re feeling like stress is starting to impact on the quality of your life then the first thing would be to get it down on paper. Spotting stress in its early stages can help prevent things from getting worse. Things to include in your “stress diary”:
- Date, time and place of the incident
- What you were doing, before, during and after
- Who you were with
- What were your feelings, before, during and after
- Any physical sensations
- Give the event a “stress rating” e.g 0 = no stress, 10 = the most stressed you could possibly feel.
Making a stress diary is helpful because it aids our ability to make connections between the context and the symptoms. Ideally, a stress diary should be continued for at least 2 weeks. This helps us to see things in perspective. Additionally, this is a vital piece of evidence to discuss with your GP if you’re feeling overwhelmed and unable to cope.
When I searched ‘wellbeing’ in Amazon at the beginning of the year, I was astounded at the number of different products that claim to enhance one’s wellbeing: necklaces, crystals and orthotic sandals sat alongside the list of ‘new age’ literature that was available. I’m not sure it’s something that can be bought. There’s certainly no single ‘cure all’ solution. Therefore it’s worth trying, or combining, a number of different approaches until you succeed. Most research shows the following are a good place to start:
- Physical activity – doesn’t need to be a gym membership, incorporating 30 minutes of activity can help boost mood and clear the mind (remember it can be in blocks of 10 minutes)
- Sleep better – ideas for improving your sleep can be found at http://www.nhsinform.co.uk/mentalhealth/wellbeing/stress-management/
- Relaxation techniques such as mindfulness and breathing exercises are evidence based ways of reducing stress. Courses are available across the region, check the local press or http://www.uws.ac.uk/wellnessandrecoverycollege for details.
Nursing is acknowledged to be a stressful profession. In our profession, we tend to put everyone before ourselves, but who looks after the caring professions? I passionately believe that we need to give ourselves the time and effort to look after our own mental wellbeing, and being aware of our stress levels is intrinsic to this.
Further self help resources to try:
- Living Life telephone self help service and online programme for people with mild to moderate feelings of anxiety and depression using Cognitive Based Therapy. See http://www.llttf.com/ for more info
- Breathing space – confidential helpline that describes itself as a ‘first stop’ service which aims to listen and provide emotional support. http://breathingspace.scot
- Moodjuice – a website designed to improve people’s emotional resilience and ability to solve problems. http://www.moodjuice.scot.nhs.uk/
- Steps to Deal with Stress – you may have noticed the little square booklets floating around NHS D&G, pick one up, they have great common sense tips to help with stress busting. More info at http://www.stepsforstress.org/
A last word
If you or someone you know is struggling and self help techniques haven’t worked, you may need to seek expert help. For some people a combination of medication, talking therapy alongside some of the techniques outlined above are appropriate. Also, it’s worth remembering that the Samaritans have changed their number to 116 123. Further helplines can be found at http://www.nhs.uk/Conditions/stress-anxiety-depression/Pages/mental-health-helplines.aspx
And remember… “taking on too many commitments” may lead to feelings of stress!
Amanda Taka is a Keep Well Nurse at NHS Dumfries and Galloway