This leaflet gives some general tips on how to reduce stress. However, see a doctor if you develop persistent anxiety symptoms.
What is stress?
Stress is difficult to define or measure. Some people thrive on a busy lifestyle and are able to cope well with daily stresses. Other people become tense or stressed by the slightest change from their set daily routine. Most people fall somewhere in between but may have periods when levels of stress increase.
Stress can be acute - a single major event such as a bereavement, feeling unwell or an argument. But it can also be due to longer-term causes, such as heavy workload or conflict with people you encounter regularly. Many minor sources of stress or tension, which you could manage perfectly well if there was no other stress in your life, can build up to make you feel overwhelmed.
Telltale signs of stress building up include:
- Not being able to sleep properly with worries going through your mind.
- Minor problems causing you to feel impatient or irritable.
- Not being able to concentrate due to many things going through your mind.
- Being unable to make decisions.
- Drinking or smoking more.
- Not enjoying food so much.
- Being unable to relax and always feeling that something needs to be done.
- Feeling tense. Sometimes 'fight or flight' hormones are released causing physical symptoms. These include:
- Feeling sick (nauseated).
- A 'knot' in the stomach.
- Feeling sweaty with a dry mouth.
- A 'thumping' heart (palpitations).
- Headaches and muscle tension in the neck and shoulders.
Sometimes stress builds up quickly - for example, the unexpected traffic jam. Sometimes it is ongoing - for example, with a difficult job. Sometimes symptoms of stress occur in response to a very upsetting and unexpected event in one's life. When this happens, the stress is referred to as 'acute". See the separate leaflet called Acute Stress Reaction.
Is stress harmful?
Ongoing stress is thought to be bad for health but this is difficult to prove. For example, stress is possibly a risk factor for developing heart problems in later life. Stress may also contribute to other physical illnesses in ways that are not well understood. For example, it is thought that irritable bowel syndrome, psoriasis, migraine, tension headaches and other conditions are made worse by an increased level of stress.
Your work performance and relationships may also be affected by stress.
How can I avoid stress?
The following is a list of suggestions that may be useful to try to combat stress. Some will be more appropriate than others for people:
You can try making a stress list. Try keeping a diary over a few weeks and list the times, places and people that aggravate your stress levels. A pattern may emerge. Is it always the traffic on the way to work that sets things off to a bad start for the day? Perhaps it's the supermarket check-out, next door's dog, a work colleague, or something similar that may occur regularly and cause you stress.
Once you have identified any typical or regular causes of stress, two things may then help:
- If you discuss this with a close friend or family member, it may help them and you to be aware of the reasons why you are feeling stressed. Simply talking it through may help.
- These situations can be used as cues to relax. You can use simple relaxation techniques (see below) when a stressful situation occurs or is anticipated. For example, try doing neck stretching exercises when you are in that traffic jam rather than getting tense and stressed.
Try simple relaxation techniques
- Deep breathing. This means taking a long, slow breath in and very slowly breathing out. If you do this a few times and concentrate fully on breathing, you may find it quite relaxing. Some people find that moving from chest breathing to tummy (abdominal) breathing can be helpful. Sitting quietly, try putting one hand on your chest and the other on your tummy. You should aim to breathe quietly by moving your tummy, with your chest moving very little. This encourages the diaphragm to work efficiently and may help you avoid over-breathing.
- Muscular tensing and stretching. Try twisting your neck around each way as far as it is comfortable and then relax. Try fully tensing your shoulder and back muscles for several seconds and then relax completely.
Try practising these simple techniques when you are relaxed; then use them routinely when you come across any stressful situation.
Set specific times aside to relax positively. Don't just let relaxation happen, or not happen, at the mercy of work, family, etc. Plan it and look forward to it. Different people prefer different things. A long bath, a quiet stroll, sitting and just listening to a piece of music, etc. These times are not wasteful and you should not feel guilty about not 'getting on with things'. They can be times of reflection and putting life back in perspective.
Some people find it useful to set time aside for a relaxation programme such as meditation or muscular exercises. You can also buy relaxation tapes to help you learn to relax.
Try to allow several times a day to 'stop' and take some time out. For example, getting up 15-20 minutes earlier than you need to is a good start. You can use this time to think about and plan the coming day and to prepare for the day's events unrushed. Take a regular and proper lunch break, preferably away from work. Don't work over lunch. If work is busy, if possible try to take 5-10 minutes away every few hours to relax.
Once or twice a week, try to plan some time just to be alone and unobtainable. For example, a gentle stroll or a sit in the park often helps to break out of life's hustle and bustle.
Many people feel that regular exercise reduces their level of stress. (It also keeps you fit and helps to prevent heart disease.) Any exercise is good but try to plan at least 30 minutes of exercise on at least five days a week. A brisk walk on most days is a good start if you are not used to exercise. In addition, if you have difficulty in sleeping this may improve if you exercise regularly.
Smoking and alcohol
Many people find that a hobby which has no deadlines and no pressures and which can be picked up or left easily, takes the mind off stresses. Such hobbies include, for example: sports, knitting, music, model-making, puzzles and reading for pleasure.
Some people find they have times in their lives when stress or anxiety becomes severe or difficult to cope with. See a doctor if stress or anxiety becomes worse. Further treatments such as anxiety management counselling - for example, cognitive behavioural therapy (CBT) - or medication may be appropriate.
Further reading and references
; NICE Quality Standards, Feb 2014
; NICE Technology Appraisal Guidance, February 2006 (last updated May 2013)
; The Relationship between Anxiety and Coping Strategies in Family Caregivers of Patients with Trauma. J Clin Diagn Res. 2017 Apr11(4):IC06-IC09. doi: 10.7860/JCDR/2017/25951.9673. Epub 2017 Apr 1.
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