Stress: Public Enemy Number one

Over the last year or so, especially the post COVID world of homeworking and increasing global uncertainty, I am beginning to notice a trend, a theme of symptoms that just seem a bit more apparent than usual. Things like; ‘I just cannot get anything done…I cannot focus…concentration is shot…up through the night…just so distracted all the time…constantly restless and fidgety…even when I’m out with friends I just feel on edge…not patience with my kids…appetite is gone…feeling exhausted all the time…can’t get to the gym…not engaging with hobbies…keep getting ill…worrying and overthinking’.

You may guess that this is some anxiety problem, perhaps they are depressed or have gone through some trauma, perhaps even symptoms of Attention Deficit Hyperactivity Disorder. Perhaps it is one of these things or all of them. But whatever is wrong, whatever diagnosis they have or are going to have, one thing is almost always a given; this person is stressed. And this stress isn’t the short-term fight or flight of stress where a car has just screeched around the corner. It’s the stress that’s like a fire alarm just constantly going off in the background for weeks, months and years. The persistent kind, where it just niggles and niggles, where you can generally tolerate but every now and then it really gets under your skin. At its worst, stress will kill you. Just short of killing you, it’ll take some years off and can bring along with it a range of physical and mental health problems. We can all benefit from understanding what stress is and some ways to deal with it. By the way, when I say stress I don’t mean something that makes you stressed, that is a ‘stressor’ or something that’s a bit annoying and stressful. I mean stress with a capital S. Stress, the all-encompassing  physiological response to a stressor. 

Although stress is often seen as really bad for us, it isn’t bad. In fact, stress is necessary, helpful and amazing really. In the short term it boosts your immune system, gets your body ready to move, gives you drive and motivation. It helps you get stuff done. Whether it’s getting out of danger, getting that assignment or report done or doing an intense workout. Removing the stress response completely from a human would probably have disastrous consequences and long-term knock-on effects. To experience stress in a range of forms is completely and totally human. We are animals with big brains that are separated from the wild by a double-glazed window and an Iphone. If you think for a second that you should experience zero stress and that stress is bad, I’m afraid you’re wrong and you need to change your tune. Our ancestors worried and were stressed too, just like us. They worried about their ill loved ones, they worried about their next meal as well as the odd saber tooth tiger. Our source of stress can vary. It could be something that lingers, where the problem isn’t as simple as running from a tiger, where you don’t bounce back, where it’s subtler and where you can’t just do one thing to fix it. This is when it becomes a problem and suddenly all the good short-term effects of stress suddenly start to become a little insidious.

So, a little physiology, (I’m a MH nurse so forgive me).  We have 2 modes: the sympathetic nervous and the parasympathetic. AKA, the fight or flight/stress system and the rest and digest system. I’ve also heard the rest and digest referred to as ‘feed and breed’, which I kinda like. One is for action, getting us to move and deal with a stressor or difficult situation. The other calms us, helps us digest food, reflect, see the bigger picture and engage with others. One turns us up, the other turns us down. One increases our heart rate, the other turns it down. When stress is activated, everything in your body prioritises short term survival. Even having a dry mouth when nervous is an example of this. A mouth is a reservoir of enzymes that help break food down and is part of our digestive system. Why does your body want to digest food when it just wants to survive right now? Whereas when you are calm, you can eat/speak away. Been struggling with Irritable bowel symptoms? There are a lot of causes for this, but on the top of your list should be finding ways to manage stress. Persistent activation of your stress system and the constant turning on and off of your digestive system can play havoc with your gut. Also sleep can be ruined. Why the hell would your body let you sleep properly when you’re in danger. If your body thinks you have pressing matters to attend to, you are going to have a hard time sleeping through. Furthermore, and unfortunately, I see it time and time again, stress is the precursor to a mental health condition or a relapse back into something.

I love an analogy and I often describe this lingering stress as like driving down the motorway stuck in 3rd gear. The car is moving, but at some point, something is going to break or burn out. When it burns out, the car just doesn’t work properly anymore, and it needs to go to the garage. The mechanic will fix it, and prob tell you off a bit. It’s a bit like your body, when it’s really stressed, it just aint worker properly and something needs to be fixed. If you don’t drive, another analogy is your phone, imagine mobile data is on for all apps and they are all open, wireless turned on, Bluetooth is on, location settings are one and its streaming music videos, battery isn’t going to last. Just like your battery. You need a bit of time in flight mode and to clear some of the crap that runs in the background. So, let’s think about stress and some things we can do to manage it.

‘I thrive off stress’. Most of us do. This is the short to medium term good kind that energises us and gets us to move. Stress is where we also learn to do things differently providing we aren’t avoiding things that would actually help us in the long run. If we allow recovery from periods of stress, we can learn a lot from it. A little bit of stress in my day means I get stuff done. What we don’t thrive off is stress day in and day out for weeks/months/years, with no time to bounce back, no recovery, the trickling in of fatigue and the negative thinking that follows. All the positive short term chemical processes that happen with stress are no longer useful. We need to replenish and recover. If you have a predisposition for any mental or physical health difficulties, being under prolonged stress is going to make a relapse or emergence of a difficulty much more likely. Sadly, time and time again I see this. I speak to and have spoken to people who have had breakdowns, psychotic episodes or the increase in severity of depression and anxiety disorders due to the impact of stress. Take time out to relax and do things you enjoy and can focus a little attention on. Relaxation can be lots of different things, but something that’s not going to put you into a place of rumination, worry and anxiety.  We all need to find ways to turn the stress off from time to time.

Just Breathe. Sounds simple or too good to be true right? If you’re on Instagram regularly it seems that every health guru/life coach is talking about breathing like it’s this new thing. I was teaching people struggling with managing emotions way before it was cool, that wasn’t original either. Using breathing to help regulate your stress system is something that’s been done for thousands of years and probably predates recorded history. You can just imagine an ancient hunter gatherer just steadying his breath before the hunt. If you notice heightened stress, notice feeling anxious, getting a bit hot, a bit of a dry mouth, heart beating hard, follow this simple exercise. Breathe in for a bit and out for longer. However long depends on what’s comfortable for you. Something like in for 4 seconds and out for 8 is good. As long as you’re able to do it in a controlled and relaxed way using your diaphragm. Granted the first few breaths might be a bit tricky to regulate, but you should be able to adhere comfortably to 4 in, 8 out pretty quick. Do this for a few minutes. Count the numbers loud in your mind and focus attention on your breath and the numbers. This works because when you are stressed or very anxious, you are in the stress mode, your heart pumps regularly and harder. It’s getting blood around your body to gear you up to do something quickly. A heart at rest and heart and body that is healthy and recovered will beat in a variable way, little faster breathing it, little slower breathing out. This is referred to as Heart Rate Variability (HRV), if you’ve got a fancy garmin, it’s probably on there. The higher the HRV, the more relaxed you are, the lower, the more stressed. It’s even a good predictor of illness as it can indicate a stressor somewhere. If you can feel your pulse, you can even notice the change in the beat of your heart if HRV is high. Also, by applying your attention to the numbers and breathing, whatever was bothering you is no longer the focus of your mind’s eye, this can be really really useful. Be wary however as if you are using this as your only way to cope, or can’t do things without it, you may be in a little trap.  Still struggling? Speak to someone about it. Want to learn a bit more about breathing? Check out this book by James Nestor.

Sleep. This might seem a bit like an annoying paradox as the more stressed you are, typically the worse your sleep is. Annoyingly, sleep is one of the main things that can help us reduce stress. Providing you don’t have some sort of sleep disorder and you don’t need a bit of extra help to manage it, most people could do with getting a little more shut eye and can do this on their own steam, just by changing a few things. All the bad stuff that happens with long term stress can be somewhat alleviated with stress. See my blog on sleep. Think about that car on the motorway stuck in third gear. Sleep is a bit like a little trip to the garage to get it checked over or plugging that phone in so tomorrow it can deal with all the apps.

Think about stress differently. It’s not easy but you’ve got to start somewhere. Imagine you’ve got a challenge where the outcome will be potentially really good for you, like starting a gym class or applying for a job. However, there are going to be a lot of stressful obstacles along the way. You can A: avoid it and potentially lose the positive outcome, B: embrace the obstacle and learn that you can cope and get the positive outcome. Imagine Person A, when stressed, will think ‘that’s it, I’m stressed, I can’t cope with this, it’s all gone to shit, I give up…’  and so on. That person is going to do far worse than person B, ‘stress is where I learn and grow, this is temporary, it’s normal, when I overcome a stressful time obstacle, I learn I can cope…’, and so on. A & B could be exposed to the same stressor, but A gets worse, and B grows as a person. Now imagine person A & B 5 years from now. They will be 2 very very different people.

Take small steps to get affairs in order. I’ve left the hardest, but most obvious one till last. If there is a glaring stressor in your life that involves you putting one foot in front of the other to get it resolved, you kinda need to do it. Sometimes we have genuine and horrendous stressors to deal with that cannot be solved, like a loss. In these situations, it’s about taking on the small stressors that are adding to the pile; a job around the house that needs to be done, a friend you’ve got to message, or an application form you need to get off. It’s obvious and a bit patronising, but the longer you leave something, the harder it gets. Motivation doesn’t magically appear; it is borne out of a little discipline in doing things you don’t want to do. A little tip here is to not fixate on the big task but break it down and just do a small step at a time and treat each obstacle like something you can learn from. I am a very big fan of the 10-minute rule; just tell yourself I will do X for 10 minutes even though I don’t feel like it. Set a timer and I’ll guarantee you’ll want to carry on when the timers up. Lastly, when stressed get others your trust and love involved.; speak to people about what’s bothering you, tell people what you are going to do to overcome a stressor, get help off them, just as you’d help them if they asked. Getting it off your chest, getting others involved and just talking out loud about it can help us problem solve, motivate us, and rationalise the stress we are going through. If it’s all still a bit too much, speak to your GP or your local wellbeing services and get some help and direction.

There are a lot of courses out there and services that offer online and face to face classes and groups for learning about managing stress. Contact your local MIND as they often run Cognitive Behavioural Therapy informed stress-based courses. Or if you’re like me and like a book, the ‘Overcoming’ self-help range have got one on Overcoming Stress.

To drive home an already driven home point, we need to understand Stress and look after our minds and bodies to stop that short term stress becoming a chronic problem.

About the author

Paul Regan

I have been working as a mental health nurse since 2016 and have been around the block working in a lot of different areas. At present I work in a service where I assess people and provide interventions. I love my job, I love learning and talking to people about mental health and wellbeing. This article represents my personal opinion and is certainly not medical advice. If you have concerns about your mental health please speak with a GP or health professional.

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