As Mental Health Awareness Week kicks off and seeks to shine a spotlight on stress, we talk to some of our experienced therapists about stress management and associated coping mechanisms.
Most people experience stress or anxiety at some point in their lives but when this becomes chronic, symptoms can take an extreme toll on a person’s mental, emotional and physical wellbeing.
While symptoms of sustained stress may vary, Anxiety UK suggests that if someone exhibits five or more of the following symptoms, it may be an indicator they are experiencing stress:
• Obesity and over-eating
• Increased or excessive drinking of alcohol, coffee or smoking (if you smoke), or other substance abuse
• Loss of appetite
• Excessive and continuing irritability with other people
• Inability to make decisions, large or small
• Inability to concentrate
• Increased and suppressed anger
• Inability to cope with life or feeling out of control
• Jumping from one job to another without finishing things
• Excessive emotion and crying at small irritations
• Lack of interest in anything other than work
• Feeling permanently tired even after sleep
• Decreased sex drive / libido
• Nail biting.
“It is useful to remember that anxiety in itself can be a useful alarm bell or warning sign,” says Psychodynamic Psychotherapist and Arts Psychotherapist, Margaret Ross.
“It is the body’s way of letting us know that all is not well, which sounds very obvious but we often ignore this at our own expense and then the more insidious problem of chronic stress occurs, which in turn increases our anxiety levels even further.”
According to a recent report from the Government’s Health and Safety Executive, ‘Work-related Stress, Depression or Anxiety Statistics in Great Britain 2017’, the total number of working days lost due to work-related stress, depression or anxiety alone totalled 12.5 million days last year.
“Anxiety and stress can be ‘reactive’ as in the case of a bereavement or a job loss and other life changing circumstances. It can also be due to trauma, either one-off such as an accident or life-threatening experience,” according to Margaret.
“However one of the most common causes, and one we are becoming increasingly aware of is due to ‘developmental’ trauma such as psychological, emotional and sexual abuse in childhood,” she says.
There are times when a stress response to certain situations is appropriate and even beneficial, helping us to power on through certain intense situations (such as sitting an exam, making a speech in front of many people or competing in high level or extreme sports). As long as these moments of stress are short-lived, the body can return to a resting state fairly quickly, with no negative health implications.
The danger comes when stress becomes too much to deal with and our stress responses are activated repeatedly, leading to wear and tear of the body and causing us to feel permanently in a state of ‘fight or flight’. (Source: Mental Health Foundation)
“The effects of chronic stress concern all aspects of our life, relationships, physical health, lifestyle choices and possible substance misuse and addiction,” says Margaret.
“What often happens when we are anxious is that we try to avoid the distress and difficult feelings. We employ coping strategies that give short-term relief but ultimately have a longer term cost. That cost often results in chronic stress and self-limiting behaviour.
“Our capacity to self-regulate emotionally is compromised, often leading to unhelpful thinking patterns and negative self-appraisals which can result in loneliness and isolation.”
The effects of stress can go beyond the psychological and manifest physically.
“Activation of the stress response causes muscles throughout the body to tense up. When the event ends, the muscles relax. However, if stress is constant, the muscles may remain in a slightly tensed state. This may lead to joint aches and pains, headaches, chronic back and neck pain, and other symptoms,” observes Elisha May, Massage Therapist, Reflexologist and Myofascial Release Practitioner.
“It is well known that the body’s immune system can also become vulnerable,” adds Margaret.
The ramifications of stress on those nearest
Acute stress and anxiety can also have a detrimental impact on those closest to the person inflicted. In addition to it being upsetting and worrying to see a loved one suffering from stress and anxiety, the impact is often more far reaching.
The Anxiety and Depression Association of America suggests that for those in a partnership, it can lead to one or more problems within the relationship itself or the spouse/partner of the person inflicted taking on more of the normal share of domestic, economic, parenting and other responsibilities.
“If anyone you know is suffering from severe stress and anxiety it is important to be able to listen to them first of all. They may be aware of what is going on for them and feel paralysed as to what to do about it, or they may be ‘acting out’ and causing others to suffer as a result, without meaning to.
“It is also important to remember that as a close family member, partner or friend you can’t necessarily be the one to do everything. A visit to the GP may be helpful and accessing talking therapies is usually possible, as well as medication if this is appropriate,” says Margaret.
How to manage stress and prevent it from becoming chronic
“Try to use anxiety as an indicator that something needs attending to and address this before the unhelpful thinking and behaviour patterns kick in,” advises Margaret.
“If this is not possible, and often circumstances prevent us from doing this, then simple activities such as exercise and mindfulness can open up a space for reducing the effects of chronic stress, remembering that it can be small amounts on a regular basis that begin to effect change.”
For many, the perfect combination of exercise and mindfulness comes in the form of yoga and its potential benefits on helping to alleviate stress go beyond the theoretical.
“It’s fairly well documented both scientifically and anecdotally that certain types of yoga and meditation act to ‘turn-on’ the parasympathetic nervous system (PNS) in the body, or to put it simply our ‘rest and digest’ mechanism,” observes Nicki Le Masurier, one of Clerkenwellbeing’s longstanding yoga teachers.
“Couple that with Pranayama exercises or simple mindful breathing and you’re already increasing your chances of feeling less stressed and anxious. I always start or end my classes with meditation and pranayama to give my students a full body/mind and dare I say it, soulful experience.”
Nicki initially started practising yoga to balance the demands of a hectic career. For her personally, yoga offers some much-needed time out.
“I view yoga as the equivalent of placing a ‘Do Not Disturb’ sign over a door knob or engaging Airplane mode on a smart phone,” she says.
“Some changes are immediate. Like that yoga glow you experience after schvasana or the calmness that surrounds you after a good pranayama session and if you’re consistent, this will make you more resilient to the daily grinds of life.
“Practising yoga gives you space, both physically and mentally and in today’s over-stimulated society people are slowly realising this is more of a necessity.”
The benefits of massage on stress and anxiety management are also well documented.
“Massage can help you feel in control of your health,” says Elisha. “It can lower your heart rate and blood pressure, relax your muscles and increase the production of endorphins, your body’s natural “feel good” chemical. Serotonin and dopamine are also released through massage, and the result is a feeling of calm relaxation that makes stress and anxiety much easier to overcome.
“Clinical studies show that even a single 1 ½-hour session can significantly lower your heart rate, cortisol levels and insulin levels, all of which will help with a reduction in stress. Massage also helps to improve sleep quality, which can significantly reduce the symptoms of anxiety.”
Margaret also suggests talking as a way to overcome the symptoms of stress. “I would also encourage people to talk (not necessarily to a professional). Therapy is a personal choice and many things can be therapeutic. The important thing to remember is that you are not ‘mad or bad’ and that you are not alone,” she says.
“There is a plethora of advice ‘out there’ but you are an individual and what suits you may not suit the next person. Try to identify and focus on what you can do something about rather than worrying endlessly about what may not be possible to ‘fix’ straight away.”
DIY stress management
There are various activities simple enough to do at home in order to help maintain healthy stress levels.
“Stretching is very good to get rid of the daily tension and stress that the body holds on to. It doesn’t have to be for a long time, a little before bed to wind down. As is a warm bath with some relaxing salts and oils that are calming and reading or finding a way to switch off from the daily grind and to take the mind away from stress,” advises Elisha.
Nicki likes to keep a journal: “I keep two notebooks by my bed. In one, I write down any worries or concerns I have about my day and in the other I write down all the things that I am grateful for or note any good things that happened to me during that day, however small. I know this sounds cheesy as hell, but trust me, it really does work and you’ll begin to see brighter thought patterns if you stick at it.
“The other thing I would recommend is PUTTING DOWN YOUR PHONE. Or if that seems like a heinous idea, try turning all notifications off or popping it into Airplane mode for at least an hour and leaving it out of reach. A smartphone/blue screen curfew every evening, preferably before bed is the easiest way to feel less anxious. Try it, you might just surprise yourself.
When it comes to yoga poses that can be done at home to instil a sense of calm, Nicki’s go-to pose is Balasana (Child’s pose).
“There’s something wonderfully comforting and protective about this pose,” she says. “Generally speaking any forward fold will help ease you into a more peaceful state of mind and if you consider the physiology of a fold – you’re protecting your heart and other internal organs whilst limiting outside stimulus. There are plenty and if you come to one of my Restorative classes I will show you!”