STRESS MANAGEMENT. What Causes Stress?

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1 We are all familiar with the word stress. Stress is when you are worried about getting laid off your job, or worried about having enough money to pay your bills, or worried about your mother when the doctor says she may need an operation. In fact, to most of us, stress is synonymous with worry. If it is something that makes you worry, then it is stress. Stress is common to everyone. Our bodies are designed to feel stress and react to it. It keeps us alert and ready to avoid danger. It is not always possible to avoid or change events that may cause stress. We can feel trapped and unable to cope. When stress persists, the body begins to break down and illnesses can occur. The key to coping with stress is identifying stressors in your life and learning ways to direct and reduce stress. Dr. Hans Selye, the father of stress theory, defined stress as "the nonspecific response of the body to any demand made upon it." The "demand" can be a threat, a challenge or any kind of change which requires the body to adapt. The response is automatic and immediate. Stress can be good (called "eustress") when it helps us perform better, or it can be bad ("distress") when it causes upset or makes us sick. Another commonly accepted definition of stress (mainly attributed to Richard S Lazarus) is that stress is a condition or a feeling that is experienced when a person perceives that demands exceed the personal and social resources the individual is able to mobilise. What Causes Stress? Stress can be caused by anything that requires you to adjust to a change in your environment. Your body reacts to these changes with physical, mental and emotional responses. We all have our own ways of coping with change, so the causes of stress can be different for each person. There are external and internal causes of stress. External stressors include: Physical environment: noise, bright lights, heat, confined spaces. Social (interaction with people): rudeness, bossiness or aggressiveness on the part of someone else. Organisational: rules, regulations, "red tape," deadlines. Major life events: death of a relative, lost job, promotion, new baby. Daily hassles: commuting, misplacing keys, mechanical breakdowns. 1

2 Internal stressors include: Lifestyle choices: caffeine, not enough sleep, overloaded schedule. Negative self-talk: pessimistic thinking, self-criticism, over-analysing. Mind traps: unrealistic expectations, taking things personally, all-or-nothing thinking, exaggerating, rigid thinking. Stressful personality traits: Type A, perfectionist, workaholic, pleaser. Occupational Stress One of the main areas that can cause a great deal of stress in a individual s life is occupational stress. Among the intense stressors at work are the following: Having no participation in decisions that affect one's responsibilities. Unrelenting and unreasonable demands for performance. Lack of effective communication and conflict-resolution methods among workers and employers. Lack of job security. Long hours. Excessive time spent away from home and family. Office politics and conflicts between workers. Wages not commensurate with levels of responsibility. What Are Common Symptoms of Stress? Manifestations of stress are numerous and varied but they generally fall into four categories (this is only a partial list of most common symptoms): Physical: fatigue, headache, insomnia, muscle aches/stiffness (especially neck, shoulders and low back), heart palpitations, chest pains, abdominal cramps, nausea, trembling, cold extremities, flushing or sweating and frequent colds. Mental Processes: decrease in concentration and memory, indecisiveness, mind racing or going blank, confusion, loss of sense of humour. Emotional (Feelings): anxiety, nervousness, depression, anger, frustration, worry, fear, irritability, impatience, short temper. Behavioural: pacing, fidgeting, nervous habits (nail-biting, foot-tapping), increased eating, smoking, drinking, crying, yelling, swearing, blaming and even throwing things or hitting. 2

3 OVERSTRESS makes people feel terrible. People complain of being tired, unable to fall asleep or to obtain a restful night's sleep. They have plagues of aches and pains, lack of energy, lack of enjoyment of life. They feel depressed, anxious, or just unable to cope with life. What can you do to reduce stress in your life? Accept that there are events that you cannot control. Be assertive instead of aggressive. "Assert" your feelings, opinions or beliefs instead of becoming angry, combative or passive. Learn to relax. Eat well-balanced meals. Rest and sleep. Your body needs time to recover from stressful events. Don't rely on alcohol or drugs to reduce stress. Decrease caffeine (coffee, tea, colas, chocolate). Regular exercise (at least 30 minutes, three times per week). Leisure time (do something for yourself everyday). Diversion and distraction. Take time-out (anything from a short walk to a vacation) to get away from the things that are bothering you. This will not resolve the problem, but it will give you a break and a chance for your stress levels to decrease. Then, you can return to deal with issues feeling more rested and in a better frame of mind. Relaxation exercises (e.g., mind relaxation, deep breathing relaxation). RELAXATION EXERCISES 2-Minute Relaxation Switch your thoughts to yourself and your breathing. Take a few deep breaths, exhaling slowly. Mentally scan your body. Notice areas that feel tense or cramped. Quickly loosen up these areas. Let go of as much tension as you can. Move your head to your right shoulder, then to the left shoulder, move your head forward from your chin to your chest and move your head backwards. Roll your shoulders forward and backward several times. Let all of your muscles completely relax. Recall a pleasant thought for a few seconds. Take another deep breath and exhale slowly. You should feel more relaxed. 3

4 Mind Relaxation Close your eyes. Breathe normally through your nose. As you exhale, silently say to yourself the word "one," a short word such as "peaceful" or a short phrase such as "I feel quiet" or "I'm safe". Continue for ten minutes. If your mind wanders, gently remind yourself to think about your breathing and your chosen word or phrase. Let your breathing become slow and steady. Deep Breathing Relaxation Many individuals under stress breathe shallowly and rapidly from the upper chest as if preparing for flight or reacting to fear. This type of breathing intensifies anxiety. To reduce stress, take several deep breaths and practice slow, abdominal breathing every chance you can. Imagine a spot just below your navel. Breath into that spot and fill your abdomen with air. Let the air fill you from the abdomen up, then let it out, like deflating a balloon. With every long, slow breath out, you should feel more relaxed. During a break or after lunch, try this relaxing posture. Sit somewhere quiet. Comfortably round your shoulders so they feel relaxed. Drop your arms to the sides. With the palms up, rest your hands on top of your thighs. Bend your knees comfortably while extending your legs. Allow your feet to fall outward, supported by your heels. Next, let your jaw drop, close your eyes and practice your deep breathing for several minutes. Progressive Muscular Relaxation (PMR) Experiment with PMR by forming a fist, and clenching your hand as tight as you can for a few seconds. Relax your hand to its previous tension, and then consciously relax it again so that it is as loose as possible. You should feel deep relaxation in your hand muscles. Alternately contract and relax each muscle group. Start at the head and work to the toes or vice versa. Do the head, face, neck and shoulders and then each arm, hand and finger. Move to the chest, back, abdomen and pelvis, then each leg, foot and toe. Imagine the tension draining from your fingertips and toes. Notice how different you feel once you have contracted then relaxed a muscle group. This exercise helps you to recognise the difference between being tense and relaxed. Eventually it will be easier to conjure up this relaxed feeling under stress or to remain relaxed. Visualisation Sometimes we are not able to change our environment to manage stress this may be the case where we do not have the power to change a situation, or where we are about to give an important performance. Visualisation is a useful skill for relaxing in these situations. Imagery is a potent method of stress reduction, especially when combined with physical relaxation methods such as deep breathing. One common use of visualisation in relaxation is to imagine a scene, place or event that you remember as safe, peaceful, restful, beautiful and happy. 4

5 You can bring all your senses into the image with, for example, sounds of running water and birds, listening to rain on a tin roof while snuggled in bed. Use the imagined place as a retreat from stress and pressure. Scenes can involve complex images such as lying on a beach in a deserted cove. You may see cliffs, sea and sand around you, hear the waves crashing against rocks, smell the salt in the air, and feel the warmth of the sun and a gentle breeze on your body. Other images might include looking at a mountain view, swimming in a tropical pool, or whatever you want. You will be able to come up with the most effective images for yourself. Other uses of imagery in relaxation involve creating mental pictures of stress flowing out of your body, or of stress, distractions and everyday concerns being folded away and locked into a padlocked chest. With visualisation, you substitute actual experience with scenes from your imagination. Your body reacts to these imagined scenes almost as if they were real, calming you down. THOUGHT AWARENESS, RATIONAL THINKING AND POSITIVE THINKING Thought Awareness Quite often, our experience of stress comes from our perception of the situation. Perception is the key to this, as situations are not stressful in their own right. Rather it is our interpretation of the situation that drives the level of stress that we feel. Often that perception is right, but sometimes it is not. Often we are unreasonably harsh with ourselves or instinctively jump to wrong conclusions about people s motives. This can send us into a downward spiral of negative thinking that can be hard to break. Quite obviously, sometimes we are right in what we say to ourselves. Some situations may actually be dangerous, may threaten us physically, socially or in our career. Here, stress and emotion are part of the early warning system that alerts us to the threat from these situations. Very often, however, we are overly harsh and unjust to ourselves in a way that we would never be with friends or co-workers. This, along with other negative thinking, can cause intense stress and unhappiness and can severely undermine self-confidence. A major problem with this is that negative thoughts tend to flit into our consciousness, do their damage and flit back out again with their significance, having barely been noticed. Since we do not challenge them, they can be completely incorrect and wrong. Yet, this does not diminish their harmful affect. 5

6 One of the ways to monitor our thoughts is through the use of a stress diary. One of the benefits of using the Stress Diary is that you log all of the unpleasant things in your life that cause you stress for one or two weeks. This would include negative thoughts and anxieties, and can also include difficult or unpleasant memories and situations that you perceive as negative. By logging your negative thoughts for a reasonable period of time, you will quickly see patterns in your negative thinking. When you analyse your diary at the end of the period, you should be able to see the most common and the most damaging thoughts. Tackle these as a priority. Rational thinking The next step in dealing with negative thinking is to challenge the negative thoughts that you identified using the Thought Awareness technique. Look at every thought you wrote down and rationally challenge it. Ask yourself whether the thought is reasonable: Does it stand up to fair scrutiny? As an example, by analysing your Stress Diary you might identify that you have frequently had the following negative thoughts: Feelings of inadequacy Worries that your performance in your job will not be good enough An anxiety that things outside your control will undermine your efforts Worries about other people s reactions to your work Starting with these, you might challenge these negative thoughts in the ways shown: Feelings of inadequacy: Have you trained and educated yourself as well as you reasonably should to do the job? Do you have the experience and resources you need to do it? Have you planned, prepared and rehearsed appropriately? If you have done all of these, are you setting yourself unattainably high standards for doing the job? Worries about performance: Do you have the training that a reasonable person would think is needed to do a good job? Have you planned appropriately? Do you have the information and resources you need? Have you cleared the time you need and cued up your support team appropriately? Have you prepared appropriately? If you have not, then you need to do these things quickly. If you have, then you are well positioned to give the best performance that you can. Problems with issues outside your control: Have you conducted appropriate contingency planning? 6

7 Worry about other people s reactions: If you have put in good preparation, and you do the best you can, then that is all that you need to know. If you perform as well as you reasonably can, then fair people are likely to respond well. If people are not fair, then this is something outside your control. Positive Thinking Where you have used Rational Thinking to identify incorrect negative thinking, it can often be useful to prepare rational positive thoughts and affirmations to counter them. Continuing the examples above, positive affirmations might be: Feelings of inadequacy: I am well trained for this. I have the experience, the tools and the resources I need. I have thought through and prepared for all possible issues. I can do a superb job. Worries about performance: I have researched and planned well for this, and I thoroughly understand the problem. I have the time, resources and help I need. I am well prepared to do an excellent job. Problems issues outside your control: We have thought through everything that might reasonably happen and have planned how we can handle all likely contingencies. Everyone is ready to help where necessary. We are very well placed to react flexibly and effectively to unusual events. Worry about other people s reaction: I am well-prepared and am doing the best I can. Fair people will respect this. I will rise above any unfair criticism in a mature and professional way. Summary This set of tools helps you to manage and counter the stress of negative thinking. Thought Awareness helps you to understand the negative thinking, unpleasant memories and misinterpretation of situations that may interfere with your performance and damage your self-confidence. Rational Thinking is the technique that helps you to challenge these negative thoughts and either learn from them or refute them as incorrect. Positive thinking is then used to create positive affirmations that you can use to counter negative thoughts. These affirmations neutralise negative thoughts and build your self-confidence. It is also used to find the opportunities that are almost always present to some degree in a difficult situation. 7

8 WHAT OTHER CONDITIONS HAVE THE SAME SYMPTOMS AS STRESS? Anxiety Disorders The physical symptoms of anxiety disorders mirror many of those of stress, including a fast heart rate; rapid, shallow breathing; and increased muscle tension. Anxiety is an emotional disorder. It is characterised by feelings of apprehension, uncertainty, fear, or panic. Anxiety or Panic attacks are the best example. Seemingly out of nowhere, a person experiences a racing heart beat, tightness in the chest, dizziness, sweaty hands and dry mouth, and a feeling of disorientation. People who suffer panic attacks will quickly tell you that they don't know what is happening to their bodies and they think they are having a heart attack or some other terrible illness. Stress is that powerful. Unlike stress, the triggers for anxiety are not necessarily or even usually associated with specific stressful or threatening conditions. Some individuals with anxiety disorders have numerous physical complaints, such as headaches, gastrointestinal disturbances, dizziness, and chest pain. Severe cases of anxiety disorders are debilitating, and interfere with career, family, and social interaction. Anxiety disorders can, in, turn progress to an individual suffering specific phobias such as: agoraphobia, social phobia or obsessive compulsive disorder. Post-Traumatic Stress Disorder Post-traumatic stress disorder (PTSD) is a reaction to a very traumatic event: it is actually classified as an anxiety disorder. The event that precipitates PTSD is usually outside the norm of human experience, such as intense combat or sexual assault. The patient struggles to forget the traumatic event and frequently develops emotional numbness and event-related amnesia. Often, however, there is a mental flashback, and the patient re-experiences the painful circumstance in the form of intrusive dreams and disturbing thoughts and memories, which resemble or recall the trauma. Other symptoms may include lack of pleasure in formerly enjoyed activities, hopelessness, irritability, mood swings, sleep problems, inability to concentrate, and an excessive startle-response to noise. Depression Depression can be a disabling condition, and, like anxiety disorders, may result from untreated chronic stress. Depression also mimics some of the symptoms of stress, including changes in appetite, sleep patterns, and concentration. Serious depression, however, is distinguished from stress by feelings of sadness, hopelessness, loss of interest in life, and, sometimes, thoughts of suicide. Acute depression is also accompanied by significant changes in the patient's functioning. Professional therapy may be needed in order to determine if depression is caused by stress or if it is the primary problem. 8

9 Cognitive-Behavioural Techniques (CBT) Cognitive-behavioural methods are the most effective ways to reduce stress which has resulted in an anxiety related disorder or a depressive disorder. They include identifying sources of stress, restructuring priorities, changing one's response to stress, and finding methods for managing and reducing stress. Individuals who are suffering from these disorders will be most often be treated by psychologists or doctors. Some of the CBT techniques that are prescribed for anxiety and depression include: relaxation training, goal setting, problem solving, flooding, systematic desensitisation and cognitive restructuring. Sometimes CBT techniques are not effective enough on their own to treat the depressive or anxiety disorder. That is when an individual may require antidepressant medications. The use of medication is then combined with psychological treatment methods such as CBT and prove more efficacious than the use of either treatments on their own. 9