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Mind guide to managing stress

This booklet is aimed at anyone who wants to know how to cut down their stress levels.

It explains when and how stress can be bad for you, and describes the signs to watch out for. It also provides helpful strategies for dealing with stress, and tells you where to go for further help.

This booklet can be purchased from the online shop.

Copyright note: professionals are not permitted to print off copies for distribution to colleagues or clients. For more information see Mind's copyright guidelines.

When and why is stress harmful?
How can I tell if I'm under too much stress?
What's the best way to handle pressure?
How can I overcome the ill effects of stress?
How can I help myself to relax?
What else can I do to reduce my stress levels?
Useful organisations
Further reading

The more I did, the more I seemed to have to do. I felt as if I was on the verge of flu, but it never seemed either to turn into full-blown illness, or to go away. Eventually, after a good few weeks, I went to the doctor, and she said what I needed was a holiday, and she wished she could give it to me on prescription.

When and why is stress harmful?

Stress is something we all encounter. Life changes, such as moving house, getting married or coping with a bereavement, can all cause it, while negative social conditions, such as unemployment, poor housing, noisy neighbours, relationship problems and difficulties at work, can also contribute. However, stress also has a positive side. A certain level of stress may be necessary and enjoyable in order to spark us into action.

Stress means different things to different people. A situation that is intolerable to one person may be stimulating to another. What you feel is determined not just by events and changes in the outside world, but how you perceive and respond to them. The important point is that you can learn to recognise your own responses to stress and, if necessary, develop skills to deal with it. I

In the animal world, the response to danger is to run away or to turn and fight. People respond to emotional stress as if it were a physical threat; rapid changes in the muscles and organs of the body are involved. Your muscles tense, ready for action and your heart beats faster to carry blood to where it's most needed - the muscles and the brain. You breathe faster, sweat more and your mouth becomes dry. These physical reactions are due to hormones that the body produces, including one called adrenalin.

This automatic reaction to a threatening situation is known as the 'fight or flight' reaction. It equips us to fight or escape from an enemy. You may merely be having an argument with a colleague, but your body may react as though you were gripped in a life-or-death struggle with a lion.

Unfortunately, many people turn to cigarettes, alcohol or tranquillisers as a way of coping with stress. These may seem to help in the short term but, in the longer term, may further undermine your wellbeing.

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How can I tell if I'm under too much stress?

As stress begins to take its toll physically, emotionally and on your behaviour, a variety of symptoms can result. Check off the symptoms you recognise in the following lists. If you identify a large number of signs in yourself, don't panic. You're among those who can benefit from applying the principles and techniques outlined in this booklet.

How your body may react

breathlessness
headaches
fainting spells
chest pains
tendency to sweat
nervous twitches
cramps or muscle spasms
pins and needles
high blood pressure
feeling sick or dizzy
constant tiredness
restlessness
sleeping problems
constipation or diarrhoea
craving for food
indigestion or heartburn
lack of appetite
sexual difficulties.

How you may feel

aggressive
irritable
depressed
bad or ugly
fearing diseases
fearing failure
dreading the future
a loss of interest in others
taking no interest in life
neglected
that there's no-one to confide in
a loss of sense of humour

How you may behave

have difficulty making decisions
avoiding difficult situations
frequently crying
have difficulty concentrating
biting your nails
denying there's a problem
unable to show true feelings.

In ticking off your own reactions, you can get an idea of your characteristic responses to stress.

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I was so worried about the money, but there was nothing I could do. I felt I couldn't worry my wife about it, so I kept quiet about it. She finally wheedled it out of me. It was such a relief. Telling her about it made me realise I'd got the whole thing out of proportion.

What's the best way to handle pressure?

Remember that a little stress is good for the body and alerts the mind. However, the methods of coping with stress described in this guide should enable you to deal more effectively with it.

Manage your time

Although we often plan for months ahead, it's also important to plan our days. Making time for leisure, exercise and holidays is just as essential as spending time on business or home worries.

Everybody has a time when they feel at their best. Identify your best time (you may be a morning person or feel more active later in the day) and use it to carry out important tasks that need the most energy and concentration.
Make a list of things you have to do on any given day. These are your priorities; everything else can be left until later. Arrange these priorities in order of importance, and stick to that order.
Try to take tasks one at a time, until each is finished. If you try to do too many at once, you're more likely to end up muddled and accomplishing less.
Variety is a good idea. If you can, vary your tasks in a day; dull jobs with interesting tasks, tiring jobs with easier ones.

Act positively

Once you've finished a task, take a few moments to pause and relax. Remember to use your break wisely: do you really need that cigarette or cup of coffee? Why not eat an apple or try some deep breathing instead?
In the face of unrealistic demands and expectations coming from other people, be prepared to say no. Practise being straightforward and assertive in communicating with others. (See Mind's booklet How to assert yourself.)
At the end of each day, sit back and reflect on what you've done and what you've achieved, rather than spending time worrying about what still needs to be done.
Try to make time to switch off from your tasks at home or at work. Use your free time to relax and unwind.
A change of scene can help. Try to get away every so often, even if only for a couple of days.
Develop an absorbing hobby or interest, one that is far removed from everyday stresses and strains; you'll be glad you did.

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I was on a short fuse with everything and everyone, and it was a sort of vicious circle, because then the whole family began to snap at each other. I couldn't understand what was wrong. I just wanted to shut myself away. But, then, when I was on my own, I felt as if everyone else was having a better time without me. I'd wake up in the middle of the night and not get back to sleep, and I was getting more and more tired. Things didn't start getting better until I realised that I had to change the way I was organising my life, and let other people take on some of the strain.

How can I overcome the ill effects of stress?

Sleep problems

Sleep problems, such as insomnia, are a common sign of stress. It seems that about one person in five suffers from them. Worries about personal problems, family, or work may make it increasingly difficult to fall asleep, and sleep may be disturbed by vivid, bad dreams. There are several simple measures worth trying if you want to establish a better sleeping pattern.

Pay attention to your surroundings. If you are troubled by noise, use earplugs; if light from the street disturbs you, use thick, lined curtains or blinds.
It makes sense to wake up at the same time each morning and go to bed at about the same time every night. Usually, if people get up regularly at the same hour, they will tend to become sleepy by a certain hour in the evening.
It can be helpful to follow a night-time routine in order to wind down before bedtime. You could try going for a walk, listening to the radio or watching a relaxing TV programme, reading an undemanding magazine, taking a warm bath or having a hot drink (but avoid stimulants, such as tea and coffee, and heavy meals, late at night). Relaxation and deep breathing exercises can also help you switch off and prepare for sleep.

Many middle-aged and older people feel that they sleep less well than they would like, but people do tend to sleep less soundly as they get older. Physical discomfort or pain will certainly affect sleep, but it's worth noting that drugs prescribed for an illness may also cause insomnia.

Underlying emotional problems can make people much more vulnerable to stress. Depression may make it difficult for you to get to sleep, or you may find you wake very early feeling particularly depressed and anxious. Consider contacting your GP to discuss your sleep problem. Alternatively, if you wish to explore any underlying reasons, you could consider counselling. See Useful organisations for more information, and Mind's booklets How to cope with sleep problems, How to stop worrying and Understanding depression.

The holistic approach to healthcare emphasises the need to look at the whole person and not just their problems, and this can also be very helpful for stress-related symptoms. Many practitioners of alternative and complementary medicine take a holistic approach. Meditation, massage and autogenics can all help relieve stress disorders and promote relaxation. For more information about these and about other strategies, see 'Further reading' and 'Useful organisations'.

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How can I help myself to relax?

Relaxation is the natural answer to stress. Each and every one of us should make time in the day to relax, whether we feel under stress, or not. The following techniques can help.

Deep breathing

The way you breathe can have a dramatic effect on your sense of wellbeing. Many people breathe poorly, without even realising it. This is especially true of people under stress. To improve the way you breathe, try this simple exercise for just five minutes a day. It can help relieve tension, anxiety, dizziness, pins and needles, cramps and chest pains.

Don't be concerned if these breathing exercises aren't for you. Not everyone feels comfortable focusing on their breathing, and if this is the case, there's no need to pursue it.

Sit down, or lie down on your back. Make sure you are comfortable, and loosen any tight clothing.
Become aware of your breathing, its rhythm, depth or shallowness, and its speed.
Put one hand on your upper chest and one just below your ribs on your abdomen.
Slowly let out your breath.
Gently breathe in, so that you feel your abdomen rise slowly under your hand.
Breathe out again, feeling your abdomen fall, and make sure you exhale a little longer than you inhaled.
Pause for a few moments and then repeat the process again.

If you find that only the hand on your abdomen moves, then you are breathing correctly; the abdomen is moving as your diaphragm rises and falls rhythmically. There should be little or no movement in your upper chest; your hand should stay still.

Simple relaxation

Try this every now and again, especially when you feel under pressure. It should take you no more than five to ten minutes.

Have a stretch. Then let your shoulders and arms relax into a comfortable position. Shrugging, wriggling and shaking all help your muscles to stop tensing and to relax.
Ease off the tension in your feet, ankles, calves, knees, thighs, chest, arms and neck.
If you are sitting in a chair, or on the floor, allow yourself to feel as if the chair or the floor is supporting your whole weight; feel yourself letting go.
Try to be peaceful; loosen your jaw and face. A bland expression will help your face muscles to relax.
Follow the breathing technique described above.
Close your eyes and imagine a peaceful scene, such as an exotic desert island, the shady depths of a forest, or sunlight glistening on a lake.
Choose your own special place, whatever seems most restful to you. Then for a few moments, imagine that you are really there.

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What else can I do to reduce my stress levels?

Physical activity is an important means of reducing stress levels and preventing some of its damaging effects on the body. Exercise uses up the adrenalin and other hormones that the body produces under stress, and relaxes the muscles. It will help to strengthen the heart and improve blood circulation too.

Research suggests that physical activity can lead to a change in body chemistry that can affect the way people feel, as well as their physical condition. And that's not all. Exercise can also help to raise self-esteem and reduce anxiety and depression.

You don't necessarily have to take up a competitive or vigorous new sport. Remember that you can benefit simply by becoming more active, as part of your daily routine. So, walk to the shops, don't drive, climb the stairs, don't use the lift, cultivate your garden. (See The Mind guide to physical activity.)

Healthy eating

When things get too hectic or difficult, and you feel under stress, it's often easy to forget about what you eat; it just doesn't seem important, or there isn't time. But what we eat, and when we eat, can make a big difference. It's important to make time for regular food or snacks and not to miss out on meals, such as breakfast. Try not to rush; take time to enjoy what you're eating.

Choose a good variety of foods, making sure you have a balance of protein (from meat, fish, nuts or cheese), starch (from bread, potatoes, pasta and rice) and fibre (cereal and wholemeal bread). Eat plenty of fresh fruit and vegetables (a minimum of five portions a day). Finally, cut down on saturated fat (from dairy products), sugary foods and salt. (See The Mind guide to food and mood.)

Having fun

Making time for regular leisure activities can help you release the tension that stress can cause, and to take your mind off the worries of the day. Whether you unwind by soaking in a hot bath, browsing through your favourite books, listening to music, gardening or taking photographs, the important point is to enjoy the activity as an end in itself, purely for the pleasure of the moment.

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Useful organisations

British Association for Counselling and Psychotherapy (BACP)
tel. 01455 88 33 00
web: www.bacp.co.uk
Contact for details of local practitioners

British Autogenic Society (BAS)
tel. 020 7391 8908
web. www.autogenic-therapy.org.uk
For simple exercises in body awareness and relaxation

The British Complementary Medicine Association (BCMA)
tel. 0845 345 5977
web: www.bcma.co.uk
Supports and protects the integrity of therapists, ensures the protection and wellbeing of clients, and the quality of service delivered

The British Holistic Medical Association
tel. 01278 722 000
web: www.bhma.org
Information about holistic approaches to health

The British Wheel of Yoga
tel. 01529 306 851
web: www.bwy.org.uk
For information about yoga and teachers in your area

First Steps to Freedom
helpline: 0845 120 2916
web: www.first-steps.org
Helpline for anxiety problems. Offers advice, information leaflets and relaxation tapes

The Institute for Complementary and Natural Medicine (ICNM)
tel. 020 7922 7980
web: www.i-c-m.org.uk
For for details of complementary practitioners

International Stress Management Association (ISMA)
tel. 01179 697 284
web: www.isma.org.uk
A registered charity for the prevention and reduction of stress.
Contact for advice and for details of practitioners

No Panic
helpline: 0808 808 0545 (freephone)
web: www.nopanic.org.uk
Helpline for people experiencing anxiety. Local self-help groups

United Kingdom Council for Psychotherapy (UKCP)
tel. 020 7014 9955
web: www.psychotherapy.org.uk
A body of around 80 organisations offering psychotherapy

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