Everyone reacts to stress in different ways. However, there are some common symptoms to look out for. Your symptoms can be psychological, emotional, behavioural or physical, or a mix of these.
Psychological symptoms of stress can include:
- constant worrying
- an inability to concentrate
- feeling that you have poor judgement
- seeing only the negative
- anxious thoughts
- memory problems
If you’re affected emotionally by stress, your symptoms may include:
- mood swings or changes in your mood
- irritability or having a short temper
- an inability to relax
- feeling overwhelmed
- a sense of loneliness
- low self-esteem
Your behaviour might also change and you may be:
- eating more or less than usual
- sleeping too much or too little
- isolating yourself from others
- neglecting or putting off responsibilities
- using alcohol, tobacco or illegal drugs to relax
- developing nervous habits, for example, nail biting or not being able to sit still
Stress can affect you physically, causing symptoms such as:
- aches and pains
- diarrhoea and constipation
- nausea or dizziness
- chest pains
- loss of sex drive
These symptoms may be caused by problems other than stress. If you have any of them, speak to your GP for advice.
If you have a pre-existing health condition, stress may cause it to worsen or flare-up. For example, conditions such as migraine, eczema, asthma, irritable bowel syndrome or psoriasis can all be aggravated by stress.
There is no specific test to diagnose stress. If you think you’re stressed or if you feel very anxious, talk to those around you who are likely to be supportive, or your GP. Your GP will usually be able to recognise the symptoms and give you advice about how to deal with it. Your GP may also suggest that you talk to a counsellor.
You might feel reluctant to ask for help if you’re stressed or feel under pressure. But don’t be afraid to speak to your GP, friends or family. It’s important to recognise the symptoms of stress so you can learn how to manage them and begin to feel better.
One way of helping to identify your stress triggers, how you react to them and how they make you feel, is to keep a diary. You could make a note of what made you stressed, how stressed you became, what symptoms you experienced and how well you coped.
There are a number of treatment options for stress. These are described below. Which treatments you are offered will depend on your personal circumstances. Your GP will discuss these with you to help you make a decision that’s right for you. Your decision will be based on your GP’s expert opinion and your own personal values and preferences.
To be able to tackle stress, it’s important to recognise the symptoms as well as the problems that it’s causing. There are a number of ways to reduce the effect that stress can have on you. If these don’t work, your GP may recommend other options, such as cognitive behavioural therapy (CBT).
Exercise can be effective at relieving stress and is good for your wellbeing. It can improve your mood, give you a sense of achievement and help you release tension. According to the Department of Health, there’s evidence that physical activity reduces your risk of depression and improves your quality of sleep. It helps reduce stress hormones and stimulates the release of endorphins (the hormones that make you feel good).
It can help to incorporate exercise into your daily routine. A brisk walk to the shops, cycling to work or gardening can help. The recommended healthy level of physical activity is 150 minutes (two and a half hours) of moderate exercise per week. One way to achieve this is to do 30 minutes of exercise at least five days a week.
There are a number of other things you can try to help deal with and manage your stress better.
- Manage your time more effectively and prioritise more important jobs first.
- Adopt a healthy lifestyle – eat a balanced diet, rich in fruit and vegetables, exercise regularly, and make sure you get enough sleep.
- Know your limits – don’t take on too much.
- Find out what causes you to feel stressed and try to change your thoughts and behaviour to reduce it – talking things over with a friend or a family member can help.
- Try not to get into situations that make you feel angry or upset.
- Accept the things you can’t change and concentrate on the things you have control over.
- Make time for the activities you enjoy and for the things that make you feel relaxed – you’re more likely to neglect this area of your life if you’re stressed.
- Find time to meet friends and have fun – arrange to do something you enjoy.
- Develop a positive thinking style – try to look at a problem differently or discuss it with someone.
- Don’t drink too much alcohol, or caffeine, or use tobacco or illegal drugs as a way to cope. In the long term, these things will only make you feel worse.
You can also learn techniques to manage your stress from self-help books, podcasts and CDs. Or by attending a stress management course. Some people find that meditative approaches, such as mindfulness, meditation, yoga or tai chi, are effective at reducing stress and anxiety. Yoga and tai chi help you control your breathing and relax your mind. Meditation helps you learn to reduce anxious thoughts and become calmer.
Explore the options available and find a solution that fits you, your lifestyle, work and personality. There is no right or wrong approach as everyone reacts to stress in different ways. And different approaches will work for different people.
CBT is a talking treatment. It looks at how situations can lead to thoughts that impact your feelings and behaviour. It aims to change the way you think and behave, and helps you to challenge negative thoughts or feelings.
CBT can help to treat many problems, such as sleeping difficulties, relationship problems, drug and alcohol abuse, anxiety or depression. The therapy focuses on your thoughts, images, beliefs, feelings and attitudes (known as your cognitive processes) and how these relate to the way you behave. CBT sessions may be on a one-to-one basis or with a group of people. Sessions may last for between five and 20 weeks, with each session typically lasting between 30 and 60 minutes.
Medicines are not generally helpful for treating stress.
Some people find that complementary therapies, including acupuncture, visualisation, reflexology and herbal remedies, offer some benefit. However, there isn’t enough evidence to say if they are effective or not.
Massage and aromatherapy can promote a sense of wellbeing and provide a relaxing environment that helps you unwind. There's little scientific evidence to show whether or not aromatherapy is an effective treatment for stress.
You may find herbal remedies helpful, but it’s important to remember that natural doesn’t mean harmless. Herbal remedies contain active ingredients and may interact with other medicines or cause side-effects. Don’t start taking any herbal remedies without speaking to your pharmacist first.
Sometimes there is no obvious cause for stress. However, all sorts of situations can cause it. Some of the common triggers for stress are:
- unachievable work demands, changes in work patterns or feelings of a lack of control over your work
- money matters
- difficult relationships with partners, children or other family members
- moving house
Stress can also be caused by a build-up of small things over time. For example, you may not feel valued at work or you may have a child whose behaviour has been consistently hard to deal with.
It may be helpful to try to recognise the difference between temporary stress and long-term stress. Temporary stress goes away once a specific problem is resolved. Long-term stress doesn’t and can be damaging to you, your health and those around you.
Can stress affect my sleep patterns?
Yes, a common symptom of stress is poor sleep, which may make you feel even worse and more anxious. However, there are some simple steps you can take to try and help you sleep better.
Around one in five people have sleep problems. If you’re stressed or anxious about a certain situation, for example, if you have a lot on at work, you might find it hard to fall sleep. You may also wake up during the night and have trouble getting back to sleep or have bad dreams. Some simple tips to help you sleep better are listed below.
- Create a good sleeping environment. Wear earplugs if you’re easily woken up by noise. If light disturbs you, make sure you have thick curtains, blackout blinds or wear an eye mask.
- Try to go to bed and get up at a similar time every day. If you have a routine, you’re more likely to get sleepy at a certain time.
- Develop a routine to help you relax and wind down before you go to bed. For example, have a warm bath or read a book.
- Don’t drink tea or coffee from early afternoon onwards as these drinks contain caffeine, which is a stimulant.
- Not only does exercise reduce stress, it may also help you sleep better at night.
You may have sleep problems if you have depression. Speak to your GP if you’re worried about your sleep patterns or feel very stressed, depressed or anxious.
Can stress cause other illnesses?
Prolonged, severe stress can lead to physical and emotional exhaustion. It can make some existing health conditions worse and sometimes it can lead to other illnesses.
Being stressed, especially over a long period of time, can cause emotional and physical problems. Some links have been made between stress and certain illnesses. For example, some research has suggested that stress can lead to stomach ulcers. However, this is likely to be because being stressed may cause you to smoke and drink more, which is known to cause peptic ulcers. It’s possible that if you already have rheumatoid arthritis, stress may cause a flare-up of your symptoms. Being stressed or anxious may also mean you’re more likely to get constipation or trigger an asthma attack if you already have the condition.
Some people may use smoking, drinking alcohol or overeating as a way of coping with stress. All of these things increase your risk of cardiovascular disease, such as heart attack and stroke, and have other harmful effects on your body.
There is no clear evidence to suggest that stress causes coronary heart disease or heart attacks. It may, however, cause unhealthy behaviours that increase your risk of getting these conditions. If you already have coronary heart disease and get feelings of anxiety or are under lots of stress, it may bring on symptoms such as angina.
How can I relax after a tough day?
If you feel stressed or under pressure, there are some techniques you can learn to help you relax and wind down.
Simple breathing exercises can have a positive effect on your sense of wellbeing and reduce your stress levels. Try the following exercise at the end of a tough day to relieve tension and anxiety.
- Sit or lie down and make yourself comfortable.
- Become aware of your breathing and the rhythm of your breath.
- Put one hand on your chest and one just below your ribs on your abdomen (tummy) and slowly let out your breath.
- Breathe in and out slowly – make sure you exhale a little longer than you inhale.
- Your hand on your abdomen should move up and down as your diaphragm rises and falls rhythmically. There should be little or no movement in your chest.
You can use a deep breathing technique during the day if you notice that you’re becoming stressed. Take a deep breath and hold it for a count of three seconds, then slowly breathe out. Continue this slow breathing until you feel more relaxed. You will then be able to carry on with what you were doing, feeling less tense and with a clearer head.
You can also try some simple relaxation. This exercise doesn’t take long and can help you to relax and reduce your stress levels if you’re feeling anxious or under pressure.
- Shrug, wriggle and shake your muscles to release any tension and relax into a comfortable position.
- Ease off the tension in your feet, ankles, calves, knees, thighs, chest, hands, arms and neck.
- Loosen your jaw and face, and try to be peaceful. A bland expression will help your face muscles to relax.
- Follow the deep breathing technique described above.
- Close your eyes and visualise a peaceful scene, such as a sandy beach with waves gently lapping at the shore. Imagine you’re there and relax as you visualise the sights and sounds of your chosen place.
- Try to practise this relaxation technique as often as you can – it only takes about five to 10 minutes.
What is post-traumatic stress disorder (PTSD)?
Post-traumatic stress disorder (PTSD) can affect anyone and develops in some people following a major traumatic event. For example, a serious accident, sexual assault, military combat or being diagnosed with a life-threatening illness.
If you have PTSD, you may get any of the common symptoms of stress, such as poor sleep, worrying, tearfulness, irritability and mood swings. It’s also characterised by:
- re-experiencing symptoms – these may occur as flashbacks in the daytime when you’re awake or as nightmares when you’re asleep
- staying away from people or places that remind you of the event
- emotional numbing – this means that you find it difficult to express and experience feelings
- being ‘on guard’ all the time and looking around for danger
The symptoms of PTSD will usually appear within one month of the traumatic event. However, in a small number of people, symptoms may not appear for several months or even years after a traumatic event.
Psychological treatments, including CBT, which aims to help you challenge negative thoughts and feelings, and group therapy, may help you overcome PTSD. These types of therapies focus on the traumatic event you experienced. CBT can help you to make sense of the traumatic event and the feelings you have about it by breaking them down into smaller parts.
EMDR (Eye movement desensitisation and reprocessing) is another technique that has been shown to help. This involves using repetitive eye movements while mentally focusing on the traumatic experience, and helps the mind to reprocess the event.
Group therapy involves meeting with other people who have also been through a traumatic event. It can be easier to talk about what happened if you’re with other people who have been through a similar experience.
If psychological treatments aren’t successful, or you have ongoing symptoms, your GP may offer you an antidepressant medicine, such as mirtazapine or paroxetine.
What type of exercise is best for relieving stress?
Any aerobic exercise can be helpful. It doesn’t matter what type of aerobic exercise you do, as long as you enjoy it and can do it on a regular basis. Even a brisk walk to the shops or gardening can help relieve stress and anxiety.
Any type of moderate aerobic exercise can be very effective in relieving stress. Moderate means that your breathing is faster, your heart rate is increased and you feel warmer. The recommended healthy level of physical activity is 150 minutes (two and a half hours) of moderate exercise a week. You can do this by carrying out 30 minutes of exercise a day on at least five days each week.
Exercise helps to reduce stress hormones (chemicals produced by your body) and stimulates the release of endorphins in the body. These are the hormones that make you feel good. Exercise can also help raise your self-esteem and reduce any anxiety or depression you may have. Exercising might also help you sleep better.
You may feel you don’t have time to exercise but you may be able to build it into your everyday life.
- Walk or cycle to and from work instead of driving or taking the bus.
- Use your lunch break to go for a brisk walk.
- If you have children, take them to the park to play a game.
- Organise a family bike ride.
- Do some gardening.
Big White Wall
This online, anonymous community provides a secure environment for you to seek help if you’re feeling stressed, anxious or down about anything. You can share stories to get and give advice, find information and do courses to understand better how you’re feeling and make positive change. And trained professionals keep an eye on things 24 hours a day to make sure everyone stays safe and supported.
This website-based mindfulness programme is made up of 10 30-minute modules for you to do at your own pace. It teaches mindfulness techniques to help you manage stress or simply to try to live a happier, healthier life. The programme uses audio clips, text-based information and a library of resources and exercises, and you can track your progress as you go along.
The charity Mind has information to support people with a mental health condition and those who care for them. If you’re stressed, they have a range of in-depth content, including these relaxation techniques.
They also have suggestions of ways to manage or relieve stress.
You may find these short, sharp tips helpful for coping with stress.
Mind's booklet ‘How to manage stress’ pulls together all their content covering what stress is and its causes, and things you can do to cope.
This charity has support groups, runs campaigns and can direct you to local mental health services, as well as providing information. One of their resources – the ‘Good health guide’ – sets out practical steps that people with mental illness can take to look after their physical health.
The Mental Health Foundation is a charity that carries out research and offers information about many areas of mental health. Their comprehensive page about stress gives details about the different causes and symptoms. It also gives advice about how you can tackle it but also where to go if you want professional help.
- Simon C, Everitt H, van Dorp F. Oxford handbook of general practice. 3rd ed. Oxford: Oxford University Press, 2010: 996
- How to manage and reduce stress. Mental Health Foundation. www.mentalhealth.org.uk, published January 2013
- Stress. Mental Health Foundation. www.mentalhealth.org.uk, accessed 12 March 2014
- Start active, stay active: a report on physical activity from the four home countries’ Chief Medical Officers. Department of Health. www.dh.gov.uk, 2011
- Cognitive behavioural therapy. The Royal College of Psychiatrists. www.rcpsych.ac.uk, published July 2013
- Complementary and alternative treatment. Mind. www.mind.org.uk, accessed 12 March 2014
- Different therapies. Mind. www.mind.org.uk, accessed 12 March 2014
- How to manage stress. Mind. www.mind.org.uk, accessed 12 March 2014
- Managing pressure. Mind. www.mind.org.uk, accessed 12 March 2014
- How to relax. Mind. www.mind.org.uk, accessed 12 March 2014
- Stress disorders. The Merck Manuals. www.merckmanuals.com, published November 2013
- Stress, anxiety and depression. British Heart Foundation. www.bhf.org.uk, accessed 12 March 2014
- Coping with stress. British Heart Foundation. www.bhf.org.uk, published 1 May 2013
- Insomnia – good sleep hygiene. NICE Clinical Knowledge Summaries. cks.nice.org.uk, published July 2009
- Depression – summary. NICE Clinical Knowledge Summaries. cks.nice.org.uk, published August 2013
- Goyal M, Singh S, Sibinga EM, et al. Meditation programs for psychological stress and well-being: a systematic review and meta-analysis. JAMA Internal Medicine 2014; 173(2): doi:10.1001/jamainternmed.2013.13018
- Peptic ulcers. British Society of Gastroenterology. www.bsg.org.uk, published May 2009
- Post-traumatic stress disorder. The Royal College of Psychiatrists. www.rcpsych.ac.uk, published March 2010
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