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Stress can be defined as the way you feel when you're under pressure, for example, if you are speaking in public for the first time.

Some stress can be positive and research suggests that a moderate level of stress makes us perform better. It also makes us more alert and can help us in challenging situations. Stressful situations can also be exhilarating and some people actually thrive on the excitement that comes with dangerous sports or other high-risk activities.

However, stress is only healthy as a short-lived response. Excessive or prolonged stress can lead to illness and physical and emotional exhaustion. Research has shown that around 12 million adults see their GP's with mental health problems each year. Most of these suffer from anxiety and depression, much of it stress related.

Mental illnesses affect 1 in 4 people at some point during their lives.

When you are stressed, your body produces more of the so-called 'fight or flight' chemicals, which prepare your body for an emergency.

Adrenaline and noradrenaline raise your blood pressure, increase the rate at which your heart beats and increase the rate at which you perspire. They can also reduce blood flow to your skin and reduce your stomach activity.

Cortisol releases fat and sugar into your system (but also reduces the efficiency of your immune system).

All of these changes make it easier for you to fight or run away, which was extremely useful to the human race in past times.

Unfortunately these changes are less helpful if you are stuck in a busy office or on an overcrowded train. You cannot fight or run away, and so cannot use the chemicals your own body has produced to protect you. Over time these chemicals and the changes they produce can damage your physical and mental health.

For example, you may start to experience headaches, nausea and indigestion. You may breathe more quickly, perspire more, have palpitations or suffer from various aches and pains such as:

chest pains,
constant tiredness,
constipation or diarrhoea,
cramps or muscle spasms,
craving for food,
fainting spells,
lack of appetite,
nail biting,
feeling sick,
frequent crying,
nervous twitches or muscle spasms,
pins and needles,
sleeping problems, and
a tendency to sweat.
Longer term you may be putting yourself at risk from high blood pressure, heart attacks, strokes, impotence.

Emotional changes

When you are stressed you may experience many different feelings, including anxiety, fear, anger, frustration and depression. These feelings can themselves produce physical symptoms, making you feel even worse. Extreme anxiety can cause giddiness, heart palpitations, headaches or stomach disorders. Many of these symptoms may make you feel so unwell that you then worry that you have some serious physical conditions such as heart disease or cancer, making you even more stressed.

Behavioural changes

When you are stressed you may behave differently. For example, you may become withdrawn, indecisive or inflexible. You may not be able to sleep properly. You may be irritable or tearful all the time. There may be a change in your sexual habits, and even if you were previously mild-mannered you may suddenly become verbally or physically aggressive.

All sorts of situations can cause stress. The most common involve work, money matters and relationships with partners, children or other family members. Stress may be caused either by major upheavals and life events such as divorce, unemployment, moving house and bereavement, or by a series of minor irritations such as feeling undervalued at work or dealing with difficult children. Sometimes there are no obvious causes.

Some people seem to suffer from stress more than other people. Psychologists call these people 'type A'. Type A people tend to be impatient, driving and sometimes aggressive. They also seem to suffer a higher than average incidence of heart attacks. People who abuse alcohol or drugs are also more likely to suffer from stress.

You may be diagnosed with stress if you exhibit one or more of the symptoms (see Symptoms section).

Do not be afraid to seek professional help if you feel that you are no longer able to manage things on your own. Many people feel reluctant to seek help as they feel that it is an admission of failure. This is not true and it is important to get help as soon as possible so you can begin to get better.

The first person to approach is your GP. He or she should be able to advise about treatment and may refer you to another local professional such as a counsellor. Treatment can involve talking your problems through with someone trained to deal with stress conditions and may also mean the use of medication for a short period. There are also a number of voluntary organisations which can help you to tackle the causes of stress and advise you about ways to get better.

Excessive, prolonged stress may contribute to a wide range of other mental health problems such as anxiety and depression. Stress may also contribute to physical health problems such as:

stomach and duodenal ulcers,
high blood pressure,
rheumatoid arthritis,
thyroid over-activity,
ulcerative colitis, and
persistent skin damage from scratching.

An important step in tackling stress is to realise that it is causing you a problem.

If you find yourself becoming angry or upset you may find it helpful to take time out, even if only for five minutes. Try to relax your muscles and calm yourself down by slow, deep breathing.

Try to identify the underlying causes of your stress. You may need to review your whole lifestyle. Are you taking on too much? Are there things you are doing which could be handed over to someone else?

A healthy diet will help prevent you becoming overweight and will reduce the risks of other diet-related diseases.

Keep smoking and drinking to a minimum and try doing some form of physical exercise, even if it's only a daily walk to the park.

Take time to relax. Saying `I just can't take the time off' is no use if you are forced to take time off later through ill health.

Sleeping problems are common when you're suffering from stress, but try to ensure you get enough rest. Try not to take sleeping pills for longer than a night or two.

One of the best antidotes for stress is enjoying yourself so try to bring some fun into your life by giving yourself treats and rewards for positive actions, attitudes and thoughts.

Try to keep things in proportion and don't be too hard on yourself. After all, we all have bad days

© Queen's Printer and Controller of HMSO, 2005

Crown copyright material is reproduced with the permission of the controller of HMSO and the Queens Printer for Scotland.



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