Stress treatment

Everyone experiences stress from time to time, and you probably do too. Stress is a natural physical reaction to demanding situations, and it is actually helpful when we face a challenge or a major demand. That is, if it is short-lived.

It was the researcher Hans Selye who formulated the original theory of stress. He showed that stress is the body’s reaction to any demand, psychological or physical, and the body’s way of defending itself against both internal and external demands. He divided the reaction into three phases, which he called the general adaptation syndrome: the alarm phase, where the body prepares to fight the strain, the resistance phase, where it fights to restore balance, and the exhaustion phase, where it gives up.

Biologically, stress releases adrenaline and cortisol, the two primary stress hormones. The pulse rises, blood pressure increases, breathing becomes faster and the senses sharpen. That helps you react quickly to a physical danger. But the strains most of us face today are not physical dangers as in prehistoric times. They are work pressure, finances that do not add up, or tensions in the family, and they rarely pass quickly. So the body’s quick reaction drags on, because the threat does not go away. In the end the fight-or-flight response is constantly switched on, and that is the chronic state of stress you may know right now.

Chronic stress can have serious consequences for health: an increased risk of heart disease, disturbed sleep, weight gain, digestive problems and a weakened immune system. It can also lead to depression and anxiety. That is why it is crucial to recognise the signs and act on them. And that is why it is good that you are here, looking into your options for help.

Stress does not discriminate. Anyone can be affected, regardless of age, gender, background and social status, but the causes and the experience differ from person to person. Children and young people can be affected by school pressure, performance demands and problems with friends or at home. Adults are often affected by work pressure, responsibility for the family, finances or illness, and major events such as divorce, job loss or having a child can set it off. Older people can be affected when their health fails, or when they lose people close to them or their independence.

Life experiences also play a part. Refugees, war veterans and people who have been subjected to abuse can develop long-term stress or PTSD. And people living in poverty are under more strain, because food, housing and health are uncertain in everyday life.

Finally, your personality matters. If you have a perfectionist side and high expectations of yourself, you feel the pressure more strongly in situations where you have to perform. The people I meet in my practice are often the most responsible and conscientious. Stress says nothing about how strong or capable you are. It says something about how long you have carried too much.

Stress can be classified by cause, duration and the way it shows. The label rarely matters for what we do together, but it can help you recognise what you are facing.

• Acute stress is the most common. It comes as an immediate reaction to a new challenge, an event or a threat. The symptoms can be physical, such as a rapid pulse and headache, or emotional, and they usually disappear again once the situation is over.
• Episodic acute stress is when you experience acute stress again and again, often because you take on too many commitments, worry constantly or take a gloomy view of things. Over time it wears on both body and mind.
• Chronic stress is the long-term stress that lasts for weeks, months or years. It typically comes from life situations that do not change: an unhappy marriage, a dysfunctional family or a work situation that is constantly too much. It can lead to heart disease, diabetes, depression and anxiety.
• Traumatic stress can arise after a serious accident, a natural disaster, war, abuse or other life-threatening events. The symptoms can last a long time and include flashbacks, avoidance and heightened vigilance, and they can develop into PTSD.
• Eustress is the positive stress you feel with good but challenging changes such as a new job, a move or a child. It can motivate you and improve your performance, but it is also a strain.

Stress can also be classified by where it comes from: work, family, finances or your relationships. Understanding the source and type of your stress is the first step to handling it and finding the right help.

When the body experiences stress, it switches on the fight-or-flight reaction, and you notice it physically, emotionally, in your thoughts and in your behaviour. Here are the reactions I most often hear about in my practice.

You do not need to have all the signs, and your reaction depends on what is pressuring you, how long it has been going on, and who you are. Physical symptoms can also have causes other than stress, so talk to your doctor if you are worried.

Life with stress can be overwhelming and draining. Everyday tasks and routines that you used to manage without thinking suddenly feel insurmountable, and it is hard to find joy in what you used to love.

The feeling of constantly being on guard makes it hard to sleep, and then you are tired but cannot relax. The tiredness and tension give you a short fuse, and it often affects those you love most. Some withdraw from the people around them, others react with anger or frustration over small things and feel bad about themselves afterwards.

In your head the worries go round in circles, and it feels as if the mind never gets any rest. Decisions become hard, concentration fails, and it affects both work and the ability to be present in what you are doing. The body responds with headaches, stomach pain and tension, and over time chronic stress can contribute to serious health problems such as heart disease, diabetes and a weakened immune system.

Leisure, hobbies and time with others, which you used to look forward to, become burdens. So you isolate yourself, get even less peace and time for yourself, and the stress grows. That is the vicious circle I help you out of. It can be broken, and most people notice that it begins to turn once the body settles.

Stress begins with a trigger. It may be overload at work, conflicts at home, financial problems or a major event such as divorce or bereavement. The brain assesses in a flash whether the situation is a threat, and if it is perceived as threatening or overwhelming, the body’s stress response switches on. Adrenaline and cortisol are released, the pulse rises, breathing becomes faster and the muscles tense. Your body is ready to fight what put it under pressure.

The problem is what we then do. The body is ready to remove the strain, so that calm and balance can return. But most of us react instead by working faster, withdrawing from our partner or arguing even more. We focus on the wrong thing, and the calm never comes. If it continues over a longer period, the body becomes exhausted. Then sleep and eating habits start to slip, and some reach for alcohol or other things to dampen the unease.

If the strain continues, or we fail to deal with it, the stress becomes chronic, and then the physical, emotional and mental symptoms follow. Untreated, it can contribute to heart disease, high blood pressure, diabetes, anxiety and depression. How fast it goes, and how hard it hits, varies a great deal from person to person. It depends on your genes, your earlier experiences, your personality and the support you have around you. In treatment we find out where the circle can be broken for you.

The first and most important thing is to understand, acknowledge and accept that you are stressed, and that gritting your teeth will not make it pass. Once you know what triggers your stress, you can begin to act on it instead of just putting up with it.

There is a good deal you can do yourself to help the body along:

• Create an overview and set boundaries. Plan and prioritise your tasks, and learn to say no, so you do not overload yourself.
• Get moving. Exercise is one of the most effective remedies for stress. It releases endorphins, the body’s own painkilling and mood-lifting substances.
• Find calm. Try deep breathing, meditation, progressive muscle relaxation or yoga.
• Look after your sleep and diet. Good sleep rebuilds the body’s and brain’s resources, and a balanced diet gives energy and a better mood. Cut down on caffeine, alcohol and sugar.
• Talk to someone. Share your worries with someone you trust: a friend, a family member or a therapist. It eases the burden.
• Give yourself time. Read a book, listen to music, be creative, or just relax without having to do anything.

Everyone experiences stress differently, and what works for one does not necessarily work for another. Choose a few changes at a time, and find the techniques that suit you. The work of getting better must not become yet another task you have to perform perfectly. And if you feel that the stress is out of control, or you notice signs of anxiety or depression, then seek help from a psychologist. That is what I am here for.

As a relative or friend you can make a big difference, and the most important thing is to show understanding and support without taking over. Listen actively without judging. Just knowing that someone hears and understands can be a great comfort. Avoid minimising the problem with phrases like "you shouldn’t feel like that" or "it’s not that bad". They can come across as condescending. Instead, say "I am here for you" or "how can I help?"

Practical help often counts for more than you think. Take on some of the household tasks, help with childcare, or just make a cup of tea. Encourage healthy habits by suggesting activities you can do together: walks, cooking, meditation or something else that brings calm. Learn about stress yourself from books, articles or courses for relatives, because the more you know, the better you can support them. And if you see signs of serious low mood, anxiety or other psychological difficulties, encourage them to seek professional help, and offer to help find a therapist.

Look after yourself too. Supporting a person with stress is emotionally draining, and you cannot rescue the other person. You can offer support, but you must set boundaries to protect your own wellbeing, take time for your own needs and seek support yourself if you need it. Being there for someone experiencing stress makes a big difference, but both the person with stress and you yourself need someone to lean on.