Stress: How to De-Stress without Doing Less (2 page)

So, before we get too much further, let's look at what exactly we mean by ‘stress'. Most people think they have a pretty good idea of what stress is. Stress is something often talked about, mentioned in media reports and linked with all kinds of issues. The word is one we come across all the time, but it's important to be really clear exactly what it is – and of what I mean when I use the word in this book. This is because one of the most important things to understand about stress is that the way a lot of people use the word often reveals a basic misunderstanding about what stress is. Often when I start working with someone who is struggling with stress-related problems, what they mean by the word ‘stress' is often not the same as I do.

So who gets ‘stressed'?

Think about it. When ‘stress' is talked about, the word is generally used to describe something emotional – something going on in our minds – or stress is blamed for something that happened which we wish had not happened. So, if someone is not coping very well with something demanding – be it a job, small child or life crisis – we talk about them being ‘stressed'. When that colleague goes off sick again and again with something that just won't get better, we might hear someone saying that it is because he or she lets themselves get so ‘stressed'. Or, if someone is suddenly very
moody, seeming grumpy and unreasonable, or, at the other extreme, prone to taking things too personally and bursting into tears all the time, very often people will put it down to ‘stress'. This use of the word ‘stress' perhaps strongly shows its origin – in the word ‘distress'; originally stress described an emotional response. Even now dictionary definitions still show this tendency.
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What is also apparent in the way we talk about stress is a hint of the opinions we often have about it. Many of us talk about stress as though it were something we should ideally be able to avoid. We sometimes even look down on people who struggle with ‘stress'. Very often people I work with are reluctant to admit that stress has anything to do with their problems and see it almost as admitting some kind of weakness. In high-flying and very demanding careers, where stress-related illness is common, it is often simply not done to admit that you find it difficult to deal with the stress. Managing to continue working under extreme stress can be seen as some kind of extra qualification or ability, as essential and valued as academic brilliance, and anyone who falters under the weight of that stress ‘can't take the heat' or ‘isn't up to it'.

In fact, if we're honest, most of us have a tendency to look down on someone who is showing too many signs of ‘stress'. It's something that people do where any kind of emotional or ‘mental health' problem is concerned. Most people like to think that the world is made up of two kinds of people – those who struggle with ‘mental health' problems (including those who might struggle with ‘stress') and those who don't. It's as if we can divide everyone we know into two categories. On the one hand are most of the people we know – in the ‘happy and healthy' category. They are what
we might call ‘normal' and don't suffer from any emotional or mental health problems. They are happy and successful. Meanwhile, a few people we know would fall into the other category – the ‘unhappy' or ‘ill' box. These are the people who suffer from emotional or psychological ill health that has been significant enough to cause them to seek some kind of help. This is not generally thought to be a box you can move out of – once someone has had a mental health problem on the whole they are thought of as someone with that inherent ‘weakness'. One friend of mine, who has been recovered for more than a decade from the serious psychological problems he developed in his early twenties, remembers the response he received when telling a friend about how he had been struggling to cope with recent pressures at work: ‘Ah, but you have always been a bit “vulnerable”, haven't you?'

Some people who are in the ‘ill' category have struggled for a long time – often since their teens or early adult life. This leads to the conclusion that emotional and psychological problems are things that affect only a small proportion of people, who are in some way different or vulnerable. Every once in a while someone develops a problem in adult life for the first time, and this apparent change of category can take us by surprise. One person I worked with told me of the day she admitted at work that her long absence was not in fact due to a bad dose of flu but because she had been struggling with depression. She overheard two colleagues talking about her later on. ‘I never knew she had those kind of problems,' one said to the other. ‘It just goes to show you never can tell, can you?'

We like to believe in this ‘either healthy or ill' system because it protects us from a very basic truth. It means that if, so far, we have not had any emotional problems, we
fool ourselves into thinking that we probably never will. In fact, most so-called ‘mental health' problems can and often do affect anyone, including those people you might think least likely to suffer; those people who have never suffered from anything before. My job brings me into contact every day with people who are perfectly ‘normal' but who have encountered difficult or extreme experiences in life and as a result found themselves struggling with some kind of emotional problem. The truth is that, in some ways, there is nothing more scary than the kinds of things that ‘normal' people like you and me can be pushed to if life throws things at us that are beyond our capacity to cope with.

Stress is linked to the development of almost all mental health problems and, as we will see, can trigger both physical and psychological ill health. But in the same way that we like to believe we are not at risk of mental health problems, we also often think we are immune from the impact of stress. Particularly in a culture where life is jam-packed, full of pressure and the need to achieve, we feel that we should manage to be superhuman and cope with all the things thrown at us. We'll freely admit that life is ‘stressful' but put ourselves under pressure never to show any signs of that stress. We slip into believing that by ignoring stress we can avoid it having any impact on us.

So, what is the truth about stress?

If you listen to a doctor or psychologist talking about stress, you'll quickly realize that they mean something much more than a response that is all in our minds. In fact, stress is a very real physical phenomenon that causes real physiological changes within our bodies
and
our brains. Stress is something
that we all need to be aware of, because many of the signs and symptoms stress can trigger are actually caused by the physiological changes that it has triggered.

This doesn't mean that the way we respond – emotionally and psychologically – to situations, or indeed to stress, doesn't have an impact. Our individual response to difficult things, as well as some basic things about the way our minds work, can certainly make stress more or less of a problem, and we'll talk about some of these things in later chapters. But at the root of stress are real physical changes with real physical impacts.

What we call stress refers to a response that our brain triggers when the situation we find ourselves in requires us to do something specific or be ready to react in a certain way. It might be that something is happening now, or that our brain has detected a chance that something might happen and so primes our body to be alert in case it does. The actual response could be any number of things. It may be about getting us physically ready, such as the well-known ‘fight or flight' response that occurs if we feel threatened or at risk. Or stress can be part of our brain keeping us mentally prepared – for example, concentrating on something for a long time and focusing our attention. Stress can be something that happens in a flash and is over very quickly (‘acute' stress), or something that lasts longer and requires a more long-term physiological adaption (chronic stress).

If we think back over the last month or so, we'll probably be able to think of lots of different examples of things that we have found stressful. So, for example, stepping out into the road and then realizing we are about to be hit by a bus triggers what we might call an acute (short-term) stress reaction (that ‘fight or flight' response again) which prepares us to jump
out of the way. But living or working under a lot of pressure to get more done in the time we have than is realistically possible will trigger a more chronic (long-term) response as our body tries to focus our attention over long periods of time and work harder and faster. And the nature of stress means that even things we might not think of as ‘stressful' do in fact produce a stress response in our body. A job that involves a lot of driving is actually very stressful, even on those days when the roads are clear and we are not running late, simply because of all the attention and concentration that driving requires.

Often, however, the most difficult causes of stress come from a third source. These are psychological and social triggers that are around us all the time in twenty-first-century life. They are more to do with situations that we
perceive
might happen and the emotional reaction we have as a result than with actual real-life disaster scenarios. So, everyday things can become a source of stress if we are pushing the limits. Being slightly late leaving for a meeting makes us worry and rush in case we miss it – that is a source of stress; trying to keep several things in our mind that we know we mustn't forget – that is stress; carrying responsibility for lots of different things such as our job, our children, our family – that is stress! Emotional stress responses occur when our brain pushes our body into responding to things that have not even happened yet. When our brain detects a set of things going on around us which
might
lead to a bad outcome, it triggers anxiety and a stress response almost as bad as if that most dreaded thing really had happened. In fact, sometimes it can feel even worse than if it actually had happened. How many of us have experienced how stressful it is to be driving somewhere
to something we really shouldn't be late to, such as a vital work meeting, appointment of some kind, or to collect the children from school or nursery – and then been stuck in traffic? The stress response we experience then is often worse than the real result of being late. For some of us, these psychological triggers start to become overwhelming and the level of stress this can produce is huge as our body responds inappropriately to our worries and fears.

The physical response to stress

We'll look more at the emotional side later on, but for now let's concentrate on what happens physically when we are reacting to stress. Physiologically, the stress response is largely the same no matter what the trigger, because it uses the same system – something called the sympathetic nervous system. This is one of a set of nervous systems that operate automatically to try to keep things in our body in order. The sympathetic nervous system, roughly speaking, puts our body in a state in which we would be able to respond to any kind of danger or demand. So, it controls the fight or flight reflex but also responds to the more general or chronic stresses that we often find ourselves under. At the same time, it inhibits the action of another system working in our body called the parasympathetic system. This one keeps our body ticking over in the non-emergency moments and controls functions such as digestion. Activity in this system slows down when the sympathetic (stress) system is activated so that attention and resources are directed to where they are immediately required (or might be required).

So, when our brain identifies that something significant is happening, or might be about to happen, it triggers the
sympathetic nervous system. This system is really a cascade of hormones and chemical messengers, each triggering the release of the next down the line. Each hormone or messenger released causes changes in the way our body is working. For example, when the sympathetic system is triggered, the combination of hormones causes glucose to be released into the blood as ready energy for our muscles, our heart rate to increase in order to deliver that glucose to where it is needed, and our breathing rate to go up so that we are flooded with oxygen and ready to react. Meanwhile, our parasympathetic system is slowed down, meaning that digestion and other functions are put on hold.

The stress response is a very complicated system made up of combinations of changes in lots of different places and with lots of different chemicals. It affects the body – but also the brain – not just in terms of how we think but at a real physiological level. The stress response seems to activate something called the serotoninergic system within the brain – that's the system that uses a chemical called serotonin to send messages, one which has been found to be very important in depression and anxiety amongst other things.
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Stress also causes the release of other chemicals called peptides, which is all part of controlling our response and readying the body for action. Peptides are important in lots of areas of the body, including some parts of the brain, the immune system and even the reproductive system.

This means that the stress response really is one that affects our whole body. Although our emotions are often a significant component, just as much of the stress response comes from the real practical need that our body has to work harder and faster in order to meet the demands we are placing on it. In the same way that an engine has to work
harder in order to move the car faster, the stress response revs our body faster in order to make sure that we keep up with the things we are trying to get done. This is not an optional response! If we are doing things hour after hour, day after day, that need us to concentrate or have us ready to react to anything that places us under physical or emotional pressure, we will experience a stress response to each of those things. Of course, everyone is different and just how aware we are of stress depends on many things to do with our personality, lifestyle and physical and mental health. We'll look at some of those things later. But, just like a car, if we constantly drive our body at high revs, we can expect to see some impact of that eventually.