Stress S.O.S

Sometimes a little stress can be good. It can help you meet a deadline and keep you on your toes. But it’s a tricky thing. It exists in a delicate balance and if this balance tips too far in the wrong direction, it can have a serious impact on our physical, mental and emotional wellbeing.

“Stress is the feeling somebody gets when they feel under pressure or unable to cope. Either that there’s just too many demands upon them or they get exhausted trying to manage a lot of different things,” says Consultant Psychiatrist and stress expert Dr Abbie Lane.

Dr Lane has been working in the area of stress since 1996 and says that while anything can trigger stress, everyone has their own limit.

“Everyone has their limit in relation to stress and once they go over that limit for whatever reason, they can develop stress symptoms that can lead to illness. So even the strongest person can become overwhelmed or over-stretched and typically it’s a combination of maybe things in the home, things in the workplace, financial strain. It may be a number of sustained pressures over a period of months.”

In recent years stress has become something of an epidemic in Ireland however it is hard to get accurate figures.

“The only way you can look at it is through sickness – the reasons for absence from work – and stress would be one of the top reasons for certified sick leave for more than three weeks. It used to be back pain, so stress has overtaken that now at the moment.

“The other thing is if you look at the ERSI [Economic and Social Research Institute] figures for bullying and harassment in the workplace, they’re high too. So by inference then you can look at that being stress as well.”

When it comes to stress, modern lifestyle is something that doesn’t help.

“We’re very busy and it seems as if people feel guilty if they’re taking time out or having quiet time. The nature of our digital world is that we’re constantly being interrupted. We’re constantly getting messages late at night, through the night and into the morning…

“We’re constantly open to information coming at us and the speed of that and the speed of response can be very stressful.”

So what are the main symptoms of stress then?

“One of the first symptoms generally is sleep disruption. So problems getting to sleep and staying asleep or waking and worrying about things. Then irritability would be another one – being cranky and short-fused. Feeling overwhelmed and not able to cope. Then for some people their concentration goes, so they’re not able to take information in or they have difficulty making decisions or completing work.

“Or they can start to feel uncertain in themselves or insecure or fearful – an on-edge or ‘panicky’ type of feeling – constantly worried. And the for some people it can be that their mood can vary a lot, from being happy and content to being upset, fatigued, exhausted and even into a constant sense of depression.”

Understandably all of these emotions and bodily processes have an impact on the body and chronic feelings of stress have been linked to physical issues.

“Stress activates our protective response – our ‘fight or flight’ response. So that leads to adrenaline and cortisol secretion. Adrenaline tends to fire up our heart rate so it gets us ready for threat if you like and that causes a lot of tension in the body, so it can be linked to things like high blood pressure, cardiac problems and irregular heartbeats.

“Then it can add to a lot of discomfort and pain, so headaches, abdominal pain, irritable bowel and bowel problems.”

As well as having an impact on our physical body, chronic stress can also be a precursor for more serious types of mental illness. Dr Lane says that “there’s a known link between prolonged stress and low mood or anxiety and panic.”

When it comes to dealing with feelings of stress, prevention is essential.

“Prevention is really important and that’s getting to know your own optimum stress levels and your own indicators. How do you know when you’re becoming over-stressed? Do you start getting irritable? Does your concentration go? Does your sleep go?”

One of the key tenants of helping to manage and prevent stress is to have a personal self-care scaffolding that you practice on a daily basis.

“Now these things are not fool proof, but the more of them you can manage, then the better your position is to withstand the unexpected or the extra pressure that comes at us. Activity is the main one. That comes under exercise, swimming, walking, cycling. That’s very important and regarded as being as helpful as some forms of therapy for stress, anxiety and mood problems.

“Having an interest as well outside of home and work is important – a hobby, a class, a voluntary activity. Learning how to relax in some way through forms of meditation, brief forms of 10-15 minutes a day using some of the apps that are around and YouTube videos. Mindfulness. Yoga, Pilates, spirituality, Tai Chi – all of those are really important and then looking at the foods we eat. Staying away from too much sugar and caffeine.”

But what should you do if you find yourself becoming completely overwhelmed with stress?

“Stop, pause and ask: ‘What’s happening here for me?’ Try and identify where the stress is and then try and look to see if there are any solutions to it or ways of managing it. Maybe enlist the help of somebody you know well to help you with it. Maybe take some quiet time to think about what’s going on.

“I would say to most people if you’re in a busy working environment or if you’re busy in the home to try and take half a day once a month just to have time to do activities that give you an uplift or that you enjoy. And then obviously if it doesn’t settle with just taking some pause and some time and having a look at what’s causing your stress, it can be useful to talk to your GP about it if it’s something that you think is going on for a period of time or certainly if your sleep is becoming very disturbed.”

Dr Lane stresses that it’s important to see your GP if you find yourself struggling.

“In the past there was that sense that, ‘Oh you know, it’s just stress. We all have it and we’ll all be fine, we just need to suck it up.’ But that isn’t the case now. We now know that stress can be harmful. Talking to your medical practitioner about it may clarify what’s going on for you. If you have a lot of physical symptoms it’s important that you have a physical check up and intervene early.”

And like prevention, early intervention is also key. Sometimes this involves a simple GP visit and sometimes it may involve attending a therapist or seeing a psychiatrist. The earlier you intervene the better.

“The earlier you intervene the more likely that straightforward measures like the ones we talked about: lifestyle measures, self-care etc. [would help]. Then the next step would be maybe therapy and then the next step for a small proportion of people would be medication in combination with therapy.”

Dr Abbie Lane is a Consultant Psychiatrist and an Associate Dean Consultant with the St Patrick’s Mental Health Services. She runs her own private practice in Blackrock, county Dublin. For more information log on to www.abbielane.ie