Spreading Awareness: A Full Guide on Stress and Related Illnesses.

A small amount of pressure can push some people into improving their performance and productivity within the workplace; a useful tool in keeping employees motivated. However, too much pressure or prolonged pressure can lead to stress, which is unhealthy for the mind and body.

It’s hard to estimate how common stress is because not all cases are reported to GPs, however research suggested a quarter of all adults will have a mental health problem such as depression or anxiety at some point within their lives. A recent NHS survey during 2008-2009 estimated over 40,000 Britons fell unwell with work-related illnesses resulting in stress. Another survey from 2009 found that around one in six workers thought that their job was stressful.

Symptoms of Stress

Please remember like most conditions Stress affects different people in different ways, and everyone has their own way of dealing with it. Your mood and mind set can alter depending on the chemical hormones released within your body, an over exertion of a specific hormone released by stress can build up over time and cause various mental and/or physical symptoms. We have listed the most common below, do any of these relate to you or a loved one?

Mental Symptoms of Stress (That affect you mind) Include:

• Changes in behaviour: Anger, depression, anxiety, frequent crying or having difficulty concentrating.
• Changes in eating patterns: Food cravings or a lack of appetite.
• Changes in sleeping patterns: Difficulty sleeping (due to mental health problems) or feeling tired.

Physical Symptoms of Stress (That affect your body) Include:

• Aches and Pains: Chest pains, Ramps or muscle spasms, when your muscles contract (shorten) painfully, general muscular aches or Pins and needles (paraesthesia), a cold, burning, prickling or tingling sensation in your arms, legs, hands or feet.
• Bowel Changes: Constipation (an inability to empty your bowels), Diarrhoea (passing loose, watery stools)
• Manifestations of Stress: Biting your nails, nervous twitches
• Insomnia: Difficulty sleeping (due to physical problems) or feeling restless.
• Sexual physical problems or changes: Erectile dysfunction (an inability to get or maintain an erection) or a loss of sexual desire
• Other symptoms: Dizziness, fainting spells (Temporary loss of consciousness), sweating more or breathlessness.
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Long-term Symptoms:

For many experiencing even one or two of the symptoms listed above can make you feel anxious or frustrated, making this a vicious circle as you want to avoid stress yet frequent crying or nervous twitches can leave you feeling annoyed with yourself resulting in you being even more stressed.

If you have experienced any of the above listed symptoms for a long period of time you could be at risk of developing high blood pressure, also called hypertension. High blood pressure can lead to more serious symptoms such as:

• A heart attack: a serious medical emergency where the supply of blood to your heart is suddenly blocked, usually by a blood clot.
• A stroke: a serious medical condition that occurs when the blood supply to the brain is interrupted.

For further information High blood pressure about please see the NHS’ Health A-Z topic about this condition.

Other serious long-term symptoms Include:

• Stomach and duodenal ulcers (Open sores that develop in the stomach or small intestine)
• Asthma: a condition that causes inflammation (Swelling) of the airways in the lungs
• Rheumatoid arthritis: a condition that causes pain and swelling in the joints, initially in the hands and feet but any joint may later become affected
• An overactive thyroid gland (hyperthyroidism)
• Blood clot (thrombosis): a serious condition that is caused by blood clots within the blood vessels
• Aneurysm: a serious condition that is caused by a weakness in the blood vessel wall, which forms a bulge in the blood vessel

Medical Causes of Stress

When faced with a situation that makes you stressed, your body releases hormones (chemicals) that cause the physical symptoms of stress. However, what causes stress for you may be different to someone else. Stress hormones include:

• Cortisol: A build up can increase your blood pressure, s Suppress your immune system (the body’s natural defence against illness and infection), which means you may not be able to fight off an illness or recover from an injury. Or release fat and sugar into your bloodstream, which may lead to weight gain.
• Adrenaline or Noradrenalin: A build up of either hormone can increase your blood pressure, your heart rate and the amount you sweat.

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These hormones are all produced by the adrenal glands (Two small organs that are located just above the kidneys). They invoke the ‘fight or flight’ feelings that help you to deal with a stressful situation. However, when it is impossible to fight or escape a stressful situation, such as being on an overcrowded train, these chemicals are not used. If the chemicals that are released during stressful situations accumulate (build up), you will feel their effects in your body.

Environmental Causes of Stress

Everyone reacts differently to stressful situations, and a situation that one person finds stressful may not be stressful to someone else. Therefore, almost anything can cause stress. Sometimes, just the thought of something, or several small things that build up, can lead to stress. Common causes of stress include:

• Money worries
• Job issues
• Relationships
• Bereavement (The loss of a loved one)
• Family problems
• Moving house
• Extra responsibilities such as being a carer or a high stress profession where you may worry about the person you care for.

Sometimes, there are no clear causes of stress. Some people naturally feel more frustrated, anxious or depressed than others, which can cause them to feel stressed more often.

Diagnosing Stress

Your GP can usually diagnose stress based on your symptoms. They may also ask you about your family history and your personal life to help determine the cause of your stress. In some cases, your GP may also want to carry out some tests to rule out any underlying health conditions. This could include:

• A blood test, when a sample of your blood is tested for abnormalities
• A urine test, when a sample of your urine is tested for abnormalities
• An assessment of your overall health, for example by listening to your breathing and measuring your blood pressure

Treatments for Stress

Some people are often unwilling to ask for help if they feel stressed, some may feel embarrassed or think that they should be able to deal with stress on their own. However, if you are stressed, it is important to speak to someone about how you feel; particularly if it is interfering with your daily life.

Speak to your GP if you are stressed and under too much pressure, speaking to someone about your feelings may help you identify what is causing your stress, which is a positive step. Your GP may suggest that you try some self-help techniques, which are listed below, or they may recommend other treatments, such as a talking therapy. Your treatment may depend on a variety of factors such as the underlying cause of your stress, the severity of the symptoms you are experiencing and whether or not you have been diagnosed with any other conditions. See the following common treatments below for further information:

Counselling
Talking to someone about a range of issues, such as what causes you to feel stressed. A counsellor will encourage you to discuss your feelings and they can help you find solutions to your problems. They can also help you discover ways to deal with stress and its effects. See the NHS’ Health A-Z topic about Counselling for more information about this type of treatment.

Cognitive Behavioural Therapy (CBT)
A broad title that describes a number of therapies designed to solve problems; CBT starts with the idea that your problems are often created by you. It is not the situation itself that is making you unhappy, but how you think about it and react to it. CBT aims to change the way that you think about a situation, as well as influencing your behaviour. See the Health A-Z topic about CBT for more information.

Anger Management
Stress can cause you to feel angry; Anger management is a form of counselling that encourages you to deal with anger in a healthy way. Including steps to recognise when you get angry, taking time to cool down and reducing your general stress levels in life; see the Health A-Z topic to see if Anger management would be a suitable treatment for you.

Support Groups
Independent support groups help people recognise and overcome stress, your GP may be able to give you details of support groups in your area. For example, the mental health charity Mind has a network of local associations. No Panic, a charity for people who have panic attacks, phobias or anxiety, also has a network of local support groups, although there is a membership charge.

Medication
Medication may be used if your stress leads to further problems and you are diagnosed with:

• Depression: when you have feelings of extreme sadness, despair or inadequacy that last for a long time. If you have depression, you may be prescribed antidepressant medicines. The neurotransmitters (chemicals that carry messages between brain cells) do not work properly in people with depression. Antidepressant medication boosts the activity of neurotransmitters so that brain signals function effectively and your mood is stabilised. See the Health A-Z topic about Antidepressants for more information.
• Anxiety: constant feelings of unease, such as worry or fear that affects your daily life. Several medications may be used to treat anxiety including sedatives (which help you relax and calm you down), antihistamines (Which have a calming effect on your brain) and certain types of antidepressants.

Self Help and Prevention of Stress

Being able to identify what leads to stress is an important step in preventing it. Identifying the causes of your stress will enable you to take steps to avoid them and will help you to recognise when you are becoming stressed again. Alternatively you could make a list of all the things that make life stressful and a list of things that would help make life less stressful. This can help you sort out how you feel about certain situations. There are several ways that stress can be prevented. Some of the methods below may be useful to you.

Deep Breathing
If you feel yourself getting stressed, try to halt those feelings by relaxing your muscles and taking deep breaths. Start by inhaling (breathing in) for three seconds before exhaling (breathing out) for a little longer. This will remove the older oxygen from your lungs and replace it with fresh oxygen, improving your circulation and alertness. Continue these deep breathing exercises until you feel calmer and ready to continue what you were doing. It might be better to do something else rather than continue with the stressful task.

Healthy Eating
Food and drink can have a big impact on how you feel and act. It is therefore important to eat a healthy, balanced diet. Stress causes some people to snack on sugary, unhealthy foods, such as crisps and biscuits. This gives your body a sugar rush followed by a sharp drop in your sugar and energy levels. This can make you feel tired or irritable, as well as making it difficult for you to concentrate. Eating at regular times and not skipping meals can make a big difference. This will allow your body to release a steady stream of energy throughout the day, which will improve your concentration and mood.

A balanced diet consists of food from the five main food groups:

• Protein, such as meat, fish, cheese, tofu and eggs
• Carbohydrates, such as bread, pasta, rice and potatoes
• Dairy, such as cheese, milk and yoghurts
• Fruit and vegetables (aim for at least five portions a day)
• Fats and sugars, such as nuts, avocados and sweet food

See the Health A-Z topic about Diet for more information and advice about eating healthily.

Fluids
Try to reduce the amount of caffeine (found in coffee, tea and cola) and alcohol that you drink. These can have a similar effect on your body as stress and anxiety. If you drink alcohol, do not exceed the maximum recommended daily intake of:

• 3-4 units of alcohol for men
• 2-3 units of alcohol for women

One unit of alcohol is a single (25ml) measure of spirit, a small glass (125ml) of wine or half a pint of standard-strength lager, cider or bitter. Drinking more than the recommended amount can have a negative effect on your health. Drinking too much caffeine can leave you feeling anxious, irritable and restless. Try to drink more caffeine-free varieties or opt for squash or water instead. Drink six to eight glasses (1.2litres) of fluids a day.

Exercise
Exercise has numerous benefits and is known to release a chemical called serotonin, which makes you feel happier and less stressed. Improves circulation and prevent conditions such as a stroke and heart attack (serious medical emergencies that occur when the blood supply to your brain or heart is interrupted or blocked) Also allowing you to take out your frustration and anger in a constructive way – an important step in relaxing your body and mind. Aim to do at least 30 minutes of exercise five times a week. The exercise should increase your heart rate and leave you slightly out of breath. Examples include: Running, swimming and cycling.

Sleep
A disturbed sleeping pattern is common for people feeling stressed, you may find it difficult to get to sleep or you may wake up a few times during the night (insomnia). Contact your GP if you are having difficulty sleeping. They will be able to discuss your sleep pattern with you and any potential causes of stress. Your GP could possibly prescribe medication to help you sleep or perhaps recommend cognitive and behavioural treatments to change any unhelpful thoughts and behaviours that are contributing to your insomnia.

Quit Smoking
Contrary to popular belief, smoking does not help combat stress. In fact, it can make stress worse as well as causing damage to your body. Giving up smoking is not easy and, in the short term, may cause you to feel more stressed or annoyed. However, irritability and craving are signs that your body is trying to repair itself.

See the Health A-Z topic about Quitting smoking for more information and advice or speak to your GP or pharmacist. The NHS Smoking Helpline can offer you advice and encouragement to help you quit smoking. Call them on 0800 022 4 332 or visit the NHS Smokefree website

Relaxation
When you are stressed, your muscles often tense. This can cause muscular aches to develop later on. If you feel yourself getting stressed, shrug your shoulders a few times and shake out your arms and legs. This will help loosen your muscles.

Some people find that imagining a peaceful place, such as a desert island or a tranquil lake, can help them relax. Imagine yourself being there and the scenery around you. Diverting your mind to a calming environment will help to distract you from the stress and relax your body. You can also relieve tension by having some time to yourself. Spend some time doing whatever you enjoy.

Clinical Trials – Help researchers learn more

The following information is provided by WHO International Clinical Trials Registry, all trials below are relevant to Stress. For the whole directory of clinical trials, go to clinical trials search. All the trials listed below are currently recruiting from across the United Kingdom:

• Standardised stress management mental health training: does it have a beneficial effect?
• Feasibility of Comparing Two Surgical Treatment of Female Urodynamic Stress Incontinence
• Screening for pregnancy endpoints: preeclampsia, growth restricted baby and spontaneous preterm birth.
• Exploring the potential new way of risk prediction in heart diseases
• Transvaginal Tension Free Vaginal Tape-Obturator (TVT-O) Versus Transobturator Tape-Mentor (TOT) in the Management of Urodynamic Stress Urinary Incontinence
• The acceptability and effectiveness of cognitive behavioural therapy for the treatment of post-traumatic stress disorder within schizophrenia
• Randomised controlled trial of brief cognitive therapy for posttraumatic stress disorder (PTSD)
• Chronic pain and post traumatic stress disorder (PTSD) in survivors of war and torture – efficacy of a biofeedback-based cognitive behavioural therapy (CBT): A randomized trial
• Cognitive behavioural therapy (CBT) for the treatment of post-traumatic stress disorder (PTSD) in intensive care unit (ICU) survivors

Help spread awareness for symptoms of stress. With awareness comes individual prevention. With individual prevention on a global scale we can minimise stress related illnesses for good.