What is it

The word stress has its origin in the more mechanical/physical sense of placing stress on an object. Its use to describe psychological stress is largely attributed to Dr Hans Seyle in the 1930’s, and became more widely adopted in the 1950’s.

Stress is not a psychiatric diagnosis and has no formal medical definition. Many health professionals disagree over whether stress is the cause of problems or the result of them.

Stress can be largely consider in two ways:

  • Acute stress is a short term response. There are times when this could be considered natural or even useful for example during competition or sport where stress can help with motivation and performance.
  • Chronic stress is a longer term response and is unlikely to be useful. It leaves the body in an over amplified state of alert and runs the risk of developing mental health problems.

Stress can be an innocuous word, used dismissively to describe low grade irritation or indeed often worn as a badge of honour. This dismissiveness however shields a more sinister undertone. Stress causes changes in our physiology. Hormones such as adrenaline and cortisol released as part of our fight and flight response have wide ranging effects on our body tissue. Designed to give us an advantage temporarily this becomes problematic when our bodies are over responding. The stress then starts to become physical affecting multiple body systems. As scientific understanding of chronic stress becomes more developed, its links to serious illness are becoming clearer. Cardiac disease, diabetes, gastrointestinal disorders, Alzheimer’s disease are just some examples of medical problems with links to chronic stress.

What causes it

This is where the picture starts to get murky because whenever we talk about stress there is a tendency to form a negative connotation and think only in terms of unpleasant things. In fact stress comes from a myriad of different sources. What is important here is not what the source is, but how an individual interprets and responds to it and this can be influenced by any number of factors for example: Life experience, socioeconomic status, work, lifestyle, genetics. This quote is useful in considering how stress affects us:

Work plays a key role in stress. Problems such as work life imbalance, feeling undervalued, reward v effort ratio all inform someone’s individual experience of stress.

‘Evidence is clear that different individuals respond to the same set of stimuli differently, but a single subject responds to different stimuli consistently.’ (Field, 1985)

Stress becomes a problem for us when there is too much of it. If we think of this like a container, it’s the point at which its starts to overflow. This is another key area of misunderstanding because the point of overflow is also an entirely individual thing. We all have different vulnerability to (or capacity for) stress which again is determined by different factors, many of which are beyond our control.

How do you recognise it

When stress overflows and becomes too much for us we will respond emotionally. This may differ from person to person. Some people feel their stress as anger and may express this. Others may internalise it and become withdrawn, or cry. Its useful to consider how you respond to stress so that you can identify when your own container may be getting too full but its equally important to develop a broader awareness of how other people may respond to stress so you can recognise the early signs in others. Open and honest discussion about stress can help to develop this understanding.

How do you treat it

Benjamin Franklyn famously said “An ounce of prevention is worth a pound of cure”. The way to treat stress most effectively is to manage it so that it doesn’t spill over emotionally and reach a point overwhelm or burnout. We can focus on two areas:

  • Stress reduction – Considering seriously how much stress we burden ourselves or others with and if its all necessary or manageable.
  • Balancing stress by creating effective releases or coping methods.

It sounds really simple doesn’t it but if it was, stress wouldn’t be the societal problem it currently is. In the Mental Health Foundations 2018 study “Stress: Are we coping” 74% of respondents reported feeling stressed to the point of overwhelm at some point in their life. Of these, 32% reported having suicidal thoughts or feeling.

What next – Home and professional intervention

Stress is one of those areas of life that is simple to comprehend but difficult to truly understand. Because we all encounter stress (frequently), it is easy to form unhelpful judgements based on our own experience. I have found similar parallels in my clinical work discussing pain where people have been judged (quite often by medical professionals) on the validity or even existence of pain because the person they were speaking to experienced it differently or not at all in response to a similar experience.

Removing the barriers to empathy is one of the most important things we can do to support people in managing stress. This comes with understanding and practise. Creating honest and non-judgemental discourse about stress both at work and at home is essential in deepening our understanding and in creating environments where people can flourish because they feel valued and understood.

Why MHFA is so important

Mental health first aid training is part of a wider strategy for organisations and communities to start changing the culture around mental health and wellbeing. Mental health first aiders are equipped not only to identify emerging problems and intervene, but also to champion a greater understanding of mental health amongst their communities.

Written by Tony Sigrist, Head of Mental Health Delivery at ABC Life Support