Factsheet 4. Coping with Stress and Anxiety What do we mean by stress and feeling anxious? Anxiety is an emotion you feel when your body thinks there is a threat. Negative thoughts relating to particular events can cause us to think and behave in an unhelpful way, and we may experience a physical reaction as a result of the anxiety. You may feel more anxious or stressed when you are tired, rushed, in a crowded or noisy place, when you feel pressured or overwhelmed, or do not know what to expect. You may also experience anxiety if you do not feel able to do the things you used to, or to do them as well as you used to. You may feel anxious if you feel you do not have any control. Stress is often used as another word to describe anxiety, or can refer to anxiety that is short-lived or less severe. Stress and anxiety can affect us in a number of ways. It can affect how we think (our thoughts), what we do (our behaviour), how we feel (our feelings) and our physical body sensations. The diagram below gives some examples of how stress affects each area. Are any of these familiar to you? Try using the Stress Checklist tool to tick them off if they apply to you often or sometimes: 1
Thoughts (Worries, racing thoughts, negative thoughts about ourselves) Feelings (Anxiety, panic, low mood, irritability) Stress Behaviour (Being snappy, trying to keep busy, staying in more, doing less, changes in appetite, poor sleep, drinking or smoking more) Body sensations (Racing heart, sweaty palms, changes to breathing, stomach problems, feel dizzy, headaches) How dementia can affect your stress levels Some of the symptoms of stress and anxiety overlap with the symptoms of dementia. For example stress can lead to poor concentration, poor attention, forgetfulness and irritability. Living with dementia can be very stressful for people as they come to terms with the diagnosis and deal with changing symptoms and abilities. Illness is a common stressor for people, and if people feel unable to cope it can lead to further symptoms such as forgetting, which causes further stress a vicious circle. An example below shows the impact that dementia might have on someone s stress levels and in turn on their memory: 2
Stressor - Forgetfulness Physical sensations- Sickness, shaky, muscles tense, cannot concentrate Thoughts 'I cannot cope, what will happen in the future?' Behaviour Withdrawal, don t go out Emotions Anxiety, low mood, frustration Why do some people experience more stress than others? There are a number of reasons why some people experience more stress than others. Some people have more stressors to deal with such as illness, bereavement, financial or job difficulties. Others have fewer resources to cope with stress. They may just be the type of person that reacts more quickly or intensely to stress or they may have fewer coping strategies and less support available to them. The following analogy helps to explain this. 3
The Stress Bucket We are all born with certain genes that scientists believe may affect how well we cope with stress. Some of this will be to do with our personalities. We grow up and may learn helpful or unhelpful ways to cope with stress and these can be difficult to change if they become a habit. One way to understand stress a little better is to imagine that a bucket represents how well we cope with stress based on what we were born with and what we have learnt growing up. Some people have a big bucket of resources as they have learnt lots of helpful ways to cope, others have a small bucket. Small bucket Less able to cope with stress Big bucket More able to cope with stress If we imagine that water pouring into the bucket represents stressors in our lives, we can think about all the different things that might cause it. Here are some examples: 4
Housing issues Financial worries Ilness Relationship problems We all experience stress from time to time, and most people have one or two small stressors in their life at any one time, such as a bill to pay or an event to organise. However the more stressors we have, the more filled our bucket gets. If it gets to the point where our bucket overflows we may feel that we can no longer cope and at this point we start to experience the symptoms of stress. This can make us feel low in mood and unwell. Coping strategies We may think that the best way to cope with stress is to remove the stressors (the things causing the stress). We may try to sort out our finances, try to keep fit and healthy and stay organised. This may help us to some extent, however some stressors cannot be prevented and we 5
can cause ourselves exhaustion and more stress, if we constantly try to avoid them! The other way we can cope with stress better is to change how we respond to stress rather than trying to remove it. We can develop coping strategies so that when stress comes along we are better equipped to deal with it. In the bucket example, we can imagine that these coping strategies are like holes in our bucket they help to reduce some of the water (stress) so that we are less likely to overflow into a meltdown: Some of the coping strategies work really well they represent the big holes letting out more stress. Examples might include getting help from others, taking up a relaxing hobby such as gardening or yoga, or taking more time out to relax. Have a think about stress in your life: Do you have a big or a small bucket when it comes to coping with stress? What are your stressors (what causes you stress)? Has your bucket ever overflowed? When did or does it happen? What are your bucket holes (coping strategies)? Which holes are big (really help you) and which are small (help a bit)? Is there anything that you do that makes it worse and adds to your stress? 6
Relaxation One of the key ways to improve our physical and emotional wellbeing is making sure we take time regularly to really RELAX. Relaxation helps us our minds and bodies to be calm, helping us to de-stress and better cope with life challenges. Relaxation is not always an easy thing to do and some people find it difficult especially if they are experiencing anxiety or pain. Physical and mental relaxation Many people assume that they relax when they watch TV or sleep. However, even then our bodies can remain tense and even if we become physically relaxed, our minds may not be. It is important to give our minds a rest as they can get overwhelmed with large amounts of information each day in the form of music, TV, conversations, reading and so on. We need to try to learn to relax mentally as well as physically. Sometimes our bodies find it hard to relax. Life can be stressful and cause us to experience anxiety. Exercise, a good diet and doing things you enjoy will all help, but there are also techniques you can use to help you relax. See the next section for links to relaxation techniques to help you learn to relax more effectively. Changing your breathing and relaxing your muscles can also help you to relax and can have a positive effect on your physical and mental wellbeing. It may be that you find one technique more helpful than another, which is totally normal. Give each a try and if one helps, stick with it! The more often you practice the technique, the easier it will get and the more helpful it will be. Some people find it useful to try to include a brief relaxation technique each day in their daily routine for example after lunch. Including this on a to-do list each day to tick off, can help you to remember to do it. 7
Tips and strategies to help you cope with stress and feel less anxious: Exercise: This can help to relive stress, relax muscles and improve sleep. See Section 2 - Physical health & Wellbeing. Sleep: Make sure you get enough sleep. A lack of sleep can make you more anxious and also adds to stress if you struggle to do things as a result of tiredness. See Section 5 Improving your sleep. Eat well: Our bodies need sufficient nutrients and energy to help us to regulate our mood and cope with life s challenges. Caffeine and alcohol can both increase anxiety levels so try to limit these and see how you feel. Try to ensure you are eating a healthy balanced diet where possible. See Section 2 - Physical health & Wellbeing. Take a break: Sometimes we feel stressed because we create very high standards for ourselves which are impossible to maintain. For example we feel that we must do all the chores and jobs even when we feel exhausted! Ask yourself whether it really would be a disaster if the housework or jobs were left until tomorrow and have an entire day off. Rest, relax and do something you enjoy. Do not feel guilty you deserve this and it is an important part of managing stress and keeping well. Relaxing activities: Take a bath, meet a friend for tea and cake, go for a short walk, listen to music or read a newspaper or magazine. All these things can help to relax our minds as well as our bodies. Aim for mental as well as physical relaxation: Sometimes people think they are taking time out to relax when in fact that they are relaxing their bodies but not their minds. For example, watching TV may help to relax your body, but it can overstimulate the brain as we watch multiple adverts and the television 8
programme or film that we choose may not have a very relaxing theme! Switch off the TV or computer and avoid noisy or busy situations. Find somewhere peaceful to relax and listen to calming music or read something uplifting to calm your mind. Tools to help you: Relaxation, breathing and Imagery techniques: Try the tools in Section 4, which may help you explore different relaxation techniques and help you find what works for you. Identify stressors: What triggers you to feel stressed? Is it something that you can change? Try the Stress Checklist, and Anxiety Body Map tools to consider this more. Remove or manage stressors: Although we cannot always avoid stressors such as illness, there may be some stressors that we can avoid. Do you take on too much? Can you plan or organise your finances to reduce stress there? Could you employ a cleaner if housework is proving difficult? Problem solve: Are you stressed about something that you need to change or make a decision about? Sometimes we can find it difficult to work out how to solve a particular issue and this can create anxiety. Try the Goal Setting tool to help you. Talk to others or write down how you feel: If you do not feel comfortable talking to friends and family about your stress or worries, consider writing things down to help let it out, or ask your GP about seeing a counsellor. Coping with worry: Try keeping a diary of worries to help manage stress and combat worries with problem solving rather than allowing them to turn over and over in your head. You could also try the Worry Coping Map tool to help you cope when you have a particular worry. 9