'I am so stressed! It is so stressful! I'm under stress!' Stress is a term that is widely and often used and noone among us will claim never to have been stressed.

The first and most important step in managing stress is to recognize and understand it:

What is stress?

Actually, it is more useful to use the terms stress factor (or stressor) and stress reaction. Stress factors are real or perceived challenges that we encounter and that we have to react to in order to cope with them. If we are faced with a stress factor our body reacts with a stress reaction that is aimed at enabling us to deal with the stress factor. There are very many different stress factors, e.g. a change in temperature, a new task at work, climbing stairs or an attack on us. It becomes clear that stress factors are not necessarily bad and are actually all around us. Equally, stress reactions can be useful as they allow us to deal with challenges we are presented with. Stress reactions become problematic, however, if they are too intensive and too long-lasting and not alternating with relaxation periods.

What happens during a stress reaction?

During a stress reaction certain brain centres are activated. This leads to the excretion of adrenalin (epinephrine), but also of cortisol and many other hormones and substances within the body. This is part of the 'fight-and-flight' reaction that is aimed at preparing the body for action. During this activation heart rate, blood-pressure, breathing rate and muscle tone increase. Changes within the immune system occur and the activity of digestive system is reduced. In addition, brain functions such as perception, attention, problem-solving skills and memory processes are influenced.

Stress reaction and performance:

A moderate stress reaction increases performance. If the intensity of the stress reaction increases more, however, performance is reduced, especially for complex tasks. This connection was first described by R. Yerkes and J.Dodson at the beginning of the 20th century. It is often depicted in the Yerkes-Dodson-Curve. This influence of the intensity of the stress reaction on performance plays an important role, whether for students during exams, pilots, CEOs, politicians or for everyone dealing with difficult situations.

Stress created by ourselves: External stress factors vs internal stress factors:

Of course there are situations that trigger a stress reaction in nearly everyone such as relationship conflicts, big exams, moving house, falling ill or physical attack. In addition to these external stress factors we tend to create internal stress factors in many situations thereby adding to the intensity and duration of the stress reaction. In an exam situation for example the following thought patterns may increase the stress reaction above useful levels:

-Perfectionism: trying to achieve unrealistic goals (e.g.'I MUST always be the best')

-Black-and-white thinking: 'The result is either superb or it is a catastrophe, there is no middle ground.'

-Catastrophization: 'If I do not pass the exam now, I will never pass it. I will never get a job. Everyone will look down on me, my  wife will divorce me and I will be poor and deserted!!'

This combination of external and internal stress factors cause an excessive stress reaction that actually reduces performance. The unhelpful thinking patterns can also be part in intensive form in generalised anxiety disorder (GAD).

Health and stress:

Short stress reactions are actually good for our physical and mental well-being as long as they are not too intense. However, chronic stress reactions are harmful. Chronic stress reactions mean an excessive and enduring stress reaction without periods of relaxation in between. This leads to a dysregulation of hormones and transmitter substances within the body. As a result symptoms can include insomnia, increased heart rate and blood pressure, restlessness, muscle tension, exhaustion, irritability and difficulty concentrating. Moreover changes in the immune system occur.

It is suspected that chronic stress reactions influence many illnesses negatively. A negative influence on the cardivascular system, the digestive system, the skin, wound-healing and chronic pain problems has been proven. In addition, chronic stress reactions also interfere with fertility as well as with preganancies.

Attempts to reduce our experience of stress such as smoking more, drinking more or 'comfort eating' actually often reinforce the negative consequences of chronic stress on the body rather than alleviating them.

Stress Management:

Stress management consist of a programme tailored to the individual person. The program includes learning to recognise stress factors and differentiate between internal and external sources of stress. As concerns external sources of stress creating even small changes can result in substantial benefits (e.g.using work breaks in different ways). As concerns internal stress factors learning how to challenge stress enhancing thinking patterns plays an important role. Pros and cons of strategies used so far to combat stress are examined and more helful strategies are explored and practised. For example, learning techniques to directly facilitate a relaxation response in the body allows to counteract the dangers of chronic stress.

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