Managing your stress
A summary of Wrexham Adult Social
Care’s Workforce Development training
presentation for Carers
Aims of this presentation
To become more knowledgeable about the
nature of stress, it’s management and
To be able to apply this knowledge to
recognises stress in yourself and develop
strategies to manage and prevent
A definition of stress
Stress is when pressure exceeds a
person’s perceived ability to cope.
Costs of stress
In individuals, stress has been identified
as potentially contributing to a range of
illnesses and conditions such as high
blood pressure, heart attacks/strokes,
stomach ulcers, diabetes, angina, cancer,
rheumatoid arthritis, psychological
The 5 stages of stress
S.Palmer and W. Dryden 1995
It is now acknowledged that there are 5 stages in the ‘stress response’
There is pressure, usually perceived by individual to be from
Person believes they cannot cope and so feels threatened
Psychophysiological changes occur in the body (the actual stress
or ‘fight or flight’ response)
This stage depends on the consequences of the individual’s
response above and how they judge themselves in this
Feedback, via the mind to the body – this depends on stage 4
above. Success restores equilibrium, failure increases pressure
and prolongs stress
Stage 3 in more detail – the ‘Fight or Flight’
response – referred to as the BASIC ID
Behavioural eg. avoiding, procrastinating
Affective - emotional feelings eg. anxiety
Sensory - butterflies, dry mouth
Imaginal – pictures in your head of what might
• Cognitive -own perceptions/labelling of yourself
• Interpersonal – actions with other people
• Biological – physical symptoms eg skin,
bladder, bowels, blood – leads to repressed
immune system
Some effects of stress on your body
Blood vessels constrict, except those to the heart, legs and arms, which need the
oxygen and sugar transported by the blood in order to run away or fight (eg people go
white with fear because the blood has drained from their face)
The muscles in the gut slow down because these are not essential for running away or
fighting (eg people feel ‘butterflies’ in their stomach when frightened)
Mental activity in the brain is increased, so people are suddenly much more alert in order
to work their way quickly out of danger
Blood suddenly has an increased ability to clot, so if injured (as they fear) they won’t
bleed to death as quickly.
Blood also suddenly has increased levels of fats and sugar, to be transported to the
muscles in the heart, arms and legs to provide energy for quick action.
Salivary glands are not important for fighting or fleeing, so there is a decreased flow of
saliva (eg. people experience going dry-mouthed with fear)
The heart increases it’s rate and force of beat to get the blood round to the legs and
arms faster (eg people experience their heart ‘thumping with fear’)
Hormones – the chemical
There is a long list of hormones, each with their own
specific effects on the body.
It is only relatively recently that the role of hormones in the
stress response has begun to be understood. Some of
this understanding has come through the measurement
of levels of hormones in the bloodstream, particularly of
people in certain situations.
Hormones with important implications for stress include
adrenaline, noradrenaline and cortisol
Effects of Hormones
Some effects are:Adrenaline:- stimulates heart rate, dilates blood
vessels and air passages
Noradrenaline:- increases supply of oxygen to
brain improving attention and response, triggers
release of sugar into bloodstream
Cortisol:- increases blood sugar levels, shuts down
reproductive system, counteracts insulin
Emotions and corresponding levels of
hormones appearing in the bloodstream
big increase
small increase
no change
big increase
small increase
Depression, cortisol
Loss of
big increase
no change
no change
Emotions and corresponding levels of
hormones appearing in the bloodstream
Pressure and Stress
Research shows that there is a physiological difference between
pressure and stress
A person experiencing stress has higher levels of various hormones
such as adrenaline, noradrenaline and cortisol in their bloodstream
than a person who merely feels challenged.
It can be seen from the previous pages what some of the physiological
effects of this will be. The stress response is crucial if the body
needs to run away or fight, but if it merely has to stay put and take
the pressure and this happens repeatedly, the cumulative effects
can be negative and harmful.
Physical results of longer-term
We noted earlier for instance, that one result of experiencing the ‘fight
or flight’ or stress response is that the blood supply to and working
of the muscles in the gut is slowed, because the workings of the gut
are not important in these circumstances. If a person regularly and
repeatedly feels anxious, angry or afraid, then this interference of
the proper working of the gut happens regularly and repeatedly.
Stomach ulcers, chronic constipation and Irritable Bowel Syndrome
can result. These all in turn affect the proper digestion of food and
uptake of nutrients, which will affect many other aspects of the
body’s functions.
Fats released into the bloodstream to help muscles fight or flee will
course around the system if not used because a person is having to
sit and take something. Unused fats will then be deposited on artery
walls, eventually risking high blood pressure and strokes.
Reduced immunity.
Another result of on-gong stress which is linked to the effects of
hormones in complex ways and which is the subject of on-going
research is the effect on the immune system. Lymphocytes or white
blood cells in the bloodstream combat disease and measuring their
levels is one indication of how healthy a person’s immune system is.
Lowered immunity results in more frequent infections, ranging from
cold sores (herpes virus) and colds to more serious such as flu,
through to ME and cancer. Examples of research are:Partner caregivers of patients with dementia revealed decreased
responses of blood lymphocytes; reduced cellular immune control
over latent herpes viruses – not due to drugs, alcohol, sleep habits
or nutrition. (Kiecolt et al 1991)
Spouses of women terminally ill with breast cancer – reduced
lymphocyte responses one month after death – return to baseline
during 4 to 14 month follow-up period (Schleifer et al, 1983)
• Think back to a time you were stressed. How did you
feel? What symptoms did you suffer? Did you enjoy the
• Now think back to a time you felt challenged but not
overwhelmed. How did you feel? What symptoms did
you suffer? Did you enjoy the experience?
Changing thinking to conquer
Cary Cooper and Stephen Palmer amongst others
propose that we can change how we respond to
a pressure by managing how we think about it
and thus managing whether it’s in fact merely a
pressure, or actually a threat (resulting in the
stress response). They advocate
• identifying stress-inducing thinking errors
• using problem –solving thinking skills
Exercise – your thoughts when stressed
Think back to a time you felt stressed
Bring the incident back to mind. What ideas or thoughts
were going through your mind at the time?
Did these thoughts help or make things worse?
Stress-inducing Beliefs (SIB), or stress
inducing thinking errors
Some beliefs we hold can be self-defeating and
task-interfering and can then create or
exacerbate stressful situations.
If a person holds on strongly to an SIB, then when
an event occurs that does not live up to
expectations, this increases the pressure they
feel about it and stress may result
Examples of Stress Inducing
Things should be going smoothly
I must not get bored
I should get on with my family
Things never work out well for me
If things go wrong, those that are responsible are ‘stupid’, ‘useless’, ‘idiots’
If things go badly I ‘can’t stand it’
Notice how extreme these statements are and how often the words ‘should’ and
‘must’ appear in them.
Helpful challenging questions to counteract
a stress-inducing belief (SIB)
Where is the belief written?
Is it realistic?
Would my friends agree?
Does everybody share my attitude? If not, why not?
Am I expecting myself or others to be perfect instead of
fallible human beings?
Will it seem this bad in 1, 2 or 6 months time?
Am I exaggerating the importance of this problem?
Am I agonising over how things should be instead of
dealing with them as they are?
Am I taking things too personally?
If I can’t stand it, will I really fall apart?
Changing your behaviour to conquer stress
• Social support – research shows how important it is for our mental
health and strength to have a network of friends and family you can
relax with, turn to, talk to, take breaks with. This can be wide or
small as long as it feels right for you.
• Assertiveness –be assertive in your behaviour, as opposed to
aggressive or passive. Know your rights and develop and practice a
range of assertiveness skills
• Time management – you need to practice good management of
your time in order to avoid running out and pressure building up.
Some of this relates to practicing assertiveness above.
Improving your health to conquer stress – ways of
taking this into your own hands to combat the
threats described earlier
• Exercise
- anything vigorous check with GP
- grade into manageable chunks
- try to make it an enjoyable habit
• Nutrition
- aim for a healthy, balanced diet
- consider lifestyle changes (eg cutting out
- take obesity seriously
• Relaxation - various techniques including yoga,
massage, meditation, imagery