Understanding Stress

This page gives some resources about stress

and how it impacts our health and well-being.


March 2020 site update – this site has been fully updated to provide specific well-being support for the current home confinement period


  

THE SECTIONS below the image GIVE INFORMATION ABOUT:

1. Symptoms of stress and emotional distress.

2. Specific stresses delivered in the current COVID-19 period.

3. The neuroscience of stress – information about different types of stress.

4. Stress from Adverse Childhood Experiences.

5. Therapeutic support for working with stress and emotional distress.

6. How to start your well-being journey on this site.



1.Symptoms of stress and emotional distress

Stress and emotional distress symptoms can include:

  • Not being able to concentrate
  • Problems sleeping
  • Restlessness
  • Constant worrying
  • Avoiding specific situations
  • Being critical of yourself
  • Having strong emotions that feel overwhelming
  • Not being able to relax or “switch off”
  • Finding it difficult to trust yourself or others
  • Challenges in expressing, regulating and managing your emotions
  • Anxiety and depression
  • Hypervigilance
  • Restricting positive life activities due to fears, worries or anxieties
  • Undermining yourself
  • Feeling emotional pain, for example from anguish, distress, embarrassment, fear and shame
  • Feelings of rejection and worthlessness
  • Low self-esteem
  • Negative self-talk
  • Hopelessness

Emergency situations are very stressful and challenging times, and we are likely to experience a range of stress and emotional distress symptoms.

 


2. Specific stresses delivered in the current COVID-19 period

mancovidsocialisolation1In the current coronavirus (COVID-19) period, there are additional features from this uncertain and challenging situation that deliver additional mechanisms for increased stresses. In the current situation everyone is being exposed to additional dimensions of stress, which include:

  • The stress is unpredictable. Animal research shows that animals that could anticipate a stressor — for example, they received a shock after a light turned on — were less stressed than animals that received the same number of shocks randomly. The same is true in humans. If a person can anticipate stress, it is less damaging than stress that appears to be more random. In the current COVID-19 period, it is difficult to have the knowledge and experience to anticipate what we are going to face, and to anticipate.

  • There is no time limit on the stress. If you are stressed about a presentation at work or an upcoming exam, the stress you are experiencing has an end point when you know you will get relief. If the stress has no end point — for example, as in the specific COVID-19 period — it may be more challenging to cope with.

  • You lack support. If you feel supported during your stress, you are likely to weather it more successfully than if you don’t. So reach out, get connected, and get support. It’s vital for our well-being in the current COVID-19 situation.

In an emergency situation, it is common to feel stressed and worried. It is normal to feel sad, distressed, worried, confused, scared or angry during a crisis. Emergencies are always stressful. We may feel helpless, powerless, lonely and depressed. The World Health Organization offers the following health behaviours advice:

coping-with-stress

On a more positive note, some people may have positive experiences in an emergency situation, such as pride about finding ways of coping and resilience. Faced with disaster, community members often show great altruism and cooperation, and we may experience great satisfaction from helping others (World Heath Organization 2020).

schedule1Another way forward in the current COVID-19 period is to establish some control over your situation. If stress isn’t predictable, focus on controlling the things that are. “Having a routine is good for development and health,” says Dr. Kerry Ressler, professor of psychiatry at Harvard Medical School. Predictability combats stress. So, especially when facing home confinement, create a daily schedule and routine for you to work through, with a range of activities for you to complete. We can differentiate our weekend schedule from our weekday one, if we are in home confinement. This helps us to mark the passage of time, sustains our interests, and also helps us stay with a routine. Without having a routine in the current situation that can sustain us, we can quickly become overwhelmed by stress and emotional distress, potentially feeling hopeless, powerless and depressed. This risks our self care and health.

carrying1The types of specific stresses from COVID-19 can also make it more difficult for us to have the strength to carry or support the people we care about. We may need to provide extra support, as well within challenging situations. We may become worn out from all of these stresses. We may have a long journey ahead for  each of us.

The resources on this site can act as protective factors, so we can strengthen our well-being, and pace ourselves in this challenging time.

Confinement and domestic violence risks

A further point to be aware of here is that the specific stresses from confinement can present many risks to people, which is why this site is focused on helping to manage our stress and emotional distress. For example, there is the potential for people living in close confinement with each other during COVID-19 to experience accentuated tensions, stresses and distresses that impact behaviours and relationships very negatively. Worst case this may lead to increasing levels of domestic violence across the UK during COVID-19, with more severe outcomes. Signposting for help with Domestic Violence: for any domestic violence situation in the UK, you can call 999 then press 55. This will transfer your call to the relevant police force who will assist you without you having to speak. There are also specific resources on the UK Home Office website to give support in this situation. Here is the government link: Coronavirus (COVID-19): support for victims of domestic abuse

KEY SOURCE INFORMATION:

  • The SOURCE in this section about additional stress factors is from Harvard Medical School, from Dr. Kerry Ressler, professor of psychiatry at Harvard Medical School. This source information has been reviewed and then applied to the current COVID-19 situation by the mental health consultant and researcher who maintains the Well-being Doc site.

4. The neuroscience of stress.

stress1Extensive research on the neuroscience of stress now shows that healthy development can be derailed by excessive or prolonged activation of stress response systems in the body and the brain, with damaging effects on learning, behaviour, and health across the lifespan.

Using a conceptual framework about different types of stress and their impacts is helpful in understanding the neuroscience of stress.

Positive stress refers to moderate, short-lived stress responses, such as brief increases in heart rate or mild changes in the body’s stress hormone levels. This kind of stress is a normal part of life, and learning to adjust to it is an essential feature of healthy development.

Tolerable stress refers to stress responses that have the potential to negatively affect the architecture of the brain but generally occur over limited time periods that allow for the brain to recover and thereby reverse potentially harmful effects. Tolerable stress responses may occur as a result of the death or serious illness of a loved one, a frightening accident, persistent discrimination, or other serious events, but always occur in the context of ongoing, supportive relationships. In the absence of supportive relationships the stress can become toxic to the body’s developing systems.

stressbrain1Toxic stress refers to strong, frequent, or prolonged activation of the body’s stress management system. Stressful events that are chronic, uncontrollable, and/or experienced without having access to positive support relationships tend to provoke these types of toxic stress responses. Studies indicate that toxic stress can have an adverse impact on brain architecture.

Extreme exposure to toxic stress can change the stress system so that it responds at lower thresholds to events that might not be stressful to others, and, therefore, the stress response system activates more frequently and for longer periods than is necessary, like revving a car engine for hours every day. This wear and tear increases the risk of stress-related physical and mental illness.

Stress and the architecture of the brain. The capacity to deal with stress is controlled by a set of interrelated brain circuits and hormone systems that are specifically designed to respond adaptively to environmental challenges. When an individual is threatened, this system sends signals to the brain that trigger the production of brain chemicals, as well as stress hormones that are sent through-out the body and cue the brain to prepare the individual to respond adaptively to threat. A poorly controlled response to stress can be damaging to health and well-being if activated too often or for too long.

Human brain development is a prolonged process that begins in the gestational period and extends through to late adolescence, as well as throughout the lifespan.

This is why it is important to understand the impact of stress on our well-being, and to take active steps to help support ourselves and others in stressful times, like COVID-19.

MAIN SOURCE: Harvard University 2014.


4. Stress from Adverse Childhood Experiences.

neglect1Stresses from Adverse Childhood Experiences. Many adults have experienced traumatic experiences that occur before the age of 18. For some of those adults where these traumatic experiences are still remembered, and are still currently having a negative impact in adulthood, these are termed “Adverse Childhood Experiences” (shortened to “ACEs”). ACEs can cause chronic stress on individuals in childhood, which may continue into adulthood. ACEs are significant barriers to mental health and well-being, that can erode the quality of life for some adults. For more details, please click on this ACEs information sheet link here. During COVID-19 there is the potential here for a disproportionate increase in the impact of stress for individuals who have experienced ACEs. Individuals may already have had their stress response activated for a long period of time prior to COVID-19, meaning increased vulnerability to negative stress outcomes.


5. Therapeutic support for stress and emotional distress

aerial-air-travel-blue-756799There are a number of scientific evidence-based psychological therapies (drawn from the third wave of Cognitive Behaviour Therapy) that are designed to address these types of barriers to our well-being. These therapies include Acceptance and Commitment Therapy, Dialectical Behaviour Therapy, Mindfulness-based Cognitive Therapy and Meta-cognitive Therapy (Hayes and Hofmann 2017). These therapies can help provide protective factors and resilience to cope with the consequences of the negative impacts of stress and emotional distress due to stressful life experiences. This site draws on these evidence-based psychological therapies, as well as from psychology, neuroscience and public health, and include a socio-ecological systems perspective.

The Finding Resilience and Recovery page gives some examples of the specific barriers to resilience in the context of stress and emotional distress, which these therapies target for each person’s resilience and recovery. All of the resources on this site are designed to help strengthen your protective factors and build your resilience.


6. Starting your well-being journey

Your  journey begins with choosing a resource page on this site, and working through it 🙂

Go to the Explore Well-being page on this site, which has the full site index on it. Pick a page and use the resources on it for your well-being.  Each day practice the activities you have chosen to complete, like a regular exercise activity. You will build your resilience and coping skills as part of this journey.

This site will be being regularly updated given the current COVID-19 situation, to add more resources and information to help support you in this challenging time. 

bloom-blossom-field-36032

 


References

Crane, R.2017. Mindfulness-based Cognitive Therapy. London and New York. Routledge. 

Fisher, P. 2009. Metacognitive Therapy. London and New York. Routledge. 

Flaxman, P.E., Blackledge, J.T. and Bond, F.W. 2011. Acceptance and Commitment Therapy. London and New York. Routledge.

Hayes, S.C. and Hofmann, S.G .2017. The third wave of cognitive behaviour therapy and the rise of processed-based care. World Psychiatry, 16 (3), pp.245-246.

The Home Office. 2020. Guidance. Coronavirus (COVID-19): support for victims of domestic abuse. Available at: https://www.gov.uk/government/publications/coronavirus-covid-19-and-domestic-abuse/coronavirus-covid-19-support-for-victims-of-domestic-abuse

National Scientific Council on the Developing Child. 2014. Excessive Stress Disrupts the Architecture of the Brain.Massachusetts: Harvard University.

Neenan, M. 2018. Developing Resilience. London and New York. Routledge.

Resilience Research Centre. 2019. What is Resilience? Nova Scotia. Dalhousie University. 

Ressler, K. 2018. Harvard Medical School. Protect Your Brain from Stress. Massachusetts: Harvard Health Publishing.

Stiles, J. and Jernigan, T.L. 2010. The basics of brain development. Neuropsychology Review, 20 (4), pp. 327-348.

Swales, M.A. and Heard, H.L. 2017. Dialectical Behaviour Therapy. London and New York. Routledge.

World Health Organization. 2020. Coping with stress during the 2019-nCov outbreak. Geneva. The World Health Organization.

Ungar, M. 2008. Resilience across cultures. Social Work, 38 (2), pp. 218-235.

Ungar, M. 2011. The social ecology of Resilience. American Journal of Orthopsychiatry, Vol 81(1), pp. 1-17.