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"Stress is the combination of psychological,
physiological and behavioural symptoms that
people can experience when they are exposed
to any change in their lives which they perceive
as challenging and they perceive as being difficult
to cope with."


Anxiety and depression are serious, debilitating and all to common psychological health problems that cause untold suffering and pain to the people who are affected by them and also to their families. People who suffer with these health problems are vulnerable to suffering further relapses often precipitated by a stressful event or trigger, so it is vital to use all the strategies that are available to us to reduce the chance of relapse.

The great problem is that people are often just given a prescription, and as vital as this is, they are often not taught the psychological and physical strategies that can improve their resistance to anxiety and depression.

In physical medicine if you suffer a heart attack when recovering it is common practise to be referred to a cardiac rehabilitation course where you are taught strategies like relaxation, diet and stress management techniques because research has indicated that this will help to prevent you suffering a second heart attack. On the cardiac rehabilitation courses you are taught strategies like stress management, nutrition, and exercise. A similar approach to anxiety and depression would also help to reduce the chance of a relapse. Research has indicated that chronic levels of unmanaged stress can be a trigger or exacerbate the anxiety or depression. It makes no sense just to take medication without dealing with the factors that triggered the psychological health problem in the first place and the failure to deal with these factors is one of the reasons why some people suffer a second relapse of their anxiety and depression.

In the following pages you can learn the techniques for reducing stress in your life which not only help to reduce your risk of relapse but also as a consequence you can lower your risk of other physical health problems, as well as improving your quality of wellbeing. Even if stress didn't cause your depression, living with a chronic illness can be a stressful experience in itself and so learning the strategies will improve your stress resistance.

Research has indicated that the stress of living with a person who suffers anxiety and depression can increase the partners chances of also suffering anxiety and depression. So it would be helpful if all the family also followed this programme.

In order to manage our stress we have to have some knowledge of stress. In the next few pages we will provide you with the basics of stress management training that you should find useful in helping to reduce anxiety and depression.


Stress is a somewhat difficult concept to define largely because it's a uniquely individualistic and subjective experience. Even stress management professionals cannot agree on an acceptable single definition for what stress is. The term stress has become a misused and misunderstood term that means different things to different people and this is partly the cause of some of the confusion that surrounds stress.


It's a common belief that we need a certain amount of stress to be able to function. This isn't so, what we need is a certain amount of pressure, and pressure is not stress. Stress is the result of too much pressure.

Psychologist Cary Cooper from the University of Manchester Institute of Science and Technology, very aptly summed up the difference between stress and pressure when he wrote:

"Research has shown that there is a
physiological difference between
pressure and stress. A person experiencing
stress has higher levels of the various
stress hormones in their blood stream than
a person who merely feels challenged."
(Cooper C.L., Palmer S. (2000) "Conquer your Stress"
publishers: The Institute of Personel and Development)

Anxiety and depression are health problems that are far more severe than stress, but stress can be a factor in the development of these illnesses, or exacerbating their symptoms.


Stress, especially chronic stress, can cause a wide variety of symptoms in indviduals including the following:


Headaches, sweaty palms, sleeping problems, dizziness, back pain, neck and shoulder pain, palpitations, grinding teeth, increased infections like colds, flu, impotence, low libido, increased sensitivity to pain, itchy skin, more accident prone, fatigue, constipation/diarrhoea, pounding heart, pre-menstural syndrome, nausea, breath holding, hyperventilation, tight muscles.


Increased cigarette smoking, increased alcohol intake, decrease/increase in appetite, critical of others, increased spending, substance abuse, risky sex behaviour, withdrawing from relationships, impulsive behaviour, nail biting, poor hygiene, aggression, carelessness, hostility, impatience, difficulty relaxing, irritability, unkempt appearance, losing temper more easily.


Crying, edginess, ready to explode, anger, irritability, snappy, unhappy, moody, worries about health, mood swings, feeling more cynical, loss of confidence, tearful, SAD, increased pessimism, increased negative thinking, increased feelings of guilt, suicideal thoughts, often anxious for no reason, abrasive, hostile, blaming others.


Troubld concentrating, trouble thinking, memory problems, inability to make decisions, constant worry, loss of sense of humour.


Absenteeism, presenteism, poor time keeping, overworking, failure to delegate, difficulty with exams, fall in usual standards, sloppy work, more irritable with colleagues.


Some of the above symptoms can be caused by health problems like thyroid dysfunction, anxiety, depression, infection, etc., so it is vital that you see your GP and not to diagnose yourself as suffering stress. It's perfectly healthy to be affected by symptoms such as the above on an occasional basis, but if these symptoms persist and interfere with your life it would be wise to see your GP to rule out more serious health problems.


Every human being has an inherent built-in system of the body whereby part of the brain activates the autonomic nervous system to trigger a number of biochemical, hormonal and physiological reactions when we perceive that our sagety is threatened. These changes enable us to have greater strength to fight a threat or greater speed to run away from a threat.

This system, called the stress response or fight-flight response, is as old as the human race and was designed for us to deal with a physical threat by running away or fighting a physical threat such as being attacked by a wild animal like a sabre tooth tiger. Its a very valuable part of our defence system which has protected us and enabled us to survive to reach the state of evolution we have today. Without it the human race would not have survived. This system was designed to be triggered by a perceived physical threat which we could fight or run away from. By design, its use was meant to be short term and infrequently triggered. However, today we live in a vastly more complex society than we were designed to, the physical threats are by and large gone. However, they have been replaced by the infinitely more difficult to deal with psychologically based stressors. You can't fight or run away from chronic financial problems. The brain can't differentiate between a physical or psychological threat to our wellbeing and triggers the same biochemical, hormonal and physiological stres response, however this is an inappropriate response for dealing with chronic psycholoical stressors that mainly effect us in the 21st Century.

When we perceive a physical or psychological threat this triggers an alarm system in the brain called the hypothalamus which secretes a hormone called Corticotropin Releasing Factor (CRF). This triggers the pituitary gland to release a hormone called ACTH and this travels to the adrenal gland to cause the release of a stress hormone called cortisol. At the same time that the hypothalamus triggers the stress hormonal response, it also triggers electrically, nerve impulses travelling at 150 metres a second, the release of stress hormones from the adrenal gland called adrenalin and nor adrenaline.

These stress hormones cause widespread physiological changes that prepare the body to fight or flight, such as:

1. Our heart rate increases
2. Our muscles tense
3. Our blood pressure rises
4. Our breathing speedsup and swithces to chest
5. Blood is moved to muscles (an increase of 300%)
6. Blood is moved to important areas like brain and away from less important areas like digestion.
7. Our mouth dries up
8. We get sweaty clammy hands
9. Perspiration increases
10. Pupils dilate
11. Our senses of hearing become more acute
12. Digestion slows
13. Our blood clots more easily
14. Blood sugar levels rise
15. Blood cholesterol levels rise
16. We can think more quickly and clearly
17. Our spleen discharges extra red blood cells into the bloodstream.

These changes are excellent in the short term, but in the long term can undermineour psychological and physiological health. Once the stressor has gone our bodies are supposed to turn off the stres hormones and start to calm down, blood pressure falls, heart rate falls, muscles relax etc, etc, and our hormone levels return to normal. However in modern life, the stressors can go on for weeks,months even years. (Alice Domar has estimated that we trigger the stress response up to 50 times a day)


Mind Body Medicine Institute


1. Davis M., 2000, The Relaxation and Stress Reduction Workbook, New Harbinger inc.


A Comprehensive Report on Stress

How to Self Massage Part I

How to Self Massage Part II