I’m a GP – here are five signs you’re more stressed than you realise

Feeling stressed? You’re not the only one. Research has shown that 41 per cent of us label our predominant mood as “stressed” and half of us report feeling stressed at work. We are, in short, overwhelmed. Stress is a normal and appropriate physiological response to threat or pressure. And we actually need this biological response, so that if we experience an acute threat or need to adapt to an imminent challenge, we can respond in a way that keeps us safe, by eliminating or running away from the threat. This is the classic fight or flight response, which results in our bodies releasing chemicals such as adrenaline and cortisol, which act to increase our heart rate and blood pressure, raise our breathing rate, prepare our muscles for movement, and widen our pupils so we can see better. This is healthy, acute stress. Today, however, we perceive threats such as emails, phone beeps and bongs, someone hooting us in a car, being late for our train or the washing machine not draining properly as though we are in imminent life-threatening danger. These are obviously annoying frustrations, but our bodies and brains react as though something catastrophic is happening. And if we interpret enough of these everyday annoyances in this way, we will end up being chronically stressed. Shorts Chronic stress can also be caused by constant and overwhelming pressure, where our time, energy, skill sets or abilities are stretched too far. We may have busy work diaries or be asked to complete projects that just are out of our remit; we may have conflicting personal caring responsibilities that we just can’t meet at the same time as self-care; or we may experience massive life changes or events such as bereavement, financial problems, relationship breakdown or ill health, which mean we have to adapt rapidly to new circumstances. Sometimes it is easy for us to notice the amount of stress we are under, but most of the time, we are focusing so much on just surviving the onslaught that we don’t realise just how we are affected by everything. Stress means we can’t step out of the box we feel we are in, in order to reflect clearly on what is happening to us. The key is to increase such awareness early on, because then we can put in a pause to the cycle of trigger and stress, and prevent burnout. The sooner we get help, or realise we are demonstrating the more subtle signs of stress, the better. So, what are they? 1) Forgetting things and finding it harder to concentrate Chronic stress and anxiety reduce our ability to concentrate, and we can find it harder to deal with things changing, or take in new information. We may have less mental energy or reserve because our thoughts about our problems are churning over and over, or we just haven’t focused on what someone has told us and so are unaware. This can make things even more chaotic and stressful for us, because we become less mentally efficient and productive. Noticing this is happening can help us; we can take steps to reduce the load on our plates, delegate, ask for support from others, write things down, and break up larger problems into smaller, more manageable ones. 2) Sleep problems Stress affects both the quantity and quality of our sleep. We end up being on edge all of the time, and hypervigilant to everything. This means we have chronically raised cortisol and adrenaline levels, which affects our ability to fall asleep and to stay asleep. Poor sleep then makes us tired and less able to manage stress the next day, and so it goes on and we can develop a cycle of stress/sleep problems. We also tend to have fewer deep cycles of sleep and so we don’t get the physical or mental benefits. To break this, we can take some simple steps. A while before bed, get a notebook and write down all of the things you are worried about, or the things you need to do, because this can help your brain to rest. You can also make sure you have a better routine before bedtime that promotes relaxation and rest, with a warm bath, reading a book, soft lights and putting away devices, as well as breathing exercises. And if you find yourself waking at night and cannot sleep for 20 to 30 minutes, then get up and read or listen to some relaxing music before trying again. Stress can lead to sleep problems (Photo: Oleg Breslavtsev/Getty) 3) Irritability and impatience Stress often makes us snap at others, or we find that even the smallest thing sets us off on a tirade of worry and upset. This is because we don’t have any emotional reserve to tolerate any more. Our nervous systems are overworked and exhausted and so we don’t have the ability to dig deep for resilience or rational thought, and we react rather than respond calmly. We can also get irritable as a kind of defence strategy; it is sometimes easier to express anger than it is to address our fears about something. Be honest with yourself and take responsibility with others: tell them how you really feel, breathe and notice that you need to slow down and take a step back. When things are stressful, we often speed up to try to cope; instead, do the opposite. 4) Gut changes Stress can cause changes in appetite and our digestive systems, resulting in diarrhoea, stomach cramps, nausea, heartburn or lots of gas. Our fight or flight response can slow down our gut movement, because our bodies are focusing on other perceived more vital things, making our gut more sensitive. Our appetites can change in that we either eat more to give us a sense of emotional comfort, or we eat less because we feel less interested or we feel sick because of anxiety. Notice what is happening to your gut and get yourself checked out by your doctor, if you are worried, and ultimately find ways to relax and rest – that might be a new hobby, breathing exercises, mindfulness, meditation or time in nature, or exercise. 5) Diary dropouts When we are stressed, the first thing to go is our social life; we say no more often to friends, we stop going to do that hobby or activity that makes us feel good, and we start to prune our diaries for only what we consider to be “essentials”. This is understandable, but it is also self-sabotage; research shows that our friendships and relationships are our fail-safe when we are stressed. Hobbies and time out that takes our mind or body away from stress help us to relax and get perspective, and just being “functional” makes life even more miserable. It may be helpful to reduce the commitments you have, but make sure you keep those regular slots for friends, and for hobbies, and for free time for yourself, so you can look after you and have time to reflect on how you feel.