There are many things you can do to reduce stress and help your body and mind adapt to stress in a healthier way. Here are some stress relieving and relaxation techniques that have demonstrated beneficial effects on those experiencing chronic stress. Not everything works for everyone, but try different techniques and stick with what works best for you, for both stress management and general health and well-being. Remember, you’re never going to completely banish stress, because life is a big stressor in itself, but you can change how you react to stress and bring inner calm to many situations in your life. 

Acupuncture

Traditional Chinese philosophy states that our health is dependent on the free flowing movement of qi (life force energy) within the body. Stress, emotional trauma or any other emotional or physical problem disrupts this flow, causing pain, tension, stiffness and a myriad of health disorders. Acupuncture seeks to address these energy blockages by inserting the tips of fine needles into specific points on the body.

Research conducted by Butler et al (2005) on 55 patients suffering from stress-related emotional disorders found that acupuncture reduced the symptoms in all patients by 95.4%. In a 2002 study based in Scotland hospice staff were measured for stress using a psychological profile and tested again following four acupuncture treatments. A 44% reduction in stress was reported.

For more information on acupuncture see www.acunpuncture.org.uk.

Breathing

Breathing in oxygen is the essence of life. Our cells require oxygen for survival and their waste product, carbon dioxide must be expelled. Although breathing is an automatic process many of us have very poor breathing patterns that have a deleterious impact on our health and well-being.

When an individual is experiencing stress their breathing often becomes rapid and shallow. They use their shoulders, rather than their diaphragm to push air into and out of their lungs. This releases too much carbon dioxide from the blood. Continuous rapid, shallow breathing has been linked to fatigue, stress, palpitations, asthma, colds, panic attacks, indigestion and other health problems.

When a person is relaxed their breathing becomes slower and deeper, allowing them to inhale more oxygen. This is often referred to as diaphragmatic breathing, belly breathing or abdominal breathing. This refers to breathing into the lungs by flexing the diaphragm, rather than shallow breathing by flexing the rib cage. In doing this the lower abdomen expands when inhaling, rather than the chest.

The knock-on effects of proper diaphragmatic breathing can include:

• Lowered blood pressure.
• Reduction in stress hormones.
• Reduction in lactic acid accumulation in muscle tissues.
• Balanced levels of oxygen and carbon dioxide in the blood.
• Improved immunity.
• Greater energy levels.
• Sense of calm and well-being.

The diaphragm

The diaphragm is a dome shaped sheet of muscle that extends across the bottom of the rib cage. It separates the heart, lungs and ribs from the abdominal cavity, as well as performing a respiratory function. The top is located around 1.5 inches from the bottom of the sternum and supports the heart. The bottom of the diaphragm is attached around our lower ribs. When we inhale the surface of the diaphragm moves downwards and upwards as we exhale. If we take a correct, deep breath the diaphragm moves further down into the abdomen, allowing our lungs to expand more into the chest cavity and facilitating an increased intake of oxygen and release of carbon dioxide. As the diaphragm moves it massages the surrounding vital organs, promoting blood flow and peristalsis.

Overbreathing

If breathing is deep and fast, this can result in more carbon dioxide being expelled from the body and subsequent abnormally low levels of carbon dioxide in the blood. As a result the airways in the lungs narrow in attempt to counteract the loss of carbon dioxide. This is referred to as hyperventilation or overbreathing and can lead to breathlessness and dizziness. Asthmatics often chronically overbreathe.

The Buteyko Method focuses on breathing less, nasal breathing and relaxation. The method has been shown to reduce asthma symptoms in numerous studies. Between 1962 and 1982 thirty-five studies were conducted in Russia that demonstrated Buteyko as a safe and effective treatment for asthma and other breathing disorders. There have also been studies conducted in the West demonstrating its efficacy.

For more information see www.buteykobreathing.org

Click here for some simple tests to ascertain whether you are breathing correctly and breathing exercises that can help you to relax and reduce your stress levels.

Exercise

We all know that exercise keeps the body healthy but it’s also a fantastic way of reducing stress and relieving mild to moderate levels of depression. Researchers have found that physically active individuals are less likely to suffer from anxiety and depression than sedentary people. This is possibly because exercise elevates brain concentrations of the neuromodulator norepinephrine, which may help the brain deal with stress in a more efficient manner.

Often people claim not to like exercise, but it takes many different forms and there is something for everyone to benefit from. If you can’t stand the gym perhaps take up a sport such as badminton or tennis. If you prefer something gentler, try yoga, tai chi, qi gong, pilates or another more relaxing form of exercise. Even a brisk walk every day counts. The important thing is to get off the couch and get moving.

Hypnosis

Hypnosis or hypnotherapy is a trance-like state where your focus and concentration is heightened. It usually creates a feeling of calm and relaxation and is used to help people make positive changes. Either a qualified hypnotist can facilitate the experience, or an individual can practice self-hypnosis. It doesn’t work for everyone, but researchers conducting an imaging study of hypnotised individuals found that those who were susceptible to hypnosis displayed decreased activity in the parts of the brain associated with daydreaming.

In other research hypnosis was found to reduce stress symptoms in Irritable Bowel Syndrome sufferers. This resulted in a corresponding reduction in IBS symptoms. It has also demonstrated other benefits such as reducing pain from cancer and other chronic conditions.

Here is a simple self-hypnosis technique:

1. Sit in a comfortable position, in a quiet place, without distractions.
2. Choose a goal for yourself with an accompanying positive affirmation, such as “I am extremely calm and relaxed.” Avoid negative statements, such as “I’m not stressed,” which can be ignored by the subconscious and might in fact focus your attention on the word stress, thereby elevating the problem.
3. Begin breathing in and out through your nose, slowly. As you breathe in silently say to yourself “I am breathing in calm,” and as you breathe out silently say to yourself “I am releasing stress completely.” Spend at least a couple of minutes doing this.
4. Choose an environment that is calming and relaxing to you. Perhaps it’s a beach, a forest, a beautiful palace – whatever conjures peace and well-being for you. Perhaps it’s even a luxury spa where you can leave your worries behind. Imagine going deeper into this environment. Feel and see the colours more as you leave your regular surroundings behind. Imagine the sights, sounds and smells. If you are at the beach, perhaps you can hear the sea lapping at your feet and the sensation of beautiful warm white sand between your toes. If you are in the forest, you might hear the crunch of leaves under your feet, see the sun shining through the trees and warming the top of your head and hear birds singing merrily. If you are at a spa, the therapist may be talking to you in a calm voice before conducting a wonderful soothing massage with blissfully aromatic oils.
5. When you feel more relaxed, begin to repeat the initial positive phrase you chose for yourself. Think about the sounds and vibrations the phrase makes within your mind. Each time you repeat the phrase, feel your body let go and sink deeper into relaxation.

Tip: Personally, I have found that recording myself talking through a guided visualisation helps me. Before I go to bed I listen to the recording on an mp3 and it’s very much like being my own personal hypnotist. Try talking in a very soothing, relaxing voice. Speak slowly and deeply.

Meditation

Meditation is a wonderful way of relieving stress and boosting health and well-being. It has been shown to decrease levels of the stress hormone cortisol in healthy volunteers and in patients suffering from cancer. Meditation has also demonstrated positive effects in medical students, who often report high levels of stress.

In a study at Massachusetts General Hospital meditation was found to physically change the structure of the brain, thickening the regions associated with concentration, emotions such as compassion and sensitivity to external stimuli. Older participants who meditated were found to have less neural degeneration in one area of the brain, compared to those who didn’t meditate.

Meditation techniques

1. A really simple meditation technique is to focus your attention on your breathing, noticing the passage of the air into and out of your nostrils. Whenever your mind drifts, bring your focus back to the breathing.
2. Another easy meditation technique is to focus on a single object or word. For instance, you might place a beautiful vase in front of you, as you sit in a relaxed position and really notice the detail. Every time your mind drifts, bring it back to the object again.
3. Mantras can also be used during meditation. Chanting a single word repeatedly can help you to enter a meditative state. In the Japanese Shinto tradition words are believed to carry a spiritual energy, so by chanting them, you evoke that energy. You can start off with something simple like ‘OM,’ or ‘Haa.’

Qigong

Qigong (or ch’i kung) is an internal Chinese meditative practice that uses slow graceful movements and controlled breathing to promote the flow of qi (life force) energy within the body. There are numerous forms and it is practiced by millions of people around the world. Medical qigong is recognised as a standard medical technique in Chinese hospitals and is included in the curriculum at major universities in China. A study published Complementary Therapies in Clinical Practice, found that qigong reduces the symptoms of stress by having a positive impact on the sympathetic nervous system – a branch of the autonomic nervous system that becomes more active when stress is experienced.

Progressive Muscle Relaxation (PMR)

PMR is a useful techniques for stress relief and general well-being. The exercise involves tensing one muscle group at a time and then releasing the tension. For example, you can tense one leg - squeezing the muscles as tightly as you can and relax the muscles, then do the same with the other leg and work your way up the body until you have contracted and relaxed all the muscles within your body. This technique is often used at the end of yoga classes to relax the body. 

Reiki

Reiki is an energy healing modality originating in Japan where a qualified Reiki practitioner channels external universal energy into a client to promote health and well-being, and to work directly on any physical illnesses or emotional issues. Studies so far support the ability of Reiki to reduce anxiety and pain, increase relaxation, improve fatigue and symptoms of depression and heighten general overall well-being.

Reiki is very simple to learn in a two-day course. Click here for information on Reiki courses and Reiki treatments.

Visualisation

Our power to heal seems to often lie in our perception. Placebos work better if they smell medicinal and appear like pharmaceutical drugs. It’s even been found that we associate particular colours with different things. Blue placebo pills administered as sleeping pills had a much greater ‘sedative’ effect on patients than pink ones in one study, because the patients associated blue with calm and relaxation. Angina patients who received fake surgery in a study reported greater improvements than those who received real surgery, because the knowledge that they were having an operation was enough to ignite their expectation of a drastic improvement.

The mind is more powerful than we ever dare to imagine, after all we don’t use two-thirds of it, even more for some individuals. When we learn new things, though, the brain changes and grows thicker in certain areas corresponding to the newly undertaken activity. It’s not static.

Thoughts actually produce chemicals (many of these are called neurotransmitters), which when repeated enough activate genes on DNA, producing substances that create new connections between neurons (impulse conducting cells in the brain and nervous system that process and transmit information). So, our thoughts affect our genes. Other chemicals known as neuropeptides correspond with different emotions and attitudes and interact with neurons by affixing themselves to areas of the surfaces known as receptors. Neurons have different shaped and sized receptors to match different shaped and sized neuropeptides. These correspond with our different emotions and attitudes. When a neuropeptide sits on its relevant receptor specific messages are transported to the cells, which activate or deactivate certain genes. The genes in turn produce a protein, which may for instance, be a hormone that instigates repair within the body.

Say you had an injury and you were in a bad mood and feeling self-loathing because you believe you brought it on yourself, the neuropeptides associated with these emotions would activate specific genes with proteins being produced. Some genes may not be activated adequately because of the effect of your state of mind on the body and some may be deactivated (for instance the all important hormones that instigate repair). Your state of mind would then stop your body repairing at its optimum level. It’s actually been found that a number of genes are upregulated or downregulated by stress, which could cause adverse effects within the body, such as cell death for instance, instead of cell repair. In contrast, if you were completely relaxed and calm the body would repair more quickly.

The key is to make positive thinking a habit. Stress and emotional traumas can actually kill cells in certain parts of the brain, such as the hippocampus, but an enriching environment, certain therapies, talking to others about your problems and freeing yourself from that stress and those emotional traumas may regenerate the damaged areas – a process known as neurogenesis. Learning new skills may also have this effect.

Visualisation has proved beneficial to those who have suffered from strokes, spinal injuries, Parkinson’s disease, cancer, asthma, allergies, depression, hay fever, depression, heart conditions, blood pressure, arthritis, stomach ulcers, weight loss and numerous other conditions.

Remember, when you visualise yourself getting better, the brain and body responds accordingly. The key is to visualise the healing taking place within your body, to make the experience fairly light-hearted so the visualisation doesn’t cause you stress and to focus on the area of the body that needs fixing, to target the healing more accurately.

Click here for some easy stress-reducing visualisation techniques.  

Yoga

Yoga, which dates back over 5000 years, originated in India and encompasses physical postures, breathing control and meditation. The benefits of yoga are many and varied. Numerous studies have been undertaken on the benefits of yoga. Researchers in the UK examining the effectiveness of yoga in enhancing well-being and resilience to stress among university employees, found that those who had taken part in a six week Dru Yoga intervention (taking one 60-minute class per week) reported improvements in feelings of clear-mindedness, composure, elation, energy and confidence. Participants also reported increase life purpose and satisfaction and greater feelings of self-confidence during stressful situations. Yoga was also found to aid relaxation and diminish stress levels in cancer patients. Other reported benefits of yoga include:

• Weight loss.
• More positive self-image.
• General improvement in health and well-being.
• Increased fitness levels and flexibility.
• Reduction in back pain.
• Increased confidence levels.
• Improved sleep patterns. 
• Improved mood.

Hatha yoga, which focuses on purifying the physical body in order to purify the mind, is a good place to start for beginners because the movements are slow and the postures are easier to hold.  Yoga can be used for personal and spiritual development, as well as physical health and well-being, so it's well worth researching the different types of yoga to see what appeals to you the most. 

Stress is endemic and never completely avoidable but there are strategies to improve your coping mechanisms and reduce stress. Even if our external environment cannot be changed to enable us to better cope with stress, we can change the way we think and how we act. Think of it as maintaining internal equilibrium as the storm rages outside. Managing stress is most effectively achieved using a holistic approach that incorporates exercise, good nutrition, sleep, a positive attitude and perhaps even nutritional supplementation where necessary. Here are some suggestions for stress management to get you started.

Keep a stress journal

This can help you identify stress triggers in your life and they way you handle them. Write down what caused the stressful situation, how it made you feel, how you responded and what eased the situation. If you can identify the stressors in your life, it will be easier to develop a stress management plan. 

Ditch unhealthy stress ‘coping’ mechanisms

It might seem easy to drink ten cups of coffee or reach for the biscuit tin, but these habits cause more harm than good. Try to avoid the following as temporary stress relievers and look for longer term, healthier solutions:

• Smoking.
• Drinking too much caffeine (which can actually increase the production of the stress hormones cortisol and adrenaline).
• Drinking too much alcohol (which causes dehydration, a stressor which leads cortisol levels to rise).
• Eating packaged and processed foods or overeating.
• Spending hours in front of the television.
• Isolating yourself from friends and family.
• Using recreational or pharmaceutical drugs to relax.
• Sleeping excessively.
• Taking your stress out on others.

Learn to say no

Don’t take on more than you can handle, either in the workplace or at home. There is nothing wrong with saying ‘no.’

Pace yourself

Don’t rush to get everything done. Your concentration and focus will be better if you devote all your attention to one task at a time. Rushing will likely cause panic and anxiety, which will in turn lead to further stress and poor concentration. None of us are superhuman, our bodies require homeostasis, a state of balance, and demanding too much of ourselves can push our bodies over the edge. Take a step back and slow down.

Breathe deeply

In modern society it is very common for people to have very poor breathing patterns. Breathing really is the very essence of life and breathing in a shallow erratic manner can cause an array of harmful physiological reactions, such as the accumulation of carbon dioxide or lactic acid in the body. Take the time to think about your breathing patterns. Take a long, slow deep breath. If, when breathing in you find your shoulders lifting upwards then you are not breathing correctly.

Avoid people who make you stressed

Think about the relationships you have in your personal life with friends and acquaintances. If anyone is making your life difficult and consistently causing you stress perhaps it’s time to spend less time around that individual, or end the relationship.

Be prepared to make changes

Some stressors are easy to take control of. If drinking caffeine at night keeps you awake, thereby causing stress, don’t drink caffeine at night. If going to bed late causes you stress because of lack of sleep, go to bed earlier. If shopping makes you anxious, shop online instead. There are some things you can change quite easily. Make a note of these things and what you can do to make your life easier and reduce stress.

Make a list and cut it down

Assess your schedule and responsibilities and pare it down to the absolutely essential tasks. Eliminate anything that isn’t really important.

Express yourself

Find a way to diplomatically communicate your feelings to others in a respectful manner. Keeping your emotions bottled up will increase resentment and the situation will not be resolved.

See the positive

Try to look at situations with a positive slant. Perhaps there is a lesson to be learned, or perhaps you are actually being given an opportunity. If your train is an hour late, stressing about it won’t make it come any quicker. Take the time to relax and reflect. It may give you the time to make that to-do list!

See the bigger picture

Sometimes we get so caught up in our daily struggles that we forget to look at the bigger scheme of things. Ask yourself if all of your niggling worries are really important. If some of them don’t really matter, then focus your attention elsewhere.

Be kind to yourself

Don’t be hard on yourself. No one is perfect. Everyone makes mistakes. No one is immune to stress. If you demand perfection from yourself you will set yourself up for failure, because no human being is perfect, nor ever will be. Be accepting of yourself.

Relinquish control

We love to rigidly control our lives but fail so miserably at it. This is because we don’t have as much control as we’d like to think. The behaviour of others is beyond our control and our direction and path is often beyond our control. Learn to become more intuitive and let go. This will enable you to develop greater clarity. Accept life’s twists and turns and change the things you can change, without worrying about what you can’t.

Have some 'me’ time

Everybody needs to have quiet time by themselves to relax, contemplate and just to be. This can be a time where you do some gentle yoga, tai chi, meditate, have a relaxing bath, create your own home spa or simply sit down quietly and listen to some soothing music. This will enable you to develop greater clarity in your life and foster self-esteem, as you are giving yourself the respect and time you deserve. Additionally taking time out demonstrates a willingness to take responsibility for your own health and well-being, something we all need to do.

Eat healthily

Eating a healthy, balanced diet is so important. Processed, packaged and convenience foods are full of additives, preservatives, trans-fatty acids, artificial sweeteners, sugars, and other nasties that could leave you with a headache and a ton of stress. They are also low in nutritional value and fibre. Monosodium Glutonate (MSG) is a flavour enhancer added to many foods. A Harvard Medical School Researcher discovered in one study that nearly 30% of 1, 529 people reacted to MSG. Some of the study participants had emotional reactions such as depression and insomnia.

The important thing to remember is not to spend your life leaping from one diet craze to another but to adopt a healthy lifestyle. Make sure you get plenty of fruit and vegetables (organic if possible as these are richer in nutrients and are not grown in nutrient deficient artificial fertilizers then sprayed with pesticides).

Essential fatty acids cannot be produced by the body so need to be obtained from dietary sources. These include Omega 3 and Omega 6 EFAs. The EFAs perform important functions such as: maintaining cell membranes and regulating cholesterol levels. Foods such as fish oil, flaxseed oil, rapeseed oil and walnut oil along with green leafy vegetables are good sources of Omega 3 fatty acids. Omega 6 fatty acids can be found in foods such as: sunflower , safflower, wheatgerm, sesame and corn oil. Also be sure to get plenty of fibre in your diet from fruits, vegetables, legumes, grains, nuts, seeds and other healthy sources.

Some other key tips for tackling stress with nutrition include:

• Eat a healthy breakfast to set the tone for the rest of your day. Poached eggs, natural probiotic yoghurt, oatmeal, a green veggie juice with protein powder and sprouted rye bread are all good examples of a healthy, nourishing breakfast.
• Eat until your 80% full, rather than gorging on large meals, which will leave you feeling bloated and adversely impact on your digestion. 
• Make sure you are getting enough protein in your diet. Protein is needed by the body for our muscles, skin, hair and for our internal organs to function smoothly. If you eat meat and fish, opt for organic where possible. If you are vegetarian, goats milk and cheese and eggs are good sources of protein, as are legumes, nuts and seeds. 
• Drink lots of filtered or distilled water. Water makes up around three quarters of the human mass and is a major component in every cell. Water is absolutely vital to human health for numerous reasons. 

Make sure you do your research before embarking on any new dietary regime and consult a qualified health practitioner.

Get to a therapist

There are many complementary therapies out there that can soothe your stress away: acupuncture, aromatherapy, homeopathy, reflexology. Why not treat yourself to a few sessions with a professional complementary health therapist who can get to the route causes of your stress and help to empower you to make positive changes in your life. An American trial in 1993 demonstrated that reflexology reduced the participants PMS symptoms by 41% and a Danish study of migraine and tension headache sufferers found that reflexology helped 81% of the participants. Aromatherapy massage has been used on hospital patients to provide relaxation and relieve tension and stress.

Many people in modern society realise the benefits of complementary therapies and if they can squash your stress, you’ll be all the better off for it. 

Get regular exercise

Frequent exercise is one of the best methods of reducing stress, improving blood flow to the brain, helping eliminate toxins and releasing mood boosting endorphins that give you a greater sense of happiness and well-being. Exercise can also decrease stress hormones such as cortisol, divert your attention away from your problems to another activity, improve your appearance and skin tone, boost self-esteem, increase your health and improve your resilience to stress.

Get adequate sleep

Adequate sleep is crucial to proper brain function. Sleep deprivation has a negative impact on mental and physical performance. It has been reported that people who regularly get poor sleep can become less sensitive to insulin, increasing their risk for diabetes and high blood pressure. It is also suspected that inadequate sleep hastens the onset of aging, as well as diseases such as hypertension, obesity and memory loss. The hormone melatonin, which is a powerful antioxidant released by the pineal gland in the brain, gets to work during sleep, clearing out free radicals and other harmful toxins. Growth hormone, which is involved in tissue growth and repair is also secreted during sleep. 

The founder of modern stress research, Hans Seyle, suggested that stress is not completely avoidable, or else we would have to avoid life, which is of course an impossible task. The key is to understand what can be changed, develop skills to bring about change and know when to take a step back, avoid a situation or look for new, creative solutions to life’s problems. There is no single solution to stress in any walk of life, whether its origins are in the work place or our external environment.

Tackling stress requires thought, planning and action. Ignoring stress and hoping it will subside of its own accord is rarely an adequate solution. Below are some general tips on tackling work place stress.

Good time management

Focus on the tasks that matter. Think about what your priorities are in life and what you want to achieve. Work out some short-term and medium-term goals to help you achieve those things. If you have lots to do write a list – single lists are better than multiple lists, which can become overwhelming and unattainable.

Don’t forget to take a lunch break

Having rest will improve your concentration. Take regular short breaks throughout the day, wherever possible.

Delegate where possible

If something can be better handled by someone else then delegate. Relinquish the desire to control every aspect of your work. Sometimes we all need help, that is why most businesses consist of teams rather than a single individual.

Know when to say no

Don’t take on too much and realise that you do have a choice. It may be useful as a short-term strategy but becoming the employee who ALWAYs says yes can have negative consequences for you in the long-term.

Arrive earlier at work

If you can, get to work a bit earlier to give you more time to settle down and get stuck into your work, rather than running late, which causes stress in itself.

Don’t stay silent

Speak to your manager or another team member if you are feeling under pressure, or find an outside organisation that can help. Don’t suffer in silence. Under the Health and Safety at Work Act 1974 your employer is obliged to ensure your health and safety, and conduct risk assessments for work-related stress.

Deal with bullies

If you are being bullied at work, explain to them that their behaviour is unacceptable and making you feel uncomfortable. Explain that if it happens again you will take action. Remain composed and calm and note down the times and dates when incidents took place, what witnesses were present and what events occurred. Ask your colleagues if they are also having problems with the individual. If you are a member of a union you can talk to a representative who will be able to help you. Be sure to go through official channels and if you require counselling or other help speak with your doctor.

Whilst there is no statute specifically covering stress in the workplace, employers are expected to fulfil certain duties under the:

Management of Health and Safety at Work Regulations 1999, to assess the risk of stress-related ill health caused by work activities.

Health and Safety at Work Act 1974, to undertake measures to control any risk.

Disability Discrimination Act 1995, to ensure that those with a disability are not discriminated against. In some cases 'anxiety', 'stress', and 'depression', may qualify an individual as disabled under the act, if there is a long-term impact on their ability to perform day-to-day tasks at work. 

Protection from Harassment Act 1997, to protect against bullying in the workplace. 

There are also other regulations requiring employers to consult their employees on health and safety matters.

HSE Management Standards

The HSE has developed voluntary Management Standards to help reduce levels of work related stress among British employees and aid employers in measuring their performance in managing the causes of stress, as while as identifying areas for improvement. Developed in 2004, these standards encourage employers to take steps to prevent stress by taking a risk assessment, which usually involves questioning employees about job satisfaction within the six areas delineated below. If any problems are identified, employers should then discuss solutions with their employees. The organisation then needs to establish an action plan detailing measures that will be taken. 

The primary sources of stress at work delineated by the standards are:

For more information on stress at work see www.hse.gov.uk and www.acas.org.uk.

What employers can do to tackle work related stress

• If workloads are too high consider how they might be reduced and ensure that targets are realistic. Encourage delegation of work where possible.
• Keep employees informed to reduce uncertainty about jobs.
• Be communicative and approachable.
• Ensure staff are using their holiday entitlement.
• Ensure employees are suited to their roles.
• Ensure employees understand what their roles require of them.
• Review people’s performance so you can identify areas where extra training is required.
• Encourage employees to discuss any problems with you and offer them opportunities to give feedback about their work.
• Offer reward and recognition for a good work performance.
• Provide opportunities for career development.
• Ensure that effective disciplinary and grievance procedures are in place to deal with bullying and harassment.

Work/life balance programs that aim to tackle stress among employees have demonstrated numerous benefits such as:

• Attracting new employees.
• Retaining staff.
• Increasing diversity in skills and personnel.
• Increasing morale.
• Reducing sickness and absenteeism.
• Improving working relationships between colleagues.
• Encouraging employees to demonstrate more commitment and teamwork.
• Increasing productivity and satisfaction.
• Reducing stress and ‘burnout’.

Helping employees with stress outside work

Employers are not obliged to do anything about the stresses employees are experiencing outside work, but offering support can be useful. Some of the following things may help:

• Be sympathetic and allow the employee to voice anything they wish to discuss with you.
• Consider offering the employee the option of more flexible working hours or even paid time off to resolve their problems if necessary.
• Suggest outside support groups.
• Make the employee aware of support offered by your organisation that may be able to help them, such as:

1. Childcare services.
2. Fitness and stress programs.
3. Family leave policies.
4. Eldercare initiatives
5. Referal program to relevant organisations.
6. Other leaves of absence.
7. On site seminars and workshops (on subjects such as stress, nutrition, smoking etc).

Most people spend the best part of the day at work and this is where stress often becomes a major problem, for both employers and employees. According to the 2008/09 Labour Force Survey (LFS) an estimated 415,000 individuals in Britain, working in the last year, believed that they were experiencing work related stress at a level that was making them ill. Estimates from the LFS suggest that self-reported work related stress, depression, or anxiety accounted for around 11.4 million lost working days in Britain in 2008/09 (Source: Health and Safety Executive.) In fact, work related stress is one of the biggest causes of sick leave. The HSE define stress as,

The adverse reaction a person has to excessive pressure or other types of demand placed upon them.

A distinction is made between pressure that acts as a motivating factor and stress, which relates to excessive pressure. Stress in itself doesn’t constitute an illness, but prolonged, excessive stress may contribute to or cause illness. 

No one is completely immune from stress and whether the stress originates from our home life or work environment, it still has an impact on our working life. 

• Poor working conditions
• Long working hours
• Relationship with colleagues
• Victimisation or bullying
• Lack of job security and stability
• Difficult commute to and from work
• How the company is managed
• Inability to cope with a heavy work load
• Insufficient workloads
• Lack of control
• Lack of a clear job description
• No recognition or reward for good performance
• No opportunity to voice complaints
• Weak or ineffective management
• Inflexible working hours
• Too much or too little responsibility
• Working in an unhealthy environment

Symptoms of stress include:

• Anxiety and irritibility.
• Mood swings.
• Paranoia.
• Increased blood pressure.
• Sweating.
• Muscle tension.
• Dry mouth.
• ‘Butterflies in stomach’.
• Difficulty concentrating and making decisions.
• Headaches, palpitations or hot flushes.
• Shaky hands.
• Dry mouth.
• Difficulty sleeping.
• Waking up during the night.
• Excessive intake of alcohol, caffeine, cigarettes or unhealthy foods.
• Tics such as hair pulling or scratching.
• Tearfulness, depression or suicidal feelings.
• Chest pain.
• Loss of appetite.
• Diarrhoea or constipation.
• Loss of sex drive.
• Worsening of skin or breathing conditions.

Work Stress and Mental Health

Work related stress and mental health are interwoven and work related stress may exacerbate or even activate an existing mental health problem that the individual would otherwise have effectively handled, without it impacting adversely on their work. Mental health problems and stress can have different causes. Stress may be related to events at work, where as mental health problems may arise through external causes, such as divorce or bereavement. The symptoms of both are often similar and it is difficult to distinguish when stress transcends into a mental health problem. A GP will usually make the relevant diagnosis.

Signs of stress among employees:

• High absenteeism and sick levels.
• Low morale and commitment.
• Poor performance and productivity.
• High staff turnover.
• Customer complaints.
• A possible increase in accidents.

By taking steps to reduce stress among your employees you can mitigate the impact of these problems.

If stress becomes chronic it can have numerous detrimental effects on our health and well-being, both on a physical and psychological level. Below are just some of the conditions and health issues that have been linked with chronic stress:

Aging

Stress accelerates the aging process, affecting molecules that play a key role in cellular aging. A study published in 2004 in the November 30 issue of Proceedings of the National Academy of Sciences, found that chronic stress and perception of stress have an impact on the length of telomeres (that cap the end of chromosomes and protect the DNA from damage), the activity of telomerase and levels of oxidative stress, in healthy premenopausal women. Every time a cell divides the telomeres shorten and eventually it diminishes so much that the aged cell stops dividing. When cells die our health deteriorates. This is a common feature of growing older. Telomerase is an enzyme that replenishes a portion of telomeres with each cell division, offering a protective effect. Oxidative stress causes DNA damage, which hastens the shortening of telomeres.

The study involved 58 mothers between the ages of 20 and 50. 39 of these were mothers of a chronically ill child and the other 19 'controls' were mothers of healthy children. One of the study's key findings was that more years of care giving, resulted in shorter telomeres, lower telomerase activity and greater oxidative stress. In addition, the telomeres of women with the highest perceived psychological stress had undergone the equivalent of 10 years of additional aging, in comparison with the women across both groups who had the lowest perception of being stressed. 

“The results were striking,” says co-author Elizabeth Blackburn, PhD, Morris Herzstein Professor of Biology and Physiology in the Department of Biochemistry and Biophysics at UCSF. “This is the first evidence that chronic psychological stress—and how a person perceives stress—may damp down telomerase and have a significant impact on the length of telomeres, suggesting that stress may modulate the rate of cellular aging.”

Numerous studies have solidly demonstrated a link between chronic psychological stress and indices of impaired health, including cardiovascular disease and weakened immune function,” says lead author Elissa Epel, PhD, UCSF assistant professor of psychiatry. “The new findings suggest a cellular mechanism for how chronic stress may cause premature onset of disease. Anecdotal evidence and scientific evidence has have suggested that chronic stress can take years off your life; the implications of this study are that this is true at the cellular level. Chronic stress appears to have the potential to shorten the life of cells, at least immune cells.”

Depression

Thought to be due to the continuous release of the stress hormone cortisol by the adrenal glands, resulting in a serotonin imbalance.

Damaged Immune System

Stress can have an extremely deleterious impact on the immune system, which has wider implications for the overall health of our bodies. Stress can:

• Suppress the immune system's response to infections. There have been some studies demonstrating that people suffering from chronic stress have low white blood cell counts. This makes them more susceptible to colds and infections.
• Stress can trigger the release of cytokines (protein molecules released by the immune system to cause a reaction in other cells) in the body, causing an inflammatory response throughout the body. As a result of this the the adrenal glands produce cortisol and other glucocorticoid (anti inflammatory) hormones to suppress the immune system and inflammation reactions once the infection has cleared. However, in cases of chronic stress the cortisol levels remain continuously elevated so the immune system is constantly being suppressed.
• Conversely in some situations stress can generate an overactive immune system, increasing the risk of developing autoimmune diseases (where the immune system attacks your own body). In addition stress can aggravate the symptoms of autoimmune disorders that are already in existence.

Some studies on animals have demonstrated that excessive levels of stress had detrimental effects on the functioning of the immune system and was a contributing factor in tumour growth. Stress can also lead to self destructive behaviour (such as drinking alcohol, drug taking, poor diet), which could potentially contribute towards developing cancer.

Allergies

Stress can make allergies worse by impairing immune system function, either by suppressing it or making it overactive. Stress can also aggravate skin conditions such as: eczema, psoriasis, dermatitis and acne.

Insomnia

Stress can cause insomnia as someone who is chronically stressed will often lay awake thinking about their problems. In turn sleep deprivation then causes further stress and may result in an impaired nervous system function. Sufferers of insomnia may feel extreme fatigue, irritability and poor memory amongst other symptoms.

Memory Problems

The immediate effect of stress can prove detrimental to our short term memory. Chronic stress can cause loss of concentration in sufferers along with a tendency to be more accident prone. Some studies have demonstrated that prolonged exposure to the stress hormone cortisol can lead to the hippocampus (vital for long term memory storage) shrinking.

Sexual and Reproductive Problems

Stress can result in a decrease in sexual desire, impotence in men and an inability to orgasm in women. Stress can also diminish fertility, interfering with the ovulation process. Stress hormones adversely affect the hypothalamus (which regulates the ovaries amongst other things). Stress can also stop menstruation completely.

Pregnancy Problems

Stress can interfere with adrenal hormone levels or resistance in the arteries in a pregnant woman, which can affect the blood flow to the placenta. Stress during pregnancy has been linked with a higher risk of miscarriage, premature births and low birth weights. This is said to be due to the presence of high levels of Corticotropin- releasing hormone in the blood, which encourages early births. There has also been evidence that stress in a pregnant woman can affect the way the baby's brain and nervous system respond to stressful situations.

Cardiovascular problems 

Stress can cause blood vessel constriction, palpitations and 'sticky' blood, elevating the risk of blood clots and high cholesterol - due to the impaired metabolism of fat deposits and the release of cytokines causing damaged arteries. Stress is one of the main causes of high blood pressure. Recent studies have also demonstrated how high stress levels can increase the risk of a stroke. 

Headaches/ Joint and Muscular Pain

It has been said that stress can increase chronic pain caused by various conditions. Stress can also cause headaches, especially stress caused by emotional traumas. The stress hormone cortisol can also damage the nervous system and hamper the ability of neurons (nerve cells) to survive oxidative stress, causing nerve cell death.

Digestive Disorders

The brain and intestines are highly connected and the enteric nervous system regulates gastrointestinal motility. Stress can delay the production of stomach acid and digestive processes, slowing or even halting digestion. Prolonged stress can irritate the gastrointestinal tract and cause problems such as: diarrhoea, constipation, cramping and bloating. Stress has been linked with: Irritable Bowel Syndrome, Peptic Ulcers, Ulcerative Colitis, Crohn’s Disease and Leaky Gut Syndrome.

Eating Disorders

Stress elevates cortisol levels which can potentially cause cravings for sugary, salty or fatty foods to relieve tension. This  results in weight gain. This can then cause feelings of low self esteem in the sufferer, increasing stress levels and resulting in further comfort eating. Studies have shown that the release of the stress hormone cortisol seems to encourage the accumulation of fat in the abdominal area around the liver and other vital organs.

Stress can also cause a reduced appetite, therefore cause weight loss and in some cases an overactive thyroid.

Diabetes

Stress has been linked to diabetes as it can effect how the body utilises insulin to regulate blood glucose levels, causing persistent high blood glucose levels. During periods of chronic stress the body starts to break tissue down for energy and blood glucose levels rise. Consequently, the pancreas releases insulin - a hormone that is central to regulating the energy and glucose metabolism in the body. However, cortisol hampers the effects of insulin, leading the pancreas to pump out even more insulin. The body becomes less sensitive to its effects, resulting in insulin resistance and high blood glucose levels, both implicated in type 2 diabetes. 

Throughout our lives we are constantly subjected to stressful situations and emotional traumas, starting with being separated from our mothers at birth. We then experience stress when we are hungry and need changing or a hug and as we grow up our interactions with other people generate stress such as: gaining parents and peers approval, pressure to succeed at school, work or in other areas of life, forming relationships and relationship breakdowns, bereavement, personal or family health problems. If our work and home lives are creating conflicting demands excessive stress may prevail.

Common causes of stress include:

• Work life
• Finding work
• A job promotion
• Unemployment
• Commuting
• Environmental factors (such as external toxins, tobacco, pollution, alcohol, food)
• Bereavement
• Divorce of separation
• Holidays
• Ill health within the family
• Exams
• Moving house
• Driving
• Shopping
• Having children
• Children leaving home
• Caring for dependents
• Money worries
• Changes in personal habits e.g. going on a diet, giving up smoking
• Illness and injuries

Our survival depends on how we respond to physical and social demands. Long-term exposure to stress hormones can have very negative consequences.

There are two instinctive stress responses, fight or flight and general adaptation syndrome.

Fight or Flight is an essential means of survival. In threatening circumstances our bodies release hormones that help us to act rapidly and escape the dangerous situation. These include elevated heart rate and blood pressure and increased oxygen and blood to activate vital muscles. This phenomenon was first described by physiologist Walter B. Cannon, as a series of biochemical changes preparing you to deal with danger. Primitive man required bursts of energy to fight or escape from predators. Once the short-term stress has ended the body returns to a normal state.

In modern times this form of stress has become far less useful to us. We don’t experience the same threats as our primitive ancestors and short-term stress often turns into longer-term chronic stress leaving us unable to make effective and focused decisions.

General Adaptation Syndrome refers to the reactions caused by longer-term exposure to stress. This was identified by the first major researcher on stress Hans Seyle, a Canadian endocrinologist.

In studies on animals that were put under extremely stressful circumstances, including subjection to blaring light, loud noise and extreme temperatures, the animals reacted in three stages:

1. Alarm phase- where they react to the stressful situation. In the alarm phase stress hormones known as catecholamines (adrenaline and noradrenaline) and glucocorticoids (cortisol) are released. Secreted by the adrenal glands these hormones put the body in a catabolic state, where glucose, fats and amino acids are broken down to release energy. This is the fight or flight situation and the heart rate, blood pressure and oxygen levels increase to improve performance.
2. Resistance phase – resistance to the stressor increased as the animal adapted to and coped with it. The body attempts to adapt to the presenting demands, although this becomes increasingly difficult. 
3. Exhaustion phase – entered into once resistance was exhausted. The body can no longer maintain a balanced state and normal functioning. 

Rats exposed to constant stress in research conducted by Seyle presented enlarged adrenal glands, gastrointestinal ulcers and wasting away of the immune system. In further studies persistent stress caused the animals to develop diseases similar to those seen in humans, such as strokes, heart attacks, kidney disease and arthritis. 

We often hear of individuals suffering from ‘adrenal fatigue’ or ‘burnout’, reaching a stage where they can no longer withstand the stresses they are experiencing. Humans experiencing chronic stress often present health problems such as adrenal problems, weakened immune system and digestive disorders.

Seyle used the term stress to refer to the body's reaction to a situation and 'stressor' to refer to the stimulus. 

Hans Seyle also differentiated between good stress and bad stress. Good stress protects us in times of danger and enables us to meet life’s challenges. Bad stress is when a person constantly experiences stress, leading the temporary fight or flight responses to occur more frequently or even continuously. This can damage our health and cause illness.

There is no concrete definitive definition of stress, because knowledge within this area is constantly evolving. The term is ubiquitous but its meaning is rather an unknown quantity. Definitions of the term ‘stress,’ differ depending on the source, but most of us consider ourselves to have experienced stress. Indeed, with our fast-paced lifestyles and increasing work demands, stress has become endemic and how we manage stress is crucial to our happiness and well-being. 
 
In the eighteenth century and earlier what we might today call stress was often referred to as “passions,” such as nerves and hysteria, and used as explanations for various illnesses. Scientists of the time highlighted the faster pace of life and the subsequent impact on health. Even in the nineteenth century there were concerns that our human nervous systems were not well-adapted to cope with increasingly complex modern lives. During this period it became a common belief that the stresses and strains of life could bring about mental disease. This belief is still commonly held by many.

One of the most commonly accepted modern definitions is that,

Stress is a condition or feeling experienced when a person perceives that demands exceed the personal and social resources the individual is able to mobilise.

Lazarus and Folkman define stress in a similar tack as

A particular relationship between the person and the environment that is appraised by the person as taxing or exceeding his or her resources and endangering his or her well-being.

If individuals feel they cannot cope with expectations or demands required of them, they experience stress. Coping means balancing the pressures placed on you with your capabilities and the resources available to you.

Although stress is often linked to excessive demands, it can also be caused by having limited demands, leading people to experience boredom and a sense of being undervalued.

It’s important to remember that not all stress is bad. Most individuals require a level of pressure in order to succeed and remain motivated. This is often referred to as positive stress. Challenge energises us and when we meet a challenge our well-being is increased, but when this transforms into a situation where demands cannot be met and exhaustion prevails, we experience chronic stress.