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Stress

Stress is often described as feeling overloaded, wound-up, tense and worried, and occurs when we face a situation we feel we can’t cope with.1

While stress is usually referred to as a negative experience, not all stress is bad. Some stress can be helpful, motivating us to get a task finished, or spurring us to perform well.

However, if stress is ongoing or the stress response continues over a long period, the effects of stress can impact negatively on our physical and mental health.2

Types of stress

There are different types of stress, defined by the duration and intensity experienced.

Acute stress

Acute stress is stress that lasts only for a short period of time. This includes situations such as sitting an exam, starting a new job, giving a speech, or being faced with a work deadline.

The body typically bounces back well from acute stress if the stress experienced is managed by the person.Acute stress in the form of mild challenge can even be beneficial as it provides the brain and body a chance to ‘practise’ its adaptive response in preparation for future challenges.3, 4

However, if the stress experienced is severe or presents a life-threatening situation, such as being the victim of an assault, for some people, such an acute stress can lead to significant mental health problems such as post-traumatic stress disorder.

Chronic stress

Chronic stress is stress that continues for a long period of time and does not go away. This can occur in circumstances such as ongoing financial difficulties, social isolation and loneliness, relationship problems, chronic health problems, caring for someone with complex needs, overwork, bullying, or living in an unsafe environment such as a war zone or where there is violence in the home.1, 5

Stress can also be cumulative, which means that when a number of stressors occur at the same time or one after the other and the person has not had the opportunity or time to recover, stress levels can rise and stay high.1

Symptoms

When we face a stressful event, our bodies respond by activating the nervous system and releasing hormones such as adrenalin and cortisol. These hormones cause physical changes in the body, such as increased heart rate, blood pressure and muscle tension. Our breathing and metabolism speeds up. Our pupils dilate and we sweat more. These physical changes help us to react quickly and effectively to get us through stressful situations.2, 6 These are the usual signs of acute stress.

When stress stays high, additional symptoms can be experienced.1, 2, 5

Symptoms of chronic stress include:

  • Physical symptoms such as heart palpitations, fatigue, sleep disturbance, insomnia, stomach upset, diarrhea, frequent headaches, muscular aches and pains, weakened immune system, high blood pressure
  • Psychological symptoms such as worry, fear, anger, tearfulness, irritability, anxiety, helplessness, difficulties with concentration or memory, or feeling overwhelmed.

Treatment

A number of treatment approaches have been found to effectively reduce stress. These include cognitive behavioural stress management, stress inoculation training, mindfulness-based stress reduction, and a range of relaxation-based approaches.7-11

Cognitive Behavioural Stress Management

Cognitive behavioural stress management (CBSM) includes a range of techniques such as relaxation, communication skills training, problem-solving, time management and strategies to address unhelpful thinking that can contribute to stress.

Stress inoculation training

Stress inoculation training (SIT) teaches people specific skills to handle stress more effectively.12 SIT educates the person about stress and how unhelpful coping strategies or self-talk can contribute to stress. The person is also taught to tell the difference between what can be changed and what is beyond their control, so they can direct their energies to take more constructive action.

The person then learns a range of coping skills (e.g., relaxation, problem solving, and communication skills) designed to reduce anxiety and increase confidence. These coping skills are then practiced while rehearsing stressful situations.

Mindfulness-based stress reduction

Mindfulness-based approaches have been found to effectively reduce stress by drawing the person’s focus to the immediate moment, free from the distraction of real and imagined worries.10

Relaxation-based approaches

There are a variety of relaxation-based approaches that have been found to decrease stress, particularly when practised on a regular basis.7

The goal of relaxation skills training is to achieve deep relaxation and reduce stress by teaching the body to respond to simple verbal cues (e.g., I feel warm, heavy and relaxed) and combining this with calming, regularly paced, deep breathing. This is done in a quiet place, free from distraction, where the person can sit or lie down in a comfortable, relaxed position.

Seeking help

Seeing a psychologist

If you feel that stress is impacting on your ability to enjoy life, a psychologist may be able to help. Psychologists are highly trained and qualified professionals, skilled in providing effective interventions for a range of mental health concerns, including stress. A psychologist can help you to identify and address factors that might be contributing to your stress and the most effective ways to address stress using techniques based on best available research.

Psychologists usually see clients individually, but can also include family members to support treatment where appropriate. Psychologists sometimes offer group therapy, involving a small number of people with similar issues.

If you are referred to a psychologist by your GP, you might be eligible for a Medicare rebate. Ask your psychologist or GP for details.

There are number of ways to access a psychologist. You can:

  • use the Australia-wide Find A PsychologistTM directory or call 1800 333 497
  • ask your GP or another health professional to refer you.

Getting a medical check-up

A medical check-up with a GP might also be helpful to see if there is an underlying health issue. A GP or other medical specialist might also offer advice around whether medication might be of benefit.

Tips on managing everyday stress

Recognise signs of stress

Signs of stress vary from person to person, but recognising your own personal signs can help you take positive steps.

Signs of stress might include tensing your jaw, grinding your teeth, getting headaches, having problems sleeping, or feeling irritable or short tempered.

Identify causes of stress

It is easy to plough on, day after day, without taking a step back and identifying what is causing you stress. Identifying stressors is the first step to doing something about them.

Use problem-solving

Sometimes the situation causing the stress can be changed, for example, by getting an extension on a school assignment or work deadline, changing jobs, or sharing the workload with a colleague. Problem-solving involves identifying the problem causing stress, writing down a list of solutions, working through the pros and cons of each, selecting the best one and trying it out, and evaluating its success.1

Change the way you talk to yourself

When we are stressed we sometimes say negative or self-defeating things to ourselves over and over. Unhelpful self-talk might include things like, “I can’t cope”, “I’m too busy to deal with all this”, or “I’ll never get this done”. Negative self-talk can make it more difficult to manage stress.

Notice your self-talk and work on using helpful, soothing and calming self-talk, such as, “I am coping well given what I have on my plate”, “Relax, this stressful time will pass”, or “This is a stressful situation, but what is one thing I can do to help me get through this?”

Keep things in perspective

When we are stressed, it is easy to see things as worse than they really are. Rather than imagining the worst-case scenario and then worrying about it, ask yourself:

  • Am I overestimating the likelihood of a negative outcome?
  • Am I overestimating how bad the consequences will be?
  • Am I underestimating my ability to cope?

Rehearse tackling stressful situations

If there is a stressful event coming up, prepare for it. Work on developing the skills you need to tackle the situation as well as you can. Rehearse the situation before you have to perform on the actual day. This might include imagining yourself successfully handling the situation, or setting up real-life rehearsals.13

Practise relaxation

Practising relaxation (such as autonomic relaxation, meditation or mindfulness) has been found to decrease stress. Meditation and relaxation techniques, if practised regularly, can help reduce stress levels by allowing the body and nervous system to settle and readjust to a calm state.14

Organise your time

Research suggests that good time management can decrease stress, increase work and life satisfaction, and improve health.15

Time management strategies include setting goals, prioritising and planning tasks, writing to-do lists, using a diary, setting reminders for jobs that need doing, delegating tasks that can be done by others, and grouping similar jobs that can be done together.5,15

Create a better work-life balance

People sometimes become stressed when they devote too much time and energy to one aspect of their life, at the expense of other important areas.16

Think about how satisfied you are with different life areas (e.g., relationships, work, recreation, health, exercise) and whether you are devoting the amount of attention you would like to each. If not, think about how you could improve your work-life balance, making more time for some, and putting boundaries around others.

Taking time to wind down and enjoy relaxing activities is an important part of a balanced life and helps to reduce stress. Include relaxing activities such as gardening or reading, or activities you find uplifting such as listening to music, walking or dancing, in your daily or weekly routine.14

Look after your health

Stress can affect your immune system and make you more vulnerable to a range of health problems. Keeping yourself fit and healthy by doing the following can increase your resilience to stress:

  • make sure you are eating healthy food and getting regular exercise
  • avoid using alcohol, tobacco and other drugs to cope.

References

  1. Aldwin, C. (2012). Stress and coping across the lifespan. In S. Folkman (Ed.), The Oxford Handbook of Stress, Health, and Coping: Oxford University Press.
  2. McEwen, B. S. (2005). Stressed or stressed out: What is the difference? Journal Of Psychiatry & Neuroscience: JPN, 30(5), 315-318.
  3. Jamieson, J. P., Mendes, W. B., & Nock, M. K. (2013). Improving acute stress responses: The power of reappraisal. Current Directions in Psychological Science, 22(1), 51-56. doi: http://dx.doi.org/10.1177/0963721412461500
  4. Hermans, E. J., Henckens, M. J. A. G., Joëls, M., & Fernández, G. (2014). Dynamic adaptation of large-scale brain networks in response to acute stressors. Trends in Neurosciences, 37(6), 304-314. doi: http://dx.doi.org/http://dx.doi.org/10.1016/j.tins.2014.03.006
  5. Barlow, D. H., Rapee, R. M., & Perini, S. (2014). 10 steps to mastering stress: A lifestyle approach. New York, NY: Oxford University Press.
  6. Pretzer, J. L., & Beck, A. T. (2007). Cognitive approaches to stress and stress management. In P.M. Lehrer, R.L. Woolfolk & W.E. Sime (Eds.), Principles and Practice of Stress Management (Third ed., pp. 465-496). New York: Guilford Publications.
  7. Crawford, C., Wallerstedt, D. B., Khorsan, R., Clausen, S. S., Jonas, W. B., & Walter, J. A. (2013). A systematic review of biopsychosocial training programs for the self-management of emotional stress: Potential applications for the military. Evid Based Complement Alternat Med, 2013, 747694. doi: http://dx.doi.org/10.1155/2013/747694
  8. Fjorback, L. O., Arendt, M., Ornbol, E., Fink, P., & Walach, H. (2011). Mindfulness-based stress reduction and mindfulness-based cognitive therapy: A systematic review of randomized controlled trials. Acta Psychiatr Scand, 124(2), 102-119. doi: http://dx.doi.org/10.1111/j.1600-0447.2011.01704.x
  9. Faasse, K., & Petrie, K. J. (2015). Stress, coping and health. In James D. Wright (Ed.), International Encyclopedia of the Social & Behavioral Sciences (2nd ed., Vol. 23, pp. 551-555): Elsevier.
  10. Sharma, M., & Rush, S. E. (2014). Mindfulness-based stress reduction as a stress management intervention for healthy individuals: A systematic review. Journal of Evidence-Based Complementary & Alternative Medicine, 19(4), 271-286. doi: http://dx.doi.org/10.1177/2156587214543143
  11. Chiesa, A., & Serretti, A. (2009). Mindfulness-based stress reduction for stress management in healthy people: A review and meta-analysis. The Journal of Alternative and Complementary Medicine, 15(5), 593-600. doi: http://dx.doi.org/10.1089/acm.2008.0495
  12. Stetz, M. C., Thomas, M. L., Russo, M. B., Stetz, T. A., Wildzunas, R. M., McDonald, J. J., . . . Romano, J. A. (2007). Stress, mental health, and cognition: A brief review of relationships and countermeasures. Aviation, Space, and Environmental Medicine, 78(Supplement 1), B252-B260.
  13. Meichenbaum, D. (2007). Stress Inoculation Training. In P.M. Lehrer, R.L. Woolfolk & W.E. Sime (Eds.), Principles and Practice of Stress Management, (Third ed., pp. 497-516). New York: Guilford Publications.
  14. Kaplan, A., & Laygo, R. (2003). Stress managment. In W. O'Donohue, J. E. Fisher & S. C. Hayes (Eds.), Cognitive behavior therapy: Applying empirically supported techniques in your practice (pp. 411-417). New Jersey: John Wiley & Sons.
  15. Claessens, B. J. C., van Eerde, W., Rutte, C. G., & Roe, R. A. (2007). A review of the time management literature. Personnel Review, 36(2), 255-276. doi: http://dx.doi.org/10.1108/00483480710726136
  16. Sirgy, J. M., & Wu, J. (2013). The pleasant life, the engaged life, and the meaningful life: What about the balanced life? In Antonella Delle Fave (Ed.), The exploration of happiness: Present and future perspectives (pp. 175-191). Dordrecht: Springer Netherlands.

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