When you know you’re stressed and you know that stress is making you feel unwell, distressed and overburdened, it may get worse if you do nothing. By taking steps to rebalance yourself, you can prevent cumulative stress from overwhelming you and you can regain perspective and equilibrium. The suggested steps are:

1. Identify the stresses in your life via the Work and Home Stress Tables and a Stress Diary.
2. List and prioritise the sources of stress
3. Identify the appropriate stress management strategies
4. Create a Stress Management Plan

Stress Management Resources

• The Work Stress Overview Table looks at your potential work stress
• The Home Stress Overview Table looks at your potential stress at home
• Keeping a Stress Diary offers information on why a stress diary may be useful and how to use it.
• The Stress Diary Template is a diary template to print out, complete and collate your experiences.
• Listing & Prioritising the Sources of Stress advises you on how to use the information you have gathered via the stress tables and the diary
• Identifying appropriate Stress Management Strategies offers support, resources and potential solutions for the stressors you have identified.
• The Stress Management Plan Template is to print out and complete once you have decided on the appropriate strategies and time frame for your circumstances.

There is no need to go to India or anywhere else to find peace. You will find that deep place of silence right in your room, your garden or even your bathtub.

Elisabeth Kubler-Ross

Go through each item on the list you have put together and prioritised from information gathered via the Home Stress Table, the Work Stress Table and the Stress Diary and check it against the list of possible stressors below.

Click on the links to find support, resources and potential solutions. If you have an item on your list which does not appear below, click on one or more of the links which seems to be in that area of concern and look at possible options.

• Difficulty for PMs in Managing Partners – see Managing Managers and Emotional Intelligence in Professional Relationships
• Difficulty for PMs in Managing Staff – see Managing Staff and Emotional Intelligence in Professional Relationships
• Difficulty in relationships at home – see Emotional Intelligence
• Feeling isolated (PMs) – see Isolation
• Feeling Powerless – see Timekeeping and Emotional Intelligence and Managing Managers
• Feeling overwhelmed – see Timekeeping and Managing Managers and Managing Staff and Isolation
• Feeling exhausted – see Timekeeping and Managing Staff and Isolation
• Feeling burdened by the demands of external agencies eg QOFs, ICBs etc. – see Timekeeping and Managing Staff and Isolation

You can then enter the most important stressors on the Stress Management Plan Template and for each one, decide on what action you will now take to reduce the stress it is causing.

When you find yourself stressed, ask yourself one question: Will this matter in 5 years from now? If yes, then do something about the situation. If no, then let it go.

Catherine Pulsifer

You may be on the road to burnout if:

• Every day is a bad day.
• Caring about your work or home life seems like a complete waste of energy.
• You’re exhausted all the time.
• The majority of your day is spent on tasks you find either dull or overwhelming.
• You feel like nothing you do makes a difference or is appreciated.

The Mind Tools website contains a very useful, online, informal self-test for Burnout.

A lot of stress arises from regret for the past and fear of the future.

Rosemary A. Payne

What are the Symptoms of Chronic Stress

Physical Symptoms

• Heart palpitations
• Increased blood pressure
• Raised blood sugar levels
• Insomnia
• Headaches
• Dry mouth
• Cold feet and cold clammy hands
• Abdominal pain
• Increased sweating
• Trembling hands
• Tight shoulders and neck
• Lower back pain
• Increased sensitivity to noise and light

Mental Symptoms

• Difficulty concentrating
• Problems with decision making
• Fuzzy thinking
• Mind going in circles
• Memory lapses
• Difficulty making rational judgements
• Forgetfulness
• Confusion
• Problems understanding new information
• Lower back pain
• Increased sensitivity to noise and light

Behavioural Symptoms

• Irritability
• Irrational Anger
• Overuse of stimulants, depressants and painkillers
• Inflexibility
• Feeling constantly anxious
• Oversensitivity to criticism
• Being antisocial

Adapted from Stress and Employer Liability (Developing Practice Series) Earnshaw, Jill and Cooper, Cary L. 2001 edition.

Stress is mental or emotional pressure exerted on someone by others, by situations or by themselves. This pressure is part and parcel of everyday life and is not necessarily negative.

Positive stress

Positive stress provides us with the energy to take risks, to tackle new projects, to confront demanding situations that we know need our conviction and expertise. Positive stress empowers us to climb a mountain, change a tyre, walk out on a stage or write a letter. Positive stress puts the zing into life and fuels our passion for delight and adventure. Stress only becomes harmful when it begins to exceed our ability to cope.

Negative stress

Hans Selye, a famous endocrinologist who pioneered work on the stress response, defined stress as the body’s nonspecific response to a demand placed on it. Negative stress occurs when we feel that we do not have the skills or resources to meet that demand. If this demand continues or is frequently recurrent, stress may become chronic.

Chronic stress

Chronic stress is very common. It essentially means that the nervous system is on constant alert as though danger were ever present. Optimally your body is in a state of internal balance where all systems function smoothly. However, stress releases a complex cocktail of hormones which readies your body for action and the physiological effects may include:

• The brain releases endorphins to relieve pain
• Heart rate increases and heart increases its strength of contraction to pump more blood
• Blood pressure rises
• Digestion slows so the blood may be diverted to muscles
• Salivation and mucous secretion decreases
• Pupils dilate so that you have a more sensitive vision
• All of your senses – sight, hearing, smell, and taste – become more acute, ready to identify any threats
• Sweating increases to flush waste and to cool down the body
• Blood clotting increases to prevent blood loss during physical threat
• Sugars and fats are released into the blood stream to supply fuel
• Adrenaline and other hormones are released into the bloodstream to provide energy
• Muscle tension increases to prepare for action in the shortest time
• Bronchi dilate, allowing for more air into the lungs
• Breathing gets shallow and faster

Once the demand, the threat or the situation is over, the body should return to its state of normal equilibrium and the physiological effects should diminish. However, when stress has become chronic, the body loses its ability to return to normal, and exhaustion may result. This is caused by the depletion of the body’s resources and a loss of the ability to adapt, and may have long-term effects on the cardiovascular system, the digestive system or the immune system.

Reality is the leading cause of stress for those in touch with it.

Jane Wagner