Do you have some very stressful moments in your day to day life? Things that feel beyond your control or overwhelming? Quickly being able to calm your mind and body is possible.
That's what we are talking about today on Episode 2: Managing Stressful Moments.
Your Better Mental Wellbeing is a weekly podcast helping you to manage stress and build resilience with easy evidence-based tools.
We're your hosts, Neera and Soen.
Dr Neera Dholakia is a GP for Boots Online Doctor and the NHS. She is an expert in mental wellbeing and has extensive experience designing mental health services whilst working for NHS England, Healthy London Partnership and mental health trusts. As well as promoting self-care, she also works to improve mental wellbeing in the workplace.
Soen Trueman is a full stack developer with Boots Online Doctor, specialising in graphics design, user experience, and user behaviour. Soen’s interests in behavioural analysis extends to psychology and further to neuroscience, which he is currently studying at Harvard University.
Links to this week's discussion:
[01:56] Why stress is important and how it impacts our daily lives in both beneficial and unhelpful ways
[04:58] How our body reacts to stress
[07:28] Ways in which our thoughts and feelings can affect how we perceive and respond to stressful situations
[14:27] What we can do to cope with stress when it starts including breathing techniques
-Whenever we encounter events or situations that we perceive to be stressful, our bodies experience a physiological stress reaction
-We may not always be in control of the situation, but we're always in control of how we respond to it.
-We can use tools including breathing exercises to calm and restore ourselves.
Join us next time for an Impactful 10 episode: And Breathe - guiding you through some breathing exercises in real-time, to calm yourself quickly.
Find our more:
For transcripts visit our website: https://www.yourbettermentalwellbeing.show
For great health, lifestyle and wellbeing information visit: https://onlinedoctor.boots.com
The information in this podcast is not intended to replace your own GP or other doctor’s professional medical advice.
Do you have some very stressful moments in your day to day life? Things that feel beyond your control or overwhelming? We'll be taking you through some ways to manage these. Quickly being able to calm your mind and body is possible.
That's what we're going to talk about today on Your Better Mental Wellbeing. Helping you to manage stress and build resilience with easy evidence based tools.
Hello and a very warm welcome to you. You're listening to Episode 2, Managing Stressful Moments. I'm Dr. Neera Dholakia. I'm a GP for Boots Online Doctor and the NHS, and my expertise is in mental health and wellbeing. I've enjoyed working with NHS England, Healthy London Partnership, and mental health trusts, designing services for mental health, and I'm really pleased to be hosting this show, focusing on improving your mental wellbeing.
And I'm Soen Trueman. I'm a software developer for Boots Online Doctor. I have a background in neuroscience research, and I'm looking forward to helping you understand the science of mental health and wellbeing.
Just before we get into it, I wanted to let you know that Boots Online Doctor has lots of great information on lifestyle and wellbeing. You'll find this on the website at onlinedoctor.boots.com.
Now let's get to it and talk about stress.
Do you have a particular habit when you feel stressed?
Yes, I have a habit of clenching my jaw and grinding my teeth when I feel stressed. I can feel my jaw ache and also my neck muscles become tense, which gives me a headache.
When I get stressed, I stop sleeping well, which means my energy levels go down and I want to eat all the wrong things because my body is wanting more energy. So I reach out for all the sugary foods like chocolate and ice cream.
So it sounds like stress is affecting us both in different ways during the day and at night. And stress can definitely affect your sleep, even if you don't realise it. So, what is stress?
Stress is a natural response that our bodies and minds experience in reaction to the demands and pressures we encounter in our daily lives. It can make us feel tense or overwhelmed and can affect our bodies physically too. We all face stress in different areas of our lives, whether it's due to daily hassles, life changes, work issues, our home lives or relationships.
Quite frankly, I wouldn't mind living without stress.
Yeah, I'm sure we'd all say that. Um, but actually stress is quite important. Whilst we often think of stress as being a bad thing, it does have a positive, beneficial effect. In the right amount, it can help motivate us, help us to overcome challenges and push us to meet our goals. If you think about... the feeling of excitement or anticipation you get before you do something important to you, say a performance or competition or a big event, that positive stress helps you stay alert, sharpens your focus and enhances your performance.
Actually, Soen, you're right, that little bit of adrenaline before the start of a race or that moment just before the roller coaster drops is stress preparing your body for what happens next.
Exactly, but how stressed we feel in a day is impacted by our daily hassles. These are things that happen frequently and are irritating, frustrating, or distressing, such as being in a rush, forgetting to buy something out when shopping, worrying about money, and being worried about others we care about. Some types of daily hassles also have changed in the recent years, if we consider social media, messages 24x7, and changes to working structures, things like working from home, working part time, doing childcare, and doing household things all at the same time. All of these things create stress, which can add up over time.
But we do also have daily uplifts, such as having an interesting conversation with someone, completing a task, getting enough sleep, and also doing an activity you enjoy, and these uplifts can help us to balance the stress caused by daily hassles.
Yes, and when we think about the stress of life events, often these are large one off things. Even positive changes can be stressful. Moving house involves paperwork, financial changes, and figuring out a new place. Having a baby leads to sleepless nights, and even going on holiday can be stressful. Preparing for it and even getting there. It depends on whether the situation is stressful for you. A divorce might be a disaster or a relief. In fact, these life events can also lead to daily hassles.
But what about when these daily hassles continue on and on, and perhaps you have several life events all contributing to a feeling of continual stress?
This can lead to long term or chronic stress, which can have a significant impact on both your mental and physical health. In episode 4, we'll talk about chronic stress and how we can deal with it. For today though, let's focus on managing those daily stressful moments, which in turn will help dealing with any longer term stress.
We've talked a little about the sorts of things that can make us feel stressed. So what does our body do when stress occurs? What is the body's stress reaction?
When we experience stress, our body goes through a series of remarkable changes. It is the same natural physiological reaction in everyone, getting our bodies ready to face a challenge or danger. A key player in this process is our autonomic nervous system, which is like the control centre of our body, and it helps to regulate vital functions such as heartbeat, breathing, and digestion. It connects the brain to the spinal cord and our organs. It has two main branches, the sympathetic nervous system and the parasympathetic nervous system. The first one, the sympathetic nervous system, is responsible for activating your fight, flight, or freeze response whenever we encounter a stressful situation. It releases stress hormones such as adrenaline and cortisol into our bloodstream, which prepares our body for action.
Okay, so imagine you're walking in a dark forest, and suddenly you hear a loud noise. Your heart starts pounding, your breathing quickens, and your muscles tense up. That's your sympathetic nervous system in action, getting you ready to either face the danger, run away from it, or be very still. And adrenaline gives us an instant burst of energy. It increases our heart rate, sharpens our focus and heightens our senses. And then cortisol is responsible for regulating our metabolism, our immune system, and also our blood sugar levels. It can increase our glucose levels for the extra energy our body needs to use, take action when there's danger.
Now it may surprise you to learn that the body's stress reaction is the same whether you hear a loud noise, encounter a lion, open an important letter or have to deal with a difficult person. The key difference is what you do in response to a stressful event.
And if I want to get back to feeling calm from the stress reaction, this is where the second branch of the autonomic nervous system, the parasympathetic nervous system, comes into play. It acts as the body's natural calming mechanism and is known as the rest and digest mode. It helps restore the balance and counteracts the effects of stress. When activated, it slows down our heart rate, lowers our blood pressure, and promotes relaxation and healing. And what's interesting is that we can activate our rest and digest mode, the calming and restoring parasympathetic nervous system, using simple tools such as breathing and relaxation techniques, and mindfulness.
We'll be talking through some key breathing techniques in just a few minutes, and our next episode is fully focused on practising this breathwork, so don't miss that.
So Neera, how do we effectively deal with stress?
The psychologists Richard Lazarus and Susan Folkman did a lot of research into stress, coping and managing stressful situations. They discovered that the level of stress a person experiences is directly related to how confident they feel about dealing with a threat. Their idea is that the way we interpret or perceive a situation or event determines how we respond to it. Our thoughts, our beliefs and our coping strategies all shape our stress response. And in fact, our response to an event can have a more powerful impact on our stress levels than the event itself.
So what you're saying is that we can change the way we respond to a stressful situation, which will then impact our stress reaction and stress levels.
Exactly. The other day I was in my GP surgery and I realised that the back of my trousers had some mashed banana stuck on it.
Oh, Neera, you're not supposed to wear your breakfast.
Yes, thank you. It was a bit disgusting. I felt a bit annoyed about it and tried to clean it off, but it was stuck on well. Previously, I'd have felt stressed that everyone would see it and I'd be conscious of it all day and try not to turn around. However, instead I thought: my patients are here for my medical care and are more bothered about being seen on time rather than what I'm wearing. I'm sure some people did notice though and were probably too polite to say anything. Now I know that seems like a very minor stressful event but it could have been different if instead I'd been going for a job interview.
I think there'll be lots of people who can relate to this, who spilled coffee or something over themselves at some terribly unfortunate moment.
Okay, so you changed the way that you thought about the mashed banana, so it felt less stressful for you. That's actually a powerful mindset shift. Let's dig into that. How can we think about the stressful situations differently to ease the stress it can create?
Stress often occurs when you don't feel in control of a situation, but whilst you might not have control over the situation, you can control how you respond to it. So this response starts with a couple of assessments of the situation. The first assessment that happens is that we consider the potentially stressful event or situation and think, what does this situation mean to me? It could be, this is not important to me, or this could be good. Or, this is stressful. If your train is cancelled, you might think it's not that much of a big deal because you don't have to be there at a certain time. Or, you might think this is actually quite good as you won't have to go to that meeting now, so you can do something else. Or, you might see the cancelled train as stressful because you were due to meet up with friends. And then the second assessment happens almost at the same time as the first, where you consider how you feel about dealing with the event or the stress. So with the cancelled train, what are you saying to yourself? This could be something positive such as: I can figure out a way to attend the work meeting or to see my friends, or it could be negative, this always happens to me, I'm going to be late again and will miss everything.
So you're first thinking about the event itself and what it means in terms of how stressful it might be for you. And if it is stressful, whether it is a threat or a challenge, and then secondly, you're considering how you feel about coping with it.
For me, a great example of this is when an electricity bill lands in my inbox. I've had a few issues with my electricity bill when the company got taken over. So even before I've opened it, I'm already thinking this is going to be stressful. And... I feel my body's stress reaction start. And then I have a flow of negative thoughts that I can't cope with it because the figures are always wrong, or it's an estimated rather than actual reading, and then customer services are so hard to get hold of, and the chatbot thing is really unhelpful, and that I don't have time to waste on it, and it's going to take a long time to sort out. And by this point, my heart's beating a bit quicker, my breathing is more shallow, my fingers are a bit sweaty, and my muscles become tense. Actually, I'm starting to feel a bit like that now, just talking about it.
So then I suppose, because you're now in this heightened stress state, about to run away from the lion leaping from your inbox, you aren't able to think logically through the steps you need to take to sort this out. Or to acknowledge that you've obviously coped with much more stressful things before, and can definitely cope with this.
Yes, exactly. And then, if I don't open the bill and address the situation, it remains on my mind, and the stress feeling builds up more. My response to the situation becomes more stressful than the actual situation itself. And I think if I was able to calm myself at that point of both when I see the email and then when I open the bill, I'd be able to have a more rational, problem solving approach to it.
What about you, Soen?
There's a classic response I have when my boss gets in touch to say 'we need to talk'. It suddenly gets my alarm bells ringing, even though I don't know what it's about yet. My anxiety and stress work overtime to try and second guess what my boss wants. Does he want me to do something, or is he about to fire me? And I start thinking, I can't cope with finding another job just now, or doing any extra work. However, if I take a step back, I can realise that I'm attempting to second guess somebody else's actions or motivations, which is a fruitless endeavour, and recognizing that helps reduce my anxiety or stress levels. After all, I know, really, that it's most likely my boss is just going to ask me to do something relatively straightforward, and that it would be very unlikely that he would be firing me out of the blue. But even if he did, I know I'd be able to get another job with my skills.
So you manage that initial stress reaction by recognising that you've jumped ahead to worrying about something that might happen, but that you know is actually quite unlikely. And by refocusing on what is actually more likely to happen, and reminding yourself that you can cope with whatever the outcome is anyway, you're able to deal with it more rationally and calmly.
Yes, absolutely. It's really about having confidence in my coping skills. As the psychologist and philosopher William James said, the greatest weapon against stress is our ability to choose one thought over another.
So let us quickly recap. We all encounter events or situations that have the potential to be stressful. When we perceive it to be stressful, our bodies experience a physiological stress reaction. We may not always be in control of the situation, but we're always in control of how we respond to it. We can change how we view a situation and be more confident in our coping skills to deal with it. And we can use tools such as: acknowledging how something makes us feel, and reframing our view into something more positive, and then using breathing exercises to calm and restore ourselves.
Okay, Neera. I know there are lots of strategies to manage stress in general. Self care things like doing something relaxing, doing something enjoyable, getting a good night's sleep, eating well, practising a hobby and exercise. But when our stress reaction occurs, how do we calm ourselves down quickly to enable us to think more clearly?
A really powerful technique is to focus on your breathing. Breathing is something we all do unconsciously all the time, but the way we breathe really impacts our physical and mental state.
We breathe in air, which is a mixture of oxygen and carbon dioxide. Some of this oxygen is used by the body to support its processes and also creates carbon dioxide as a result. So the air we breathe out contains less oxygen and more carbon dioxide. Many of us over breathe sometimes, or a lot. This happens when we are in stressful situations, our breathing becomes faster and shallower as it prepares the body for action via the sympathetic nervous system. This results in even more carbon dioxide being exhaled and this leads to a smaller amount of carbon dioxide remaining in our body. It's this lower level of carbon dioxide that promotes adrenaline and stimulates the body by increasing our heart rate and breathing rate.
And by intentionally engaging in slower, deeper breathing, we can increase the level of carbon dioxide in our body, which will activate our body's parasympathetic nervous system, our rest and digest mode, triggering our relaxation response and reducing the levels of stress hormones. Our heart rate slows, our blood pressure goes down, our muscles become less tense, and we feel more relaxed and calm. Breathing techniques have the short term benefit of reducing our stress reaction, but also longer term benefits of acting as an anchor, connecting our body and mind in the present moment.
So focusing on our breathing can direct our attention away from the stress or situation causing it, allowing us to regain a sense of control and clarity. And of course, the real bonus is you can practise these breathing techniques at any time without any special tools, building them into your daily routines, so that when you need them during stressful moments, they're ready for you.
Are there some specific breathing techniques that you like?
Yes, there are three really simple ones that anyone can do. You can join me in the next episode where I'll take you through these in more detail, when you'll be able to actually experience and practise them in real time, but just as an overview for now.
The first technique, which I find really helpful in those stressful moments, is a 4-7 breath. Essentially, you take a deep breath in through your nose, or you count to 4 in your mind, and then breathe out through your mouth and count to 7. The key is for the out breath, the exhalation, to be longer than the inhalation, which is what activates a relaxation response. And once you've done it a few times, you can add in a pause after the inhalation, holding your breath, and this increases the relaxation response.
And the second technique is called diaphragmatic or belly breathing. This is where you place one hand on your chest and one hand on your belly, first noticing how you're breathing currently and then slowly deepening your breath by taking a slow deep breath in through your nose and then exhaling slowly through your mouth. Making sure the air is travelling down into your belly rather than staying high up in your chest. And the third common technique is called box breathing or square breathing.
Yes, this is my favourite one.
So imagine a square box. Start at the bottom left corner. Take a deep breath through your nose, counting to four as you trace the left line going up. Then hold your breath as you trace the top line, counting to four. Then breathe out as you count to four going down the right side. And then hold for four as you return from the right bottom corner to the left bottom corner. And then repeat this box. And by maintaining a steady rhythm, it will regulate your breathing and bring focus back to the present moment.
There's no right or wrong with these techniques. They're just guidelines. Find what feels right and natural for you. That might mean changing the counts, or not counting at all, or adapting it if you can't breathe in through your nose or breathe out through your mouth. And if you find your mind wandering whilst you are doing them, that's okay, just bring your focus back to your breathing when you notice.
Neera, it's been fascinating talking about stress and our reactions to it, and how we can take control of the way we respond.
Yes, it's made me remember about noticing those early signs of my stress reaction and taking action to stop it building up. I'm going to pay more attention to things that make me feel stressed, and then when I start to feel my jaw clenching, to breathe deeply and relax my muscles.
When I next reach for a sugary snack, I'll pay attention to see whether I'm stress eating or not. This will then help me make better choices in future.
Stress is a very personal experience. We all have different triggers and coping mechanisms. So having compassion for ourselves and learning compassion for other people when they are feeling stressed are really helpful habits to develop.
What things in your daily life make you feel stressed? What do you notice in your mind and body when you are stressed?
And what changes could you make to how you respond to stressful situations? And which breathing technique will you start with?
Thank you so much for listening to this episode of Your Better Mental Wellbeing. Join us next time for our first Impactful 10 episode, And Breathe. It's a short 10 minute episode taking you through breathing exercises to calm yourself quickly in real time.
You can find more information and podcast transcripts on our website, yourbettermentalwellbeing.show. And if you liked this episode or think it would be useful for someone else, please follow us and share.
And remember, to live your values, accept yourself and let go.
Music credits: Main theme by AudioCoffee, Impactful 10 by Dream-Protocol, Jingle by Serge Quadrado Music