On Thursday 26 June, our
medical experts were here to help, returning with another live chat
- this time on managing feelings of stress and anxiety.
Dr Mark Winwood is the clinical director for psychological
health for AXA PPP healthcare's specialist Health Services division
- and with ten years of experience as a senior psychologist, he
offered live, expert insight on managing stress and anxiety
effectively. Here's what was said on the day:
Live chat participant: I'm not going to admit
who I am, but I do need help. I'm good at my job, I work hard, but
I'm not getting anywhere. The reason is that my behaviour lets me
down. I lack self-belief; I constantly put myself down. I am very
thin-skinned and defensive. I take challenges to my decisions
personally. I damage relationships I have worked very hard to
build. I can be abrasive, sometimes angry. My unpredictability
means I'm not trusted with the responsibility that my manager has
said I am easily capable of. I'm frustrated. My manager is
frustrated. I hate being this person. I want to stop!!
Mark Winwood: You clearly have identified some
things that are difficult for you - you describe a range of
problems which would perhaps better be addressed by speaking to a
professional. Your organisation may have access to an EAP or
counselling service. Alternatively try visiting your GP and
exploring supports available.
Suzy asked: I suffer quite badly with stress
related to driving. I was in a road accident as a child, which led
to my Father being killed. A few years later, I learnt to drive,
but have always struggled with stress relating to the way others
drive (not indicating / pulling out in front of me / etc). I have
tried to cope with this but find myself getting extremely stressed
to the point where I feel as though I am out of control. I need to
drive as my partner does not, any tips on how to manage this?
Mark Winwood: Suzy - it is quite common for
distressing things that might have happened in the past to affect
the way be cope with similar situations in the future. So feeling
anxious about driving maybe something you have learned because of
the experience of losing your father in a road accident. It is also
quite common to fear 'losing control'. There are many things you
can do to reduce your anxiety to a more manageable level - taking
action can be an important first step and makes you feel more in
control although it may be uncomfortable to start with. Facing up
to your anxiety is the first step in breaking the cycle. Relaxation
techniques can be used to reduce the unpleasant feelings and
therapeutic techniques that are available in self-help books and
on-line that teach you to challenge the evidence around your fears
may also help.
Nifnif asked: My other half works in the
police force and his employers have recently changed his shift
pattern which means that he will now have very little contact with
his 4 year old son (with his ex-wife). The Olympic shift pattern
they have imposed also means he will not see his son for 2 months
and when he returns to normal shifts in September he doesn't know
if he will have a job on his unit and may go back to what he was
doing when he first started 20 years ago. He had a clash of
personality with his direct boss which led to the original move.
His ex makes contact very difficult too. Our relationship is now
suffering physically and emotionally and, all in all, he cannot
cope. He cannot go to the doctor for help as his employers will not
allow any kind of medication. I am at a loss as to how to help.
Mark Winwood: With so many things
going-on for your partner it is important for him to try and remain
as healthy as possible by getting rest, exercise and healthy food.
It sounds that you both feel overwhelmed by the difficulties you
are experiencing - it might be an idea to sit and make a list if
priorities and to tackle one at a time in order to feel you have
some control over the problems you are dealing with. It could also
be an idea for your partner to speak to his manager at work or his
HR department to discuss his future. Medication is not the only way
of coping with these difficulties and a conversation with his GP
might really help him think of other ways to deal with these
stresses. It is important for you to think o f what is important
for you in this as well - and the effects this is having on
PARROT asked: I think I am suffering from
stress, I constantly feel tired and most mornings feel nauseas! I
was diagnosed with Glandular Fever 12 months ago but don't really
know if this is still affecting me! I always need at least 10 hours
sleep otherwise i feel dreadfully tired and lethargic! I am 40
years old. Could this be stress or still the Glandular Fever?
Mark Winwood: A very common feature of
stress is fatigue and nausea - this is a physiological reaction to
excessive amounts of adrenaline and cortisol being produced. Having
glandular fever will also make you very fatigued and this can be a
'longer term' symptom of the illness. in order to answer your
question it may be an idea to try and reduce your levels of stress
to determine if the glandular fever is causing your symptoms. in
order to do this it might be a good idea to identify aspects of
your life that are stressful and then apply some stress reduction
techniques such as relaxation to see if this has an effect. If you
are still feeling constantly exhausted I would recommend visiting
Fiona asked: I think I react very physically to
being stressed - within hours of feeling pressure my hands break
out in blisters which has been diagnosed as eczema, and now I've
noticed I get a sore right shoulder during periods of stress. What
can I do to stop this happening?
Mark Winwood: There is plenty of research
evidence to suggest that there is strong link between stress and
physical wellbeing. Muscular and skeletal pain can be made worse
due to stress - if we are anxious we tend to tense our bodies and
this prolonged tension can cause pain. This might be happening in
your shoulder. Relaxation techniques have been found to be really
helpful in addressing this. These are readily available on the web
or via self-help guides such as 'manage Your Mood' by Veale and
Everred asked: Can eczema be caused by
Mark Winwood: Eczema can be caused by a number
of factors including allergies. There is evidence to suggest that
some skin conditions such as Eczema and Psoriasis can be
exacerbated by stress. There are a number of physical problems that
are related to high levels of anxiety and stress.
Michelle, a blogger from Peachy Palate asked: If
I manage my stress is it likely I can clear up my psoriasis
completely? What other key signs should I watch out for that I'm
stressed as it's something I'm clearly not 100% conscious of or
perhaps I've just become accustomed to it!?
Mark Winwood: Studies have shown that stress
and psoriasis go together. And while stress is known to make
psoriasis worse also having psoriasis can also make you stressed.
We are not sure how stress and psoriasis are linked but it may have
to do with an effect on the immune system. Some people have their
first flare of psoriasis during a particularly stressful time.
there are 50 or more common signs of stress but things to watch out
for are - stomach problems, sweating, headaches, irritability,
difficulty concentrating, chest pain, breathlessness, dry mouth -
any of these can be a sign that you are feeling stressed and
reducing these symptoms may well help your skin condition.
jimmy_20 asked: Hi Mark, I am currently in the
middle of changing jobs and also going through a divorce and as I
am sure you can imagine it is quite a stressful time for me. I feel
like I need help but don't know where to start or look, can you
Mark Winwood: Jimmy - you are currently going
through two of the most challenging life events and it is normal
for you to feel stressed. Saying that there are also ways you can
reduce the uncomfortable feelings associated with this. It is
really important that you make time for things you enjoy and plan
some time to do these things. Also taking some time for exercise is
really important as a feeling of wellbeing will make your problems
feel more manageable. Speaking to a close friend about your
feelings and needs can also help build resilience against stress.
It is OK to ask for help. if you feel anxiety is effecting your
health - contact your GP or a counsellor if you have access to one.
These stressors are to degree temporary and getting few coping
strategies could help you through the coming months. These may
include looking at your strengths and applying them to different
situations or challenging any negative thoughts about your future
that you might have. Self help guides such as Manage you Mind
(Butler & Hope) and on-line self help tools such as 'Living
Life to The Full'
Emmar asked: Hi I find that my eye lid flickers
when I think I am stressed - are the two related?
Mark Winwood: The most common things that make
the muscle in your eyelid twitch are fatigue, stress, and caffeine.
Eyelid twitching usually disappears without treatment. In the
meantime, the following tips might help the symptoms Get more
sleep, drink less caffeine and try lubricating your eyes with
eye-drops. So to answer your question there is definite link
between eye-twitch and stress.
Emmar asked: Thanks Mark, funnily enough I
don't drink coffee or any of the associated drinks - but thanks for
Daisydiamond asked: I get the eye lid flickering
too and only just realised its worse when I'm stressed. What causes
this? Also, I've found stress harder to cope with since the
menopause. Have never taken HRT but is there something that will
help. The more I try not to be stressed the worse it seems to
get!!!! Grateful of any guidance.
Mark Winwood: Daisydiamond and Emmar - the
eye-twitch could well be caused by muscle tension which is a common
feature of stress and anxiety. But also eye-strain if you spend a
lot of time in front of the computer.
Mark Winwood: Daisydiamond - many women find an
increased difficulty in coping with stress during the menopause.
This is due to changes in hormone levels and for some women HRT has
been helpful. As we get older we generally tend to find that after
about 55 our general levels of stress tend to reduce. It sound that
your stress levels are increasing due to failed attempts at trying
to manage your stress. This is causing you to experience a
worsening cycle - the more you try the worse it gets. The best
thing to do is to try and break the cycle by trying something new.
Sometimes - accepting your feelings of tension and stress can be
helpful. There is a technique called 'mindfullness' which helps you
do this and many people find it helps them feel much better. The
techniques involve some meditation and relaxation. Try on-line
www.getselfhelp.com and look at the mindfulness section.
Jane: Hi Mark, I've been stressed lately and
now I have an infection that won't go away. My doctor has been
prescribing antibiotics that aren't working. Is it possible the
stress is stopping my body from healing itself and if so what would
you advise? Thanks.
Mark Winwood: Jane - if you are using
antibiotics to manage an infection that are not working it is best
to return to your GP as the infection may insensitive to the drugs
you are taking. Saying that - our ability to heal is effected by
our psychological health - high levels of adrenaline adn cortisol
common to stress can have negative impact on our physical
wellbeing. When we are stressed we sometimes do things to help cope
which are in our best interest - for example we may drink more
alcohol, smoke more cigarettes, not exercise, eat more unhealthy
food etc as all of these things can also inhibit our ability to
recover from illness.
Ianto asked: I've been using hypnosis tapes to
help me cope with stress/ anxiety and they seem to work very well.
However, I'm concerned that these things may be bad for me - is it
healthy to use hypnosis tapes over the long term?
Mark Winwood: Hi Ian. Well done for finding
something that works for you and has helped reduce your symptoms.
There is no evidence to suggest that using hypnosis in the
long-term has a negative impact. The fact that it is helping you
relax and deal with any stressors more effectively is a very
Ianto asked: One more question - are there any
quick/ easy ways to assess your own level of stress? The reason I
ask is that often in the past I'm unaware how stressed I am until
maybe a few days in - would rather identify and deal earlier!
Mark Winwood: Ianto - there are a number of
products on the market that 'claim' to assess your stress. But you
are your best 'assessor' - try and notice how you feel when you are
feeling well and then monitor any changes to that. Common early
signs are sleep disturbance, negative thoughts, irritability- (but
you may have your own) - if you notice these it might be time to
start applying your coping strategies!
Seasonal asked: Hi Mark I tend to get
clusters of migraine headaches when my stress levels increase. I've
also started to suffer with panic attacks this year. Both these
things put me out of action for a while. Are there any ways to
reduce stress levels, anything practical that I could do?
Mark Winwood: Headaches and migraine are common
symptoms of stress. Panic attack is an exaggeration of the bodies
normal response to fear, stressor excitement - it tends to manifest
in the build-up of overwhelming sensations ie pounding heart,
feeling faint, chest pains, feelings of loss of control - you may
be convinced that you are going to die making it a terrifying
experience. There are 2 main types of treatment depending on the
severity and frequency - psychological and medical (or combined).
The psychological treatment is Cognitive Behaviour Therapy and the
medical one is Antidepressant therapy.
Seasonal asked: How does Cognitive
behaviour therapy work? Thanks for the detailed answer btw
Mark Winwood: Cognitive Behaviour Therapy or CBT is evidence based
therapy and is available on the NHS and through Private Medical
Insurance Schemes. It is a short term therapy (approx 8 -20
sessions), which can be delivered face to face, on-line or over the
telephone. The therapy examines and challenges the relationship
between the way you think and how that affects your mood and your
behaviour. CBT will encourage you to develop new ways of thinking
and to work out strategies for managing anxiety so you feel
increasingly in control.
woodie19838 asked:What is the best method to
unwind from a hard day in the office - particularly after a
Mark Winwood: We often feel stressed at the end
of a busy day at work - to relieve that pressure it is important to
get a sense of control - so learning to manage your stress can be
really helpful so try taking control of your thoughts, your
emotions , your schedule and your environment. Try and book-in some
'you' time by making sure you have something to look forward to -
exercise, hot bath, trip to the cinema, evening with friends
etc.... Many people have a drink to unwind after work - which can
be a quick-fix and very successful. However, over-time this can
have negative consequences for your medical and psychological
health and then increase stress.
888565 asked: A great deal is spoken about
"stress" but in terms of it being a problem what actually is it. We
might say we are "stressed" because we have a lot to do, a time
deadline to meet or are unsure of the result of something. Is
stress simply bad or does it need to be stress that causes
Mark Winwood: It might be helpful for us to
think of the distinction between stress and pressure. Pressure is
something that drives us and can be really helpful to assist us in
reaching our goals and stops us stagnating. However, if pressure
builds and we feel that we cannot achieve the demands that are
placed on us either at work or home we start to get the negative
feelings of stress. Stress is never good but pressure can be.
Brendanjmagill asked: Monday to Friday I suffer
flu like symptoms and have poor quality of sleep yet at the weekend
or on holidays I feel great so i am assuming this symptoms are
related to stress of my job as they never appear when I'm not
working. Am I correct and if so is there anything I can take?
Mark Winwood: Poor sleep is affecting more and
more people - it also has a huge impact on our mood and our
wellbeing. It is hard to say whether the poor sleep is making you
feel stressed and then work is more difficult - or you feel
over-whelmed by demands at work and that is affecting your sleep -
either way improving your sleep will help you. There are
medications you can take - but it may well be worth trying some
other interventions that have more long-term effects and no
side-effects. As with any sleep improvement plan you sometimes feel
worse before you feel better.
1. Have a night-time wind-down routine - ie bath, read
2. No caffeine or alcohol before going to bed
3. Promote your bed as the place to sleep - so if you are lying
awake after 20 minutes - get up and do something non physical
4. Only go to bed when you are tired
There is an on-line tool called 'Sleepio' which is a really good
Cognitive Behavioural programme to help people with insomnia - I
highly recommend it.
P-Duncan asked: Hello. I have read a bit about
mindfulness meditation in newspapers recently, they were saying
that it can reduce not only stress but it can also have a positive
effect on depression as well. BUT most times I look into mediation
it always seems to be a course costing a lot of money - can you
tell me if meditation does work and if so, where can I learn it
Mark Winwood: Hi - I am not aware of any free
meditation centres - however, you can download free guided
visualisation scripts and podcasts which can be useful to help you
achieve a relaxed state. Also if you go to www.getselfhelp.com you
will find some free to download mindful meditation tools which can
be really helpful.
From Liz, a blogger from The Mum Blog- How can
you control negative urges (like snacking on rubbish) if you're
feeling stressed? Can stress ever be good for you?
Mark Winwood: Hi Liz. I don't think
stress is ever good for you. Stress occurs when the pressure
build-up makes you feel unable to cope. Gaining control of
these pressures is one of the first steps in tackling your
stress. If you find yourself snacking on rubbish - try the
following tip. When you get the impulse to snack - STOP -
think and take a breath - consider what you are doing - consider
how you might feel once you have snacked on that food - make
an informed choice - and then proceed with an option that you have
control over. This will make you think twice before going for
unhealthy options. Make sure you have plenty of healthy
snacks available and try and reduce temptation by not having the
unhealthy ones around.
From Charlotte, a blogger from Mum of the Mig-
How can I best support someone close to me who is struggling to
deal with stress?
Mark Winwood: Hi Charlotte. It is very
difficult to watch someone we care about deal with difficult
situations. I always find that rather than second guess what
might be the best sort of support for someone - you are better off
asking them what they might find useful. It could be that you
can support your friend by listening to there concerns or
helping them priorities their problems. However,
practical help may be more helpful to reduce the pressure in this
persons life. Often by saying 'how can I help' you will
automatically reduce your friends levels of stress as they will
appreciate that they are not alone with their concerns and they
have friends that care about them.
From the blogger notSupermum:I'd like to know
what's the best way to deal with the first signs of stress. We all
have to deal with stressful situations in life, but what's the best
way to stop it developing into something we can no longer deal
Mark Winwood: Hi NotSupermum - The
symptoms of stress often build up gradually before you start to
notice them. Stress can affect how you feel, how you think,
how you behave and also how your body functions. Stress
affects people in different ways, but if you are stressed, you may
have a number of the symptoms I will now describe. You may
Feel-irritable, anxious, low in self-esteem, low in
mood. You may find that you: have racing thoughts, worry
constantly, imagine the worst, go over and over things. You might
notice that you: lose your temper easily, drink more, smoke more,
are on the go all the time, talk more or talk faster, change your
eating habits, feel unsociable, are forgetful or clumsy, act
unreasonably, find it difficult to concentrate. Physically you
might experience: headaches, muscle tension and pain, stomach
problems, sweating, dizziness, bowel or bladder
problems, breathlessness, dry mouth, sexual problems. It is
important to learn how stress affects you because it will help you
figure out what coping techniques work best for you. It will also
enable you to avoid resorting to unhealthy habits, such as smoking,
drinking and comfort-eating.
From Claire, a blogger from The Lazy Girl's Guide to
Life:What action can I take to avoid letting stress get
the better of my own health?
Mark Winwood: Hi Claire - Gaining control
is the key to avoiding stress. Stress management starts,
however, with identifying the sources of stress in your life.
This isn't as easy as it sounds. Your true sources of stress aren't
always obvious, and it's all too easy to overlook your own
stress-inducing thoughts, feelings, and behaviours. For
example you may know that you're constantly worried about
work deadlines, however, maybe it's your procrastination,
rather than the actual job demands, that leads to feel stressed
over a looming deadline.
To identify your true sources of stress, look closely at your
behaviours, thoughts and beliefs:
- Do you explain away stress as temporary ("I just have a million
things going on right now") even though you can't remember the last
time you took a breather and didn't feel stressed?
- Do you define stress as an integral part of your work or home
life ("Things are always really busy around here") or as a part of
your personality ("I have a lot of nervous energy, that's
- Do you blame your stress on other people or outside events, or
view it as entirely normal and unexceptional?
Until you accept responsibility for the role you play in
creating or maintaining it, your stress level will remain outside
your control. Once establishing this you will be able to make
choices which help you reduce your stress.
colnik asked: I have a busy life and recently
been a bit stressful for lots of reasons.I am getting tremendous
pain shooting up the back of my head. Never had this before altho I
have been much more stressed than I am now. We are suffering
particluarly bad weather movements and the atmospheric pressures
seem to be moving an awful lot---can this be making the pain
Mark Winwood: Hi Colnik - interestingly I
have read recently that in a recent piece of research 3 out of 4
respondents believed that the weather had an effect on triggering
headache pain. No one is really sure why this occurs but some
evolutionary scientists believe that it may a naturally
occurring protective factor encouraging the sufferer from moving to
an environment with a more 'health' temperature or humidity.
The recent pain you describe in the back of your head,
however, could well be due to pressure build-up in your life,
making you feel unable to cope and causing a stress
response. As this pain is new - I would recommend visiting
your GP so that any physical problems can be investigated and
excluded where necessary.
Dervla asked: I was involved in a car accident
back in December and was struck by a lorry from behind with some
force leaving me in hospital for a week, however the physical pains
are much better but I suffer with incredible palpitations both day
and waking me through the night. I have been advised that it is
anxiety but I have also developed tremors in my right hand and arm,
more notable whilst holding a cup, eating or reading. I am
extremely tired all the time and have aversions to certain smells
and tastes, I have just had some blood samples taken today but I
keep being told this is a normal reaction after what I have been
through, but unfortunately I do not feel convinced.
Mark Winwood: Hi Dervla, thank you for your
message the traumatic nature of a car can leave people with varying
degrees of post-accident anxiety. Anxiety is a feeling of
nervousness, fear, worry, and overall apprehension. This can happen
after being involved in an accident where people may suffer from
anxiety attacks which reduce their ability to drive or function
normally in their daily lives. This intense panic and fear people
can experience after an accident often causes people to
harbor a fear of being in another accident or of riding in a
car; everyday activities that people engage in daily.
Other types of anxiety after a car accident can include:
- various ongoing health issues that create stress;
- insomnia, nightmares, or disrupted sleep; and
- Post-Traumatic Stress Disorder (PTSD).
Anxiety manifests differently for each person. Some people
experience panic which can be very frightening, this can include
some of the symptoms you are experiencing such as:
- heart palpitations;
- trembling, numbness, and tingling;
- shortness of breath and dizziness;
- chest pain;
- nausea, chills, and hot flashes;
- fear and panic;
- incoherent thoughts and inability to concentrate;
- persistent, excessive, unrealistic worry;
- exhaustion and sleep problems;
- restlessness and irritability; and
- development of phobia
It may be worth speaking to your primary care physician about
the concerns you have about your symptoms and how you feel these
may be linked to a psychological process rather than a physical
Go on-line and visit www.anxietyuk.org.uk
they have some useful self-help information and guides.
optometrist asks: I had a back surgery in 2009.
A few weeks ago I had a road traffick accident causing whiplash and
my back pain has increased, working as an optometrist makes it
worse. I am in agony at the end of the day after work. Is there
anything that i can do to help?
We asked Jan Vickery, our Lead Physiotherapist to answer
Jan Vickery: Yes, there is plenty that you can do
- Firstly, try to avoid prolonged periods of being in the same
posture. Break up static postures by moving around as much as
possible. It may not be feasible to go for a walk, but simply
adjusting you working posture can have a big impact on discomfort.
Similarly, try to avoid doing the same thing repeatedly. If you
can, alternate or rotate the different tasks that you do so that
this creates postural variation.
- Aim to keep you back in an s-shaped posture and make sure that
it is well supported whenever possible. This means that if you are
sitting down, ensure that the arch in your lower back is well
supported by the chair backrest.
- Take a good look at your workplace - look at whether working
heights and equipment layout are conducive to the optimal working
- If you have Occupational Health support at work they will
be able to give you further, more specific guidance.
Want to find out more about stress? Feel free to browse our stress factsheets, or leave a question for our panel
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