Week 1: Understanding chronic pain

Week 4: Healthy thinking, healthy self

Week 5: Balancing your activity patterns

Week 6: Maintaining your gains and staying well

Stress management and relaxation

What is stress?

We all feel stressed from time to time. Stress is simply our body’s response to pressure that we believe we can’t cope with. There are many different situations and events that trigger stress. What triggers stress for one person may not be the same for another. Stress usually occurs in response to situations that are new, unexpected, difficult to control or threatening in some way. The things that trigger stress are called ‘stressors’. Stressors can be internal (e.g., physical illness) or external (e.g., time demands). 

Other examples of common stressors include work and study demands, relationships, injury, important life events, and other day to day tasks that involve time pressures. Stress is not always ‘bad’. Positive events can also trigger stress. For example, planning a holiday or a wedding can be very stressful, even though it is something that you want in your life. Although it can feel uncomfortable, ‘good’ stress can also push us to achieve things and perform better. For example, stress may motivate you to study hard so that you do well on an exam. 

We all deal with stress in different ways. Some people are able to manage stress effectively, whilst others are less likely to cope well. It is helpful to understand what triggers stress for you. Take a moment to think about the types of situations or events that leave you feeling overwhelmed and unable to cope. How do you tend to manage stress? Do you try to avoid the stress or approach it and solve the problem? Understanding your ‘go-to’ way of coping with stress is helpful when learning to mitigate the negative effects of stress. 

Understanding the stress response 

Your brain and body are in constant communication with each other. If you’ve ever experienced a ‘gut feeling’ or ‘butterflies in your stomach’, then you have felt the effects of the brain-body connection. There is evidence that the communication between the brain and the body is altered in people with chronic pain. When you feel stressed, your brain activates it’s ‘stress response’, which can trigger pain. Having pain can also cause stress and anxiety. As such, stress and chronic pain are intertwined and keep each other alive. 

Your body’s stress response is also called the ‘fight or flight’ response. It is a survival response, designed to help you escape real or imagined danger in your environment. When activated, the fight or flight response causes a range of physical changes in an attempt to help you respond quickly and protect yourself. Your heart and breathing rate gets faster, your blood is directed towards major muscle groups, you start to sweat, your eyes widen, your digestive system slows down, and your muscles tense in preparation for action.  

The name ‘fight or flight’ comes from the way we typically respond to danger; we either stand and fight or we run away (flee) from the situation. Once the danger has passed, the physical changes reverse in an attempt to restore the body to a more relaxed state. Your heart and breathing rate decrease, muscles begin to relax and normal bodily functions begin again. However, the return to normal doesn’t happen straight away and symptoms can remain for some time after the danger has gone. Problems occur when the fight or flight response is triggered too easily, when we are not in a life or death situation. 

In the past, danger mostly came in the form of threats to physical safety. Our ancestors were faced with many life threatening situations, like predator attacks and extreme living conditions. In these cases, the fight or flight response served them well by allowing them to navigate a dangerous world. However, the challenges we face today are often very different to those of the past. Life threatening situations are far less common and modern day ‘predators’ come in the form of inescapable social or psychological pressures. Many of today’s stressors are ongoing and simply don’t allow us to fight or run away from them.  

Examples of ongoing stressors in modern life include a looming work deadline, family difficulties, money issues, traffic jams and a build up of housework. So long as we interpret these things as threatening, our fight or flight system will be activated. As a result, there is chronic or repeated activation of the stress response. Chronic stress can lead to a range of health concerns, including high blood pressure, heart disease, poor sleep, and mental health problems like anxiety and depression. It is also a risk factor for obesity, causing people to eat more, gain stomach fat, and exercise less.