Stress as a perceived demand or threat can come to us from multiple sources, and usually many are occurring at once. In stress management, we can generally refer to stressors as being of a personal or environmental nature. The environmental ones may be general or special. Part of your discussion with a stressed client can usefully centre on which types of stressors the client is experiencing more of. For instance, some clients may be very comfortable in their work environment, but are having intense relational difficulties (a personal stressor), while others may be dealing with the effects of events such as job redundancy, resulting in the environmental stressors of insufficient funds, possible need to shift house or relocate to a different city, or massively re-arrange finances in order to survive.

Sources of stress

Personal stressors refer to perceptions, events, or occurrences that are personal to us, such as problems in relationships, self-doubt, fears, and questions about our own worthiness. Rigid or unrealistic attitudes belong to this category, as when we are perfectionistic, place unrealistic expectations on ourselves or others, or decide that we cannot possibly be happy if we do not attain ______.

General environmental stressors refer to external factors such as having insufficient money, substandard housing, or a poor physical environment (say, one which is polluted, too hot or cold, or dangerous). Special environment stressors include those areas of perceived pressure or threat to do with particular aspects of our environment, such as work and family events.

An example of how all three sources could contribute at once can be found in the example of the woman who, for instance, has an argument with her partner in the morning (personal). She is upset because the apartment they are living in is expensive, but still cold and humid (general environmental). The woman goes to work feeling stressed already, but upon arriving, gets a dressing-down from the project manager over something that has gone wrong in the new multi-million dollar computer system that is being trialled (special environment).

Here is what is interesting about stress management, however. The woman will respond to all of these events according to her mental/emotional makeup, level of coping skills, and even, how well she feels physically on the day. Someone else may respond totally differently, or she herself may respond differently on another day. Thus, it is crucial to note that stress is at least partly a function of our reaction to perceived threat, pressure, or demand (AIPC, 2012). Note that this is a crucial point for clients to get about stress: their reactions, like their DNA, are unique to themselves, so you cannot tell them how much stress they will have as a result of a given stressor. Only they – through constant attention to self-awareness – can work out how much they are being affected. Below we look into symptoms of stress that may manifest upon being exposed to stressors.

Symptoms of stress

As your clients come into greater self-awareness, they may notice symptoms that they had not particularly focused on before. Our reaction to stressors can include a wide array of physical, emotional, cognitive, and behavioural responses, many of which can also be characteristic of other physical or mental disorders. A doctor can help them rule out causes other than stress after they have undergone a physical examination. Signs of stress can include the following (give the client a copy of the following list and invite him or her to tick which ones apply):

Physical:

• Poor eating
• Digestive upsets
• Lump in the throat
• Nausea
• Dizziness
• Sweating/sweaty palms
• Chills
• Broken sleep
• Excessive dreams
• Rapid breathing
• Clenched jaw
• Racing heart
• Aching muscles or muscle tension/twitching
• Increased heart rate
• Hyperventilating
• Grinding teeth
• Difficulty swallowing
• Nervousness
• Agitated behaviour, like twiddling fingers
• Playing with one’s hair
• General restlessness
• Non-cardiac chest pains
• Stumbling over words
• High blood pressure
• Lack of energy
• Fatigue

Emotional

• Undue anxiety
• Undue fear
• Irritation
• Undue concerns
• Low self-esteem
• Mood swings
• Sudden anger
• Feeling alone
• Feeling lost
• Feeling guilty
• No sense of humour
• Wanting to hide
• Feeling overworked
• Easily upset
• Feeling overwhelmed
• Frustration
• Jumpiness/over-excitability
• Sense of helplessness
• Apathy

Psychological

• Confused thinking
• Poor decisions
• Constant worry
• Difficulty concentrating
• Disorientation
• Mental slowness
• Reduced scrutiny
• Memory lapses
• Forgetfulness
• Abnormal ‘after the event’ thoughts
• Undue daydreaming
• Racing mind
• General negative attitudes
• Decreased problem-solving

Additionally, you may exhibit some of the following behavioural signs of stress:

• Decreased contact with family and friends
• Poor work relations
• Sense of loneliness
• Decreased sex drive
• Avoiding others (and being avoided) because of being cranky
• Failing to set aside times for relaxation through activities such as hobbies, art, music, or reading

The presence of only one or two of the above symptoms could be from other sources, but when several are present, the chances are good that stress is causing them. Clients who are experiencing the symptoms may know their own body/mind well enough to know whether the symptoms are probably “just” stress or they indicate something else. Be alert, however, for signs that the client may be denying or minimising what is happening for them. Alternatively, some people may acknowledge a phenomenon (admitting that they aren’t seeing friends so much or that they haven’t wanted any sex lately, for example), but disavow the effect on themselves. If you are supporting someone who is undergoing a challenging period, strongly urge the person to see a doctor and get the symptoms checked out as an early “homework ” task for their psychoeducation program with you (AIPC, 2012; Bressert, 2013).

When the stress goes on too long

If the stress becomes chronic, serious health consequences follow. Diseases such as the following have been identified as stress-linked:

• High blood pressure
• Angina (chest pain due to inadequate oxygen to the heart)
• Atherosclerosis (hardening of the arteries)
• Thrombosis (blood clot problems)
• Coronary heart disease
• Depression
• Migraine
• Back problems
• Ulcer
• Asthma and allergies (Clarke, 1998)
• Suppression of the immune system leading to:
• Cancer and
• Gastrointestinal,
• Skin,
• Neurological, and
• Emotional disorders

In addition, escalated stress and anxiety in individuals without a means to cope with them are often linked to psychological and physiological conditions such as:

• Amnesia
• Sleepwalking
• Dissociative Identity Disorder (formerly called Multiple Personality Disorder)
• Obsessive-compulsive disorders
• Phobias
• Generalised anxiety disorder
• Hypochondriasis (AIPC, 2012; Bressert, 2013)

Additional reading

There are literally thousands of books, articles and websites that cover stress and stress management. However, the ancient and natural ways are probably still the best ways towards peace and serenity. The old adage, ‘prevention is better than cure’ is certainly true for stress management. This article covers three counselling techniques to help clients.

References

• Australian Institute of Professional Counsellors (AIPC). (2012) Mental Health Social Support, an online course. AIPC.
• Bressert, S. (2013). The impact of stress. Psych Central. Retrieved on 3 February, 2016, from: hyperlink.