Treating stress

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Once a professional medical practitioner, such as your doctor has diagnosed stress, there are several means of intervention that they might recommend, depending on the severity of the stress and what is triggering it.

It may be that in collaboration with your doctor the best plan of action is to pursue self-help and non-medicinal routes before trying prescribed or over the counter medication.

The NHS site on stress and anxiety mainly concentrates on the many routes there are for the therapy and self-help route. This page will give an overview of these, but for further comprehensive help and information it is always important to consult your GP or other qualified medical practitioners.

In the “Moodzone” on the NHS choices website there are links to several short audio files presented by a medical practitioner on practical problem solving, sleep problems, problems with low mood and depression, and anxiety control training.

For example, the practical problem solving audio  discusses and describes practical problem solving skills - to counter the common side effect of stress and anxiety, namely being unable to focus on the issues at hand, often extreme difficulty in starting or completing tasks in a timely way, and withdrawal.

  1. Cut down the problem into manageable chunks.
  2. Brain storm how to deal with each chunk.
  3. Choose one idea and make a plan to carry it out - particularly one that doesn’t frighten you too much. Then take a piece of papered write down the steps to complete it. Make a note also of the possible obstacles such as unhelpful people, that could stop it happening. Then Think about and write down the solution to those obstacles.
  4. The plan can now be put it into action using a check list - is it realistic, does it aim at one thing at a time, is it slow and steady, does it comprise small easy steps, and are you ready to unblock it if necessary.

Another of the audio files discusses low mood and depression.

In this one 5 key areas of life are assessed.

  1. The people and events going on around you.
  2. Thoughts that are self-critical and unhelpful - blaming yourself for unrealistic chains of events and things which are often not true. 2nd guessing.
  3. Altered feelings - what we think affects our emotions and feelings.
  4. Alterered physical feelings and sensations - exhaustion, tiredness and lethargy. Muscle aches, churning stomach, low sex drive.
  5. Vicious circle - behaviour and activity levels. Sudden or gradual changes in behaviour and decrease in activity; both become a vicious cycle.

These types of assessment and approach are part of what Cognitive Behavioural Therapy (CBT) can achieve. It is designed to help someone understand their situation and to suggest small things that can help to address the issues. A vicious cycle can spin both ways, so a small change in one part can have positive knock on benefits. For example making a small change in behaviour such as calling or speaking to a friend bit how you are feeling can help break out of the isolation which stress, anxiety and depression can lead to.

Cognitive Behavioural Therapy has the aim of helping someone think less negatively, so that instead of feeling hopeless and depressed, better coping mechanisms are explored. Together with the therapist goals are set to carry out tasks between sessions. Someone would typically have around six to 15 sessions, which last about an hour each. It deals with current situations more than events in your past or childhood. CBT has been shown to be very effective for a variety of mental health problems, but this doesn't mean that it's better than other therapies, but simply that others may not have been studied as much. It is available on the NHS for people with depression or any other mental health problems such as anxiety and panic attacks.

Sometimes in consultation with your GP it may become apparent that a combination of CBT and medication may be needed. There are several drugs which could be prescribed - all in the antidepressant family of drug, such as Seroxat. More information can be found about this drug and its side effects on the NHS website.

Your GP can also refer you to other professionals who are trained to treat or help with stress, such as therapists, counsellors and psychotherapists.

Psychotherapy involves talking more about your past to help you overcome problems you’re having in the present. It tends to last longer than CBT and counselling. Sessions are an hour long and can continue for a year or more, sometimes longer. There are different types of psychotherapy, but they all aim to help you understand more about yourself, improve your relationships and get more out of life. There's some evidence that psychotherapy can help depression and some eating disorders.
NHS psychotherapists normally work in a hospital or clinic, where you'll see them as an outpatient. Private psychotherapists often work from home.

All of these professionals belong to their own professional bodies and can be accessed privately as well via referral on the NHS.


References

http://www.nhs.uk/conditions/stress-anxiety-depression/Pages/low-mood-stress-anxiety.aspx

http://www.nhs.uk/Conditions/stress-anxiety-depression/Pages/Types-of-therapy.aspx

http://www.psychotherapy.org.uk

http://www.nhs.uk/medicine-guides/pages/default.aspx

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