Moodzone – Stress, Anxiety and Depression

Life’s ups and downs: reasons we’re not cheerful..

Most people experience ups and downs in their life, and can feel unhappy, depressed, stressed or anxious during difficult times. This is a normal part of life.

Many difficult events and experiences can leave us in low spirits or cause depression: relationship problems,bereavement, sleep problems,stress at work, bullying, illness, and pain being just a few.

Changes to hormones, such as during puberty, after childbirth and during the menopause, can also have an effect on your emotional and mental health.

But sometimes it’s possible to feel down without there being an obvious reason.

What is the difference between low mood and depression?

A general low mood can include:

• sadness
• an anxious feeling
• worry
• tiredness
• low self-esteem
• frustration
• anger

However, a low mood will tend to improve after a short time. Making some small changes in your life, such as resolving a difficult situation or talking about your problems and getting more sleep, can improve your mood.

A low mood that doesn’t go away can be a sign of depression. Symptoms of depression can include the following:

• continuous low mood or sadness
• feeling hopeless and helpless
• having low self-esteem
• feeling tearful
• feeling guilt-ridden
• feeling irritable and intolerant of others
• having no motivation or interest in things
• finding it difficult to make decisions
• not getting any enjoyment out of life
• having suicidal thoughts or thoughts of harming yourself
• feeling anxious or worried

Read more about the symptoms of depression, including the physical and social effects.

Depression can also come on at specific points in your life, such as the winter months (SAD) and after the birth of a child (postnatal depression).

Getting help

Whatever the cause, if negative feelings don’t go away, are too much for you to cope with, or are stopping you from carrying on with your normal life, you may need to make some changes and get some extra support.

” We all know what it feels like to be down, says Professor David Richards, professor of mental health services research at the University of Exeter. Most people who feel low will start to feel better after a few days or weeks. But if these feelings persist or get in the way of everyday life, it’s time to seek help.”

If you’re still feeling down or anxious after a couple of weeks, talk to your GP or call NHS 111. A GP will be able to discuss your symptoms with you and make a diagnosis.

Seek help immediately

If you start to feel like your life isn’t worth living, get help straight away. Either see your GP or call NHS 111. You can also contact helplines such as Samaritans on 08457 90 90 90 for confidential, non-judgemental emotional support.

If you’ve had depression or anxiety in the past, even if they weren’t formally diagnosed, get help immediately. You’re more likely to have an episode of depression if you’ve had one before.

What type of help is available?

What is stress?

Stress is the feeling of being under too much mental or emotional pressure.

Pressure turns into stress when you feel unable to cope. People have different ways of reacting to stress, so a situation that feels stressful to one person may be motivating to someone else.

Many of life’s demands can cause stress, particularly work, relationships and money problems. And, when you feel stressed, it can get in the way of sorting out these demands, or can even affect everything you do.

Stress can affect how you feel, think, behave and how your body works. In fact, common signs of stress include sleeping problems, sweating, loss of appetite and difficulty concentrating.

You may feel anxious, irritable or low in self esteem, and you may have racing thoughts, worry constantly or go over things in your head. You may notice that you lose your temper more easily, drink more or act unreasonably.

You may also experience headaches, muscle tension or pain, or dizziness.

Stress causes a surge of hormones in your body. These stress hormones are released to enable you to deal with pressures or threats – the so-called “fight or flight” response.

Once the pressure or threat has passed, your stress hormone levels will usually return to normal. However, if you’re constantly under stress, these hormones will remain in your body, leading to the symptoms of stress.

Managing stress in daily life

Stress is not an illness itself, but it can cause serious illness if it isn’t addressed. It’s important to recognise the symptoms of stress early. Recognising the signs and symptoms of stress will help you figure out ways of coping and save you from adopting unhealthy coping methods, such as drinking or smoking.

Spotting the early signs of stress will also help prevent it getting worse and potentially causing serious complications, such as high blood pressure.

There is little you can do to prevent stress, but there are many things you can do to manage stress more effectively, such as learning how to relax, taking regular exercise and adopting goodtime-management techniques.

Studies have found that mindfulness courses, where participants are taught simple meditations across a series of weeks, can also help to reduce stress and improve mood.

Read more about mindfulness.

When to see your GP about your stress levels

If you’ve tried self-help techniques and they aren’t working, you should go to see your GP. They may suggest other coping techniques for you to try or recommend some form of counselling or cognitive behavioural therapy.

If your stress is causing serious health problems, such as high blood pressure, you may need to take medication or further tests.

Mental health issues, including stress, anxiety and depression, are the reason for one-in-five visits to a GP.

Recognising your stress triggers

If you’re not sure what’s causing your stress, keep a diary and make a note of stressful episodes for two-to-four weeks. Then review it to spot the triggers.

Things you might want to write down include:

• the date, time and place of a stressful episode
• what you were doing
• who you were with
• how you felt emotionally
• what you were thinking
• what you started doing
• how you felt physically
• a stress rating (0-10 where 10 is the most stressed you could ever feel)

You can use the diary to:

• work out what triggers your stress
• work out how you operate under pressure
• develop better coping mechanisms

Doctors sometimes recommend keeping a stress diary to help them diagnose stress.

Take action to tackle stress

There’s no quick-fix cure for stress, and no single method will work for everyone. However, there are simple things you can do to change the common life problems that can cause stress or make stress a problem. These include relaxation techniques, exercise and talking the issues through.

Find out more by checking out these 10 stress busters.

Get stress support

Because talking through the issues is one of the key ways to tackle stress, you may find it useful to attend a stress management group or class. These are sometimes run in doctors’ surgeries or community centres. The classes help people identify the cause of their stress and develop effective coping techniques.

Ask your GP for more information if you’re interested in attending a stress support group. You can also use the search directory to find emotional support services in your area.

Anxiety: sometimes helpful, sometimes a problem

Anxiety is a feeling of unease, such as worry or fear. Everyone has feelings of anxiety at some point in their life.

It’s normal to feel anxious about something like a medical test or job interview.

A little bit of anxiety can be helpful; for example, feeling anxious before an exam might make you more alert and improve your performance. But too much anxiety could make you tired and unable to concentrate.

Anxiety can have both psychological and physical symptoms. Psychological symptoms can include:

• feeling worried or uneasy a lot of the time
• having difficulty sleeping, which makes you feel tired
• not being able to concentrate
• being irritable
• being extra alert
• feeling on edge or not being able to relax
• needing frequent reassurance from other people
• feeling tearful

When you’re feeling anxious or stressed, your body releases stress hormones, such as adrenaline and cortisol. These cause the physical symptoms of anxiety, such as an increased heart rate and increased sweating.

Physical symptoms can include:

• a pounding heartbeat
• breathing faster
• palpitations (an irregular heartbeat)
• feeling sick
• chest pains
• headaches
• sweating
• loss of appetite
• feeling faint
• needing the toilet more frequently
• “butterflies” in your tummy

Anxiety can also be a symptom of another condition, such as panic disorder (when you have panic attacks) or post-traumatic stress disorder, which is caused by frightening or distressing events.

Is anxiety bad for you?

A little anxiety is fine, but long-term anxiety may cause more serious health problems, such as high blood pressure (hypertension). You may also be more likely to develop infections. If you’re feeling anxious all the time, or it’s affecting your day-to-day life, you may have an anxiety disorder.

Anger is a feeling that affects us all. Things that can make us feel angry include a threat to us or people close to us, a blow to our self-esteem or social standing in a group, being interrupted when we’re pursuing a goal, being treated unfairly and feeling unable to change this, being verbally or physically assaulted, or someone going against a principle we feel is important.

Anger is an important emotion, according to Celia Richardson of the Mental Health Foundation.

“It’s the one that tells us we need to take action to put something right,” she says. “Anger is a problem-solving emotion. It gives us strength and energy, and motivates us to act.”

But for some, anger can get out of control and cause problems with relationships, work and even the law.

Physical signs of anger

Everyone has a physical response to anger. Our body releases the hormone adrenalin, making our heart beat faster and making us breathe quicker and sweat more.

This allows us to focus on the threat and react quickly, but it can also mean we don’t think straight, and maybe react in ways we might regret later on.

“One person in five has ended a relationship because of the way the other person dealt with anger,” says Celia.

“Reports show that anger problems are as common as depression and anxiety, but people don’t often see it as a problem, or don’t realise there are ways to tackle it.”

Individual reactions to being angry

How people react to feeling angry depends on many things including the situation, their family history, cultural background, gender and general stress levels.

People can express anger verbally, by shouting. Sometimes this can be aggressive, involving swearing, threats or name-calling. Some people react violently and lash out physically, hitting other people, pushing them or breaking things.

Other people might hide their anger or turn it against themselves. They can be very angry on the inside but feel unable to let it out.

It’s important to deal with anger in a healthy way that doesn’t harm you or anyone else. Intense and unresolved anger is linked to health conditions such as high blood pressure, depression,anxiety and heart disease. It can also affect your relationships and your work, and get you into trouble with the law.

Dealing with anger in a healthy way includes:

• recognising when you get angry
• taking time to cool down
• reducing the amount of stress in your life

You can also look at what makes you angry, and how you deal with those feelings. For specific tips, you can read the article about how to control your anger. The Mental Health Foundation’sCool Down: anger and how to deal with it booklet may also help. It includes advice on where you can go if you want professional support.

The charity Mind also provides information about dealing with anger in a healthy way.

Learning to control your anger

Anger management courses involve group discussions and counselling. If you feel you need help controlling your anger, see your GP.

If uncontrolled anger leads to domestic violence or abuse (violence or threatening behaviour within the home), there are places that offer help and support. Talk to your GP, or contact domestic violence organisations such as Refuge, Women’s Aid or the Alternatives to Violence Project.

Help and support is available for men who are victims of domestic abuse from Men’s Advice Line on 0808 801 0327 or Mankind on 01823 334 244.

You can find out more about recognising the signs of domestic violence, and getting help if domestic violence is happening to you.

Panic symptoms in mind and body

A panic attack is a rush of intense psychological and physical symptoms. These symptoms of panic can be frightening and happen suddenly, often for no clear reason.

Panic attacks usually last between five and 20 minutes, and although it may feel as though you are in serious trouble, they aren’t dangerous and shouldn’t cause any physical harm. It is unlikely you will be admitted to hospital if you have a panic attack.

You may feel an overwhelming sense of fear and a sense of unreality, as if you’re detached from the world around you.

As well as psychological symptoms, you may also experience physical symptoms of panic, such as:

• a sensation that your heart is beating irregularly (palpitations)
• sweating
• trembling
• shortness of breath
• a choking sensation
• chest pain
• feeling sick

The physical symptoms of a panic attack are caused by your body going into “fight or flight” mode in response to something you think is a threat. As your body tries to take in more oxygen your breathing quickens. Your body also releases hormones, such as adrenaline, causing your heart to beat faster and your muscles to tense up.

Trying to slow your breathing may help in panic attacks

If you’re breathing quickly during a panic attack, slowing this down can ease your other symptoms. Here are some things you can try:

• Breathe in deeply through your nose.
• Breathe out slowly through your mouth.
• Focus your thinking on the word “calm”.

Keep calm and concentrate on your breathing. You should start to feel better as the level of carbon dioxide in your blood returns to normal, although you may feel tired afterwards.

Should you see your doctor about panic attacks?

A panic attack can make you feel like you’re about to die but it’s usually harmless once the symptoms pass. However, in some cases, you may need medical advice to rule out an underlying physical cause.

Seek medical advice if:

• Your panic attack continues after following these breathing techniques for 20 minutes.
• You still feel unwell after your breathing returns to normal.
• You still have a rapid or irregular heartbeat or chest pains after your panic attack.
• You regularly have panic attacks, as this could be a sign that you have panic disorder.

Avoiding panic attacks

The following practical suggestions may help prevent panic attacks:

• Learn relaxation techniques, such as deep breathing and muscle stretches – see Relaxation tips to relieve stress.
• Eat regular meals to stabilise your blood sugar levels.
• Avoid caffeine, alcohol and smoking – these can make panic attacks worse.
• Listen to this brief audio guide on understanding panic attacks.

NO PANIC

No panic offers advice, support, recovery programs and help for people living with phobias, OCD and any other anxiety based disorders.

Click here to visit their website

It has long been known that regular exercise is good for our physical health. It can reduce the risk of cancer, heart disease and strokes.

In recent years, studies have shown that regular physical activity also has benefits for our mental health. Exercise can help people with depression and prevent them becoming depressed in the first place.

How much exercise do you need to stay well?

Dr Alan Cohen, a GP with a special interest in mental health, says that when people get depressed or anxious, they often feel they’re not in control of their lives.

“Exercise gives them back control of their bodies and this is often the first step to feeling in control of other events,” he says.

Adults should be active for at least 150 minutes (2 hours and 30 minutes) every week. Find out more:

• activity guidelines for adults (19-64 years old)
• activity guidelines for older adults (65 and over)

Who can benefit and what type of exercise is best?

Anyone with depression can benefit from doing regular exercise, but it’s especially useful for people with mild depression.

“Any type of exercise is useful as long as it suits you and you do enough of it,” says Dr Cohen. “Exercise should be something you enjoy, otherwise it will be hard to find the motivation to do it regularly.”

How often do you need to exercise?

To stay healthy, adults should do 150 minutes of moderate-intensity activity every week. Find out more about:

• physical activity for adults (19-64 years old)
• physical activity for older adults (65 and over)

If you haven’t exercised for a while, gradually introduce physical activity into your daily routine.

Even a 15-minute walk can help you clear your mind and relax. Any exercise is better than none.

How to get started

Take part in a team sport, attend classes at a sports centre, or just be more active in your daily routine by walking or cycling instead of travelling by car.

Find an activity you can do regularly. For more ideas on different types of exercise and the benefits of being more active, see our Fitness section.

To find local exercise classes and sports clubs, search the sport and fitness directory.

If conservation work appeals to you, look at the Green Gym website. Green Gym projects, run in association with The Conservation Volunteers (TCV), provide exercise for people who don’t like the idea of a sports or leisure centre.

A typical project involves working in local woodlands or creating community gardens. Sessions are free and led by a TCV member of staff.

Exercise on prescription

If you haven’t exercised for a long time or are concerned about the effects of exercise on your health, ask your GP about the exercise on prescription programme. Many GP surgeries across the country prescribe exercise as a treatment for a range of conditions, including depression.

Your GP will refer you to a local active health team for a fixed number of sessions under the supervision of a qualified trainer.

You decide what type of activity will suit you with your GP and the active health team. Depending on your circumstances and what’s available locally, the exercise programme may be offered free or at a reduced cost.

Further information on exercise and mental wellbeing

Many treatments are available for depression, including talking therapies, antidepressant medication and self-help of various kinds. Find out more about treatment for depression.

If you’ve been feeling down for more than two weeks, see your GP to discuss your symptoms. They can tell you about the choice of treatment available for depression and help you decide what’s best for you.

Step right up! It’s the miracle cure we’ve all been waiting for. It can reduce your risk of major illnesses, such as heart disease, stroke, diabetes, and cancer, by up to 50%. It can lower your risk of early death by up to 30%. It’s free, easy to take, has an immediate effect and you don’t need a GP to get some.

Its name? Exercise.

Exercise is the miracle cure we’ve always had, but many of us have forgotten to take our recommended dose for too long. Our health could now be suffering as a consequence.

Exercise is no ‘snake oil’. Whatever your age, there’s strong scientific evidence that being physically active can help you lead a healthier and even happier life.

People who do regular activity have a lower risk of many chronic diseases, such as heart disease, type 2 diabetes, stroke and some cancers.

Research shows that physical activity can also boost self-esteem, mood, sleep quality and energy, as well as reducing your risk of stress, depression, dementia and Alzheimer’s disease.

“If exercise were a pill, it would be one of the most cost-effective drugs ever invented,” says Dr Nick Cavill, a health promotion consultant.

The health benefits of exercise

Given the overwhelming evidence, it seems obvious that we should all be physically active. It’s essential if you want to live a healthy and fulfilling life into old age.

Research has found that people who do regular physical activity have:

• up to a 35% lower risk of coronary heart disease and stroke
• up to a 50% lower risk of type 2 diabetes
• up to a 50% lower risk of colon cancer
• up to a 20% lower risk of breast cancer
• a 30% lower risk of early death
• up to an 83% lower risk of osteoarthritis
• up to a 68% lower risk of hip fracture
• a 30% lower risk of falls (among older adults)
• up to a 30% lower risk of depression
• up to a 30% lower risk of dementia

What counts as exercise?

Moderate-intensity aerobic activity means you’re working hard enough to raise your heart rate and break a sweat. One way to tell if you’re working at a moderate intensity is if you can still talk but you can’t sing the words to a song.

Examples of moderate-intensity aerobic activities are:

• walking fast
• water aerobics
• riding a bike on level ground or with few hills
• playing doubles tennis
• pushing a lawn mower

Daily chores such as shopping, cooking or housework don’t count towards your 150 minutes. This is because the effort needed to do them isn’t hard enough to get your heart rate up.

Lack of exercise is a modern problem

People are less active nowadays, partly because technology has made our lives easier. We drive cars or take public transport. Machines wash our clothes. We entertain ourselves in front of a TV or computer screen. Fewer people are doing manual work, and most of us have jobs that involve little physical effort. Work, house chores, shopping and other necessary activities are far less demanding than for previous generations.

Recommended physical activity levels

• Children under five: 180 minutes every day
• Young people (5-18): 60 minutes every day
• Adults (19-64): 150 minutes every week
• Older adults (65 and over): 150 minutes every week

Sedentary lifestyles: a “silent killer”?

Inactivity has been described by the Department of Health as a “silent killer”. Evidence is emerging that sedentary behaviour, such as sitting or lying down for long periods, is bad for your health. Spending hours sitting down watching TV or playing computer games is thought to increase your risk of many chronic diseases, such as heart disease, stroke and diabetes, as well as weight gain and obesity.

Not only should you try to raise your activity levels, but you should also reduce the amount of time you and your family spend sitting down. Common examples of sedentary behaviour include watching TV, using a computer, using the car for short journeys and sitting down to read, talk or listen to music.

“Previous generations were active more naturally through work and manual labour but today we have to find ways of integrating activity into our daily lives,” says Dr Cavill.

Whether it’s limiting the time babies spend strapped in their buggies to encouraging adults to stand up and move frequently, people of all ages need to reduce their sedentary behaviour.

“This means that each of us needs to think about increasing the types of activities that suit our lifestyle and can easily be included in our day,” says Dr Cavill.

Crucially, you can hit your weekly activity target but still be at risk of ill health if you spend the rest of the time sitting or lying down. For tips on building physical activity and exercise into your day whatever your age, read Get active your way.