Barking and Dagenham

Stress

Stress causes physical changes in the body designed to help you take on threats or difficulties. You may notice that your heart pounds, your breathing quickens, your muscles tense, and you start to sweat. This is sometimes known as the fight or flight response.

Once the threat or difficulty passes, these physical effects usually fade. But if you're constantly stressed, your body stays in a state of high alert and you may develop stress-related symptoms.

Symptoms of stress
Stress can affect how you feel emotionally, mentally and physically, and also how you behave. How you may feel emotionally overwhelmed irritable and "wound up" anxious or fearful lacking in self-esteem How you may feel mentally racing thoughts constant worrying difficulty concentrating difficulty making decisions How you may feel physicallyheadaches muscle tension or pain dizziness sleep problems feeling tired all the time eating too much or too little How you may behave drinking or smoking more snapping at people avoiding things or people you are having problems with Visit the Mind website for more signs of stress.

How to tackle stress

You can't always prevent stress, but there are lots of things you can do to manage stress better. You could:

• try these 10 simple stress busters
• use these easy time-management techniques
• try mindfulness – studies have found mindfulness can help reduce stress and improve your mood
• use calming breathing exercises
• download some relaxation and mindfulness apps on to your phone
• listen to an anxiety control audio guide

Depression

Depression is more than simply feeling unhappy or fed up for a few days. Most people go through periods of feeling down, but when you're depressed you feel persistently sad for weeks or months, rather than just a few days. Some people think depression is trivial and not a genuine health condition. They're wrong – it is a real illness with real symptoms. Depression isn't a sign of weakness or something you can "snap out of" by "pulling yourself together".

The good news is that with the right treatment and support, most people with depression can make a full recovery.

How to tell if you have depression
Depression affects people in different ways and can cause a wide variety of symptoms. They range from lasting feelings of unhappiness and hopelessness, to losing interest in the things you used to enjoy and feeling very tearful. Many people with depression also have symptoms of anxiety.

There can be physical symptoms too, such as feeling constantly tired, sleeping badly, having no appetite or sex drive, and various aches and pains. The symptoms of depression range from mild to severe. At its mildest, you may simply feel persistently low in spirit, while severe depression can make you feel suicidal, that life is no longer worth living.

Most people experience feelings of stress, unhappiness or anxiety during difficult times. A low mood may improve after a short period of time, rather than being a sign of depression. Read more about low mood and depression. If you've been feeling low for more than a few days, take this short test to find out if you're depressed.

Insomnia

Insomnia means you regularly have problems sleeping. It usually gets better by changing your sleeping habits.

You have insomnia if you regularly:

• find it hard to go to sleep
• wake up several times during the night
• lie awake at night
• wake up early and can't go back to sleep
• still feel tired after waking up
• find it hard to nap during the day even though you're tired
• feel tired and irritable during the day
• find it difficult to concentrate during the day because you're tired.

PTSD (Post-traumatic stress disorder)

In our everyday lives, any of us can have an experience that is overwhelming, frightening, and beyond our control. For example, we could find ourselves in a car crash, be the victim of an assault, or see an accident. Most people, in time, get over experiences like this without needing help. In some people, though, traumatic experiences set off a reaction that can last for many months or years.

There are three main types of symptoms of post-traumatic stress disorder (PTSD):

• Flashbacks and nightmares. You find yourself re-living the event, again and again. This can happen both as a ‘flashback’ in the day and as nightmares when you are asleep. Ordinary things can trigger off flashbacks.
• Avoidance and numbing. It can be just too upsetting to re-live your experience over and over again. So you distract yourself. You keep your mind busy by losing yourself in a hobby, working very hard, or spending your time absorbed in crosswords or jigsaw puzzles. You avoid places and people that remind you of the trauma, and try not to talk about it.

Being ‘on guard’. You find that you stay alert all the time, as if you are looking out for danger. You can’t relax. This is called ‘hypervigilance’. You feel anxious and find it hard to sleep.

Phobias (social phobia and specific phobia)

Social phobia

Social phobia involves a fear of embarrassment or humiliation in situations where you may be exposed to the scrutiny and judgment of others or you must perform. It is a fear of being with other people which can cause significant restrictions on the way in which an individual can lead their life. This can make it hard to eat out or speak to other people, particularly if you are meeting someone for the first time or at parties.

The most common form of social phobia is a fear of speaking in public. Other social phobias include:

• A fear of blushing in public
• A fear of choking or spilling food whilst eating in public
• A fear of crowds
• A fear of using public toilets

People can also experience a number of physical symptoms such as a very dry mouth, sweating, palpitations, wanting to pass water or empty their bowels and a feeling of numbness or pins and needles in their fingers and toes.

Specific phobia

Specific phobias are common and typically involve a strong fear and avoidance of one particular type of object or situation. The fear and avoidance typical of specific phobias can cause an individual significant distress and interfere with daily functioning and lead to increased anxiety.

Among the most common specific phobias are the following:

• Fear of animals
• Fear of heights
• Fear of flying
• Fear of lifts
• Fear of the doctor/dentist
• Fear of thunder and/or lightning
• Fear of blood, your own or others
• Illness phobia

Specific phobias are often childhood fears which were never outgrown, may develop after a traumatic event such as an accident, natural disaster, illness or for example, being bitten by an animal. These may also develop from the repeated observation of a parent or primary caregiver who also has a specific phobia.

OCD (obsessive compulsive disorder)

In general, people with OCD experience obsessions. These are thoughts, pictures or impulses which are usually unpleasant and come in to mind when we don’t want them. Many things can trigger these obsessions and they usually leave the person feeling very anxious, uncomfortable or frightened. The compulsion is the behaviour performed in order to “put right” the obsession.

Sometimes the behaviour is quite irrational, such as counting up in sevens for seven minutes. Sometimes the behaviour is more closely related to the obsessional thought such as washing hands many times to avoid contamination.

Most people with OCD know that their compulsions are irrational or “over the top”, but they feel unable to control their thoughts or change their behaviour.

OCD affects people in a number of ways, such as the following:

What we think:

• Obsessions
• Guilty thoughts

How we feel:

• Tension
• Anxiety
• Agitation

What we do:

• Compulsion
• Avoidance
• Seeking reassurance

Most people who have OCD find that there is a pattern in their thoughts, feelings and actions. They feel anxiety or discomfort at having the obsession and relief once they have carried out the compulsive act. This becomes a vicious cycle which strengthens itself and becomes more likely to happen again.

Generalised anxiety disorder

Anxiety can feel like a fear and when it’s caused by a problem in our life that we can’t solve, such as money difficulties, we call it worry. If it is a sudden reaction to an immediate threat, like looking over a cliff or being confronted by an angry dog, we call it fear. Although these feelings are unpleasant, they exist for a purpose. Worry, fear and anxiety can all be helpful.

Psychologically – they keep us alert and give us the motivation to plan and to deal with problems

Physically – they prepare our body for sudden, strenuous exercise, to run away from danger or to attack it – the ‘fight or flight’ response.

These feelings become a problem when they are too strong, or when they carry on even when we don’t need them anymore. They can make you uncomfortable, stop you from doing the things you want to – and can generally make life difficult.

Some of the symptoms people experience are feeling worried, tired, and unable to concentrate, being irritable, sleep disturbance and feeling depressed. There are also a number of common physical reactions such as palpitations, muscle tension, breathing fast, faintness and trembling.

Agoraphobia

Although commonly known as a fear of open spaces, agoraphobia is where a person is afraid of being in situations from which escape might be difficult or help may be unavailable if you were to suffer from a panic attack. Situations can vary from individual to individual and examples can includes a fear of crowds, public places, enclosed or confined places, public transport or being at home alone.

The anxiety involved with agoraphobia arises from the anticipation that you might be stuck in a situation in which you would panic.

The most common feature of agoraphobia is about being far away from home, or far from a safe person, usually a spouse, partner, parent or anyone with whom you have a primary attachment.

This disorder can cause significant restrictions on the way in which individuals lead their lives and, because of this, people may also be depressed. Depression arises from feeling as though you are powerless and have no control over this condition.

Coping better with long term conditions and persistent physical symptoms

Talking Therapies Barking & Dagenham offers support for adults diagnosed with long term health conditions and persistent physical symptoms, such as Diabetes, chronic pain, cardiac and respiratory conditions and long Covid (this is not an exhaustive list), who are experiencing symptoms of depression, anxiety and/or stress, using NICE-approved psychological therapies in primary care settings. Living with long term health conditions and persistent physical symptoms can be stressful and difficult to manage, at times, and feeling this way can make it more difficult to manage the condition well.

You may find you prefer either remote or face-to-face sessions and treatment can be offered using digital therapies, group therapy as well as individual treatment according to your individual circumstances.

Please do self-refer to our service. You will have the opportunity to discuss your needs in an initial screening appointment where we will think about the best treatment strategy to help with you individual circumstances’.