Charlie Palmer, Clinical MSK Lead and Dr Jagdeep Ghundoo, Clinical Lead for Kent & Derby psychological therapies discuss how to spot the signs and how to recognise the difference between good and bad stress
Embark on a journey of understanding as physiotherapist Charlie Palmer dissects the dual nature of stress as both a protective mechanism and a motivational force in our daily lives. Jagdeep, a beacon in the field of psychology, navigates us through the murky waters of common stressors, including life changes.
Charlie Palmer, Clinical MSK Lead and Dr Jagdeep Ghundoo, Clinical Lead for Kent & Derby psychological therapies discuss how to spot the signs and how to recognise the difference between good and bad stress
Embark on a journey of understanding as physiotherapist Charlie Palmer dissects the dual nature of stress as both a protective mechanism and a motivational force in our daily lives. Jagdeep, a beacon in the field of psychology, navigates us through the murky waters of common stressors, including life changes.
Yes, and welcome along to another of the Vita Health Group podcasts. Thanks so much for joining us. I'm Glenn Thompson, and the aim of this series of podcasts is to raise awareness of what Vita Health Group has to offer. To do that, I'm joined on each episode by various experts in their chosen field, and today's episode is all about stress. It's fair to say that we all get stressed from time to time, some more so than others, and it affects us in different ways. To chat about stress today, I'm joined by Charlie Palmer and also Dr Jagdeep Gundu. Hello to both of you. Welcome to the podcast. How are you doing?
Speaker 3:Nice to speak with you.
Speaker 2:Nice to speak with you as well. Let's start with you, then, Charlie. Charlie Palmer, who's a clinical lead for Vita's MSK Corporate Service. That sounds like a glorious role.
Speaker 3:Hi, Glenn, Nice to speak with you. Well, my role I've been a physiotherapist for gosh about 18 years now, working in different sectors NHS, privately, in sports settings and my current journey at the moment, at Vita Health Group, we provide physiotherapy and rehabilitation to employees and patients within private medical markets and within occupational health and insurance. So we help support patients who need our help with aches and pains and different conditions that they may have been diagnosed with, and for occupational health, help support, get them back to work and fighting fit as well. So my specific role as clinical lead within our service is to ensure that we're delivering good clinical quality and maintaining good high standards, ensuring that we're safe and we're optimal in terms of making people better. Really.
Speaker 2:And, fair to say, you keep very busy, I would imagine.
Speaker 3:Very busy, yes.
Speaker 2:Yes.
Speaker 3:It's a job that's very busy but very, very varied, which I love. That's the best part of the job.
Speaker 2:Okay, lovely, all right. Dr Jagdeep Gundu, you're a psychologist and clinical lead for Kent and Derby IAPT Services. Nice to talk to you. What exactly does that job entail, then?
Speaker 4:Hi, Glenn, the IAPT Services. They're involved in the NHS side of the business and basically we offer psychological therapies to those that are living in certain areas of the country. Some of those therapies include cognitive behaviour therapy, counselling and EMDR as well. So my job really is just to oversee clinical delivery in Kent and Derby and to ensure that everyone that's living in those areas are receiving good quality psychological therapies.
Speaker 2:All right, jags, thanks very much for that. Let's delve into today's subject, then, which is stress. Charlie, come to you. First of all, simple question what is stress? We all suffer stress, I'm guessing, in different ways, don't we?
Speaker 3:We do in Deagland. Yes, so stress isn't a normal psychological and physiological reaction. That is usually a response to feeling under pressure, challenged or even threatened. Our bodies are actually designed to identify, experience and to react to stress. We often relate this to things like danger, when our bodies' defences automatically initiate a fight or fight response, and this happens through the release of chemicals like adrenaline, and it's our body's way of protecting us, particularly in emergency situations. So, for example, when we need to slam on the brakes to avoid a car accident or we go to catch our child that's falling. And stress processes, when working optimally, can actually help us to stay alert. They can help us to stay focused and energetic and can also help us to rise to meet challenges. So, for example, when that important presentation is coming up or that job interview, that certain level of stress can help us to meet that challenge. But as you said, glenn, we obviously all have different ways of reacting to stress. So a situation that may feel motivating or exciting to one person may actually feel quite threatening to somebody else.
Speaker 2:So I mean, there are physical stresses aren't there? And there are mental stresses and I would imagine you can tell me, because this is the area you work in, your area of speciality, over the last couple of years with COVID and what have you? People have been stressed in different ways, haven't they?
Speaker 3:Yeah, certainly. I mean I think COVID has put a lot of people under pressure mentally, financially, changes in job role, lots of you know, relationship issues due to the stresses that it, that it's placed on us even simple things like childcare and two people trying to work from home, and how do you juggle that when the nursery's closed. So, yeah, certainly, additional pressures like that I think may affect us mentally. I imagine Jags probably has a bit more of an input on that area.
Speaker 2:Yeah, I mean Jags. What are the common causes of stress then?
Speaker 4:There are many factors that can lead to stress, such as bereavement, divorce or separation, losing a job or unexpected money problems, illnesses or living with long term health conditions such as cancer, or any unexpected life events or changes can all lead to chronic stress. Covid was, yes, definitely one of them as well. Another very common area is work related stress as well. This can have quite a negative impact on your mental health and is a particular area of concern for many employers and organisations, as those affected by work related stress typically lose an average of 24 days off work due to ill health. So typically, work related stress could be due to a troubled or difficult work environment. You may feel as if you're unable to cope with the demands of the job and a feeling unsupported. You may be having trouble with relationships at work or are being bullied, or there may be a change in roles and responsibilities which makes it feel unmanageable in some way.
Speaker 2:I mean, you could be the most relaxed and chilled out sort of person on the surface of the world, but you probably still get stressed, don't you Charlie?
Speaker 3:Oh, definitely, as I said earlier, it's quite a normal response and can be quite a positive response to help us react to things. But everybody reacts differently and certainly what may seem like a normal level of stress for one person can feel quite overwhelming for somebody else, and it's when it becomes overwhelming or particularly persistent or chronic that that's when it can really start to cause some issues, you know, mentally and physically longer term within our bodies.
Speaker 2:And what should you do when you start feeling that stress coming on? I mean, do you talk to your GP? A lot of people just keep it bottled up, don't they? They share their problems with their partner or their close family members. They don't sort of do anything in terms of seeking proper medical help, do they? Yeah?
Speaker 3:definitely. I think it's really important to speak to people and to communicate, so knowing when to ask for help or support and knowing when to say no to things Certainly, speaking with people who are close to you your friends and your family is really important, or equally, if you don't feel that you can for whatever reason, certainly discussing how you're feeling with your GP. It's a really important part of the process to ensure that you can manage and cope with your stress properly. They might be able to help provide some strategies that will help you. Obviously, in this day and age as well, there's plenty of resources on the Internet and social media and things like that and lots of really nice, nice tips and things that you can look into to try and help as well.
Speaker 2:Jex, coming to you, what are the outward signs of stress and the symptoms, if you like? I mean, a lot of us just bottle it up and keep it to ourselves, don't we? We don't sort of want to burden other people with it, but what are the outward signs of it?
Speaker 4:People can respond in different ways. However, the common signs that we see are a change in our cognitive abilities. For example, some people may have difficulty concentrating on tasks or have a shorter attention span or difficulty focusing as well as what they used to be able to. They may become more forgetful or have difficulty in retaining new information. They may struggle when it comes to making decisions and be quite indecisive. They might feel like they're lacking in confidence or start to have a real shaky sense of self At times. They may feel quite overwhelmed and be constantly worrying and noticing some signs of anxiety, as well as feeling irritable. And you might also notice some changes in your behaviour as well, such as becoming more withdrawn or avoiding certain places or people.
Speaker 2:So anxiety and stress, charlie, would they go? Is it fair to say they go hand in hand?
Speaker 3:Yeah, I believe so. I think stress can feed into anxiety and then the more anxious you become about things that the more stressed you will become. It can become a little bit of a vicious cycle. Obviously, that vicious cycle then has an effect on you physically as well. So some of the physical signs and symptoms that somebody might be stressed is having less energy, perhaps changes in appetite, frequent illnesses or infections, maybe difficulty sleeping or feeling fatigued during the daytime and even things like decreased sexual appetite. So it's really important to identify where there are levels of stress and anxiety which seems to be driving more of the issue, but certainly trying to break into that vicious cycle that can develop.
Speaker 2:And what about the effects of stress, I mean, on your everyday life? It can be a real burden, can't it?
Speaker 3:Oh, definitely, yeah.
Speaker 3:So chronic stress can affect both our mental and physical well-being. In fact, medical research shows that stress can contribute to the development of a number of major health problems. So things like high blood pressure, heart disease, weakened immune system, obesity, adrenal fatigue, even muscle pain. So over the years as a physio, I've seen many, many cases where musculoskeletal pain, or what we call joint a-companies, and muscles can be actually attributed to chronic stress. So what tends to happen is that muscles tend to contract and tighten as a response to our emotive state and that in turn can then cause discomfort and also restrict blood flow in that area, and over time this can cause chronic pain, particularly in areas of the body like the neck or the back, and can lead to then secondary problems like headaches and migraines. So this is why we have phrases and idioms like someone has the weight of the world on their shoulders or someone's a pain in their neck. It's not necessarily a bit of an old wives tale. Clinically, I used to find that there would often be a link between the two Chronic stress.
Speaker 4:It can lead on to further mental health problems, including depression. So that is usually typified by continuous low mood, feelings of apathy, decreasing motivation, as well as negative or unhelpful thinking and just generally not getting any joy out of life. So again, we might withdraw from any of those activities and, like Charlie said, if you're starting to then feel and experience physical difficulties, you slowly start to withdraw further and further out of your routine and it becomes difficult to keep up with life in general.
Speaker 2:So with stress, then if I'm waking up in the middle of the night and I'm waking up thinking of all sorts of different things, is that anxiety or is that stress?
Speaker 4:It's a good question to ask Glenn. It can be a bit of both, it's like does one lead on to the other? And typically what we tend to see in practice is that when we are stressed we do tend to wake up earlier. So we do tend to have early awakening where things can start to run through our mind and we start to become worried. So the symptoms do sort of cross over into the other.
Speaker 2:If that's happening on a regular basis, you do need to seek some sort of professional medical help, don't you?
Speaker 4:There's a thing about, I think, differentiating between what is a healthy level of anxiety and where that crosses over into it starting to become a little bit more unhelpful, a little bit more in terms of impacting on your quality of life and your daily living, and then seeking help from your GP, for example, to just get a bit of help or a bit of a discussion at least going around what's happening to you, and particularly if it's been ongoing for quite a long period of time as well.
Speaker 2:So how do we cope with stress then, jags, what's the best way of managing it and coping with it?
Speaker 4:Okay. So the first thing is to acknowledge it. What is it that's stressing you? Write it down and try to identify what the problem is. Talk to somebody that you trust, be it a family member or a friend or your GP. A problem shared is a problem halved, and it does tend to help quite a lot because we're used to sort of bottling things up and keeping things to ourselves. So, talking to your GP, that might be the first step in being able to help even just with some medication. The next step is to slow down. Slow everything right down. Think about what your mind needs, and it's usually rest. When we think about those stress symptoms that we've talked about, of shorter attention spans, concentration and ability to retain information, or decreasing, it's because our brains generally just need a rest and they need a switch off from any stimulus and situations that trigger stress.
Speaker 2:Does this happen? Does stress happen to people who maybe don't relax enough, charlie? They don't sort of take enough time out for themselves. You know, go on a cycle ride, go on a run, take the dog for a walk, you know, go for a bit of a walk in the countryside. Does stress affect people who are, you know, focused on work all the time and they don't take any chill out time really?
Speaker 3:Yeah, I definitely think that can play a role. We're all different in how we live our lives and I think it's important that we just ensure we make enough time for ourselves, time for you. We tend to put our own well-being last quite frequently, I think, particularly if you have children or family that you care for. So my recommendations really would be to do anything that you enjoy or anything that makes you feel relaxed, whether that's having a bath, doing a puzzle, reading a book, maybe watching your favorite film or listening to some music, but really just focusing on you.
Speaker 3:I definitely think that exercise plays a key part as well, perhaps those of us that aren't quite active enough, because when we exercise it helps to release the natural feel-good endorphins in our brain. But it's important, obviously, with that to pick something that's realistic and something that you will enjoy and not setting yourself unrealistic goals or something that you don't really want to get out and do because you're not going to do it and then it's not really going to help. And even things like eating well, you know, there's a lot of evidence around the positive effects of eating a healthy, balanced diet in the role of helping with stress things like plenty of fruit and veg, drinking often water, avoiding things like caffeine and alcohol, particularly before bedtime.
Speaker 3:Cutting down on that screen time as well, particularly if you're feeling that your sleep patterns are affected too.
Speaker 2:Yeah, you hear this, don't you? A lot of people who get frustrated with technical things in their lives and devices, phones always on the go, you know there are always messages coming through. That stresses you out, I think also. I mean, my own experience of this is to turn the phone off at night. I always put the phone in the cupboard, you know, in the kitchen. It's never on the side in the bedroom. I just want to keep away from emails. I want to keep away from messages coming through. It doesn't ring that often these days, but you know, I think, switch your device off as well. Move away from that stress. These little devices that we have in the palms of our hands. They're great and they're very helpful, but they can also be a huge stress factor, can't they?
Speaker 3:Totally agree. Yeah, I think they can really impact on our level of stress. You know you could be taking your child to school and if you have your phone with you that has work notifications or social media notifications popping up, it can really distract you from what your priority is there, and then it can add to the list of things that you need to do in your life that day. I think that's a really valuable point, just trying to cut down on that level of communication that isn't necessarily always necessary at that moment in time. Just focus on one thing at a time, even when you're working on your. You know, if you're somebody that works on your computer, don't have all of your programs open at the same time. If you're not sitting tending to your emails, don't have them open in the background, because while you're trying to complete a task like an assignment or a presentation, your emails will be constantly popping up in the background. That will then affect your time management. It will then probably stress you out a little bit and will probably affect your productivity too.
Speaker 2:Absolutely great advice and Jax coming to you finally on today's podcast, really the importance of telling people about how you feel. Don't keep it to yourself. It's so important, isn't it, to share? You know, your stress, problems with other people, with your family members, your partner, isn't it?
Speaker 4:Absolutely. Yeah, it is really important and just speaking about it, even with somebody like your GP or an IAP service, you know, contacting one of the IAP services up and down the country another way to cope with stress is to build our resilience. This is the ability to withstand adversity and bounce back from difficult life events. When it comes to managing stress, being positive generally in life gives us buoyancy and it gives us that bounce, and this helps us to build resilience and strength. So we can start by using things like relaxation techniques. Now, everyone's different, but work out what works for you. Is it meditation? Is it walks amongst nature? Is it music and movement, or mindfulness, or progressive muscle relaxation, where various muscles that usually become tense while we're under stress are engaged for at least 10 to 20 minute periods across three or four times a week. Another thing that we can do is engage in talking therapies, such as cognitive behaviour therapy, which is available in IAP services up and down the country. This can help you tackle any unhelpful thinking habits, such as dwelling on any negatives, becoming self-critical, jumping to conclusions or mind-reading or worrying about what other people think of us as well. Now, when we're stressed, these unhelpful thoughts tend to increase. The thing about unhelpful thinking habits is that they are just that. They are very unhelpful, so it's important to keep on top of them and try and tackle them, and doing that within treatment can be really helpful.
Speaker 4:Also, make some lifestyle changes, such as practising being assertive and straightforward when communicating with others. If people make unrealistic or unreasonable demands on you, so be prepared to tell them how you feel and say no. I can appreciate it. That takes a lot of practice, but it's definitely definitely worth it and can really help you in terms of creating a bigger buffer for yourself and, I think, give yourself a break as well.
Speaker 4:We are generally our own harshest critics, but reward your achievements, however big or small it might be, from cooking dinner to a promotion at work. But taking time out to reflect and be grateful for your achievements and being your own best friend is really important. Thinking about how quickly you'd give a shout out to a friend or a family member for an achievement and how quick you'd be to do that. Why not try that out for yourself? And I think, finally, one of the biggest buffers that we can have is to spend time with friends and family. Now, from an evolutionary perspective, human beings are social beings, and being amongst our circle or group has huge benefits for us and our well-being. So make plans and catch up with those who make you feel like you again.
Speaker 2:In valuable advice. Thank you, jags. The one that leapt out at me there, charlie, was be your own best friend, definitely. I think that's a great phrase be your own best friend.
Speaker 3:I think that's really nice and I totally agree with you there, jags, in terms of us being our own harsh critics. I think society and everything around us does place a certain amount of pressure, but I think for a lot of us we probably pile on the pressure ourselves, sometimes unnecessarily too.
Speaker 2:Lots of help out there. Isn't there guys who you know? If you are suffering stress, there's a lot of help available, isn't there?
Speaker 4:Definitely, there is always information on the NHS websites. There's also information, therefore, you on the Vita health group websites as well. So, in terms of IAPS services, they're available up and down the country and if you're age 16 plus, you're welcome to contact for psychological treatment, and also your GP as well is a good point of contact as well to be able to give more advice on how you're feeling and how to cope with that.
Speaker 2:Well, it's been a fascinating conversation on stress. Thank you so much for your contribution today on the Vita health podcast Charlie Palmer, who is a physiotherapist at Vita health group and looks after the corporate sector, and also dr Jagdeep Gundu, who's a psychologist and clinical lead for Kent and Derby, two areas that are quite wide apart there, aren't they? Really there's quite a gap between the two counties there. Jagdeep isn't there.
Speaker 3:It's a mileage there. Absolutely but we, strangely, we end up working together quite frequently, jag Do you.
Speaker 2:Well, it's been absolutely lovely talking to both of you. Thank you so much. I've learned a lot about stress today and I'm going to keep it well under control because I think you know we all suffer stress in different ways, don't we? As I said at the beginning of the year podcast, some people you know harness it quite well. Others, you know, suffer with it big time, don't they, lovely, take care good to talk to you. All the best.
Speaker 1:Thank you for listening to this making people better podcast, part of the well-being series from Vita health group. Improving your lives, physically and mentally, drives everything we do, and getting you back to doing what you love is our priority. Vita health group making people better wwwVitaHealthGroupcouk.