Stress Management

Practical support to reduce overwhelm and build healthier coping strategies

Stress management focuses on helping you recognise the physical, emotional and behavioural effects of stress and develop practical strategies to manage them more effectively.

Stress is a normal response to demanding situations, but when it becomes persistent it can affect:

• Sleep
• Energy
• Concentration
• Mood
• Muscle tension
• Exercise
• Recovery
• Work
• Relationships
• General wellbeing

The aim of stress management is not to remove every source of pressure from life. It is to help you understand your stress patterns, improve coping strategies and create routines that make day-to-day demands feel more manageable.

Where stress is linked with significant anxiety, depression, trauma or other mental health concerns, additional psychological or medical support may be needed.

What is stress management?

Stress management involves identifying:

• What tends to trigger stress
• How stress affects your body
• How you respond when under pressure
• Which habits make stress easier or harder to manage

Support may include:

• Breathing strategies
• Relaxation techniques
• Physical activity
• Sleep routines
• Time management
• Pacing
• Boundary setting
• Reducing unnecessary overload
• Building recovery time into the day

The approach should be practical and tailored to your circumstances.

Who may benefit from stress management?

Stress management may be useful if you:

• Feel constantly under pressure
• Find it difficult to switch off
• Experience stress-related muscle tension
• Notice your sleep is affected
• Struggle to concentrate
• Feel mentally or physically exhausted
• Find work demands difficult to manage
• Experience stress during rehabilitation
• Find that stress affects exercise or recovery
• Want healthier ways to cope with a busy lifestyle

It may also be helpful for people returning to work after illness, injury or a prolonged period of stress.

What happens during your first appointment?

The first session usually focuses on understanding your current situation.

You may be asked about:

• Work
• Family responsibilities
• Sleep
• Physical activity
• Current symptoms
• Medical conditions
• Pain
• Exercise
• Stress triggers
• How long symptoms have been present
• What you currently do to cope
• What feels most difficult

The aim is to identify the main areas contributing to stress rather than trying to change everything at once.

Understanding the stress response

When you experience stress, the body can become more alert and prepared to respond to a perceived challenge.

You may notice:

• Faster heart rate
• Muscle tension
• Changes in breathing
• Sweating
• Restlessness
• Difficulty concentrating
• Feeling on edge

These responses can be useful in short-term situations.

Problems can develop when the stress response remains active too frequently or for long periods without enough recovery.

Physical signs of stress

Stress can sometimes show up physically before you recognise feeling emotionally overwhelmed.

Common signs may include:

• Neck and shoulder tension
• Jaw clenching
• Headaches
• General muscle tightness
• Fatigue
• Restlessness
• Sleep disturbance
• Digestive discomfort

These symptoms can also have other causes, so persistent or unusual physical symptoms should not automatically be attributed to stress.

Emotional and cognitive signs

Stress may also affect how you think and feel.

You may notice:

• Irritability
• Worry
• Difficulty concentrating
• Feeling overwhelmed
• Racing thoughts
• Reduced patience
• Difficulty making decisions

Recognising these patterns can help you respond earlier rather than waiting until stress becomes difficult to manage.

Behavioural signs of stress

Stress can change everyday behaviour.

Some people may:

• Exercise less
• Stay up later
• Skip meals
• Use more caffeine
• Drink more alcohol
• Withdraw socially
• Work longer hours
• Stop taking breaks

These behaviours can sometimes make stress harder to manage over time.

Identifying your stress triggers

Stress triggers vary between individuals.

They may include:

• Work deadlines
• Financial pressure
• Family responsibilities
• Relationship difficulties
• Health concerns
• Injury
• Lack of sleep
• Travel
• Study
• Major life changes

A useful first step is identifying which demands can be changed and which need to be managed differently.

Short-term versus long-term stress

Short periods of stress are common and do not necessarily indicate a problem.

For example, you may feel temporarily stressed before:

• An important meeting
• An examination
• A sporting event
• A deadline

Long-term stress is more likely to affect health and wellbeing when there is little opportunity for recovery.

Stress management may therefore focus less on eliminating individual stressful moments and more on improving the overall balance between demand and recovery.

Breathing and stress

Stress can change breathing patterns.

Some people begin to breathe:

• Faster
• More shallowly
• Mostly through the upper chest

Slow, controlled breathing can sometimes help reduce physical arousal.

A simple approach may involve:

• Relaxing the shoulders
• Breathing gently
• Slowing the breathing rate
• Allowing a slightly longer exhalation

The goal is not to force very deep breaths.

The technique should feel comfortable.

Breathing exercises

Breathing exercises can be used:

• During stressful moments
• Before sleep
• After work
• Before a difficult conversation
• During periods of tension

You do not need to practise for long periods.

A few minutes may be enough to create a clearer pause between the stressor and your response.

Relaxation techniques

Different relaxation techniques suit different people.

Options may include:

• Slow breathing
• Progressive muscle relaxation
• Gentle stretching
• Walking
• Meditation
• Listening to music
• Quiet time without screens

The most useful technique is usually one you can realistically use when stress is actually present.

Progressive muscle relaxation

Progressive muscle relaxation involves deliberately tensing and then relaxing different muscle groups.

This can help you become more aware of where you hold tension.

It may be useful for people who notice stress around the:

• Jaw
• Neck
• Shoulders
• Back
• Hands

It should remain gentle if you have an injury or painful condition.

Mindfulness and stress

Mindfulness involves paying attention to the present moment rather than becoming completely absorbed by thoughts about:

• The past
• The future
• Work
• Worries

Some people find short mindfulness practices useful for reducing mental overload.

However, mindfulness is not essential.

If another relaxation technique works better for you, it can be used instead.

Physical activity and stress

Regular physical activity can be a useful part of stress management.

This may include:

• Walking
• Cycling
• Swimming
• Strength training
• Running
• Exercise classes
• Sport

Exercise can provide:

• A break from work
• Physical release
• Routine
• Social connection

The activity should be appropriate for your health and current physical ability.

Exercise does not need to be intense

Stress management does not require exhausting workouts.

Moderate activities such as:

• Walking
• Easy cycling
• Gentle strength training

may be more sustainable during busy or stressful periods.

Very intense exercise can become another source of pressure if it is difficult to recover from.

Stress and exercise consistency

When stress increases, exercise is often one of the first habits to disappear.

Instead of abandoning exercise completely, it may help to temporarily adjust:

• Session duration
• Intensity
• Frequency

For example, a shorter walk may be more realistic than a full gym session during a particularly demanding day.

The aim is to keep some movement in the routine without creating additional stress.

Stress and sleep

Stress can make it harder to:

• Fall asleep
• Stay asleep
• Switch off mentally
• Feel refreshed

Poor sleep can then make stress more difficult to manage the following day.

Stress management may therefore include:

• A consistent evening routine
• Reducing late work
• Limiting stimulating activity before bed
• Creating a clear transition between work and sleep

Persistent sleep problems may require more specific sleep assessment.

Creating a wind-down period

A short wind-down period can help separate the working day from the evening.

This might include:

• Changing clothes
• Going for a walk
• Preparing dinner
• Listening to music
• Reading
• Gentle exercise

The routine does not need to be complicated.

The aim is to provide a clear signal that the demanding part of the day has ended.

Stress and work

Work is a common source of stress.

Contributing factors may include:

• High workload
• Tight deadlines
• Long hours
• Lack of control
• Difficult communication
• Constant availability

Stress management may involve reviewing what can realistically be changed.

This may include:

• Prioritising tasks
• Taking regular breaks
• Setting clearer boundaries
• Reducing unnecessary multitasking
• Discussing workload where appropriate

The solution should reflect the actual demands of your role.

Taking breaks at work

Working continuously for long periods can increase:

• Fatigue
• Mental overload
• Physical stiffness

Short breaks may involve:

• Standing
• Walking
• Getting water
• Changing tasks briefly

The aim is not to stop work constantly but to prevent hours of uninterrupted physical and mental demand.

Work boundaries

Technology can make it difficult to stop working.

Some people continue to:

• Check emails
• Reply to messages
• Think about work

well into the evening.

Where possible, setting a clearer finishing point can help protect:

• Sleep
• Exercise
• Family time
• Recovery

Not every job allows complete separation, so boundaries should be realistic.

Working from home

Home working can blur the boundary between:

• Work
• Rest
• Family time

Helpful strategies may include:

• Working in a designated area
• Starting and finishing at predictable times
• Taking a short walk after work
• Putting work equipment away

These routines can create a clearer transition even when your workplace is at home.

Time management

Poor time management can increase the feeling that everything is urgent.

Stress management may involve:

• Prioritising important tasks
• Breaking large tasks into smaller steps
• Allocating realistic time
• Avoiding unnecessary over-scheduling

The goal is not to fill every minute more efficiently.

It is to reduce avoidable overload.

Prioritising tasks

Not every task has equal importance.

It may help to separate tasks into:

• Urgent and important
• Important but not urgent
• Tasks that can wait
• Tasks that can be delegated or removed

This can reduce the feeling that everything must be completed immediately.

Multitasking

Trying to manage several demanding tasks at the same time can increase mental fatigue.

Where possible, focusing on one task for a defined period may improve:

• Concentration
• Efficiency
• Sense of control

Reducing notifications or unnecessary interruptions may also help.

Setting realistic expectations

Stress can increase when expectations consistently exceed available:

• Time
• Energy
• Resources

This may involve expectations from:

• Work
• Family
• Yourself

A useful part of stress management is recognising when “good enough” is more realistic than trying to complete everything perfectly.

Perfectionism and stress

Perfectionism can contribute to:

• Procrastination
• Overworking
• Difficulty finishing tasks
• Fear of mistakes

You may benefit from setting clear standards for what genuinely requires high precision and what simply needs to be completed appropriately.

Learning to say no

Taking on too many responsibilities can create chronic overload.

Where appropriate, stress management may involve practising how to:

• Decline additional tasks
• Negotiate deadlines
• Ask for help

This does not mean avoiding responsibility.

It means recognising realistic limits.

Stress and pain

Stress can influence how pain is experienced.

When someone is:

• Tired
• Tense
• Anxious
• Overloaded

pain may feel more difficult to manage.

This does not mean the pain is imaginary.

Stress management can sometimes support pain rehabilitation by reducing one of the factors contributing to overall sensitivity.

Stress-related muscle tension

Some people notice more tension around the:

• Jaw
• Neck
• Shoulders
• Back

during stressful periods.

Relaxation and movement may help.

Persistent or recurrent symptoms may also require:

• Physiotherapy
• Strengthening
• Workplace changes

Muscle tension should not automatically be treated as purely stress-related.

Stress and headaches

Stress may contribute to some types of headache.

However, headaches can have many causes.

New, severe or unusual headaches should receive appropriate medical assessment.

Stress management may be useful when tension or lifestyle factors appear to contribute to recurring symptoms.

Stress and jaw tension

Some people:

• Clench their jaw
• Grind their teeth
• Hold facial tension

when stressed.

Helpful strategies may include:

• Becoming aware of clenching
• Relaxing the jaw
• Breathing exercises
• Managing stress triggers

Persistent jaw pain may also require TMJ assessment or dental review where appropriate.

Stress during injury rehabilitation

Injury can be stressful.

People may worry about:

• Recovery time
• Work
• Sport
• Loss of fitness
• Reinjury

Stress management may help you stay engaged with rehabilitation without becoming overwhelmed by every symptom or setback.

The physical rehabilitation programme should still progress according to the injury.

Stress and persistent pain

Persistent pain can itself become a major source of stress.

People may experience:

• Frustration
• Worry
• Reduced activity
• Sleep disruption

A broader pain-management approach may therefore include:

• Exercise
• Pacing
• Stress management
• Sleep support

The goal is to improve overall function rather than focus only on pain intensity.

Stress after surgery

Recovery after surgery can involve uncertainty and reduced independence.

Stress may increase because of:

• Pain
• Restrictions
• Time away from work
• Reduced exercise

Stress-management strategies may help maintain a more stable routine while physical rehabilitation progresses.

Any surgical restrictions should still be followed.

Stress and long-term conditions

Living with a long-term condition can create ongoing demands.

These may include:

• Appointments
• Medication
• Fatigue
• Changes in mobility

Stress management may help with:

• Planning
• Pacing
• Maintaining activity
• Protecting recovery time

Medical management should continue alongside lifestyle support.

Stress and neurological conditions

Conditions such as:

• Parkinson's disease
• Multiple sclerosis
• Stroke

can affect both physical function and emotional wellbeing.

Stress management may support:

• Routine
• Sleep
• Activity
• Coping

Symptoms related directly to the neurological condition should continue to be managed by the appropriate healthcare team.

Stress and Long COVID

Long COVID can involve:

• Fatigue
• Sleep disturbance
• Difficulty concentrating
• Reduced exercise tolerance

These symptoms can themselves be stressful.

Support may include:

• Pacing
• Managing routines
• Reducing unnecessary demands
• Sleep support

Activity should not simply be increased if it causes delayed worsening of symptoms.

Stress and cardiac rehabilitation

Stress management can form part of broader cardiovascular rehabilitation.

Strategies may include:

• Relaxation
• Physical activity
• Sleep routines
• Reducing unnecessary overload

New chest pain, fainting or significant unexplained breathlessness requires medical assessment rather than stress coaching alone.

Stress and breathing difficulties

Anxiety and stress can sometimes make breathing feel:

• Fast
• Shallow
• Difficult to control

Breathing strategies may help where stress contributes.

However, new or significant breathlessness should not automatically be assumed to be caused by stress.

Medical assessment may be required.

Stress and digestion

Stress may affect:

• Appetite
• Digestive comfort
• Eating habits

However, persistent digestive symptoms should receive appropriate medical assessment rather than being attributed automatically to stress.

Stress and caffeine

People sometimes increase caffeine when they feel:

• Tired
• Busy
• Under pressure

High caffeine intake may contribute to:

• Restlessness
• Palpitations
• Poor sleep

Reducing late or excessive caffeine may be useful for some people.

Stress and alcohol

Some people use alcohol to:

• Relax
• Switch off
• Help themselves sleep

This may provide short-term relief but can worsen:

• Sleep
• Mood
• Recovery

If alcohol use is becoming difficult to control or is causing harm, appropriate specialist support should be sought.

Stress and smoking or nicotine

Some people use nicotine during stressful situations.

Although it may feel temporarily calming, nicotine can contribute to dependence and may affect:

• Sleep
• Cardiovascular health

Specialist cessation support may be useful if you want help reducing or stopping.

Stress and food

Stress may change how people eat.

Some may:

• Skip meals
• Eat more frequently
• Choose convenience foods

The goal is not to create rigid dietary rules.

A more consistent routine around meals may support energy and general wellbeing.

Specialist dietary concerns should be managed with an appropriately qualified professional.

Social support

Talking to someone can help reduce the feeling of managing everything alone.

Support may come from:

• Family
• Friends
• Colleagues
• Community groups
• Healthcare professionals

Stress management may involve identifying where asking for support is appropriate.

Making time for enjoyable activities

When people become very busy, enjoyable activities are often removed first.

However, hobbies and social activities can provide:

• Mental recovery
• Social connection
• Enjoyment

Stress management may therefore include protecting time for activities that are not related to work or responsibilities.

Spending time outdoors

Outdoor activity can provide:

• Movement
• A break from screens
• A change in environment

This may include:

• Walking
• Gardening
• Sitting outside

It does not need to involve formal exercise.

Digital overload

Constant notifications, messages and online information can make it difficult to mentally switch off.

Strategies may include:

• Turning off non-essential notifications
• Setting periods without work email
• Keeping the phone away during selected activities
• Reducing unnecessary news or social media checking

The goal is not complete digital avoidance.

It is to regain more control over attention.

Stress management and meditation

Meditation can be useful for some people.

It may help create a period of:

• Quiet
• Attention
• Reduced mental stimulation

It is not essential to meditate for long periods.

Short practices may be more sustainable.

If meditation makes you uncomfortable, other strategies can be used.

Journalling

Some people find writing useful for organising thoughts.

You may write down:

• Concerns
• Tasks
• Priorities
• Things to address tomorrow

This can sometimes reduce repeated mental rehearsal at night.

Journalling should be used only if it feels helpful rather than becoming another task.

Planning recovery time

Recovery is not only relevant to athletes.

Busy periods of work, family responsibility or rehabilitation can also require deliberate recovery.

This may include:

• Sleep
• Exercise
• Social time
• Quiet periods
• Hobbies

Recovery should ideally be built into the routine rather than added only after exhaustion occurs.

Pacing and stress

Pacing can help when physical or mental demands become difficult to sustain.

This may involve:

• Breaking tasks into smaller sections
• Alternating demanding and lighter tasks
• Planning breaks
• Avoiding repeated boom-and-bust cycles

Pacing should support continued participation rather than encourage complete avoidance.

Avoiding an all-or-nothing approach

Stress can make routines unpredictable.

You may not always manage the full planned:

• Workout
• Relaxation session
• Walk

A shorter version can still be useful.

Flexible routines are often easier to maintain than plans that only work on ideal days.

Building habits gradually

Trying to change:

• Sleep
• Exercise
• Work habits
• Diet
• Relaxation

all at once can create more pressure.

It may be more useful to begin with one or two changes.

Once they feel manageable, additional strategies can be introduced.

Tracking stress

Some people find it useful to notice patterns in stress.

You might record:

• Major triggers
• Sleep
• Exercise
• Energy
• How you responded

Tracking should remain simple.

The purpose is to identify patterns, not to monitor every moment of the day.

Stress management at work

Workplace strategies may include:

• Clearer task priorities
• Short breaks
• Better communication
• Adjusting workload where possible
• Planning demanding tasks at more suitable times

Where work stress is severe, discussion with:

• A manager
• Occupational health
• Human resources

may also be appropriate.

Returning to work after illness or injury

Returning to work after a health problem can be stressful.

You may be concerned about:

• Workload
• Fatigue
• Physical demands
• Keeping up with colleagues

A phased return or temporary modification of duties may sometimes be appropriate.

Stress management can support this process alongside rehabilitation and occupational guidance.

Stress management for athletes

Athletes may experience stress related to:

• Competition
• Selection
• Injury
• Performance
• Training demands

Support may involve:

• Better recovery routines
• Sleep
• Planning
• Breathing strategies

Significant performance anxiety may require input from an appropriately trained psychologist or other specialist.

Stress before competition

Feeling some stress before competition is normal.

The aim is not always to eliminate nervousness.

Strategies may include:

• Familiar warm-up routines
• Controlled breathing
• Focusing on controllable tasks
• Avoiding major changes to routine

For some athletes, a moderate level of arousal may feel useful rather than harmful.

Stress and exercise performance

High levels of stress may affect:

• Concentration
• Recovery
• Motivation
• Perceived effort

If training feels unusually difficult during a stressful period, temporary adjustments may be appropriate.

This does not necessarily mean stopping exercise completely.

Stress management for students

Study-related stress may come from:

• Exams
• Deadlines
• Workload
• Lack of sleep

Useful strategies may include:

• Breaking study into planned blocks
• Regular movement
• Protecting sleep
• Taking short breaks

Significant anxiety or difficulty coping should be discussed with an appropriate healthcare or educational support service.

Stress management for carers

Caring responsibilities can create sustained physical and emotional demands.

Carers may neglect:

• Exercise
• Sleep
• Medical appointments
• Social activity

Stress management may involve identifying realistic opportunities for:

• Rest
• Support
• Shared responsibilities

The needs of the carer are also important.

When stress management is not enough

Stress-management techniques may be useful for everyday stress, but they are not a replacement for specialist mental health care.

Additional support may be appropriate if you experience:

• Persistent low mood
• Severe anxiety
• Panic attacks
• Trauma-related symptoms
• Significant difficulty functioning
• Major changes in sleep or appetite
• Increasing dependence on alcohol or other substances

These concerns should be discussed with an appropriate healthcare professional.

Stress management is not psychotherapy

Stress management may include practical support around:

• Routines
• Relaxation
• Activity
• Coping strategies

It does not replace formal psychological therapies when these are needed.

Psychological therapies may be more appropriate when thoughts, emotions or past experiences are creating significant distress.

Stress should not explain every physical symptom

Stress can contribute to many physical sensations, but new symptoms should still be appropriately assessed.

Do not automatically assume symptoms are caused by stress if you develop:

• Chest pain
• Fainting
• Significant breathlessness
• New neurological weakness
• Persistent severe headache
• Significant unexplained weight loss
• Severe or rapidly worsening pain

These may require medical assessment.

Stress management alongside physiotherapy

Stress management may complement physiotherapy when stress is affecting:

• Pain
• Sleep
• Exercise consistency
• Rehabilitation confidence

Physiotherapy can address physical limitations while stress-management strategies help improve the wider environment in which recovery takes place.

Stress management alongside lifestyle coaching

Stress is often linked with:

• Sleep
• Exercise
• Work
• Daily routines

It may therefore form part of a broader lifestyle coaching programme.

The aim is to identify the smallest useful changes rather than create another demanding list of tasks.

Stress management alongside sleep optimisation

Stress and sleep frequently influence each other.

A combined approach may focus on:

• Evening routines
• Reducing late work
• Caffeine timing
• Relaxation
• Consistent sleep habits

Persistent insomnia may still require specialist assessment or treatment.

Progress is not always linear

Stress levels can change because of:

• Work
• Family responsibilities
• Health
• Financial concerns

A difficult week does not mean your strategy has failed.

The aim is to develop tools you can return to when demands increase.

Treatment based on your goals

Your stress-management plan should reflect what matters most to you.

Goals may include:

• Feeling less overwhelmed
• Sleeping more consistently
• Managing work pressure
• Reducing physical tension
• Exercising more regularly
• Supporting rehabilitation
• Improving work-life balance
• Developing healthier coping strategies

The plan can then be adjusted as your circumstances change.

What happens after a stress-management session?

You may leave with a small number of practical strategies.

These might include:

• A breathing exercise
• Scheduled movement breaks
• A more realistic work routine
• A wind-down period
• An exercise goal
• A boundary around work communication

The plan should feel manageable rather than becoming another source of pressure.

How many sessions will I need?

There is no fixed number.

Some people may benefit from one or two sessions to identify practical changes.

Others may prefer periodic reviews while establishing new routines.

If stress is more complex or significantly affects mental health, referral to an appropriate specialist may be recommended.