As it was Stress Awareness Month last month, it has given me an opportunity to reflect on how stress plays a significant part when navigating trauma. This blog will focus on the topic of stress and stress management with regards to trauma recovery and post-traumatic growth.

Nowadays, almost everyone lives busy lives with long to-do lists that can leave them feeling frazzled and overwhelmed. If this sounds familiar to you, you’re not alone. Stress is a common experience, but letting it take over can impact your physical and mental well-being. The good news is that you don’t have to be a victim of stress, as there are practical steps you can take to manage it effectively and find your inner calm amidst the chaos. These steps are called stress management, which can be thought of as building a toolkit of healthy habits and coping mechanisms. It’s not about eliminating stress entirely (which is often unrealistic!), but rather about learning how to navigate it in a way that supports your overall health and happiness.

Most of us know what stress is, and some of us have heard of PTSD, but not many realise the impact of stress on those living with PTSD. After all, the ‘S’ in PTSD stands for ‘stress’. Stress and PTSD have a complex and significant relationship, to say the least. Living with PTSD can make managing everyday stress feel like navigating a minefield. The hypervigilance, intrusive memories, and intense emotional reactions that characterise PTSD can amplify even minor stresses, making it crucial to develop specific and effective coping strategies.

PTSD develops after exposure to a traumatic event, meaning an experience of extreme stress that overwhelms an individual’s coping mechanisms. This could involve actual or threatened death, serious injury, or sexual violence. The intense stress experienced during the trauma can lead to lasting changes in the brain and body’s stress response systems.   

Individuals with PTSD often have a over-active stress response system. This means they may have a heightened baseline when it comes to their nervous system arousal. So they feel constantly on edge, even in non-threatening situations.  They may also have an exaggerated startle response, which means reacting intensely to sudden noises or unexpected movements. They may have difficulty regulating emotions, which means experiencing intense emotional reactions that are disproportionate to the situation, or abnormal hormone levels. For example, studies show that people with PTSD may experience high cortisol levels whilst others can have normal to low levels of cortisol (a key stress hormone) and elevated levels of other stress-related chemicals. 

These symptoms can combine and may make everyday stressors that most people can manage worsen for trauma survivors, and can often also be very triggering. These triggers can be reminders of the trauma, some of which can be obvious (anniversaries, similar locations) or subtle (certain smells, sounds, or even emotions. Pete Walker identifies the latter as an ‘Emotional Flashback’.). Other triggers can be just general life stresses that can overwhelm a system already sensitised by trauma. Individuals with PTSD, when stressed, may experience flashbacks (especially emotional flashbacks), intrusive thoughts, increased anxiety, hypervigilance and a stronger emotional reactivity, especially when it comes to anger, fear or sadness. 

Living with PTSD often involves a state of chronic stress due to the persistent symptoms and the effort of managing them. This chronic stress can have negative consequences for both mental and physical health, potentially exacerbating PTSD symptoms and increasing the risk of co-occurring conditions like depression, anxiety disorders, and addictions.   

In essence, the initial extreme stress of the traumatic event can lead to long-lasting changes in how the body and brain respond to stress. Subsequent stressors, even mild ones, can then trigger the intense and distressing symptoms of PTSD, creating a cycle where stress and PTSD reinforce each other. Therefore, managing stress is a crucial component of managing PTSD. By developing healthy coping mechanisms and reducing exposure to unnecessary stressors, individuals with PTSD can work towards lessening the frequency and intensity of their symptoms and improving their overall well-being.

As you know from lived experiences (or by supporting loved ones), navigating PTSD presents unique challenges when it comes to stress management. By understanding your triggers, utilising grounding and relaxation techniques, prioritising self-care, building a strong support system, and seeking professional help, you can develop effective strategies to navigate stress and improve your quality of life. Remember that you are not alone, and that help is available.   

Here are a few key areas to focus on:

1. Prioritise Your Physical Well-being:

• Move Your Body: Exercise isn’t just about physical fitness; it’s a fantastic stress reliever. I believe we are really lucky here in Sheffield with nature being literally at our doorstep. Whether it’s a brisk walk in Endcliffe Park, a swim at Ponds Forge, or a cycle through the Peak District, find an activity you enjoy and make it a regular part of your routine. Physical activity releases endorphins, which have mood-boosting and stress-reducing effects. This is the case for everyone, but even more important for trauma survivors.
• Nourish Your Body: What you eat can significantly impact your stress levels. Focus on a balanced diet rich in fruits, vegetables, whole grains, and lean protein. Limit processed foods, excessive caffeine, and alcohol, as these can exacerbate stress symptoms and also affect your sleep.
• Prioritise Sleep: Aim for 7-9 hours of quality sleep each night. When you’re well-rested, you’re better equipped to handle daily stressors. Establish a relaxing bedtime routine, create a comfortable sleep environment, and try to stick to a consistent sleep schedule, even on weekends. I know too well how sleep is often difficult for trauma survivors. I have written a blog about tips that might help here: Trauma, PTSD and Sleep – Stepping Stones Psychology

2. Cultivate Mindful Practices:

• Embrace Mindfulness and Meditation: These practices help you focus on the present moment without judgment, reducing rumination and worry. Even a few minutes of daily mindfulness can make a difference. There are plenty of free apps and resources available to guide you. For example Headspace, Breathe and Calm.
• Practice Deep Breathing: When you feel overwhelmed, take a few slow, deep breaths. This simple technique can calm your nervous system and bring you back to the present. Inhale deeply through your nose, hold for a few seconds, and exhale slowly through your mouth. Repeat several times. It is not a ‘hippie thing’ but scientifically proven to reset and calm our nervous system.
• Connect with Nature: Spending time outdoors has been shown to reduce stress levels. Take a stroll through the Botanical Gardens, enjoy the fresh air in one of our many local parks or woods, or simply sit on a bench and observe your surroundings. Again, there are scientific studies showing that connecting with nature is a natural antidepressant.

3. Nurture Your Connections and Set Boundaries:

• Connect with Others: Strong social connections provide support and a sense of belonging, which can buffer the effects of stress. Make time for friends and family, share your feelings, and lean on your support network when you need it.
• Learn to Say No: Overcommitting yourself can lead to increased stress. It’s okay to say no to requests that will overwhelm you or don’t align with your priorities. Setting healthy boundaries is essential for protecting your time and energy. I often recommend the books, especially the workbooks by Nedra Glover Tawwab.
• Schedule Downtime: Just like you schedule work or appointments, make time for relaxation and enjoyable activities. This could be reading a book, listening to music, pursuing a hobby, or simply doing nothing. Allow yourself to unwind and recharge. This is particularly crucial for trauma survivors, where self-care should be used as a prevention rather than aftercare. For trauma survivors, a daily regular practice of grounding techniques and relaxation techniques is highly recommended as part of the preventative self-care routine. 

4. Prioritise daily self-care routine

• Healthy Lifestyle: Maintain a balanced diet, get regular exercise (even a walk around the block can help), and prioritise sufficient sleep. Avoid excessive caffeine and alcohol, as they can worsen anxiety and PTSD symptoms.   
• Engage in Enjoyable Activities: Make time for hobbies and activities you find relaxing and pleasurable. 
• Comfort Yourself: Find activities that bring you comfort, such as listening to soothing music, spending time with a pet, or wrapping yourself in a cosy blanket.   

5. Develop Healthy Coping Mechanisms:

• Identify Your Stressors/Understand your Triggers: Understanding what triggers your stress is the first step towards managing it. Keep a journal or pay attention to patterns in your mood and energy levels to identify common stressors. You can identify and track your triggers by paying close attention to situations, people, places, sounds, smells, or even thoughts that trigger your PTSD symptoms. Keeping a trigger diary can be helpful in identifying patterns.   
• Develop a Safety Plan: Once you know your triggers, create a plan for how to respond when you encounter them. This might involve leaving a situation, using grounding techniques, or contacting a support person.  For grounding techniques, it can be something as simple as engaging with your senses, but you can also use physical or mental grounding techniques. For relaxation techniques, you can use Deep Breathing as slow, deep breaths can help calm your nervous system. Inhale deeply through your nose, holding the breath for a few seconds, and exhale slowly through your mouth. Trauma-sensitive Mindfulness and Meditation are practices that can help you focus on the present moment and reduce intrusive thoughts and anxiety. The apps mentioned earlier can also be integrated into a safety plan along with Pete Walker’s steps, which can be found here: Managing Triggers during the Festive Season – Stepping Stones Psychology Another great technique is Progressive Muscle Relaxation (PMR) where you tense and then release different muscle groups in your body to reduce physical tension.   

• Challenge Negative Thoughts: Stress can often lead to negative self-talk. Learn to identify and challenge these thoughts, replacing them with more balanced and realistic perspectives.
• Seek Professional Support When Needed: If you’re struggling to manage stress on your own, don’t hesitate to reach out to a therapist or your GP. They can provide you with tools and strategies tailored to your specific needs.

6. Build a Strong Support System:

• Connect with Trusted Individuals: Talk to supportive friends, family members, or partners about your experiences and feelings when you feel ready.
• Consider Support Groups: Connecting with others who have PTSD can provide a sense of community and understanding. You can inquire about PTSD support groups in Sheffield through your GP, therapist, or local mental health organisations. Our local charity Mental Mate is another excellent resource: Home – Mentalmate If uou are a man who has been feeling stressed or overwhelmed lately you might find the videos by the wonderful and inspiring Tom helpful. He is in recovery from alcoholism and is also a strong advocate for men’s mental health and emotional wellbeing. His life mission is to promote a culture of men speaking out about mental health and addictions. This is his support group: https://www.facebook.com/groups/902414635294724/?ref=share&mibextid=controlMsg and this is his Youtube channel: https://www.youtube.com/shorts/FPXLNwB0VQc
• Seek Professional Help: Therapy, particularly trauma-focused therapies like Cognitive Behavioural Therapy (CBT) or Eye Movement Desensitisation and Reprocessing (EMDR), is crucial for managing PTSD. Your GP can refer you to mental health services in Sheffield, such as NHS Sheffield Talking Therapies or the Specialist Psychotherapy Service at Sheffield Health and Social Care. Organisations like the Sheffield Wellness Centre and Saffron (Sheffield Women’s Counselling and Therapy Service) also offer specialised support.   

7. Manage Triggers in Daily Life:

• Limit Exposure to Media: Be mindful of news and media that might trigger your trauma.
• Communicate Your Needs: Let friends, family, and colleagues know about your triggers and how they can support you.   
• Create a Safe Environment: Make your home a safe and comfortable space where you feel secure.

Managing stress is an ongoing process, not a destination. Be patient with yourself, experiment with different techniques, and find what works best for you. By incorporating these practical tips into your daily life here in Sheffield, you can cultivate greater resilience and find more moments of calm amidst the everyday hustle.  

 Be Patient and Compassionate with Yourself:

Healing Takes Time as Recovery from PTSD is a journey, and there will be good days and bad days. Be patient with yourself and acknowledge your progress. Practice Self-Compassion where you treat yourself with the same kindness and understanding you would offer a friend or loved one going through a difficult time.   

What are your favourite ways to manage stress?

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