The 4 S’s of Stress

April is Stress Awareness Month, held every year since 1992 to raise awareness of the causes and cures for our modern-day stress epidemic. We all experience stress at times in our lives and it can affect us all differently. Here, Sabina Kelly, the Chiswick Nursing Centre’s Community Matron, explains what stress is and how we might deal with it.

Stress could be defined as a reaction to a perceived threat or danger. It is an alarm signal embedded in our hormonal infrastructures, in order to warn us of impending danger. It is an internal alarm system. It can protect us, for example, it can alert us to an immediate threat. As in the animal kingdom, it makes us prick up our ears, look around and move us to a safer area.

On the other hand, stress can move in on us slowly and insidiously, building up over a matter of time, again alerting us to perceived threats or dangers, until we find ourselves reacting physically and psychologically to our inner turmoils, eventually causing physical or mental ill health.

Many of have experienced stress and anxiety in our lifetimes, whether it hits us suddenly, leading us to become overwhelmed with all the tasks we have to do, or whether it creeps into our psyches, slowly gnawing away at our already existing fears and throwing negative spanners into our psychological processing of life and work events.

The causative factors of stress may be external events such as situations beyond our control for example the death of a loved one, redundancy, divorce ,or our own internal anxieties which may range from the fear of someone outperforming us, fear of losing one’s job, financial worries, to name but a few, but all can have devastating effects on our daily lives, both physically and psychologically.

Stressors impact our moods and relationships. We live in a target driven society; more and more demands are made on our work and leisure time. Technology enables us to take work home and continue our working day, therefore, work/life balance becomes harder to achieve. Personal relationships may suffer and there is an ever-increasing pressure on young people to look beautiful and older people to look young. For some people it may be time to step back and reflect and identify what disproportional stressful factors are affecting lives.

Are you sleeping well? Do you work late into the night? Do you switch off your e mails and phone during out of work hours? Do you break into a sweat each time a situation becomes tense? Do you get that gnawing feeling in your stomach? Do you sometimes feel out of control? Has your concentration lessened? Do you become irritable and moody? If you recognise one or more of these psychological responses and if they occur in a cluster, then you are recognising responses to stress.

What may affect you in some ways, may affect others differently and we all use different coping mechanisms. Either way life becomes difficult when we undergo the effects of stress.

I suggest that stress is not self-inflicted, but is the response to a perceived threat in whatever form it may take and that the causative factors in our busy worlds set up internal conflicts and exacerbated by external challenges such as working in a toxic culture, under resourced working teams, financial difficulties and problematic relationships which can all lead to personal emotional pressures. However, this does not take us out of the loop of responsibility as it is our own responses and how we react to these pressures.

I categorised these pressures into the 4 S’s of Stress.





Stress is a solitary occupation. It can cause feelings of isolation. We cannot admit to others or be seen to be not coping. We must not let our guard down or be seen as weak. Weakness is allegedly seen as a negative personality trait. So, we can feel alone and isolated and unable to show our true feelings. We may speak to close friends who can only listen and attempt to give advice, but they may not be able to remove you from the environment that is causing you to feel stressful.

This also leads to Silence. Admitting you are stressed by a situation may facilitate feelings of shame, embarrassment, self-loathing that you are not coping and that you fear situations which lead us to continue in a muted anxiety mode. So, we keep silent. 

If the cycle is not interrupted, it will Spiral. Negative thoughts and scenarios made up of what ifs?  spinning round in your mind in a vortex of anxiety, stress levels increase, and your body reacts physically.

Stigma may be attached to people suffering from these reactions. Management, friends or partners may perceive it as mental health issue but do not have the patience to deal with it. Gp’s may sign you off for a couple of weeks or offer you short term medication. However, we still may still see ourselves as outsiders, as failures and attach our own stigma to being stressed.

So how can we try and counteract the effects of stress?

Firstly, seek professional help. There is a plethora of information that will advise on stress, such as meditation, deep breathing, exercise, but professional help such as counselling or cognitive behavioural therapies can explore and drill down to the roots of the anxiety behaviour. By recognising and identifying the root causes is the first step to modifying the anxieties.

We can make lists of our fears and action how to adapt or manage them. We can reframe the narrative, for example look at the fears as a catapult to change something in our lives, stop looking at our failures and look at what we are good at. It may be that if a situation becomes too toxic we have a choice to walk away, no matter how painful it is and explore other opportunities. We do have choices to walk away from something that is causing us harm. Often when we feel the world is falling around us unexpected doors become open.

It may mean being thrown out of our comfort zone, by trying something new but we may also wonder why we didn’t do this sooner. One needs to be courageous to do this, but we are questioning why we allow ourselves to be miserable. However, if we are unable to walk away or change direction due to life circumstances, again by seeking professional help may enable us to look at choices and explore coping mechanisms.

Florence Nightingale stated “How very little can be done under the spirit of fear” Choice and help can motivate us to identify and challenge our fears and take charge of our stress levels. And ultimately take responsibility to care for ourselves.

SABINA KELLY RN B.Sc. (Hons) Ba (Hons)

One of the most stressful situations is facing the decision that you or a loved one may no longer be able to cope at home or that they might need long term care. Don’t face the situation alone. Our friendly team is well used to such circumstances and can provide help, reassurance and take you through all the options available at The Chiswick. We are just a phone call away, so don’t hesitate to contact us on 0208 222 7800 for a friendly chat.

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