December 23rd – CBT session 7

Hey folks,

Been a very productive person this morning! Did all my housework in 2 hours, had a bath and hair wash and went to the shop all before lunch! Now I’m here writing to you, aren’t you lucky!! Anyway, this is CBT session 7, and it’s a long one! It is all about…

Stress Management!!

Stress plays an important role in our vulnerability to depression. Stress can be thought of as resulting from an imbalance between demands and resources, or as occurring when pressure exceeds our perceived ability to cope. In relation to depressed mood, it can be a person’s thought processes that determine the response, particularly where situations are viewed through a mental filter of insecurity and negativity.

Acute stress is the most common form of stress; it deals with the pressures of the near future or dealing with the very recent past. This type of stress is often misinterpreted as being negative. Whilst this is the case in some circumstances, it is also a good thing to have some acute stress in your life. Running or any other form of exercise is considered an acute stressor, as is riding a roller coaster. Acute stress is short term and does not result in any damage.

Chronic stress is the exact opposite. It has a wearing effect on people, that can become a health risk if it continues over a long period of time. It can impact on-going functioning in areas such as memory and drive. The severity of the impact varies from person to person, with individuals having a stress/vulnerability threshold; whereby if the combination of the stress and the vulnerability exceeds the threshold, an individual’s psychological health may be compromised.

Vulnerability comprises of the following factors:

  • genetic
  • psychological (thought processes)
  • biological
  • social
  • situational

There are also historic factors, such as our relationship with our parents or peers when growing up and on-going factors such as our lifestyle (smoking, caffeine, alcohol, junk food) or marital relationships.

Protective factors are important to consider in the interaction of vulnerability and stress. They can provide a buffer against the effects of major stressors and reduce vulnerability. Examples of early protective factors include a positive parent-child attachment relationship, on-going protective factors may include a supportive peer network, or high self esteem.

Basically, the more vulnerable you are, the less stress you can handle and vice versa.

All people have some level of vulnerability towards certain psychological disorders, but there is a large range of individual differences in the point at which a person will develop a certain disorder.

A toolbox of stress and anxiety management techniques

Once we have identified the triggers to stress, there are a lot of techniques to draw on, which won’t be relevant to everyone, but I wanted to include as many as possible for you to choose from. Choose one or two, or several, depending on your circumstances.

  • Worry management
  • Problem solving
  • Relaxation – Controlled breathing, Progressive Muscle Relaxtion, Mental exercises and visualisation.

Worry is a major problem for many people with anxiety and depression. If you are a “worrier” you are likely to worry about lots of different things. You may find that you move from one topic of worry to the next; so even if you manage to deal with one, you just move on to another.

There is a structured way of solving the problem of worry. There are two types of worry – things you can do something about and things that you cannot do anything about. Using a worry tree, you can work out what you can do, create a plan to solve it or accept that it’s out of your control.

Worry Tree

Worrying thought – Is there anything I can do about it right now? – Yes, plan to act and act on it/No, distract yourself from the thought and let it go.

Easier said than done, I know! I’m a born worrier, and often am worrying about something! I am slowly learning to let go of the things that I cannot change though, so am making progress!

It is not uncommon for people who have distressing or anxiety-provoking thoughts, to try to suppress them; people try not to think about it, or push it to the back of their mind. Usually though, this only makes matters worse and you end up thinking about it more. It is more helpful to deal with the worries that you can deal with, and let go of the worries that you can’t do anything about. Focusing your mind on something else is a good technique to stop yourself worrying. You can use mental exercises such as doing word puzzles or crosswords, read a book or listen to music. Try hard to focus only on what you are doing.

To problem solve a worry, takes a few steps:

  1. Identify the worry you want to focus on
  2. Convert the worry into a practical problem
  3. Identify the solutions
  4. Analyse the strengths and weaknesses of each solution
  5. Select a solution
  6. Plan implementation
  7. Implementation
  8. Review

When we worry, our problems can sometimes feel overwhelming, like there are no solutions. But using the steps above, helps you to distance yourself from your worries and to think  about different types of practical solutions that there may be.


This is a complex skill, and takes a great deal of practice. It calms anxiety and helps the body to recover from everyday stresses. Things such as music, a long soak in the bath or a walk in the park are effective ways to relax. Or perhaps taking a meditation class could be an option. Your GP or local library will have details of such things.

A few techniques that I use are:

Controlled breathing – It involves learning to breathe gently and evenly, through your nose, filling your lungs completely and then exhaling slowly and fully through your mouth. By breathing out for longer than we breathe in, we are preventing oxygen build up.

Progressive Muscle Relaxation – For this you’ll need a nice, quiet place to lay down. Close your eyes and concentrate on your breathing for a few minutes (see controlled breathing above), and then work through the following muscle groups, breathing in as you tense the muscles, and breathing out when you relax them.

  1. Hands
  2. Arms
  3. Neck
  4. Face
  5. Shoulders
  6. Chest
  7. Stomach
  8. Bottom
  9. Legs


Mood often goes hand in hand with sleep. The more anxious or depressed you are, the harder it can be to fall asleep. When you are tired from lack of sleep, you are less able to deal with the stressors in your life. Insomnia is something I suffer with from time to time, and it can honestly be debilitating. Worrying about getting to sleep, waking early or not getting enough sleep can exacerbate the problem.

Tips on improving your sleep pattern –

  • Fix a bed time and wake up time and stick to them
  • Avoid napping during the day
  • Avoid drinking heavily and caffeine before bedtime
  • Exercise regularly, but not before bed
  • Use comfortable bedding and find a comfortable temperature setting
  • Keep the room well ventilated
  • Block out all distracting noise where possible
  • Try and keep your bedroom only for sleep
  • Practice the relaxation techniques before bed
  • Don’t take your worries to bed; write them down instead
  • Establish a routine such as a warm bath or a few minutes of reading before getting into bed
  • Don’t go to bed hungry


This plays an important role in helping to overcome and relieve anxiety, stress and tension. It uses up excess adrenaline triggered by the fight or flight response. It also causes the release of hormones, in particular Serotonin, which are natures relaxants and help to combat low mood.


Eating healthily not only applies to our physical health, but also our mental health. We should try to eat a balanced diet, with a minimum of unhealthy processed foods, to maintain a healthy weight and increase a sense of well-being.


For people who experience anxiety or low mood, it is advised that you avoid caffeine. (Something I should really do!!). It increases anxiety and contributes to insomnia. When taking medication, it is also advised to avoid caffeine, and it can cause excitability, nervousness and hyperactivity. It can also mean the effect of the medication is reduced.

Drugs and Alcohol

These affect mood and can therefore have a negative impact on low mood and anxiety. Initially using substances will relieve the symptoms, but this can escalate into an addiction and needing them on a daily basis just to cope. I used to self medicate with alcohol, and that became a big problem.

Regular use of drugs and alcohol, can cause mood fluctuations; this can make anxiety and low mood even harder to manage.

I hope this has helped; sorry it was so long, but there’s a lot to it! Thanks for reading, and well done if you read it all!!

Until next time…..


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