Stress and relaxation

How have things been?

Review of your goals, progress:

• What went well?
• What didn’t go well?
• Problem solve as a group to help each other overcome difficulties.

• Feeling tired or unwell and not being able to do what we expect of our bodies can make us feel stressed, frustrated and under pressure
• Stress, frustration and anger are all draining emotions. They demand a lot from our bodies and will contribute to the primary neurological fatigue you are already experiencing

Our bodies have this internal ‘flight’ or ‘fight’ mode which can be fired up when experiencing stress

Emotional response

• Angry, irritable and wound up
• Anxious and full of dread
• Unhappy, upset and tearful
• Lacking in interest
• Overwhelmed and frustrated
• Guilty and worthless

• Thoughts racing
• Changes to vision
• Dry mouth
• Heartbeat faster
• Nausea and butterflies in stomach
• Hands get colder
• Muscle tension
• Dizzy or light-headed
• Breathing becomes quicker or slower
• Adrenal glands release adrenaline
• Bladder urgency
• Palms become sweaty

• Identify causes of stress
• Learn and use relaxation and breathing techniques
• Get support to help to reduce problems (formal or informal)
• Ensure your days and weeks are balanced, work, rest and play
• Remember the 3 P’s
• Learn some skills to help challenge any unhelpful thoughts

• Reduces stress (which is very tiring) to allow you to engage
• Boost immune system to keep you well
• Calms the body and mind to allow you to focus
• Lowers risk of secondary illnesses, for example, high blood pressure, muscle tensions

• Deep breathing or abdominal breathing
• Progressive muscle relaxation
• Visualisations
• Massage or reflexology
• Tai Chi or Yoga
• Aromatherapy
• Meditation
• Mindfulness

• Get comfortable wherever you are sitting and close your eyes if you are able
• Breathe in through your nose. Let your belly fill with air
• Breathe out through your nose
• Place one hand on your belly. Place the other hand on your chest
• As you breathe in, feel your belly rise. As you breathe out, feel your belly lower. The hand on your belly should move more than the one that’s on your chest
• Take three more full, deep breaths. Breathe fully into your belly as it rises and falls with your breath

• While you do deep breathing, use a picture in your mind and a word or phrase to help you feel more relaxed
• Close your eyes if they’re open
• Take a few big, deep breaths
• Breathe in, imagine that the air is filled with a sense of peace and calm. Try to feel it throughout your body
• Breathe out, imagine that the air leaves with your stress and tension
• Now use a word or phrase with your breath. As you breathe in, say in your mind, “I breathe in peace and calm.”
• As you breathe out, say in your mind, “I breathe out stress and tension.”
• Continue for 10 to 20 minutes.

In this technique, you breathe in as you tense a muscle group and breathe out as you release it. Progressive muscle relaxation helps you relax physically and mentally.

• Lie comfortably on the floor.
• Take a few deep breaths to relax. Breathe in. Tense the muscles of your feet.
• Breathe out. Release the tension in your feet. Breathe in. Tense your calf muscles. Breathe out. Release the tension in your calves.
• Work your way up your body. Tense each muscle group. This includes your legs, belly, chest, fingers, arms, shoulders, neck, and face.

Mobile phone apps can be a useful strategy to incorporate in fatigue management as they can guide your relaxation:

• Calm
• Headspace
• Feeling good: Mental fitness

• How do our thoughts, emotions and behaviours interact with one another
• Helpful and unhelpful thoughts can become a pattern
• How might this impact on your fatigue levels?

Wake up feeling extremely fatigued:

Think: ‘I am too tired to do anything today’

Behaviour: Cancel meeting your friend for a drink

Feel: Low, lonely, disappointed, fed up

Physical symptoms: You rest but still feel fatigued for most of the day, focused on symptoms, not distracted by other events.

Think: ‘I am tired today, but I really want to see my friend’

Behaviour: Do it but pace and plan! Rest before you go out. Meet your friend for a drink as planned, meet at a quiet place and then rest once home.

Emotion: Hopeful, happy, looking forward to seeing friend.

Physical symptoms: Still feel fatigued but have an extra sense of energy and satisfaction as enjoyed the day.

• How am I doing so far?
• What do I still need to change (to better manage my fatigue)?
• What goal do I want to set now?

• Work towards goal from today’s session, for example, practice relaxation technique
• Identify a cause of stress for you, for example, overloading pressures (housework, socialising, work, family)
• How could you manage this stress?