Stress keeps building up. How do I spot it and cope?

Built-up stress is stress that carries on for weeks or months without a real chance to recover. It shows up in several ways: getting irritable easily, moods that swing, trouble concentrating, tense muscles, an unsettled stomach, and sleeping or eating more or less than usual. What you can do yourself is move regularly, breathe deeply, talk to someone you trust, set a clear end to the workday and avoid caffeine and alcohol before bed. If you can't cope on your own, or stress is starting to affect your work or family life, see a doctor. If you have thoughts of harming yourself, call the 1323 mental health hotline straight away.

This article is about stress that builds up from everyday life and the shallow sleep that comes with it. If your mind won't switch off when you get into bed, see Can't sleep because your mind won't stop thinking?, and if stress goes to your stomach, see Stress gives me diarrhoea then constipation. What can I do?

What is built-up stress, and how is it different from ordinary stress?

Cleveland Clinic describes stress as a natural reaction that happens to everyone. When you face a change or a challenge, your body and mind respond so you can adjust, and some stress keeps you alert and motivated. The trouble starts when the pressure keeps going with no break.

Three kinds of stress

Source: Cleveland Clinic

Why small things add up

For many people, stress does not come from one big event but from small things that pile up every day: traffic morning and evening, deadlines stacked on top of each other, a work LINE group that keeps pinging at 10 p.m., household bills, looking after parents or children after work. Each one may be manageable, but when no part of the day lets you put them down, repeated short-term stress slowly turns into the weeks-long stress Cleveland Clinic calls chronic.

What are the signs of built-up stress?

The UK's NHS groups the signs of stress into three areas, and the US CDC lists similar ones. Many people do not realise they are stressed but notice these changes first.

Irritable, with moods that won't settle

The NHS lists being irritable and snappy as one of the behaviour changes that come with stress. Often the people around you notice first: you snap at family over small things, or a colleague's habits start to grate when they normally wouldn't. If this is happening more than usual, it may be a sign that something is building up.

Tense muscles and an unsettled stomach

Muscle tension or pain is one of the physical signs the NHS lists, and many people feel it after a full day at a screen during a high-pressure stretch at work. Stress and digestion have their own story, covered in Stress gives me diarrhoea then constipation. What can I do?

Changes in sleep and eating

The NHS notes that stress makes some people sleep more and others less, and the same goes for eating. You might find yourself reaching for something sweet every afternoon, or the opposite, forgetting lunch because work is overflowing. Change in either direction can be a sign.

Work pressure means I never sleep deeply. What should I change?

Stress and sleep affect each other in both directions. Understanding how the loop works helps you see where to start.

Why stress makes sleep shallow

Sleep Foundation explains that under stress the brain signals the body to release stress hormones such as cortisol and adrenaline, which keep you alert and make it harder to fall asleep. People under chronic stress may also spend less time in deep sleep and have disrupted dream (REM) sleep. That is why you can get your full hours and still wake up feeling unrested.

The stress and poor-sleep loop

According to Sleep Foundation, poor sleep makes the day more stressful, and that stress then disturbs the next night, creating a cycle. The good news is that working on one side often helps the other, and Sleep Foundation notes that sleep problems may begin to fade once the stressful situation ends and stress eases.

Draw a clear line under the workday

When work follows you home on your phone, your brain never leaves work mode. Try setting your own cut-off, such as no work email or work LINE group after 8 p.m. If you are worried about forgetting something, jot down what is still open before you switch off and pick it up tomorrow. The NHS suggests time management and planning ahead for situations you know will be hard, which means fewer work thoughts following you to bed.

Before bed

In real life, a second iced coffee at 3 p.m. or a Thai tea after dinner may still be keeping you alert at bedtime, and the after-work beer that seems to relax you can leave you waking on and off all night. Thailand's heat also makes a cool enough bedroom matter more.

If work thoughts are still circling when you lie down, the bedtime list and breathing in bed are covered in Can't sleep because your mind won't stop thinking?

How can I look after myself day to day when stress builds up?

You don't need to do everything at once. The NHS advises against trying to tackle everything at the same time, so start with one or two things that fit your life right now.

Move your body

The NHS lists exercise as one way to manage stress. The CDC suggests moving for a total of 2½ hours a week, and Cleveland Clinic notes that even a short walk can help you feel better. You don't need a gym to start: get off the BTS one station early and walk, take a lap of the park in the morning before the sun gets strong, or stand up and walk around once an hour at work.

Breathe deeply and stretch

The CDC suggests taking deep breaths, stretching or meditating, and the NHS also recommends breathing exercises. You can do this at lunch, on the commute or before a tense meeting, with no equipment at all.

Talk to someone you trust

The NHS suggests talking about your feelings with someone you trust and reminds you that you are not alone in feeling stressed. The CDC also suggests connecting with others and sharing your worries with people you trust. That could be family, a close friend or a colleague who understands the same job.

Break work into pieces

The NHS suggests managing your time, planning ahead and not dwelling on things you can't control. Split big tasks into small steps, decide what comes first, and focus only on the part you can actually do. Finishing one step today counts as progress.

Take a break from news and social media

The CDC suggests taking breaks from news and social media and practising gratitude each day. Scrolling late at night tends to add stress and push bedtime later at the same time.

Avoid ways of coping that make things heavier

The NHS advises against using alcohol, cigarettes, gambling or drugs to cope with stress. Cleveland Clinic lists relying on substances to cope as one reason to talk to a doctor.

I'm irritable and my moods won't settle. Where should I start?

The honest answer is to look at sleep, meals and movement first, rather than looking for one thing to add. Cleveland Clinic lists enough sleep and good nutrition as part of managing stress.

Eat proper meals

The CDC suggests fruits and vegetables, lean protein and whole grains. Day to day, that might mean not skipping breakfast in the rush out of the door, not letting lunch slide to 3 p.m. because of meetings, and picking at least one vegetable dish when you buy rice and curry or a made-to-order plate.

Coffee, tea and alcohol

The CDC suggests limiting alcohol, and Sleep Foundation advises avoiding caffeine in the hours before bed. If a busy patch has you drinking several coffees a day or a beer every evening, that is both one of the signs of stress the NHS lists and something you can change.

Before you start taking anything new

If you are thinking of starting a supplement or any other product, or you take regular medicines, talk to a doctor or pharmacist first. If your moods stay unsettled to the point of affecting daily life, a doctor can help look at the cause more accurately than guessing.

When should I talk to a doctor about built-up stress?

Stress is normal, but you don't need to wait until you can't cope before asking for help.

Book an appointment

The NHS advises seeing a doctor if:

• you have had a low mood for more than 2 weeks
• you are struggling to cope
• the things you are trying yourself are not helping
• stress is affecting your daily life, such as work, study or relationships at home

Cleveland Clinic adds that it is worth seeing a doctor if symptoms continue despite self-help, if stress is affecting your physical health, or if you are relying on alcohol or other substances to cope.

Get help straight away

If you have thoughts of harming yourself, or feel you cannot keep yourself safe, get help now rather than waiting for an appointment.

• Call the Department of Mental Health's 1323 hotline, which gives free, confidential support 24 hours a day.
• Go to the nearest hospital emergency department.
• Ask someone close to you to stay with you.

If a family member or friend seems different and talks about harming themselves, you can also call 1323 for advice on their behalf.

Before your appointment, note down

• what has been stressing you and when it started
• which of the signs in the table above you have noticed
• how your sleep has changed, and what time you go to bed and get up
• whether you are drinking more coffee or alcohol, or smoking more
• all the medicines and supplements you take

This helps the doctor understand your situation faster. Use any medicine only as advised by a doctor or pharmacist rather than starting it on your own.