Check Your Pressure Gauge Often

A few basic facts you should know about stress

• You are not immune to stress. Everyone is affected by stress. With your family member's injury and added responsibilities, you may be more vulnerable to the negative effects of stress.
• The effects of stress add up over time. You may not feel "all that bothered" by what has happened. You may feel that you "can handle things OK." Know that stress weakens your ability to handle new challenges. Without breaks, you run the risk of emotional collapse.
• Many people don't realize how much stress they have faced and are facing. Lack of recognizing comes from a focus on doing things and "trying not to think about what's happening."

What is stress?

Think of stress as "carrying a stuffed backpack up a big mountain." Climbing the first hundred feet, your pack may not seem heavy at all. Though you don't add anything to the pack as you climb, the pack seems heavier and heavier as you climb higher without resting.

For most people, stress is a feeling or thought that you must do something. In general, the amount of stress you feel relates to several factors:

• How much you have to do and the number of people telling you to do it. The more you must do and the greater number of people telling you to do it, the more stress you will feel.
• The difficulty level of tasks. The harder and more challenging the tasks you have to do, the more stress you will feel.
• Your beliefs about the consequences of failure. The worse you think the consequences will be, the greater the amount of stress that you will feel.

What are the major dangers of stress?

• Reduced quality of life:
  Feeling stressed is very unpleasant. You may end up feeling hopeless and feeling that you have no control over your life.
• Reduced productivity:
  High levels of stress will make your work seem harder. You will become less productive and you will be less able to help others.
• Impaired health:
  As you become less productive, the risk of health-related problems increases. Sleep problems, headaches, fatigue and even memory problems are common. Preoccupied with all you have to do, you may find yourself driving dangerously, or eating to much or not at all.
• Reduced motivation:
  Feeling like you don't have the energy or the will to try.
• Harming you relationships:
  Support from other people will help you do much better. Yet, your relationships are easily damaged by how you act when you are stressed. Irritability, impatience, losing your temper and being aggressive are common reactions to stress. Some people stop communicating and withdraw from others. They stop talking, go in a room and close the door.

What is the first step in controlling stress?

Recognizing the amount of stress you are facing. When faced with many responsibilities, you may only think about:

• How much you have to do
• How little time you have
• The bad things that will happen if you don't finish.

Check your pressure gauge often, especially when you have a lot on your "to do" list. At least several times a day, ask yourself, "How much stress am I feeling right now?"

You can also ask your family and friends to give you feedback about how you are handling stress and where your stress is coming from. By monitoring stress levels, you can better control your feelings, actions, efficiency and quality of life.

The 13-Item Stress Test

The following test will help you identify your stress level. Complete it with other family members, review and discuss your responses.

Take the test once a week or more often, depending on how you're doing. By doing so, you'll have a better idea about the sources of your stress and your reactions.

1	I have a lot to do.	TRUE	FALSE
2	I have more to do than I can handle.	TRUE	FALSE
3	I am not being productive.	TRUE	FALSE
4	I'm trying really hard but I'm getting nothing done.	TRUE	FALSE
5	I'm feeling unhealthy.	TRUE	FALSE
6	I can't afford to take breaks or time off.	TRUE	FALSE
7	I'm pushing myself too hard.	TRUE	FALSE
8	I don't sleep very well.	TRUE	FALSE
9	Too many people are telling me what to do.	TRUE	FALSE
10	I'm not treating people the way I want to be treated.	TRUE	FALSE
11	I feel totally exhausted.	TRUE	FALSE
12	Nobody is happy with what I do.	TRUE	FALSE
13	I can't stand living like this.	TRUE	FALSE

Scoring:

The more TRUE responses you have, the greater pressure you are feeling.

Identify the Signs of Stress for You

Recognizing how you show stress is the first sign toward coping successfully. How do you show stress? How do you know you have more problems than you can handle?

Below, make a list of your personal stress signs:

1. ______________________________________________
2. ______________________________________________
3. ______________________________________________
4. ______________________________________________
5. ______________________________________________
6. ______________________________________________
7. ______________________________________________
8. ______________________________________________
9. ______________________________________________
10. ______________________________________________

Managing Stress More Effectively

Many family members learn to cope with stress effectively. Below is a list of ideas that have helped others. Review the list and try out the ideas.

Use the Stress Management Worksheet that follows to try out more ideas.

Take breaks often

Famous last words "I can't take a break. People will think I am lazy and that I don't care."

• Realize that most family members don't give themselves enough rest.
• Realize that working harder doesn't necessarily mean accomplishing more. Instead, recognize that taking breaks can help you accomplish more and feel better.
• Avoid the cycle of going beyond your limits, spinning your wheels and becoming frustrated.
• Take several 20-30 minute breaks each day. Take more time if needed.
• If you can't spare 20 minutes, take 10. A short break is better than no break.
• If you are working, make your home a comfortable place by leaving your work behind.

Make a list of what you need to do in the short- and long-term, and set priorities

• Number the items on the list by priority.
• Start with number 1 and work your way down the list, crossing off each accomplished item.
• Regularly review your accomplishments to help you keep a positive perspective.
• Remember that you can only do one, or maybe two, things at a time effectively.
• Remember that "good" things can also be stressful (e.g. planning and having a birthday party, preparing to visit and visiting other family members).
• Don't forget activities related to helping yourself (e.g. getting rest, spending time with other family members) can also be important priorities.
• Learn and recognize the difference between what you "have to" do and what you "want to" do.

Set reasonable goals and expectations

• Learn to recognize what you do best.
• Recognize your limitations. Most relate to being human.
• Avoid letting people pressure you into taking on more than you can handle.
• Recognize what others do best and ask for their help.
• If you keep missing deadlines, be less ambitious.
• Distinguish between what you want and expect and what other people want and expect from you.
• Recognize and avoid harmful feelings like guilt or frustration.

Learn and apply negotiating skills

• Realize that few of your responsibilities are "set in stone" and most people who expect you to do things are willing to negotiate.
• With other family members and co-workers, negotiate timelines and the amount of responsibilities you agree to take on.
• If you are afraid of negotiating, practice by rehearsing "in your head."
• Realize that taking on too much, too soon will cause failure.
• Balance wanting to please with your knowledge of what you must do to succeed.

Learn and use relaxation techniques

• Breathe slowly and deeply.
• Close your eyes and imagine yourself in a relaxing situation.
• Listen to soothing music.
• Take a walk.
• Talk to someone you like.

Tell yourself things that will help

• I'm doing the best that I can.
• I'm a good person. I'm trying.
• If I take my time, I'll do things right.
• Things will work out for the best.
• We've really come a long way since he was hurt.
• I can count on my faith, my friends and family to help me through.

Avoid pushing yourself too hard and putting yourself down

• I've got to do more.
• I've got to try harder.
• I've got to get this done the right way.
• I should have finished a week ago.
• I'm letting everyone down.
• I'll never get another chance.
• I can't believe I'm doing so bad.

Ask for help

• Seek help from people that have offered.
• Recognize that asking for help is better than failing.
• Don't let your pride get in the way.
• Recognize that everyone needs help sometimes.
• Better to ask early on than right before you fail.

Common sense strategies can help you be strong

• Focus on one thing at a time.
• Work on your hardest responsibilities at times when you feel most fresh and rested.
• Have "quiet times" for everyone. Noise can increase stress and reduce productivity.

Have a backup plan

• Failing and not knowing what to do next is a bad situation.
• Anytime you plan something, have a backup plan.
• Recognize your human imperfections. Most people fail sometimes.
• When your first approach doesn't work, go to your backup.

Recognize that life has many challenges

• Brain injury or not, many people struggle to enjoy successful lives.
• Recognize that many of the issues that face you are faced by others.
• Be patient. Everyone finds obstacles on the road to success.
• Recognize that persistence, faith and your good character will help you succeed in time.

Stress Management Worksheet

To help identify and better manage stress, you and other family members are encouraged to complete this worksheet, and compare and discuss answers.

Completing the questionnaire at several points in time will allow you to identify progress and ideas to improve coping.

1. What are the main sources of stress in my life?
2. What do I do now that helps me manage stress effectively?
3. What can I do now that makes it harder to manage stress?
4. What can I do to better manage stress?
5. Where should I start to make things better?