Your hidden stresses revealed

A friend of mine recently experienced a revelation. She had been sleeping badly and couldn’t get to the bottom of why. Lying in bed she felt stressed and anxious, making it all but impossible to nod off. One evening she realised the problem. Over a series of nights she had been woken up by inconsiderate upstairs neighbours arguing at 2am and a small child, who sounded like a not-so-small elephant, running up and down their hardwood floor.

Her brain had taken this information on board and decided that if she was going to get woken up at 2am, she might as well be prepared for it and not get to sleep at all. Of course, this wasn’t a conscious thought for my friend and I write it a little tongue in cheek, but in a nutshell that was what her brain decided to do to her. Ridiculous isn’t it? In order to mitigate the stress of being woken, her subconscious decided no sleep at all would be the better option. This is what I term ‘hidden stress’, where the brain quietly makes environmental assessments without relaying them to your consciousness.

Cause and effect

In 2006 a group from Johns Hopkins University published work into the relationship between stress and heart-related health problems (Blumenthal RS et al, 2006). The research focused on what it termed ‘mental stress’, of which sufferers were often unaware and which led to a rise in blood pressure. It was found that those whose blood pressure rose as a result of such hidden stresses were six times more likely to suffer a heart attack than those who were in calm state. In fact, it was deduced that mental stress was a more serious causative factor when it comes to heart-related illness than high cholesterol, diabetes or gender.

The results led the researchers to believe that conscious stress and biological stress may be two different issues. As one of the members of the study, Diane Becker, stated: ‘There was no relationship between people’s perception of stress and their actual mental stress.

‘People’s capacity to tell you they are stressed is worth about nothing. We would see people with hideous responses who say they are fine.’

Finding the stressor

The key factor to hidden stress is that of change. Any change, even if it seems like a positive move, will affect your stress levels. The effect is an evolutionary one; if things change, the body goes through hormone and neuron changes to help deal with potential danger. Thus the body will experience physiological symptoms of stress until you have learnt to deal with it.

In addition, when you are trying to identify hidden stressors, look for situations where reality did not live up to your expectations.

How to solve the problem

We all need to take action to mitigate disappointment and there are many possible sources of hidden stress; remember that some causes may not be obvious to you.

Consider your expectations for life events such as retirement, going on holiday or moving to a new job, and talk to others to find out their experiences. In this way you can plan for some of the problems that may rear their ugly heads. Of course, you can’t plan for every eventuality but you can leave space to accommodate for the unforeseeable and unintended, and enjoy the changes.

So what might constitute a hidden stressor? Promotion is deemed to be a form of remuneration for hard work or for being especially capable. You get more money and/or a more prestigious job title. What’s not to like? However, promotion can disturb your sense of self. Without realising it, you might be worried about whether you are up to the new tasks or if you are capable of handling more responsibility. Even earning more money can cause problems; to where will that extra money be channelled? Might it cause arguments at home?

Holidays are a reward for working hard; you book one as a treat and to get away from the every-day stresses and strains of your job. But to get away you have to deal with all sorts of potentially fraught situations such as car trouble, an ill child, delayed flights or lost luggage. Now I don’t point all this out to get your heart racing, rather my aim is to highlight the potential for trouble to encourage you to build in time to cushion those possibilities should they come to pass. Again, it is all about expectation. Murphy’s law is never far around the corner. If your expectations are realistic you won’t be disappointed, and that hidden stress won’t end up gnawing away at you when instead you could lament a delayed flight over a pint of Guinness at the airport while having a good old chat with a fellow traveller.

Time management

Managing your time is a particularly effective way of tackling stress. Identify the time of day at which you are at your best and use this period to carry out tasks that require extra concentration or energy.

In addition, create a time frame in which to achieve the things you really don’t want to do and have been putting off. Delaying dealing with such matters will only exacerbate your anxiety. You know you will feel so much better if you stop procrastinating and get that dreaded task done and dusted.

Never underestimate the power of writing lists. First of all, putting all your ‘things to do’ in writing immediately puts you on the path to being organised. As you complete each task, cross it out – just the sight of this will have a hugely beneficial effect on your stress levels. And remember the golden rule – always factor in time to deal with potential problems and when they don’t arise, this time ‘cushion’ allows you to enjoy a few minutes of peace and quiet.

Relaxation techniques

It is important to use your spare time in the right way. While sitting down in front of the television after a stressful day might seem like the perfect answer, since it is in fact a mindless activity, it gives your brain the opportunity to mull over the day’s events. What you really need is to engage your brain in a hobby that requires concentration; this will help to avoid detrimental thoughts.

Physical activity uses up the excess adrenaline that affects us when we are stressed. It also produces mood-enhancing endorphins. It really doesn’t matter what form your exercise takes, as long as it helps you to wind down.

Lots of people I know suffer from what I call the ‘night nadgers’. Who hasn’t felt that wave of panic at two o’clock in the morning when you wake up with a start because your brain has flagged up your anxieties? This is a really hard issue to deal with; in the middle of the night everything always seems so much worse than it does in the cold light of day.

There are a couple of easy ways of dealing with this problem. The first is that if you are waking up at the same time every night, stop checking your alarm clock when you awake. Just as you get used to the time you set your alarm, so that you are rarely asleep when it goes off, your brain will start to associate 2am or 3am with wake up and panic time. If you can’t remember to stop looking, drop your alarm clock down between the bed and the bedside table. You will still hear your morning alarm but, in the early hours, in the moment it takes to wonder where your clock has gone, you will recall why you didn’t want to see the time. This may seem like a silly idea but it is a tried and tested way to break the cycle.

Also worth trying is hypnotism CDs, not necessarily so much for the messages they convey but because they really are very relaxing and will help you to achieve a calm state and get back to sleep. Hypnotism CDs that specifically address sleep disorders and stress management are readily available.

Remember, not everything is necessarily as it seems. If you feel stressed out for no apparent reason, take the time to look at your environment and open your mind to the possibility that your stressor is hiding away somewhere out of sight.


Blumenthal RS, Becker DM, Yanek LR, Moy TF, Michos ED, Fishman EK, Becker LC (2006) Comparison of coronary calcium and stress myocardial perfusion imaging in apparently healthy siblings of individuals with premature coronary artery disease. Am J Cardiol. 97(3): 328-33

Get the most out of your membership by subscribing to Dentistry CPD
  • Access 600+ hours of verified CPD courses
  • Includes all GDC recommended topics
  • Powerful CPD tracking tools included
Register for webinar
Add to calendar