I have written previous articles on how to identify your stress triggers, and I thought it would be useful to also look a bit deeper. Sometimes we have other causes for our stress that we don't really consider because perhaps it happened a while ago, or has been going on for so long that we have almost accepted them as a regular part of life. So let's look at whether your stress is temporary or long-term.

Short-term stress is easier to cope with because we know that once the stressful situation is resolved then we will return to normal. Simple self-help measures like chatting to a friend or taking a break will help relieve the situation for us. Long-term and continuous stress is harder to deal with, and is potentially much more damaging, emotionally and psychologically, both for us and our family and friends.

One of the difficulties with long-term stress, is that we start to take it for granted and simply don't realise the enormous pressure we are under, and the strain that our body and emotions are going through. You may feel tired, irritable or have other symptoms that soon seem part of your normal behaviour. So it is very helpful to be able to take a dispassionate look at your life right now and see how many major external stressors you are under.

Your External Stress Profile - Dealing with stress is not just about what has happened this week, or in the last month, but over the last year. Our response to stressful events can build up, especially if we don't deal with them as they immediately arise. The effects of your stress will continue to ripple out, like dropping a stone into a pond, for some time after the initial event. You may notivce the immediate stress, that first ripple, but as time goes on you become less aware as your body automatically adjusts to deal with the stress. The'ripple' is less visible, but it is still there.

Identifying external stressors - These questions cover all the main stress events that you are likely to have encountered. Read through and tick the ones that have applied to you in the last year:

STRESS EVENT AND IT'S SCORE

** Death of spouse or partner/ 100

** Divorce/ 60

** Separation from spouse or partner/ 60

** Imprisonment or public disgrace/ 60

** Death of close family member/ 60

** Serious injury or illnesss/ 45

** Marriage or establishing new partnership/ 45

** Loss of job/ 45

** Marital or relationship reconciliation/ 40

** Retirement/ 40

** Change in health of immediate family member/40

** Work for more than 40 hours a week/ 35

** Pregnancy or responsible for a pregnancy/ 35

** Sexual difficulties/ 35

** Gain of a new family member/ 35

** Business or work role change/ 35

** Change in financial status/ 35

** Death of a close friend/ 30

** Increase in marital or partnership arguments/ 30

** Mortgage or loan for a major purpose/ 25

** Foreclosure on a mortgage or loan/25

** Sleeping less than 8 hours a night/ 25

** Change in responsibilities at work/ 25

** Trouble with in-laws or children/ 25

** Outstanding personal achievement/ 25

** Spouse or partner stops or starts work/ 20

** Start or end of school life/ 20

** Change in living conditions (visitors in the home,change in roommates, renovating or redecorating house)/ 20

** Change in personal habits (diet, exercise, smoking, etc.)/ 20

** Chronic allergies/ 20

** Trouble with boss or colleagues/ 20

** Change in work hours or conditions/ 15

** Moving to new home/ 15

** Pre-Menstrual tension/ 15

** Change of school/ 15

** Change in religious activity/ 15

** Change in social activity (more or less than before)/ 15

** Minor financial loan/ 10

** Change in frequency of family get-togethers/ 10

** Holiday/ 10

** Major family celebration (e.g. Christmas, wedding) / 10

** Minor violation of the law (e.g. parking ticket) / 5

Ok, now add up the total points for each one that you think has occurred to you in the last year and write it here: TOTAL SCORE:_________________

If you have had a year of major upheaval involving perhaps death, divorce, change of home then that has a serious impact on your stress levels. If you already have a low stress tolerance, then a score of even 150 can lead to you being overstressed.

However for the majority of us with average stress tolerance a score of more than 250 is a potential red flag. This shows where we are feeling the strain and gives a clue to how to begin putting an action plan in place to reduce our stress.

When to see Your Doctor Initially there are many practical self-help methods we can use to start addressing our stress levels, but if your stress rating is high and you are experiencing physical symptoms, severe distress or having difficulty functioning normally, then it is advisable to see your doctor sooner rather than later and have a thorough check up.

Your sleep patterns are important, so if you have gone over four days with broken sleep and are worn out, then it's time to see your doctor. You need to seek medical help if you start noticing you lose your temper more frequently or are feeling moody or depressed.

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