Stress First Aid: A Practical Approach to Caring For Your Mental Health.

Day-to-day stress is a normal part of life, but when unmanaged stress becomes excessive or ongoing, it can start to negatively impact your emotional, mental, and physical wellbeing. That’s why it’s so important to know the signs of when stress is becoming too much and be equipped with practical steps you can take to intervene before the stress becomes more severe. 

Stress First Aid is a framework to recognize and address stress early and quickly.

Originally designed for the military, Stress First Aid is a model for helping people without formal mental health training learn to identify early signs of chronic stress and know how to return to a calm, confident, and hopeful state of being. It’s meant to be used to recognize stress in your own life as well as others around you, such as your family members, friends, and coworkers. When used regularly, it can help to prevent significant stress or shorten the amount of time someone spends experiencing excessive, overwhelming stress. Stress First Aid is also used by members of the MedStar Health team to support their own wellbeing–more than 2,700 associates have been trained in Stress First Aid via in-person and virtual trainings. With the support of generous donors, including associates at MedStar Health, we help support programs like this through the MedStar Health Center for Wellbeing.

When is stress “too much"?

Our bodies and minds are equipped to handle stress to a degree, but many factors can impact the amount or type of stress we’re able to handle before things start to spiral downward. Chronic stress looks different for everyone, but it often impacts your ability to function or feel like yourself. If you’re chronically stressed, you may:

• Have trouble functioning
• Be distracted 
• Have difficulty making decisions
• Feel irritable
• Struggle to enjoy things you used to
• Have trouble sleeping

In other words, if stress is interfering with your ability to enjoy life, rest, or function, it may be time to talk to someone and make a change.

Where do you fall on the Stress Continuum?

The Stress First Aid model uses a visual continuum to help you assess where you or others fall on a spectrum of four stress response zones. We frequently cycle through each of these colored zones, but the goal of Stress First Aid is to help us learn to recognize patterns of stress quickly so we can move back towards the right end of the stress continuum.

Green: I’m thriving and ready.

The goal is to stay in the green zone or return to it quickly when larger stresses arise. That’s not to say you won’t experience any stress in the green zone but rather that any stress you’re experiencing is manageable. Stress can actually be a good thing if it helps you to grow or realize you have more capacity than you expected. In this optimal zone, you’re feeling good and prepared to navigate stress as it comes your way. 

Yellow: I’m surviving.

If you’re feeling some mild and temporary distress, you may have moved into the yellow zone. Inevitably, something in life will go wrong or overwhelm us. You might experience some signs of stress, like muscle tension, difficulty concentrating, or anxiety. However, in this zone it’s likely still easy for you to return to green after the stressor passes, like going home at the end of a tough workday and doing something to decompress.

Orange: I’m struggling and I need help.

If you can’t seem to get back to the green zone because of the severity or type of stress you’re experiencing, you could slide into the orange zone. For some, this could be the result of the wear and tear of daily life, while for others, a significant or extended personal loss or injury can lead to this state.

More intense and ongoing physical, mental, or emotional stress is not sustainable long-term, even if you are really good at managing stress. Sometimes the stress is just too big to shoulder on your own and something needs to change. When you feel like you can’t stay on top of everything or you don’t feel like yourself, it's important to use Stress First Aid strategies to help reduce your stress and return to a calm, steady state. At this point in the continuum, it’s especially important to talk to someone you trust, whether it’s a friend, supervisor, or mental health professional.

Red: I’m in crisis.

When severe ongoing stress impacts your ability to function or you feel hopeless, it’s critical that you seek prompt help. In the red zone, you may feel constantly overwhelmed, have difficulty sleeping, or be struggling with other mental health challenges, such as anxiety, depression, or post-traumatic stress disorder. When you or someone you know is in crisis, it’s important to take it seriously and act quickly to stop the stress in its tracks. You may even consider texting or calling 988, the national mental health crisis hotline.

Take action with the 7 C’s of Stress First Aid.

It’s important to normalize saying “I’m not okay” and reaching out to others when it seems something is off. To help you recognize how you or someone else are functioning amidst stress, Stress First Aid recommends the 7 C’s, which include:

• 1. Check: Monitor where you (or a loved one) are on the continuum by assessing your stress reactions on an ongoing basis. If you notice something, say something. Then…
• 2. Coordinate: Get help for yourself or connect others to resources when needed. For example, if your child seems to be struggling in the orange, consider taking them to the pediatrician to discuss support. If you know you’re experiencing chronic stress at work, perhaps you would benefit from talking to a supervisor who could help to alleviate some stressors.

Checking and coordinating should be performed on an ongoing basis for optimal self-care or recognition of someone else who may need additional support. The last five C’s can be used as needed to help people when they’re stressed:

• 3. Cover: Get to safety, physically or psychologically.
• 4. Connection: Avoid staying isolated and seek support from others. 
• 5. Calm: Find a way to soothe your mind and body, whether through breathing exercises, meditation, prayer, mindfulness, or walking in nature.
• 6. Competence: Get equipped to feel effective at what you're facing. Perhaps that means pursuing a training course, asking for practical help, or reminding yourself of your skills and abilities so you feel less stressed about your circumstances.
• 7. Confidence: Restore self-esteem and hope by finding or clarifying your purpose in life.
  
  

If you don’t feel like yourself, we can help.

For some, talking through their stress with someone they trust, like a family member or friend, co-worker, or supervisor can help to alleviate the overwhelm. For others, meeting with a primary care provider or mental health professional is the best next step. At MedStar Health, we have an extensive network of primary care providers that can offer advice about the kind of help you might need and connect you with an appropriate resource. In addition, our mental health professionals provide comprehensive psychiatric care for patients of all ages, including therapy, medication management, and the full-range of inpatient psychiatric services to meet you where you are and figure out what treatment approach will be most helpful. 

Taking care of your mind and emotional wellbeing is just as important as seeking medical care for any physical ailments, so seek help if you are struggling. You don’t have to struggle alone.

If you’re interested in making a gift to support programs like this at MedStar Health, please click here to make a gift today.

References:

Watson PJ & Westphal RJ (2020). Stress First Aid for Healthcare Workers. U.S. Department of Veteran Affairs. National Center for PTSD.

Colorado Healthcare Ethics Resource. “Supportive resources for Colorado healthcare workers” https://cohcwcovidsupport.org/ Accessed on July 23, 2021.