My name's Alan Cohen,

My name's Alan Cohen,
I've been a GP for about 25 years.

I am Primary Health Advisor for
the National Institute of Mental Health.

Stress is how the body reacts
to external pressures

that we perceive to be
difficult, uncomfortable.

It creates both physical changes
in the body,

so sweating, or worry,
or frustration, or anger.

Talking to you today, stress is not
a problem, it's good for me,

it makes me perform better
and more effectively.

Stress becomes a problem
when instead of helping me perform

it actually becomes counter-productive
and I go terribly tongue-tied

and can't think of what to say.
That's when it become unhelpful.

When that lasts a long time,
we get chronic stress,

then people become really quite unwell.

The difficulty is know for an individual
when they should seek help,

when stress has stopped being good
and started being bad for them.

Stress can affect anybody, you or me.

And what's interesting is that
what may be stressful for you

may not affect me very much,
and vice versa.

So it's very much
an individual perception,

a meeting of the individual personality
with an external event.

So common causes of stress are things
like pressures at work, for example,

pressures at home,
pressures around money,

pressures around employment,
especially nowadays.

These are all things that commonly cause
symptoms of stress.

When stress becomes bad for you,

the commonest sort of feelings
that one gets inside oneself

is one of either anxiety
and/or depression.

You feel unable to manage things,
unable to think clearly,

everything becomes an effort, you're
slowed up, you can't think clearly,

as well as feeling on edge,
unable to concentrate, tearful,

a whole variety
of these uncomfortable emotions.

Often these are associated
with physical symptoms as well.

So you might get headaches,
tummy ache, back ache,

and one can describe these as being
linked to the mental health problem

because of the way the body works,
it doesn't separate mind and body,

We work together as a single unit.

In the same way
that the emotions get disturbed,

so the way the body works
gets disturbed.

As a GP, I see lots of people
with a whole variety of symptoms

that they come and present to me,

some of which is psychological,
some of which is physical.

It's the skill of the GP that they need
to disentangle what's going on,

to work out whether the abdominal pain
and the sweating

is due to an underlying physical cause
like an ulcer,

or whether there's something going on at
home or at work that's upsetting them.

How you identify that depends on
the ability to listen to the patient,

to understand
what the symptoms mean to the patient,

to listen to what
their possible explanations are.

It's about good conversation
between the doctor and the patient

and both being honest with the other.