Wellbeing and resilience

Guidance notes

1. Maintain good sleep hygiene, including establishing a regular nightly routine and a pleasant sleep environment, if possible.

Sleep is vital to health and wellbeing. The average adult needs seven to nine hours of sleep a night. Not getting enough quality sleep will affect so many aspects of your waking life. Sleep deprivation or disrupted sleep will affect your mood, concentration, and memory, and longer-term may weaken your immune system and raise your blood pressure, for example. Whether you tend to sleep well or have difficulties getting a good night’s sleep, it is important to maintain good habits around sleep.

As best you can, try to create a cool, dark and quiet environment in which to sleep. Remove anything to do with work from where you sleep, including your phone if possible. For at least one hour before you would like to be asleep, avoid eating, drinking (especially alcohol and caffeine), smoking, looking at screens, and all stimulating activity, including exercise. Try to put your worries and your to-do list to one side and consciously foster a state of rest and relaxation. When possible, go to bed at the same time every night and wake up at the same time each morning, going outside into natural light as soon as is practical. Regular daytime exercise will also promote the length and quality of your sleep.

Be mindful of any sudden, unexplained changes in the quality and quantity of your sleep or your usual sleep/wake schedule. Completing a sleep diary or using a tracking app, such as Sleep Cycle or SleepScore, may help you identify any changes. Changes to your sleep pattern may indicate that your sleep hygiene needs attention using the above guidelines. If your sleep does not improve, you should consult a healthcare provider or mental health professional. Sleep disorders, such as insomnia, sleep apnoea and Restless Leg Syndrome, may benefit from specialist support, such as Cognitive Behavioural Therapy (CBT) or medication.

2. Eat regular meals and maintain a healthy diet.

The food we choose to eat, when we eat it, and the amount we consume are all critical to our health and wellbeing. Our energy levels, mood, performance and longer-term health are all impacted by our daily choices around food.

The work we do can be demanding, and it is sometimes tempting to rely on caffeine or sugary snacks to get us through a stressful day. Likewise, busy schedules may encourage us to skip the occasional meal or eat at irregular times, such as late at night. These choices will contribute to spikes and crashes in your blood sugar levels, and may leave you craving more carbohydrates than you actually need. Longer-term, poor nutrition and diet can lead to health problems, including obesity, diabetes, and hypertension. It is therefore important to make conscious decisions around both what we eat and when we eat.

It may help to plan ahead and have healthy food and snacks to hand and not shop when you are tired or hungry. Choose foods that are high in protein and low in saturated and trans fats (though it is important to have small amounts of mono- and polyunsaturated fats in your diet). Eat at least five to seven portions (80 grams each) of a variety of fruit and vegetables every day.

Staying hydrated will also help you maintain energy levels and concentration throughout the day. Official advice on how much fluid you need each day varies from country to country, but is generally around two litres (with around a fifth of this coming from the food that we eat). In general, it is a good idea to at least drink a glass of water with each meal and between meals; before, during and after exercise or physical activity; and if you feel thirsty.

3. Regularly walk, exercise or play sport.

There are many benefits to regular exercise that go beyond the obvious physical impacts of improving our cardiovascular health and strengthening our bodies. Research shows that regular exercise is one of the best ways to respond to stress, reduce anxiety, increase self-esteem, and improve sleep. Exercise causes a release of endorphins and other neurotransmitters (chemical messengers), including dopamine, norepinephrine, and serotonin. These brain chemicals all play important roles in regulating mood and lowering stress levels.

Higher-intensity exercise, including running, aerobics, and sports, will provide the greatest physical health benefits. But even making moderate activity, such as brisk walking or riding a bike, part of your daily routine will have positive impacts, particularly if you combine it with reducing sedentary behaviour the rest of the time. Incorporating activities that strengthen your major muscles, such as yoga or heavy gardening, is also important. Overall, it will help to choose activities that you enjoy and look forward to, rather than imposing a strict regime on yourself that you feel you should engage in but may frequently fail to do so. If you have a disability or decreased mobility, there will likely still be aerobic activities and resistance and flexibility exercises that will suit your physical abilities.

Incorporating regular exercise and physical activities into your schedule will also encourage you to take breaks and maintain a healthier work-life balance. For some people, team sports and other more social physical activities may offer additional benefits, as membership of a group offers us shared goals, social contact and a sense of connection, which all help improve wellbeing.

4. Address physical illness or injury, and give yourself time to heal.

It is tempting to believe that our work is so important and our workload so heavy that we do not have time to be sick. In fact, continuing to work when we are unwell is detrimental to both our short-term recovery and our long-term wellbeing. If you regularly ignore illness and injury, you may be contributing to the development of more serious and chronic conditions. You may also be drawn to relying on unhealthy coping mechanisms, such as excessive use of painkillers or drinking too much caffeine. In short, if you are wondering whether you are well enough to be productive, it is probably a good idea to stop, rest and recover.

Working through illness can also be detrimental to others. Infectious diseases can spread easily around a community or workplace and to beneficiaries and others that we work with. We may also affect our co-workers’ effectiveness and wellbeing if we are present, but irritable, distracted and unproductive.

It is important to explore whether recurring physical symptoms are linked to psychological pressures. Physical conditions, such as migraines and irritable bowel syndrome, may be at least partially triggered by stress and anxiety. Whatever the reasons behind your illness or injury, take the self-care approach and give yourself time to heal. Follow the guidance here on sleep, diet, exercise, meditation, avoiding drugs and alcohol, and staying in contact with close friends and family. Speak to a healthcare provider as soon as possible if you have any concerns.

5. Engage daily in self-reflection and contemplative practices.

We all have multiple and complex roles within our families, communities and workplaces. For many, the digital age means that we are contactable by co-workers and others whenever and wherever. And social media and the 24/7 news cycle demand our constant attention. Against this backdrop, it is important to make space for being over doing.

A wide range of everyday activities can aid self-reflection and contemplation. These include journaling, reading, gardening, cooking, or listening to music. Such activities can enhance our sense of balance, gratitude and wellbeing. Beyond that, there are many inward-facing or spiritual practices that help calm our minds, regulate our bodies, and create a greater sense of ease and contentment.

Meditation is a practice of contemplation and focus on a particular object, thought, sound, visualisation, movement, or the breath. Mindfulness meditation, in particular, has grown in popularity in recent years in line with increasing evidence of its effectiveness. Mindfulness is a psychological state of awareness; it is being present in the moment, without judgment. It has proven beneficial impacts on stress, focus, and emotional reactivity. You may be able to access meditation classes in a variety of traditions locally or you can pursue a daily solo practice with the help of a book or an app, such as Calm or Headspace.

If you are a person of faith, it may already be a cornerstone of your life to engage in meditation and contemplative prayer, and will likely find a deep sense of meaning in these and other spiritual practices.

Self-reflection can also be fostered through movement. For example, yoga is an ancient practice that supports health and relaxation through postures or poses and working with the breath and meditation. Alongside the physical benefits, it can reduce stress, anxiety and depression and improve sleep. Other forms of physical activity, such as walking in nature, may be your way of promoting relaxation and a sense of calm.

6. Do not use drugs or alcohol as a way of coping with stress or trauma.

The use of recreational drugs presents complex issues for health and wellbeing. Individuals, communities and societies all differ on questions of legality, abstinence, and the concept of harm. But be mindful that if you are breaking the law in the country that you are living in, then you are placing your livelihood and potentially your family life in jeopardy.

As a psychoactive substance that is socially acceptable in many societies, alcohol presents particular challenges. The ‘hidden alcoholism’ of those who regularly drink at the end of a busy or stressful day may risk negatively impacting family members, friends, and co-workers, as it can result in mood swings, tiredness and/or more-frequent illnesses. If you drink regularly, you should aim to have two or three alcohol-free days a week, and only drink in moderation at other times. But it is useful for each of us to consistently and honestly assess our choices around alcohol and be mindful of sliding into dependency. The Alcohol Use Disorders Identification Test (AUDIT), devised by the World Health Organization (WHO), can help you self-assess your alcohol consumption and identify any implications for your health and wellbeing. It is available in over 40 languages.

In general, signs that you have an unhealthy relationship with a substance include regularly having hangovers or comedowns, using drugs or alcohol when alone or secretly, and prioritising your access to drugs or alcohol over other personal and professional responsibilities. If you recognise any of these behaviours, you may find it helpful to talk with a healthcare provider or mental health professional. Be mindful that alcohol and other recreational drugs can interact with each other and with prescribed medication to reduce either’s efficacy or create unexpected and potentially serious effects.

7. Maintain relationships with friends, family, co-workers and community members who can support you.

Support from trusted others is the most important factor in preventing and mitigating the harmful effects of stress and poor wellbeing. Unfortunately, our pursuit of professional and personal goals, a passionate focus on a social or environmental cause, or simply a heavy workload can lead too many of us to neglect our relationships. Worse, we may sometimes channel frustrations and disappointments unhelpfully towards the ‘safest’ people in our lives: friends, family and co-workers.

It is crucial to nurture your key relationships. Try and ensure that there is openness, trust and mutual respect between you. If there are conflicts or rifts in your family relationships, ask yourself if and how they can be resolved, being mindful of any need to protect yourself from harmful relationships. If you do not live near your close friends and family, prioritise maintaining regular communication with them and ensuring that they feel connected to your daily life and you to theirs’. Be mindful of making time for children and elderly members of your family and community as individuals as well as in group settings.

It may be helpful to regularly examine your work-life balance to check that your priorities have not drifted away from your relationships without you realising. Be pro-active and make a conscious effort to set aside time to call or socialise with friends and family. Remember that social media, text messages and video calls can help us stay in touch and feel connected, but be careful not to let digital communication replace face-to-face contact when possible.

8. Understand what stressors might trigger changes in your health and wellbeing and learn to recognise the signs and symptoms of stress in yourself.

Stress is not always negative; sometimes, some stress can be good. It may motivate us and can push us to engage and achieve. When stress helps us to challenge ourselves and to be active, it can be positive, keeping us in our ‘green zone’. When we have too much stress in our lives, we can feel overloaded and overwhelmed. We can start to feel exhausted – instead of energised – and move into our ‘amber zone’.

Signs and symptoms of stress fall into five categories: physical, emotional, psychological, behavioural, and spiritual. In the physical realm, you may become tense, get backache or experience stomach problems. In the emotional realm, you may become angry, tearful or fearful. Psychologically, you may begin to doubt your competency or imagine that you are being judged harshly by others. Behavioural manifestations of stress may include unwise spending, smoking, speeding or avoiding people. Signs of spiritual loss of wellbeing may include questioning your faith or belief system, withdrawing from spiritual practices or breaking your own ethical codes.

Changes in any of these realms can indicate that our health and wellbeing is deteriorating. When this is prolonged, without suitable adjustments, our ability to cope diminishes. This can lead to unpleasant and even frightening symptoms and contribute to a range of physical and mental health disorders. Ultimately it can leave us burnt out and ill, pushing us into the ‘red zone’.

Try and build up a picture of what you look like in the different zones and what stressors might put you in the amber or red zone. If you move into the amber zone, it is important to do something about it straight away – do not wait until you get into the red zone, where it is much more difficult to recover. With stress and other mental and physical health concerns, including depression and anxiety, for example, it is important to know the warning signs. Be mindful of any negative changes in your sleep, appetite, mood and functioning. Follow the self-care guidance above on sleep, diet, exercise, meditation, avoiding drugs and alcohol, and staying in contact with close friends and family. If you have any concerns, speak to a healthcare provider or mental health professional as soon as possible.

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