People often tell me that they 'thrive on stress'. I respond that they might be confusing pressure – which can be energising and motivating, if we respond to it well – and stress, which always has a negative impact on us. Let me give you two examples:

James is a 30-year-old entrepreneur, who has recently launched a startup website selling his own brand of clothing. James is passionate about his new business and thrives on the pressure he puts himself under to make it successful.

He works long hours, but knows this is necessary to get a new business up and running. James thoroughly enjoys every minute of his working day, so never feels stressed or overwhelmed – the fact that his business is doing well helps him stay positive and optimistic about the future.

So for James, it's clear that the – self-imposed – pressure is a positive thing; it gives him the energy and drive he needs to make his new business a success.

Emma is a 26-year-old nurse working in a busy hospital in inner London. Over the last year, she has seen wave after wave of cuts in the number of nurses and support staff working on her ward. She and her colleagues work very long hours with no breaks – Emma wolfs a sandwich during her daily meeting with the other nurses. Sometimes she goes hours without even a drink of water or toilet break, as she is swamped with constant crises and demands from her patients.

Emma's nerves are stretched and jangling, she feels exhausted and irritable all the time – recently she snapped at a difficult patient, which shocked and upset her. Emma is so stressed that she doesn't know how much longer she can take it and is seriously considering quitting nursing before she becomes seriously ill.

The impact of chronic stress

It's clear that Emma is suffering from chronic, debilitating stress, which is affecting her physically and psychologically. Like many people suffering from stress, she feels overwhelmed, under-supported and out of control of her working life. If she doesn't do something soon, she may will burn out or develop a more serious illness, as all the research shows that long-term stress is harmful to the body and mind.

In schema therapy terms, this kind of stress is generally caused by a demanding part, which drives us on to work harder and harder, never feeling that what we do is good enough. This part can also make us feel under pressure – but it's not the kind of positive, motivating pressure James thrives on. This pressure is unpleasant, debilitating and overwhelmingly negative.

James's enjoyable pressure is probably coming from his Healthy Adult, which encourages and motivates us, rather than being critical or undermining of our best efforts.

If you are struggling with short-term stress, cognitive behaviour therapy (CBT) will be extremely helpful. If becoming stressed is a pattern for you, or it's affecting every area of your life, schema therapy may be more suitable.

Warm wishes,

Dan