Stress

STRESS

The Concept

Stress is a normal human reaction, and everyone feels at times, there are all kinds of stressful situations that can be a part of our daily life. When the human body experiences stressful events, will result in a state of alertness and produce physical and mental responses, Low-level stress can even be helpful or motivational.

Stress is not a mental health diagnosis, but if stress lasts for a long time (chronic) it can lead to mental health problems such as anxiety or depression, where as experiencing a very stressful or traumatic event could cause post-traumatic stress disorder (PTSD), a well defined diagnosis listed by the International Classification of Diseases 11th Revision · The global standard for diagnostic health information · Use ICD‑11 ·

and the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

Research findings- Statistics:

The Mental Health Foundation's 2018 study was an online poll undertaken by YouGov, and had a sample size of 4,619 respondents. This is the largest known study of stress levels in the UK.

The study in the past year, 74% of people have felt so stressed they have been overwhelmed or unable to cope.

30% of older people reported never feeling overwhelmed or unable to cope in the past year, compared to 7% of young adults.

46% reported that they ate too much or ate unhealthily due to stress. 29% reported that they started drinking or increased their drinking, and 16% reported that they started smoking or increased their smoking.

51% of adults who felt stressed reported feeling depressed, and 61% reported feeling anxious.
Of the people who said they had felt stress at some point in their lives, 16% had self harmed and 32% said they had had suicidal thoughts and feelings.

37% of adults who reported feeling stressed reported feeling lonely as a result

American Research findings showed that despite several months of acclimating to a new reality and societal upheaval spurred by the COVID-19 pandemic, about 78% reported that coronavirus pandemic is a significant stress in their life and 67% say they have experienced increase stress over the course of the pandemic.

The potential long-term consequences of the persistent stress and trauma created by the pandemic are particularly serious for youngest individuals (ages 13-23) are facing unprecedented uncertainty, are experiencing elevated stress and are already reporting symptoms of depression.

Compared with 2019, the majority of adults still say health care (66%), mass shootings (62%) or climate change/global warming (55%) is a significant source of stress. Around half say the same about the rise in suicide rates (51%), immigration (47%), widespread sexual harassment/assault reports in the news (47%) or the opioid/heroin epidemic (45%). Only reports of mass shootings as a significant source of stress have declined significantly since 2019 (71% in 2019).

Nearly 2 in 3 adults (65%) say the current amount of uncertainty in our nation causes them stress. Further, 3 in 5 (60%) say the number of issues America faces currently is overwhelming to them.

General Causes of stress

In general, change in an existing situation of a human being causes stress. This is due to lack of control over the existing situation. The changes might be good or bad changes, but they might cause stress to a person.

Stress can be caused by a variety of different common life events, many of which are difficult to avoid such as:

Serious or chronic Health problem in oneself or or family member or a friend
Injury or accident
Bereavement in the family or close relationship

Financial worries
Being under lots of pressure
Facing big changes

Not having much or any control over the outcome of a situation and times of uncertainty

Organising important personal or family events

Getting married, pregnancy and becoming parent
Marital relationship problem (disharmony, separation or divorce)
Family relationship difficulties (parents, siblings, children ..)
Caring for ill or elderly parents, relative or friend
Loss of job or long-term unemployment
Retirement
Job interview or Starting new job
Difficult issues at work
Study or exams situation
Moving house

Stress triggering events are different for different individuals. According to surveys, stress related to work contributes the highest percentage. In the United states, 40% workers admit to have stress caused due to their work and 25% …..

However many studies reported strong connection of long –term stress to negative health outcomes. Stress can affect health directly, through autonomic and neuroendocrine responses, but also indirectly, through changes in health and behaviours

Physiological changes during stress

the “fight-or-flight response,” helps the body face stressful situations which manifested by increase in heart beats, breathing, sweating and other physical symptoms.

Long –term stress will result in psychological, behavioural and physical symptoms such as :

Psychological symptoms:

Anxiety
Depression
Feel overwhelmed
Racing thoughts and difficulty concentration
Lack of confidence
Panic attacks
Unhappiness
Irritability
Sleeping problems
Appetite problems (loss or excessive eating)

Physical symptoms of stress:

Chest pain
Palpitation
Breathing difficulty
Headache
Aches and pains.
Sleeping difficulty
Tiredness.
Dizziness or shaking.
Muscle tension or jaw clenching.
Digestive symptoms.

Behavioural problems:

Alcohol Drinking problem.
Smoking
Drugs abuse
Gambling.
Participating in compulsive behaviours such as shopping or internet addiction)

When considering the physical and emotional toll of increased stress, nearly half of adults (49%) report their behaviour has been negatively affected. Most commonly, they report increased tension in their bodies (21%), “snapping” or getting angry very quickly (20%), unexpected mood swings (20%), or screaming or yelling at a loved one (17%).

The Diagnosis of stress

The clinical diagnosis should be reached following a thorough personal, family and health history taking, conducted by a specialist healthcare professional (psychiatrist or psychologist) in addition to full physical examination and appropriate laboratory tests to rule out any possible underlying medical conditions.

The specialist healthcare professional should also evaluate the mental state to determine any possible associated psychiatric disorder such as depression or anxiety

Treatment

If severe chronic stress is causing significant distress or impairing the person’s ability to function normally, professional therapy is indicated to help developing new coping skills and find ways to lower the stress the most appropriate approach is

Cognitive behavioural therapy (CBT):

Employing CBT can train the person to learn to identify negative thoughts patterns that contribute to chronic stress. Also to enable the person to change these thoughts to more productive, realistic and helpful ones.

Medications: such as antidepressant can be prescribed by the doctor to treat the

associated symptoms of depression, anxiety and sleeping problems etc.

Prevention of stress

Healthy life style: healthy diet, exercise, healthy and adequate sleep will help your body to handle stress much better.
Relaxation programs and relaxation activities such as breathing exercise, physical activities and gym, meditation, and muscle relaxation.
Stay positive and self control when you are stressed .
Positive Social activities (family member and close friends )
stress management techniques

How to handle stressful situations?

Challenge your negative though,The way you think affects the way you feel and your attitude or behaviours, hence positive productive thoughts will bring about positive thinking behaviour and happy feelings .
Highlight your positivity and recall things you are thankful for and about splendid occasions or things in your life.
Planning out your upcoming stressful events by listing things you needs and tasks you needs to complete.
Break up large responsibilities to minor tasks and reward yourself for
accomplishment

Dr. Akeel. A.Abdul Wahab

Fellow & Member of The Royal College of Psychiatrists (UK)

FRCPsych. (UK), MRCPsych. (UK), Board NeuroPsych. (London University ,UK), Dip.Psych. (London University, UK), MB.ChB.(Basra University , Iraq )

Formerly Senior Consultant Psychiatrist & Clinical professor

References & further readings

Post traumatic disorder (PTSD)-International Classification of Diseases 11th Revision · The global standard for diagnostic health information · Use ICD‑11 ·

(PTSD). a well defined diagnosis listed by the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

The Mental Health Foundation's study 2018 study,UK

STRESS AND HEALTH: Psychological, Behavioral ... - NCBI

https://www.ncbi.nlm.nih.gov › articles › PMC2568977

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Stress Research - The American Institute of Stress

https://www.stress.org › stress-research

Stress in America™ 2020: A National Mental Health Crisis

https://www.apa.org › stress › 2020 › report-october

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Stress in America 2020 survey signals a growing national ...

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