How can I cope with stress?

Dear Doc,

How can one cope with stress?

Clearly, stress can cause health problems like hypertension and this can lead to heart ailment. In this modern era where one has to make ends meet and the pace of life is hectic, is there any mechanism where work efficiency is enhanced and one is not unduly fatigued? Please enlighten me.

ADW

Dear ADW,

Stress occurs when the demands on you feel greater than your capacity to cope. Stress may be good for you (eustress) when it improves performance, such as in healthy competition and pushing for a specific goal/achievement. However, when the stress exceeds what is needed for optimum performance, you are unable to cope (distress), leading to negative emotions, poor decision-making and performance and lack of sleep, among others.

When your brain encounters a stressor (for example a deadline at work), there is an immediate response that is activated, which leads to the release of adrenaline and a delayed response that triggers release of cortisol from the adrenal gland.

The immediate response causes your heart rate and blood pressure to go up, you breathe faster, your body releases more glucose, your muscles tense, and there is increased blood and oxygen supply to the brain and muscles all in readiness for “fight or flight”. The delayed response helps with mobilization of energy stores and also has an inbuilt “off-switch” that moves the body into rest-and-digest mode.

However, if there is continuous activation of the stress responses, the off-switch may become dysfunctional and the body is constantly in fight-or-flight mode. This is what leads to the negative effects of stress like high blood pressure, heart attack, stroke, muscle aches, ulcers, indigestion, immune dysfunction, sleep dysregulation, poor memory, mental health disorders, alcoholism and learning challenges. In children, chronic stress can lead to developmental delays.

Since stress is a part of everyday life, the best thing you can do is to build your resilience; increase your ability to tackle whatever life throws your way. Part of resilience is inherited genetically, part is taught, and part is acquired by repeatedly tackling challenges. Resilience is built by first being self-aware (what are my strengths and weaknesses, how do I deal with stress), learning how to self-manage, creating boundaries, identifying and living according to personal values, adopting positive coping strategies, taking care of yourself, finding and living your purpose, and building healthy connections.

Positive social support is the greatest building block of resilience. Cultivating healthy thoughts is also vital. When you face a stressor:

Avoid – learn to say no, get rid of unnecessary tasks and avoid people/circumstances that affect you negatively.

Alter – change what can be changed, like leaving a few minutes earlier to avoid traffic and prioritising tasks to meet deadline.

Adapt – for what you can’t change, adjust your attitude or your standards, or look at it from a long-term/wider perspective

Accept – there are stressors that do not need our input, though they affect our lives significantly, such as national politics, epidemics and death of a loved one. It is best for us to accept, express emotions positively and let go.

Hi doc,

I am a university student and one of the problems I have struggled with during my schooling, is sleep, especially when I settle down to study. This happens even when I have had enough time to sleep. Could it be a medical condition and if so, how can it be addressed?

Muriuki

Dear Muriuki,

Sleeping in class or while studying is a very common problem for people of all ages. Studying is a lot of mental work, which utilises a lot of the body’s energy. Typically, the brain uses about 20 per cent of the available energy, and when your brain is very “busy”, you use up more, which means there is less energy available for the rest of the body, leading to feeling fatigued. In addition, level of interest, study patterns and environment, diet, hydration status, distractions, stress, burnout, sleep habits and physical illness can also contribute to sleeping while studying.

If you suspect that you may have a physical or mental issue, kindly visit a health professional for evaluation and management.

Here are some tips to manage sleepiness during study:

Identify a good study environment. Do you prefer complete silence or background noise? Inside or outside? Trying different locations to stimulate the brain.

Do not get too comfortable. Choose a hard chair and sit upright. If you prefer to study with music, choose fast-paced energetic music, and if possible, get instrumental music.

When studying at night, get a bright light.

Get rid of clutter and distractions.

Take regular breaks during your study sessions, for example, study for 25 minutes then take a five-minute break, and after two hours, take a 20-minute break. During the break, get up and move around, or do breathing or stretching exercises.

Read aloud and write, study with others and rotate study topics.

Eat well – take regular balanced meals rich in whole grains, seeds, fish, lean meats, nuts, fruits and vegetables, and stay well hydrated.

Take power naps – take a 20 to 30 minute nap if you are really struggling with sleep.

Have a good sleep pattern – establish a sleep routine that includes relaxing activities; sleeping at the same time each night; sleep for seven to eight hours; remove distractions from your bedroom; avoid caffeine, alcohol and screens close to sleeping time; avoid working or staying up at night as much as possible; eat a healthy balanced diet and exercise; and maintain a healthy weight.

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