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Everyone is familiar with stress. We experience it in varying forms and degrees every day. In small doses, stress can actually be beneficial to us. It is only when the stress becomes too great, affecting our physical or mental functioning, that it becomes a problem. Dr R.O Adenikinju, enumerates the benefits and otherwise of stress.
The Oxford Concise Medical Dictionary defines stress as “Any factor that threatens the health of the body or has an adverse effect on its functioning, such as injury, disease or worry. The existence of one form of stress tends to diminish resistance to other forms. Constant stress brings about changes in the balance of hormones in the body”.
Stress can also be defined as “a person’s physiological response to an internal or external stimulus that triggers the fight or flight response”.
Factors in the environment (Physical, Psychological or social) that can produce adverse effects are called stressors. This can further be extended to include events that are not experienced as adverse at the time, but may still have long-term effects e.g. intense competition may produce an immediate feeling of pleasant tension, though it may sometimes lead to unfavourable long-term effects.
The effect on the person can be described as stress reaction. This reaction includes:-
(i) Autonomic responses (e.g. rise in blood pressure)
(ii) Endocrine changes such as the secretion of adrenaline or nor adrenaline.
(iii) Physiological responses such as feeling of being keyed up i.e. excited, nervous or tense.
In small doses, stressors can help give us increased energy and alertness, even helping to keep us focused on the problem at hand. This type of stress is good. People may refer to the experience of this
type of stress as feeling “pumped” or “wired”.
As the level of pressure gets too great, stress eventually surpasses our ability to cope with it in a positive way. At this level, people often describe themselves as being stressed out, burned out; or at wits end.
At this point, it is important to find positive and productive ways to deal with the stress and more
importantly, to address the person or situation that is causing the stress.
Everyone reacts to stress differently. Each of us has a different level of pressure and anxiety that we can handle without a bad outcome. Only you can assess your level of tolerance to stressful situations. The best treatment for stress is to prevent getting into situations that are likely to overwhelm your ability to cope. However, this is not always possible because the stressors may often come from outside sources that are beyond our control.
Causes of stress
The risk factors for uncontrollable stress include the following:-
(a) Social or financial problems
(b) Medical illness
(c) Lack of social support in the work place, family etc.
(d) Family history
Manifestations of stress
Stress usually first affects the inner emotions. Initial symptoms of stress may include the following feelings: Anxiety, nervousness, distraction, extensive worry, internal pressure.
These emotional states can then begin to affect a person’s outward appearance. The individual is unusually anxious or nervous, distracted and irritable etc.
As the stress level increases, or if it lasts over a longer period of time, a person may begin to feel more severe emotional or physical effects such as: excessive fatigue, depression, suicidal tendencies,headaches, nausea and vomiting, diarrhea, chest pain or pressure, heart racing, dizziness or flushing,Tremulousness or restlessness, hyperventilation or choking sensation.
In most cases, these symptoms are very minor and do not last for long. If they become more severe or increased in frequency and severity, please seek medical help.
At this juncture, I will like to dwell more on the physiological reactions of stress:
This results from central nervous system (CNS) mediated response and outpouring from endocrine glands.
There is release of catalolamines (Adrenaline and Nor Adrenaline) from adrenal medulla, cortisol from adrenal cortex and thyroxine from the thyroid gland.
The Catecholamines produce marked vasoconscrition and also have pronounced effect on sugar and lipid metabolism.
The Adrenal cortical hormone (Cortisol) regulates sugar metabolism and that of minerals, sodium, potassium and water.
Thyroid hormones increase turnover of carbohydrates, fats, cholesterol, calcium and magnesium.
They increase heart rate and contractility; increase total peripheral resistance; increase secretion of Hydrocortisone and growth hormones.
The overall effects of these is the elevation of blood pressure, tachycardia, irregular heart beats,
muscular tension, headache, dryness of mouth/throat, overproduction of gastric juice resulting in dyspepsia and ulcer.
Treatment of stress
Examination and tests (investigations)
The physician needs to take a careful history and perform a physical examination in order to find any medical problems leading to your symptoms. The doctor looks for an underlying stress or psychological disorder that could be the source of stress.
It is very important for the patient to be open and not to hide any information from the physician.
Also laboratory tests or other diagnostic tests such as ECG (a heart tracing) may be needed to completely rule out underlying physical cause of the symptoms.
If the physician’s examination findings and the tests are normal, the physician may refer the client for specialist’s attention.
Self – Care at Home
• When you find yourself experiencing the bad effects of stress, the following action should be taken without delay.
(a) Identify the cause of the Stress
Sometimes this is a known source such as a deadline at work, a pie of unpaid bills or a relationship that is not working out.
At times it can be more difficult to identify the source.
Often many relatively mild stressors occurring at once can bring on the same stress as a larger problem or known source of anxiety or worry.
Also some people experience stress from events that occurred in the past (post-traumatic stress disorder).
(b) If you can identify the source of the stress, remove yourself from it or address the situation (such as an argument) or mentally removing yourself from the stressor (such as financial worries) through a mental distraction, often called a time-out.
The point of these actions is to allow you a moment to relax and formulate a plan for dealing with the problem at hand.
If you are unable to determine the source of your stress, you need to seek outside help, sometimes discussing your situation with family, friends; or a spiritual adviser can be helpful. If these routes are not successful, you should make an appointment with your doctor or a mental health professional to determine the source of the stress and rule out any potentially reversible medical causes of your stress.
Stress management encompasses techniques intended to equip a person with effective coping mechanisms for dealing with psychological stress.
As defined earlier, stress is a person’s physiological response to an internal or external stimulus, that triggers the fight or flight response. Stress management is effective when a person utilizes strategies to cope with or alter stressful conditions.
Some techniques of time management may help a person to control stress. In the face of high demand; effective stress management involves learning to set limits and to say ‘NO’ to some demands others make.
Some techniques for stress management includes the following:
1. Autogenic training
2. Cognitive therapy
3. Conflict resolution
6. Deep breathing
8. Relaxation Techniques
– Fractional Relaxation
– Progressive Relaxation
– Stress balls
1. Time Management
2. Listening to certain types of Relaxing music, particularly
– New age music
– Classical music
PREVENTION OF STRESS
You can take the following steps to prevent stress in your life:
(a) Set realistic goals and limits for yourself.
(b) Put things into perspective and try not to get upset about insignificant or relatively unimportant matters.
(c) Take stress; time management or anger management classes.
(d) Find activities that you enjoy and set time aside to participate in item on a regular basis.
(e) Participate in regular physical exercise
(f) Maintain a positive outlook.
(g) Set goals and break them down into easily achievable tasks.
Adenikinju, is the Director of Medical Services , Federal University of Technology, Akure,FUTA.
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