HEALTH PLUS MED­ICAL COR­RE­SPON­DENT

As the Nov­el coro­n­avirus ac­cel­er­ates in trans­mis­sion across Trinidad and To­ba­go and the world, anx­i­eties and stress about COVID-19 are be­com­ing just as con­ta­gious in its pro­lif­er­a­tion and pos­si­bly even more dam­ag­ing health wise.

Stress can be help­ful, but stress can al­so bring a per­son to full blown pan­ic at­tacks and at worst, de­pres­sion, and sui­cide. Health Plus ex­plored the GOOD, the BAD and the UG­LY of Stress and ways to pre­vent this from erod­ing your op­ti­mised health.

Har­vard Health de­fines Stress as a nat­ur­al process by which we re­spond to cer­tain stim­uli, events or stres­sors that we per­ceive as neg­a­tive, chal­leng­ing, or threat­en­ing.

Is stress a per­cep­tion? It is well doc­u­ment­ed that dif­fer­ent peo­ple per­ceive dif­fer­ent stim­uli to be more or less stress­ful. Many times, stress can be a time-con­sum­ing and counter-pro­duc­tive re­ac­tion to an in­ert stim­u­lus. How­ev­er, once we can de­lib­er­ate­ly choose a re­sponse ver­sus a re­ac­tion to this stim­u­lus, we can in­ten­tion­al­ly train our minds to cope bet­ter with stress.

The Good: Eu­stress

Eu­stress: mod­er­ate or nor­mal psy­cho­log­i­cal stress in­ter­pret­ed as be­ing ben­e­fi­cial for the ex­pe­ri­encer. Stress means you care about some­thing. Be­ing stressed out is the body’s at­tempt to tell us this thing is im­por­tant. A study pub­lished in the Jour­nal of Pos­i­tive Psy­chol­o­gy shows high­er lev­els of stress cor­re­lates to more mean­ing in the par­tic­i­pants’ lives. Kel­ly Mc­Go­ni­gal, a health psy­chol­o­gist at Stan­ford Uni­ver­si­ty, ar­gues that stress has nu­mer­ous up­sides, if it is viewed in the right light. “Those who be­lieve stress is neg­a­tive have worse out­comes than those who rec­og­nize that stress is a nat­ur­al re­sponse that peo­ple can use to their ben­e­fit.”

Stress can be good, with the right mind­set.

Go­ing back to the de­f­i­n­i­tion of stress, it is a nat­ur­al, phys­i­o­log­i­cal re­sponse. While stress can be a com­plex re­sponse to neu­tral sit­u­a­tions, evo­lu­tion de­signed stress to help us sur­vive harm­ful sit­u­a­tions. Whether one is new­ly con­firmed pos­i­tive for COVID-19 or to ap­pear in a pub­lic speak­ing event or take an ex­am, our brain com­mu­ni­cates sig­nals to pre­pare for the sit­u­a­tion, re­leas­ing our bat­tle hor­mone, Adren­a­line. Over-ex­po­sure can be dam­ag­ing to one’s health. Be­cause of this, adren­a­line is a hor­mone worth un­der­stand­ing.

The fight-or-flight hor­mone: Adren­a­line

Adren­a­line caus­es a no­tice­able in­crease in strength and per­for­mance, as well as height­ened aware­ness, in stress­ful times. This re­ac­tion caus­es air pas­sages to di­late to pro­vide the mus­cles with the oxy­gen they need to ei­ther fight dan­ger or flee. Adren­a­line al­so trig­gers the blood ves­sels to con­tract to re-di­rect blood to­ward ma­jor mus­cle groups, in­clud­ing the heart and lungs. The body’s abil­i­ty to feel pain al­so de­creas­es, which is why you can con­tin­ue run­ning from or fight­ing dan­ger even when in­jured. Adren­a­line al­so caus­es a re­lease of glu­cose which a fight-or-flight re­sponse would use. Af­ter the stress has sub­sided, adren­a­line’s ef­fect can last for up to an hour.

Prob­lems as­so­ci­at­ed with adren­a­line

While adren­a­line is an im­por­tant sur­vival strat­e­gy of your body's abil­i­ty to en­dure, some­times the body will re­lease the hor­mone when it is un­der stress but not re­al­ly fac­ing phys­i­cal dan­ger, it may be per­ceived dan­ger. This can cre­ate feel­ings of dizzi­ness, light-head­ed­ness and vi­sion changes. When no dan­ger is present, that ex­tra en­er­gy has no use, and this can leave the per­son feel­ing rest­less and ir­ri­ta­ble. For a di­a­bet­ic, the ex­tra glu­cose cir­cu­lat­ing with­in the blood­stream will cause a hy­per­gly­caemic spike. Ex­ces­sive­ly high lev­els of the hor­mone due to stress with­out re­al dan­ger can cause a jit­tery, ner­vous feel­ing, pal­pi­ta­tions, in­creased blood pres­sure, anx­i­ety, heart dam­age, in­som­nia, and the list can go on.

Height­ened stress with­in a pan­dem­ic is NOR­MAL, but it can quick­ly trans­form in­to anx­i­ety that im­pairs clear, con­cise think­ing, al­ters be­hav­iours and have long term ad­verse health ef­fects.

The Ug­ly: Be­com­ing anx­ious and over­whelmed

Glob­al­ly we know that this pan­dem­ic is caus­ing peo­ple to feel anx­ious, dis­tressed or wor­ried: fear of con­tract­ing the virus, of fam­i­ly be­com­ing sick­ened; stress and anx­i­ety re­lat­ed to iso­la­tion and quar­an­tine mea­sures; dis­tress about sep­a­ra­tion with fam­i­ly mem­bers; los­ing one’s job, now un­able to meet bills; fear of longer term im­pacts of the glob­al dis­rup­tion; among oth­er rea­sons. The stress of a pan­dem­ic can take a toll on your men­tal health.

There are al­so sev­er­al per­sons and com­mu­ni­ties who are par­tic­u­lar­ly vul­ner­a­ble to the psy­choso­cial im­pact of the pan­dem­ic:

• The el­der­ly, who have dif­fi­cul­ty car­ing for them­selves, es­pe­cial­ly in iso­la­tion and those with co­mor­bidi­ties and/or cog­ni­tive de­cline or de­men­tia, may be­come more anx­ious, an­gry and stressed.

• Peo­ple with ex­ist­ing men­tal health con­di­tions may ex­pe­ri­ence an in­crease in psy­cho­log­i­cal dis­tress and trau­ma symp­toms if they are iso­lat­ed or their group treat­ments have been dis­rupt­ed.

• Peo­ple who are at risk of sex­u­al and gen­der-based vi­o­lence are like­ly to ex­pe­ri­ence in­creased stress as the iso­la­tion may in­crease their risk, and they may be un­able to seek help. Con­tin­ued ser­vice pro­vi­sion and ac­cess for sur­vivors must be a pri­or­i­ty.

• Chil­dren may feel fear and sad­ness. They need to ex­press and com­mu­ni­cate their feel­ings in a safe and sup­port­ive en­vi­ron­ment, and to have fa­mil­iar or new rou­tines like en­gag­ing in age-ap­pro­pri­ate ac­tiv­i­ties, play­ing and so­cial­is­ing with oth­ers, even if on­ly with­in the fam­i­ly. Chil­dren need to be close to their par­ents and fam­i­ly, if con­sid­ered safe, or to stay in reg­u­lar con­tact with them.

• Health care work­ers are fac­ing unique hard­ships dur­ing this pan­dem­ic, work­ing in ex­tra­or­di­nary cir­cum­stances, like­ly to feel un­der pres­sure and stress and in many cas­es, are wor­ried about trans­mit­ting the dis­ease to their fam­i­lies.

It is now im­per­a­tive to de­vel­op sus­tained cop­ing mech­a­nisms to stay re­silient dur­ing this coro­n­avirus pan­dem­ic.

Pre­pare, Plan not pan­ic

Knowl­edge and prepa­ra­tion can help re­duce feel­ings of pan­ic and as­so­ci­at­ed stressed. Pre­pare for the worst-case sce­nar­ios and cre­ate a plan for you and your fam­i­ly.

• Write down spe­cif­ic wor­ries you have about how coro­n­avirus may dis­rupt your life. If you start feel­ing over­whelmed, take a break.

• Make a list of all the pos­si­ble so­lu­tions you can think of. Try not to get too hung up on “per­fect” op­tions. In­clude what­ev­er comes to mind that could help you get by.

• Fo­cus on con­crete things you can prob­lem solve or change, rather than cir­cum­stances be­yond your con­trol.

• Af­ter you’ve eval­u­at­ed your op­tions, draw up a plan of ac­tion. When you’re done, set it aside and re­sist the urge to go back to it un­til you need it or your cir­cum­stances sig­nif­i­cant­ly change.

Emo­tions are con­ta­gious, so be mind­ful who you seek sup­port and coun­sel from

Fo­cus on the things you can con­trol

There are so many things out­side of our con­trol, in­clud­ing how long the pan­dem­ic lasts, how oth­er peo­ple be­have, and what’s go­ing to hap­pen in our com­mu­ni­ties. That is a tough thing to ac­cept. When you feel your­self get­ting caught up in the whirl­wind of fear of what might hap­pen, try to shift your fo­cus to things you can con­trol.

• Shift your mind­set to bet­ter adapt to the dai­ly changes or dis­rup­tions that oc­cur

• Take steps to re­duce your own per­son­al risk

• Stay in­formed, but be se­lec­tive in the sources of me­dia

• Stay con­nect­ed, even if phys­i­cal­ly dis­tanced apart

• Take care of your well-be­ing, keep to a healthy rou­tine

• Re­duce so­cial me­dia in­put and dig­i­tal dis­trac­tions; re­con­nect with na­ture in­stead.

• Be kind to oth­ers and help if you can

• Be kind to your­self and less judg­men­tal

Be a calm­ing in­flu­ence

If friends or loved ones are pan­ick­ing, try to help them gain some per­spec­tive on the sit­u­a­tion and shifts in mind­set. In­stead of scare­mon­ger­ing or giv­ing cre­dence to false ru­mours, re­fer them to rep­utable news sources. Be­ing a pos­i­tive, up­lift­ing in­flu­ence in these anx­ious times can help you feel bet­ter about your own sit­u­a­tion too. En­cour­age all to fo­cus on things we should be grate­ful for, even the sim­plest but an in­valu­able as­set – the abil­i­ty to breathe freely.