STRESS

Stress is a state of mental or emotional strain or tension resulting from adverse (undesirable) or demanding
situation or circumstances. Therefore, anything that brings about a feeling of worry or despair is a stressor

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otherwise called stress stimuli. Stress may involve mental, physical and chemical reactions.

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Stress has physical and emotional effects on us and can create positive or negative feelings. As a positive
influence, stress can help compel us to action; it can result in a new awareness and an exciting new perspective.
As a negative influence, it can result in feelings of distrust, rejection, anger, and depression, which in turn can
lead to health problems such as headaches, upset stomach, rashes, insomnia, ulcers, high blood pressure, heart

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disease, and stroke. With the death of a loved one, the birth of a child, a job promotion, or a new relationship, we
experience stress as we readjust our lives. In so adjusting to different circumstances, stress will help or hinder us
depending on how we react to it.

Types of Stress

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There are two (2) major types of stress. That is to say; Harmful stress is called Distress whereas beneficial stress
on the other hand is called Eustress.
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There are also two (2) levels of stress namely.
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a) Excessive stress also known as Hyper stress

b) Insufficient stress also known as Hypo stress.

Characteristics of stressful person

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Usually when a person is faced with stress, the following characteristics can be exhibited;
o The blood pressure may rise or significantly go low to abnormality,

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 o The heart may pound too much,
o Muscles may tighten and sometimes muscle-pull is the resultant of the same,
o The stomach may become tense and aching results
o Issues such as telepathy (extra-sensory perception) may arise and person becomes hopeless all the time.
o The person makes uncoordinated movements and when asked by the colleagues around, he /she may not

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explain exactly reasons for such behavior.

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CAUSES
It is imperative to note that the causes of stress range from Psychological, personality and Bio-ecological spheres
as analyzed below’

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1. Psychological processes
a) Need to adjust or adapt to changing circumstances
When an individual is faced with challenges of new environment, one may be stressed up. For example, a student
being offered a place at a higher institution of Learning may be stressed due to new course offered, facing new

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people in life and thus coping up with the same brings stress.

b) A sense of frustration that accompanies inability to achieve goals

This is a situation where someone set goals or targets to achieve in a given time scope to his /her surprise, fails to
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achieve the same. For example, a student targets that after completion of a Diploma in Clinical Medicine he gets a
well paying job but takes more than 5 years on streets looking for the opportunity to exercise his potential.
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c) Excessive workload

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It is always the case that when people are looking for jobs they set high standards for headhunt. For example a
professional in Dentistry when looking for a hob in clinic could talk of work over weekend with minimum
supervision. But after getting the same job with the said specifications, one may become overworked and fatigue
ensues, hence stress.

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d) The underestimation of one’s expectation

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An individual may underestimate his/her potential and therefore getting different results altogether. For
example, a person contesting in competitive politics to become an area Member of Parliament and eventually
loses the seat due to academic qualifications may lead to stress.

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e) Juggling with many roles
It is also evident that when an individual has many roles to play at the same time, it brings about stress. For
example, if one is a father of many children, heading an extended family setting as well as village Local Council 1
Chairman and in addition undertaking further studies, may overwhelm the person in question hence lead to

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stress.

f) Financial worry
An individual may be worried because of the financial needs that could be pressing hard to the extent that the
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expenditure is greater than the income, prompting someone to live in a life borrowing throughout. This also
brings abut stress.
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2. Bio-ecological causes
These are external factors or conditions that produce response which is biologically instinctive. The factors
range in following arenas;
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a) Pollution

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 A person may get stressed up with the pollution either where he works or where he stays. For example,
people who stay nearby a busy Pentecostal church may finally get stress due to sound pollution overnight and
sessions.

b) Diseases

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A disease is a natural phenomenon where a person’s health is interfered by artificial agents causing the body
to be weak and if not attended to, may finally lead to loss of life. Therefore, this one of the stressing factors.

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For example, a person who suffers from chronic diseases such as asthma, diabetes mellitus or cancer may die
fast than expected because of the stress that the diseases pose to the individual.

c) Environmental hardships

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The environmental hardships can also cause stress. For example people who live in desert or semi-arid areas
find a lot of hardships in finding water and food because most of the time it is a dry spell. During the day time
it is extremely hot yet at night it’s extremely cold.

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3. Personality traits
The personality traits make us more vulnerable to stress as follows;
a) Low self esteem
An individual with low self-esteem is always stressed because in whatever circumstances that occur, he/she
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blames himself/herself. For example, a short man will always blame himself for failure to play basketball game
without even trying to practice the same so as to check on the possibilities of success.
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b) External Locus of Control vs. Internal Locus of Control

Whereas a person with internal locus of control believes that he/she can influence events surrounding him/her
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and their outcomes, a person with external locus of control blames always outside forces for everything that
happens in his/her life. For example, a poor man may fail to utilize properly the loan offered from Bank just

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because he feels it is the rich that are well placed to earn more wealth thus improving drastically their well-
beings.

d) Fearfulness
When a person is naturally fearful, their reaction to something immediate that threatens security or safety is

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always at the forefront of everything in their life. Therefore, they always fear to venture into anything that may
be of great importance to them. Thus, this situation is naturally stressful.

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IMPACT OF STRESS
The impact of stress is fourfold. That’s is to say, Physical, Mental, Emotional and behavioral folds as put below;

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1. Physical spheres
a) Stress can bring about frequent colds or flu
b) Persistent headaches
c) Muscle pull may also come as a result of stress e.g. to footballers especially when team is losing

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d) Insomnia or lack of sleep. Or restlessness. A person sleeps for a while and wakes up very fast or even takes
long to sleep or rest.
e) Skin problems may also arise due to stress. These could be skin lashes, goose pimples or even pimples.
These normally come unexpectedly due to a stressing event or situation.
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f) Indigestion or stomach upsets also come as a result of stress. For example, upon receipt of bad news such
as death of loved one, someone may develop stomach upset due to shock.
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g) Ulcers may also result from stress.

2. Mental spheres
This is stress that emanates from the mind of an individual and below is the analysis;
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a) Poor or no concentration at all. A person is always divided in the mind and fails to prioritize issues. For
example a student may perform poorly in class due to stress factors.

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 b) An individual normally forgets due to stress. An example a person suffering from stress may ask for a knife
while holding tit in his /her hand.
c) Frequent negative thoughts such as a feeling of committing suicide, develops ideas of sadism such as
inflicting pain on others.
d) Speech problems may also occur due to stress. For example, a leader gets overwhelmed by massive

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support of the people led and when given chance to address them he/she stammers or the vice suddenly
gets lost. Another example of stress is when one loses a loved one and is given chance to speak on behalf

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of the grieving family, it is always the case that such people tend to lose the voice.

3. Emotional spheres
a) Anxiety: This is when a person is emotionally characterized by feelings of tension and worried thoughts all

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the time.
b) Learned Helplessness is also an emotional stand where a person is forced to adhere to aversive stimuli
(unpleasant or painful stimuli) yet there was a possibility of escaping the same. for example, when one is
used to loan stress, they go ahead to get more even when there is no need for it after all they presume

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they are used to such habit!
c) Lack of purpose
d) Relationship problems at home: this may be present itself in form child abuse and domestic violence.
e) Sudden anger / frustration: This is a natural and automatic response to pain. This occurs when one is
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rejected or feels their interests are threatened or when one experiences loss of certain form.
f) Depression: this is a mood disorder that causes persistent feeling of sadness and loss of interest.
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Sometimes it is called clinical depression which affects how one feels and behaves and thus may lead to a
sense of carefree life makes life meaningless.
g) Irritability: Thus is a feeling of agitation. When one is irritable, they become upset, moody or frustrated
easily.
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4. Behavioral spheres

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 a) Poor eating habits: This implies loss of appetite
b) Driving recklessly: When one is stressed, they may drive anyhow hence causing accidents due to a feeling
of ‘I care less’
c) Alcohol or drug abuse/addiction/hypochondriac: in this state, a person who is stressed is seen in drug
addiction such as marijuana, cocaine, mairungi, opium or even self-medicate all times when they feel

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unwell.
d) Accident prone: a stressed person may also present cases of accidents all the time. For example, when

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taking tea or alcohol, they pour accidentally, moving in corridors and accidentally knock ones’ toes among
other uncontrolled accidents.
e) Aggressive behavior: This is where a person is having uncontrolled temper even when there are light issues
in day today life.

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STRESS MANAGEMENT (coping up with stress)

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Identifying unrelieved stress and being aware of its effect on our lives is not sufficient for reducing its harmful
effects. Just as there are many sources of stress, there many possibilities for its management. However, all
require work toward change: changing the source of stress and/or changing your reaction to it. How do you
proceed?
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1. Become aware of your stressors and your emotional and physical reactions.
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Notice your distress. Don’t ignore it. Don’t gloss over your problems. Determine what events distress you.
What are you telling yourself about meaning of these events?
Determine how your body responds to the stress. Do you become nervous or physically upset? If so, in
what specific ways? Once one gets to know their source of distress, then management of the same is
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possible.

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 2. Recognize what you can change.
Can you change your stressors by avoiding or eliminating them completely?
Can you reduce their intensity (manage them over a period of time instead of on a daily or weekly basis)?
Can you shorten your exposure to stress (take a break, leave the physical premises)?
Can you devote the time and energy necessary to making a change?

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Answer: (goal setting, time management techniques, and delayed gratification strategies may be helpful
here)

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3. Reduce the intensity of your emotional reactions to stress.
The stress reaction is triggered by your perception of danger… physical danger and/or emotional danger.
Are you viewing your stressors in exaggerated terms and/or taking a difficult situation and making it a

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disaster?
Are you expecting to please everyone?
Are you over reacting and viewing things as absolutely critical and urgent?
Do you feel you must always prevail in every situation?

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Answer: Work at adopting more moderate views; try to see the stress as something you can cope with
rather than something that overpowers you. Try to temper your excess emotions. Put the situation in
perspective. Do not labor on the negative aspects and the “what if’s.”
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4. Learn to moderate your physical reactions to stress.
Slow, deep breathing will bring your heart rate and respiration back t normal.
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Relaxation techniques can reduce muscle tension. Electronic biofeedback can help you gain voluntary
control over such things as muscle tension; heart rate, and blood pressure.
Medications, when prescribed by a physician, can help in the short term in moderating your physical
reactions. However, they alone are not the answer. Learning to moderate these reactions on your own is a
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preferable long-term solution.

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 5. Build your physical reserves
Exercise for cardiovascular fitness three to four times a week (moderate, prolonged rhythmic exercise is
best, such as walking, swimming, cycling, or jogging)
Eat well – balanced, nutritious meals.
Maintain your ideal weight.

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Avoid nicotine, excessive caffeine, and other stimulants.
Mix leisure with work. Take breaks and get away when you can.

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Get enough sleep. Be as consistent with your sleep schedule as possible.

6. Maintain your emotional reserves.

Develop some mutually supportive friendships/relationships.

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Pursue realistic goals which are meaningful to you, rather than goals others hove for you that you do not
share.
Expect some frustrations, failures, and sorrows. Always be kind and gentle with yourself – be a friend to
yourself.

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IMPLICATIONS TO MEDICAL PERSONNEL

o Stress in medical practice has always been a topical issue. This is partly because medical service

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involves taking care of other peoples' lives and mistakes or errors could be costly and sometimes
irreversible.

o It is thus expected that the medical doctor himself must be in a perfect state of mind devoid of
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morbid worries and anxieties. This is however not usually the case, because the doctor apart from
being affected by the same variables that impose stress on the general population, is also prone to
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stress because of the peculiarity of his work situation and the expectation of the society at large.

o Becoming a physician is a not just a career choice, it is “a calling” and a lifelong commitment.
Making life and death decisions, keeping patients and families satisfied and maintaining the highest
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professional standards can absolutely take its toll.

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 o Social expectation- A medical personnel is still perceived as a very comfortable person in our society
and expectations are usually high financially and otherwise. Failure or inability to ‘meet up’ may
constitute a significant stress factor in some physicians.

o It is also noted that many to physicians, the professional rewards of status, security, and meaningful

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work are threatened by enormous responsibility and stress characterizing today’s practice
environment. Therefore as medical personnel, one should take note of that.

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o If left unattended to, stress can result in dire consequences for the physician both patients and the
professional. This may lead to job dissatisfaction hence quitting the service.

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o Stress can adversely impact on the quality of care and patient outcomes. Once the medical personnel
fails to handle the patients with love because of stress, then the core values as enshrined in the
Hippocratic Oath are grossly violated.

o Research also suggests when physicians are down and running low on empathy, their patients take

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longer to recover from illnesses and is less likely to adhere to treatment recommendations. This is
because the environment in which the patient is treated must be comfortable and conducive enough
for quick recovery.
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o Medical personnel must know that investigative psychology should be employed where necessary
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since some illnesses can emanate from stress itself.

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