#BTColumn – The effects of stress and limiting its impact

Disclaimer: The views and opinions expressed by the author(s) do not represent the official position of Barbados TODAY.

by Dr. Colin V. Alert

Almost everyone would agree that the COVID-19 pandemic has caused, and in many cases, is still causing, severe disruption to the local community, disrupting almost everyone’s lifestyle.

Long before COVID-19 our communities were being badly affected by obesity, diabetes, hypertension and cancer, among others, and these dangerous diseases still exist. In fact, they may have gotten a boost from the COVID pandemic.

How did COVID affect us? COVID forced us to introduce social distancing, which caused increased social isolation and loneliness particularly among our older community members, the group most affected by the non-communicable diseases (NCDs). Contact with other family members, with each other, with the church and fellow church goers, and with their health care professionals, was restricted.

The threat of contracting a contagious disease in a crowded supermarket, or a ‘socially spaced’ church, stopped many from shopping or church-going.

Similarly, fear of crowded medical clinics, with persons who may actually have COVID, caused many to avoid medical clinics altogether, abandoning medical visits and sometimes even their medications. This caused even further damage to their health.

Regular exercise, a vital component of both health preservation and disease prevention, was stopped by a combination of curfews, crowd-size limitations, and personal fear of contact with other persons.Eating habits were altered by access to food limitations.

Financial considerations probably also played a large part as the national economy took a nosedive, and our welfare agencies were overwhelmed by requests for assistance by persons in severe need. Even our pediatricians expressed fear about the re-emergence of malnutrition.

These combinations of factors are the fuel on which the NCDs thrive, but these factors also contributed to an upsurge in mental health issues, issues in their own right but which also make NCD treatment more difficult. When stressed, people change their usual behaviours, sometimes just because ‘they don’t feel right’.

They may feel anxious or nervous, feel they can’t eat or sleep well or may become angry or depressed. If they don’t sleep well, they are fatigued the next day, unable to concentrate on their normal everyday duties at work (or school). They may stop taking their usual medications. Sometimes when stressed they turn to cigarettes, alcohol or marijuana to ‘ease the pressure’.

If severe, these issues may progress into full-blown mental illness of anxiety and depression, or of drug addiction and dependency, requiring specific intervention often by psychological health specialists in overcrowded institutions, or even jail. Stress has also resulted in an increase of violence within families, and an increased rate of suicides.

But even in the less severe cases these stress-related issues interfere with the NCDs. If an individual has hypertension, for example, ongoing stress is likely (by normal physiological mechanisms) to raise the blood pressure even further.

[The high prevalence of hypertension worldwide is believed to be related to the stresses many people feel about their lives]. If only the symptom [blood pressure] is treated, without attempting to treat the underlying issues, stress in this case, then the treatment has less chance of being successful. The same is true for all the NCDs.

So, stress will always threaten our health and wellbeing, more so if we already have an NCD and/or psychological challenges, or a full-blown mental illness.

All stressors cannot be avoided, but their effects can be minimised. This starts off with developing a positive attitude to life. Maintain positive relationships with your family members, co-workers and friends.

As the 1970s hit song by Diana Ross implored us to do: “Reach out and touch somebody’s hand, make this world a better place if you can”. Of course, the telephone is the main tool for doing that these days.

Practise healthy eating, avoid alcohol, avoid smoking, avoid marijuana, avoid sugar sweetened beverages (SSBs), avoid illicit drugs and get a good night’s sleep every night. Regular exercise is critically important, and maintaining regular communication with your health care professional, who should advise on specific stress relieving measures, is recommended.

Dr. Colin V. Alert, MB BS, DM. is a family physician and associate UWI family medicine lecturer.