How you perceive stressful situations could help minimise their health impact

Seeing a stressful situation as a challenge, rather than a threat, can help you avoid suffering both physically and mentally. — AFP

Reframing stressful situations could help minimise health and well-being problems

 FROM mounting workloads to relationship problems, moving house or looming exams, stressful situations come and go, but they all have one thing in common: they can play havoc with your health.

But it all depends on how you view them, a new British study reveals. In fact, seeing stressful situations as challenges, rather than threats, could prove beneficial to physical and mental health.

The figures speak for themselves: the global population is struggling. According to the World Health Organization (WHO), nearly a billion people worldwide were living with at least one mental disorder in 2019, and the situation has since worsened considerably.

The global health authority estimates that the worldwide prevalence of anxiety and depression rose by 25% in the first year of the Covid-19 pandemic alone. 

It's an edifying finding, and one that serves as a wake-up call to the importance of taking action to try and curb the phenomenon.

While action is needed on a global and national scale, each of us also has the opportunity to take action, at our own personal level, to better cope with situations that could affect our health and well-being.

So suggest the findings of a new study by researchers at the United Kingdom's University of Bath, who found that the way we approach stressful situations can have an impact on our physical and mental health (or not, as the case may be).

Perception of stress

The study authors started from the simple observation that a person can perceive a stressful situation in two ways. 

They can either feel overwhelmed, and therefore see it as a threat, or they can feel capable of dealing with it, or even managing it, and therefore see it as a challenge.

This can be particularly true in the world of sport, where mindset can influence an athlete's performance.

In fact, the researchers turned to athletes to carry out their research, which is based on "valid and reliable" measures of challenge and/or threat assessment, mental health, well-being, and physical health problems from 395 athletes who responded to an online survey.

Published in the journal Stress and Health, the results suggest that participants who saw stressful situations as threats were at greater risk of physical and mental health problems, compared to those who saw them as challenges.

"We found a convincing link between mental and physical ill-health, and the way a person typically views stressful situations," said study co-author Dr Lee Moore from the Department for Health at the University of Bath, quoted in a news release.

"The more you’re able to appraise a stressful situation as a challenge, the more likely you are to report good health and well-being."

He continues: "Researchers have speculated for the past 15 years that people who repeatedly believe they don’t have the resources to cope in stressful situations are putting their health at risk, but we believe this is the first time the theory has been properly tested, leading to us finding a link between stress appraisals and health."

Although the study was carried out on athletes, its authors believe that the findings are equally valid for the rest of the population. 

They point out that the negative consequences induced by the way stressful situations are approached can range from a simple cold or flu, or even a weakened immune system, to mental health disorders such as anxiety or depression. 

It is hoped that this research will ultimately lead to the improved identification and management of people at risk of health problems due to increased stress.

"Most people will fluctuate in the way they appraise a situation, depending on the details of the specific situation, however, some people are far more likely to appraise all stressful situations as a threat, and this study shows that this tendency is associated with poorer health and well-being," concludes Moore. – AFP Relaxnews

Pullout quote: "The more you’re able to appraise a stressful situation as a challenge, the more likely you are to report good health and well-being." - Dr Lee Moore

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How to lose weight without exercising

 

Most adults need seven to eight hours of sleep every night to restore and repair the body. — TNS

Who doesn’t want to be lean and slim without putting in effort?

Physical activity or exercise has plenty of physical, emotional and mental benefits, but it doesn’t necessarily mean you will shed the kilos easily by partaking in it.

Some people hate exercising and are not motivated to push or challenge themselves – they simply don’t get the same endorphin release as others.

Reluctant exercisers need external motivators to keep going, like the promise of boosting their overall health, to look good, or because their physician has said they must do so to stay alive.

Our ancestors remained active out of necessity, not choice: they had to move to hunt for food.

Once fed, they rested to conserve energy because there was nothing much to do.

When food supply diminished, they’d be on their feet, hunting again.

Resting is a natural human tendency, so don’t beat yourself up if that’s what you like to do.

With advances in technology and labour-saving devices, the world is now accessible with our fingers, and even minimal movement seems to have taken a backseat.

That’s why we are blossoming sideways.

Is that bad?

It depends on how much weight you’re putting on.

One 2021 study published in the Annals of Epidemiology found that people who started adulthood with a body mass index (BMI) in the normal range, and became overweight – but never obese – in later life, tend to live the longest.

Adults in this category lived longer than even those whose BMI stayed in the normal range throughout their life.

However, those who started adulthood as obese and continued to add weight had the highest death rate.

So, a bit of extra weight is okay as long as you don’t balloon out of control.

Any healthy person can lose weight without exercising – you just need a lifestyle tweak and some discipline.

Prioritise what you enjoy doing instead of struggling to achieve unrealistic goals.

Try some of the following tips to help you trim down.

Chew your food thoroughly and savour every morsel before you swallow it to feel full faster. — AFP

> Hydrate with water

Make it a point to drink two glasses of water after waking up to help “activate” your internal organs.

The water will help to remove any toxins before your first meal of the day.

Water helps regulate body temperature, lower blood pressure, carry nutrients and oxygen to various cells, and maintain optimal kidney function.

Replacing sugary drinks and alcoholic beverages with water can help reduce your daily caloric intake.

Whenever you feel hungry, you may actually be thirsty, or even slightly dehydrated.

So don’t reach out for snacks, but drink a big glass of plain water first – and ideally wait 30 minutes before eating.

Drinking water prior to meals can help you feel fuller and reduce your overall food intake, which can lead to weight loss over time.

If plain water isn’t appealing, try adding fruit slices like oranges, or herbs like mint, lemon and rosemary, for extra flavour and nutrients.

> Eat slowly and mindfully

Instead of munching down solid food, especially poultry and meat, chew thoroughly.

Some time back, I attended a wellness retreat where we were told to chew every mouthful 27 times and savour all the flavours before swallowing.

The food almost turns to liquid by the time it goes down the throat.

Not only does this increase the amount of nutrients absorbed by the body, it’s also easier on the digestive process.

Additionally, longer chewing also helps develop a stronger jaw and chin, suppress hunger and gets you full faster, aiding in your weight loss journey.

> Load up on fibre and protein

You don’t have to eliminate all carbohydrates, just minimise overly-processed ones, such as white breads and pre-packaged foods like cookies and crackers.

This is because such foods are rapidly digested and converted into blood sugar.

Instead, consume more protein and fibre.

Protein takes longer to digest and decreases the level of the hunger-regulating hormone ghrelin, making you feel fuller for a longer period.

Fibre expands in your gut like a sponge, so it’s a natural appetite suppressant.

It also moves faster in your intestines, which signals to the brain that you are full.

Along with lean meats and poultry, add on a good mix of fresh fruits, vegetables and whole grains to make up the rest of the meal.

Even a five-minute break to take deep breaths at work can do wonders to bring down stress levels. — AFP

> Scale back on added sugar

Sugar itself doesn’t make the weighing scale jump up, but it tends to be in foods that have too many calories.

Whether it’s soft drinks, teh tarik or desserts, it should be the first thing to go if you’re trying to lose weight.

The sweet stuff is also hidden in all sorts of foods from salad dressing to sauces to canned fruits, so don’t be deceived that you’re eating a healthy salad when you’ve doused the greens with salad dressing.

ALSO READ: You wouldn't expect to find sugar in these foods

When it comes to caffeinated beverages, skip the sugar, honey and creamer if possible, as these can quickly add to the calories.

Having your tea or coffee black is best, but if like me, you need to add some milk, opt for skim or low fat over full cream.

By eliminating sugar, you can lower your risk of heart disease dramatically because too much sugar in your diet heightens your risk of high blood pressure, obesity, and diabetes – the three main risk factors for heart disease and cardiovascular decline.

ALSO READ: What you can do to reduce heart attack and stroke risk

> Manage stress levels

This is hard for everyone, but we’ve got to try.

When the body is under pressure, it releases the hormone cortisol, which is linked to increased appetite and fat storage.

Excess cortisol levels can increase appetite and cravings for energy-dense, comfort foods.

High cortisol levels over time have also been linked to abdominal fat gain.

Take time daily to do something to lower the stress levels: laugh, read a good book, play with a pet or just take deep breaths.

Find a quiet corner at work, close your eyes and spend five minutes mid-morning and in the afternoon to do a few rounds of deep breathing by inhaling through the nose and exhaling through the mouth or nose.

Do this again in bed, just before you sleep.

> Get proper sleep

Your body relies on sleep to restore and repair itself, and getting enough rest can also benefit your weight-loss efforts.

There is mounting evidence that people who get too little sleep have a higher risk of weight gain and obesity than people who get seven to eight hours of sleep a night.

Sleep deprivation changes your endocrine function and metabolism by affecting your production of the hunger-regulating hormones ghrelin and leptin.

This can make you feel hungrier than usual, increasing the likelihood of craving for unhealthy snacks.

It’s no surprise that when you’re exhausted, it’s harder to control your impulses for comfort food like cookies, chocolates and ice cream.

Practise good sleep hygiene by sleeping at the same time every day, switching off all gadgets two hours before bedtime and ensuring the room temperature is comfortable.

By Revathi Murugappan who is a certified fitness trainer who tries to battle gravity and continues to dance to express herself artistically and nourish her soul. For more information, email starhealth@thestar.com.my. The information contained in this column is for general educational purposes only. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

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Death by overwork

 

Working more than 55 hours a week is killing us through ischaemic heart disease and stroke.

THE Japanese call it karoshi or “death by overwork”.

The signs: a sudden stress-induced heart attack, stroke or extreme mental pressure leading to suicide.

After World War II, the Japanese struggled to cope with defeat and an insecure future, so they threw themselves into work, determined to advance economically and fuelled by an ingrained culture where collectivism is valued above individualism.

Annually, thousands of Japanese workers die from karoshi, but in recent years, China has overtaken Japan with an estimated 600,000 deaths from overworking in 2016.

A large number of deaths in China are coming from industries such as media, advertising, medical care and information technology.

With the Covid-19 pandemic, more people are working from home (WFH) and feeling the strain of being forced to take on additional work.

As businesses cut costs and struggle to stay afloat, it translates to more work and longer working hours for employees still on the payroll.

For some, it is either do the job or get the boot.

This certainly doesn’t bode well for our health.

In fact, even before the pandemic, a 2019 AIA Vitality survey revealed that workers in Malaysia are often overworked and sleep deprived, with 51% suffering from at least one dimension of work-related stress and 53% getting less than seven hours of sleep in a 24-hour period.

It was also reported that Malaysia had experienced a three-fold increase in mental health problems over the past two decades.

According to the latest estimates by the World Health Organization (WHO) and the International Labour Organization (ILO) published in the journal Environment International last month, long working hours led to 398,000 deaths from stroke and 347,000 deaths from ischaemic heart disease in 2016 – a 29% increase since 2000.

Most of the deaths recorded were among people living in the Western Pacific and South-East Asia regions, who had worked for 55 hours or more per week, when they were between the ages of 45 and 74 years.

Young and otherwise healthy people can be struck by a stroke due to long-term unbalanced lifestyles and stress. — 123rf.com Just because bosses send messages throughout the night doesn’t mean they expect you to respond or react immediately, says Dr Yong. — AFP

The heart has its limits

James (not his real name), a marketing director of a multinational company, had been WFH and logging in at least 60 hours of work weekly, including on weekends, ever since the pandemic began.

At 51, the father of two teenagers eats healthy, rarely gets sick, enjoys the occasional drink and lets off steam by waking up at 4.30am to cycle or run for an hour every day.

Two months ago, he was in a virtual meeting when he started sweating profusely and felt pain radiating down his left arm.

As it was an important meeting, he ignored the symptoms, which eventually disappeared.

He continued cycling the next morning without any problem.

“But the pain returned a week later, and this time, it was accompanied by chest discomfort and dizziness.

“My wife drove me to the hospital, and after doing some scans, I was told I had a heart attack, with three blocked arteries,” he recalls, still in disbelief.

James’ wife broke down. She had been telling him to slow down, but he wouldn’t listen, continuing to work and exercise hard.

He had to have two stents inserted to open up his arteries.

“Prior to that, I hadn’t taken leave in a year. These days, I’ve learnt to switch off and no longer answer calls after 6pm.

“The cycling has been replaced with meditation and long walks,” he shares.

It’s quite an adjustment to make, but work is no longer his number one priority.

Says consultant cardiologist Dr Kannan Pasamanickam: “All of us are guilty of overworking – yours truly included!

“We have to remind ourselves that we cannot take health for granted; if you become ill, you may never be able to work again.”

Many patients shun hospitals during this pandemic as they fear running an increased risk of contracting Covid-19.

However, this might result in them delaying getting much-needed treatment – James was lucky that his first episode was not fatal.

Signs of a unhealthy heart include increased breathlessness; getting tired more quickly during physical exertion; chest/jaw/upper abdominal/arm pains brought on by exertion and relieved by rest; leg swelling (although this can be due to several other causes as well); breathlessness when lying flat in bed; and unusual palpitations, among others.

“Do annual medical exams, especially when you cross the golden age of 40, or start younger if you have a family history of vascular disease,”advises Dr Kannan.

If you’re living alone and experience a heart attack, he suggests that after calling for help immediately, take one tablet of aspirin straight away (barring an aspirin allergy), keep calm, remain seated (preferably on a sofa) and wait for help.

“If you feel like fainting, start coughing.

“If the heart stops because of sudden, irregular beating of the heart called ventricular fibrillation or tachycardia, which can occur soon after a heart attack, or the blood pressure becomes very low, coughing can maintain an adequate blood pressure until help arrives,” he says.

A stroke in time

We often think that stroke only strikes old people and those with uncontrolled high blood pressure,but these are myths.

Stress has been identified as the most important causative factor for a stroke or so-called “brain attack”.

The warning sign of an imminent stroke is a transient ischaemic attack (TIA), also known as a mini stroke.

This can happen up to seven days before the actual stroke and last up to five minutes or so. Consultant neurosurgeon Datuk Dr Kantha Rasalingam explains: “There could be sudden numbness or weakness in the face, arm or leg, especially on one side of the body.

“Individuals may also experience sudden double vision, confusion, inability to talk or understand things, instability when walking, and problems with balance or coordination.

“The key term here is ‘sudden onset of any neurological deficit’. “If you recover within a few minutes, it is a warning sign of TIA. If it persists, then it is a stroke.”

Some healthy individuals in the 18-49 age group – males, in particular – are being struck by strokes as a result of unbalanced lifestyles and stress.

“This is quite sad. If you push the boundaries and the body becomes exhausted, there is a possibility of getting a stroke.

“It’s a wake-up call for everybody,” remarks Dr Kantha. He shares the case of a 41-yearold lady who came into his clinic last week as she had experienced sudden right-sided upper and lower limb weakness.

An MRI (magnetic resonance imaging) of the brain showed a left-sided cerebrovascular accident (i.e. stroke).

Her husband was devastated, angry and blamed her employer.

Dr Kantha elaborates: “The husband said his wife was WFH more than normal the last month as her boss was asking her to do more work or else she would be retrenched like her other colleagues.

“Stressed, she tried her best to keep up, and a few days ago, while going out to buy food, she passed out in the car.”

Unfortunately, she sought treatment too late and there wasn’t much the doctor could do as the brain cells controlling her right side were already dead.

“I don’t think she will be able to go back to work unless she drastically improves,” he says.

“But work should be the least of her priorities as she has a six-yearold daughter.

“Often, people just dismiss the weakness and wait till it’s very late to seek treatment.

“Some go to smaller clinics, then smaller hospitals, and by the time they come to a bigger hospital, time has lapsed and we can’t do much. 

“If a patient comes in early (within six hours of the onset of symptoms), we can do interventional therapy, e.g. embolism to break the clot.” He adds that a useful acronym to remember is FAST: if you experience a Facial droop, Arm weakness and Speech difficulty, it’s Time to call for help.

Note these symptoms

If you’re working long hours, it usually also means a more sedentary lifestyle, and reduced physical activity is a risk factor to getting a stroke.

Look out for symptoms such as a lack of concentration at work, lack of energy, irritability, forgetfulness and poor sleep.

Says consultant neurologist Dr Kok Chin Yong: “These symptoms are easily overlooked and frequently attributed to other factors.

“In fact, these symptoms may be correlated with each other to form a vicious cycle and may lead to depression and anxiety.

“Individuals should get medical help when the above symptoms start to disrupt daily activities, such as personal relationships or work.

“If we can prevent these symptoms from getting worse, we can prevent heart attacks and strokes.”

To address being overworked, he recommends following “SEMMS”.

“Sleep is key; Exercise regularly at least 40 minutes three times a week; practise Meditation, which has been proven to reduce the relapse rate in both depression and addiction; adopt a combination of the Mediterranean and DASH diets for neurodegenerative delay, consisting of green, leafy vegetables, whole grains, berries, olive oil, poultry and fish; and be Socially active,” he says.

Dealing with bosses

The Malaysian Employment Act defines the work week as 48 hours, with a maximum of eight working hours per day and six working days per week.

But many employers blatantly disregard these guidelines.

How can we deal with unreasonable employers and maintain sanity while WFH?

Clinical psychologist Dr Lynne Yong says: “Discuss with the human resources (HR) people on what your job scope really encompasses and know your rights.

“There are laws to protect employees against exploitation

“However, the first step would be to ask yourself if you are overthinking your employer’s expectations.”

While some employers might be demanding, they can also be reasonable.

She says: “Just because bosses send messages throughout the night doesn’t mean they expect you to answer immediately.

“Because of these uncertain times, people tend to see things in black and white, but the reality is more nuanced than they think.”

The president of the Malaysian Society of Clinical Psychology suggests these steps to help manage your workload:

> Are you looking at your job situation clearly and objectively? > Is it the bosses’ expectations or your own interpretation of your bosses’ expectations?

> If the boss is really unreasonable, can you discuss the issue with HR?

> Turn off notifications at a reasonable hour, perhaps two or three hours before bedtime.

Fellow clinical psychologist Prof Dr Alvin Ng Lai Oon adds that another helpful way is to affirm that you will be willing to do the expected task, but bring up problems at home that would need some mutual problem-solving between the boss and you.

“Say something like ‘Sure, boss, I can do that. But if I do, then there’s this other thing that becomes a problem, which I’m afraid would continue to persist if I do the task you just gave me.

“‘I’m concerned that this problem would affect my productivity in the long run. So, how?’” he suggests

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A stroke is a medical condition in which poor blood flow to the brain results in cell death.^[5] There are two main types of stroke: ischemic, due to lack of blood flow, and hemorrhagic, due to bleeding.^[5] Both result in parts of the brain not functioning properly.^[5] Signs and symptoms of a stroke may include an inability to move or feel on one side of the body, problems understanding or speaking, dizziness, or loss of vision to one side.^[2][3] Signs and symptoms often appear soon after the stroke has occurred.^[3] If symptoms last less than one or two hours it is known as a transient ischemic attack (TIA) or mini-stroke.^[3] A hemorrhagic stroke may also be associated with a severe headache.^[3] The symptoms of a stroke can be permanent.^[5] Long-term complications may include pneumonia or loss of bladder control.^[3]
The main risk factor for stroke is high blood pressure.^[6] Other risk factors include tobacco smoking, obesity, high blood cholesterol, diabetes mellitus, a previous TIA, end-stage kidney disease, and atrial fibrillation.^[2][6][7] An ischemic stroke is typically caused by blockage of a blood vessel, though there are also less common causes.^[12][13][14] A hemorrhagic stroke is caused by either bleeding directly into the brain or into the space between the brain's membranes.^[12][15] Bleeding may occur due to a ruptured brain aneurysm.^[12] Diagnosis is typically based on a physical exam and supported by medical imaging such as a CT scan or MRI scan.^[8] A CT scan can rule out bleeding, but may not necessarily rule out ischemia, which early on typically does not show up on a CT scan.^[9] Other tests such as an electrocardiogram (ECG) and blood tests are done to determine risk factors and rule out other possible causes.^[8] Low blood sugar may cause similar symptoms.^[8]
Prevention includes decreasing risk factors, as well as possibly aspirin, statins, surgery to open up the arteries to the brain in those with problematic narrowing, and warfarin in those with atrial fibrillation.^[2] A stroke or TIA often requires emergency care.^[5] An ischemic stroke, if detected within three to four and half hours, may be treatable with a medication that can break down the clot.^[2] Aspirin should be used.^[2] Some hemorrhagic strokes benefit from surgery.^[2] Treatment to try to recover lost function is called stroke rehabilitation and ideally takes place in a stroke unit; however, these are not available in much of the world.^[2]
In 2013 approximately 6.9 million people had an ischemic stroke and 3.4 million people had a hemorrhagic stroke.^[16] In 2015 there were about 42.4 million people who had previously had a stroke and were still alive.^[10] Between 1990 and 2010 the number of strokes which occurred each year decreased by approximately 10% in the developed world and increased by 10% in the developing world.^[17] In 2015, stroke was the second most frequent cause of death after coronary artery disease, accounting for 6.3 million deaths (11% of the total).^[11] About 3.0 million deaths resulted from ischemic stroke while 3.3 million deaths resulted from hemorrhagic stroke.^[11] About half of people who have had a stroke live less than one year.^[2] Overall, two thirds of strokes occurred in those over 65 years old.<sup>[17]

Read more:</sup>

Stroke - Wikipedia

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