Stress may lead to sudden death — Expert

Dr. Peter Ajiboye

In this interview with MOTUNRAYO JOEL, a consultant psychiatrist, University of Ilorin Teaching Hospital, Dr. Peter Ajiboye, discusses stress and its effects

What is stress?

Stress is a scientific concept which has suffered from the mixed blessing of being too well known and too little understood. Stress in the everyday language is used to connote unpleasant situation. It could also apply to events or situation such as preparing for examination which could have adverse effects on someone.

Medically stress can be defined as situations and conditions, which place an individual under pressure and may involve adjustment to their behaviour and can cause changes which are unpleasant, sometimes maladaptive and even associated with physical changes. It can also refer to a state that occurs when people are faced with events they perceived as endangering their physical or psychological well-being and are unsure of their ability to deal with these events.

What causes stress?

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Stress is everywhere and in everyday activity. Major causes include how to survive, how to feed, and interpersonal relationship (between married couples, a boss and his subordinate, colleagues etc). However the causes can also be grouped into three: psychological, social and biological. The psychological causes include things that have to do with life events in people (pleasant or unpleasant) such as marriages, deaths, promotion, success, failure, moving into a new house or building of your own, retirement, children going away from home, loss of job and other social events that impinge on our lives.

Social causes include economic hardship and certain social evils such as threat to personal safety (from Boko Haram, cultism, kidnappers, thieves etc), tribal and ethnic clashes, frustrating traffic delays in most cities, lack of social welfare policies, high rate of poverty, road traffic accidents, increase in substance (drug and alcohol) abuse, high unemployment rate etc.

Biological causes of stress include inherited disorders such as sickle cell anaemia, mental illness in close relatives, metabolic and endocrine disorders such as thyrotoxicosis, diabetes. Others include dangerous infections (HIV, Ebola virus), trauma, neoplasm (cancer), and degenerative disorders.

What are the signs of stress?

With adequate coping, an individual remains unscathed when faced with a stressor. However, if the intensity of the stressful stimulus subdues coping efforts, the individual decompensates and develops features of stress such as anxiety, with autonomic arousal leading to tachycardial or palpitation or racing heart, rapid but shallow breathing (dyspnoea), aches in the back of the neck (muscle tension), tiredness on minimal exertion (fatigability), loss of interest and motivation (paralysis of the will) and inadequate or unrefreshing sleep. Other subtle features which most stressed individuals may not recognise as originating from a stressed body or mind include irritability (for example snapping at people), unexplainable low spirit, a sense of impending doom, poor concentration, and increase frequency of error, poor judgment, and low decisions making ability. All these features are potentially reversible if what is causing the stress (stressor) is removed or controlled.

What is the first action one should take after witnessing these signs?

The person should remove, avoid or control the cause of stress.

What is job stress?

This has to do with stress arising from job related issues such as financial remuneration for basic survival needs. Work also has benefits which in combination can enhance an individual’s sense of worth and self-esteem. Work also provides an opportunity to actualise personal aptitudes and competency allows a situation of social interaction with others (co-workers) in mutually supportive system geared to productivity and confers on life a time-frame structure for the accomplishments of goal. Failed aspirations and unmet needs in any of these areas can lead to job stress. The areas where job stress could arise can be broken down to small bits such as job pressure (security and tension), job satisfaction, intrinsic rewards, interpersonal rewards, extrinsic status rewards (factors relating to income and status), extrinsic opportunity rewards, social support etc.

Why is stress a problem?

This is because if it persists it could result in overt disease (physical or psychological).

Is there a link between stress and illness?

Yes there is.

What are the diseases triggered by stress?

They can be divided into two groups (physical and psychological diseases). The physical disease conditions include hypertension, ulcer of the stomach and intestines, diabetes mellitus, coronary artery disease (in which blood supply to the heart is reduced).

Psychological- any psychological disorder can arise when stressor is not controlled or removed. These include anxiety disorders, depression, psychotic disorders and manic-depressive disorder.

How can stress be controlled?

It can be controlled by reducing frequency of stressors- adopt healthy life style, careful and sensible forward planning in conduct of personal affairs and at the societal level. Mobilisation of social and political order in the direction that guarantees good health and satisfactory quality of life.

There is also the need for professional intervention programme to reduce the intensity of the biological responses to stress (e.g. relaxation techniques, meditation techniques, counseling, psychotherapy, and the use of medication).

Is there a link between stress and sudden death?

Yes there is. Some of the disease conditions mentioned above (hypertension, coronary artery disease and even diabetes mellitus) could result in sudden death.

How does stress affect adults, teens and children?

In adults, stress can arise more commonly from those conditions mentioned under the causes of stress. But in teens and children, that period is an adventurous period and can be a crisis period. This is the period children want to be free from parental control and choose role model. It is a period that teenagers experiment and try many things. There is peer pressure and pleasure seeking is common at this stage. There is high risk behaviour among them and this is associated with serious negative consequences. It can take many forms, including drug and alcohol use, getting involved in sexual practices (unwanted pregnancies), self injurious behaviours and reckless driving. Sexually transmitted diseases are also very high among teenagers. All these will affect them adversely and lead to stress.

How can one relax if one is feeling stressed?

A person can engage in physical exercise but more importantly could seek professional intervention where the individual is taken through relaxation techniques, meditation techniques and medication can also be given to relieve tension and help a person to relax.

What can one do to relieve stress?

Reduce frequency of stressors by adopting healthy life style. Talk to a professional where you can ventilate your feelings and emotion and you also get counselled and appropriate treatment will be recommended.

Is stress now different and more dangerous?

Stress is not different from what it used to be but if you say people are exposed to more stressors or stressful conditions and situations, I will say yes. Uncontrolled stress has always been dangerous but may be the difference now is that people are more stressed nowadays than before and we now see more of the consequences than before.

Does chronic stress cause high blood pressure?

Yes, persistent and uncontrolled stress can cause high blood pressure.

Can medicines help lower stress level?

Yes they can, some medications can help reduce the level of tension in an individual, if they are tensed up and can also induce sleep in a person that cannot sleep as a result of stress. All these will invariably lower the stress level but medication is not the ultimate thing in stress management but removing the stressor and building the coping capacity of the individual.