Stress can occur for so many reasons and the most common of these factors in our country include job loss, falling out of a relationship, the hassles involved in getting to work due to chaotic transportation links, the stress caused by accommodation requirements and the uncertainty of power supply. Add to these factors the challenges of living in an environment with security challenges and you have the perfect situation in your hands that often will cause enough reasons to be emotional, high-strung and uncertain about the next minute.
It is normal, therefore, for people to be emotional when they are stressed. Today, we shall be discussing the emotional signs of stress while also outlining the strategies that can help prevent the emotional reactions that stress can bring about, plus the treatment that would be useful in dealing with some of these challenges. In the end, it is the common things which people know about already that constitute the real issues that must be confronted for the challenges posed by the various forms of stress we have named to be dealt with successfully. Some of these features are irritability, mood swings, feeling of isolation and loneliness, addictive behaviour, changes in appetite, anxiety, depression, changes in sex drive and memory problems.
Some people will feel the sting of increased irritability and anger when they are under stress. This combination of stress and anger have a cyclical relationship which in a 2015 study was also linked with a higher incidence of coronary heart disease. Therefore, such people may be more prone to suffering heart attacks especially when their anger is not expressed. It is a good recommendation, therefore, for people who have a lot of stress and anger issues to learn how to safely manage their anger and express their views more constructively. There are techniques employed in the management of anger which such people are well advised to imbibe. They will also have to learn to reduce their levels of stress by delegating responsibilities more effectively and diminishing their workload. A combination of these tactics often helps to accomplish much in terms of proper stress management. The other related cause of stress is mood swings, which very often are a side effect of any combination of the issues we have itemised above. However, mood swings are unique in their category because no specific treatment for it is available. On the whole, if such events ensue after exposure to certain unpleasant circumstances, the mood is often found to improve if they would simply avoid the scenario that is causing the provocation. For example, sleep disruption due to work or leisure or emergency calls are known to cause mood swings.
The realisation of the connection between sleep disruption and stress could prompt a consultation with a doctor who would be able to make some recommendations. Stress and loneliness also have a cyclical relationship as referred to above. It is said that such people have increased activity in their hypothalamic-pituitary-adrenal axis, which we discussed earlier this year when talking about the fright, fight and flight response. It is the pathway through which the body responds to stress so that when people are in that state, the system is activated and the adrenal glands which sit on top of the kidneys release cortisol and other steroid hormones into the system. It is believed that frequent activation of this pathway may cause the hippocampus to reduce in size, thereby causing the symptoms of depression to develop. There are many modalities for treating depression these days and they include the use of medications, the deployment of psychotherapy and the use of electroconvulsive therapy. The latter is used mainly in the treatment of severe forms of depressive illness and is used on inpatient treatment. In delivering this peculiar mode of treatment, anaesthesia is used as well to better control the convulsions that are caused. In the same way, people who develop anxiety often generate high stress levels in order to prepare for events they may perceive as threatening to their status.
The common features of anxiety disorders are the development of a rapid heart rate, sweating and dizzy spells and fear about a specific, impending event. Several studies have found that people will experience stress in their jobs as a result of rapid employee turnover, the drive to expand especially if this expansion drive is of an international nature and when people become concerned about their job security. It was found that there is a strong link between such job insecurity, stress at home and the development of anxiety and depression. When the chaos that transportation and power challenges in Nigeria are added to the mix, it can be appreciated that a tinderbox kind of situation is there for the average individual to succumb to. The twin challenges of loneliness and isolation are also likely to suffer from social isolation; they accordingly suffer from or experience increased activity of their HPA axis, and are therefore more likely to form poor lifestyle habits that increase the likelihood of succumbing to stress. It is often advisable that such people join social networks, increase interactions with family members and forge new relationships. They can also perform better by joining support groups, classes, religion-related activities and clubs. Without adequate treatment, having a high level of stress can negatively affect a person’s ability to recall new memories or form them. Such people are often unable to learn new things and because it affects the hippocampus, which is responsible for retaining memory, that ability is gradually lost.
Stress can negatively or positively affect a person’s sex drive. A study in 2018 discovered that stress and depression often negatively affect the sex drive in women who are menopausal. Another study four years earlier found that young women who were under stress and were dealing with anxiety and depression were more likely to have sex frequently than the older women. Such women were more likely to engage in highly risky behaviour by having sex with multiple partners and on a whim and with an increased tendency to use addictive drugs. This resort to recreational drugs that have an addictive liability such as cannabis, hashish, cocaine and heroin often tends to take on a life of its own with other problems developing along the way. The effects of such engagements become long-term as such people no longer feel good unless they engage in their drug habit. Such a status requires the person to seek help within a support group, get adequate psychotherapy and obtain treatment to handle the effects of drug withdrawal. As anxiety and depression negatively affect the sex drive in menopausal women, so it does in middle-aged men and the elderly ones where it causes erectile dysfunction. As in those who suffer from anxiety and irritability above, it is important for people who belong to this category to seek help among support groups and from doctors.
Lastly, people suffering from depression as a result of the effects of stress usually have much difficulty in feeling motivated. They are seldom hopeful about anything. They are irritable, find it difficult to concentrate on most things, have trouble sleeping and do not enjoy what normal people enjoy doing. Social interactions, food and sex hold little or no appeal to them.
Questions and answers
Dear doctor, well done for this good work you do. I am 75 years old and I always have waist pain each time I sit down or want to get up. Please what is the remedy for this? 0802xxxxxxx
Thank you very much for your kind words. At your age, it is likely that you will have pains like this one in different parts of your body. However, you should still see a doctor for a proper examination in addition to tests so that a possible cause can be established. Whether there is a cause or not, your treatment will be a mixture of physiotherapy, medications and regular exercises.
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 Dear doctor, my three-year-old daughter has had a fever off and on for one week now despite using Camosunate which I bought for her use. I also added paracetamol syrup but since she completed it three days ago, she still has a temperature in the morning and evening but plays normally in the afternoon. Also, she refuses to eat but is always asking for water. What should I do sir? Thank you. 0810xxxxxxx
There is a very high likelihood that the treatment of your child’s condition has been ineffective. For one, no diagnosis has been made and we are only assuming that she has malaria. It is better at this stage to go to a nearby hospital or health center to get a few tests done so that you can have an idea what ails her. That is the only way you will get effective treatment for your daughter. Times are hard, we appreciate that, but these tests are not too expensive, and they certainly cost a lot less than if this ailment is managed poorly and the only option left is hospital admission.
Dear doctor, during my interaction with some ladies, they said it was wrong for ladies to wash their genitals with soap and that they only use water. I tried to explain to them that the vulva and the external part of the genitalia can and should be washed with soap but not by putting their hands in their vagina to try and wash it with or without soap because that can cause vaginal pH imbalance and lead to an infection. I want to confirm from you and show them your response because some of them believed me while others did not.
BA
 Your explanation to them is absolutely correct sir. Women should wash their labia with soap and water like a normal kind of bath. It is not recommended that they should dip their hands into the vagina or use soap for that purpose due to the excellent reason you offered them. Many women remain unaware about certain practices they must jettison in order to keep being healthy.
Dear doctor, I wish to join so many others in appreciating you for the good work you do for the public. I have a swelling on the inner aspect of my left thumb but I don’t feel any pain. However, it has been increasing in size over the past one year and it is making me a bit anxious. I am a 40-year old travel agent and I don’t know what could have caused this. Please advise me. Thank you.    0802xxxxxxx
 Thank you very much for your kind words. I appreciate you very much. The swelling you showed in the picture you sent seems to be a ganglion cyst. Your description is also sort of typical for it. You should, therefore, see a surgeon in order to have it treated properly. Plastic surgeons, orthopedic surgeons and general surgeons can deal with this problem which can be removed under local anesthesia and you will be able to return home on the same day.
Dear doctor, I am a 34-year-old furniture dealer. I got married two years ago. The first problem I encountered soon after marriage was that I was not able to have sex. One doctor I complained to placed me on some drugs after I did a number of tests, and I became okay. However, over the last six to eight months, I feel weak on the right side of my body. I can drive and hold cutlery with my hand, but it feels abnormally heavy as if it is not part of my body. I have several hospitals in Lagos, but the doctors seem confused too. I am worried, having done different tests and the results came out as normal. What could be wrong? 0802xxxxxxx
Some conditions we suffer from could prevent a straightforward diagnosis, which could be the reason why your doctors have been unable to identify the problem. However, your problem could reflect a psychological problem and it could reflect a nerve-based issue. It would be appropriate for you to seek an audience with a neurologist. Any of the doctors you have seen can give you a referral letter to that effect or arrange for one to see you at the hospital you have used in the past. This would be a step forward to making a diagnosis.
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Dear doctor, thank you for all you do. Last week, my baby who was born preterm at 34 weeks was found to have hernia at six weeks of age. The doctors I saw called it inguinal hernia but to my surprise my husband said I caused it because when I express breast milk, put it in a warmer sometimes so that my baby can still enjoy taking it. Could that truly be the cause?
0805xxxxxxx
Thank you very much for your kind words. Your husband’s hypothesis is not correct. The truth behind this occurrence is that when the testes descend into the scrotum around the time of birth, they sometimes leave a small pathway behind which ought to close soon after. In some babies, this closure does not happen, and they develop these hernias. The likelihood is more the less mature a baby is before delivery, so this has nothing to do with how you preserve your breast milk.
Dear doctor, cancer is described as a deadly disease, but some people get cured. Does it mean there is hope of a cure in some cases? 0902xxxxxxx
Nothing has changed with regard to cancer. Treatment possibilities occur when it is diagnosed early in what is called stage one disease state and there is enough money to follow up the trail of treatment as advised by your doctors. By the time any cancer is said to be in stage three or four or even stage five in some cases, you are usually informed that the treatment you are being offered is palliative. In other words, such treatment is designed to make your last days somewhat more comfortable rather than getting cured of the condition. So, yes, early cancer can be cured.
