COVID-19 distress


IF SYMPTOMS PERSIST

Dr. Jose Pujalte, Jr.

“What peaceful hours I once enjoy’d!”
William Cowper (1731-1800), English poet and hymnodist
Walking with God (c.1779)

Here’s a conundrum: Here you are WFH (working from home) and yet – you’re stressed (!).
It comes as an irony that William Cowper suffered a nervous breakdown from the stress of studying for an exam. He sat for a Clerkship of Journals at the House of Lords, couldn’t handle the anxiety, and was later committed to a sanatorium.

We intuitively know what stress feels like but here’s how stress research pioneer and endocrinologist Dr. Hans Selye defined it: “Stress is the state manifested by a specific syndrome which consists of all the nonspecifically-induced changes within a biologic system. Thus, stress has its own characteristic form and composition, but no particular cause. The elements of its form are the visible changes due to stress, which are addictive indicators expressing the sum of all the different adjustments that are going on in the body at any time.” Now that gives me stress.

Anyway, the good doctor simplified stress by saying that it is the “nonspecific response of the body to any demand, whether it is caused by, or results in, pleasant or unpleasant conditions.” He then differentiated between good stress or “eustress” – the kind of which has a positive effect on us – a doable challenge, competition viewed as enjoyable, etc. and the bad stress or “distress.” This is negative stress because of our refusal or inability to adapt to the stressors. And what are some of these stressful life events?

Holmes and Rahe stress scale. In 1967, two psychiatrists listed 43 stressful conditions that are linked to illness. Attempting to quantify stress, a score of “100” is given to the highest stressful life event. The top 10 are:

  1. Death of a spouse (100);
  2. Divorce (73);
  3. Separation (65);
  4. Imprisonment (63);
  5. Death of a close family member (63);
  6. Personal injury or illness (53);
  7. Marriage (50);
  8. Dismissal from work (47);
  9. Marital reconciliation (45);
  10. Retirement (45).

I’m not so sure if this list works out just as well in 2021 but we all get the picture that some fairly common experiences affect us greatly. Another scale for non-adults has two top stressors: unwed pregnancy (100), and death of a parent (100). How does pandemic anxiety score?

Stress relief. Try the 4 “A”s – Avoid, Alter, Accept, Adapt. It comes as a surprise that you can reduce the likelihood of stress by avoiding what causes it in the first place (if possible). If you hate traffic, leave for work early. You don’t like someone? Then get away from him (or her). Learn to say NO. By now, if you are still living your life pleasing only other people but not yourself, you must be one miserable clot of a human being.

“Alter” means taking charge of a situation where you often are stressed out. Manage your time or give a time limit for certain behaviors that stress you after a certain point: a wife’s nagging or a colleague’s jabber are examples.

“Accept” is not abject resignation but an enlightened view that while external circumstances are stressful, you can live through it somehow.

Finally, to “adapt” to stress means several things: “Thought-stopping” is catching yourself becoming gloomy or negative about a situation or a person and then pulling back; “adjusting standards” means letting go of perfection in matters of behavior and habits because so much energy is consumed just trying to become #1 all the time and “look at the big picture.”

When faced with a stressful event, ask yourself if it will matter a year or 10 years from now. Most likely, it won’t. Stress is inescapable. We must all deal with our demons which in this day and age are those stresses that poke us from every angle. Borrowing from Cowper’s immortal phrase, maybe stress too “moves in a mysterious way.”

Let’s think straight in a pandemic stress and – stay alive. CNN predicts that the new normal incorporates WFH – paving the way to new boredom and not stress. (email [email protected])