is a normal part of life. Many happenings in our lives and
many things that we do, require us to make a change or adjustment.
The body reacts to these changes with physical, mental, and
emotional responses. Stress can be positive, keeping us alert
and active to achieve goals. This is eustress. Stress becomes
‘distress’ when a person faces difficult situations
John, a 40 years old executive in a reputed Kuwaiti company,
came to consult me (NZ) because his diabetes was not under
control even with the maximum dose of oral medicines and his
doctor advised Insulin injections. He admitted that he was
under a lot of stress at work. A MINI neuropsychiatric interview
scored high for depression and anxiety. He was advised stress
relieving measures and a safe, non sedating and non habit
forming medicine. Within a few weeks his diabetes came under
good control and he was able to perform better at work, home
and social life. He did not require insulin and is in the
process of reducing his medicines. He is just an example of
the many with diseases like diabetes, high blood pressure,
heart disease, asthma, peptic ulcer and headache whose illness
is made worse by stress.
Stress can be experienced in different circumstances. Sometimes
the cause of stress is immediate and often following an event
like death of a relative. A difficult marriage or work situation
can lead to chronic distress.
The cause of stress is not always external. When suffering
with a physical or psychological illness, a person many feel
Not all causes for stress are negative, even the success in
our lives can increase stress like a promotion or a transfer.
Each individual may have different reactions to the same stressful
Many people experience a mixture of psychological and physical
symptoms. This can lead to disorders, such as:
• Raised blood pressure, palpitations, chest pains
• Abdominal pain, peptic ulcer, bowel disorders, “gas”,
• Muscular strain, backache , arthritis, general aches
• Changes in the hormonal levels leading to menstrual
• Weight gain or loss of weight.
• Diabetes and related complications
• Psychological illness such as depression, anxiety,
• Skin problems like pimples, repeated or prolonged
• Breathing problems like wheezing , continuous cough
• Sleep problems
• Cold and sweaty palms
• Tiredness, exhaustion
• Trembling and shaking
• Dizziness and headaches
• Weakening of the immune system leading to repeated
infections or even certain cancers
Studies show that over 75% of the outpatients have diseases
caused or made worse by stress.
What makes us prone to stress?
Stress is not due to a single reason but often a combination
Hereditary : Those who are prone to experiencing
stress often have family members who also suffer from stress.
Home situation : difficult living conditions,
loss of a parent in child hood, physical and or emotional
Personality : Some people are more prone
to feeling stressed than others. Attitudes that cause more
Perfectionism - constant pressure
to achieve, criticising oneself when not perfect, never satisfied
with what we have done
People pleasing – care for
others than self, doing things only to please others, worried
over disappointing others
Need for Control – want to
be in perfect control at all times, view mistakes as signs
of weakness, uncomfortable with delegating work
Competence – low confidence,
undermining self, not happy when appreciated, low self-esteem.
Cultural: social expectations one finds difficult
to fulfill can cause distress
Gender: Women are more prone to stress during
their monthly periods, childbirth and menopause. .Also in
many cultures there are more demands or restrictions placed
on women. Working women have more stress in managing both
career and home efficiently.
Men experience stress to achieve more and provide well for
their families for which they may need to spend extra time
and sharpen their skills.
How do I know if I am stressed?
Some of the common indicators of increased stress are:
Experiencing difficulty or change in any aspect of life –home,
work or health.
Increased worry, anger, periods of boredom.
Increased sensitivity to criticism and decreased motivation
Inability to concentrate, forgetfulness.
Difficulty with sleep.
Sexual difficulties including inability to perform, lack of
interest and pleasure Initiating or excessive consumption
of cigarettes, coffee, tea, alcohol or drugs
Illnesses with no specific cause or that recur for no particular
How can we prevent and relieve stress?
Major life events are usually not the main cause of stress;
most of human stressors are caused by day-to-day event.
Life style to follow
Work regular hours and take adequate breaks and holidays.
Sleep and rest are nature’s own stress relievers .A
sleep deprived person is less able to face the stress of routine
Eat healthy, well-balanced meals.
Avoid cigarettes, alcohol and stimulants.
Engage in activities that one enjoys like listening to music,
Practise stress relieving measures - regular exercise, yoga,
meditation and prayer, fellowships help many to feel less
Attitudes that decrease stress.
Keep a positive attitude.
It is necessary to know one’s own abilities and limitations.
One who prefers to work by himself may excel as a researcher
and not as a personnel manager.
One must acknowledge that some events are beyond our control
or ability to change.
Do not avoid thinking about difficult events or feelings;
they never go away until resolved. If ignored, the distress
intensifies or appears in another form such as an illness.
Be assertive instead of aggressive. Assert our feelings, opinions,
or beliefs instead of becoming angry, defensive, or passive.
Enhance skills of management of time, decision-making, career
planning. Delegate responsibilities instead of trying to manage
Build relationships with those who share professional or homemaking
interests. Confide difficulties to them and they could encourage
or point out areas for improvement.
Stress and distress are part of our lives. Often it helps
us to plan and prepare better at home or work. However excess
stress can be very damaging to our physical and emotional
lives. Life style and attitude change are often sufficient.
Combating negative thoughts and replacing them with positive
ones takes practice, but the results are worth it.
the stress experienced is not fully relieved in spite of all
efforts, it is time to seek professional help. A psychiatrist
is the best person to consult. If psychiatric help is not
available, an enlightened family physician or GP can help.
Safe and non habit forming medicines are available to relieve
depression and anxiety. These should be used without hesitation
if the doctor advises.
Dr. Noble Zachariah
German Medical Care
Jleeb Al Shouyuk