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Taking care of you: Mental well-being in a constantly changing world

Health & Science
 An illustration of a stressed and worked-out employee. [Getty Images]

Lately, it seems like so many negative things are happening around the world. From news of tragedies to signals that the cost of living will be going even higher -- it's difficult to escape, disconnect or unplug from these happenings especially when they directly affect us. 

Personal and family stressors like illness or financial hardship always seem to follow and if individuals or family members do not find ways to cope, it can lead to long-term stress. 

It is normal to be stressed sometimes but long-term stress can lead to psychological issues like anxiety and depression, according to experts, and this might manifest in physical problems like heart disease. 

To properly understand the effects of stress and trauma on mental health, it is important for an individual to distinguish between the two concepts as we sort through the abundance of available information that one consumes. 

Professor Lukoye Atwoli, Deputy Director of the Brain and Mind Institute at Aga Khan University, explains stress as a condition where coping abilities are overwhelmed, different from when faced with potentially stressful circumstances. 

“You encounter stressful things on a day-to-day basis and it's part of the normal human experience to experience these potentially stressful things and to deal with them,” he says. “When you're overwhelmed, you can't cope any more. When your ability to cope with or deal with stressful events is overwhelming, then you're stressed.”  

Prof Atwoli adds that chronic stress can have physical and psychological effects; it can have problems with the cardiovascular system, including heart disease, respiratory problems, aches and pains and joint problems.

“Psychological problems can also emanate from chronic stress. This includes depression, anxiety disorders and substance-related disorders that can occur as a result of chronic exposure to stress,” he explains.

“Having a disagreement with someone, for instance, can cause stress, but it doesn't constitute trauma because it is not a threat to your life or limb or that of people close to you. So trauma is very specific, as stress is more generic,” he says. 

Prof Atwoli warns against using the term “trauma” carelessly and defines it as exposure to life-threatening events. He highlights how specific it is to situations in which there is an immediate risk to life or limb, giving rise to conditions like acute stress disorder and post-traumatic stress disorder (PTSD). 

“A traumatic event is often considered to be an out-of-the-ordinary experience for a human being. It is not something that, any day you're walking around, you're expecting to encounter a traumatic event,” he elaborates.  “Trauma is a very specific thing. Trauma is not the same way you'd say, ‘I was traumatised because somebody did this.’ It's not that way.”

“It refers to experiencing this very specific event that, in your estimation, poses a direct threat. Something that can kill you or injure you badly, or seeing these things happen to other people, seeing people being killed or seeing people being injured, or these things happening to somebody close to you, to a loved one,” Prof Atwoli says.

Psychologist Nancy Wanjiru K of Hisia Psychologist Consultants affirms that excessive stress can lead to trauma, especially when exposed to negative news or information.

“If somebody is exposed to just negative news or information around them, their system can start growing into something we call acute stress. Acute stress would either lead to excess anxiety, major depression disorders, dysfunctionality just within your environment, or relationship issues,” she notes.

“But when you lack support, you will go into a state where you've exhausted your internal resources, ecological resources, leading to the growth of acute stress, anxiety, or major depression disorders. Sometimes also into substance use disorder.”

“People exposed to traumatic events often develop post-traumatic syndrome. So not everybody exposed to trauma will develop a post-traumatic syndrome or a disorder. Some people experience traumatic events and they grow. They develop better resources for coping and they thrive after exposure to trauma,” Prof Atwoli says.

“Not everybody experiencing a traumatic event gets sick, but a portion of people exposed to trauma develop post-traumatic syndrome,” he explains.  "You can also get other syndromes like adjustment disorders that occur after trauma exposure and for children, their reactive syndromes that would occur after exposure to trauma,” he notes.

“Exposure to trauma is like water breaking barriers and overflowing and the effects are both psychological but can also increase physical problems," he says.

GOOD STRESS, BAD STRESS

Prof Atwoli distinguishes between "bad stress," which is overwhelming and has detrimental effects on one's physical and mental health and "good stress," which inspires people to go beyond boundaries.

“Good stress is a feeling of tension before you do something that you consider to be overwhelming; something you consider to be bigger than you expected, or meeting an unexpected situation and then having to think about how you're going to deal with it and then dealing with it successfully. That is good stress that pushes you to think creatively and pushes you to do things differently.”

“Bad stress is stress that freezes you or stress that makes you feel inadequate; Stress that makes you feel unable to move beyond that event or that thing. That is bad stress and that is the one that causes negative effects in your body and your mind.”

 WHAT DEMOGRAPHIC IS MOST AFFECTED?

Regarding mental health and the impacted populations, Ms Wanjiru points out that the effects of stress differ according to a person's role, the demands they encounter and their stage of psychological development.

“A teenager has not fully developed coping mechanisms or distress tolerance. So a teenager would be highly affected if it was war news or just major distressing news,” Ms Wanjiru explains.

“When you think about grown adults, their role determines how they function. For example, a man who needs to provide for the family and in that process also experiences an illness and maybe their child is also sent away for school fees, might not have enough coping skills at that particular time because there are so many moving parts.”

“If you look at a woman, depending on the role she plays and the support she gives the family, She might also be overwhelmed. Even if it is physical, it could be psychological and emotional,” she adds.

Speaking of the impacted demographics, Prof Atwoli points out that although mental illness can affect anyone, some are more vulnerable than others, such as those living in poverty or areas experiencing conflict.

“Everybody is potentially at risk of developing a mental illness. So if you talk about mental illnesses in general, everybody can get any mental illness and they're at risk. So it would be wrong to single out a particular group and say these ones are more at risk based on their demographics of developing mental illness,” Prof Atwoli says.

“However, having said that, people who are living in poverty as a social demographic group have a higher risk of mental illness than people who are not in poverty or people who have more resources,” he notes.

“People who are living in conflict-affected areas are at higher risk of developing mental illnesses than people who are not. People who experience adverse childhood experiences, which include poverty, gender-based violence, and living with parents who have mental illness or who have a chronic physical condition. All those are risk factors for children developing mental illness.”

“When you talk about specific mental illnesses, each has its own demographic distribution.” 

COPING MECHANISMS 

Ms Wanjiru highlights healthy coping strategies, stressing the value of realising what is under your control and asking for help when you need it. 

“It's good for an individual, first of all, to understand what is within their control. If you're concerned about the war, the flooding and all that, look at the measures you have put into place to protect yourself and your loved ones.” Ms Wanjiru emphasises, “If you haven't put anything in place, try to think about it and what is possible to implement. So start with what is within your control and then what is out of your control, seek support. There are so many bodies and so much information out there; you just have to seek the right one.” 

“Be very cautious not to overconsume information because when you have too much, you might not know what is useful to you,” she stresses. 

SPEAK UP 

“If you're struggling with finances, it's also good to speak up rather than put up a face. You can also think about changing your lifestyle and stepping it down a notch so that you can get through that window,” Ms Wanjiru adds. 

“If you notice you're struggling, talk to someone, look for someone you can talk to because it starts from there. When you start talking about these things, you will get better because a problem half shared is a problem half solved. It doesn't even have to be a professional at first. You can look for someone to talk to—a mom, a sister, a caregiver, a friend; someone you can share things with,” Beryl Njoki, a Psychologist, says. 

COMMUNITY SUPPORT

“It is important to ensure that families and members of the community know what they need to do to support each other and create a very supportive environment. And also know what they need to do to prevent mental illnesses, for instance, by looking out for each other, preventing violence, preventing trauma and then also knowing when members of the community start spiralling out of control when they need help and channel them to a place where we can get care,” Professor Atwoli says. 

“It is not the responsibility of health workers, psychiatrists, or mental health workers to support people in the community. It is the responsibility of each of us to take care of those that are close to us and that will be important in improving mental health.” 

WHY IT IS IMPORTANT TO TALK ABOUT MENTAL HEALTH 

Professor Atwoli underlines the significance of having a conversation about mental health and the variables that affect it, such as exposure to potentially traumatic events, conflicts and changes in finances. 

“People don't know about the risks that they face on a day-to-day basis, but once you know, then you know there's a channel where you can get help,” he remarks.

“Sometimes you keep things to yourself, thinking you're the only one experiencing them and yet many people are experiencing them and dealing with them one way or another. So you could learn by talking to other people.” 

WHEN SHOULD ONE SEEK HELP? 

“At the end of the day, if whatever is giving you stress is still not sorted, it means you're still going to be in that state of despair. Maybe looking for professional help or someone who can help you navigate the issues that are causing that. As you navigate it you get to realise that 'Maybe I need to start looking at things in this way', "Ms Njoki says. 

When sleep issues, communication difficulties, or emotional upheaval interfere with day-to-day functioning, Ms Wanjiru suggests getting assistance. 

“When you're unable to function, your everyday functionality is interfered with. You're having struggles with sleeping, or you're struggling with communication, expressing yourself, or having anger outbursts, unable to perform, feeling hopeless, helpless and unmotivated,” Ms Wanjiru explains.

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