Tag: stress

Posted in Simple Pleasures of Life

Simple Pleasures of Life #18

Posted on by Jinavie

Surviving a tough rotation and getting good feedback at the end.

I survived obstetrics & gynaecology!!! The team I was on is infamous because the consultant is well-known for…yelling at students if they do something wrong. Won’t go into detail but we (two other students and I) must’ve been the first group to go the six weeks without being yelled at. Even got very positive feedback today for last day assessment! She wrote on the form “encouraged to consider O&G” (I’d never). Still it’s been rather stressful because of the sheer pressure and time spent in hospital. And I have an OSCE (clinical exam) tomorrow morning, yippee.

The end is in siiiiiight. Just OSCE, short cases and two exams until freedom! May Robert Downey Jr. watch over me.

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Posted in Psychology & Medicine

Placebo Effect

Posted on by Jinavie

A strange phenomenon found in medicine is the placebo effect, where a patient’s symptoms improve after being given a completely inert substance (like a sugar pill) under the guise of a medication. The placebo effect is not only limited to pills, but any procedure that is intended for a therapeutic purpose (but does not have any actual therapeutic value). It is believed that the placebo effect is a strong component in many forms of alternative medicine such as homeopathy and faith healing. The placebo effect has been proven to be effective in improving or even curing the symptoms of some diseases such as allergies, asthma, headaches, abdominal pains and even severe illnesses such as heart attacks and cancer. Placebos are particularly effective for psychological symptoms.

There has been much research to determine how the placebo effect works. The leading theories so far are that placebos act to relieve anxiety and condition the patient into a more positive mindset, reducing stress and boosting the body’s natural healing process. This would also explain why placebos are effective in pain relief as perceived pain is amplified by negative emotions. Cognitive dissonance may also play a role, where the patient’s mind believes that since it is receiving treatment, it must be getting “better”, producing a beneficial psychosomatic reaction. Essentially, fooling the mind to believe and expect that it will get better makes the patient actually feel better.

Research into the placebo effect has also revealed some bizarre characteristics of the effect. For example, it has been found that the placebo effect is stronger if there are more pills, the pill is larger, branded or generally looks fancier. Even colour plays a role, with blue pills acting better as depressants (“downers”) and red pills acting better as stimulants (“uppers”). Telling a patient that a placebo will have a certain effect boosts that effect. Human factors such as the doctor’s credibility and confidence or the patient’s expectations and culture are known to drastically change the efficacy of a placebo. What is weirder is that studies have shown that telling a patient that they are being prescribed a placebo will not affect its efficacy, as long as they are told that “it could help them”.

The placebo effect is a great example of how much influence our mind, beliefs and expectations have on our health and our lives. The more positive thoughts and beliefs we have, the healthier we become. The more negative we are, the less effective treatments become. In fact, the same pill that gives people the placebo effect can be used to increase pain and symptoms if it is described in a certain way. This is known as the nocebo effect – the opposite of the placebo effect.

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Posted in Psychology & Medicine

Laughter

Posted on by Jinavie

We laugh when we are happy. Laughter provides us with happiness and is the best medicine available to us, relieving the pain and stress of life. In fact, when we laugh we secrete a neurotransmitter called endorphin, which as the name suggests (endo(inside) + morphine), has the same properties as morphine.

What makes us laugh? The best theory to date is that laughter is an instinctive response to the passing of danger (also called the relief theory). For example, if our ancestor came across a predator but it passed by without noticing him, he would have laughed in response to the relief he felt. Others would see from his laugh that the danger had passed and laugh also (possibly explaining why laughter is contagious).

This theory also explains why humour makes us laugh. When you throw a joke, you are essentially giving the other person a “cognitive riddle” with a logical inconsistency. This inconsistency causes the recipient’s subconscious to become confused: “Why is it funny? Why can’t I understand it?”. As jokes are fundamentally a “surprise” to the other person’s mind, they try to solve it and figure it out whether it is a danger or not. If they get the joke, the inconsistency is solved and the person feels relief (as it has been revealed that the confusion brought on by the inconsistency was not dangerous). Once the confusion passes, the person laughs in response. But if the person does not get the joke, the “danger” has not passed and the person does not laugh. This is the basis of one of the laws of comedians: “if the audience is confused, they do not laugh”.

Laughter is beneficial for your health. Frequent laughter lowers the blood pressure, boosts the immune system, relieves pain and lowers the levels of stress hormones such as cortisol. Laughter is especially good for your mental health, therefore having a five-minute laughter yoga session every day where you just laugh as hard as you can will help you lead a happier life. However, ironically laughter can kill you too. Cases of “death from laughter” have been recorded since ancient Greek times to the modern day. The cause has not been identified but it is known that intense laughter can cause cataplexy, which is a paralysis induced by extreme emotions. It is possible that intense laughter overloads the nervous system and causes a heart attack.

Whatever it is, anything is toxic in excess.

Posted in Psychology & Medicine

Fugue State

Posted on by Jinavie

Any computer user would have had an (unfortunate) experience where their computer crashed and all the information there was destroyed in a second. You may still be able to format it and use it without problems, but the data you had on the computer and any customisation you made would be lost. But what if this exact thing could happen to a human being?

There are many types of amnesia, with causes ranging from neurobiological (where trauma to the brain, a drug or some other pathology causes memory loss) to psychogenic (where there is no apparent biological cause for the amnesia). With psychogenic amnesia, one only experiences retrograde amnesia, where they cannot recall memories from the past. However, anterograde amnesia, where you cannot form new memories and keep forgetting what happened, is absent in psychogenic amnesia. Psychogenic amnesia is often caused by extreme stress or a traumatic event. One type of psychogenic amnesia is situation-specific amnesia, as seen in post-traumatic stress disorder (PTSD) that occurs after a severely stressful experience such as war, rape, child abuse or witnessing a brutal death. In this case, the patient tends to only lose memories regarding the event, as if the brain is trying to protect the person from the hurtful memories.

A more interesting and much rarer type of amnesia is global psychogenic amnesia, also known as a fugue state or dissociative fugue. Unlike situation-specific amnesia, patients in fugue states have absolutely no memory of their original identity and personality. Simply put, they (usually) retain all their functions such as speaking and social interactions, but their persona has been wiped out like a formatted computer. Fugue states often develop after severe stress and can happen to anyone. Similar to situation-specific amnesia, the brain blocks all memories of the past in an attempt to protect the person’s psyche. Due to the “deletion” of the previous persona, patients in fugue states often generate new identities and begin wandering (sometimes even travelling to another country) away from the place they lost their memories. This is most likely the brain attempting to leave the environment to avoid the stressor that caused the event. 

Fugue states are often short-lived, lasting from days to months. However, very rarely they can last for years. Once out of a fugue state, the patient recovers all of their past memories but have no recollection of what happened during the fugue state. This creates a hole in their memory. For obvious reasons, this usually causes intense confusion and distress in the patient and treatment is often based around helping the person come to an understanding about the episode and cope with the stressor that caused it.

Posted in Psychology & Medicine

Emotion

Posted on by Jinavie

Unless you are a psychopath, as a human being you are bound to feel emotions. Love, happiness, anger, sadness… there are many emotions that range from simple to complex. Emotions are an interesting system as they allow us to respond rapidly to a situation without thinking, while alerting other members of our society to what is happening to us. Essentially, emotions help us in survival and social interactions. 

According to Professor Paul Ekman, emotions are universal from culture to culture, with facial expressions being almost identical from tribal cultures to modern ones. He found that there are six major emotions: anger, fear, disgust, sadness, surprise and happiness. He also pioneered the field of micro-expressions, which studies the flickering change in our facial expressions whenever we feel a certain emotion. As emotions usually occur before the conscious mind thinks, we are often unaware of the expressions we make.

Another psychologist, Dr. Paul Gilbert, divided emotions into three affect systems. They are as follows:

  • Threat/protection system: associated with the fight-or-flight response, activates in response to danger. It causes anger and fear and is related to catecholamines (e.g. adrenaline) and cortisol (stress hormone).
  • Want/desire system: associated with hunting and rewarding behaviour, helps us perform actions that aids survival such as obtaining food and mates. It is related to the emotion of excitement, which is caused by the neurotransmitter dopamine (part of the reward system).
  • Contentment system: associated with met needs and social connection, especially when we feel safe and relaxed. It produces feelings of happiness and peace, linked to the hormone oxytocin (released with human touch, especially during kissing).

Dr. Gilbert also posited that as societies have evolved over time, our affect systems have been altered. For example, despite the lack of natural predators around, urban dwellers are often in a state of high anxiety. This causes a sustained stress response, leading to negative health outcomes. Furthermore, the agitation and the paranoia caused by constant fear leads to crimes such as murder and war. Our want/desire system has also been heightened as we find pleasure in gaining material wealth. This has led to aggressive capitalism, exploiting other people and the environment for selfish gain.

On the other hand, the contentment system has shrunk. People feel less content despite being in a generally healthier and richer world than 100 years ago. The reason being, our brain has evolved to help us survive, not to keep us happy. 

One must learn how to adapt to these changes by finding a way to relieve tension and stress, while finding inner peace and happiness. Whether it be through sports, music, humour or simply talking to another person, finding your own way to deal with anxiety is the best road to being happy and content.

Posted in Psychology & Medicine

Broken Heart Syndrome

Posted on by Jinavie

Countless novels and films depict a character, heartbroken from the loss of a loved one or due to a break-up, suddenly clutch their chest and collapse. Although this may seem like a dramatic plot device, it is actually possible to die from stress.

The condition, colloquially termed broken heart syndrome for obvious reasons, is known as takotsubo cardiomyopathy or stress-induced cardiomyopathy. As the name suggests, the heart suddenly goes into congestive heart failure after sudden emotional stress. In simpler words, the heart’s ability to pump blood is sharply reduced due to muscle weakness and blood is not circulated properly. This causes blood to dam up and cause symptoms such as chest pain, breathlessness, fluid overload and much more.

The characteristics of this disease is that the heart temporarily enlarges so that the tip (apex) bulges out while the function of the base (upper part of the heart) is normal. The muscles in the apex is thinned while the base has hypertrophied and thickened. This gives the appearance of a thin pocket with a thick entrance, thus giving the name takotsubo cardiomyopathy, which means “octopus trap” in Japanese.
Given the patient survives the initial heart failure, their condition improves over the course of two months. The patient may also need psychiatric help or antidepressants and sedatives to ease the stress that led to the heart failure. 

As the presentation is very similar to a normal myocardial infarction (“heart attack”), the diagnosis may be difficult. The cause has not been identified yet, but researchers believe it to be due to a combination of blood vessel spasms disrupting blood supply to the heart and high levels of catecholamines. As catecholamines (adrenaline/noradrenaline) are released in great quantities in times of stress, this theory has some plausibility. A similar thing happens when patients with heart problems are exposed to significant levels of fear – their heart goes into overdrive and develop cardiac arrest due to an exacerbation of their condition.

The concept of dying from intense emotions such as anger and stress is found in almost every culture, where a person collapses and falls deathly ill after shocking news or a particularly stressful experience. But modern medicine has only just begun to understand the scientific reasoning behind this strange phenomenon.

It has also been noted that takotsubo cardiomyopathy tends to affect post-menopausal women, especially widows. Interestingly, most of these patients are not considered “at risk” for a heart attack and generally healthy. 
Thus, stress alone can be enough to “break” someone’s heart and cause sudden death.

(Source: http://sndr.deviantart.com/art/Broken-Heart-7445432?q=boost%3Apopular%20broken%20heart&qo=0)

Posted in Life & Happiness

Progressive Muscle Relaxation

Posted on by Jinavie

Everyone goes through a tough time at least once in their lives. As modern life is ideal for stress to build, it is easy to get weighed down by fatigue and negativity. Pent-up stress is the cause of all ill health and one cannot lead a healthy life without overcoming their stress.
Although everyone has a unique method of overcoming stress, there are some very effective generic methods of stress relief. Some examples include hobbies, laughter yoga and meditation, but the method that will be introduced here is progressive muscle relaxation, or PMR.
PMR is very simple and doesn’t take up much time, making it a useful way of relieving stress for busy people.

  1. Sit back comfortably, close your eyes and rid yourself of all thoughts.
  2. Breathe in slowly and deeply and then breathe out. Concentrate on your breathing.
  3. Relax all the muscles in your body into a jelly-like state.
  4. Squeeze both hands into a fist as hard as possible for 5 seconds, then release.
  5. Rest 5 seconds and then repeat twice more.
  6. After three cycles of contraction and relaxation, repeat with your arm muscles.
  7. Apply the same three cycles on your feet, legs, abdomen, chest, neck and head.

The key principle of PMR is achieving complete relaxation by concentrating all your energy into one spot then releasing it. Furthermore, concentrating on your slow breathing has a meditation effect, resting both your mind and body. Once you are relaxed from head to toe, you will feel all the fatigue in your body disappear.
There is no greater enemy than stress. Therefore, it is best to have your own defence mechanism against it, but it also very useful to know a few general methods.

Now, try the progressive muscle relaxation on yourself to resolve all the stress that accumulated over the day.

Posted in Psychology & Medicine

Confidence

Posted on by Jinavie

Two psychologists, Bob Josephs and Pran Mehta, performed an interesting experiment studying the how extroverted and introverted people react differently to a rigged game. They told a pair of participants to play a game where they had to draw lines to connect numbers in sequence as they popped up in a grid. They also told them that it was to study their spatial awareness and intelligence. The pair were given the game in a competitive setting at the same time so one could tell if they were “winning” or not.
The grid could be easily rigged to determine who would win. Josephs and Mehta posited that men and women with high testosterone levels would have high confidence in their spatial awareness, while those with low testosterone would be the opposite. 
What they found was quite interesting.

When those with high confidence in their abilities lost a game, they were more distressed relative to when they won (as measure by their cortisol, a stress hormone, level). Those with low confidence were more distressed when they won a game.
Furthermore, after winning a game these participants would show a fall in their ability to reason and solve logic problems. 

The reason behind this perplexing result is likely to be a cause of “mismatch”. It has been hypothesised that human beings are very protective of their self-identity and when this is challenged, they try stubbornly to rationalise their identity even if it means a negative outcome. For example, a person who believes they are not creative will dress and act to show this trait, even if it means others will see him in a negative light.
In the case of the game, the participants were confused as they won the game when they believed they would do badly. 
This same effect has been found in studies looking at pay raises. Those with self-esteem issues are less likely to be satisfied with a raise as they feel that “they do not deserve it”. They are also more likely to quit after a raise rather than before. It is quite possible that this would also apply to students with low self-esteem, as they would expect lower grades and (subconsciously) actively achieve lower grades to satisfy their self-identity.

Posted in Life & Happiness

Boredom

Posted on by Jinavie

Boredom can strike anyone at any time. When you aren’t interested in what you are working on, or have nothing special to do, it comes knocking like an unwanted guest. When you are bored, you can’t be bothered doing anything, you can’t sit still and experience a strange phenomenon of time slowing down.

Everyone has a unique way of resolving boredom, usually tailored to one’s style. There are simple ways such as bouncing a ball off a wall, or you can pick up a guitar and sing a song.
However, there are times (such as in the middle of a lecture) where props like these are not available. In these situations, first check what you are carrying; with imagination, anything is possible.
If you are carrying a cellphone or an iPod, problem solved – but be careful not to get caught. If you have a book, read; if you have pen and paper, write (or draw). If you have absolutely nothing, fall back into your imagination and thoughts. You will find an endless supply of fun.