Medical expert’s stress-busting tips

Are you burnt out at work? Do you worry about your family members and loved ones? Are money problems leaving you anxious? Singapore physician and stress-busting expert Dr Caroline Low gives her advice on how to identify and manage our stress for happier, healthier lives.

The cause of stress for many people is worry for their loved ones. How do you manage stressful situations when the stressor is not under your direct control and you’re limited in your ability to change or affect it?
A little bit of stress is good for you – it’s a defence mechanism. But prolonged stress breaks the body apart.

Stress is both external and internal. When everybody talks about self-expectation – that’s internal stress. Internal stress all depends on your personality type. If you’re someone that has no expectations you will never ever be stressed. If, however, you are someone who has very high self-expectations, your stress levels will be high.

To deal with stress you first have to quantify your personality type and look at the best ways of stress management. Being highly stressed affects the way the body functions. The adrenal glands get totally overworked and the stress hormone cortisol is at a constant high. This gives rise to stomach ulcers and low immunity, which leaves the body open to constant illness.

How do people usually cope with stress? What are the pros and cons of different reactions?
Many people cope with stress by avoiding the issue. But even if you ignore it, that won’t change how your body reacts. You might think you are masking the symptoms in the short term, but it will damage long-term health. Taking a holiday for example just masks the problem, it might help you forget for a while, but the problem will still be there when you come back. What matters is going after the root cause of the stress and solving it there.

Escape and avoidance are very common coping mechanisms. That's why we work with behavioural psychologists to help people understand stress, quantify it and deal with it.

Some people ask for medication, but again this will only mask the problem and can’t be recommended. The key to coping with stress is to control your body’s output of cortisol. What we ultimately want to achieve is to bring the cortisol levels down. If you don’t bring them down you will suffer from symptoms of stress: insomnia, high gastric juices and a change in your immune system. You will probably fall sick all the time. By recognising the problem that’s causing you stress and finding ways to cope, you will teach your body to control the amount of cortisol released.

The price you pay for not bringing them to a manageable level is adrenal crash – which leads to burn out. By the time people come to see me they have usually already ‘crashed’. My job then is to make sure they reproduce cortisol. When you are burnt out and don’t have enough cortisol, you are still stressed but lack the energy to do anything about it. Typically at this stage people will eat high sugar foods to try and give themselves energy, which exacerbates the strain on the body even more.

To increase your cortisol production, you should exercise regularly and keep your intake of sugar at a steady level. To make sure your sugar levels don’t fluctuate, eat every three hours rather than binge eating. That way it keeps the cortisol excretion constant. Also, try and improve your sleep. Make sure your bedroom is as dark and quiet as possible. A deep sleep – what’s known as a stage 4 sleep – will help reboot your cortisol.

What are some of the best steps to take to manage stress?
There are three points to remember for dealing with stress in a measured and effective way:

1. Recognise. I recommend writing down what the issue is in order to be able to address it.
   
2. Quantify. Have a frank, realistic discussion with a close friend about the stressor, in order to better understand it.
   
3. Share. Talk to a close family member or friend. You might also like to seek professional help from a psychologist or psychiatrist about your feelings of stress.

Whether it’s a domestic or career issue, you can apply these to any situation that is causing stress.

Social networks, like friends and family who always there for you, provide a good safety net. If you work through stress together you have divided the problem by two.

Medically, in acute cases, we monitor cortisol levels by taking blood tests on a monthly basis. Cortisol levels should be measured before food (after you eat it can go up to show an artificial level).

As a professional in a stressful job, how do you personally manage stress?
As a doctor you never get personal. It’s stressful having to have to break the heartbreaking news to someone they are dying or they have cancer. You have to stay professional and learn to compartmentalise, otherwise the stress would wear you down.

I exercise daily. I find running a great stress buster. The release of endorphins from exercise counterbalances excessive stress.

Can you share any success stories?
I see a lot of people who physically suffer from the breakdown for their marriage. I had one patient who came to me who was initially on anti-depressants. Her cortisol level was all over the place. I corrected that using phosphotidylserine, an amino acid that lowers cortisol levels, and aswashgandha, also known as Indian ginseng, which also reduces cortisol. That allowed her to respond to stress appropriately. She felt less overwhelmed and emotionally more in control – automatically, she had a very different outlook. She was able to take control of her life – and that’s the first step to healing.

When something like a marriage breakdown occurs you need to take steps to gain control and be able to move on. You won’t have the physical or mental energy to do this if your cortisol levels are all over the place.

What three things would you recommend people do to successfully manage cortisol levels?

1. Wake up with a positive attitude. Get a good night’s sleep and your cortisol will be nice and high the following morning. That has a positive impact on your moods and energy.
   
2. Exercise. Cardiovascular exercise increases cortisol production. Pick an exercise you like, so that you’ll keep on doing it.
   
3. Keep sugar in your blood stable. A low glycemic index (GI) diet helps when you are stressed. Keeping sugar levels stable help to calm a stressed system. It also improves your mood and energy levels.

Want to know your Stress Personality Type? Try our quick quiz to determine how you handle stress.

A low-GI diet can be beneficial at lowering your stress levels. Find out how and where sugar might be hiding in the foods you least expect.

Doctor Caroline Low
Dr Caroline Low, is an anti-aging physician and graduate of the Royal College of Surgeons in Ireland, she is also a general practitioner with over 20 years of experience. Her area of professional expertise includes preventive medicine and aesthetic medicine.

Find out more at www.drsjitenandcaroline.com.