Coping with stress

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April 30, 2021

Writer: Alvin Joseph Mapoy
Researchers: Angelica Jane Evangelista, K Ballesteros
Graphics: Krystle Mae Labio, Bee Fukumuto 
Moderators: Richardson Mojica, K Ballesteros, Marga Miñon 
Documentation: Ian Stephen Velez, Alvin Joseph Mapoy

Imagine holding a glass of water for twelve hours. You cannot drink the water, you cannot put the glass of water on the table. You have to hold on to it everywhere you go for twelve hours. It’s uncomfortable. This is comparable to holding on to your stressors. Carrying stressors for a long time affects our physical and psychosocial well-being. This April, we recognize the ways we cope with stress. 

Since 1992, the Health Resource Network (HRN) has designated the month of April as Stress Awareness Month (Healio, 2021). During this thirty-day period, healthcare professionals and health promotion experts work to increase the public’s awareness of stress and how to cope with it (Mort, 2020). As  HRN (Stress, 2021) mentioned, “Stress Awareness Month is a national, cooperative effort to inform people about the dangers of stress, successful coping strategies, and harmful misconceptions about stress that are prevalent in our society.”

Before the pandemic, the Social Weather Stations (SWS) published a survey which showed that one out of four Filipinos (27%) frequently experience stress in their lives. The survey was conducted from December 13 to 16 of 2019 (Hallare, 2020). When the pandemic hit in March 2020, the Philippines was identified as one of the high-risk countries for the COVID-19 outbreak. The national government announced community quarantines and declared a state of calamity for the next six months on March 17, 2020 (Duddu, 2020). With the implications of the COVID-19 pandemic continuing to unfold in the following months, the feeling of stress became a normal reaction for individuals across the globe (University, 2020).

One year after the declaration of a state of calamity, on March 20, 2021, #UsapTayo discussed how burnout has caused pandemic fatigue among Filipinos due to  the ongoing national community quarantine imposed by the government. Without a doubt, the COVID-19 pandemic has caused major disruption in our lives. This led Filipinos to experience various stressors: physical, academic, economic, and psychosocial stress (Duddu, 2020). 

Stress defined

Stress is defined “as the reaction of our mind and body that disturbs the well-being, state of calm, or equilibrium of a person” (Santos, 2016). Stress is a normal reaction in individuals. It involves situations that put pressure on us and our subsequent reactions (Mind, 2021). Baum (1990) stated that stress is a “negative emotional experience accompanied by predictable biochemical, physiological, and cognitive, behavioral changes that are directed either toward altering the stressful event or accommodating its effects”.

There has been a common belief that stress involves unhealthy emotional experiences. However, researchers identified that there are two types of stress: eustress and distress. Eustress is the “good stress” associated with positive emotions and benefits (Li et al., 2016). There are situations that were thought of as happy events. For example: going through a  pregnancy, and getting married are considered stressful. These events can bring about big adjustments and unusual demands on an individual (Mind, 2021). 

On the contrary, distress is the negative stress that is commonly associated with negative emotions. The amount of stress that we feel may depend on many factors, such as one’s perception of the situation, your experiences dealing with the stressor, and emotional resilience (Mind, 2021). Situations such as bereavement, going through a break-up, losing one’s job, and poverty can cause stress (Mind, 2021). 

In the context of the pandemic, minimum health safety protocols such as social distancing are necessary to minimize the spread of the virus. However, these protocols make people feel isolated and lonely, thus contributing to increased stress (Centers, 2021). The American Psychological Association (APA) cited that money, work, family, economic outlook, and relationships were the five factors cited that contributed to stress (National, 2021). Other causes of stress include pressure, adjustments, and uncertainty (Mind, 2021). Let us look at the different stressors that we experience:

The physical signs of stress

Most people recognize that they are stressed when physical signs such as “tiredness, headaches, or an upset stomach” (Mind, 2021) are present. People who are under chronic stress are susceptible to various physical ailments ranging from headaches and insomnia to high blood pressure and heart disease (National, 2021). These physical signs can be a result of faulty sleeping patterns and poor diet (resulting from stress) that consequently affect our health. In turn, these physical signs and symptoms make us feel stressed emotionally (Mind, 2021). Other physical signs of stress include: shallow breathing, muscle tension, blurred eyesight, and fatigue (Mind, 2021). 

But how do we explain how these physical signs and symptoms appear? 

When we are stressed, our body releases hormones called cortisol and adrenaline. This is the body’s automatic response to a threat known as the “fight-or-flight” response (Mind, 2021). This idea was pioneered by American physiologist Walter Cannon in the early 20th century. He suggested that the fight-or-flight response is the first stage of stress” that organisms use to respond to stress (National, 2021). If an individual is releasing a lot of stress hormones such as cortisol and adrenaline, this can make the person feel physically unwell (Mind, 2021). 

A framework on stress response was developed by Hans Selye (1936) known as the General Adaptation Syndrome (Santos, 2016). This pioneering work of Selye for stress response states that our body undergoes three response stages: alarm, resistance, and exhaustion (National, 2021). Alarm manifests when the individual recognizes the threat. Resistance happens when the person desires to either confront the stressor (fight) or run away from the stressor (flight). The final phase is exhaustion in which the body’s resources will be depleted. 

Stress in studying? 

Educational institutions around the country were closed from March 12, 2020 onwards (Duddu, 2020). This prompted the Department of Education and Commission on Higher Education (DepEd) to resort to online and modular learning. 

Reddy et al. (2018) stated that dimensions of sources of stressors include “personal inadequacy, fear of failure, interpersonal difficulties with teachers, teacher pupil relationship and inadequate study facilities”. These factors contribute to the ongoing struggle that students face with their academic life. 

Aside from the common factors of stress among students, the additional stressor of the pandemic heightened the amount of stress. Mahapatra and Sharma (2020) identified additional academic stressors such as the challenges of home-schooling, digital learning, and the psychological impact of academic stress. Liu (2015) further emphasized that academic stress is significantly associated with lower academic motivation and academic engagement. 

Last March 30, on the #UsapTayo tweetchat, we talked about academic stress and how it affected taking professional examinations. Students and teachers alike addressed their concerns with online schooling demands — internet connectivity, financial challenges, and learning challenges. 

Uncertainty in employment and economic activity, upsurge of stressors

While academic stress affected students, the pandemic has caused uncertainty in employment and academic activities. 

Stress in the workplace has been a concern for companies ever since the 1970s. In 1974, an organization aimed to manage personal stress in the workplace was founded. This organization is now known as the Stress Management Association (National, 2021). 

Job burnout is commonly experienced by employees around the world. It is a special type of work-related stress that involves “physical or emotional exhaustion with a sense of reduced accomplishment and loss of personal identity” (Mayo, 2020). Possible causes of job burnout include lack of control, unclear job expectations, and dysfunctional work dynamics (Mayo, 2020). Extreme job burnout can have significant consequences such as fatigue, insomnia, and addictive behaviors (Mayo, 2020). 

Aside from job burnout that most employees experience, socioeconomic status is also considered to be associated with stress (Baum et al, 1999). It has been found out in multiple studies that stress accounts for the socioeconomic effects on health among individuals. Lower socioeconomic status is associated with social and economic conditions that contribute to chronic stress such as crowding, crime, and noise pollution (Baum et al., 1999).

During the community quarantine, domestic transportation was banned. Residents were not allowed to leave the safety of their homes unless necessary. Checkpoints were placed to entry points around the country (Duddu, 2020). Furthermore, travel restrictions were imposed. On February 2, 2020, the government announced that only Filipino citizens and permanent residents were allowed to enter the country (Duddu, 2020). 

The tourism sector is a major contributor to Philippine economy and employment, comprising 12.7% of the Philippine economy in 2018 (Duddu, 2020). Moreover, airline operators were forced to retrench workers due to the impact of the pandemic on the sector (Duddu, 2020). 

More than 400 economic zones were placed in community quarantines and approximately 700 factories were closed (Duddu, 2020). Thus, unemployment and underemployment were rampant during the community quarantine period. The Philippine government’s stimulus package of approximately 200 billion pesos was set to  protect workers and businesses from  the economic impact of the pandemic (Duddu, 2020). However, it seems that these efforts were not enough with the rise of community pantries. Community pantries were established in different local government units across the country. In the context of pandemic, food-insecure Filipinos were given a relief of stress (Rivera, 2021). 

Economic stressors are rampant due to the instability of employment among Filipinos especially this pandemic. Research shows that economic stress is triggered by factors such as job retrenchment, major changes in family’s income, and feeling of not having enough financial resources (Brown, 2020). All these factors mentioned were amplified by the ongoing pandemic. 

The stress within

Individuals who were laid off from work or are experiencing struggles with their academics may experience psychosocial stressors. 

According to Scott (2020), psychosocial stress that individuals experience include “social status, self-esteem, self-worth, and lack of self-control”. All of these stressors affect one’s thoughts about themselves. 

When unmanaged, stress can cause “mental health problems and make existing problems worse” (Mind, 2021). Vice versa, having mental health problems can also cause stress. Thus, stress and mental health problems feel like a vicious cycle when unmanaged (Mind, 2021). Unmanaged stress can affect how we feel. Feelings of irritability, anxiousness, and an overwhelming sense of dread may be experienced by individuals with chronic stress (Mind, 2021). 

Because of stress, several changes in one’s behavior may be noticeable. These behavioral changes include: constant worrying, arguing with people, poor eating habits, smoking and drinking alcoholic drinks more than usual (Mind, 2021).  These psychosocial stressors that one experiences leads to impaired health behavior affecting one’s physical health (Beutel et al., 2018). Thus, a vicious cycle of stressors continues when it is unmanaged. 

How to deal with stress

Despite the negative effects of stress, minimal and manageable stress can help sometimes. As the National Institution of Mental Health stated, “stress can motivate people to prepare or perform and might even be life-saving in some situations.” (National, 2021).

Identify your stressors. Taking time to reflect on the events that make you stressed can be beneficial as it can help you prepare for such situations. Issues that come up regularly, one-off events, and ongoing stressful events need to be identified for effective stress management.

Organize your time. Adjustment in organizing time can be beneficial in managing the stress and pressure experienced in the workplace or academic setting. Making a list of your tasks, setting short-term and long-term goals, and taking breaks (Mind, 2021). 

Practice meditation. To deal with stress, individuals need to practice how to silence the mind. Yoga, meditation or tai chi are some of the ways to achieve this (National, 2021). Mindfulness meditation through focusing on breath flow and being aware of your senses and emotions can help reduce stress (Mayo, 2020).

Take care of your body. They always say that “physical health is as important as mental health”. There is a strong association between  our physical health and stress. Thus, exercise helps reduce debilitating effects of stress. Jogging, cycling, and taking long walks can be included in our daily routine while maintaining health protocols (National, 2021). Furthermore, eating healthy and well-balanced meals can help in managing stress (Centers, 2021). Getting enough sleep can also help restore your well-being (Mayo, 2020). 

Take social media and information breaks. It is good to be informed about the current situation of the country, but information on social media and hearing stories about the pandemic can be disappointing most of the time. Thus, taking a break from reading, listening, or hearing news stories can be beneficial from time to time (Centers, 2021). 

Connect with others. Talking with people you trust about your concerns and emotions can help lessen the burden that you are experiencing (Centers, 2021). Creating memories with your family and friends virtually by watching videos together can improve your mood and immune system (Center, 2020). When dealing with workplace stress, you can also seek support from your co-workers, support and collaboration on the tasks can significantly reduce stress (Mayo, 2020). 

Develop hobbies. Exploring one’s creative side through adult coloring books, painting, writing, drawing, and taking pictures inside the safety of one’s home can help us relax and recharge (Center, 2020). 

Helping others cope. During this time, everyone experiences some degree of stress. It is important to help others cope with the situation that we are experiencing. However, we have to better equip ourselves to take care of others. One can help others cope through phone calls or video calls to feel less isolated (Centers, 2021). As one helps others cope, help others reflect when they are stressed and listen to how they are feeling (Mind, 2021). 

As we end the Stress Awareness Month, join us on our tweetchat this Friday, April 30. Let’s talk about how we cope with our personal set of stressors! Tara, #UsapTayo!

Also, celebrate with us, #MentalHealthPH is turning 5 on April 30! #MHPHturns5

Questions: 

  1. What are the changes you noticed in yourself when you experience stress?
  2. How do you cope with stress? Share your coping strategies. 
  3. How can we help people who are experiencing stress? How can we raise awareness on stress?

Cited Works and Other Readings

Baum, A. (1990). Stress, intrusive imagery, and chronic distress. Health Psychology, 9(6), 653–675. https://doi.org/10.1037//0278-6133.9.6.653

Baum, A., Garafolo, J. P., & Yali, A. M. (1999). Socioeconomic status and chronic stress. Does stress account for SES effects on health? Ann N Y Acad Sci., 896, 131–144. https://doi.org/10.1111/j.1749-6632.1999.tb08111.x.

Beutel, T., Zwerenz, R., & M, M. (2018). Psychosocial stress impairs health behavior in patients with mental disorders. BMC Psychiatry, 18, 375. https://doi.org/10.1186/s12888-018-1956-8

Brown University. (2020). Economic stress. https://www.brown.edu/campus-life/health/services/promotion/general-health-emotional-health/economic-stress#:~:text=Research%20demonstrates%20that%20economic%20stress,to%20work%20while%20in%20college

Center for Health and Well-Being. (2020). Relax and recharge during stress awareness month. https://yourhealthandwellbeing.org/relax-and-recharge-during-stress-awareness-month/

Centers for Disease Control and Prevention. (2021, January 22). Coping with stress. https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html

Duddu, P. (2020, March 30). Coronavirus in Philippines: The COVID-19 risk, impact and measures. Pharmaceutical Technology. https://www.pharmaceutical-technology.com/features/coronavirus-affected-countries-philippines-measures-impact-tourism-economy/

Guzman, N. Q. (2016). Understanding the stresses and coping resources of Filipino clergy families: A Multiple-Case study. Pastoral Psychology, 65, 459–480. https://doi.org/10.1007/s11089-016-0698-0

Hallare, K. (2020, March 31). 27% of Filipinos frequently experience stress – SWS. Inquirer. https://newsinfo.inquirer.net/1251893/27-of-filipinos-frequently-experience-stress

Healio. (2021, April 5). Stress awareness month 2021: COVID-19-related stressors, prenatal stress and more. https://www.healio.com/news/psychiatry/20210405/stress-awareness-month-2021-covid19related-stressors-prenatal-stress-and-more

HelpGuide. (n.d.). Coronavirus anxiety: Coping with stress, fear, and worry. Retrieved April 24, 2021, from https://www.helpguide.org/articles/anxiety/coronavirus-anxiety.htm

Mahapatra, A., & Sharma, P. (2020). Education in times of COVID-19 pandemic: Academic stress and its psychosocial impact on children and adolescents in India. International Journal of Social Psychiatry, 1. https://doi.org/10.1177/0020764020961801

Mayo Clinic. (2020). Job burnout: How to spot it and take action. https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/burnout/art-20046642#:~:text=Job%20burnout%20is%20a%20special,as%20depression%2C%20are%20behind%20burnout

Mind for Better Mental Health. (2021). How to manage stress. https://www.mind.org.uk/information-support/types-of-mental-health-problems/stress/signs-of-stress/

Mort. (2020, November 1). Welcome to stress awareness Month–April 1–30, 2021. Stress Awareness Month. https://stressawarenessmonth.com/

National Today. (2021). Stress awareness month – April 2021. https://nationaltoday.com/stress-awareness-month/

Piedmonth Healthcare. (n.d.). Managing stress during the COVID-19 pandemic. Retrieved April 24, 2021, from https://www.piedmont.org/living-better/managing-stress-during-the-covid-19-pandemic

Reddy, K. J., Menon, K. R., & Thattil, A. (2018). Academic stress and its sources among university students. Biomedical and Pharmacology Journal, 1. https://doi.org/10.13005/bpj/1404

Rivera, K. (2021, April 19). On community pantries. Inquirer. https://opinion.inquirer.net/139447/on-community-pantries

Scott, E. (2017, February 27). How you can manage psychosocial stress. Verywell Mind. https://www.verywellmind.com/what-is-psychosocial-stress-3145133

Stress Management Society. (n.d.). Stress awareness month 2021. https://www.stress.org.uk/national-stress-awareness-month-2019/

The University of Melbourne. (2021). Coronavirus (COVID-19): Managing stress and anxiety. https://services.unimelb.edu.au/counsel/resources/wellbeing/coronavirus-covid-19-managing-stress-and-anxiety  

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