(First of two parts)

Even during pre-COVID times, about a third of patients we saw in the clinic had stress-related symptoms. During the pandemic, this has easily doubled in incidence.

Most of them really have some medical or health issues; but constant, inadequately managed stress has blown their symptoms out of scale.

We call it the mole hill-mountain syndrome because of the patient’s propensity to magnify small problems into major health issues because of their stress, fear or anxiety. And an excessive paranoia toward COVID-19 has made many victims of this syndrome.

One patient we saw regularly in the clinic had adequately controlled blood pressure, with just one antihypertensive pill. After her spouse and son got infected with the virus in the early stage of the pandemic, she had this constant fear that she would soon have it, too. Fortunately, she has been spared so far, but her hypertension has taken an entirely different pattern, and now requires a three-drug combination to keep it from rising to perilous levels.

Another patient had stable coronary artery disease before the onset of the pandemic. He had a single blocked artery, which we deemed could be adequately controlled with conservative medical treatment, and not requiring aggressive intervention. But a few months into the lockdown, he started having more frequent and more severe angina or chest pains.

He was rushed to a nearby medical center one night and the doctors there decided to do a coronary angioplasty to ease the heart artery blockage.

Imagined symptoms

For some, the COVID-related fear and anxiety may make them imagine all sorts of symptoms from shortness of breath or easy fatiguability to bum stomach or colicky abdominal pains; yet all tests would turn out to be unremarkable.

Excessive fear and anxiety increases the stress hormone cortisol, which shifts the body’s mode of action from growth and regeneration to a fight-or-flight mode. This weakens the body’s immune system and can make us more vulnerable to diseases.

In a way, it’s also true what they say that stress can make us dumber because the brain gets relatively less blood supply, which is shunted to the muscles due to the fight-or-flight response. Hence, we may have a relatively impaired brain functioning, judgment and decision-making.

Decision makers, like our government officials, must really be good at stress-management. The public welfare hangs in the balance with some decisions they make. We don’t want them making crucial decisions when their cortisol levels are shooting through the roof.

It’s understandable to be really under stress during this time. Public health measures, such as quarantine and social distancing, can make people feel lonely and isolated. That can increase stress and anxiety more via a snowballing effect.

Necessary for survival

Stress is not inherently bad though. Some degree of stress is healthy, as it is a coping or compensatory mechanism. The fight-or-flight response is also needed for survival, such as when we’re confronted with a life-threatening situation like being attacked by the proverbial saber-toothed tiger. But this should not be persistent.

When it remains for prolonged periods of time, so there’s practically no more stress-free interval, then physical, emotional and mental turmoil can occur in our body and mind.

If you have any of the following symptoms, your stress level may already be on the unhealthy side:

Do you constantly worry about COVID-19 for yourself and your loved ones?

Do you have this lingering fear or belief that it’s just a matter of time before you or your loved ones will get the infection?

Is there any change in your eating pattern or bowel movement?

Are you having appetite problems, either overeating or anorexia?

Do you have difficulty in concentrating in your work or study?

Do you have sleeping problems?

Do you wake up in the middle of the night feeling agitated or restless?

Do you lose your temper more easily?

Do you feel unusual symptoms of being unwell you didn’t feel before?

Do you have a feeling of hopelessness about the current pandemic and can’t seem to see the light at the end of the tunnel?

If you answered yes to any three of the questions, then it may be necessary to take a pause and seriously address your stress problem.

Our stress may have occupied a good part of our conscious and subconscious minds, so we have to start addressing it there. A healthy positive mind-set is the starting point of any stress-management regimen. INQ

(To be continued)