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APBAM 2020 : Tobacco Harm Reduction – Myths & Reality

APBAM 2020 : Tobacco Harm Reduction – Myths & Reality

According to the World Health Organisation, tobacco kills more than 8 million people worldwide each year, and is one of the biggest public health threats the world has ever faced. But contrary to popular belief that smokers are “uneducated regarding it’s harmful effects”, or are simply “not bothered to make an effort to quit”, studies have shown that 70% to 80% of smokers do hope to quit smoking. The only thing holding them back is that they can’t

Nicotine is widely known to be a highly addictive substance. It is the chemical in tobacco that makes it hard to quit and nicotine withdrawal symptoms that smokers experience can be extremely unpleasant physically and mentally. Apart from the intense craving for nicotine, withdrawal symptoms may also include sweating, increased irritability, difficulty in concentrating, as well as difficulty in sleeping. However, nicotine dependence is causing the compulsion to smoke, it is other chemical substances that cause physical damage to the body. Chemicals such as tar can paralyse the hair-like structures in the lungs (also known as the cilia), contributing to diseases such as chronic bronchitis. Moreover, smokers are also vulnerable to the development of lung cancer. Cigarette smoke contains a cancer-causing substance, benzopyrene, which can attack and damage the p53 gene. When the tumour-suppressor gene is damaged, cancer cells have a higher chance of proliferating due to uncontrolled cell division, hence increasing the risk of tumour growth. 

Ideally, quitting smoking and nicotine completely would be the best, but it’s proven to be tough for addicted cigarette smokers to stop all at once. As such, a harm reduction strategy would be switching to a less harmful nicotine alternative for smokers, and ideally would result in them ultimately quitting nicotine use altogether. This is all about lowering the health risks to individuals and wider society associated with tobacco smoking. Some of the more commonly known alternatives include electronic cigarettes and heated tobacco products (also known as heat-not-burn or HnB). Although these may not be accessible in Singapore, other countries have legalised these smoke-free nicotine products that generally deliver far lower levels of toxic compounds. 

E-cigarettes are battery-operated electronic devices that mimic the act of regular smoking by heating a liquid to generate an aerosol, which is inhaled by users through the mouthpiece and exhaled as a visible vapour. Often, the usage of e-cigarettes is also known as “vaping”. Not to be confused with e-cigarettes, HnBs work in a different manner. In some way, HnBs are a hybrid of traditional cigarettes and e-cigarettes.  In HnBs, the tobacco is heated to 350℃, compared to traditional cigarettes that combust and burn at a temperature of up to 900℃. On the other hand, e-cigarettes heat nicotine-containing liquid to approximately 250℃, causing it to be vapourised and then inhaled.

Although not risk-free, what makes e-cigarettes and HnBs a better option compared to conventional, combustible cigarettes? Cigarette smoke is pretty much the main cause of harm, with thousands of toxins released in high concentrations upon the combustion of tobacco. Unlike traditional cigarettes, its alternatives are smoke-free – this means that smoke-induced health effects are significantly reduced. When smokers make the switch to using e-cigarettes or HnBs, these devices also have the added advantage of replicating the ever so familiar hand-to-mouth ritual of smoking. However, it is crucial to note that both e-cigarettes and HnBs still contain nicotine, so while smoke-induced health effects are reduced, the effects of nicotine consumption is still prevalent, for as long as these products are used. 

It must be acknowledged that many health professionals, tobacco-use control professionals and policy-makers who recommend the harm reduction alternatives have very good intentions. They advocate reduction in conventional cigarette smoking as a pragmatic way of reducing the devastating health effects associated with nicotine dependency. However, good intentions must always be supported by strong evidence. 

This year, the Asia Pacific Behavioural and Addiction Medicine Conference (APBAM 2020) will be a socially distanced online conference. Focusing on “Tobacco Harm Reduction – Myths and Reality” for it’s first forum, the speakers will examine the use of new ways to overcome nicotine dependence, as well as the various policies that different countries have taken in their approaches and their effects on reducing the harms caused by cigarette smoking. Speakers will include Prof Alex Wodak (AUS), Dr. Jeremy Lim (SG), Dr. Takao Ohki (JP), Dr. Rusdi bin Abd Rashid (MY), Dr. Ben Cheung (HK), Dr. Munidasa Winslow (SG), Andrew da Roza (SG) & Dr Sivakumar Thurairajasingam. Do join us on 26th September 2020, we hope to see you there!


References:

https://www.who.int/news-room/fact-sheets/detail/tobacco (Accessed 06/09/2020)

https://www.cdc.gov/tobacco/basic_information/e-cigarettes/about-e-cigarettes.html (Accessed 07/09/2020)

https://www.athra.org.au/what-is-tobacco-harm-reduction/ (Accessed 07/09/2020)

Treat Smokers with Compassion – Why Quit Smoking is so tough

Treat Smokers with Compassion – Why Quit Smoking is so tough

Written by: Andrew da Roza, Addictions Therapist

To non-smokers and those who have an occasional cigarette at a party or outside a bar, it is baffling why smokers just can’t simply quit. What’s the big deal?

If you think this, then the conclusion may be: “well they just don’t want to quit”; or “they are uneducated, and don’t know how much damage they’re doing to themselves and those around them”; “they have no conscience” or “they have no self-control”. 

The problem with these conclusions is that the scientific evidence doesn’t support them. 

70% to 80% of smokers want to quit – and many of them desperately want to quit – and most smokers fail.  

A majority have tried to quit multiple times – and about 40% are still drawn to smoking -even after losing fingers and toes to gangrene, or lungs to cancer and COPD, as a result of smoking. Many suffer heart attacks, mouth, throat and colon cancer, or labour under serious diabetes problems; some even lose their close relationships with their families. 

They wish that if only they could quit, their lives would be so much better – yet they continue to smoke. 

So, there is more to the compulsion to smoking than meets the eye. 

Perhaps kindness and compassion for smokers may be a more rational reaction – than dismissal, frustration, irritation, anger or contempt?    

There are very good reasons why the chemicals in cigarette smoke are so compelling – and it’s to do with our brains and our bodies. It’s not a mystery.  

Although nicotine in the smoke is a comparatively benign substance, and it doesn’t cause the damaging effects of the other harmful substances in the smoke – it is highly addictive. It is the nicotine that causes the addiction – but it is the tar and other substances that cause the damage. 

In addition to nicotine, there is another substance, in smoke, that creates a potentially “pleasant” psychoactive effect.  It is a monoamine oxidase inhibitor – which results in chemicals in the brain staying longer in the space between neurons and firing those neurons.

And the effect the smoker feels? Well, there can be numerous combinations of “positive” effects. 

Those smokers who feel down, moody and unmotivated, may feel a pleasant “lift” or “boost”. Anxious, fearful and nervous smokers, may feel calmer, and more able to think straight. Smokers who are tired, sleepy or lethargic, may be able to focus, concentrate and pull themselves out of their procrastination.  

Smoking helps some people become more energetic, have better reactions times and become more effective or efficient. Smoking enables people who are mentally tired with work or constant rumination, to feel like they are taking a break and “relaxing” from their thoughts. They can just let their minds gently wonder. They may even feel that after their “reverie” with a cigarette, they have managed to solve a problem that they have been grappling with.

Some people use smoking as a bonding experience. Ironically, all the community stigma that surrounds smokers makes some feel like a “band of brothers and sisters”, as they stand outside in smoking areas or in smoking rooms. It enables instant connection and the sense of “belonging”.

In short, the effects of smoking depend on how you are feeling in the moment. 

Insidiously, mental illness and other addictions result in many becoming vulnerable to smoking – either to cope with: their illness; the difficult side effects of their medication; and the social stigma against mental illness addiction that so oppresses and shames them. 

By way of examples, ADHD, schizophrenia, bipolar disorder, anxiety and major depressive disorders, and personality disorders, can all result in life-long suffering – that smoking may appear to “take the edge off”.  

There is now persuasive research that some people are more genetically susceptible to being addicted to cigarette smoke. They may get more of a “buzz” from it, they may be more tolerant to its side effects, the effects may wear off faster, and they may feel the withdrawal effects (when not smoking) more keenly. They may have more trouble starting to quit – and staying quit. 

There are many other vulnerability factors as well: adverse childhood events (which afflicts 2 out of every 3 Singaporeans); traumas; family and peer modelling; rebelliousness, isolation and loneliness, financial distress, problems in relationships and at work; and many more factors, may all conspire to lead smokers to smoke daily. 

Once they smoke enough cigarettes for long enough – the brain changes, it becomes “hijacked” by the smoke.  

Smokers experience brain changes as: 

  • Tolerance – the need for more smoking, more often, to get the same effect;
  • Withdrawals – 45 minutes to two hours after smoking, they may feel the exact opposite of what they felt when they smoked – and therefore need a cigarette to feel “normal”;
  • Impulsiveness – in the moment (of smoking), they forget about the harms of tobacco and their resolves to quit, and habitually light up;
  • Smoking triggers – smoking cues are everywhere – and they trigger the urges and cravings – and once these build up, they become overwhelming;
  • Stress – their stress response slowly but inexorably ratchets upwards, daily – so that even things that used to be experienced as minor, now elicit strong and intolerable emotions. If health, relationships, jobs and self-image are all on the line because of smoking – the stress can be intense. 

Luckily – there is a solution. Smokers now have access to psychotherapy, nicotine replacement therapy, quit smoking medication, and any number of other tools to help them on their quit journey. In other countries, new nicotine delivery technologies like e-cigarettes and heat-not-burn are being improved and refined – and they are much safer than smoking. 

Smokers deserve our respect and compassion in their struggle with cigarettes. And they don’t have to do it alone. So that the help-seeking and quit smoking load can be lightened. 

You can also hear more from Andrew at the 7th Asia-Pacific Behavioural & Addictions Conference (APBAM2020: Forum 1 – “Tobacco Harm Reduction: Myths & Realities).

 


 

Burnout and How to Heal from It

Burnout and How to Heal from It

It is an undeniable reality that life, in general, is busy. With long work hours and bills to pay, there are so many things going on that we must and are expected to do. With the increase in pressures and demands in daily life, it is very common for people to feel exhausted and burnt out.

Burnout is a state of exhaustion caused by chronic stress. According to the World Health Organisation, it is classified as “chronic workplace stress that has not been successfully managed”. It is characterised by 3 dimensions: Feeling exhausted or devoid of energy, being mentally detached from your job and being less efficient in work. Employee burnout in Singapore is among the highest worldwide, where work is a vital cause of high-stress levels, and where almost one in eight employees cannot cope with their stress. There are many potential causes of chronic stress in the workplace, such as having too many responsibilities, having a negative view of yourself and the world, or a perceived lack of control over your life and work. All of these factors could cause one to burn out easily.

Let us recognise the signs that indicate a burnout. Physical signs include exhaustion, change in sleep habits or diets, frequent illness and headaches; Emotional signs include lack of motivation or enjoyment towards life events and feeling negative emotions such as anger, anxiety or depression; Behavioural signs include adverse coping mechanisms such as overconsumption of alcohol, withdrawal from responsibilities, taking out your frustration on others and reduced work performance. If you are currently experiencing these symptoms, then it is very possible that you may be burning out from work.

Now, you may ask, if busyness in work is inevitable, then how do we overcome this seemingly unmanageable stress? Below are 4 tips that could help you manage stress and prevent burnout:

  1. Turn to other people

It is extremely beneficial to have a social circle or support network, such that there are people that you can rely on for support, encouragement and a listening ear. Friends or family members can recognise maladaptive patterns in your behaviour, identify your burnout signs, and offer you constructive feedback or advice. Through doing that, you can work towards overcoming burnouts. Likewise, if your loved one is going through a burnout, engage her in a conversation and let her open up about what she is going through, while staying patient and understanding. Confiding in and spending time with loved ones would serve to reduce stress and strengthen your relationship with them as well.

If it is possible, try befriending your colleagues. With a similar job scope, your colleagues can better understand your stress at work and everyone can draw support and motivation from one another. Additionally, good relationships with your colleagues enable you to work faster and better while reducing your work’s monotony. Thus, a more positive work environment keeps you energised and productive, countering the effects of burnout.

 

  1. Live a healthy lifestyle

Healthy lifestyle habits such as sleeping, exercising and healthy eating can have a huge impact on your mood and energy, helping to reduce stress and prevent burnouts. Exhaustion or a lack of rest often worsens burnout through causing you to think irrationally, and can take a toll on your energy and emotional balance. Thus, getting a good night’s sleep energises you and improves your mental state, ultimately improving your productivity at work.

What you consume can greatly impact neural circuits in your body that control emotion, mood and motivation. As such, eat food that can elevate your energy and mood such as fruits, vegetables and food that is rich in whole grains; and reduce consumption of food with lots of caffeine, sugar, chemical preservatives and hormones.

Exercising also enables stress relief. While engaging in exercise, you can focus on your body rather than your thoughts, and how your body feels as you move (feeling the sensation of the wind against your cheek can be strangely calming!). However short or simple, any form of rhythmic exercise is beneficial as it can increase your energy while simultaneously relaxing your mind and body. Ultimately, a healthy lifestyle does wonders to your wellbeing.

 

  1. Find ways to relax and unplug from work

We often burnout due to lack of time for ourselves. Thus, give yourself a chance to slow down, rest and heal. Set time aside for activities that are not work-related and do activities that make you happy and relaxed. This includes your personal hobbies, interests or a passion project such as photography, baking or exercising. Doing these activities can make you feel rejuvenated and accomplished, and helps you rediscover joy and meaning in your life outside of work.

Additionally, reserve some time to disconnect from technology. In today’s day and age, smartphones cause us to “carry an office in our pocket”, and make us psychologically connected to our work all the time. Hence, it is a good idea to limit your phone time after work, to prevent yourself from checking your emails or calling your office; such that you can spend quality time with yourself and your loved ones. Through these regular breaks, you are given an opportunity to restock your mental energy and engage in self-care, which can increase your happiness and quality of life.

 

  1. Re-evaluate priorities and set boundaries

Lastly, reflect on the cause of your burn out and consider what makes you feel stressed and anxious. Ask yourself, Is my work making me stressed? Exactly what aspects of work are making me stressed? Do I spend enough time for myself? Through this self-reflection, you can find ways to reduce this burnout. A good solution is to set boundaries for yourself and re-evaluate priorities, such as knowing how much time to allocate to work and relaxation (possibly placing more importance on rest and less importance on work) and learning how to say “no” to tasks. Do not stretch yourself beyond what you can handle or commit to. If you struggle with this, remind yourself that saying “no” enables you to say “yes” to tasks that you find more fulfilling. Through re-prioritising your commitments and tasks, you are able to find balance in your life and focus on parts of life that bring you joy, meaning and satisfaction (even beyond your job).

If possible, you can also identify or consider which aspects of your job you enjoy and find the most fulfilling. After doing so, you could ask your supervisor if you can focus on these tasks as they are more aligned with your responsibilities and strengths. Doing this helps you find value and regain a sense of control in your work, giving you a positive outlook and attitude towards your tasks.

 

Healing from a burnout definitely is not easy, and takes lots of time and commitment to overcome, but it is possible. Take the effort and steps necessary to manage your time and reduce stress, and keep to it. It may be difficult to adjust and keep to these new changes, but ultimately, it will prove effective in preventing burnouts and will improve your physical, emotional and mental well-being.


References:

https://www.helpguide.org/articles/stress/burnout-prevention-and-recovery.htm

https://hbr.org/2015/04/how-to-overcome-burnout-and-stay-motivated

https://www.who.int/mental_health/evidence/burn-out/en/

https://www.pacificprime.sg/blog/employee-burnout-in-singapore/

https://www.fairview.org/patient-education/85169

https://www.helpguide.org/articles/sleep/getting-better-sleep.htm

https://www.inc.com/john-rampton/8-ways-to-get-over-job-burnout-without-leaving.html

Building Trust in Relationships

Building Trust in Relationships

Scientists believe we are essentially wired to connect with other people, to socialise and build relationships with others. Indeed, we are all a profoundly social species as our drive to connect with others is embedded in our biology and evolutionary history. But what makes a healthy and meaningful relationship? A healthy, functional relationship usually involves a few characteristics, and trust is undeniably a key one. A relationship can’t last without trust for a number of reasons. We won’t dispute the cliché, “Breaking someone’s trust is like crumpling up a perfect piece of paper. You can smooth it over but it’s never going to be the same again”. 

 

Building trust in relationships doesn’t occur overnight, it happens over time. Trust can be defined as having confidence, faith or hope in someone or something. But in another sense, trust can also mean believing that the other party will act in our best interest. With that said, let’s take a closer look at how we can learn to build mutual trust between ourselves and others in our personal and even work life.  

 

  1. “Say What You Mean And Mean What You Say”

Trust is fundamentally built on integrity, transparency and truthfulness. We trust those that stay true to their words and follow through with their actions. Perhaps it is also our instincts for self-protection, honed evolutionarily over centuries, kicking in. We pick up easily on red-flags and are particularly attentive to the proverbial boy crying wolf. Afterwhich, we learn to adjust our expectations and behaviour, doubting others and trusting them less in order to avoid getting hurt or being let down. Even the smallest of lies, when told frequently over time, will erode the level of trust between individuals. Actions speak louder than words – don’t allow yourself to give empty promises. Learn to keep to your promises and refrain from making commitments you are unable to honour. Be clear of what you have on your plate. In fact, if you are unable to commit to a request or a favour, have the courage to turn others down and explain your situation. Everyone would be worse off if you had promised something but was unable to follow through with it. In addition, avoid saying things that don’t actually represent your feelings. Hiding behind a facade may give others the feeling that you are being manipulative, and that you have an ulterior motive. This will make you appear unreliable and untrustworthy.

 

  1. Consistency

Demonstrating consistent behaviour is key to maintaining a trust-based relationship with anyone, whether friends or colleagues. This means constant communications, being clear with your expectations, and being there for others during both good and bad times. How would you feel if a friend of yours is always there when things are going smoothly, but is the first to go off the radar whenever things get rough? Or if she bad-mouths you or reneges on her promises? It goes without saying that we will start trusting these people less over time, having known that they are not likely to support us when we need them most. Regularly showing your loved ones that you are there for them whenever they need support and care will go a long way in building and maintaining a healthier and stronger relationship.

 

  1. Show Respect

Respect is key in any relationship, and it builds trust by illustrating to others that you value them. If it helps, think of respect as the common denominator in any relationship. People come from different backgrounds and are brought up to believe in different viewpoints.  Disagreement or arguments often happen not because we have different opinions, but often because of the way we put our views forward. Often, our trust in and relationship with others are broken because we are being treated with condescension or contempt instead of the respect we all deserve. Likewise, we should always extend basic courtesy to the people around us and respect their right to an opinion.  

 

  1. Watch Your Body language

Did you know that over 50% of communication is non-verbal? Our body language is a form of non-verbal communication. Simple nonverbals that project openness and warmth can include a genuine smile, eye contact, an open body posture and coming down to their level. Moreover, this also ties in with the previous topic of respect. When talking to others, be present in the moment. Sometimes, we focus only on the words we use but neglect what our nonverbals are projecting. All too often, we try to multitask – and sometimes this means that we use our phones while sitting in front of someone else who’s talking. While we are used to multitasking in such a fast-paced era, simple gestures such as taking some time away from our phones and providing our full attention to others when necessary can help us to build mutual trust and respect.

 

  1. Work on Your Emotional Intelligence

Emotional intelligence can play a huge part in building trust, since it can give you greater insight into how others may be feeling about certain situations. This allows you to be better able to show authentic empathy and give them the support they need. Honing your emotional intelligence will take time, but it can be as easy as making an effort to examine how your words and actions will affect others before executing them. When people feel that you genuinely care for and recognise their feelings and needs, they will find themselves trusting you more. Of course, it is best that you follow through on ways to support them apart from active listening in order to strengthen the trust. 

 

As mentioned, trusting relationships aren’t formed overnight. However, trust is integral to any healthy relationship. Without it, the relationship will end up being shaky and deprive you of emotional security. If you ever feel that a relationship between you and a loved one isn’t working out, and that it is barely kept afloat, it might be a good idea to seek the appropriate help and counselling. 

 


References:

https://www.forbes.com/sites/bernhardschroeder/2019/12/23/to-build-a-great-company-you-need-trust-10-ways-to-build-trust-between-employees-or-cofounders/#2038713767c4 (Accessed 26/06/2020)

Photo by Priscilla Du Preez on Unsplash

Overwhelmed At Work?: Demystifying Executive Functioning Deficits

Overwhelmed At Work?: Demystifying Executive Functioning Deficits

Written by Dr B. Malavika, Psychological & Educational Therapist

Have you met <please insert a suitable name> recently? He/She’s the bright, young, dynamic person at our office… I always thought of him/her as the person who’s the life of the party, and he/she genuinely seems to care for his/her colleagues… Aah, yes, the same person who unfortunately missed out a promotion this year… I heard his/her boss say that he/she definitely had the potential,  but it wasn’t showing up in his/her work. He/She would initiate tasks with enthusiasm but would lose interest quickly; turned up late for meetings, or even forgot about them, and frequently misplaced important files as his/her table was often cluttered.

Does this seem familiar? Do you recognise similar signs in yourself or someone else you know? These issues might be due to something known as Executive functioning deficits or disorder (EFD). Though symptoms start in early childhood,  the challenges might have been seen as the individual’s behaviour problems and not as a syndrome. Even as adults, many of those with EFD aren’t aware they have it — they just know that even everyday tasks can be challenging. 

 

What is EFD?

Executive functions are the set of higher-order mental skills that allow us to analyse, plan, organise,  make suitable decisions, manage time, focus attention and execute the plan. No matter how smart or talented one is, not much will get done well without these key capabilities. The human brain comprises of two systems: the automatic and the executive.  While the automatic system guides 80 to 90% of our activities every single day, the executive system guides the remaining 10 to 20% and requires purposeful, regulatory effort.1

 

What causes EFD? 

 Experts don’t know exactly what causes this and a 2008 study found that differences in these skills are “almost entirely genetic in origin due to differences in brain chemicals” 2

People who have executive functioning deficits might have problems with many of these functions:

  • starting, organizing, planning, or completing tasks on deadline.
  • multitasking
  • listening  or paying attention
  • remembering tasks or details
  • problem-solving
  • time management
  • decision making
  • controlling emotions or impulses
  • prioritizing

But it is important to note that EFD is not associated with low IQ.

Almost everyone has some symptoms similar to EFD at some point in their lives but It isn’t EFD if the difficulties being faced are recent or occurred only occasionally or intermittently in the past. If you’re curious to know if you do have EFD, you could take the test given below. 

https://www.additudemag.com/executive-function-deficit-adhd-symptoms-test-for-adults/

Even if you’re not sure if EFD is indeed the cause of the problems experienced, or, if you do not want to give it a label, you could still use the tips/ strategies given below to enhance your general skills and productivity at work. 

One surprising way found to improve executive function in adults is aerobic exercise. Many research journals have published that regular aerobic exercise in older adults can boost the executive functions that typically deteriorate with age, including the ability to pay focused attention, to switch among tasks, and to hold multiple items in working memory.3

If you think that the feeling of the constant deluge at the office is largely the result of so many things clamouring for attention at once, a tool like Stephen Covey’s Quadrants can be used. Each quadrant (Q) has a different property and is designed to help prioritize tasks and responsibilities. These  are: 

  • Q 1 – Urgent and important
  • Q 2 –  Not urgent but important
  • Q 3 – Urgent but not important
  • Q 4 – Not urgent and not important

Another useful technique is the Pomodoro technique of time management developed by Francesco Cirillo in the late 1980s. It uses a timer to break down work into 25-minute intervals, separated by 5-minute breaks. This method not only helps you remove distractions and enhance focus on your task, but it also factors in time to take a short breather.  

Those who are tech-savvy can find these as smartphone apps. Other technology tools that can help are File-sharing software like Dropbox to keep notes handy,  digital sticky notes or reminders, and password manager software to keep track of passwords. Those who are not  comfortable with technology can compensate for working memory deficits by making information external — using cards, signs, symbols, sticky notes, lists, journals, clocks and timers.4

Other simple  workable strategies are: 

  •  Break large tasks into smaller individual tasks and put them into a linear order or flow chart. This helps provide clarity and allows you to monitor your progress
  • Keep a routine
  • Know yourself and get your best work done according to your own biorhythms
  • Give it a positive twist – make the activity a ‘want to do’ instead of ‘should do’.

Games can help to improve executive function skills. Games like Checkers, Monopoly, and Clue use planning, sustained attention, response inhibition, working memory and metacognition. Games like Zelda and SimCity help with problem-solving and goal-directed persistence. Managing  fantasy sports teams also use executive skills like task initiation and time management while having fun.4

Positive emotions reduce the impact of stressful events on the self and help build resilience. They make us more flexible, allowing us to be more open to options of problem-solving. Studies show that people feel and do their best when they have at least three times as many positive emotions as negative emotions.5 It is, therefore, most important that you periodically reward yourself when you have met the goals you have set.  Equally important is positive self-talk which is a powerful tool for increasing your self-confidence and strengthening your resolve to make these healthy new habits a part of your personal and working life. 

 

 When to seek help?

Diagnosis of EFD can be difficult because certain symptoms are similar to those caused by other conditions, such as ADHD, LD, depression, anxiety, mood disorders or OCD. If any of the symptoms listed above continually disrupt your life, talk to a mental health professional. There is a variety of strategies recommended by experts to help strengthen the areas of weakness that EFD creates. Treatment options could be medications and therapy such as occupational or speech therapy, Cognitive behavioural therapy (CBT).

 


References:

1 https://www.additudemag.com/working-memory-powers-executive-function/

2 https://www.understood.org/en/learning-thinking-differences/child-learning-disabilities/executive-functioning-issues/executive-functioning-issues-possible-causes

3https://www.pbs.org/wgbh/nova/article/the-science-of-smart-surprising-way-to-improve-executive-function/

4https://www.additudemag.com/executive-function-treatment/?src=embed_link

5 https://kidshealth.org/en/teens/power-positive.html

https://www.medicalnewstoday.com/articles/325402#summary

https://www.additudemag.com/executive-function-disorder-adhd-explained/?src=test

Photo by You X Ventures on Unsplash

 

 

 

 

Chronic Stress Management: Why Am I Feeling Exhausted All The Time?

Chronic Stress Management: Why Am I Feeling Exhausted All The Time?

Are you feeling tired most of the time despite having a good night’s sleep? Are you constantly feeling low energy and unproductive? These are just a few of the typical symptoms pointing towards unhealthy levels of stress. Constantly feeling worn out could be an alarm that your body is sounding – a message that it is overwhelmed and unable to keep up. Undeniably, we often put ourselves in a constant heightened state of alertness, especially in such a fast-paced society. Our sources of stress may differ, from high-pressure jobs to challenging and taxing relationships. Stress affects everybody – even if you may not be physically attending to any particular concern, allowing it to occupy your mind frequently and fretting over it can contribute to chronic stress. Without proper management and control, chronic stress puts pressure on the body and will ultimately wreak havoc on your physical and mental health.  

 

As a natural biological response to demanding circumstances or situations, our body releases hormones such as cortisol, a stress hormone. Alongside adrenaline, cortisol helps to fuel your body’s ‘fight-or-flight’ instinct whenever a crisis surfaces. A stressor may be a long term one, such as the routine stress related to the pressures of school, work, family, and other daily responsibilities, or short-term occurrence brought about by a sudden change, such as losing a job, illness, or facing dangerous situations. In an ideal situation, when an individual faces a trigger, the adrenal glands in the body secrete cortisol and a complex hormonal cascade ensues, preparing the body for the ‘fight-or-flight’ response. Following that, cortisol inhibits the production of insulin in order to increase the uptake and usage of glucose so that more energy is made available to the surrounding muscles. Arteries will also be narrowed, increasing the heart rate and forcing blood to be pumped harder and faster around the body to help you confront the immediate threat. Once the individual resolves and addresses the situation, negative feedback kicks in and hormonal levels will then fall back to the norm. 

 

With this said, when we are constantly under high levels of stress, our alarm system doesn’t turn off. This means that our body is continually in high-gear and cortisol levels will remain high, to the point where it becomes harmful. Small doses of cortisol are safe, and in fact, is important for your health as it also serves to regulate your metabolism and blood sugar level amidst other key functions. However, in the case of chronic stress, constantly high levels of cortisol take a toll on your body’s resources, leaving you exhausted. Over time, continued strain on your body from stress may contribute to serious health problems. Hence, there is a need for us to tackle the root of the problem and ensure that we manage our stress levels to reduce the risk of negative health effects.

 

You might have been advised to change your lifestyle for the better at least once in your life by a family member or a friend – and we cannot stress this enough. It is essential that you learn to live a healthier lifestyle, which includes stress reduction and learning to manage your hectic schedule. If you continue to live an overly-demanding way of life, it is highly likely that you may succumb to chronic stress or worse, other mental health issues such as anxiety or depression. Moreover, can you imagine how hard your adrenal glands will have to work in order to continue producing sufficient stress hormones? Needless to say, the high cortisol levels will also impact your physical health and lead to other conditions such as digestive problems, high blood pressure or sleep issues. This results in a vicious cycle – with less sleep, the more exhausted you feel. 

 

Working on stress reduction can be as easy as doing deep abdominal breathing exercises, and incorporating meditation. Schedule regular times for these and other healthy and relaxing activities. They are simple, cost-effective, and are readily available. In this highly technological age, there are many applications available on your devices to further assist you in such activities as well. On the contrary, if you feel that you aren’t quite the kind to sit down and meditate, you can also opt to do some physical exercise to help boost your mood and improve your health. Organising activities with your friends such as playing a game of badminton or volleyball can help you to keep your mind off things, and at the same time, seek the social support you need when necessary. Of course, exercising alone is perfectly fine too, the main point is that exercising produces endorphins – chemicals in the brain that help alleviate stress by acting as natural painkillers.

 

Watching what you ingest is also equally important. For example, for heavy coffee drinkers, try to cut down on caffeine. Although the threshold for caffeine might differ for every individual if you notice that your excessive caffeine intake is making you jittery or on the edge, consider cutting down on it. Instead, you may want to replace it with other beverages that have a calming effect, such as chamomile, lavender or peppermint tea. Drinking a cup of warm milk before bed can help you get a better night’s sleep too. In addition, you might want to consider eating foods such as avocados, which are known to offer omega-3 fatty acids that can help reduce stress and anxiety. However, we should always remember that everything should be consumed in moderation. 

 

Last but not least, learn to say no, and only commit to responsibilities that you can cope with! Although not all stressors in your life are within your control, some of them are. It is crucial that we manage what we have on our plates, and not bite off more than we can chew. Try to be mindful of what you have accomplished at the end of the day, not what you have been unable to do. Juggling many responsibilities at once can leave you feeling disheartened and overwhelmed, and this increases your stress levels unnecessarily. 

 

Sometimes, despite numerous efforts at self-help, some individuals may still find it hard to cope with their high levels of stress. If you are overwhelmed by stress, ask for help from mental health professionals, as therapy is also a way to help you navigate through and overcome your stress. 

 


References:

https://www.health.harvard.edu/staying-healthy/understanding-the-stress-response (Accessed 01/07/2020)

Photo by Keenan Constance on Unsplash