Stress Away Another Day

Article contributed by:

Raffles Medical Group

Stress is a common thing in life.  Work stress, family stress, exam stress, the list goes on.  No age group is spared.  Nobody can escape from it. Although not all stress is bad for us, chronic stress in particular can wreak havoc on your body.
 
Recent studies have established possible links between stress and many conditions, including depression, obessive - compulsive disorders, skin problems, hair loss, obesity, tooth and gum disease and stomach ulcers.  It can also aggravate certain conditions.  Our experts share their view on two commonly seen stress-related conditions - Depression and Acne.
 

1. Depression

To a certain extent, stress is beneficial.  It keeps us on our feet, motivated and primed to respond to danger.  Anyone who has faced a work deadline or competed in sports knows that stress mobilises the body to respond, thus improving performance.
 
However too much stress, or chronic stress may lead to major depression in certain people.  Specialist in Clinical Psychology, Mr Danny Ng said, “Everyone reacts to stress differently, some even find positive events such as getting married or the beginning of a new job stressful and that may trigger an episode of depression.”
 
There are two types of stress, namely chronic and acute, explained Mr Ng. Chronic stress is derived from activities such as taking care of a parent with Alzheimer’s, while acute stress is caused by losing a job or death of a loved one.
 
“These stress conditions lead to elevated hormones such as cortisol, the ‘stress hormone’, and reduced serotonin and other neurotransmitters in the brain, including dopamine, and these changes have been linked to depression.”
 
When these chemical systems are working normally, they regulate biological processes like sleep, appetite, energy and sex drive, and permit expression of normal moods and emotions.
 
When the stress response fails to shut off and reset after a difficult situation has passed, it can lead to depression in susceptible people.
 
Mr Ng further explained that the connection between stress and depression is complex and circular.  People who are stressed often neglect healthy lifestyle practices.  They may smoke, drink more than normal, and neglect regular exercise.
 
"Stress, or being stressed out, leads to behaviors and patterns that in turn can lead to a chronic stress burden and increase the risk of major depression."
 
Losing a job is not only a blow to self esteem, but it results in the loss of social contacts that can buffer against depression.  Interestingly, many of the changes in the brain during an episode of depression resemble the effects of severe, prolonged, stress.

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Building Resilience

One can guard against the onset or recurrence depression by adopting lifestyle changes.  Building resilience is particularly important if one is experiencing chronic stress, such as unemployment.
 
Examples of good habits are exercise, which can help produce chemicals to boost one’s mood and stimulate hormones; strong relationships with people; staying away from alcohol as well as a good night’s sleep.
 

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Clinical Depression

If left untreated, stress related depression may develop into a more severe condition, also known as clinical depression.  This is a mental disorder characterised by low mood and accompanied by low self esteem.  People who are affected tend to feel down most of the day, particularly in the morning.
 
It is a disabling condition that affects a person’s family, work or school life, sleeping and eating habits and general health.

“The diagnosis of a major depressive disorder is based on the patient’s self reported experiences, behaviour reported by relatives and friends and a mental status exam.  Some of the symptoms include insomnia, fatigue, recurring thoughts of death etc.”
 
According to studies, the most common time for depression to occur is between the ages of 20 to 30 years, with a later peak between 30 and 40 years.
 
Contrary to popular belief, Mr Ng mentioned that there are no defined causes to clinical depression.  “However theories have suggested biological and genetic factors, environmental influences, and childhood or developmental events as some of the contributing factors.”

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Types of Clinical Depression

Ranked in terms of severity:

1. Dysthimia – Less severe than major depression, but lasts longer sometimes even for years.  The episodes of low mood and other symptoms do not completely disrupt one’s normal activities.
 
2. Bipolar disorder – This form of severe depression usually involves alternating episodes of extreme elation called mania, or manic depression.
 
3. Major depression – One of the most severe types of depression, it is usually a change in mood that lasts for weeks or months.  The patient will lose interest or pleasure in usual activities, and it interferes with one’s normal functioning and often includes physical symptoms.
 
4. Psychotic depression – A severe condition whereby depression and hallucinations occur at the same time, causing the individual to lose touch with reality.  They are thought to be suffering from an imbalance of dopamine activity in the brain.

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2. Stress Spots on the Face

They may seem small and just bothersome.  However, for those with serious acne problems, these spots can cause much grief and stress, which may further aggravate the problem.  Recent studies have suggested a link between stress and acne.
 
Dr Chris Foo, Specialist in Dermatology, Raffles Skin Centre, shares the scientific reasoning behind this correlation: when the body is stressed, the increase in stress hormones can throw off its equilibrium thus causing acne outbreaks to occur.
 
“Stress is one of the factors that may aggravate acne, and it does so in two ways.  Firstly, it stimulates adrenal glands to produce more hormones and secondly, it slows down the healing process.”
 
“The adrenal glands produce cortisol, which can cause the sebaceous glands to produce more sebum.  As a result, the skin can become oily. Increased sebum production leads to clogging of pores and aggravation of acne as the bad bacteria get trapped.  This in turn can cause acne to occur or worsen,” explained Dr Foo.
 
If you’re experiencing a serious bout of acne, Dr Foo recommends you seek prompt medical treatment and work on reducing the stressors in your life to better manage the problem before it scars.
 
If you are experiencing high stress and it’s starting to show up on your face, literally as acne, it is important to try to find ways to control the stress in your life.  While you might not be able to quit your job or control the negative attitudes of the people around you, it is possible to control the reaction to these situations.
 
To begin with, you can incorporate exercise into your daily life.   A simple jog and a stretching routine or even light housework for 20 to 30 minutes will suffice.  Exercise produces endorphins, which are nature’s way of perking your mind and spirits.
 

The other essential thing is to keep the face clean.  Be sure to wash your face daily with a high quality acne cleanser that is gentle enough to not damage the skin.
 
Dr Foo highlighted that sleep is also essential in keeping acne at bay. “Getting sufficient ‘beauty sleep’ is important for both physical and mental wellness.”  A well-rested body is able to handle stressful situations in a more relaxed fashion.

To prevent stress from wreaking havoc on your face, find an outlet for stress. Some might find it useful to read or write, others prefer to watch romantic comedies.  With medical help, and a more relaxed lifestyle, you may be able to bid your acne woes adieu.
 

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Article contributed by:
Raffles Medical Group

Dated: December 2011

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