By Cosmas Omegoh
These are trying times for every Nigerian. People are going through a rough patch. People are stressed and having a burnout – perhaps without knowing it, says clinical psychologist, Peter Oyebola.
Oyebola, Lead Psychologist at Azalea Services Kado, Abuja in an encounter with Sunday Sun suggested how to cope with stress in these difficult times. Excerpts:
What is stress?
Stress a situation whereby an individual’s ability to cope with a particular situation or challenge – when that capacity to cope with a particular situation does not match up with the situation. Ordinarily, if one is able to cope with a situation, there is no stress there. But when the individual is overwhelmed by that situation, it means they are stressed. Indeed, what constitutes stress for one might not be stress to another. That means a particular individual’s ability to cope with their challenge might be more than that of the other person. That is where resilience comes in. Someone might say they are overwhelmed; you can fault them; that is how it is for them. For other persons, that might not be stressful given the same situation. You could see people selling sachet water on the road and you scream ‘Oh my God, how are these people coping?’ Then you see some people after spending one hour in the traffic complaining they are overwhelmed. Regarding the first group of persons, we talk about resilience; perhaps that is what they have done over time and they are able to cope with it. It doesn’t affect them anymore; whereas some people when they go through half of that, they get overwhelmed. In a nutshell, when an individual’s ability is not able to cope with what a situation presents, that individual is stressed.
So what can contribute to stress?
As I earlier mentioned, lack of resilience can contribute to stress. We also have genetic issues. Trauma too, plays a major role. If one has an underlying trauma, that can be a factor in their inability to cope with a situation. We call them psych-social factors. If for instance, I have not been able to get a good sleep, and I go to do certain things, I might not be able to cope with those things optimally. If I have inter-personal conflict with my wife, I might be irritable. If I’m experiencing gender-based violence, I might be edgy. If I come to work, things that I might be able to do I will not do them optimally. These are stress triggers. One of the things we teach people when they come for therapy is how to be more resilient in the face of challenges. This is because as much as some people might not see things that way, there is a bit of psychology that goes with stress management. So you prepare an individual to make adjustments to be able to cope mentally with a particular situation. That does not mean that the individual will not be disposed to stress but that adjustment is very important. Therefore, all of those psycho-social factors play a role when it comes to how an individual comes down with stress.
Given the prevailing conditions in the country would you say that Nigerians are stressed?
Yes indeed, Nigerians are stressed. The challenges they face are part of the psycho-social factors we are talking about. They account for the social circumstances; the economy is part of the factors that predispose everyone to stress. For instance, I have an income of N100k; with that, I was able to sustain my family but now not anymore. My income can no longer buy me what it used to and has not increased either. Obviously I’m going to be thinking about what I would be doing. That will affect my quality of life. That will affect my sleep. That will also affect my mental state and my happiness. If the children are not happy, that too will affect me. My wife is asking for certain things and I cannot afford them, that too affects me. All that will produce a spiral effect. When I go to work and I’m as productive, invariably that will make me more susceptible to what is called burnout. It is not that I don’t know what to do, but the fact is that I get overwhelmed easily. So the economic situation definitely has an impact and how people come down with stress, and how they are able to cope.
So how often do you see stressed people?
Of course, as a clinical psychologist, a lot of people come to me seeking help. When I do assessment on them I have a fair idea of the rate at which people are getting stressed. Part of what we do is that we ask questions. I try to find out what constitutes stress to them. But when you try to find out the cause-effect relationship, you begin to see things. You step into a position to ask them “ok, if you manage this, you will be able to deal with this situation? That way, you see the direct impact of their challenges on them. These are the people who I see. They are a sample of the population; so they suggest how much Nigerians are stressed. Indeed, people get stressed. But now, you can see that there is hardly anyone that comes around that you don’t see something that constitutes to stress to them.
Is there anything like accumulated stress?
Stress itself is not a diagnosis in mental health. But there is something related to that because stress is more like what we call a predisposing factor. It predisposes someone to having mental conditions. What you call accumulated stress may predispose someone to having what we call Generalised Anxiety Disorder (GAD). It is a kind of anxiety in which someone is worrying over strange things happening at the same time – worries over finances, health, and payment of school fees – a lot of things. So when this kind of person goes to the hospital and doctors test their heart, they find nothing wrong. That is why when the doctors rule out certain possibilities, they ask the patient to see a clinical psychologist. Most of the time what triggers all that is stress, more so when there is a predisposition to that.
How do you identify stress in an individual?
There are two things we use. They are clinical and at the same time psychological tools. The latter is self-reporting; you are the one that will take responsibility; there is a cut off mark that shows this is what it is. So, if during a presentation, things are looking in the direction of stress, we can confirm or rule out something and then ask what that can lead to. Stress can lead to different things: distress, depression, disorders and other myriad of issues. When we have this scenario, we can look at what the stress leads to: mental condition? Then, we will look at that individual functionality: we will ask questions about work, family; we want to look at the individual’s finances, and pattern, how it has changed over time. If we remove this factor, will the issues change? If you have more money, for instance, will the issues improve? Will the stress reduce? Is it the situation at home? Does the individual have a nagging partner? Are there any gender issues? So if you remove that, will the situation improve? We want to look at those patterns. We want to look at all the whole issues to see how they have affected the overall mental state of the individual. It is when we have been able to deal with the overall issues, that we now build a treatment plan around them.
Is stress avoidable; how can individuals cope with it?
People are different, and that we must recognise. Let me also say that not doing anything can be distressing? What constitutes stress to Person A and what constitutes stress to Person B are never the same. For instance, if a policeman tells you that his work is very stressful, does it mean that he cannot do the work? What that individual can do is to improve their resilience. Look at those factors you can address to improve your productivity and leave the ones you cannot address. The one you can address – family issues, finance, deal with them. However, stress is very necessary. In fact, there is positive stress which everyone needs to improve on their productivity. If I have an examination for instance, there is a level of stress I need to help me to prepare well. But when we now get to the point where the level of stress is overbearing, that becomes an issue. If it becomes so overwhelming that the individual is unable to cope, then we can recommend a change of job or holiday for instance.
Does stress kill?
Stress does not actually kill. However, it has what we call bi-directional relationship with the physical conditions of the individual. Stress has a direct relationship with cardiovascular issues – heart condition and all that. You cannot, therefore, say stress killed an individual, but it can set in motion a lot of issues that can shorten an individual’s life. When there is stress, a part of the brain which regulates stress hormone keeps working and working. It makes the person’s heart rate to be high. To that end, hypertension can come out of it. Inflammation can come out of it. Stress can also affect different medical and mental issues. Stress can trigger certain conditions that can eventually kill the individual.
How do you then manage stress?
The first thing we look at are the stress triggers? If you identify the triggers, can we do something about them? We can do something about some of the triggers. Some we cannot do anything about them. We then think about how to cope with the situation. It is based on what has been discovered that we build a treatment plan. You ask, is the issue work-related? Does it have to do with burnout? Can the individual need to go on vacation? Does he need to manage his work schedule better? It is when you have identified what the problem is that you will be able to build a treatment plan around it. When stress has been there for long, it may contribute to other mental health conditions. Those conditions need to be identified and worked upon.