I’m overwhelmed by stress!

Posted on 18 December 2017

Dr Jean-Louis du Plooy, a psychiatrist practising at Mediclinic Panorama, discusses why it’s critical to get your stress under control – and why inpatient treatment is sometimes necessary.

‘Some stress is good and a healthy dose of stress facilitates productivity,’ says Dr Jean-Louis du Plooy, a psychiatrist practising at Mediclinic Panorama. However, sustained and overwhelming stress can have negative consequences. ‘Inpatient treatment can be life-saving, especially when individuals feel all hope is lost and are feeling suicidal. The inpatient setting can facilitate optimising treatment and improve diagnostic efforts.’

‘Stress entails chronic activation of key hormonal axes, such as the HPA (hypothalamic-pituitary-adrenal) axis, with altered adrenergic and cortisol secretion, which can adversely affect your health,’ he adds. ‘These changes not only influence mental (and physical) health in the short term, but can also affect brain functioning for years to come. Your sleep pattern, sexual drive and appetite can also be negatively affected.’

Dr du Plooy explains that chronic stress has also been associated with increased rates and poorer outcomes of heart disease and its risk factors, which include hypertension and diabetes. ‘Excessive stress may also increase the likelihood of having a first depressive episode, or even cause a relapse of a previously treated condition. Other medical conditions, such as eczema, may also be exacerbated by chronic stress,’ he says.

Short-term relief strategies, such as avoiding the signs, self-medicating or drinking too much, may discourage solution-seeking strategies and further potentiate the stress.

‘It is never too early to seek professional help,’ Dr du Plooy urges. ‘Earlier intervention often facilitates improved outcomes. Changes in sleeping patterns, mood changes and chronic symptoms such as headaches and muscle tension may suggest a need to seek professional help. And declining levels of functioning at home, work or college may mean you’re a candidate for inpatient care.

‘No clear guidelines exist specifically for stress and inpatient treatment – each case should be considered individually,’ Dr du Plooy adds. But irrespective of whether you’re admitted in a general hospital or at a psychiatric clinic, you will receive evidence-based care within a multi-disciplinary team. ‘This team usually comprises psychiatrists, nursing staff, occupational therapists and psychologists, with assistance from various other providers,’ says Dr du Plooy.

‘Treatment for stress-related conditions will be individualised and admissions can vary in duration. This is reviewed on a regular basis, with the primary aim to enable patients to better manage stress and improve functioning, to optimise mental health and wellbeing.’

Therapeutic interventions are often both individual- and group-based. Tailored programs focus on a variety of topics, such as coping skills, mindfulness, arts and crafts, psycho-education, sleep hygiene and structured therapies such as CBT and mindfulness.

‘Careful assessment of internal (thoughts) and external (circumstances) triggers is considered in the management plan,’ Dr du Plooy explains. ‘In addition, careful planning of a return to work and facilitating such a return is also essential in long-term management.’

Published in Healthy Life

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