Research shows that up to 70% of patients who visit their primary care provider do so because of mental health problems, including depression, anxiety, stress and burnout.
Stress is defined as a process in which environmental demands strain an organism’s adaptive capacity resulting in psychological demands as well as biological changes that increase the risk for illness.
There is also a complex relationship between stress and illness
The weakening of immune function is thought to be associated with the general strain of various body parts associated with production and maintenance of the immune system. FRO example shrinking of the thymus, (a small gland in the lymphatic system that makes white blood cells called T -cells), results in its inability to produce T cells. This can lead to an inefficiency of the entire immune system. There is also an abundance of corticosteroids produced during chronic stress which provides an imbalance in these levels weakening the immune response.
Effects of stress on the heart
Psychosocial aspects of CHD (coronary heart disease) have been studied extensively and there is strong evidence that psychological stress is a significant risk factor for CHD and CHD mortality.
The INTERHEART study revealed people with myocardial infarction reported higher prevalence of four stress factors:
Doctor as a drug
rapport: noun
(a close and harmonious relationship in which the people concerned understand each other’s feelings or ideas and communicate well.)
GPs reported that patients will often present with physical concerns which are less stigmatized, and only disclose their emotional agenda after they have built up rapport and trust in their GP. GP’s may be the only healthcare professional that patients have a long-term relationship with. The stigma associated with emotional concerns means that interpersonal rapport is important. This rapport not only supports the consultation but is also intrinsically therapeutic.
Not all stress has a negative effect. Stress is positive when it is stress that may arise from doing something demanding but enjoyable according to the American Psychological Association. This action enhancing stress gives the athlete the competitive edge and the public speaker the enthusiasm to project optimally.
Stress can make you more resilient. Learning to deal with stressful situations can make future ones easier to manage.
Post -Traumatic Growth
Humans are programmed to be resilient- to grow and learn from difficult things. A study published in 2018 in the Journal of Personality and Social Psychology found that you may even have better psychological health if you accept your negative mental experiences rather than judge them. In Jordan B Petersen’s book 12 rules for life an antidote for chaos, Jordan a famous Psychologist, offers 12 rules, one of which I will share: Do not bother children when they are skateboarding.
Kids need playgrounds dangerous enough to remain challenging. People in this regard are like children. They drive and walk and play to achieve what they desire. It is in their pushing themselves a little bit at the same time so that they can continue to develop. Jordan’s opinion of people is that when untrammeled they continue to live on the edge. There, they can still be both confident in their experience and continue to confront the chaos that helps them to develop. Overprotected, we will fail when something dangerous and unexpected suddenly makes its appearance as something will, inevitably. Learning to deal with stressful situations can make future ones easier to manage.
As Jonny Steinberg mentions of Mandela in his book:” Winnie and Nelson Portrait of a marriage: “So many people who met Mandela in those early years reported a feeling of transcendence. They sensed the presence of an elevated being, of one who had suffered and forgiven.”
GPs of ten first point of call
With 40% of primary care consultations having a psychosocial component, GPs are the most frequently used providers of mental health in the UK. Guidelines, as it turns out, are not always useful. Guidelines prioritize the use of screening questions and a stepped care approach. In various studies, how GPs understand and manage their patients’ emotional concerns is not a straightforward process and does not rely on diagnostic tools and box ticking.
Talk therapy is cheap and surprisingly effective
Talk therapy, which the WHO recommends as a first line treatment for mild to moderate depression and anxiety, can be delegated to non-specialists via a concept known as “task shifting”. This approach can be used on a national scale anywhere. England has trail blazed a new cadre of talk therapy practitioners using a one-year training program in CBT.
This involves helping people identify their negative thoughts (cognitive distortions) and anxieties. It involves concrete steps for dealing with them (e.g., going on a walk or meeting a friend), and reminders on how to change your thinking.
Zimbabwe has been training elderly women to provide a form of ‘CBT’ on “friendship benches” set up in courtyards. Zimbabwe’s approach has been imitated not only in other African Countries but even in New York.
Too little use is made of cheap talk-therapy. Critics complain that standardized sessions never fit a unique set of circumstances. But the alternative is charity helplines or no therapy at all. The old notion that doctors (in this case Psychiatrists), must do everything, is not only impractical but disproved by experience.
Community health workers in poor countries treat malaria and diagnose pneumonia. Maybe it’s time to turn the tables on mental health and instead of waiting for a specialist you may never see, engage meaningfully in some “cheap talk” from a trained lay person.
One counsellor at a time they may change the lives of millions of people.
Conclusion
I recommend, from personal experience, delving into the power of the pet. I love the sleek narrow body view of my Italian greyhounds when taking them for a walk every day. It’s not dissimilar to the excellent design of a chair or bespoke architecture that we chose to admire.
Dogs are like people. They are the friends and allies of human beings. They are social, hierarchical and domesticated. They are happy at the bottom of the family pyramid. They pay for the attention they receive with loyalty, admiration and love.
Studies show that dogs reduce stress, anxiety and depression; ease loneliness; encourage exercise and improve your overall health.
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