MANAGING STRESS A WAY TO

STAY HEALTHY FOR THE AGED

Saturday, 11th December, 2021.
BY

Taiwo Lateef Sheikh

Professor of Psychiatry,
Department of Psychiatry,
Ahmadu Bello University, Zaria.
Nigeria.

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 OUTLINE
•  Introduction
•  Aging
•  Stress
•  Wellness, Mental Health & Mental Wellbeing
•  Managing Stress
•  Conclusion

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What age is considered old age?

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The World Health Organisation believes that
most developed world countries characterise old
age starting at 60 years and above. However, this
definition isn't adaptable to a place like Africa,
where the more traditional definition of an elder,
or elderly person, starts between 50 to 65 years
of age.

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 What has it got to do with our
“Brain”?
•  As we age, our brains tend to shrink. After age 40,
research has shown that human brain weight typically
decreases by about 5 percent each decade. After age
70, brain shrinkage typically occurs at an even faster
rate
•  As we age, our brain goes through changes that can
slow down our thinking: It loses volume, the cortex
becomes thinner, the myelin sheath surrounding the
fibers of your neurons begins to degrade, and your
brain receptors don't fire as quickly
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•  Normal brain aging may mean slower
processing speeds and more trouble
multitasking, but routine memory, skills, and
knowledge are stable and may even improve
with age (emotional intelligence). It's normal
to occasionally forget recent events such as
where you put your keys or the name of the
person you just met.
•  Particular parts of the brain that shrink with
age are mostly the prefrontal cortex; areas that
are associated with learning, memory,
planning, and other complex mental activities.
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 Implications…
•  When your brain shrinks, there are fewer connections
between neurons, and the neurotransmitter systems
that communicate information from the brain to
different parts of the body change, resulting in
numerous complications. All of these factors play a
role in the aging process and age-related cognitive
decline and ability to cope with stressors
•  As we can see, some amount of brain shrinkage
occurs naturally as people age. Other potential causes
of brain shrinkage include injury, certain diseases and
disorders, infections, and heavy alcohol use.
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 Stress and Wellness
•  Our capacity to cope with stressor is a true
measure of our wellness, mental well being
and collective growth.
•  Stressors are also determinants of our mental
well being!
•  If permitted, I’ll sum up Nigeria’s mental
health situation as Stress… Stress...Stress!
•  We need not consult far to understand the
relationship between stress and mental health!!
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•  Bloomberg currently ranks Nigeria as the most
stressful country to live in the world, based on
multiple factors in the living environment. To an
average Nigerian, stress is the norm; ‘Just deal
with it!’ is the popular opinion
•  From the non-existent power supply, poor road
conditions, unemployment, and abysmal working
conditions, stressful, poverty-driven lifestyles are
rampant and with these issues in mind we can
understand “Bloomberg!

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 Definition of Stress
•  Stress is a feeling of emotional or physical
tension. It can come from any event or thought
that makes you feel frustrated, angry, or
nervous.
•  Stress is your body's reaction to a challenge or
demand. In short bursts, stress can be positive,
such as when it helps you avoid danger or meet
a deadline

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•  Stress can serve an important purpose and can
even help you survive. For our ancestors, stress
was a helpful motivator for survival, allowing
them to avoid real physical threats. That's
because it makes your body think it's in danger,
and triggers that “fight-or-flight” survival mode
(“Survival mode” is needed from time to time but
not for everyday life!).
•  Common causes of stress include work, money,
relationships and illness (significant events like
the Covid-19 pandemic, banditry, kidnappings
etc.)
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 Mechanism of stress injury
•  Your body reacts to stress by releasing hormones.
These hormones make your brain more alert,
cause your muscles to tense, and increase your
pulse. In the short term, these reactions are good
because they can help you handle the situation
causing stress. This is your body's way of
protecting itself (Survival mode!)
•  When you have prolonged stress, your body stays
alert, even though there is no danger. Over time,
this puts you at risk for health problems.
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 Forms of Stress
Acute stress:
•  This is short-term stress that goes away
quickly. You feel it when you slam on the
brakes, have a fight with your partner, or at
risk of losing a high profile case. It helps you
manage dangerous situations. It also occurs
when you do something new or exciting, we all
do experience acute stress at one time or
another.

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 Chronic stress:
•  This is stress that lasts for a longer period of
time. You may have chronic stress if you have
money problems, an unhappy marriage, or
trouble at work. Any type of stress that goes on
for weeks or months is chronic stress. You can
become so used to chronic stress that you don't
realize it is a problem. If you don't find ways
to manage stress, it may lead to health
problems.

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 Types of Stress
•  Routine stress related to the pressures of work,
family, and other daily responsibilities
•  Stress brought about by a sudden negative
change, such as losing a job, divorce, or illness
•  Traumatic stress, which happens when you are
in danger of being seriously hurt or killed.
Examples include a major accident, war,
assault, or a natural disaster.

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Wellness, Mental Health, Mental
Well Being and Mental Disorder

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 WELLNESS
•  Wellness is an active process of becoming
aware of and making choices toward a healthy
and fulfilling life. Wellness is more than
being free from illness, it is a dynamic process
of change and growth. "...a state of complete
physical, mental, and social well-being, and
not merely the absence of disease or infirmity.”
-WHO

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•  "a conscious, self-directed and evolving
process of achieving full potential."
- The National Wellness Institute

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 DIMENSIONS OF WELLNESS
•  Emotional wellness relates to understanding
your feelings and coping effectively with stress.
It is important to pay attention to self-care,
relaxation, stress reduction and the development
of inner resources so you can learn and grow
from experiences.
•  Intellectual wellness involves having an open
mind when you encounter new ideas and
continuing to expand your knowledge. It
encourages active participation in scholastic,
cultural and community activities.
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 INTER-RELATIONSHIPS OF
DIMENSIONS OF WELLNESS
•  Each dimension of wellness is interrelated with
another (they are not mutually exclusive!).
•  Each dimension is equally vital in the pursuit
of optimum health.
•  One can reach an optimal level of wellness by
understanding how to maintain and optimize
each of the dimensions of wellness.
•  (Occupational, Emotional, Spiritual, Environmental, Financial,
Physical, Social and; Intellectual).
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 WHY WELLNESS MATTERS
•  Maintaining an optimal level of wellness is
absolutely crucial to live a higher quality life.
•  Everything we do and every emotion we feel
relates to our well-being.
•  In turn, our well-being directly affects our
actions and emotions. It’s an ongoing circle.
•  Therefore, it is important for everyone to
achieve optimal wellness in order to subdue
stress, reduce the risk of illness and ensure
positive interactions.
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 MENTAL HEALTH
•  Includes our emotional, psychological, and
social well-being.
•  It affects how we think, feel, and act.
•  It also helps determine how we handle stress,
relate to others, and make choices.
•  Mental health is important at every stage of
life, from childhood and adolescence through
adulthood.

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 MENTAL WELL-BEING
•  A state of well-being in which the
individual realizes his or her own
abilities, can cope with the normal
stresses of life, can work productively
and fruitfully, and is able to make a
contribution to his or her community
–  WHO

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 Mental Wellbeing
•  “The ability to cope with the day-to-day
stresses of life, work productively, interact
positively with others and realize our own
potential.”
•  Simply put; A state of well being where we can
realize our potential, cope with normal
stressors, live and work fruitfully and
contribute to society.
•  It is not just mere absence of illness.

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We are mentally healthy when we..
•  feel well, think well, act well
•  realize our potential
•  are able to cope with normal stresses of life
•  are able to work productively and fruitfully
•  contribute to our community

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 Optimum Mental Well-being
•  Importantly, good mental wellbeing is NOT
the absence of negative thoughts and feelings.
We all face difficult and challenging situations
that cause us to feel angry, sad, overwhelmed
and everything in-between.
•  Instead, “optimum mental well-being” is about
being able to understand and manage those
feelings.

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Mental health problem (distress)….
•  Mental health problems interferes with a
person’s cognitive, emotional or social
abilities, but may not meet the criteria of an
illness/disorder.
•  Mental health problems often occur as a result
of life stressors, and are usually less severe
and of shorter duration than mental disorders,
although they may develop into mental
disorders

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 Mental illness or Mental disorder..
•  A diagnosable illness that significantly
interferes with an individual’s cognitive,
emotional or social abilities.
•  There are different types of mental illnesses
and each of these occur with different degree
of severity.

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 Can work contribute to mental ill-
health?
•  Generally, work is good for our mental health
•  But, many work factors can contribute to
mental health problems or make existing
problems worse
•  Globalization has contributed to work-related
stress and its associated disorders
•  When work related stress is high and ongoing
it can be a risk factor for mental distress/illness
•  We should prevent issues where possible and
mitigate risk where it is not possible.
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 Your Work and Stress….
•  The importance of work in enhancing the economic and
social integration of people cannot be over emphasized
•  All of us have the right to decent and productive work
in conditions of freedom, equity, security and human
dignity
•  Employees’ mental health problems and their impact on
an enterprise’s productivity and disability/medical costs
are critical human resource issues.
•  The impact of mental health problems in the workplace
has serious consequences not only for the individual but
also for the productivity of the enterprise.

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 What are the common influences of
work on our mental health?
•  Structural: e.g. safe working conditions,
employment security, inclusive workplace etc.
•  Community: e.g. sense of belonging, access to
social support, freedom from bullying etc.
•  Individual: ability to deal with thoughts,
manage life and cope, including good physical
well being

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Prevalence and consequence of mental
ill-health in the workplace
•  One in five people will experience mental
illness in any twelve months at work place
•  Common work related mental disorders
include:
–  Anxiety
–  Depression
–  Substance use disorder
–  Suicide
–  Precipitation of mental health problem
–  Perpetuation of existing mental illness
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 Impact of mental ill-health in the
workplace
•  Absenteeism due to:
–  Increase in overall sickness absence from work,
particularly frequent short periods of absence;
–  Poor emotional health (depression, stress,
burnout);
–  Poor physical conditions due to persistently high
release of stress hormones (high blood pressure,
heart disease, diabetes, ulcers, sleeping disorders,
menstrual problems, infertility etc);
–  Skin rashes, headache, neck- and backache, low
resistance to infections).
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•  Strained relationships at work:
–  tension and conflicts between colleagues;
–  poor relationships with clients;
–  increase in disciplinary problems.
•  Poor work performance:
–  Reduction in productivity and output;
–  Increase in error rates;
–  Increased amount of accidents;
–  Poor decision-making;
–  Deterioration in planning and control of work.

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•  Poor staff attitude and behaviour:
–  Loss of motivation and commitment
–  Burnout
–  Staff working increasingly long hours but for
diminishing returns
–  Poor timekeeping
–  Labour turnover (particularly expensive for
companies at top levels of management).

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 Age Related Stress Reporting
•  Research has shown that those aged 18-33
years old suffer the highest levels of stress
•  Older adults were more likely to report health-
related stressors (38.6%), compared to young
(5.8%) and middle-aged adults (16.7%). The
most frequent stressors young adults reported
were school-related stressors (43.5%). Middle-
aged adults reported mostly work-related
stressors (33.3%).
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 Stress and Ageing
•  Stress doesn't just make a person feel older. In
a very real sense, it can speed up aging; stress
can add years to the age of individual immune
system cells.
•  Stress causes changes to the proteins in your
skin and reduces its elasticity. This loss of
elasticity can contribute to wrinkle formation.
Stress may also lead to repeated furrowing of
your brow that may also contribute to the
formation of wrinkles.
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 Managing Stress
Minimize Stress
Recognize Stressors
Healthy coping skills
Maintain brain health

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 Some ways you can cope with
stress:
•  Schedule time for relaxing
activities. Scheduling time for activities that
make you feel relaxed may help you reduce
stress if you feel overwhelmed by your busy
schedule.
•  Maintain good lifestyle habits. Continuing
to eat healthy diet as well as getting plenty of
sleep will help your body better manage stress.

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•  Stay active. Exercise can help you lower levels
of your stress hormones and give you some
time to take your mind off the cause of your
stress.
•  Talk to others. Talking to a friend, family
member, or mental health professionals helps
many people deal with stress.
•  Avoid drugs and alcohol. Persisted use
of drugs and alcohol can cause additional
problems to your stress.

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 Creating a Safe and Mental Health-
Friendly Workplace….
•  A healthy, rewarding environment is important for
positive mental health.
•  A mental health-friendly workplace values
diversity and includes health care that
incorporates mental health problem/illness;
•  Has programs and practices that promote and
support health and wellness (and family);
•  Provides training for supervisors in mental health
workplace issues;
•  Safeguards employee confidentiality;
•  Supports employees who seek treatment or
require hospitalization or disability leave.
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 What Employers Can Do
•  Employers can be agents of change in the workplace;
•  Should be aware of mental health issues;
•  Modify workplace risk factors for stress;
•  Develop an organizational climate that promotes
wellbeing and creativity;
•  Facilitate access to healthcare for employees who
may need it
•  Be understanding and flexible to the needs of
employees, understanding their personal situations;
•  Combat stigma and encourage open discussion in the
workplace on mental health.
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 What Coworkers Can Do…
•  Make it clear that you want to help, listen
without judgment, and offer support.
•  Encourage them to seek professional help
when they are ready
•  If you think the person is in immediate danger,
do not leave him or her alone
•  Seek professional help from the emergency
services, a crisis line, or a health-care
professional
•  Stay in touch to check how the person is doing.
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 What you can do..
You can prevent or reduce stress by:
•  Planning ahead
•  Setting achievable goals
•  Deciding which tasks to do first
•  Preparing for stressful events
•  Learn to recognize when you’re feeling stressed
•  Respect your physiological (basic) needs
•  Avoid psychoactive substances
•  Meditate and relax
•  Talk to your Doctor
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 Dealing with work place mental
health….
•  An integrated approach to workplace mental
health combines the strengths of medicine,
public health, and psychology, and has the
potential to optimize both the prevention and
management of mental health problems in the
workplace.

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 Maintaining Brain Health
•  Minimize stress
•  Sleep well
•  Daily physical
•  Take care of your heart
•  Avoid a high-sugar diet
•  Keep your mind stimulated
•  Avoid certain drugs
•  Avoid alcohol
•  Prevent falls Professor TL Sheikh 46
 Conclusion
•  Optimum Mental well-being is very
fundamental to optimum productivity and
ability to cope with stressors
•  Our mental health (emotional) is a critical
component of our day-to-day living which can
manifest with physical symptoms.
•  Mental wellness is not a mere free from mental
illness, it is a dynamic process of change and
growth; “there is no health without mental
health”.
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Thank you for listening.

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