Stress: The Good, The Bad and The Addictive

Is stress good? Or is it bad all the time? Can you be addicted to stress?
You can. My name is Mike.
It's Yuen.
Welcome to The Imperfect Clinician.
What is stress for you?
Stress for me consists of different things.
It can be small, manageable stress and it can be overwhelming stress.
And it also depends on how I feel for the day,
because it then shows how resilient I am in handling those stresses.
Do you consider everyday activities that you do as a stress?
Or is there a certain threshold that you would consider that, oh, this is feeling stressful?
So I think the threshold for me changes.
So to give an example, most of the time, waking the kids up, taking them to school,
going to work, if work is a relatively productive day, then that day feels manageable.
There will be stresses throughout the day by making sure they leave on time,
making sure that I am balancing my day from the time management perspective
and potentially difficult patients.
They are, I guess, short bursts of stress that makes me feel manageable.
However, I feel that if those stresses are continuous,
so there's a lot of talk about workload in general practice can be overwhelming
and that leads to burnout, overworking.
I think when you face with a never-ending work, it sometimes feels too much to handle.
I would say that for me, I would look at it slightly differently,
because I think that for me, if you look at two extremes, being under overwhelming pressure
and being horizontal, just looking at the sky,
everything in between that makes you make a decision or do something
is potentially a stress factor in a way.
So even raising your hand or whatever, your body has to do something.
So it isn't like a minuscule, like a micro stress, that you're doing something outside.
And now the question is whether it's something that I choose to do
or something that I have to do potentially affect on whether I am more likely to describe it as stressful or not.
There's element of control in that.
I think so, yeah. And I think that if you put it into individual pieces,
most of those events are quite healthy and just from our life.
Now, depending on the circumstances, that threshold can change,
because you can be in a different frame of mind, you might not have enough rest,
you might feel that things are getting to you much quicker.
And in my opinion, that unhealthy stress, that level that gets you,
once it passes the threshold, is what can be affecting you in a more negative way.
So this is where you can start to lose concentration.
This is where you can start to feel getting tired progressively faster.
This is when you potentially can start to make mistakes in what you're doing.
Yeah, you might feel more anxious, you might feel dread.
But I think a big element of it is also how long it is,
because if it's chronic, then it's ongoing.
You don't feel like you have any respite from it.
Yes, but then different people respond differently to that level of stress.
Some people have to be motivated by being on a go,
having something constantly going, challenging them,
and this is their normal status quo.
This is when they thrive.
A way to motivate.
Yeah, it's a way to motivate.
And this is where I think the term addiction to stress falls into.
And there are some people who are more likely to be conditioned that way.
I'm pretty sure there is no clinical condition as addiction to stress,
as described by medical literature as such.
But the anxiety around activities that you're doing
may be caused by a prolonged exposition to stress.
And obviously, when we are excited,
we release all those neurotransmitters that make us happy and go,
but then with the stress appearing, you have the cortisol being released.
And that's the fight or flight, essentially, hormone.
And a combination of those two, potentially for some people, could be addictive.
And addictive in a way that if somebody was conditioned
by growing up in a stressful environment,
those people tend to thrive and tend to be more familiar with the constant stress,
with things constantly going on, constantly triggering that.
And this is the normal condition, the normal surroundings,
and the normal state of mind that they are used to from the past.
And now going outside or stepping out of it into, for example,
more relaxed things that are not happening is not stimulating enough,
and that puts them outside of a comfort zone.
And that can create the anxiety in those people.
So I think stress is very personal,
and stress is something that is very difficult to quantify
because the sphere of feelings we were talking about for the past few seasons now.
Yeah, I think the other part that needs to be taken into account is,
you mentioned about different people have got different threshold to stress.
We have to take into account what are the stresses
that person is dealing with outside of the parts that you can see.
So perhaps in a workplace, you can see that somebody perhaps is less resilient to stress.
But if you understand the bigger picture, they might have caring responsibilities.
They might have difficult traumas that they have to overcome.
So if we look at it from just one perspective,
there is a potential that we'd lose that holistic view of that person.
And by doing so, we're not able to support that person in getting whichever help that they need.
It might slow them down or stop them from reaching their potentials.
And also, by doing that, you can potentially be quite judgmental
because you only see it from your perspective from the work productivity.
Perceiving other people stressed is a completely different peace of mind.
For me, perceiving others as stressed is them being outside of their normal self.
And for different people, that may mean different things.
If people are always happy and then all of a sudden they don't have the best day or something happened,
you might feel that they are stressed.
There might be unwell, there might be plenty of factors here.
But for me, perceiving others as under some sort of stress is when they are outside of their normal selves.
But sometimes it's very difficult to spot those symptoms.
For me, more important is how we feel ourselves.
I mean, there are potentially some signs of people who are addicted to stress,
who thrive on being in stressful situations.
When they are seeking out those potentially dangerous, potentially looking for drama,
looking for being uncomfortable when they're bored,
this is where you can engage in behaviors that can lead to those stressful situations.
And that's something that those people potentially could have grown up with
because that's the status that they find as a comfortable state.
So there are two parts.
One, when we talk about having the whole perspective,
I think it's also important to take into account that people have always been shielded growing up to any level of stress.
Because then they don't build the immunity and the threshold for stress.
So you notice that there isn't a lot that they can take on without feeling overwhelming
because they've not had that exposure at all.
So that's one thing.
The other thing what you've mentioned brings to mind balance.
So for people who like to strive and look for stressors to motivate themselves,
I think the way for me to see it is how they do outside of their environment.
So do they have something to compensate?
Do they have something to wind down?
Do they have ways to relax?
And if they don't, and that is something that is continuous, ongoing,
and they don't know how to, inverted comma, switch off,
that brings more warning signs to me.
So the warning signs could be that people say yes when they should say no.
So it's setting barriers with others,
because sometimes it might be that people want to be constantly wanted, needed,
and they sort of agree to things that they shouldn't,
because they should, for example, rest, do a little bit for themselves.
I disagree. I don't think all of it.
I want to say for a lot of people that I've seen and spoken to,
a lot of the times the inability to say no comes from the fear of,
what if I say no, and that means I lose something.
I lose somebody else's praise, or I change somebody else's perspective,
or they think I'm not good enough.
And a lot of it is very fear-driven and lacking the practice of setting boundaries.
No, I get that.
It's just, in my opinion, saying yes when you should say no in context of lacking self-care,
lacking time for yourself to do those deep breaths, to be a bit more mindful,
to be more understanding to the things around you.
And I think that in order to try to reduce the stress and to upgrade our stress immunity,
we need to find all those elements that we were talking previously,
like self-care, like self-compassion, like finding time to do things for ourselves.
And those activities, those challenges,
can create a different kind of positive self-caring environment,
even if it's, I don't know, taking up sports or, for me, going on a bike.
That is also stress, okay?
But you put your body under the stress so that your mind can relax,
because it's taken out of the equation of the everyday life.
You have time to focus, never mind, you know, that with doing some sort of exercising,
you always get all those positive hormones being released to your brain and making you just happier.
I agree, and I think it's important to give a bit more context to the word stress,
because for me, the word stress carries a negative connotation in our general language.
You know, I'm really stressed out.
Very rarely you hear, I'm well stressed or I'm having good stress.
But like you said, there are different levels of stress and there are different types of stress.
And I think having no stressors whatsoever, I simply can't imagine what that is like.
That makes us alive, essentially. I believe that.
And it can be, you know, thinking about, for some people, stressing about what to cook.
Like you said, exercise is a stressor to the body, if done in good doses, are really healthy for you.
And so I don't know how we can change the connotation of stress can be something good,
but hopefully the understanding or changing the perspective of the listeners where actually stress is so broad and so varied.
I think for me, it's more about being mindful and being accepting the fact that things that are happening around us are driving us to do certain things.
Some of them are positive or not.
So it's all about having a little thing about which ones of those things are working destructively or potentially having a negative impact in one way or another.
Yeah, and which one perhaps nourishes you.
And which nourishes you.
You know, you have to find some sort of balance that's going to prevent you getting anxiety because there's no stress or getting anxiety because there's too much stress.
And this, for me, I'm pretty sure that for people who are exposed to constant stress and who find it very difficult, there must be CBT.
There must be a way of practicing mindfulness, even breathing exercises that allows us to take ourselves outside of the stressful situation and reset in a way.
Yeah, and I think these are for doses where you think it's manageable.
If you don't think they are, there are a lot of wellbeing services available out there for people in the UK.
The support groups, yeah.
Yeah, and in the UK, you have different NHS, national health services, free wellbeing, point of contact that you can tap into, like practitioners' health and looking after you coaching.
Or people who are affected by suicide, for example, and there can be really stressful times.
So I think having, like you said, the self-awareness to seek for support, whether that is small doses of support that you can navigate through yourself, or if you need more professional support, those are available as well, and knowing when to reach out for help.
Okay, so do you prefer yourself?
I mean, I did say that it's very individual, but for yourself, do you prefer to deal with the stress yourself, or do you prefer when somebody else notices, I don't know, acknowledges it and helps you through the stressful moment?
So in the past, I'm more the latter.
I don't know why I was under the assumption, probably it was a learned behaviour.
I was under the assumption that if I am stretched and stressed, the people around me, especially the people that I care the most, should identify it and should help me with it.
And with time, I came to understand that that comes from not putting myself first.
So in terms of assessing and reflecting on my own self-worth and prioritising myself, so now I am more looking at what system do I have in place for me to be able to reflect, to be able to check in internally and see where I am.
And when I have those stressful days or moments, sometimes I have to ride it and wait for it to pass.
And usually when those happen, what I tend to do is I delve deep into why do I actually feel this way and what are the fears and what are other things that are driving this emotion?
Okay, so what's more selfish, relying on others or relying on yourself?
What's more selfish?
Do you know what I mean? You feel like you are hoping to be noticed by others, okay, by people who are going to see, oh, she's working so hard or struggling to sleep or has got some sort of other out of character behaviours, you know, cries or weeps or whatever.
So you're hoping for others to sort of notice it or you start to realise through being more mindful and more understanding of yourself and taking time out or organising more self-care, in that respect, for me, more selfish is relying on others.
So you're essentially describing it into a reactive and proactive way of dealing with it.
Exactly, yes.
The reactive way is waiting for others to notice.
But I want to say, based on my own experience, the reactive way is also more about getting reassurance from somebody, to get the recognition that you work really hard and you deserve arrest, as if that you needed to hear that from somebody else to have arrest, that you cannot allow yourself arrest.
Whereas the proactive way, I would say to myself that you work really hard and you need to take some time out to balance yourself out.
Yeah, but that puts responsibility on somebody else, essentially.
So for me, it's like pushing off responsibility of your own self-care onto others who you essentially end up being at their mercy.
Yeah, and I think when I was in that stage, I noticed that I get really resentful when you have arrest or people in the family have arrest, because I almost go, why are you resting when I'm so stretched out?
But I verbalise it in a different way, but the feeling of being resentful.
And so I blame other people, like, why don't you see that I am so tired?
Why aren't you saying something?
And why are you resting instead of me when I'm so stretched?
I guess from what I've been observing when I was growing up, I think that people who are stress dependent, who are constantly surrounded by stress, who are constantly creating situations that are stressful, that are beyond the threshold and that are grinding themselves.
Like my dad, for example, I think those people have great impact on everybody around them and they expect everybody else to be in a similar position, because otherwise there is no validation for what they are doing, trying to achieve.
Exactly.
And I could see how destructive it could be because there is no rest.
Now I, after many years, I am able to start begin to be able to describe certain behaviours, to recognise them and to disassemble them into the trigger, the cause, the effect and the longer acting effect.
And for me, with my dad having always been a thrill seeker, he has always put a lot of pressure on others to be in a similar situation.
It's like you are addicted to what you're doing.
You keep pushing and pushing and pushing.
And you think that if somebody else is not at the same level of a constant stress, you're like jealous of that?
Yeah, getting resentful.
You're getting resentful and you want everybody else to feel the same.
And now I think it starts to come to me that there is a way that my dad should have said no to certain things around him to make him more mindful, I guess.
Yeah. And I think when you are in that situation, when you've gone through that as a large part of your formative years, I should say, usually there are two ways of dealing with it.
Either you go, I don't want to do that and make extra effort not to do it, or you imitate the learned behaviour because that's what you see.
That's what you know.
That's what you know.
Exactly.
And I feel that in your case, you are making conscious effort to understand and to reflect and take a step back.
But that is not an easy route.
An easier route would be just to follow.
Well, you know, my triggers for stress will be different than yours and are different than yours.
And there are sometimes things that just click and you explode.
Not explode, but you know, you change attitude to the things that shouldn't bother you.
But then all of a sudden they do because of the urgency, because of the, I don't know, your wellbeing.
You didn't sleep well or you didn't, you know.
Yeah. I think all of those factors are so important because just like we mentioned about burnout threshold in season three,
that threshold changes depending on how you sleep, how you eat, how you drink, how you left home.
How was the drive that morning?
You know, all of the other external factors that perhaps people can't see, they do play a big role in it.
They do.
And I sometimes feel that I get stressed by things that may not necessarily be considered as normal stress factors to others.
And sometimes I am very chilled about things that should be stressful, like lady reversed into me a couple of days ago.
It didn't bother me at the slightest.
One thing checked, am I okay? Are the people in the other car okay?
I mean, you know, it's a simple, tiny collision.
The lady on traffic lights decided to reverse instead of going forward and just, you know, crashed into my car.
I accepted it as an event, okay, but I didn't get stressed about it.
I said, yes, I accepted the fact, yes, I'll have to do something about it.
I'll have to make a couple of phone calls and, you know, maybe organize a hire car when the car has been, you know, fixed.
But it didn't affect me in a way that, oh my goodness, what am I going to do now?
Is it like a complete disaster?
And maybe if I was in a different frame of mind, it would have been a different story.
Maybe if I was rushing.
There's plenty of maybes all the time.
But what about the things that you are reactive to, but you don't think other people would react the same way?
Well, I'm sure there is, you know, cooking is not a good example because I'm very passionate and I really love cooking.
And, you know, when something doesn't go according to plan, because it does, because I do experiment a lot, you know.
Drawing on the sofa, would that be a good example?
What?
Kids drawing on the sofa.
Oh yeah, yeah.
Yeah, there was a situation once when our youngest decided to grab a pen and started drawing on our brand new beautiful leather sofa with a pen.
But by the time I turned around to see it, about three quarters of the sofa was all drawn over.
No, it wasn't that bad.
It was whole front, the back, and there still are some marks that...
I didn't see that much of it.
Yeah, because I started to, you know, frantically clean it off.
Yeah, but you should say what you were doing before frantically cleaning, though.
Yeah, well, I wasn't probably the kindest of parents with my words.
I didn't swear or, you know, I don't when the children are about.
But I got really, really frustrated and really wound up to the point that I just wanted to cry.
Yeah, and by doing that made her cry too.
And of course, being upset, my little girl got upset too, and yeah.
I came to look and I was like, what's the big deal?
But that triggered...
That made you even more frustrated.
Frustrated.
But yeah, you know, later on when you rationalize it, when you put it into perspective and all,
and the fact that most of it I managed to rub off with help of, I don't know, some chemicals.
Any chemicals that you can find.
Yeah, exactly.
But that really set me off, probably because it was unexpected, probably because I don't like things that are destroyed.
I take pride in looking after things.
Yeah, the simple example, when you are reading a book, you are not allowed to fold a page.
No, I don't fold the page.
It's not that I'm not allowing you.
It's just I find it very difficult.
Yeah, but if we share a book, you find it very difficult that if I fold the page, because I read a lot quicker, I'll pass it on to you and you're like, yeah.
Yeah, because I like things to last.
I don't like, you know, throwing things away and I like for them to be used.
I wonder whether we can ask our listeners to vote.
Are you a page folder or not?
Let us know in the comments.
Well, I admit that when I'm reading books, I try to leave them in the same condition that I picked it up because there is always a possibility I might go back to that book.
And I would like to have it, you know, fresh.
And folding the book is a stressful thing for you.
And it's not for me.
Yeah.
I mean, I don't lose sleep over it yet, but it's just a tiny bit of micro annoyance.
It's just a micro aggression.
You start to breathe differently then.
He can't.
Yeah, he's breathing then becomes a bit more rapid.
But yeah, I think it's important to do the internal reflection to see how you react to situations around you.
Because, you know, like you said, it happens in minuscule doses.
It can happen in larger doses.
It can be acute.
It can be chronic.
So the shorter or longer term side of it, it's really important that you have a habit of reflecting.
But also because we are creatures of groups, we don't prefer living in isolation.
So we will interact, we will socialise with different people and understanding what stresses them.
And respecting those boundaries or sometimes putting them into perspective, I think would always help.
I think it does because it just opens up another channel of thinking.
Do you think that introverts think differently about stress than extroverts?
I know it's a big generalisation.
I was about to wrap up there.
I would say the stresses for introverts and extroverts are different.
Yes.
And the way that they recover.
But we mentioned about this in our previous episodes about introverted leaders.
I find that I'm probably, I operate better under stress.
But the stress that I can control, that I sort of give momentum to, that I sort of get myself right.
Organise I have to do this, that and the other.
But if the stress is created by others and I find it difficult to manage or difficult to contain,
that's when I become more anxious probably.
Because some people, yeah, do this, do that on top.
I don't work that way.
I have to normalise things, organise things myself and I'm just more efficient in delivering that.
So I don't think that's due to introverted or extrovertedness.
It's just how you prefer to handle stress.
Yeah, I guess.
And my way of dealing with it will be different.
So then do you think, can we be addicted to stress?
Easily.
Easily.
I agree.
I think addiction to stress is the stress from world around us, from social media, from media in general,
from work, home, pressures with money, for example, can be quite difficult to manage
and we need to find time to normalise it, to process it and to look after ourselves.
Going back to self-compassion, mindfulness, even simple breathing, it's very, very powerful.
We don't quite understand how powerful our body is in coping with stress
and we can always work on it to be better through self-care, I guess.
Yes, it's one of our, I'm sure everyone has got areas that they can improve on
and if we work on our imperfections, we can deal with our stresses better.
Yes, we are imperfect and as imperfect as we are, we came back with the fourth season.
This is the first episode.
We hope that you're going to enjoy the whole series and yeah, until next time, we'll talk to you soon.
Bye-bye.
So just to give a bit of context, she is the founder and activist behind the Me Too movement,
which is one of the largest cultural events ever.
It changes people.
She gave people the courage to step out, to free them from shame, to hold people accountable,
to seek support from each other, to form support network.
It is global.
It is much needed.
It was long awaited.
This is her memoir where she talks about how she didn't always have the courage to say,
Me Too.
Her pain, her journey and the liberation was a rollercoaster ride that leads to her wisdom and strength now
and I am completely inspired and humbled.
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