Stress

Even so, too many periods of severe stress - with emphasis on the word severe, so that the word is distress - is bad for blood pressure, predisposes to heart disease and is generally undesirable. The answer to your question is therefore that it depends on the severity of the stress, and whether in the intermediate period there is no stress, or very little. It depends how often you have these bad patches, and it depends on your own personality.

Stress affects my digestive system. I can get an upset stomach even eating the most gentle foods. My colon gets even worse, alternating constipation and diarrhoea, with horrible abdominal cramps. I’ve had irritable bowel syndrome diagnosed, and I know stress sets it off, but how can I control stress? I’m not very good at relaxing. Can you give me some tips on how to get a Type A personality to calm down? Name and address withheld

I was sorry to hear about your troubles, which are the classic signs of stress effects on the digestive system. By an upset stomach, I assume you mean nausea and vomiting. This is a standard reaction to severe stress, and is usually associated with difficulties in swallowing, so that the really stressed diner feels that they would choke if they had to take another mouthful. The other manifestation of stress exemplified by nausea and vomiting is morning sickness; it is not only the pregnant woman or the old drunk who has morning sickness, but also the person who is so tense and stressed that the day ahead is a worry in itself.

Your colonic symptoms are the classic ones of irritable bowel syndrome and intestinal hurry. People who have, by nature, a tense, competitive, ambitious personality are especially liable to suffer from irritable bowel syndrome, and a meal can produce all its symptoms. The secret of living with this trouble is not, if you can manage it, to eat business meals; any form of work-associated eating can be enough to trigger irritable bowel syndrome, even if you like all the people you are dining with.

The food you choose is important. It should be very plain, with no rich sauces and not too much fat; English school food of the 1950s, preferably home-cooked, helps, whereas restaurant food, which is deliberately made hyper-appetising, is disaster to the guts. If you are going out to a business lunch or dinner, or are likely to have an emotional meal with friends, it is a good idea to take Lomotil before you go. Prevention is easier than a cure.

The first rule about how to cope with a Type A personality is to understand that you have one, and to have an insight into its characteristics, and also to study the reasons why you have it. Is it all genetic or is it environmental? Are you just trying to please yourself and, by achieving, pour some balm on a troubled spirit, or are you competing in order to impress others? The best tip on how to control a Type A personality is to have a soul mate who can remind you every time you display it. The essential feature of the soul mate is that his or her opinion mustn’t be judgmental, but detached, so that they think just as much of you even when your most obvious perfectionist and obsessive traits are being displayed. If you are having to perform in public, a beta blocker of the more old fashioned sort, which are not cardio selective, is helpful. These are much used by musicians and public speakers, but you should discuss this with your doctor.

I have recently had ulcers of the colon diagnosed and have been told that they are most likely a result of stress. Looking back now, I see the signs that I have been stressed constantly for the last few months. This is by my demeanour, not the situations I am in. What mechanisms could I use to recognise the signs of stress and counteract them before I become ill again? Amy Sandro, London

The relationship of ulcerative colitis and the other inflammatory bowel disease to stress is a well-known one. I’m glad that you have insight so that you realise the situations for you are stressful, not so much because of the circumstances, but because of your personality, and therefore the way you have learnt to deal with whatever is happening around you. You should read my rather short, and not very expensive, book on stress and how to avoid it (see below).

I have always felt, both from my own and my family’s personal experience, and that of my patients, and from all the many lectures I have attended on stress and the books I have read about it, that the way to deal with stress is to recognise it, and to take avoiding action. The first step is to learn how to use your time wisely, and that means dividing up your day and taking particular care to manage the interface between work and home correctly.

Good luck.

My personal experience confirms anecdotal tales that worry causes grey hair. But I can find no reference to this in books. Is it true? What is the mechanism that links the two? John Hughes, Ilford, Essex

Experts will always tell us that the grey hair story is a myth, but experience with my patients, just like your own personal experience, does confirm the anecdotal tales that worry causes grey hair. Worry, particularly if it is persistent, has an effect on the cardio vascular system and on ageing. A survey carried out and published in the British Medical Journal around ten to 15 years ago showed that the single most important clue for doctors about a patient’s health was whether they looked old or young for their age. Obviously the medical problems which cause premature ageing, such as heart disease, high blood pressure, smoking and high level of blood fats, such as low density lipoprotein cholesterol, affect the appearance, but even when due allowance was made for all these, it was the way the person looked that was of prime importance.

Nothing is more ageing than grey hair, whether gradual or sudden - he went grey overnight. I have heard the latter explained on the ground that the hairs that have retained their colour drop out more quickly than the white hairs. Baldness is nearly always a question of the rapidity with which hair falls out and then doesn’t regrow.

Can stress be good for you? Robert Coker, Northampton

Stress can be good for you, in that it is stimulating, especially for those with a Type A personality. But even for the Type A personality, continuous stress, although it may be exciting and stimulating, is certainly not good for your physique. About half my working day when in practice was looking after very high-powered city and commercial tycoons. They all told me how good the stress was for them, and having seen their results I always told them how bad it was for their physiques, even if it was a very alluring stimulant. A certain amount of stress is good if you have the right temperament, but never if it is continuous, and never if it interferes with a reasonable, balanced lifestyle.

My grandson (aged three) has a habit of sucking his fingers, which his parents both nag him about whenever they catch him at it. I feel that he is just using the habit as a comfort mechanism and that constantly telling him off about it makes him anxious and stressed. Should I try to say something about it? Name and address withheld

It is too early to worry about sucking thumbs and fingers if your grandson is only three. Parents often don’t like their children to suck their fingers because it is not a very attractive habit and their pride and joy is not showing himself off at his best. They are therefore putting their own pride before the comfort which a three-year-old obtains from sucking his fingers.

You are quite right – it is a comfort mechanism, and experts even recommend some sucking as a preferable habit to sucking a dummy. Standard teaching is that it won’t do any harm to the thumb sucker’s teeth and palate until the time that the second teeth are coming through. Fortunately, at about this time, peer group pressure, the other children’s derision if one of their number is still thumb-sucking, usually persuades a child to give it up. On no account should a parent or any one very dear to the child laugh at any of their personal habits or appearance, which includes thumb-sucking. The use of derision by those close to a child to achieve an objective may have long-lasting results.

On the whole, the advice of grandparents is not welcome, I should try to withhold whatever you would like to say, but it is not a bad idea to leave books about on childcare, in particular the Great Ormond Street book, so that your family can read it.

According to your questionnaire, I seem to be a classic Type B personality but I do lead a very busy life and I get extremely angry from time to time. I was brought up not to shout and have tantrums, so I suppress the anger and sulk. Sometimes I feel I’d be better off shouting at everybody and getting it over with, and that seething away quietly is likely to damage my health in some way. What do you think? Name and address withheld

Whenever we try to define the classic personality types there is always the problem of the person who is by nature a Type A who is masquerading as a Type B, or a Type B who has been thrust into the role which needs the assumption of Type A characteristics. The clue to your problem probably lies in your phrase “I was not brought up to shout and have tantrums”. You may very well be a true Type A personality who has been forced into appearing relaxed, laid back and all-accepting by suppressing your anger.

It would be much better if you analysed what it was that made you feel that you wanted to shout at everybody, and then reorganised your life so that this no longer was the case. We all know that those people who don’t have temper tantrums live longer, have less high blood pressure, fewer heart attacks and strokes, and may be even less likely to eat too much, but these figures, I suspect, owe their significance not to people suppressing their anger, but because they genuinely don’t feel it.

I don’t think that if you suddenly started shouting at everybody and getting it over with that your physical health would be any better, and your relationships would suffer appallingly. It is better to decide what is making you angry, and what factors in your life have resulted in your stress.

My 11-year-old son gets very stressed in the weeks before exams, and will not go to bed because of imagined horrors, monsters behind the door, etc. He seems awfully young to be having this much pressure put on him, especially as he is happy and doing fine at school. What can we do to help him? Name and address withheld

Sensitive, creative, ambitious and successful 11-year-olds do get very stressed in the weeks before exams. Your 11-year-old son, if he is handled correctly, will probably have a brilliant and successful career ahead of him. It is a myth that children don’t suffer from serious psychological tensions in life. There was a brilliant book published about 40 years ago called Babies Have Worries Too. Anxiety and tension are with us from birth to the grave and, as one of our other readers has suggested, are a matter of demeanour and genetic and environmental background, as well as the situation.

So long as he is truly happy and doing fine at school, the only way you can help him is to strike that elusive balance between being encouraging and interested in his work, but on the other hand not appearing to be pushy and ambitious on his behalf. This is extremely difficult to achieve, but I hope that both you and he get your just reward when in years to come you can be proud of him, without having pressured him.