DR QURATULAIN ZAIDI of Mind N Life ponders the city’s current problems and the issue of stress.
At the time that I’m writing this in mid-November, the protests and demonstrations have escalated in Hong Kong streets. The familiar roads that had a feeling of safety are now blocked, and filled with armed police and crowds wearing black clothes and masks. My heart rate certainly went up when I wasn’t able to make my way home one evening. And an unfamiliar smell wafted my way. As I navigated alternative routes to get back to my son, I just felt sad. Sad at what is happening to the city I have called home for the last decade.
This isn’t the first time I’ve experienced political uncertainty. I was very young when my family had to leave my country of birth forever in the middle of the night to seek refuge in the UK because my father’s life was at risk.
Civil unrest and social instability have led to major transitions of societies in modern history. Social instability has spread rapidly over the past several years all over the world. From nonviolent protest movements in Tunisia and Egypt that toppled long-established authoritarian regimes, to a protest movement that evolved to a full-blown civil war in Libya.
Here in Hong Kong, we witnessed the Umbrella Movement in 2014. And, since June, protests have been escalating to a point where schools have been cancelled, the transport system is paralysed, and we find the city in the grips of increasingly violent protests.
Effect on mental health
The impact of civil unrest on our mental health can be long-lasting. Recently, I was working with a teenager who came in to see me for extreme anxiety. He had spent the first seven years of his life in a war zone. His bus rides to school were often unpredictable. This was understandably stressful for him. When his parents would go out, he was constantly checking if they were okay. The stress and anxiety that manifested in those early years are now debilitating for him.
Learning how to cope with adversity is an integral part of healthy development. When we feel threatened, our bodies prepare us to respond by increasing our heart rate, blood pressure and stress hormones such as cortisol. This is known as our biological stress response, and it’s categorised three different ways:
- A positive stress response is a normal and essential part of healthy development, characterised by brief increases in heart rate and mild elevations in hormone levels. Meeting a deadline, for example, is a time-limited stress response.
- A tolerable stress response activates the body’s alert systems to a greater degree as a result of more severe, longer-lasting difficulties such as the loss of a loved one, a natural disaster or a frightening injury. If the activation is time-limited and buffered by supportive relationships, the brain and other organs recover from what might otherwise be damaging effects.
- A toxic stress response can occur when a someone experiences intense, frequent, and/or prolonged adversity – such as physical or emotional abuse, chronic neglect, caregiver substance abuse or mental illness, exposure to violence, and/or the accumulated burdens of family economic hardship – without adequate support. This kind of prolonged activation of the stress response systems can disrupt the development of brain architecture in young children and other organ systems. And increase the risk for stress-related disease and cognitive impairment well into the adult years.
In times of civil unrest, all of us are impacted. And we’re affected by what’s going on around us. We have to be vigilant and mindful of tipping over from a tolerable stress response to a toxic stress response and check in that we are doing okay.
If the stress response is extreme and long-lasting, it can result in damaged or weakened neurological and biological systems. Potentially with lifelong repercussions. When toxic stress response occurs continually or is triggered by multiple sources, it can have a cumulative toll on an individual’s physical and mental health – sometimes for a lifetime. Physical and mental health problems including heart disease, diabetes, substance abuse, depression, PTSD, panic attacks, generalised anxiety, social anxiety and OCD are just some of challenges manifesting in adults due to prolonged toxic stress response.
The future of any society depends on its ability to foster the healthy development of the next generation. Extensive research on the biology of stress now shows that healthy development can be derailed by excessive or prolonged activation of stress response systems in the body and brain. Such toxic stress can have damaging effects on learning, behaviour and health across the lifespan.
Managing stress: how to help yourself and the family
The key to managing stress is to recognise when it’s impacting your body and mind and to put measures in place to challenge it. Look after your physical and mental health! Some of the techniques include getting a good night’s sleep, allocating regular time out and down-time for yourself, exercising, laughing daily, reducing caffeine, sugar and alcohol, practicing self-compassion and regularly meditating.
In times of uncertainty, you should:
- Talk to your children and ensure they feel secure and safe.
- Limit time on social media; watching violent images and videos is unhelpful and increases stress.
- Keep up to date with what’s going on. Situational awareness is essential, though it’s important to select limited social media sources that are useful for your safety.
- If you hear that a demonstration is taking place, take measures if you can to avoid the area. It’s more important that you get home safely to your family. During the SARS outbreak in 2004, businesses, banks and financial institutions learnt that people could work from home productively and safely. Companies survived even with a travel ban. They will do so now.
- Keep family and friends updated of your movements and plans.
- In the absence of extended family and friends who are back home, ensure you have a good support network around you that you can rely on.
I’m hoping for the best for Hong Kong’s future. Until then, take care of yourselves and those around you, and stay safe.
Dr Zaidi is a British-registered clinical psychologist who works with individuals, couples and families in her private practice in Central. And as a mental health consultant for a number of international schools. 2521 4668 | email@example.com
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This article first appeared in the December 2019/ March 2020 issue of Expat Living magazine. Subscribe now so you never miss an issue.