2025 may be remembered for a new pandemic — worldwide stress induced by Donald Trump.
With his threats to our nation's economy and sovereignty, many of my patients are fearful of the rising cost of food, housing and the other essentials of daily living as well as a radical change in international relations.
Like most family doctors, I'm an expert on stress. I care for over 2,500 patients in my practice. Every day of the week, I receive over 200 tasks related to my patients, including hospital, lab, investigation and specialist reports and requests for prescriptions, forms and other reports. Each task must be reviewed, summarized and filed into patients’ medical records.
Of the three dozen patients I see on clinic days, each may have presented with two or three concerns but some will add several more during their visits. For each problem, I take a complete history, perform an appropriate examination, formulate a differential diagnosis and discuss management options. No wonder family doctors suffer decision fatigue even before tackling two hours of tasks in the evening long after the last patient has left the clinic.
Over the past three months, patients have been reporting anxiety symptoms including insomnia, feeling on edge and overwhelmed, and excessive worry. Many are triggered by Trump’s voice.
What can we do to manage stress in this uncertain time of Trump? How can we prevent post-Trump stress disorder?
The negative (and positive) effects of stress
In the classic fight-or-flight response, our bodies respond to a threat by releasing cortisol and adrenaline that increase alertness, heart rate, blood pressure and constriction (narrowing) of arteries. This prepares us to fight or run from danger. But a prolonged fight-or-flight response to stress can be harmful by contributing to hypertension (persistent elevation of blood pressure) and stress on the heart.
We often neglect the positive effects of stress though Hans Selye coined the term eustress (in contrast to distress) nearly 60 years ago. He was referring to stress that is enjoyable, motivating and functional.
Kelly McGonagal, a health psychologist, in her Ted Talk, How to Make Stress Your Friend and her book, The Upside of Stress, emphasized that how we think about and respond to stress can determine if it will have negative or positive effects on health. When you feel your heart rate increasing before an exam or speaking at a meeting, you can remind yourself that this is your body preparing you to rise to the occasion, energizing you and helping you focus. With this reframing, your heart rate still rises but your arteries relax or dilate instead of constricting.
The pituitary releases oxytocin in the positive stress response. This hormone reduces inflammation, relaxes blood vessels and has a positive effect on heart muscle. It increases empathy and draws us closer to others so that we reach out for help or reach out to help others. This is the healthy tend-and-befriend response to stress.
Recognizing our resilience
The healthiest and happiest among us are not those who have lived a charmed life free of trauma, challenge and loss. My dad turned 95 last month. His father died when he was five and he grew up in poverty in Cumberland's Chinatown during the Great Depression. Though he was born in Canada, he endured racism and discrimination. In the chapter he wrote in the book, A Place Called Cumberland, his life is remembered without bitterness but rather gratitude for the kindness of others and how adversity brought the neighbours in his small town closer together as family.
Countering the negativity bias
Through evolution, early humans survived by recognizing potential danger. Hence, the human mind's enduring negativity bias. As psychologist, Rick Hanson has said, our brains are Velcro for the negative and Teflon to the positive. We always see more of what is wrong with us, others and our situation than the positive, even when things are going well. In fact, we need to see five positive things just to balance one negative thing to come out neutral.
But we can each improve our outlook and our relationships with others by seeking out and recognizing the good things in our lives and in others. So before you make one negative comment to yourself or someone else, come up with at least five positives.
Dealing with difficult people and Trump toxicity
Sooner or later, we all have difficult encounters with others. They may be having a bad day — an accident, a loss, or physical or emotional pain. They might have a challenging personality. In the few minutes you meet with them, remember that they come from a place of suffering. Imagine how their family members, neighbours and coworkers are suffering. Be thankful you don't have to go home with them or work in the White House.
Avoid reliving these difficult encounters over and over in your ruminations. If the daily news is your trigger and you've developed the now common habit of doomscrolling the latest news, restrict your daily dose of media. We don't have to watch the news more than once a day, and just before bedtime is not conducive to a good night's sleep.
Canada has survived two World Wars, the Great Depression, the Cold War and the recent pandemic.
Recognize what you can control
Each of us has little influence on the decisions of world leaders, the economy or the weather. We have to accept circumstances beyond our control. At the same time, your well-being is dependent on your personal agency — recognizing the many things that are within your control. What can you do today to make a positive difference in your own life and in the lives of those around you?
Daily self-care
As adults, we must be good parents to ourselves. Daily self-care follows the same advice a good mother or father would give.
1. Go to bed. Skip the evening news and go to bed early with a good book.
2. Eat your breakfast. When we're stressed, we might skip meals or emotionally. Choose and plan healthy meals throughout the day.
3. Go out and play. Get outside and reconnect with nature and your neighbourhood. An hour of moderate exercise such as a brisk walk is often recommended by psychiatrists for depression and anxiety.
4. Call home. Keep in touch and connected with your friends and loved ones.
Surviving and thriving with Canadian values
I have faith in our enduring Canadian values of kindness, courtesy and respect. We look after one another — everyone in our society including the most vulnerable. We are resilient as a nation and as individuals working together. We will survive and thrive with a positive response to today's stress, coming together, connecting with our greatest values, and making a positive difference in our daily lives.
Everyone is welcome to join me online with our next Empowering Patients talk, What You Should Know About High Blood Pressure at 7 p.m. Thursday, April 17. I’ll discuss how to tell if you’re at risk, what you can do to prevent high blood pressure (beyond managing stress), and how to effectively manage blood pressure and remain healthy. For more information and registration, go online or call Leona at 604-259-4450.
You’re also welcome to walk with Mayor Mike Hurley, me and other Burnaby doctors at the Burnaby Division of Family Practice’s annual Walk With Your Doc on Saturday, May 17. I’ll be starting the day with a motivating talk on fitting healthy physical activity into your routine. Use the same link above for information and free registration.
To get an early start with steps, join Burnaby, Vancouver and New Westminster’s Walk30 Challenge April 1-30. You can represent your city and walk on your own or join a variety of group walks. For more information, click here.
Dr. Davidicus Wong has written for the Burnaby Now and Glacier Media since 1991.
