Finding Balance Amidst Stress: Insights from a Psychiatrist and Pharmacist


Do you recognize the sensation of your jaw tightening, cold sweat dripping down your chest, muscle pain, and blurry vision? Take a moment to calm down and remember that these are natural physical responses to stress, and there is no need to worry.

In this article and video, Dr. Tay Kai Hong, Medical Doctor and Psychiatrist at Private Space Medical, and Joy Chong, Principal Clinical Pharmacist at Watsons Pharmacy Singapore, share expert insights about stress and how to properly manage it. 

What is stress? 

Stress is the way the body and mind react to a perceived threat or pressure. This reaction is natural and can be caused by different internal or external factors, such as physical, emotional, environmental, or social triggers. It can take many forms, like physical symptoms such as tense muscles, elevated heart rate, or changes in appetite and sleep patterns, as well as emotional symptoms like anxiety, frustration, or feeling overloaded. Although some can be constructive and motivational, chronic or excessive stress can have detrimental effects on both mental and physical well-being 

When we experience stress, our body reacts by initiating the “fight or flight” response. This response is activated by the release of stress hormones like adrenaline and cortisol, which prepare the body for action in the face of perceived danger. The bodily changes that occur during this response include increased heart rate and blood pressure, rapid breathing, constricted blood vessels, the release of glucose into the bloodstream for energy, and the suppression of non-essential bodily functions like digestion and the immune system.


Eustress – Eustress is a form that triggers a favourable reaction. It differs from distress and encompasses beneficial stress of any kind, whether physical or mental. It usually lasts for a short period and gives a sense of excitement. People usually find this type bearable and even motivating. 

Distress – Distress can refer to various types of suffering, such as emotional, social, spiritual, or physical pain, that may lead a person to feel sad, fearful, depressed, anxious, or isolated. Those experiencing distress may feel overwhelmed and unable to handle the changes brought on by regular life events or the presence of an illness, such as cancer.


Everything that we care about can cause stress. It may be our personal lives, family, work or school. These causes can be either intrinsic or extrinsic. 

  • Intrinsic – refers to the internal pressures or demands that a person places on themselves, which may arise from personal goals, values, or beliefs. This type of stress is often self-motivated and can be positive or negative, depending on the individual’s ability to manage it.
  • Extrinsic – Extrinsic stress refers to one that originates from external sources, such as environmental, social, or work-related factors. Extrinsic is often beyond an individual’s control and can cause negative emotional and physical symptoms, such as anxiety, depression, fatigue, and physical health problems. It is important to develop coping mechanisms to manage extrinsic stress, such as relaxation techniques, time management strategies, or seeking social support.

Major life transitions such as new work, changing schools, getting married, or moving into a new place are sometimes the main causes of stress. 

Signs and Symptoms

Stress affects the whole body which is why symptoms are classified as physical or psychological symptoms.

Physical symptoms:

  • Giddiness
  • Light-headed
  • Chest-tightness
  • Palpitations
  • Hyperventilation
  • Shortness of breath
  • Stomach-churning
  • Nausea and vomiting when under immense stress

Psychological symptoms:

  • Insomnia
  • Muscle fatigue
  • Lethargy
  • Loss of concentration
  • Lowered immune system when under chronic stress

Sometimes people do not see these symptoms as symptoms of stress and relate it to symptoms of other health problems. 

What happens when stress is left untreated?

When it is left untreated, it can have negative effects on both physical and mental health, leading to a variety of short-term and long-term problems, including some chronic diseases. Some of the common consequences of untreated stress include:

  1.     Physical health problems: Chronic stress can lead to a weakened immune system, and increased risk of cardiovascular disease, high blood pressure, stroke, diabetes, and obesity.
  2.     Mental health problems: it can cause anxiety, depression, mood swings, irritability, and sleep disturbances. It can also lead to more severe mental health conditions, such as post-traumatic stress disorder (PTSD) and substance abuse.
  3.     Impaired cognitive function: Chronic stress can affect memory, attention, and decision-making abilities, making it harder to perform everyday tasks.
  4.     Social and relationship problems: it can impact relationships with family and friends, leading to conflicts, social withdrawal, and reduced productivity at work.
  5.     Reduced quality of life: Untreated stress can lead to a reduced quality of life, decreased enjoyment of activities, and lower overall well-being.

It is always advisable to seek help if one is suffering from high levels of stress for more than a few weeks already or to the extent that it already affects daily activities such as sleep, appetite, or ability to function in respective areas. Events of acute stress may lead to chronic stress and burnout when left untreated.

What is the best way to manage stress?

Going back to our example earlier, if it is a stream of water going down on a bucket, there are many ways how we can try to increase the capacity of the bucket. One suffering from stress can observe the following to improve their condition:

  • Exercise frequently
  • Stay positive, especially during times of uncertainties 
  • Stay connected with family or friends, as they are the ones who can remind you to stay positive when you cannot remind yourself about it. 
  • Take supplements that are associated with reducing symptoms like Rhodiola, Ashwagandha, and Kava. Some studies report that these may relieve muscle tension and improve fatigue. 
  • Medical professionals, as much as possible, do not medicate stress away as they consider it a normal part of our lives. However, in worse situations where chronic stress leads to serious medical conditions, seeking professional help or taking medication can be very beneficial.


Stress is a common occurrence in today’s fast-paced and competitive society. While some amount of it can be beneficial as a motivational force for optimal wellness, behaviour, and productivity, excessive stress can lead to serious health problems. It is important to recognize the signs of overwhelming stress and seek professional help, such as a psychiatrist or counsellor if the stress persists for an extended period of time. These medical professionals can provide the necessary tools and resources to better manage stress and improve overall well-being.

Remember, when feeling overwhelmed by stress, don’t be afraid or ashamed to ask for professional help. 

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