Speaker 1: As a pre-med or medical student, I'm sure you're more than familiar with stress. Whether it's finances, academic strain, or pressure from family, friends, and peers, you're not alone. Here's how to deal with stress as a student. Dr. Jubbal, MedSchoolInsiders.com. As described by the Yerkes-Dodson Law, mild amounts of physiological or mental stress actually improve performance, but only up to a point. Further increases in stress prove detrimental not only in immediate short-term performance, but chronic stress can lead to a variety of physical and mental health issues as well. Ever since getting diagnosed with inflammatory bowel disease as a freshman in college, I began taking stress mitigation measures much more seriously. Many autoimmune conditions, including Crohn's disease, are exacerbated by unmanaged stress. These are the lessons I've learned over the years. While stress can be varied, including physical stressors like intense training or an illness, we'll be focusing on mental stressors that students face in day to day life. Academic stress is likely what you're most familiar with. This includes needing to learn and memorize large quantities of information, meet deadlines with projects or assignments, and of course the stress of upcoming exams and maintaining good grades. Social stress includes peer pressure, the stress of new relationships, whether platonic or romantic, balancing your academics with social life, and adjusting to your new environment. After all, you may not yet be fully adjusted to living on your own without your family. Stress of daily life includes other factors like financial burdens, your daily commute, or balancing a part time job. I don't believe there's a single best way to manage stress in all situations. There are a few foundations to focus on, and then a few targeted techniques depending on the specifics of the stressor. Let's start with the foundations. On a foundational level, you want to begin by focusing on organization. If you're enrolled in 4 classes, each of which has various assignments and test dates, it can quickly become overwhelming. By simply taking the time to get organized, such as putting class times in your calendar, including exam times and assignment due dates, you'll greatly reduce the sense of dread, chaos, and uncertainty you feel when approaching your academics. Organization extends to other aspects of your life too, like time management. Rather than approaching each day as a blank slate, and then doing what you feel like when you feel like, try time blocking. During those hours when you know you'll be more focused and more productive, plan on setting aside a few hours for more intense and focused work or studying. During the hours when you know focusing will be difficult, block out time to get a workout in, or do laundry, or grab groceries. Staying organized in this way will also ward off procrastination, one of the most common and insidious stressors amongst students. And it mitigates the issues of balancing social stressors with academic stressors. If you know when to study and when to hang out with friends, you won't have to make the decision each time a social opportunity presents itself. In college, I was definitely more of a night owl. For that reason, I would roll out of bed around 8 or 9am, go to lecture, and after classes, my brain would feel cooked, so I'd work out in the afternoon, then go home and eat. After cleaning up my dishes, this was the time I felt I could most effectively focus and get work done. In medical school, I became more of an early riser, and my schedule flipped. My best and focused work was in the mornings, and I stopped studying in the evenings. Don't be afraid to experiment and try a new schedule out for a few days to see how it feels. Transitioning from night owl to early bird is common as one ages. On a foundational level, you should also know that exercise is a phenomenal way to let off steam, rather than bottling it up inside you. Loneliness is also an insidious factor that can exacerbate stress. Maintaining healthy social support and connections with friends is beneficial, so long as you don't overdo it and neglect other academic and personal responsibilities. As for the targeted strategies, my recommendations depend on the magnitude of the stressor and whether or not you feel the situation is manageable. When feeling overwhelmed or out of control, two things have proven most useful to me. First, slow, deep breathing, and second, mindful observation. The deep breathing helps to activate the parasympathetic nervous system, which is responsible for rest and digest functions. This counteracts the overactive sympathetic nervous system, responsible for the fight or flight response that gets activated in stressful situations. I learned the power of mindfulness when I was battling my first acute flare of inflammatory bowel disease at 18. The pain was intense and excruciating, and I didn't know how to manage it. I tried distracting myself by playing Tetris, thinking that would occupy my mind, but it didn't do much. I was constantly fearful of the next bout of pain. But a subtle mental shift made it completely manageable. Rather than rejecting the pain and wanting to run away and avoid it, I just watched it. I noticed where it occurred, how it felt, and what made it better or worse. Rather than approaching it with fear, I approached it with curiosity. By accepting that the pain was here and simply watching it, the emotional hold it had on me vanished. It still wasn't pleasant, but my stress during the pain decreased, and the stress between bouts of pain had disappeared. You can use this same technique of mindful observation any other time you feel overwhelmed. The next time you feel stressed, observe the bodily response. Do you feel tightness in your abdomen? Is your heart racing? By watching with curiosity, you may also find it easier to separate yourself from the emotional hold of the stressful situation. In my experience, the situation becomes instantly more manageable. Whenever I sat down for a test, I always did better than what my practice questions would indicate. How? It all comes down to self-talk. When approached by a stressful situation, what dialogue occurs in your head? When it came to taking a test, I could feel that the pressure was on. Silence across the room, other than the shuffle of papers. No eye contact or interaction between students. The environment just felt higher intensity, and my body responded accordingly. That mild physiologic sympathetic response I felt was one of two things, either fear or excitement, and I could decide how to give it significance. I would approach each test with almost an adversarial relationship. It was me versus the test, and with the elevated stakes, my focus was improved. I was excited about it. In my head, the dialogue was bring it. Each time I worked through a difficult problem and I felt confident about my answer, it further bolstered my confidence that I was going to dominate this test. And when I inevitably came across a more difficult question, I acknowledged it was a good try to stop me, but I'd come back before the end of the test and get it right. I understand this sounds ridiculous and way out there, but this worked for me. In fact, I'll admit I even enjoyed taking tests. Sure, studying had its moments of drudgery and boredom, and I had to push through, but taking the test was like playing the sports game. It was showtime. In more extreme situations, where I felt out of control or overwhelmed, I found deep breathing and mindful observation to be the most effective with grounding me. Adjusting my self-talk was most effective only when I was at a more moderate or mild stress level. Deep breathing and mindfulness made chaos feel manageable, and self-talk made the situation become fun. Whether it was a test or another stressor, my self-talk focused on the opportunity to be challenged, to do my best work, and to prove to myself that I could do more than I expected. The last targeted strategy is to break down a seemingly large or overwhelming situation into more manageable steps. Rather than focusing on the idea of having to cycle 100 miles for my first century, which was incredibly intimidating at the beginning of the ride, I just focused on riding one more mile, and then another mile after that. Or let's say you're taking on a big new project at school, or you want to start your first side hustle. Don't look at the final goal, then see where you're at and feel defeated. Instead, ask yourself what is one step I can take today that will bring me closer to that goal, and what about the day after that. As they say, we often overestimate what we can accomplish in a day, but underestimate what we can accomplish in a year. Some of this stuff may seem out there, but I hope you find something useful. Since procrastination is such a common problem we all face, and a huge cause of stress, you may enjoy watching my video on 7 steps to cure procrastination. And if you're dealing with feeling like a failure or letting yourself down, I have a video on that too. Thanks for watching, much love, and I'll see you guys in that next one.