As-salamu alaykum warahmatullahi wabarakatuh and welcome back to the final segment of Salam Britain of today. Our next guest is a Birmingham-based GP and chair of council at the British Islamic Medical Association, masha'Allah, who has dedicated his work to supporting the health and well-being of Muslim communities across the UK. He joins us today to talk about something many of us experience but don't always fully understand. And it's stress. I think that's a big topic. Um he will be helping us unpack what stress does to the body, why it's on the rise, and how we can manage uh this stress in healthier, more sustainable ways.

We are really pleased to have Dr. Qasim Javaid with us today. As-salamu alaykum, doctor. As-salamu alaykum and thank you for having me on. Pleasure to be here. Uh very welcome uh to you. Um so, doctor, as a GP, what are the most uh common signs of stress you see in patients, especially the ones people tend to ignore? So, absolutely, stress is something that I will see on a regular basis as a GP in my clinic. Um sometimes the patients that are coming to me are actually not even aware that they are suffering with chronic stress. Um and that's because it can be quite tricky to pick up. There are, you know, various signs of uh physical health and

even mental health that can be affected and underlying really is elements of chronic stress. Uh when you think about, you know, symptoms physically, stress can manifest in different ways, things like headaches, things like tiredness, raising the blood pressure, uh even things like gut disturbances. So, you know, often people are becoming more aware of things like irritable bowel and having kind of variations in how your gut is working. We can definitely see signs about how that's linked to something like stress. And mental health, of course, we know that uh where people are suffering with stress on a regular basis, you know, frequently experiencing stress and worrying about stressful things, it can

certainly impact in terms of things like depression, anxiety. And really, where the patients are coming into my clinic, the worry is that I see them more so at the latter part of all of these things. So, when people are really suffering with long-term elements of stress, they might actually present to me with something like high blood pressure or they might actually present to me with something very physical, like diabetes. But really, although I can, you know, adjust things in terms of medications and do some tests, when we scale things back and look at some of the underlying reasons that things like their eating habits or things like their coping mechanisms are perhaps not quite

where we want them to be, we realize that the underlying cause is often something related to stress that's happening in their lives and causing these things to happen and it's manifesting physically or mentally, and that's where I see them in clinic really at quite a late stage. Right. Um that's very actually informative to know, doctor. Thank you for that. But now, people react to things and to situations uh very differently. You know, we are different, we perceive things differently, we understand things and um life very differently. What makes people um more susceptible to stress than others?

It's a very good question and I think there's two or three elements to that question. With stress, realistically, when I give talks on stress in the community or even to my patients in the consultation room, I would start with, you know, have you ever experienced stress? And everyone will say, absolutely yes, I have. And that's that's almost uh a funny question to ask because we know everyone would have experienced stress. It's a normal body function and response to certain situations. We need stress at certain times. Sometimes people know it as a fight or flight response or um a way of kind of responding to certain intense situations, maybe when you're rushing to get to the train or maybe when you're uh

coming towards exam season as a student or when you've had some difficult situations at work. And a short period of stress with some release of hormones like adrenaline, cortisol, things like that is totally normal for the body to do. Where we're running into issues is where we're over-activating that stress response and we're constantly releasing some of those hormones and not actually finding a way to uh dampen things down and tell the body to rest and recuperate. Some people may have developed mechanisms and their ability to actually deal with stress can really help them in the long term. And I always give this analogy that we could have two people in the same workplace with a very similar uh family situation and various

responsibilities, but their ability and coping mechanisms to handle the stress coming their way can be totally different. And that's why their outcomes, both physically and mentally, can be completely different, even if they had the very same situation. And so, there are certain, you know, tricks, mechanisms that can really help us in terms of managing and coping with stress. We're going to um reflect on the mechanisms and how to deal with stress in few minutes. But first of all, um there is something else I wanted to ask you about, doctor, and it's cortisol. Where is cortisol in all of this? So, you mentioned adrenaline. Adrenaline, that's the hormone that we need when we are stressed to prepare for an exam, so

we have that huge motivation overnight sometimes to just prepare for the exam and that get it done or to do something very urgent. That's uh that hormone we need. But where is cortisol in all of this? It's a good question and I think the way we should think about all of these hormones is actually that the body is very intelligent. Alhamdulillah, you know, Allah has created us in the best of fashions. So, things like cortisol, adrenaline are important hormones for the functioning of the body. When we when we wake up, we should have a surge of cortisol to get our day started. And actually, things should start to calm down through the day.

It's the adrenal gland pumping this hormone around to get things going, calms down during the day, and then we should have another surge a little bit later on, and then it calms down overnight. And adrenaline is something in similar fashion that should be just short bursts and surges during these important intense situations, but really should be calming down. Where we're running into issues is, of course, where these hormones are just constantly being pumped around the body and we're we're entering this high stress zone, even unnecessarily, when we're just doing things like going to work or at college and doing our regular daily activities, and our body thinks that actually we should be in the maximum fight or flight mode. And

that over long periods of time releases things causing sugar surges, causing blood pressure raising, making the heart rate go faster, the breathing rate go faster, because these are all important functions during an intense situation, but of course, when you're just supposed to be doing your regular work and day job, shouldn't really be being activated. So, can cortisol, like if it's included in the stress mechanism there, can it affect, for example, um the loss of weight? Perhaps or other kind of um vital functions in our body? It's a very good point you've made because actually we know that chronic stress can lead to issues with weight gain and having difficulty to actually manage a healthy weight.

Cortisol is likely an important factor in that because we know one mechanism of it is to release more sugar into the body. Naturally, that should be, you know, a good thing at certain times. We need the sugar boosted in our bloodstream to activate us, give us energy. But if we're actually releasing that unnecessarily and it's then being stored and causing us to increase weight, then it's becomes that unhealthy response. And what we're seeing there is a, you know, poorly regulated body system. What I observe, you know, with many of us actually is um people sometimes gain weight because of stress or they go through uh you know, um a near group of chronic diseases and the core reason for that initially was stress, but sometimes they are not aware

of that. They were just, oh, because I'm getting old, perhaps. And they don't see it as a stress or a chronic stress work-related, sometimes family-related, relations-related. So, how first of all to be aware of what's happening to us and to our body? This is really important and I tell this to a lot of people. The first way that you might manifest this is often unrelated to a stress, but actually could be physically. And people who come to my clinic in GP or people I see in the community, often the complaints that they might have might be quite non-specific, things like, you know, tiredness all the time, poor sleep, um issues with the gut as we mentioned. And although we will still look into a lot of the physical health causes of

that, we often run some tests, they might not actually find anything very clear to suggest why they're experiencing that. And that can sometimes be a very good sign for us to pick up as GPs and doctors that actually is there an underlying stress which is causing the person to feel like that. And I think one, you know, undervalued element perhaps in one society and definitely, you know, medically speaking, is the over-emphasis on looking for the physical aspects of things, looking for tests, looking for investigations, and actually treating the person more holistically and thinking, okay, what's going on in their life? Yes, they might have you know, specific medical condition like diabetes

or like high blood pressure, but aside from just the test, the medication, are there other factors that could be contributing to this person's well-being, their overall health, and how they're actually feeling day-to-day? And that's really where stress should be an important aspect of any discussion because we know it will enter everybody's life to some degree. And in the natural busy world that we're in now and the stressful elements of the world, it will be, you know, likely increasing. We know that actually for a lot of uh employers, it's the number one cause of sickness and being off work. So, to some degree, every discussion should be factoring in how are you coping with stress at the moment? Are there any stresses in

your life at the moment? Yeah. So, obviously, you know, as a human being, we are sometimes after quick solutions. Let's be honest. And what we do sometimes, if we feel um uneasy or uh a bit down, um low energy, we recognize sometimes that it's stress. So, we go we rush to some supplements and we self-medicate sometimes. So, what's your take on this? Is it efficient to treat the stress by some kind of supplements? Maybe because they are trending on social media? This is uh something that we're seeing quite a lot in clinic. A lot of people um asking about supplements. There are, you know, to good degree, some uh supplements which are effective and good for our uh general health and well-being. You know, things like

vitamin D I recommend across the board. And I know that social media has a lot of encouragement about various other supplements. But I always start with patients, let's keep it simple initially. That's the sort of the 5% or 10% at the end we should be thinking about. Initially, we should dig back into the actual main crux of what we form our well-being from. Namely, these things are you could think of in four broad areas. Your sleep because that's really important in terms of the overall well-being of your health, your recovery in terms of stress. Your eating because we know that what we consume and what we put into our body has a massive impact on how we're doing.

Your physical movement. If you're not moving, if you're not releasing good healthy hormones like dopamine and serotonin and having good outlets of stress, then you're going to have a lot of other health issues. And lastly, your recovery. And this is where actually, you know, we're we're very fortunate I'm going to be speaking on Islam channel because your recovery can incorporate a lot of things. Modern science has shown us a lot of benefit in terms of things like meditation and mindfulness. And I hope that we have a lot of good aspects of the religion to actually find, you know, small moments and small pauses in the day to really find recovery and galvanize ourselves. So, always keep it

simple. The supplements are really important aspect for some people, but actually just those four areas to really think about in terms of what's contributing to your overall health. Uh and digging into those can find many more solutions which has long-lasting impact. Right. Just to make it clear to our viewers, stress is going to be existing in our life anyway. This is something that we can't avoid. It's part of our life. But then um it differs from person to a person if they are ready and they have that recovery mechanism, they prepared for it, they understand, they are honest with themselves, they understand what their body is going um through.

Uh so, the recovery system, I think this is a very interesting thing to talk about today. What it is exactly and what are the components of this system? How can we develop it and how can we embed it in our subconscious so we can get it like as an automatic um system to uh to use when we are stressed out? Yeah, I'm I'm really glad you're talking about this because I think this is the key in how we can really look to tackle stress. Look, having a recovery system or plan is essential in the modern life and it's something that we're probably all missing to some degree. When you think of stress, that's the output. The input to that is our demands, okay? So, things like your family pressures, your work pressures or

college pressures, and certain events that just happen and you can't do anything about, financial issues or housing issues. The demands are unfortunately always going to be there and are quite tricky to change to some degree. But what are the counteracting mechanisms? Really, we should be thinking of a recovery system and methods to counteract these things. So, as well as recovery, our support and our aspects of control. So, support is things like your family, your friends, people at work who you can actually talk to in a positive social light. And we know that this has a really beneficial effect, having a way of communicating the issues you're facing. And sometimes taking those few minutes after work to

discuss with your family or your spouse about some of the stressful aspects of your day to just have that outlet can be really effective and something that we undervalue. And we know men in particular um do struggle with this in terms of, you know, releasing some of that stress that they've built up through the day and actually having a healthy outlet. The recovery systems that we should be thinking about are there any pauses in your day that you can in implement already? Because this is an easy win. Are there a 5 to 10 minute period in the day that actually you can implement which is not related to work, not related to the pressure and demands of your day and purely for yourself? You don't necessarily need to be doing

something high energy and engaging. If you can, as I said, physical movement is a really good healthy strategy. So, whether that's a uh a short walk Would walking Yeah, exactly. Yeah, absolutely. It has a huge positive effect. We're lucky now there's a bit of a change in season so we can make use of that. It can be more physical exercise. We know that people who are running, people who are using the gym, these kind of things. But the lowest and easiest way to get involved is just walking. A simple walk can do wonders. But still, the recovery at its most basic fundamental uh idea is just a period to stop doing high pressure work, high pressure family things. And a 5 to

10 minute ask is something we can all implement. Ideally, it should be about a 30 minute aspect of the day. But if we have a 5 to 10 minute period away from stress, some element of re- quiet reflection. If you can incorporate uh an Islamic aspect to that, that's also going to benefit, no doubt, in terms of, you know, uh vicar or reflection or uh reading Quran. All of these things which we know from our religion that answers are already there actually will, you know, improve us in many ways. But just some aspect of the day where you're implementing a uh concerted effort to have recovery alongside your support network and alongside some aspects of control because we know that's also

important and a slightly trickier one. But sometimes people feel more stressed when they feel there's a lack of control in their life. Whether that's things to do with the workplace, whether that's things to do with uh the financial pressures of home, all of these things. So, if you can in- increase some aspect of control in your life and something that's just for you, something that only you're doing, we know that this is a good way of counteracting stress. And although it might start quite simple and quite small, over time that system can grow and importantly is counteracting all the harmful effects of stress.

Right. Amazing. Amazing, doctors. Now, let me ask you the question that everyone is looking for. The easiest, the fastest solution. If I'm stressed now and I want just to cool down very, very quickly, what should I do? First thing to do. Always, if you look at any intervention, it is uh within NHS guidance is some form of exercise. And that's being quite honestly, you know, to the point. So, it's not some kind of new supplement that's being released. It's not some kind of uh home remedy. It can be talking to people and things like that. But we know that, you know, some form of physical movement is always a really constructive way of dealing with stress. As I say, that can be as simple as just

a small walk, you know, 20 to 20 minutes or so just in your lunch break or something like that. But somehow you need to counteract these things by releasing the endorphins, releasing the dopamine, getting some positive energy, and coping with the stress in a much healthier way than, you know, perhaps going on your social media, maybe tuning into the TV. All of these unhealthy mechanisms which or even, you know, sugar cravings and eating. All of these unhealthy mechanisms which will only compound things and increase the stress over time. Very useful. And that this reminds me actually of a quote of Rasul Sallallahu Alaihi Wasallam.

Um I'm just going to say the general idea of it. So, if you are angry, to if you are when you are angry, if you are standing, just sit down. If you are sitting down, just stand. If you are inside, just go out. So, change the position you are in. And as you said, movement. Movement is very important when you are in that situation of anger, of stress, and uh that kind of thing. Yeah, absolutely. And the answers are all there for us. And that's why we're so fortunate. So, we can put these simple interventions, simple ideas into our day-to-day. And importantly, take a proactive approach. If we take this

proactive preventative approach, it's much less likely that I will have to see people in clinic with, you know, much worse physical issues that we touched on because really we want to prevent that happening with chronic regular stress. Absolutely. Now, doctor, what role can community spaces like um mosques or youth groups, local initiatives play in reducing stress and supporting well-being, perhaps? There's a huge role for uh community organizations like the ones you've mentioned in terms of the mosques, in terms of youth clubs to proactively talk about stress. So, uh an example might be something like um with the British Islamic Medical Association,

we work closely with mosques um around the UK actually to do something called Mind Savers, which is all about mental health training and dealing with these kind of issues and getting it out into the community. Importantly, we need to have these conversations out in the community so then this information and awareness is there for people to learn from. In fact, our entire conference this year is uh for BIMA uh is labeled uh Living Well, Restoring the Balance. And it is all about restoring the balance to some of these issues that we're facing in health to try and bring back a more holistic view of health in terms of these aspects that we've touched on. So once we start

having these conversations with other mosques and with other youth clubs and organizations, that's how we'll get the information out in the community that we need to be proactive and on the front foot to try and deal with these issues. What point should someone consider speaking to their GP or professional about stress and what does that first step look like? Yeah, this is still really important because there is definitely a role for speaking to your GP with stress. Um as I said sometimes it's not always obvious but if you are experiencing these kind of physical or mental health

more non-specific concerns, there could be something that we need to dig deeper into. Sometimes with tests but sometimes with just looking back you know aspects of your day-to-day which could be contributing to these symptoms. And importantly with stress itself, you know, if you're regularly experiencing stress, it's affecting your day-to-day, it's affecting your workplace. You're constantly feeling overwhelmed and high intensity. Come to come and speak to us at the GP surgery. There are different ways we can deal with it whether it's that through talking therapies or counseling or actually talking about you know ways to deconstruct some of the four aspects of your health and well-being that I just touched on.

So these are kind of different ways that we can get and help tackle the stress with you in a consultation. Absolutely. Thank you very much doctor and again for our viewers if you feel that you're suffering from stress or you your health is deteriorating your so your [clears throat] health condition is deteriorating in somehow because of stress, just go to your GP and consult your local GP. The experts should give you the right advices and tell you what to do. Exactly our conversation day was to tell you what is stress and how can it affect your health. These are just general information and if we dig down deep down, I'm sure we will unveil lots of other details about how the stress affects your body and it's different

from a person to another.