What Doctors Don't Tell YouTest-taking anxiety or stress is common among secondary-school and university students. It can be both distressing and debilitating. It is not uncommon for a good student who has had good grades throughout the year to find that these drop at exam time. This could be due to poor exam preparation techniques, but high levels of stress and anxiety before or during a test can also reduce exam performance.
Stress is neither negative nor positive. It is just our body’s normal response to challenge, threat or excitement. A little bit of stress can spur us on to do better. But chronic stress affects not only our energy and enthusiasm for the task at hand, but our mental faculties and immune function as well. This is one reason why students under pressure are more prone to colds and other infections.
Apart from being prepared, the following can help to combat exam stress.
* Eat well. Sugar may give an instant energy hit but, eventually, it will make you even more nervy than before. Wholefoods provide sustained energy, freeing your body from the extra stress of big highs and even bigger lows.
* Exercise increases blood flow, including to the brain, and provides a buffer against anxiety associated with minor stress (Ann Behav Med, 1999; 21: 251-7). But keep it gentle. Evidence suggests that while light-intensity exercise lowers anxiety, a high-intensity workout can make it worse (J Behav Med, 1999; 22: 233-47). Yoga is a good choice.
* Avoid stimulants. Caffeine stimulates the central nervous system and heightens emotions. Nicotine is also a stimulant, so using cigarettes to calm your nerves may only deepen anxiety.
* Alcohol may help you to feel relaxed, but at a cost. Apart from a rebound stimulant effect (hyperexcitability), alcohol is an amnesiac; it helps you to forget – bad news around exam time.
* Supplement. Stress depletes the body of stress-busting vitamins C, E and the B-complex family (Am J Clin Nutr, 1995; 61: 631S-7S), and magnesium. A good-quality multivitamin should help replace what is lost.
* Try aromatherapy. Sprinkle lavender essential oil on your pillow to help you sleep. Lemon balm is also effective (Psychosom Med, 2004; 66: 607-13). Put a few drops of lavender or rosemary on a handkerchief to inhale before an exam as these can improve mental clarity (Int J Neurosci, 1998; 96: 217-24). Aromatherapy massage also has a mild, transient anxiety-reducing effect (Br J Gen Pract, 2000; 50: 493-6).
* Drink water. Your brain cells work better when you are hydrated.
* Stay positive. Don’t reinforce fears with negative thoughts. Thinking positive can change paralysing stress into motivating stress. In healthy adults, after a month, positive thinking made their outlook more positive; objective testing revealed a 23 per cent reduction in cortisol (a stress hormone) and a 100 per cent increase in DHEA (an antistress hormone) (Integr Physiol Behav Sci, 1998; 33: 151-70).
* Meditation can reduce anxiety and panic attacks in the long term (Gen Hosp Psychiatry, 1995; 17: 192-200). Mindfulness meditation reduced stress and anxiety among premedical and medical students (J Behav Med, 1998; 21: 581-99).
* Consider adaptogens, herbs that help maintain balance during stress. While the adaptogen Panax ginseng can also be a stimulant, the gentler Siberian ginseng (Eleutherococcus senticosus) is said to sharpen mental alertness and help cope with stress. Try 20 drops of the tincture up to three times a day or take three 400-500-mg capsules a day. Ashwaganda (Withania somnifera) is an Ayurvedic herb with adaptogenic properties (Altern Med Rev, 2000; 5: 334-46). Try 500 mg three times a day as tablets or capsules. Reishi (Ganoderma lucidum) mushroom extract may also help. Take up to 2 g/day as capsules, or 1 mL/day of tincture, or as a tea.
Pat Thomas
Tom Ferguson MD
Daniel Redwood DC