Last updated on August 10th, 2023
Stress can you ruin your board scores. It sounds like a cliché, but actually, it is true! Stress leads to fight, flight, or freeze scenarios. When our autonomic nervous systems are out of balance, we can go into overdrive or we can freeze up completely depending upon whether the adrenergic nervous system or the parasympathetic nervous system is over-activated. Neither one of these is helpful for a good outcome in your test scores.
Acute stress and chronic stress can both be a problem. Performance response to anxiety is an inverted, U- shaped curve. A little bit of anxiety makes us care about the outcome and increases our performance. But, as anxiety further increases, our performance degrades, and we become dysfunctional.
When stress becomes chronic, a number of physiological changes occur; cortisol levels elevate. Over time, this can lead to a number of secondary changes. The hippocampus, required for the incorporation of short-term memories, shrinks. The conversion of T4 into the active T3 hormone decreases, leaving the individual with lower thyroid function at the cellular level.
When cortisol is chronically elevated, it is often in the evening, making it difficult to get to sleep at night. It can also be elevated during the night, causing early morning awakening and difficulty sleeping through the night. Anything that is bad for sleep is bad for memory incorporation. Without good memory incorporation it is difficult to retain material that you study for the boards.
It is not just a platitude that stress management is important for health and brain function. Chronic stress rewires the brain in bad ways. Try these five stress management techniques to take control of your body’s stress responses and improve your board scores:
- Prioritize sleep try for at least 7 or 8 hours a night. Time and again I have seen someone stay up all night studying to get one more question right and what they end up actually doing is getting 10 questions wrong because they were so sleepy their brain was not functioning well.
- Don’t ride the sugar roller coaster. You need to eat healthy, low glycemic foods and healthy fats to keep your brain cells happy. Repeated spikes of sugar and insulin followed by reactive sugar lows do not promote good brain function.
- Slowing your respiratory rate to around 6 per minute with a prolonged out-breath can activate your parasympathetic nervous system and bring it in to balance . Try doing this for 10 minutes, twice a day. Or try it when you are starting to panic – just make sure you do not breathe too deeply and hyperventilate. [A smartphone Breath Pacer App is a good way to do this]
- Take a walk. Go for a swim. Workout in whatever way is most relaxing for you. The time away from study will be well spent, as it will increase your well-being and your concentration.
- Read something non-medical before you go to sleep. Getting away from screen time for 30 minutes before bed can promote deeper sleep that helps memory incorporation.
If you need help preparing to take your boards you can access our board review courses for psychiatry and neurology at Beat the Boards, and all other medical specialities at The Pass Machine.
American Physician
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