Exam Countdown has begun! Part II

 

This is in continuation to the previous blog where I wrote about pre-examination manifestation of adrenal cry. Unlike other diseases, this “adrenal cry” pathogenesis passes through distinct stages (We need not to talk about etiology, do we?). In following texts I will be discussing clinical course and pathogenesis of the adrenal cry.

Stage 1: Worried

The moment you get a circular from University, declaring the date of your final exams, you enter into this stage. To be more precise, preceding your entry to this stage, there is a transient phase of happiness (cf. transient vasoconstriction followed by prolonged vasodilatation in acute inflammation) because you have already started to think about your post examination plans.

But as soon as you work out the stuff need to be read, the worry start to play “Garba” around your grey matter on tune of “ my friend you are in stage 1”. The scenario particularly worst for PG students as they haven’t appeared for any exams in last three years (In fact, some of them already forgot to spell “examination” correctly). The thought of sitting and writing for three hours has potential to pass a chill through your skeletal in spite of obvious perspiration from face sweat glands.  This stage is further aggravated when you juniors tell you “Boss! You need not to read, you will do well”:P

Interestingly, during this phase you pass through lots of WTF moments and wonder about where you spent last three years.

The only good news about this stage is, it is short one and let you enter in the next stage of pseudo-euphoria.

Stage 2: Pseudo-euphoria

Pseudo-euphoria is actually our brain’s compensatory mechanism which works on psychology of secondary gain. As I discussed previously that in present time we don’t have option of fleeing in stressful situation, alternatively our brain has developed this adaptation. At the beginning this phase is intense and then it becomes feeble and persists in residual state till a day before exams. Eventually, it ceases itself as soon as you have exam question paper in hand while in examination hall. It is so strong betrayal, leaving you in middle of examination hall. It is akin to withdrawing sympathetic support from patient having compensated congestive cardiac failure.

This adaptive stage start with self explanation e.g, come on, I will pass the exam, it is very easy, and in last three years I have already read all books. Some of them are even little overt e.g, my memory power is very good so it would be problem, I will finish everything in couple of days.

Once you finish this job of getting explained that you will pass this exam, you are in full blown Pseudo-euphoria stage.

Stage 3. Reading

 

At the end of stage to you realize that your cool attitude is not going to work and there is only three options: Read, read and read

This stage is relatively short in duration and the quality of reading is not that good. It is more on psychological support and to maintain that residual pseudo-euphoria. Essentially the reading quality is equivalent to student on amphetamine just day before the exam. The only, goal of the reading is to turn all the pages of all the books at least once regardless of what is written in there.

It has mix picture due to residual presence of stage 1 and 2 so while planning your reading schedule (which you usually work out at the end of stage 2) you should all some days in between for possible predominant periods of aggravated residual worry and pseudo-euphoria.

Stage 4: Unsure

This stage starts couple of days before the exams and lasts till the results are declared. During this stage all of sudden your all emotional supports becomes weak but interestingly you have a hope of passing (of course hopes are all about uncertainty!). The major symptoms are: you start to believe in God and some unexplained natural powers. In spite of the fact that you haven’t walked for 20 km ever in your life, you will bargain with God with offer of walking to his temple, 20 km far away, in exchange with passing marks.

Even after passing exams, you are unsure that how examiners managed to pass you!

Conclusion:

The pathology of “Adrenal Cry” or examination related pre-cushing syndrome, in other words, passes through distinct stages which give us scope to design the intervention accordingly.

The present modality of treatment, prevention and future interventions strategies will be discussed in subsequent blog posts.   

Exam Countdown has begun!

      

You need to worry especially when your all books look New totally!

Just 60 days to Final exams!!!  My heart is pounding, and the adrenals have already started to cry. Yes, there is subtle difference between crying adrenals and adrenals with attitude “yes I can do it”. In later case you call it “Adrenal rush” and its most of time “flight or fight” response to some stressful/fearful situation. Well well well, this true in pre-civilization era where you had choice of fighting or fleeing. But, in this era you don’t have option for fleeing and you are left out with only option of fighting, that’s what known as “adrenal cry”. Interestingly, “adrenal cry” secrets plentiful of glucocorticoids (kind of stress hormone) over adrenalin compared to “adrenal rush”. Adrenal cry has deleterious effect on your physical and emotional health (most of emotional disturbance is secondary to the deteriorating physical health due to excess stress mediators).

 It’s kind of pre-cushing syndrome status, manifested by wasting of skeletal muscle which is further aggravated by forceful sedentary status as a result of 24 x7 Fevicol –ing your butt to chair and table full of books. Paradoxically, your stomach start to build belly and it is on boomerang has you have starved it for long time (its revenge time buddy). Typically, your stomach protrudes from point down to your umbilical though its anatomical location is above the umbilicus (I guess stomach has arms which are known as “greater and lesser omentum and they are extending down the umbilicus). The skin started to lose its glow and the beard purposefully start to grow which helps other people to identify you as “exam going” (it’s kind of do not disturb sign on your face). The large bowel may suffer from alternate constipation and diarrhea owing to frequent change in ratio of glucocorticoids to adrenalins. The brain is represented by slowly developing “khaduch” attitude where it usually ignores/do not appreciate beautiful things happening around.

One of important manifestation is, all of the sudden everything seem to be so important and you want do everything in this 2 months i.e, you want to start blogging, you want to fall again in habit of reading, you want to read more and more non-educational stuff, you want to start intense cycling and.. Especially you want to join gym and get your shape back by exams (I am not sure if there is any positive correlation between the body shape and exams clearance). You haven’t cleared exam yet and you start to think of getting job!!!  But, it is again adding some more key players to the vicious cycle of stress – broken goals - - stress.

The Good News!  

Is that this is self limiting status which pass through some well defined stages and it is very well preventable as well as curable! Though, right now I don’t want to add one more key player to vicious cycle by writing to too much right now. I will talk about pathogenesis, prevention and treatment later in this week. So, happy exam oriented reading now!