
Mega Doctor News
By Michael Merschel, American Heart Association News
Even without final exams looming, Andrea Rivera is all too familiar with stress.
Rivera, a 23-year-old journalism major, is taking classes at not one but two schools: San Joaquin Delta College in her hometown of Stockton, California, and an hour away at Sacramento State. She’s paying her way by working full time as a restaurant manager.

Finals make everything more hectic. “My stress just goes completely up,” she said, tallying her end-of-semester workload that includes a group project for Spanish, a social media package for journalism and a five-part project for geology.
The pressure of finals is familiar to anyone who’s been to high school or college, said Dr. Raychelle Cassada Lohmann, a licensed counselor in Cary, North Carolina.
“It’s a time when all of a sudden everything is coming down the pipeline at once,” said Lohmann, who also is an associate professor at the University of Mount Olive and spent 20 years working as a school counselor. In high school, she noted, many courses include state-mandated exams that can affect teachers, “so students may feel that pressure coming from the educators.”
Finals stress has many layers, said Dr. Leslie Ralph, a licensed clinical psychologist who is coordinator of communications for Counseling and Psych Services at the University of Arizona in Tucson.
The most obvious one for many students is that “the final exam can make or break their grade” when a lot of hopes might be pinned on the results. Being cut off from social support or relaxing hobbies during finals only adds to the stress.
In general, stress can affect both physical and mental health. Although short-term stress can help you stay alert while you study, long-term stress has been linked to problems such as the risk for developing high blood pressure or having a heart attack or stroke.
Stress, which Ralph defined loosely as feeling you have too many demands to keep up with, can also lead people to unhealthy coping mechanisms such as substance abuse. It also can lead to anxiety, where people are consumed by worry and overthinking even when a stressful period is over. That can lead to headaches, sleep difficulties, an upset stomach and more.
Here’s advice on how to cope with finals stress in a healthy way.
Come to terms with procrastination
Procrastination isn’t always negative, Lohmann said. “Sometimes we’re procrastinating because we don’t have the pieces we need to solve the problem yet.” But close to finals, “procrastination is not your friend.”
Looking at the big picture of everything that lies ahead can make the challenges seem overwhelming. Her advice is to not see the forest but individual trees – that is, small, achievable tasks that can get you toward your goal.
Start by looking at what you need to do for each class, Lohmann said. “You’re going to realize that some of the courses that you’re taking aren’t as difficult as other courses.” Figure out which ones need the most work, then divide your time accordingly.
“Start with the course that you dislike,” she advised, “because that’s the one we want to procrastinate on, and that’s the one that needs to be at the front of the line.”
Take care of the basics
Include time for your own well-being by making sure you’re getting enough sleep and eating healthy food, Ralph said.
“Basic self-care is really important,” she said, “because we know that when we’re stressed, we don’t learn or perform optimally, and we can get into a vicious cycle,” where the more stressed you are, the worse you perform, and the worse you perform, the more stressed you are.
Sleep, Ralph pointed out, is when our brains process memories and consolidate learning. (Sufficient sleep also happens to be essential to heart health.)
Lohmann advises carrying healthy snacks to study sessions. Otherwise, you’re going to be tempted by fast food, which is hardly the best fuel for your brain as you try to learn.
Steer clear of excessive caffeine and energy drinks, she said. Stress can feel like a stimulant, and energy drinks can exacerbate the symptoms of anxiety.
And don’t skimp on exercise, she said. “Go for a walk, go for a run, do something just to get some fresh air and get that heart rate up.” Physical activity can help you learn, problem-solve and improve memory, according to the Centers for Disease Control and Prevention.
Stay connected
Ralph said a sense of community is an important barrier against stress, but many students end up feeling lonely in intense academic situations. So studying with friends can help.
Lohmann said it can be validating to be around other people who share in your struggles. “You’ll hear that you’re not alone, that many of them are feeling the same thing that you’re feeling.”
But choose your study groups carefully, Lohmann said. If you’re someone who needs help focusing, you don’t want to be surrounded by people with the same problem. “You’re going to want some of those that are really self-disciplined.”
Get help
High school counselors and college wellness centers can help with problems such as test anxiety, a condition that can cause someone to forget what they’ve studied under the pressure of an exam.
“There are definitely resources available to help you learn to cope with those levels of stress, especially if it’s beginning to affect your daily functioning,” Lohmann said.
Pace yourself
Ralph likens finals preparation to training for a marathon. Ideally, you’ve been “slowly and steadily working toward that end goal” instead of using “big bursts of stressed-out energy, followed by a collapse.”
But if you find yourself in that latter category, you can still pause to make a plan that makes the best of whatever time you have now. “The last thing we want to do is get very anxious and stressed and procrastinate, and then try to pull an all-nighter or cram right before,” Ralph said. “That’s like if you were to run a marathon the day before you ran your marathon. It doesn’t work that well.”
Your plan should leave out using drugs or alcohol to cope with stress. You also should avoid beating yourself up if you’re in a tough situation.
But your plan should include breaks, Ralph said. “It can be scary to say, ‘I need to take a break from studying,'” she said, but treating yourself “like a robot” and ignoring warning signs isn’t healthy.
Keep perspective
Students can help themselves by stepping back and looking realistically at the expectations they’ve put on themselves, Ralph said. Otherwise, they can enter a spiral of “‘if I don’t pass this final, then I don’t get into my major. And if I don’t get into my major, then I won’t get into graduate school. If I don’t get into graduate school, I will never get a job.’ And it can just spin on and on.”
That kind of tunnel vision isn’t necessarily accurate, Lohmann said. “I mean, if you’ve gotten good grades throughout the duration of the semester, this one exam isn’t going to break you. But if you are a perfectionist, or you put a lot of pressure on yourself to succeed, you begin to feel that way.”
She tells students to “keep your eyes on the end goal. Know that this is just a moment in time, and within two or three hours, it’s going to be over.” And once you pass this course, “you’re done with it forever.”
Rivera, who recently wrote about student stress in the Delta College news publication, acknowledged that she’s fallen into some of the traps, getting help from caffeine while sleeping about four hours a night.
But she makes time to find a balance by reading, watching TV or talking to someone she knows is watching out for her, such as her dad, whom she describes as her “go-to guy.”
After her finals end, Rivera plans to take a day off, maybe head to the beach, acknowledge the work she’s done – and get ready for the summer class she’s taking.
But she’s indeed focusing on the end goal – in her case, graduating from college debt-free and the life that happens after that. “I’m looking forward to the payoff.”