What is Stress?
Stress is a nonspecific response of the body to any demand upon it. It is a mismatch between perceived demands and perceived ability to cope with the pressures and loads placed upon us. It can be a mentally or emotionally disruptive influence. We generally use the word “stress” when we feel that everything has become too much to bear. Anything that poses a challenge or a threat to our well-being is stress.
Stress can be positive (eustress), e.g. swerving your car to avoid a collision, or negative, e.g. unable to get up in the morning to face the overwhelming workload.
Yet, our mind does a poor job of distinguishing between daily stressful situations and life-threatening events. Anxiety or anger triggered by less important sources of stress, such as financial fears or traffic jams, don’t find a quick physical release and build up as the day rolls on. Adding to the turmoil is anticipation of potential problems, e.g. government warnings of terrorist activity or awaiting medical test results. Thus, the stress we experience becomes chronic or constant and may have medical repercussions.
Glance at the ten leading causes of death in America, and you won’t find the word “stress” anywhere. Yet many studies link stress to heart disease and stroke, two of the top ten killers. Heart disease alone was responsible for more than one in three deaths in 2002.
Stress also influences cancer and chronic lower respiratory tract diseases, which rank as numbers 2 and 4, respectively, in the top 10. With reference to executives alone, the American industry loses between $10 and $20 billion annually through lost days, hospitalization and early death caused by stress.
What creates Stress?
The specific stressor (agent or stimulus that causes stress) and the duration of the stressor, plus the individual’s make-up determines the stress impact. Generally (but not always), the more stressors we experience, the more stressed we feel.
• Stressors may be:
– Physical, e.g. pollutants
– Social, e.g. loss of a loved one
– Psychological, e.g. jealousy.
Numerous scales have been developed to quantify the impact of various stressors. Professor Thomas Holmes (psychiatrist at the University of Washington) developed the Holmes Stress scale wherein 42 stressors were rated, including changing work or schools, trouble with the in-laws, a house mortgage and others. The death of a spouse was rated as the highest stressor, followed by marital separation. Minor law violations were rated as the least cause of stress. Interestingly, vacations scored higher as a stressor.
• A person’s personality may be determined by:
– Hereditary factors
– Environmental factors
– State of mind at the time of the stress.
We all vary with regards to individual make-up and handling stress. Probably the most well known description of personality types and their susceptibility to stress was done by two cardiologists, Friedman and Rosenman. They described Personality Types A and B.
– Competitive personality who is constantly striving
– Time urgency, hostility, aggressive
– Compulsive, hard driving, deadline driven
– Impatient due to delay, suppresses fatigue, and tries to control environment
– Doesn’t listen and is a fast talker.
– Passive, restrained, not overly ambitious
– Non-competitive, unhurried, relaxed
– Listens and talks coherently.
The link between personality type and heart disease remains controversial though. It is now suggested that it is mainly hostility, a tendency to become angry quickly or react in a hostile manner, that predisposes one to cardiovascular disease.
What happens when we are Stressed?
There are two internal systems activated when stressed. One results in the release of corticosteroids (e.g. cortisone) and the other results in the release of the catecholamines (namely, adrenaline and noradrenaline).
Cortisone’s function is to prepare the body for danger, suppressing local reactions so the body is better prepared to deal with the stressor. However, if chronically produced, as in stress, it reduces the action of the defensive cells and organs of the body, such as white cells, thymus and lymph nodes. Thus, we are more prone to infection and tumour cells can spread more easily. Cortisone stimulates glucose production and inhibits insulin predisposing us to diabetes.
Catecholamine release results in what is known as the fight, fright or flight response. Catecholamines cause the motor nerves to become excited. This in turn causes the major muscles to tense up as we prepare to fight (brace for action), flee or freeze. When we are chronically stressed its leads to muscle spasms, resulting in symptoms such as tension headaches, backaches, neck and shoulder pain. At an extreme, muscle tremors may occur, together with increased breathing and sweating. Senses become hyperalert in preparation for danger and we experience decreased saliva flow.
Our bodies simultaneously try to react to the stress and recover from it as well. It’s almost as if we are driving a high-powered vehicle by flooring the accelerator and standing on the brakes at the same time. But just like a car with a constantly revved-up engine, the brakes will fail, and the body’s stress response continues unabated, repeatedly launching the stress response, impacting negatively on the body.
Chronic stress may lead to atrophy of body organs, specifically in the brain’s hippocampus and prefrontal cortex. It may impact the heart, lungs, blood vessels and kidneys resulting in an increase in heart rate, respiratory rate and blood pressure. The higher your blood pressure, the greater your risk for a heart attack, heart failure, stroke and kidney disease.
Research published in The Lancet in 2004, which involved over 24,000 participants from 52 countries, demonstrated the role of stress in heightening heart attack risk. Despite variations in the prevalence of stress across countries and ethnic groups, stress levels were uniformly higher in the individuals who had suffered heart attacks than for their healthy counterparts.
The symptoms of stress may be physical or psychological. They include and are not limited to:
• Anxious thoughts
• Poor concentration
• Sleep problems
• Tense muscles
• Stomach ache
• Weight loss or gain, etc.
Common stress related illnesses and diseases
• Angina and myocardial infarction (heart attack)
• Hypertension and stroke
• Other heart or blood vessel diseases.
• Indigestion, nausea and heartburn
• Stomach and duodenal ulcers
• Ulcerative Colitis
• Irritable Bowel Syndrome
• Diarrhoea or constipation
In England, during World War II, immediately following a bomb attack, people would appear in hospitals with bleeding ulcers.
Muscles and Joints
• Cramps/muscle spasms
• Back pain/neck pain
• Psychiatric disorders
• Skin disorders
• Rheumatoid arthritis
• Common colds and Influenza
“Stress Dwarfism” documented among children living in war zones or in orphanages where they were fed and housed, but were emotionally neglected.
Stress May also Predispose One to
• Work conflict
• Marital conflict