In medical parlance 'stress' is defined as a perturbation of the body's homeostasis. This demand on mind-body occurs when it tries to cope with incessant changes in life. Stress is a concept invented in the 1930s by Dr. Hans Selye.1 Dr. Selye admitted that stress is an abstract concept, and he admitted that stress has never been adequately defined. Dr. Selye's own definition of stress is the non-specific response of the body to any demand.2
Confusion about the concept of
stress:
Dr. Selye erred when he named his creation "stress."3 He had meant to make an analogy with the mechanical engineering concepts of stress and strain. Stress is the measure of a force that changes the length of an object (like a beam or strut), and strain is the resulting deformation of that object. Stress in the health-context, therefore, is a metaphorical allusion to strain: Dr. Selye meant to refer to a reaction to outside forces acting on the body, rather than to the outside forces themselves. So he should have named his conceptual mechanism "strain" rather than "stress. At one point or the other everybody suffers from stress.
"Nothing gives one person so much advantage over another as to remain always cool and unruffled under all circumstances." —Thomas Jefferson
There seems to
be a wide variety of life experiences, which result in some form of stress,
fear, anxiety, or psychosomatic illness.
Causes of Stress
Environmental
factors and processes
·
Changes,
such as sudden trauma, several big crises, or many small daily hassles, cause
stress.4 Intense stress years earlier, especially in childhood, can
predispose us to over-react to current stress.
·
Events,
such as barriers and conflicts that prevent the changes and goals we want,
create stress.4 Having little control over our lives, e.g. being
"on the assembly line" instead of the boss, contrary to popular
belief, often increases stress and illness.
·
Many
environmental factors, including excessive or impossible demands, noise, boring
or lonely work, stupid rules, unpleasant people4, etc., cause
stress.
·
Conflicts
in our interpersonal relationships cause stress directly and can eventually
cause anxieties and emotional disorders.5
Constitutional or physiological
processes
The genetic, constitutional, and intrauterine factors6
influence stress. Some of us may have been born “nervous” and “grouches”
Learning processes
·
Having a
"bad experience" causes us to later be stressed in that situation,
i.e. pairing a neutral stimulus (situation) with a painful, scary experience
will condition a fear response to the previously neutral stimulus. (classical
conditioning)
·
Fears and
other weaknesses may yield payoffs; the payoffs (like attention or dependency)
cause the fear to grow. (operant conditioning)
Summary
of the Effects of Stress and Anxiety
The effects or consequences of stress are also
numerous; they are both positive and negative.
First, the desirable results:
1.
We need and
enjoy a certain level of stimulation...a certain number of thrills. It would be
boring if we had no stresses and challenges. Some people even make trouble for
themselves to keep from getting bored.
2.
Stress is a
source of energy that can be directed towards useful purposes. How many of us
would study or work hard if it were not for anxiety about the future?
3.
Mild to
moderate anxiety makes us more perceptive and more productive, e.g. get better
grades or be more attentive to our loved ones.
4.
By facing
stresses and solving problems in the past, we have learned skills and are
better prepared to handle future difficulties.
5.
Anxiety is
a useful warning sign of possible danger--an indication that we need to prepare
to meet some demand and a motivation to develop coping skills.
The negative effects or consequences of
stress and anxiety
1.
Several
unpleasant emotional feelings are generated--tension feelings of inadequacy,
depression, anger, dependency and others.
2.
Preoccupation
is with real or often exaggerated troubles--worries, concerns about physical
health, obsessions, compulsions, jealousy, suspiciousness, fears, and phobias.
3.
Most
emotional disorders are related to stress; 7 they either are caused
by stress and/or cause it or both. Interpersonal problems can be a cause or an
effect of stress--feeling pressured or trapped, irritability, fear of intimacy,
sexual problems, feeling lonely, struggling for control, and others.
4.
Feeling
tired is common--stress saps our energy.
5.
Many
bad habits (e.g. procrastination and much wasted time are attempts to handle
anxiety. They may help relieve anxiety temporarily but we pay a high price in
the long run.
6.
.Psychosomatic
ailments result from stress--a wide
variety of disorders are caused by psychological factors, maybe as much as 50%
to 80% of all the complaints treated by physicians. Stress can cause headaches, irritable bowel syndrome,
eating disorder, allergies, insomnia, backaches, frequent cold and fatigue to
diseases such as hypertension, asthma, diabetes, heart ailments, migrane,
grave’s ophthalmology and even cancer.8, 9
7.
Stress/stresssful
life events can precipitate a number of psychiatric disorders including conversion disorder10
adjustment disorder11 acute stress reaction, and post- traumatic stress disorder,12 generalized anxiety
disorder13,14, depression15
and somatization disorder.16
8.
A
study has shown 96% of subjects reported dissociative ( conversion) symptoms in
response to acute stress during U.S. Army survival training.17 Another study found that
people experiencing acute stress disorder in response to a traumatic
experience have stronger ability to experience dissociative phenomena than
people who do not develop acute stress disorder.18 Severe levels of posttraumatic stress and
depressive reaction were found in adolescents in two cities of Nicaragua
affected by a hurricane.19 . Similarly after another stressful
incidence (series of sniper shooting in
9.
High stress
almost always interferes with one's performance (unless it is a very simple
task). It causes inefficiency at school and on the job, poor decision-making,
accidents, and even sexual problems. Anxiety and fear causes us to avoid many
things we would otherwise enjoy and benefit from doing. People avoid taking
hard classes, trying out for plays or the debate team, approaching others,
trying for a promotion, etc. because they are afraid.
Optimum levels of
stress
Experts tell us that stress, in moderate doses, is necessary in our life. Stress responses are one of our body's best defence systems against outer and inner dangers. In a risky situation (in case of accidents or a sudden attack on life), body releases stress hormones that instantly make us more alert and our senses become more focused. The body is also prepared to act with increased strength and speed in a pressure situation. It is supposed to keep us sharp and ready for action. Research suggests that stress can actually increase our performance. Instead of wilting under stress, one can use it as an impetus to achieve success. Stress can stimulate one's faculties to delve deep into and discover one's true potential. Under stress the brain is emotionally and biochemically stimulated to sharpen its performance.
Now I will explain the linkage between stress and performance, and show how you can ensure that you perform at your best by optimising stress levels.
The approach to optimising stress depends on the
sort of stress being experienced. Strategies to deal with short term stresses
focus on managing adrenaline to maximise performance. Short-term stresses may be
difficult meetings, sporting or other performances, or confrontational
situations. With long term stress, fatigue and high adrenaline levels over a
long period can seriously reduce your performance. Optimising long term stress
concentrates on management of fatigue, health, energy and morale. Naturally
there is some element of overlap between these.
Short term stress
The graph in Fig: 1 shows the relationship between stress
and the quality of performance when you are in situations that impose
short-term stress: Where stress is low, you may find that your performance is
low because you become bored, lack concentration and motivation. Where stress
is too high, your performance can suffer from all the symptoms of excessive
short-term stress. In the middle, at a moderate level of stress, there is a
zone of best performance. If you can keep yourself within this zone, then you
will be sufficiently aroused to perform well while not being over-stressed and
unhappy. This graph, and this zone of optimum performance, are different shapes
for different people. Some people may operate most effectively at a level of
stress that would leave other people either bored or in pieces. It is possible
that someone who functions superbly at a low level might experience difficulties
at a high level. Alternatively someone who performs only moderately at low
level might perform exceptionally under extreme pressure.
Stress
Fig: 1 The Relationship Between Stress
And Performance
Long term stress
The problems of long term, sustained stress are more
associated with fatigue, morale and health than with short-term adrenaline
management. The graph as shown in Fig: 2 show the way in which performance can
suffer when you are under excessive long-term stress:
Healthy Hardwork
Fig: 2 The Relationship between long term stress
and performance
The graph shows stages that you may go through
in response to sustained levels of excessive stress. During the first phase you
will face challenges with plenty of energy. Your response will probably be
positive and effective. After a period of time you may begin to feel seriously
tired. You may start to feel anxious, frustrated and upset. The quality of your
work may begin to suffer. As high stress continues you may begin to feel a
sense of failure and may be ill more frequently. You may also begin to feel
exploited by your organisation. At this stage you may start to distance
yourself from your employer, perhaps starting to look for a new job.
If high levels of stress continue without relief
you may ultimately experience depression, burnout, nervous breakdown, or some
other form of serious stress related illness.
Different people may move between these stages
with different speeds under different stress conditions.
Strategies for Coping with Stress
There are three basic strategies for coping with stress21,22,
(other than ignoring or denying
your problems). These are:
1. The Band-Aid
Approach--using alcohol,
drugs (prescription or illegal), cigarettes, food, sex, or anything else to
temporarily relieve the symptoms of "stress." While these coping
strategies "work" in the short-run, they have harmful long-term
effects, which make them undesirable.
2. The Stress
Management Approach---using
diet, exercise, meditation, biofeedback, behavioural techniques or other
relaxation exercises to cope with your "stress23,24."
While these coping strategies have definite advantages over band-aid methods,
they still focus mainly on just the symptoms of your problems.
i.
Eat
sensibly. A well balanced diet will improve your ability to respond to stress
appropriately.
ii.
Tiredness
Sleep-make sure you get
an adequate sleep each night.
iii.
Exhaustion
Tiredness. Cut down on
stimulants—caffeine and nicotine don’t help.
iv.
Ill-Health Breakdown
Exercise-Aerobic exercise
can reduce anxiety by up to 50 %.
v.
Relax-Learn
and practice relaxation techniques regularly.
vi.
Take time
off---Go for a walk, listen to music, take a bath .you will feel better.
vii.
Prioritise-If
you have multiple stress factors (deadlines, financial worries illness
problems) concentrate on the ‘must ‘first and put ‘shoulds' to the back of your
mind for the moment.
3.
The
Ideal Approach-----------making
stress disappear, quickly and naturally, by modifying or correcting its
underlying causes. While this is by far the best way to deal with problems in
life, most people fail to use this approach because they incorrectly understand
what causes their stress to occur.
In recent years, new insights about the causes
of human stress have emerged.25,26 These new insights focus on the
difference between obvious and non-obvious causes. Obvious causes of stress
include the things that happen to us and around us--i.e. the things we easily
see. Non-obvious causes include conversations and behaviour patterns that
become triggered within our bodies. These include expectations, judgements,
evaluations, needs for control, needs for approval, and many others.
The more
you learn to recognise and deal with these non-obvious causes of your problems,
the less stress, tension, and physical ailments you will likely experience.
References
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Mason
JW. A historical view of the stress field. Part 1. J. Human Stress 1 1975;1: 6-12
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Selye
H. Stress in Health and Disease.
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Selye
H. Confusion and controversy in the stress field. J. human . Stress 1975;
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Pasnau RO. Coping
With Stress: Effective People and Processes. Am J Psychiatry
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Selye
H. The Stress of Life.
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Selye
H. A Syndrome produced by diverse nocuous agents. Nature 1936;138:32.
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Brown
GW, Haaris TO, Peto J. life events and psychiatric disorders: the nature of
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8.
Weiner
H. Psychobiology and human disease.
9.
Alexander
F. Psychosomatic Medicine. Newyork Norton; 1950.
10.
Lempert
T, Schmidt D. Natural history and outcome of psychogenic seizures: A
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JH, Vollemer WM, Tatum El. Community patterns of post-traumatic stress
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Brown
GW, Harris TO. Stressor, vulnerability,
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KH, Mitagg GH, Erazo N, Gundel H.
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CA, Hazlat G, Wang S, Richardson EG, Schnurr P, South SH. Symptoms of dissociation
in humans experiencing acute
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Bryant RA, Guthrie RM, Moulds ML. Hypnotizability in Acute stress
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Goenjian
Ak, Molina L, Steinberg AM, Fairbank LA, Alvarez ML, Goenjian HA, et al.
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Greiger
TA,
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Charney
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