Stress:What is it and what causes it?

There are several ways to define stress. Perhaps the most encompassing is:
“Stress is the response of the body to any demand.” Just staying alive creates
demands on the body for life maintaining energy; even while we are asleep, our
bodies continue to function. So by this definition, stress is a fundamental
part of being alive and should not be avoided! The trick is to ensure that the
degree of stress we experience is such that life is a joy, not a drag.

From this perspective, energy usage is one characteristic of stress. Another
characteristic is lack of specificity. Any demands made upon us in daily life
bring about certain reactions in the body. These same reactions occur under a
whole range of different conditions, both physical and emotional – from hot and
cold to joy and sorrow. As aware, feeling people, we probably make a big
distinction between the pain caused by the loss of a loved one and the pain
caused by the temperature dropping too fast; but the nature of the demand is
unimportant at the biological level. To the body, it’s all the same because the
stress response is always the same. Nerve signals are sent from the brain to
several glands, and these react by secreting hormones to cope with the task
ahead. So stress is not just worry and strain. It is a keynote of life, with
all its ups and downs. A new and exciting love can cause us as much stress as a
cranky boss.

The range of responses triggered by stress demonstrates the intricate ties that
exist between the mental and physical components of who we are. Before we look
a little closer at these responses, it may be useful to review some of the
scientific theories about stress. It may seem that many of these theories
revolve around minor semantic differences. I’m afraid that appears to be the
level of the research on the topic to date.

Theories about stress tend to fall into three categories:

1. Stress as a stimulus: this category attempts to describe the various
   unpleasant situations that cause stress.

2. Stress as a response: this category attempts to describe the
   responses that occur in the body or the mind when we are confronted by an
   unpleasant situation.

3. Stress as a perceived threat: this category views stress as a
   reflection of our own perception that we cannot cope with our environment.

Stimulus-based approaches to stress are concerned with identifying
aspects of the environment that have an unpleasant effect on us. This very
simple approach views human stress as being the same as the physical stress
involved in an engineering project like building a bridge. The concern is with
identifying stressful situations and determining how and why they affect the
mind and body. This category of research has focused mostly on the workplace
and on factors such as ambient noise levels and heat, as well as things like
job demands. Working under deadlines with large amounts of information to be
processed would be rated as stressful under this approach, as would be
monotony, isolation, and situations in which we have little control over
events.

Viewing stress this way is fine if we think of people as girder bridges, but
that’s not how an herbalist views them! Two of the problems with this
mechanistic approach to stress are:

• Particular situations are not inherently stressful, and there is a large
  variation in their effect on different people. For example, the noise of a
  disco is stressful for some people, while others thrive on it.

• There are even variations in the same individual’s responses to the same
  situation at different times. Whether we are well rested or fatigued might
  determine how stressful we find traffic jams, for example.

It seems difficult to define a situation as stressful without taking into
account the responses of the people who might be involved. The degree of stress
a particular environment might cause has to be seen as a spectrum. There is no
doubt that, for most people, walking down the meridian of a freeway to look for
a gas station would be stressful, while watching a sunset from a flower-strewn
mountain meadow would have little inherent stress, unless it’s June and you
have hayfever!

Stress as a Response

The second category of physiological theory we’ll look at views stress
as the response to an adverse, or stressful, situation. This approach is based
on the work of the physiologist Hans Selye. Selye theorized that the stress
response is a built-in mechanism that comes into play whenever demands are
placed on us, and is therefore a defense reaction with a protective and
adaptive function. In other words, there is a general physiological reaction to
all forms of stress, which usually acts in our own best interests. Selye called
this reaction the General Adaptation Syndrome (GAS). This theory
suggests a three-stage process of response:

1. An alarm reaction.
   

2. A resistance stage, which represents a functional recovery of the
   body to a level superior to the pre-stress state.
   

3. An exhaustion reaction, in which there is a depletion and breakdown
   of the recovery of stage 2, due to continuation of the stressful situation.

The limitation of this inflexible physiological model of stress is that it
ignores the purely emotional or mental factors that can produce a wide
variation in the way we respond to potentially stressful situations.

Stress as a Perceived Threat

Much recent research suggests that specific situations or objects are
threatening to us because we perceive them as such, rather than because of any
inherent characteristics. According to this category of research, stress occurs
when we cannot cope with or adjust to the demands made on us-when it all
becomes too much. The degree of stress is partially affected by what is going
on in general, but is more intimately connected with how we perceive the
factors involved and how we are feeling at the time.

Responses to Stress

There is now a large body of research about both the physiological and
the psychological responses to stress. It is easier to explore these responses
separately, as we’ll do here, but keep in mind that they need to be looked at
in conjunction with each other in order to be fully understood.

Physiological Responses

The regulation of physiological responses to threats or stressful
demands is handled mainly by the adrenal gland. Immediate response is
controlled mainly, though not completely, by the adrenal gland’s central
medulla, while long-term response is handled by the surrounding cortex. The
initial response-preparing the body for what has been called the
fight-or-flight reaction-involves:

Increased nervous-system activity.

Release of adrenaline and/or noradrenalin into the blood stream by the
adrenal medulla. These hormones support the nervous system through metabolic
activity. The body’s response to these chemicals includes:



• increase in heart rate and blood pressure.

• surface constriction of blood vessels, so that the blood leaves the skin to provide the muscles with more sugar and oxygen (which is why we go white with shock).

• mobilization of the liver’s energy reserves through the release of
  stored glucose.
  
  

If the stressful situation is very intense or continues over a period of time,
the adrenal cortex becomes increasingly involved in the stress reaction. The
activity of the cortex is largely controlled by blood levels of
adrenocorticotrophic hormone (ACTH, which is released by the anterior pituitary
gland. When information about sustained stress has been “processed” by the
central nervous system, a whole range of new bodily responses occurs, and it is
these longer-term reactions that can adversely affect the quality of life.

Psychological Responses

In general terms, the psychological reaction to stress takes the
following course:

• The initial fight-or-flight reaction is accompanied by emotions such as
  anxiety or fear.

• Individual ways of coping are activated as we attempt to find a way of
  dealing with the harmful or unpleasant situation.

• If the coping strategies are successful, the fight-or-flight reaction and the
  anxiety state subside.

• If the coping strategies fail and the stress situation continues, a range of
  psychological reactions, including depression and withdrawal, may occur.

The implication is that the consequences of failing to cope can be serious, and
it is therefore important that we develop our own ways of adapting to and
successfully dealing with stressful situations.

Research about how we cope suggests two broad categories of coping strategies.
The first involves attempts to change our unsatisfactory relationship with the
environment. Examples of this category would be:

• Escaping from the unpleasant situation-not always possible!

• Preparing ourselves for situations that we anticipate will be stressful. This
  might involve thinking ahead of time about the situation and its likely impact,
  thereby preparing ourselves adequately for the event; or it might involve some
  actual work – for example, studying for an exam, instead of just worrying about
  it.

The second category of response research involves “palliative”
strategies that attempt to soften the impact of the stress once it has
occurred. Examples of this category include:

• Denial, by which we refuse to acknowledge all or some of the threat in the
  situation.

• Intellectualization, by which we detach ourselves emotionally from the
  situation.

Both of these strategies serve to protect us and help us maintain a reasonable
equilibrium through difficult times, but there is always the danger that such
strategies may make it more difficult for us to resolve a problem and may
become established as part of our psychological makeup.

Other coping strategies, including various relaxation techniques, may be
appropriate in some or all cases. However, the use of such strategies may delay
the direct reaction that we need to solve the problem that is causing the
stress. This is also true of another, particularly destructive way of coping:
escaping via the use of alcohol, tranquilizers, or other drugs.

There are some stresses for which no clear solution exists, for example, caring
for the chronically ill – and in such situations softening the impact of stress
may be the only way for us to cope. If stress is long-term or particularly
severe, marked emotional changes may take place. If the coping strategies we
employ don’t work, we may regard the situation as one for which there is no
solution and increasingly see ourselves as unable to control the events of our
lives. Hopelessness and helplessness are both likely to give rise to feelings
of depression, and may even lead to suicidal thoughts. Following the stress of
chronic illness, for example, patients may literally give up hope. If this
occurs, they may become not only emotionally disturbed but also more vulnerable
to further physical illness.

Factors Affecting Response

Although we can talk in general terms about physiological and
psychological response patterns, we should remember that these patterns are by
no means fixed. For each one of us, the pattern of response to stress is
determined by many factors, some of which are listed below.

• Previous experience: Once we have experienced a particular stressful
  situation, we are usually able to cope better with it if it comes up again. The
  experience provides us with knowledge about the situation and puts us in a more
  predictable position. We are more aware of how our behavior will affect a
  potentially stressful environment and how we will be affected by it. For
  example, the second visit to a doctor is usually easier than the first.

• Information: Information about an impending stressful event allows us
  to make preparations that will ease the impact and intensity of our reactions
  to the stress. It is well known, for example, that describing surgical
  procedures and typical post-operative reactions, including pain, to patients
  can often aid recovery. However, personality differences must be taken into
  account. People differ radically in their response to the stresses associated
  with illness.

• Individual differences: Some people try to protect themselves from
  the full impact of the stress by denying, playing down, or emotionally
  detaching themselves from the situation. Providing information to these people
  may actually increase their stress levels, rather than decreasing them.

• Social support: Not surprisingly, the impact of stressful events is
  affected by our social systems. Support and empathy from others greatly softens
  the degree of reaction to stress, especially when we are young and our patterns
  of behavior, response, and perception are developing. It seems that
  insufficient early social support can give rise to physical and behavioral
  problems, including a reduced ability to withstand stress. Response to stress
  can be eased by support from either the family or the community. For example,
  the recovery of patients from strokes can be significantly affected by the
  understanding and empathy shown by their families or friends, and studies have
  shown that women who have close, confiding relationships are less likely to
  develop stress-related psychiatric problems. It is not surprising, then, that
  the loss of a close relationship, which represents a sudden and severe loss of
  support, is rated among the most stressful of all life events. It says a lot
  about our rational and analytical approach to life that research is needed in
  order for the medical profession to acknowledge that caring and support are
  vital parts of the healing process. Our humanity should tell us that!

• Control: The degree to which we believe we can control a situation
  has an important impact on the degree to which that situation is likely to
  cause us stress. Research has shown that the most harmful and distressing
  situations are those in which we feel entirely helpless, believing that nothing
  we can do will significantly alter the outcome. This is a good reason to take
  power and information away from the “experts” and put it in the hands of people
  like you and me, thereby restoring our sense of control. It is also the reason
  why this book focuses on herbs and other stress fighting allies that we can use
  ourselves, rather than relying on the diagnostic powers and prescriptions of
  others. The need to take back responsibility for our own well being becomes
  acute when we realize that the tremendous progress made in the medical sciences
  in recent years has not brought with it any significant improvement in our
  overall health. In fact, the incidence of some diseases is on the increase.
  Heart problems, digestive maladies, and mental disturbances are striking people
  in their thirties, forties, and fifties. The underlying cause of many of the
  diseases that are common today is undoubtedly stress.

Statistical studies have shown a clear association between increased
incidence of disease and the presence of one or more of the following
factors.

• Social Class: Many of the common fatal illnesses tend to occur with
  higher incidence in the “lower” social classes. The reasons for this are not
  fully understood, but probably revolve around such factors as diet, housing
  conditions, employment/unemployment, and quality of medical care. In addition,
  a feeling of security, financial and otherwise-is basic to any sense of well
  being. A sense of personal power and control over one’s own life are as
  important to our health as is a good diet.

• Occupation: Some types of work, as well as the physical and social
  attributes of the work environment, are associated with higher levels of
  physiological and psychological illness. The factors known to be involved
  include:

  • Shift work, because of the disruption of circadian rhythms and social
    life.

  • Long hours (75 hours per week or more).

  • Physically adverse conditions, such as cramped or noisy quarters &
    bad lighting.

  • Changes in work environment, e.g. to a different line of work or level
    of responsibility. More heart attacks occur in the year following such
    changes.

  • Boring, repetitive work, which can produce increases in frequency of
    depression, sleep disturbances, and stomach disorders.

  • Responsibility and deadline pressures, which can result in a higher risk
    of conditions such as high blood pressure and ulcers.

  Remember that not all people react adversely to these conditions. Many people
  cope quite well with demanding work environments, and may even appear to thrive
  in them. Jobs are not inherently stressful; it is when difficulties arise in
  coping with the demands, changes, or monotony of a certain job that it becomes
  unpleasant and increases the risk of ill health. Unemployment can also lead to
  higher risk of illness, brought about by a major life change and possible loss
  of self-esteem. Work meets not only financial but also social and psychological
  needs, and failure to meet those needs carries a high personal cost in terms of
  mental and physical well being.

• Life Style: A lot of research has centered around identifying two
  basic life styles, known as type A and type B. The type A personality is
  competitive, striving, and usually under pressure; type B is more relaxed and
  calm. Type A exhibits what has been called the coronary-prone behavior pattern,
  because of increased chances of coronary heart disease. Other life styles
  supposedly represent various combinations of type A and type B, with
  proportional degrees of stress and propensity toward stress-induced diseases.
  The impact of such differences is discussed in he section on cardiovascular
  system..

• Life Events: A number of studies have demonstrated a clear
  relationship between events that change our life situation and the onset of
  illness. These events can be anything from moving to a new home or getting
  married to being sued or being involved in a major traffic accident. Life
  events require adjustments in patterns of behavior and we often experience such
  adjustments as stressful. Perhaps the most significant life event is loss,
  actual, potential, or imagined, of a loved one. It can give rise to an
  emotional response of hopelessness and helplessness that results in our
  literally “giving up.” When this happens, we can no longer cope,
  psychologically and biologically, with environmental demands. If we have a
  predisposition for a disease, then being in this psychological state makes the
  disease more likely to occur because our bodies are less capable of dealing
  effectively with the processes that give rise to the disease. Studies have
  shown that life events often cluster to a statistically significant degree in
  the two-year period preceding illness, and that the onset of an illness can be
  predicted when a number of life events coincide. As discussed below these
  results have led to attempts to quantify the impact of life changes and to
  identify the exact nature of the correlation with disease onset.