What is Stress?
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, its 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
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. Iím 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
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.
Stress as a Stimulus
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
Viewing stress this way is fine if we think of people as girder bridges,
but thatís not how an herbalist views them! Two of the problems with this
mechanistic approach to stress are:
o 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.
o There are even variations
in the same individuals 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 its June and you have
Stress as a Response
The second category of
physiological theory well 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
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
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 well do here, but keep in
mind that they need to be looked at in conjunction with each other in order to
be fully understood.
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 glands 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:
1. Increased nervous-system
2. Release of adrenaline
and/or noradrenalin into the blood stream by the adrenal medulla. These hormones
support the nervous system through metabolic activity. The bodys response to
these chemicals includes:
o increase in heart rate and
o 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).
o mobilization of the livers
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.
In general terms, the psychological
reaction to stress takes the following course:
o The initial
fight-or-flight reaction is accompanied by emotions such as anxiety or fear.
o Individual ways of coping
are activated as we attempt to find a way of dealing with the harmful or
o If the coping strategies
are successful, the fight-or-flight reaction and the anxiety state subside.
o 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:
o Escaping from the
unpleasant situation-not always possible!
o 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:
o Denial, by which we refuse
to acknowledge all or some of the threat in the situation.
o 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 donít 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
o 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.
o 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.
o 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.
o 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!
o 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.
Stress and Illness
Statistical studies have shown a
clear association between increased incidence of disease and the presence of one
or more of the following factors.
o 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 ones own life are as important to our health as is a good diet.
o 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:
o Shift work, because of the
disruption of circadian rhythms and social life.
o Long hours (75 hours per week or
o Physically adverse conditions,
such as cramped or noisy quarters & bad lighting.
o 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.
o Boring, repetitive work,
which can produce increases in frequency of depression, sleep disturbances, and
o 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
o 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..
o 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
How Stress Causes Illness
There can be no doubt that there is
a definite relationship between stress and illness. Although the exact nature of
that relationship is not yet understood, a number of ideas have been suggested.
Early theories tried to connect different illnesses with specific types of
emotional conflict or personality and body types. According to these theories,
certain body types and temperaments would be more likely to develop one physical
disease under stress than others. However, there is little agreement among the
experts about what correlates with what.
Selye has more to say on the subject. He maintains that the biological
reactions accompanying the GAS result in both short- and long-term adverse
physical changes. He calls these changes diseases of adaptation, since they are
the outcome of a system of defenses against threatening stimuli. The disease
process is thought to arise as a result of factors such as:
The physiological effect of certain hormones from the adrenal and
pituitary glands; the impact of the
inflammation process, and a general state of lowered resistance. The actual
disease that manifests itself depends on a range of factors, including genetics,
physical weakness, and even specifically learned bodily responses.
The GAS helps explain the effects of life changes or events on health.
Life changes require adjustments that could produce physiological reactions, and
sustained and unsuccessful attempts at coping with life could lower bodily
resistance and enhance the probability of illness. Thus, the more frequent and
severe the life changes we experience, the more likely we are to become ill.
The herbalist by David Hoffman, (c)1993
David Hoffman, Hopkins Technology