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 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.

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 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:

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 hay fever!

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 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 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.

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 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 activity.

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 blood pressure.

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.

Psychological Responses

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 unpleasant situation.

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 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.

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 more).

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 stomach disorders.

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 well being.

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 onset.

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.