By Stuart Nelson
The Mechanism When something happens to trigger feelings of stress in us, our body is programmed to make certain adjustments to our normal state. Indeed, our body chemistry changes quite fundamentally every time we react to stress. These adjustments probably have their origin in our distant ancestors, whose lifestyle was quite different from our own.
Imagine you are a caveman or cavewoman, going about your business of collecting wood for a fire. Suddenly you are confronted by a sabre-toothed tiger, or some other horror. What are you to do? You have three options:
1. Stay and fight.
2. Run away.
3. Give up and allow yourself to be eaten.
At this stage, because stress is quite literally “something in your head”, the first signs of danger have been detected by a part of your brain called the amygdale.
The next stage is that other brain areas will evaluate the threat’s importance, decide how to respond and remember when and where the danger occurred, thereby reducing the risk of meeting the same threat again.
You are most unlikely to choose the third option. Human beings, along with most living creatures, have a natural instinct for self-preservation. Hence you are much more likely to fight or flee.
Which you choose will depend on a number of factors, such as how fast you can run, how fast you believe the tiger can run, whether you are experienced in fighting foes of this kind, and your belief in yourself, or lack of it.
Fortunately for your body, fighting and fleeing have one thing in common: they both demand a great deal of energy. Hence the body can easily make specific adjustments to suit either choice, and that is precisely what it does. This phenomenon is known as the Fight or Flight Response (“FFR”).
Fight or Flight Response Much remains unknown about how the brain and the immune system interact, but what is clear so far is that once a trigger for stress has been recognised by the amygdale, a chain of events results in the production of cortisol by the adrenal glands.
The significance of cortisol is that at normal levels it enhances the immune system by increasing the production of cytokines to fight inflammation. However, when stress is detected, the levels of cortisol rise. This causes the immune system to stop operating (or, in some cases, to misfire). It appears also to trigger the release by the pancreas of the hormones, insulin and glucagon, and the release by the liver of glucose-tolerance factor, a substance that aids the insulin in carrying fuel in the form of glucose from the blood and into the body.
The glucagon is responsible for topping up the blood sugar if levels fall too low. Simultaneously, levels of adrenalin and noradrenalin, the so-called ‘fight or flight’ hormones, are raised and pumped round the body to provide extra resources of energy and speed in case of need in the Fight or Flight, and to divert resources from bodily functions, such as digestion, which are not essential for immediate self-preservation.
The effect of the fight or flight hormones is to:
raise blood pressure
restrict blood flow to the skin, to lessen the risk of bleeding profusely if injured (the blood thickens).
reduce stomach activity, causing a feeling of ‘butterflies’
increase perspiration, to keep the skin cool.
change the breathing.
dilate the pupils.
These things occur within seconds.
Undoubtedly, all these adjustments will be useful if we face a threat from a sabre-toothed tiger, and they could still be useful in modern times if, for example, we are attacked by a mugger in the street, but their use is highly questionable if the trigger for our stress is less life-threatening, such as the frustration of standing in a queue, or dealing with rowdy children.
The fact is that the body is unable to distinguish between life-threatening and other triggers of stress. It matters not if you are stressed through pressure at work or by a falling tree that threatens to flatten you. In either case, you will be given increased levels of cortisol and fight or flight hormones.
The difference between the two situations that I have just mentioned is that in the case of the falling tree, the result will be appropriate preparation of our organs and muscles for the emergency, whilst in the case of the work pressure, we shall be left with unwanted chemicals in our body and an immune system that is turned off or damaged. You feel wound up but can find no release. Indeed, because energy was diverted away from the normal maintenance and repair functions of the body, such as digestion, cleansing and rejuvenating, the result is that the stressful thought has caused us to age a little. Every second that we spend in a stressful state speeds up the aging process.
If you have been concentrating on the matter in hand, you may have detected in the last paragraph an unexpected assertion that the immune system might be damaged. This is a reference to something already mentioned, namely the possibility of a misfire of the immune system caused by high levels of cortisol. For reasons that are not yet understood, high levels of cortisol may sometimes reduce but not close down the immune system completely. When this occurs, the production of cytokines continues, but it changes in function so that it begins to promote inflammation instead of fight it. The cytokines involved in this distorted process have been linked by scientists to heart disease, depression, strokes and other diseases.
The results of chronic stress Some of the results of continuous stress can be predicted from what we know already about FFR. The turning off of the immune system will allow us to catch colds and other viruses more easily. We shall more readily catch infections if we are injured and our wounds will take longer to heal. Increases in blood pressure will cause headaches. Back injuries will become more common and we shall succumb to stomach problems.
Imagine too, the effects of having your pituitary, your pancreas, your adrenals and your liver continuously pumping out chemicals to control blood sugar that you do not need. Over time, your body begins to wear out and to become unbalanced. Levels of the anti-aging hormone, adrenal and of cortisol begin to fall and your resilience to stress is destroyed.
Moreover, the results will fuel the feelings of stress in themselves. Headaches and infections make us feel worse than ever and if the original causes of stress are still operating on us, we are taken to a new and higher level of stress.
Our energy levels fall and we lose concentration, and become confused and irritable. We may even freak out. Sleeping patterns are disturbed. It is hard to get to sleep, and hard to wake up. We begin to sweat much more than usual.
The Heart Under chronic stress, fat is deposited at our waist, rather than on our hips and buttocks. This raises the risk of heart disease, strokes and cancer.
Such problems are serious health-care issues. In the UK, 235,000 people die each year from cardiovascular disease (heart problems and stroke). In addition, over a million people suffer from angina.
Research in 1999 showed that women in high demand or low control jobs were more than 70% more likely to suffer coronary heart disease than women who had jobs involving high levels of control. Moreover, men in low control jobs were 50% more likely to develop heart problems than men with high levels of control.
It must not be thought that stress is the only cause of heart disease, but it appears increasingly to be an important contributory factor.
The British Heart Foundation cites research that shows that people who work while suffering depression or who work with volatile colleagues are more likely than not to develop heart problems. Moreover, they add that stress can cause angina in people who already have heart disease. Their view is supported by the American Heart Association, which suggests that there is a “relationship between the risk of cardiovascular disease and environmental and psychosocial factors”.
In some extreme cases, stress has been found to cause fatal heart attacks. For instance, it was reported in the British Medical Journal in 2000 that more men died of heart attacks on the day when the Dutch soccer team was knocked out of the European Football Championship than on a normal day.
The same publication, in 1998, described how men working long hours in Japan were more at risk of heart attacks than those working modest hours.
The Link with Mental Health People have associated depression with heart problems since time immemorial. Even Shakespeare, and Chaucer before him, talked of a broken heart when describing depression. But what evidence is there of a real connection between depression and heart disease?
In 1998, a study of the lives of 1,190 medical students tracked over 37 years revealed that being depressed had the effect of doubling the risk of developing coronary heart disease.
On the face of things, therefore, the link between depression and heart disease seems to be proven. But what of anxiety, the other mental symptom of stress? This too has been linked with heart problems.
In 1997, a study of 1,457 men was published in the British Medical Journal. It reported that those who suffered phobic anxiety were nearly four times more at risk of a fatal heart attack than those without anxiety.
Even more concerning is a study published in the journal, Circulation, in 1997, which disclosed that mild worrying almost doubled the risk of heart problems, and that high levels of worrying increased the risk to two and half times.
Some American research has even found a link between stress and the development of Alzheimer’s Disease.
The Link with Personality An increased risk of heart disease was identified some years ago in people of ‘Type A’ personality. Such people are competitive and prone to stress. A trait of the personality is shortness of temper. In 1996, the Psychological Bulletin disclosed that hostility and anger increases the risk of heart disease. Indeed, knowing as we do of the way the immune system is turned of during FFR, it should not surprise us to learn that the article went on to mention a link also with physical illness, such as back injury.
Certainly, angry outbursts can trigger a heart attack. In 1995, an study reported in Circulation revealed that intense anger doubled the risk of an attack. Moreover, hostility was linked with increased blood pressure, which can, of course, lead in its turn to heart problems and strokes.
Incidentally, whilst it is not true that high blood pressure is permanently produced by stress, unless the stress is chronic, it is true that blood pressure is raised for much longer periods than the duration of the stress, thereby increasing the risk of heart failure and strokes.
Cancer The link between stress and cancer has been believed by non-medical people for many years. But what is the truth about it?
At the time of writing, the website of Cancer Research UK contains no fewer than 34 articles containing reference to the immune system. The references appear to occur in two different aspects. First is the boosting of the immune system to overcome cancer. Secondly, there is mention of failure of the immune system as a cause of cancer.
For instance, in an article on lymphoma, one risk factor is reduced immunity. Typically this could result from the taking of immune system suppressing drugs after an organ transplant, or from bacterial or viral infections. On the other hand, it could as well result from chronic stress.
Indeed, Artritis.net, a Spanish website published in Spanish and English, claims to be a comprehensive directory of links to websites on the subject of the human immune system. Of 378 distinct links, no less than 176 relate to cancer or one sort or another.
We can surely conclude from this that the link between stress, as the cause of dysfunction of the immune system, and cancer can be established.
Conclusion Some doctors take the view that almost all disease can be attributed to stress, at least in part.
In 2000, a survey on stress was commissioned by Channel 4. a British, independent television channel. More than 500 adults and young people (over 16) in employment were interviewed.
Among other questions, the subjects of the survey were asked to list symptoms of physical illness that they had suffered in the previous year as a result of stress. These were the results:
• irritability (29%)
• changes in sleep patterns (29%)
• inability to relax (28%)
• changes in eating patterns (18%)
• inability to concentrate (17%)
• anxiety or depression (16%)
• physical illness (8%)
• memory loss (8%)
• substance misuse i.e. drugs/drinking or smoking too much (5%).
It should not surprise us, therefore, to know that the survey also reported that 20% of those interviewed considered that stress at work was causing their families to suffer. This was even more of a problem for people with children (26%) and for people who were widowed, divorced or separated (27%).
Dr. Nisha Jackson, of Oregon, USA, a nurse practitioner specialising in hormonal balance, said in 2005 that in the past ten years of practice, she had noticed a pattern in thirty-five to fifty-year old women. She reported changes in their physical, emotional and mental health. Increasingly, this group were complaining of “fatigue, depression, PMS, weight gain, repeated flu-like symptoms, cravings, anger, and just not feeling well.” These changes she attributed to increases in stress.
Stress in the pregnant mother has even been found to affect the unborn child. Research has shown that if the mother is very anxious, the baby will tend to be smaller or to be born prematurely. One particular London hospital study revealed that cortisol passes from anxious mothers to their unborn babies and may lead to those babies being more prone to stress in later life.
Another, perhaps unforeseen effect of stress on family dynamics is child abuse. According to the University of Missouri Extension, a branch of the university that reaches out to Missouri residents beyond Columbia with distance learning programs and other outreach efforts, teenage mothers are especially prone to abusing their children. Stress is a major component in the high risk.
Indeed, the possibilities for stress disrupting personal and family life must be countless. Nor can we count the cost of stress in terms of leading to accidents at work or on the road; of leading to smoking or to substance abuse (drugs or alcohol) with consequent, often fatal, risks to health, quite apart from those to the heart, already discussed.
If your experience of stress is mild, you will have the ability to conquer it by using stress management techniques. However, for those with more serious problems, you require outside help. Doctors, themselves a highly stressed group, do not always have the answer.
Stuart E. Nelson LL.B., Diplomas in Business Excellence and Life Coaching, is the founder of StressKill Services, providers of innovative forms of stress control. They provide an ascending range of products and services to suit all levels of seriousness, from e-books and e-courses to live training and coaching. They also print “Success Story”, a FREE newsletter, containing lots of information and tips about stress and about life. It contains news of the latest developments too. SIGN UP NOW! Mail to firstname.lastname@example.org
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