Everything you wanted to know about stress but were too busy to ask

There is a lot of rubbish written about stress. Dr Ian Banks cuts through the junk to explain exactly how stress works and why, in the wrong circumstances, it can be so dangerous.

There is a lot of rubbish written about stress. Dr Ian Banks cuts through the junk to explain exactly how stress works and why, in the wrong circumstances, it can be so dangerous.

In a nutshell stress is the response we feel when things that are happening exceed our ability to cope.

Stress is often confused with every day pressure. In fact we actually need pressure to perform at our best. Think of an actor or an athlete � the pressure they feel before they perform helps them give a good performance and this is the same for any of us.

Problems, however, arise when the amount of pressure we experience becomes too great. This may be due to one major event such as a bereavement, or an accumulation of many smaller hassles one after the other without enabling time to recover. The curve illustrates what happens.

As pressure increases so does our performance (A) until we eventually reach our peak (B). Give us more and more pressure beyond or peak and we think we carry on being more and more productive (C).

However, in actual fact we do not. At first we may just be irritable or snappy; make silly mistakes and be unable think clearly. However, If the pressure continues this becomes worse, our performance drops and we can start to exhibit a variety of physical symptoms (D). We can also show mental symptoms such as anxiety and eventually depression.
Stress is therefore not itself a medical condition, but if it is prolonged or not corrected then illness can arise. This is why it is important to recognise stress and to have some simple tools for dealing with the issues that can create it.

We are all different (thank goodness!), and there is much variation in our capacity to cope with the very many different things that happen to us in daily life. We therefore need to be aware that stress is not a sign of weakness but simply reflects overload at a given time.

The signs of stress may be anywhere in the body from head to toe and vary from one person to the next. Headaches, palpitations, upset stomach, sweating, strange behaviour and many others symptoms can occur when stress arises and many consultations with doctors complaining of aches or pains or other ailments are the physical manifestations of the brain complaining it can’t cope!

If a computer gets overloaded  ultimately it may lock or crash, people are the same, and a serious stress related illness can be thought of as the human version of an overloaded processor!

Why does too much pressure turn to stress?

The stress response evolved to help our ancestors cope with physical threats such as being chased by a woolly mammoth. This response, often termed the ‘fight or flight’ response, includes changes in our body that result in both mental and physical alertness. The stress response is mainly caused by the release of adrenalin and noradrenalin which alongside other changes in the body result in the common symptoms of dry mouth, sweaty palms, elevated heart rate, butterflies in the tummy. You may recognise these symptoms as ‘nerves’ before a job interview or an examination.

The major changes during the stress response are:

* Increase in sensitivity of nervous system  increases speed with which we may react to a threat.
* Muscles tense ready for action.
* Breathing rate increases to take in more oxygen into the lungs. This is then carried by the blood to the muscles where it combines with glucose to make energy.
* More glucose is released from the liver and into the blood stream used for increased energy.
* Heart rate and blood pressure increase  blood carrying oxygen and sugar is pumped to the muscles to make energy.
* Sweating increases to cool body down during running or fighting.
* Digestive system slows down if fighting for survival don’t need to be digesting food, energy is therefore conserved.
* Reproductive system slows down  also not necessary if you are fighting for survival!
* Another hormone, cortisol, is released.

What is cortisol?

One of the main functions of cortisol is to regulate the metabolism. During stress it enables the body to produce more glucose to keep it going longer. A by product of this is the production of fatty acids which can result in increased production of cholesterol. Increased cholesterol affects the cardiovascular system.

Cortisol also dampens down the immune system so over time we become more susceptible to infections.

What’s the problem with the stress response today?

While the stress response is still useful for occasional modern day physical threats, most of our modern day pressures are not physical and therefore do not need a physical response.

Many are also generated from work: the difficult boss, too much work, hundreds of E-mails and angry customers.

We cannot respond to these by running away or fighting so we sit and bottle it up. We therefore do not do what the stress response is gearing us up to do. Added to this is the fact that one pressure comes immediately after another. We do not have time to get the physiological changes out of our system before the next pressure comes along.

We can cause our own stress by our thoughts and fears. We are afraid of not being good enough or looking stupid. Job insecurity is now also very common. Pressures like these never really go away, but are constantly generating the response. Instead of being helpful, the changes taking place in our body start to work against us and we start to suffer from stress symptoms.

So what should we do to reduce the effects of stress?

If it happens, takes some exercise  this is what the caveman did. Through exercise you are doing exactly what the stress response geared you up to do: get physical.

However, you can also stop it happening in the first place by:

* Identifying causes only then can you tackle the issues.
* Changing your behaviour to reduce the onset of the stress response, eg avoid unnecessary conflict; learn to be more assertive; don’t procrastinate; attend a stress management course. If the stress is work related, raise the issue with your manager. Employers now have a legal duty of care to do what is reasonably practicable to ensure staff do not suffer from work related stress. If your manager knows you have a work related problem they must try to help reduce it.
* Changing perceptions  look at different ways you can see things. You are not indispensable, things do not have to always be perfect. Talk things over with a friend or colleague: this will often help you change your perceptions
* Taking regular breaks to allow your body time to recover between pressures.
* Learning to relax   relaxation helps reduce the stress response and hence the detrimental effect.

Most of all you must realise that stress is not a weakness. Given the right combination of events, stress can happen to anybody.

If you experience stress take action to reduce it before it gets too serious. Managing stress is about taking responsibility for yourself. Nobody else can do it for you. The stress triangle below may help.

Dr Ian Banks

Reviewed by Lindsay 03-08-10

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