One needs to understand that it’s not the normal, protective, everyday stress that is implicated as a health hazard. The true bogeyman is chronic stress, writes DR TASLEEM RAS.
STRESS is an unavoidably part of the human experience. There is not a single human being alive who would not have experienced stress in some form or another. From an unborn foetus in the mother’s womb to the elderly person who has seen all that life has to offer, stress is as part of being human as it is to eat, sleep and pray. While this article focuses on adults, it must be said that childhood stress is too important to address briefly and is beyond our current scope.
Scientists believe that the stress reaction evolved as a protective mechanism in all animals, including humans. In the face of danger, our bodies release stress hormones, the most well-known being adrenaline and cortisol, which put the body and mind into a heightened state of awareness. Each cell in the body reacts to this rush of hormones, resulting in faster breathing, elevated heart rate, pupils dilating, hair standing on end, mind becoming more active (feelings of irritation or anxiety predominate), and the digestive system loosening up. Sound familiar? Not everybody will experience all these feelings but, to some extent, each of us will feel something similar.
In short bursts, lasting for a few minutes, these stress events are very useful as they motivate us towards action that we may not have taken. But, if it really is a natural protective mechanism, why has stress become the bogeyman of the modern wellness movement? The media is replete with natural remedies, strategies to improve mental wellbeing, stress reduction exercises and other interventions, all blaming stress as the cause for cancer, heart problems, chronic pain, and now, even age-related cognitive decline. To be honest, science has linked stress to all these medical conditions, and the public attention is warranted. However, one needs to understand that it’s not the normal, protective, everyday stress that is implicated as a health hazard. The true bogeyman is chronic stress.
When I speak about chronic stress, I refer to the feeling of being stressed most of the time, for most days of the week. Unlike many mental health disorders, like depression and anxiety, where a minimum period of two weeks of feeling ill is usually required to make a diagnosis, chronic stress is not a medical diagnosis so does not need any medical criteria to be identified. However, living with this condition on a daily basis can definitely have a direct impact on our physical and mental health and wellbeing, and subsequently on our quality of work and social relationships. The impact is via two main avenues.
The first impact lies in the direct effect of long-term stress on our bodies, predominantly our mental wellbeing. When a person starts to experience feelings of demotivation, lack of interest in productivity and losing a sense of pride in their work, this is a red flag for burnout. Burnout is an important state to identify, as the impact on the person’s quality of life is negatively affected and could result in a downward spiral into full blown mental illness or substance abuse.
Often, addressing the underlying cause of the stress, taking some time out to recharge and adopting some coping strategies are sufficient to pull the person back from the brink, and does not require medical intervention. Managers, partners, HR practitioners and spouses are well placed to make the call and suggest an intervention, based on commonly available information.
The second manner in which chronic stress affects our health may need medical intervention. This is in people with pre-existing chronic diseases like hypertension, diabetes mellitus, mental health disorders and cancers. In these conditions, and others, chronic stress will have a direct negative impact on the body, resulting in difficulty in controlling the chronic disease. We know that people suffering from chronic pain due to any cause have worsened pain during periods of high stress. The same applies to people suffering with high blood pressure and diabetes. Diseases like cancer, that require a healthy immune system, are impacted as the long-term stressed state gradually weakens the immune system.
Identifying that chronic stress might be a problem is the first important step in starting to address it. The solution depends on what is acceptable to the individual culturally, personally, financially and socially. There are no one-size-fits-all approaches, and solutions don’t have to cost a cent. What is required is for the affected person to momentarily step away from the cause of the stress to evaluate two questions: what can be done about what is causing the problem; and what can be done to lessen the physical and mental effects of the stress?
- Dr Tasleem Ras is a family physician who works as an academic at the University of Cape Town (UCT). He runs the postgraduate programmes in the Division of Family Medicine.