Understanding and Managing Stress

Author: Jordan Alphonse

Stress is an increasing threat all around the world and was declared as the “Health Epidemic of the 21st Century” by the World Health Organization (WHO) [1]. It has been a growing concern with civilization and was studied by Ancient philosophers like Aristotle and Hippocrates [1]. However, it was Claude Bernard who was the first to describe the biological phenomena behind stress [1, 2]. Bernard simply outlined from his observations that an organism’s ability to maintain a constant fluid environment bathing cells which he described as “milieu interieur” is essential for life independent of the external environment [2]. He indicated that, “cells are surrounded by an internal medium that buffers changes in acid-base gaseous (O2 and CO2) and ion concentrations and other biochemical modalities to minimize changes around biologically determined set-points, thereby providing a steady state” [1]. Fifty years later it was Walter Bradford Cannon who introduced the term ‘’homeostasis’’ (from the Greek homoios or similar and stasis or position) to describe the maintenance within acceptable ranges of several physiological variables, such as blood glucose, oxygen tension and core temperature [1, 2]. Cannon also came up with the concept of fight-or-flight also called the acute stress response, which implies that animals react to threats with a general discharge of the sympathetic nervous system, in preparation for fighting or fleeing [1]. Later on, Hans Hugo Bruno Selye known as the “father of stress” gave a better definition to stress as the non-specific response of the body to any demand upon it [1, 2, 3]. Selye used the term non-specific in explaining a set of shared elements of responses – regardless of the factor that causes stress [1]. Selye proposed what is now known as Selye’s Syndrome or General Adaptation Syndrome (GAS) which is defined in three categories: an initial ‘alarm reaction’ similar to Cannon’s fight-or-flight response, a stage of adaptation, and a state of exhaustion and organismic death [1, 2]. The GAS came about while Selye was doing his research as a medical student in 1926, which he observed in many of his patients as well as from laboratory experiments on rats that patients or rats with a variety of illnesses had many of the same “non-specific” symptoms that were a common response to stressful stimuli experienced by the body [1]. Selye introduced the term heterostasis as opposed to homostasis, to describe the establishment of new steady-state by changing the “set-point” to resist unusually high demands [1, 2]. The term heterostasis is a precursor to the concept of allostasis as first proposed by Peter Sterling and Joseph Eyer in the 1980s [1, 2]. Allostasis is the phenomena where stability comes through change by regulation of the set-points that adjust physiological parameters to meet the challenge [1].

Stress in plain terms is an individual’s response to change in a circumstance or to a threatening situation [4]. Thus, stress is experienced by all organisms including both plants and animals so without adjusting or applying correct approach to the demands, organisms can actually get exhausted or get negatively impacted [1, 4]. Within the society, stress is more concerned as psychological and that is the central discussion at this point. A stressor is a certain change or threatening situation that an individual faces [4]. Stressors vary in people’s lives and some examples are; arguments, change in financial status, death of a family member or close friend, fear of failure, pregnancy, sexual harassment and the list goes on [4]. When an individual encounters a stressor, an important pathway in the brain and body, the hypothalamic-pituitary-adrenal (HPA) axis is stimulated to produce stress hormones (cortisol and catecholamine) that trigger a fight-or-flight response [5]. The immune system is also directed to be able to respond to injuries [5]. The reaction to a stressor is vital in determining whether a person will develop to a better individual or develop negative conditions [4].

Distress is the type of stress that arises from viewing an event or situation negatively [6]. People going through distress often experience an overwhelming, oppressing or an out of control feeling [6]. On the other hand, eustress known as positive stress helps an individual rise to a challenge and focus energy to excel to a higher state [6, 7]. A very good example to differentiate these two types of stress is that; many people regard public speaking or airplane flights as very stressful-causing physical reactions such as an increased heart rate and a loss of appetite –while others look forward to the event [6].

People often stress out due to three major reasons [6]: 1. The unsettling effects of change 2. The feeling that an outside force is challenging or threatening 3. The feeling of loss of control

Stress can be identified through a range of signs and symptoms experienced by an individual [4, 6]. Here are some examples of signs and symptoms experienced by most people [4, 6]:

· Headaches · Fatigue · Restlessness · Gastrointestinal problems · High blood pressure · Depression · Anxiety · Loss of memory · Loss of appetite · Frustration · Denial · Increased smoking or alcohol consumption · Loneliness · Sexual problems · Difficulty in solving problems or making decisions · Emptiness · Loss of meaning

Stress management is crucial in overcoming stress and living a healthy and happy life [4]. The most important thing in dealing with stress is for an individual to understand him/herself better [6]. Knowing oneself better helps an individual to know how they react in different situations, what causes them stress and how they behave when they feel stress [6]. Below are some actions that can be taken as guidelines in managing and overcoming stress [5, 6, 8]:

1. Identify the stressors – the event, situation or circumstance that causes an individual to get stressed most of the time has to be figured out. Once the major stressors that affect an individual is known, an individual can look into focusing on reducing them.

2. Set priorities – time management is a very important skill in delegating tasks to oneself and getting the most important tasks done rather than stressing in completing all tasks in a short period of time. Having a To-Do-List daily and noting down activities to be done based on priority helps to complete tasks on time.

3. Practice facing stressful moments – Focusing and rehearsing on certain stressors that occurs frequently in an individual’s life will enable the person to be able to deal with those situations or circumstances boldly with confidence.

4. Examining expectations – set goals according to the SMART principle - Specific, Measurable, Achievable, Relevant and Time-based. Being satisfied with an individual’s best effort is better than looking to achieve perfection but getting frustration.

5. Healthy lifestyle – Eating healthy foods, having enough rest and exercising daily will help keep the mind positive and reduce chances of getting ill.

6. Seek assistance and advice – Always find time to talk to friends, families or counselors that can help in providing guidance in overcoming stress.

Finally, stress is a major health concern that is faced by every human beings as part of growth and development. Stress can be an advantage or a disadvantage totally depending on how an individual manages stress. A person can live healthily and happily with stress by following most or all of the actions recommended above in managing stress.

Reference

1. Fink G, Stress: Definition and history. University of Melbourne, Australia: ResearchGate; 2017

2. Goldstein D.S, Kopin I.J, Evolution of concepts of stress. National Institute of Neurological Disorders and Stroke, Bethesda, USA: Informa Healthcare; 2007

3. Yong T.S, Hans Selye (1907-1982): Founder of the stress theory. Singapore: Singapore Medical Journal; 2018

4. University of Regina, What is Stress. Counselling Services; 1998.

5. Samele C, Lees-Manning H, Zamperoni V, et al. Stress: Are we coping? London: Mental Health Foundation; 2018

6. Suat J, Introduction to Stress Management. Course Hero; 2020

7. Mental Help, Types of Stressors (Eustress vs. Distress) [Homepage on the internet] c2020. Available from https://www.mentalhelp.net/stress/types-of-stressors-eustress-vs-distress/

8. Porensky E.K, Stress Management. Ohio State University Wexner Medical Center, USA