Stress and mental health

— Dr Deepanjali Medhi
Hans Selye defined stress as the nonspecific response of the body to any demand, whether it is caused by, or results in pleasant or unpleasant conditions. He observed the stress reactions in animals after injecting toxic substances into them. Selye outlined this response as the general adaptation syndrome to any kind of stressor consisting of three phases: the alarm reaction; the stage of resistance, in which adaptation is ideally achieved and the stage of exhaustion, in which acquired adaptation or resistance may be lost . His concept of stress was originally used to describe the effects of force acting against an organism’s innate resistance. Selye’s basic theory that physical and emotional stressful stimuli can produce relatively predictable common responses in every individual formed a fundamental model for stress response. But later experiments demonstrated the complex adaptational reactions to stress rather then a simple and specific general reaction. John Mason demonstrated that physiological reactions to stress are largely influenced by the emotional response to the stimuli, i.e. by the psychological factors of the particular individual. Richard Lazarus elaborated the concept of individualised stress responses, which are determined by the manner in which a person cognitively appraises and copes with stressful events. Hence a person’s reaction to stress depends on their appraisal of the stressful event and their belief in their ability to cope with the stress; their attitude regarding the significance of the outcome of the event is also considered important. The reality of stress is of less importance than an individual’s subjective cognitive assessment of it in determining the subsequent and physiological reactions.

Stress can also be labelled as a sociopsychophysiological phenomenon, along with the intellectual, behavioural, metabolic, immune and other physiological responses to a stressor (or stressors) of endogenous or exogenous origin. The stressors may involve thoughts and feelings or may be a perceived threat or some other condition such as cold. The response generally serves a protective, adaptive function.

People often suffer from feelings of insecurity, loneliness, uncertainty and role conflict in a highly competitive and rapidly changing environment. They are constantly perturbed by these modern changes and their coping potentials are also at constant threat.

The term ‘stress’ was coined by Hans Selye who first observed the different physiological responses an organism following stress. These physiological changes try to restore equilibrium of the organism perturbed by stress. These responses are mainly neurohormonal, and neuro-immunological changes following acute stress retrieve back. But changes to chronic stress are permanent and harmful. Of course, certain amount of stress is always essential for the development of coping skills and healthy personality in an individual.

The term stress refers both to an event – the stressor and the consequences of that event – the stress response. Stressors are also of different kinds – physical (i.e. heat, cold, noise, crowd), psychological (life events), social (poverty, unemployment) and biological (physical illness – as fever). Stress might trigger or precipitate different mental illnesses. The association between adverse life events and initiation of many psychiatric illnesses are revealed in different studies at different times. Chronic stressful conditions like poverty, unemployment, dangerous neighbourhood , and other like conditions place an individual at greater risk for different mental illnesses than any other acute life stress. Stress associated with daily hassles are ordinary but increasing day by day in modern society. Impulsive suicidal attempts and depression are seen to be closely associated with daily hassles of life.

Stress has been identified as a cause for almost all kinds of major or minor, acute or chronic mental illnesses like schizophrenia, depression, mania, post traumatic stress disorder, drug and alcohol abuse and anxiety disorders.

However, expression of these illnesses is influenced by factors like genetic vulnerability, pre-morbid personality, coping capacities and social and family support. Many physical illnesses are also caused by stress in direct or indirect manner and those illnesses are better referred as psychosomatic illnesses. A few of them are – diabetes, hypertension, myocardial infraction (heart attack), cerebro-vascular accidents (strokes), bronchial asthma, gastritis, peptic ulcer syndromes, irritable bowel syndromes, auto-immune diseases, cancers and some skin diseases like vitiligo and psorisis. Disturbances or inhibition of the immune system of the body by raised levels of glucocorticoids during stress has been attributed in causation of all these diseases. Intense stress inhibits mitogen induced lymphocyte proliferation, natural killer cell activity and production of interferous (INF) and inter-leukins (IL); thereby inhibit cancer protecting mechanism of our body. Many other life stress such as divorce, examinations, caring for sick relative for long time suppress the anti-viral immunity and increases the chances of different viral infections like influenza. There exists a very close relationship between depression due to stress and future cancer development.

Stress is often accompanied by an array of physical reactions. These symptoms can be characteristic of other physical or mental disorders. A healthcare professional can rule out other causes after physical examination. Signs of stress can include sleep disturbance (insomnia, sleeping fitfully), digestive upsets, difficulty in swallowing, agitated behaviour, like twiddling fingers, playing with the hair, increased heart rate, restlessness, sense of muscle tension in the body, or actual muscle twitching, non-cardiac chest pain, dizziness, lightheartedness, hyperventilation, sweaty palms, nervousness, stumbling over words, high blood pressure, lack of energy and fatigue.

The impact of stress on the human body can be countered by different techniques and skills, psychotherapy and drugs. Very commonly used stress management skills are relaxation training, time management, problem solving, cognitive restructuring and self observation. These skills are very much effective when undertaken in groups. The burden of stress on human beings is reflected by reduced productivity, increased absenteeism in workplace, and increased accidents and increased healthcare expenses. Thus, the disability associated with stress is very high both in terms of money and human productivity.

Stress has affected the human race in all spheres of life and led to numerous physical, psychological and social problems, but it is inevitable in present day situations. So we must learn to cope with it and prevent its ill effects by using different stress management skills, or else the human race might face even the question of its survival one day.
(Published on the occasion of World Mental Health Week)
sourcE: assam tribune editorial 11.10.08