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Understanding Stress


stress, bipolar, anxiety, depression

Stress is a common part of life. As the world we live in becomes smaller, faster and more demanding the simple joys of life become more precious and fleeting. Most of us cope, and get past each situation as it comes our way. For some, the stresses and demands build up and become so large we begin to wobble under their sheer weight. When our coping resources can't manage anymore, we feel acute stress and anxiety. If left unacknowledged, a host of problems come along. These may take a toll on our health, or lead to behaviors that are risky and even life-limiting. Read on, if you want to understand the stress response. If you're more interested in knowing how to learn some stress breaking strategies, then look for a related blog in the series - 'How to Manage Stress'.

We face stressful circumstances on a regular basis. For some this is a daily occurrence. Stress may come in the form of change, such as beginning school or bringing a new baby into the home. We might also feel stress for physical reasons, such as monthly cycles, or having sleepless nights due to back ache. We face stress at work - a noisy office environment, impending deadlines or crowded trains to and from the city. Then there is stress located in the social world - how a person feels on a first date, or when we feel anxious making interesting conversation at a party. Even seemingly harmless situations may cause stress, such as vacations, a change in routine or diet. And yes, those annual family get-togethers at Christmas time rate high on the stress list for many of us!

It is essential you recognise how stress plays a role in your life, and what it is doing to you. This is because stress has been implicated in a wide range of illnesses, from physical disease to behavioral, emotional and cognitive problems. Let's explore what the science is saying...

Stress changes our behavior

Increases in alcohol, smoking and caffeine use are amongst the most common responses to stress. Stress can often lead to overeating and weight gain. It's always difficult to make causal statements in this area - for example, does stress cause these changes in our behaviour, or does the research just highlight people who behave in unhealthy ways, and in so doing experience stress (or are in some way more predisposed to it)? Whatever the link, there is certainly an association. If we rely on personal experience rather than science, we know for ourselves that when we are most stressed and anxious, we reach for things that either dampen our stress or give us some degree of comfort. Unfortunately, cream cakes or an extra beer give only temporary relief - the problems that are causing our stress will still remain after we have indulged in these ways, and we may be less empowered or alert to meet the challenges before us.

Stress makes us emotionally unwell

Sustained stress has been linked to depression. It can affect our ability to sleep, or feel rested when we wake in the morning. We may begin to lose enjoyment in the hobbies and interests we once enjoyed. We may start to feel at odds with our partner or children, because minor disagreements begin to feel like major battles. Feeling sluggish, distant and anxious has to take it's toll on our mood state eventually - after all, who likes to feel this way?

Daily hassles (such as traffic jams or household chores) have a more dramatic effect on someone who is already feeling stressed. This becomes a self-perpetuating cycle of irritability and frustration - rather than reducing stress or making us feel better, this cycle just creates more problems. In so doing, a deeper depression and hopelessness can begin to set in.

Stress makes us physically sick

It's known that victims of heart attack have been found to report higher numbers of stressful incidents in the 6 months prior to the attack, than their healthy counterparts. Increases in occupational stress (e.g. as a result of increases in work load, responsibility or job dissatisfaction) have been linked to an increased incidence of coronary heart disease. Furthermore, longitudinal studies have shown that the level of self-reported stress levels are a good predictor of coronary heart disease in the future.

How might stress have such a link with heart disease ? One explanation lies in the finding that high levels of stress seem to cause excessive arousal of the endocrine system, and lead to atherosclerosis (a narrowing of the arteries). This stress response increases blood pressure, and causes hypertension. Together, atherosclerosis and hypertension are the most common cause of heart failure. If we accept that stress can also increase our caffeine intake and smoking behaviour, we know that such a lifestyle is generally not good for the heart.

There is even some evidence to suggest that more stressful lifestyles precede the development of cancer. Studies have measured stress levels in initially healthy individuals, and over a long period of time, those reporting greater stress in their life have been more likely candidates for the development of this disease. Again, the explanation may lie in the physiological response to stress, or the unhealthy lifestyle that chronic stress can create and maintain. From a physiological point of view, the mechanisms thought to be at work once again involve excessive arousal of the endocrine system. This is thought to have a depressive effect on the immune response, which has in turn been associated with conditions such as breast cancer.

In recent studies, measures of psychological state and social problems (psychosocial data) have been considered accurate predictors of mortality and cause of death over 14 years ahead ! More highly stressed individuals are thought to have upto a 40% higher death rate than their lower stressed counterparts. The idea that stress will lead to an early grave is not to be taken lightly.

It's all in the mind?

All individuals face potentially stressful experiences during their lives. However, the impact of similar stressors does not have a similar effect upon all individuals. Some people have terrible lives - they face deprivation and abuse, but somehow find the resilience to survive and lead outwardly fulfilling lives. Others have relatively more comforts and support networks, and no obvious reason to become depressed or chronically ill on account of their circumstances. Furthermore, in the same situation, two individuals do not necessarily experience the same stress. It would seem therefore that to some extent, stress is 'all in the mind'. Our attitude and mental approach, seem to make a real difference.

Research suggests that an enhanced 'hardiness' of character of an individual is the changing factor. This hardiness may take the form of a stronger commitment to self, an attitude of vigorousness toward the environment, and a belief that 'I am in control' of the events in my experience (psychologically termed a sense of self-efficacy and self-esteem).

If we have a certain mind-set or approach to life, we are more likely to become stressed over relatively small incidents and events. This mind-set is characterized by the tendency to compete heavily with others, or take a self-critical stance. It manifests in the form of racing against time and others, and becoming easily aroused or angered. It's an attitude that tells us we are not good enough, and need to be better than others to be happy or successful. It's a way of thinking that leads us to overlook or be dissatisfied with what we have, and yearn for that which is yet to be acquired. It is a case of constantly living in negative equity, and being burdened with emotional debt. When small storms come our way, this mind-set easily throws us off-balance, and we feel stress in all it's forms.

Solihull Well Being Clinic offers a number of treatments - talking therapies, alternative medicine and hands-on body treatments - which can help those who have suffered too long with stress, and want a change. Do get in touch for a friendly initial consultation.

Dr Bobby Sura Consultant Clinical Psychologist & Psychotherapist

Dr Bobby Sura is a Consultant Clinical Psychologist specialising within the field of lifespan and family based mental health needs. He works both in the public (NHS) and private sector, being the proprietor of Clinical Psychology Direct and Partner for Solihull Well Being Clinic. Dr Sura is Chartered with the British Psychological Society (BPS), Division of Clinical Psychology (DCP), Health and Care Professions Council (HCPC) with eligibility for registration with the United Kingdom Council for Psychotherapy (UKCP) and

Association of Family Therapy (AFT).

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