ABSTRACT | PDF

Faculty Forum I

Stress and modern day life

Kamal Nath
Associate Professor of Psychiatry
Silchar Medical College and Hospital

 
Introduction

 
Stress is very much an integral part of the existence of the human life. Starting from the very primitive age to the present modern day life, the history of human civilisation can be said to be nothing but stress and mastery over the stress. The different phases of its journey, the nature and the quality of stress has been changing and evolving constantly. The stress can be defined as an internal state which is caused by physical demands on the body or by environmental and social situations which are potentially harmful, apparently uncontrollable or exceeding the resources for coping, of the individual e.g. disease, extreme temperature, natural calamities, communal riots and socio political unrest.

These physical, environmental and social factors that induce the stress state are called stressors. These stressors induce the internal stress state which may lead to physical/bodily responses or psychological/ emotional responses such as anxiety, hopelessness, depression etc. In general, it is a feeling state where the individual finds it is a feeling state where the person finds it difficult to cope up or can no longer cope at all with the stressors.

In the modern day life though newer technologies are coming up to help us in overcoming the various stressors but at the same time it is also giving rise to newer and newer types of stressors on the other hand. These stressors affect the individual as well as the society at large and cost the nation billions of dollars per year as direct or indirect consequences.

Type of stressors

Though most of the stressors are negative in nature, few positive stressors are also there. A little stress is useful in helping us to adapt to the changing situation and may help us in building up new coping skills and strategies but beyond some point the stress becomes distress and usually in negative consequences, both physical and psychological.

Again there may be various kinds of stressors e.g.

(i) Physical
a) Injuries and infections of the body
b) Annoying or dangerous events in our environment
c) Major changes or transitions in our life
d) Anticipated or actual threats to our self as well as self esteem

(ii) Psychological
a) Loss or separation from our near and dear ones
b) Financial burden
c) Marital disharmony
d) Rapid changes of civilisation, culture and belief system

All these impose a huge demand on our coping skill where many of us may fail and break down.

Stress cycles

Stress has a number of immediate effects and if the stressors are maintained long term then it will have effect on behavioural, physiological, emotional and cognitive fields. All these effects may reduce the coping capabilities of the individual and may further aggravate the situations and thus a vicious cycle may set up which is called “distress cycle”. On the other hand many people under the long term stress may develop further more effective coping skills to deal with the stressors and so they respond with more positive adaptability and they become more capable of facing further complex and difficult stressors. This is called the “wellness cycle”.

What stressors do to the body

Hans Selye (1956) described the body response to stressors as General Adaptation Syndrome which consists of 3 stages:

a) Alarm reaction – In this stage there is a prompt response of the body, many of them are mediated by sympathetic nervous system that prepare us to cope with the stressors immediately.

b) Stage of resistance – If the stressors continue the stage of resistance begins. Here the body resists the effects of the continuous stressors for a long time.  During this stage certain hormonal responses of the body are important line of defense in resisting the effects of stressors e.g. activation of hypothalamic pituitary adrenal axis.

c) Stage of exhaustion – The final stage of the General Adaptation Syndrome is called the stage of exhaustion. If the stress cycle cannot be converted into wellness cycle during the first two stages then the stage of exhaustion sets in. In this stage the body’s capacity to respond to both continuous and new stressors has been seriously compromised. The individual becomes exhausted and defenseless both physically and psychologically.

Stress and physical illness

Stress may induce various types of physical illness in an individual, some of which may be subtle and some may be very much serious enough to threaten life. The relationship between physical illness and stressors may be indirect and hidden in some cases but may be direct and obvious enough in many cases. Some of the major physical illnesses that may arise due to long continued unresolved stressors are:
i.    Acid peptic disorder
ii. Ulcerative colitis
iii. Essential hypertension
iv. Coronary artery disease
v. Cardiac arrhythmia
vi. Hyperventilation syndrome
vii. Vasomotor syncope
viii. Bronchial asthma
ix. Malnutrition
x. Obesity
xi. Anorexia nervosa
xii. Tension headache
xiii. Many other endocrine and immunological disorders

Some of these disorders may be precipitated immediately following upon the stressors like vasomotor syncope, hyperventilation syndrome, bronchial asthma etc. On the other hand most of the above mentioned disorders are directly or indirectly related to long continue unresolved stressors which might initially affect the lifestyle of the individuals and then lead to the physical illness. Until and unless the stressors are detected and resolved or the patients are enabled to cope up with the stressors by psychiatric intervention like behaviour therapy, cognitive behaviour therapy or pharmacotherapy, the optimum outcome of the treatment of the physical illness is most unlikely.

Stress and psychiatric illness

Since time immemorial the association between stressors and various types of mental and behavioural disorders are well known to mankind. These stressors – psychological or physical – may directly precipitate various specific kinds of mental disorders or indirectly may be related to the various other mental disorders in different stages of illness like onset, perpetuating the illness or interfering with treatment. Some of the common psychological disorders related to stress are:
i) Acute stress reaction
ii) Post traumatic stress disorder (PTSD)
iii) Adjustment disorder
iv) Generalised anxiety disorder
v) Reactive depression
vi) Acute and transient psychotic disorder
vii) Hysterical / dissociative disorder
viii) Various sleep disorder like insomnia and nightmares
ix) Different types of psychosexual disorders
x) Post partum psychosis and depressive disorder
xi) Substance abuse disorders like alcoholism and abuse of drugs, sedatives and tranquilisers etc.
xii) Enduring personality change after catastrophic experiences.

Management

The approach to the management of the stress related physical and psychological disorder mostly depends upon the nature of the stressors, duration of the stressors, various socio demographic factors of the individual as well as cultural background. In a broad sense the approach can be divided into two groups – behavioural and psychopharmacological.

Under the behavioural therapy the modalities that can be applicable are:
i) Counseling
ii) Relaxation training
iii) Hypnosis
iv) Biofeedback
v) Systematic desensitization
vi) Cognitive behaviour therapy
vii) Meditation

On the other hand the psychopharmacological interventions are mostly related to three groups of psychotropic medications like:
i) Anxiolytic
ii) Antidepressant
iii) Antipsychotic

The role of psychopharmacological interventions is limited only to some specific conditions and for a specific time period. Long term remedy in most cases can be achieved only by enhancing the coping skills and cognitive modulation of the individual.

 

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Nach oben