We often hear the word stress. It seems to be a modern plague. It is cited as being a cause of ill health and absenteeism, as well as behavioural problems. But what is it? What causes it? How big a problem is it? How can it be managed? This page is an introduction to the subject â€“ on other pages I go into more detail about its causes, effects, and management. So, this page gives an overview, tries to produce a definition, looks briefly at some of the important issues, and provides links to the relevant pages.
What is it?
Stress, in human biological and psychological terms, is the failure to respond appropriately to any perceived physical or emotional threat (whether real or imagined).
Sounds fantastic! What does it mean? Hereâ€™s another â€˜definitionâ€™ that might make it clearer!
Stress is the state of mind we experience when we feel that there is a mismatch between the perceived demands placed upon us and our perceived abilities to cope with those demands.
In the UK, the Health and Safety Executive (HSE) defines work-related stress as: â€œThe adverse reaction people have to excessive pressures or other types of demand placed on them at work.â€
Letâ€™s see if I can make it even clearer! Sometimes we face situations that are threatening. When this happens, the body releases chemicals (adrenaline, noradrenaline, and cortisol) into the bloodstream to prepare the body to fight or flee â€“ the â€˜fight or flightâ€™ mechanism. These hormones cause the heart rate to increase, blood pressure to rise, blood to move to areas of the body where it is most needed for fight or flight (the muscles, and lungs!), sugar is released into the bloodstream â€“ the body is â€˜ready for actionâ€™! This is okay if these events happen sporadically, but in our modern society, we face many situations that we perceive as threatening every day.
In the past (i.e. thousands of years ago) early humans might have experienced threatening situations like facing a wild animal â€“ a very real dangerous situation. In the 21st century, a similar situation might be coming face to face with a knife-wielding mugger! However, in the first paragraph in this section, I noted that the perceived threat can be real or imagined. That means that the â€˜fight or flightâ€™ mechanism can be started by such things as domestic conflict, or financial worries, or overwhelming demands at work, or conflict with an immediate workplace superior (manager, supervisor, or foreman). Issues such as these can be experienced all the time â€“ persistently. We can continue to experience pressure and anxiety in relation to a situation even when we are away from the location where it is being generated. We can continue to experience work-related anxiety even when we are not at work, and we can continue to experience domestic tension even when we are away from our home.
I go into more detail about the causes of stress on another page, but as you can see from the above paragraphs (and as you may have experienced yourself!) in the 21st century, we experience many of its causes continuously, for prolonged periods of time, with no respite. The pressures we experience in such circumstances can often be compounded when we feel powerless to generate change. Indeed, feelings of loss of power and control contribute significantly to the experience of stress, and can often lead to depression. The continued physical preparation for â€˜fight or flightâ€™ (raised blood pressure, increased breathing rate, high blood sugar levels), without any release or relief, causes long-term health problems â€“ physical and psychological.
Why do we experience it?
To gain a better understanding of this we need to understand the concept of â€˜eustress' and 'distress'.
Eustress and distress are terms that were coined by the endocrinologist Hans Selye in 1975. (It was Selye who first used the term â€˜stressâ€™ in a biological context in the 1930â€™s.)
You will have heard of the concept that â€˜a little bit of pressure can be good for youâ€™ â€“ the notion that a little bit of pressure can increase productivity or be motivating or improve performance. This is eustress. Selye defined eustress as a pressure that enhances function (physical and mental) and related it to desirable events in a personâ€™s life. Examples of life events that might cause eustress are: challenging work (which differs from what someone might perceive as overwhelming demands at work!); competing and winning a race; being promoted; marriage. These things may cause temporary and slight increases in the release of adrenaline, noradrenaline, and cortisol, but the increase in their production is not persistent and prolonged as in distress. (Additionally, if the event is causing pleasure, there is also a release of endorphins â€“ the bodyâ€™s natural painkiller â€“ which may reduce some of the adverse physical effects of the other hormones!)
Distress is the opposite â€“ a state of mind that has negative consequences and leads to physical and psychological damage and impairment. Distress is a state of persistent anxiety and pressure that is not resolved through any of the methods outlined below, and which can lead to the effects outlined in the next section. In such cases, when people experience persistent unresolved exposure to a stressor, then the release of the three â€˜fight or flightâ€™ hormones is also persistent so that their negative physical effects (including reduced functioning of the immune system) are permanently being experienced â€“ without the compensating effects of endorphin release.
In some ways, the difference between eustress and distress can simply be a difference between individualsâ€™ expectations and ability to cope or adapt to the situation, so that, while one individual might experience an event as eustress, another person might experience the same event as distress.
What are the effects on the individual?
For individuals, stress can be very harmful. Its effects range from physical changes (some of which can have serious long-term consequences) to psychological harm, which may lead to behavioural changes. All of these effects can have a negative outcome on peoplesâ€™ lives.
I go into more detail on another page about the effects of stress on individuals:
What are the effects for society?
In the UK, a survey suggested that in 2009 over 400,000 people experienced work â€“related stress, although more recently an HSE report suggests that the figure may be over 500,000.
Also in the UK, a report (based on a survey of almost 2,000 companies) by the HSE suggested that over 105 million work days are lost each year due to stress, costing UK industry well over Â£1 billion!
There is a significant cost to health services, too. Still in the UK, at the end of 2009, the National Institute for Health and Clinical Excellence (NICE) reported that treating workplace-related mental health was Â£28 billion!
These are some seriously high figures â€“ stress is having a serious negative effect on society as well as for individuals.
I go into a little more detail on another page about the effects of stress for society:
How can it be managed?
It is not always possible to avoid stress! While prevention is better than cure, very often people fail to recognise the impact that unresolved pressure is having until that impact is entirely negative. At that point, it is essential to manage the effects.
I go into more detail about specific management techniques on another page, but this is a simple guide to some of the management techniques.
In simple terms, there are two ways of managing stress: managing the stressor (managing the problem itself by eliminating it or minimising it or removing oneself from it completely); managing the psychological and physiological response to the stressor (using coping techniques such as relaxation or self-hypnosis!).
Managing the stressor may not necessarily be easy! It might not be easy to change jobs, or change school, or change spouse! However, there are some things that can be done to lessen the negative impact caused by your personal circumstances. Ensure you take sufficient breaks from work (or from whatever factor is affecting you); only take work home with you if it is truly absolutely necessary; if you smoke â€“ quit smoking!; if you drink a bit too much, then cut down! Be assertive without being aggressive; look after yourself by eating properly; make time for your hobbies and interests; ensure that you manage your time effectively;
When itâ€™s not possible to avoid stressors or remove yourself from stressful circumstances, then it is necessary to manage their effects. There are two main ways to do this: adapt to the stressor; employ techniques that ensure that reduce its impact.
Adaptation involves both acceptance and looking at things from a different perspective (a technique called â€˜reframingâ€™). An example of reframing might be deciding that being stuck in a traffic jam is not so much a frustrating and inconvenient delay, but is actually an opportunity to think about something or to listen to the radio in the car, or that it is giving you more time to listen to your favourite music (how about learning a foreign language by using CDs in the car?). Itâ€™s also important to ensure that your expectations are not unrealistic and that you can see what is positive in your situation. Sometimes, all you can do is accept that you cannot change the situation.
There are a number of coping techniques that can be used: relaxation techniques; yoga; exercise (which increases endorphin production); hypnosis and self-hypnosis; meditation; find something to laugh at (a TV comedy, or comedy film on DVD, or a comedy radio programme); take time to relax with a loved one â€“ take a trip to the theatre or cinema, or restaurant; listen to your favourite music. In addition, for clinical issues (such as depression or anxiety) you should seek medical help, and your medical professional can make the following â€˜treatmentsâ€™ available: drug treatment, counselling, anger management, cognitive behavioural therapy.
Selye H., (1975) â€˜Confusion and controversy in the stress field.â€™ J Human Stress, 1: 37 â€“ 44
Selye H,. (1956) â€˜The Stress of Lifeâ€™, McGraw-Hill