Stress: How to De-Stress without Doing Less (4 page)

 

Figure 6: Just some of the ratings given on the Holme and Rahe stress scale
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(figures given are for adults)

Holme and Rahe's scale is interesting and it can give us an idea of roughly where we might expect our stress levels to be. But the truth is that different people experience stress very differently. The same event might be not much of a big deal to one person but an intolerable stress to someone else. The way we experience stress can be influenced by our personality, our aims and goals and the way we think. We also all notice stress at different levels. One person may feel dreadfully fraught and pressured, and another just think this is normal life, but both are at the same kind of stress level. Some people seem to thrive on stress and always like to be working towards something. The important thing to realize is that those people are just as likely to succumb to stress as anyone else.

How do you recognize when your stress levels are getting near that ‘crisis' limit?

People differ in what first makes them realize there is a problem, but often it takes something reaching that crisis point before they start to do something about their stress. For some people it is a physical problem. Any doctor will tell you that many of the issues they see have their root in stress. Headaches, stomach pains, sexual problems, more serious issues such as irritable bowel syndrome (IBS) or heart problems – all these can be a wake-up call that we need to do something about our stress levels. Other people find that it is the emotional load that starts to push them over. Living constantly on the edge is exhausting and has an inevitable impact on our relationships, moods and emotions, and also on our ability to concentrate and perform effectively at work. Many people find that their stress suddenly brings them to a
place where they become frightened that they simply will not be able to cope any longer and suddenly feel they are at very real risk of becoming a statistic of burn-out. If you recognize something of yourself in this chapter but haven't got to that point yet, fantastic! This is your chance to do something about your stress levels before they push you over the edge. If you have reached that point, then remember that you are not alone. Succumbing to stress is not a sign of weakness but a sign of being human. Your next challenge is to look at what it is in your life that has made you vulnerable to stress, so that you can protect yourself in the future.

So far we've seen that stress is a physical reality as well as something that affects our emotions. It is much more than the kind of ‘it's all in your mind' issue we often think it might be. Stress is something that, no matter how clever, resourceful or amazing we are, will affect us in some way because it is part of being alive. But what kind of problems can stress actually cause?

The problems caused by stress all stem from the fact that our stress system was actually designed to respond to
short-term
stress. Our bodies were simply not designed to operate with the levels of these hormones becoming raised over long periods of times. This is why chronic stress causes so many problems. It affects a vast array of different body systems and actions, with an impact that is often very complex and different for every individual. Chronic stress can affect a bewildering range of physical functions and has been linked to all kinds of illnesses, syndromes, signs and symptoms.

Physical issues related to stress

In some ways, the most serious physical results of stress are those that build up over time. The system that is most affected is the cardiovascular system – the heart and all the
arteries and veins that carry blood to and from the muscles and organs that the heart supplies with blood. Stress stimulates the body to supply more blood to the major muscles, while organs – for example, those responsible for digestion – receive less blood. All this involves changes to the way the heart pumps, as well as changes to the blood vessels themselves. The bad news is that long-term stress stimulation of this system causes our blood pressure to rise (in an equally chronic, long-term way) as the vessels struggle to cope with the extra blood rushing through. It triggers changes in the way the heart muscle works, meaning that there is an increased risk of unusual or irregular beats. As if that weren't enough, chronic stress can also increase the risk of developing narrowing of the arteries (made all the worse, of course, if we tend to have a diet that is high in cholesterol and ‘bad' fats). Chronic stress has, therefore, been linked to an increased risk of developing cardiovascular problems such as heart attacks and stroke. Acute stress can also trigger symptoms in these areas, bringing on conditions such as angina and chest pain. Meanwhile, of course, as the less important blood vessels receive less blood, stress can worsen illnesses related to poor circulation such as Reynaud's phenomenon, where people find that the blood supply to fingers and toes actually cuts off in cold weather, leaving their digits white, pale and painful.

Most of the problems stress causes in the cardiovascular system are related to the constant stimulation it receives. But remember that while the sympathetic system is overactive, it also effectively turns down the systems that control digestion. This means that stress very often causes some kind of digestive symptoms – from mild problems with indigestion to more serious conditions that require
investigation and treatment. Chronic stress has been linked to conditions such as IBS, painful stomach cramps and problems with wind and constipation or diarrhoea. Stress can also contribute towards the development of stomach ulcers – both directly and because people often respond to stress by smoking or drinking too much alcohol, which can contribute to ulcers. An ulcer can be very painful and in some cases can become serious and cause secondary problems such as bleeding from the ulcer.

Stress can also cause muscular problems. When we are stressed, we are more likely to keep our muscles slightly tensed, meaning that they can become fatigued and painful. This effect may well contribute to another common symptom of stress – a type of headache called a tension-headache, where a mild or moderate pain around the head can feel like a band being tightened. This can be caused by muscles in the neck and at the back of the scalp being too tense and can be aggravated by poor posture. Chronic stress can also contribute to all kinds of other common muscle pains, including back and neck problems. So, although a bad back might be in part down to sitting badly, high stress levels will make it even worse.

As well as causing its own physical problems, stress can contribute towards the development of some illnesses. Studies have shown that long-term stress inhibits our immune system, meaning that we are more prone to coughs, colds and other bugs. In essence, we really can get ‘run down'. Meanwhile some viruses – illnesses we have as children such as chickenpox – don't leave our body but remain dormant, waiting for a chance to re-emerge if our immune system is not working too well. Stress can trigger things such as shingles (which is what
we get when the chickenpox virus re-emerges). Just how significant this impact on the immune system can be is still being investigated; it is even being linked to the development of some cancers.

The impact of stress on metabolism and eating

If you ask people what they do when they are stressed, one of the first things they are likely to mention is a change to their eating (or drinking!) habits. Stress has a significant impact on the way we break down and use our food. When the stress response is triggered, it causes various chemical processes to occur that result in glucose and certain types of fat molecules being released into the blood. This is to make sure we have the energy we might require to respond to the apparent threat. But if this happens over a long period of time, stress starts to cause more significant changes to the way we use and store foodstuffs such as fat and glucose. Blood levels of these molecules become chronically raised, and this can have serious consequences for our health.

We hear a lot about a type of diabetes that is becoming more and more common. Type 2 diabetes is caused by the cells in our body starting to become resistant to the insulin that is circulating. (People with Type 1 diabetes stop making insulin and therefore do not have enough circulating.) Insulin is absolutely vital, triggering our cells to take up the glucose they need in order to function. This process is also involved in getting fat cells to mop up and store any excess fat. In Type 2 diabetes, the cells stop responding to the insulin, meaning that glucose and fat levels in the blood rise – again contributing to cardiovascular disease. Type 2 diabetes is primarily caused by
eating too much of the wrong things and gaining weight over a period of years. Chronic stress can add to this by causing our blood levels of glucose to be chronically higher anyway, which in itself gradually causes the cells to become less resistant to the insulin that is circulating. Type 2 diabetes is becoming a huge problem throughout the world. Previously referred to as ‘adult onset' diabetes, it is now increasingly common in younger teenagers and even in children. Although this is often related to poor diet and rising levels of obesity, stress certainly has a part to play.

These metabolic changes don't just affect things inside our body; we may well notice changes in what we eat as well. Stress certainly affects our appetite, although exactly how it does so varies from person to person. Some people (apparently it's the minority – probably about one third of people overall) lose their appetites at the first sign of stress. Meanwhile, others overeat and tend to do so by snacking on high-sugar, high-energy foods that they are craving in order to gain the energy to respond to the demands placed on them. This can contribute to weight gain and often becomes part of a lifelong struggle with weight control.

Chronic stress also affects
where
we tend to put on weight. You will no doubt have heard about the difference between weight stored around the abdominal organs (round the middle, the classic ‘apple' shape) as opposed to fat stored on the bottom and thighs (the ‘pear' shape). For those people who eat more when they are stressed, the bad news is that this will stimulate fat to be laid down around the middle. This is the classic businessman's stomach – weight gain around the tummy! Unfortunately, fat stored around the middle is yet another risk factor contributing to cardiovascular problems.

Stress and pregnancy

The impact of stress in pregnancy is worth a special mention. When they fall pregnant, or are planning a pregnancy, most women make changes to their lifestyle in order to do everything they can for the health of the child. But how many people realize the impact stress can have? Evidence suggests that stress and anxiety are transmitted to the foetus as early as four months into the pregnancy, with levels of key stress hormones in the baby going up and down in tandem with levels in the mother's blood. Sometimes this stress can be linked to more serious problems, including birth defects, premature birth and pre-eclampsia.
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In fact, amazingly, even stress in the six months
before conception
has been linked to a risk of premature birth. (A study of mothers in Denmark in 2008 looked at people who had experienced very serious stress caused by life events such as losing a partner or older child while pregnant.)

Of course, for most people this will not have any measurable impact, so don't panic – although high stress and anxiety levels in pregnancy have also been linked with having more irritable and difficult babies (something most parents are keen to avoid!). However, for those who have a personal or family history of some of these issues, it is sensible to look at how they can work on stress during this crucial time. And perhaps for all women considering pregnancy, it is worth taking stress as seriously as they do other factors such as their diet.

The physical reality of stress

This is an alarming wake-up call to the physical impact that chronic stress really can – and does – have on us. Far
from being something minor that is linked to being slightly hysterical and not coping very well, stress is a physical reality with very real and serious short-and long-term outcomes. In fact, stress has been linked to and implicated in so many illnesses, diseases or negative outcomes that there simply isn't space to list them all. This chapter is really just a very brief overview.
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The take-home message from all of this is clear: we have to stop thinking that the ‘best' people are those who can carry on in spite of lots of stress. Stress is a very real problem, a problem that affects everyone. It is something that we all need to be aware of, no matter how well we feel we may or may not cope when under stress. In fact, the more we tend to push ourselves and live life under stress, the more important it is for us to look at how we can manage that stress more effectively. It's for the sake of our health.

The good news is that we can do something about the impact stress is having on us. Look at the following true story of one person and the difference it made to his health when he changed the way he dealt with stress.

James is 36, with two young children and a busy job.

 

‘I have to say that I thought getting help with stress was something that only weak people did – especially for men. It was not something I ever thought I would need to do. In my job, stress is something you just accept, and how you cope with that is taken as a sign of how good you are at your job. So, people who struggle are felt to be not up to it and often end up leaving the company. I never paid any attention to the stress I was under and I certainly never did anything to try to control the effect it had on my health.

‘In the end, it was health issues that forced me to change that. I had been gaining weight for a while but thought nothing of it
– who doesn't gain weight! But I really didn't feel that great and I'd even had a couple of times when I had really bad chest pains – probably indigestion, but though I never admitted it to anyone, I was really worried. The final straw, though, was the headaches. I started to get really bad headaches – so bad that I just had to lie in a dark room until they had passed. It was a nightmare because I couldn't work when I had one so I was missing loads and had work stacking up behind me. I was trying to stay up late to catch up on work but that meant I missed out on sleep and made the headaches worse. In the end, I was finding that a headache would come on within less than an hour of starting work. I took a couple of weeks off but the minute I went back, the headaches came back. I went to the doctor, obviously, and they did some tests, but in the meantime they referred me to the practice nurse to talk about stress and stress management.

‘It only actually took one session with the nurse to change everything. She explained all about stress, what it was and the effect it could have. I never realized how important it was to put in times to wind down and de-stress. I realized that everything I did was stressful – even in my spare time, the things I did were not relaxing. Neither I nor my wife ever took time out for ourselves – we were so busy focusing on other people.

‘As a result of that session, I made some big decisions. I am a lot more careful now about the hours I work, and I spoke to my boss about the amount of work I was being expected to do at home in the evenings. I have started a hobby which really gets me out of the house and actually helps me to relax. I love having something in my life which I'm really passionate about but which isn't work! And it's made a difference to my life at home too as I am more relaxed with the family, so when I am there, it's more quality time. As for the headaches – well, I have to admit I was surprised. They stopped almost straight away and now I hardly ever have them. I
feel loads better in myself and I guess I am just sorry that I didn't realize sooner just how powerful stress could be.'