Medical Care

Medical Education

Some Topics

  • Is Stress Really Real?

    The word ‘stress” is another of the popular fuzzy words that everyone uses but no one really understands. Stress is a noun, verb, adjective and adverb, so versatile grammatically that it defies all reasonable definition. Hans Selye started the “stress” fad by doing terrible things to rats in his laboratory such as injuring them with painful electrical shocks, burns, toxins, and forcing them to swim in a closed container until exhausted. These near-drowning experiences were described as stressful.

    While Selye called these traumatic experiences “stress;” others might call his experiments “torture”. Sometimes the “torture-stress” was an allergic reaction to a foreign protein that he injected. Selye’s rats would tell you that “stress” was painful, scary and often life-threatening. The “stress response” that Selye observed was a progression of body responses to injury that gave an animal an opportunity to survive. Selye’s main discovery is that the adaptation to injury involved increased fight and flight responses and secretion of cortisol from the adrenal glands. If the injury was repeated or prolonged, the adaptation would fail and the animal could die.

    The original and specific meaning of the word "stress" has been lost in popular usage. Emotional responses are often referred to as “stress.” Tiring or frustrating experiences are often called “stress.” Conflict is also referred to as stress.

    One problem with such a fuzzy word is that it overrides a host of more useful concepts and words that describe human experiences in more precise and meaningful ways. Intellectual progress can be made simply by deleting the word, stress from your vocabulary or you could start with re-definition of “stress” by noting that the fundamental task of living beings to find things in the world out there that they need to survive, to avoid danger and to adapt to changing circumstances. Since the environment changes constantly, humans are required to adapt constantly. When the change is too great or too sudden, a failure of adaptation occurs, with malfunctioning of mind/body as a consequence.

    A meaningful use of the word stress in science refers to the activation of the flight and fight response with increased sympathetic nervous system activity, and the secretion of adrenalin and cortisol from the adrenal glands.

    You could argue that any interaction between individual and environment that produces dysfunction expressed as symptoms and disease could be called "stressful." Any event, agent, or component of the environment that causes a maladaptive response is then called a "stressor". A maladaptive response to a changing environment might be as simple a changing jobs and the new canteen only serves cheese burgers, French fries and coke for lunch. You get obesity, high blood pressure and diabetes after 10 years on the job.

    If you had stayed at the old company and continued to have salads and orange juice for lunch, you would be healthy and well. Maladaptation leads to dysphoria and disease. Successful adaptation leads to happiness and health. For most people living ordinary lives in relatively safe environments, the most stressful events are those changes in the environment and food supply that internal control systems can neither control nor predict.

    Events that cause unstable changes in body function require adaptive responses. If responses work, the instability is reduced and no stress occurs. If the responses do not work, then body systems, seeking balance, become confused and maladaptive body-states and maladaptive behaviors appear. A healthy person copes with a remarkable range of adversity and emerges intact, whereas a sick person cannot cope with the ordinary transactions of daily life.

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    These brief essays by Dr. Stephen Gislason are taken from his book Self Care and Medical blogs.

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