An Introduction to stress
The concept of stress is relevant to contemporary life as urbanisation is growing alongside societal pressures and expectations to succeed, as indicated by the labour force survey which calculated that between 2016 and 2017 12.5 million working days were lost due to work-related stress, depression or anxiety (HSE 2010). Chronic stress is a UK epidemic which the government spends a considerable amount of money on for its treatment and diagnosis. However, many people are unaware of the coping mechanisms to manage stress and thus it can destroy their lives.
This topic is crucial as stress is debilitating for the individual, firms, society and the economy as a whole. There are multiple individual costs of stress: the immune system and illness, waiting time to see psychologists, loss of employment, quality of life, divorces, suicide and time off work. An accumulation of these factors can be overwhelming to the individual and unhealthy coping mechanisms might be adopted, for example there has been a correlation between ‘acute and chronic stress and a person’s abuse of addictive substances’ which could include drugs, cigarettes or alcohol.
This led me to propose the research question: To what extent is stress responsible for ill health? This topic involves the exploration into the physiological impacts of stress, through stress and the immune system and it facilitating the progression of cancer. A biology mechanism underlying stress and its bodily consequences will be examined and linked to the hypothalamus-pituitary-adrenocortical (HPA) system, Adli (2011).
Additionally, the question of whether the psychological or physical impact of stress is more vital will be analysed and the extent to which cognition (coping strategies) and personality types play a role in its onset. Secondary data has been gathered from studies involving stress in relation to cancer and immune suppression (Cohen (2007), Kiecolt-Glaser (1987)) which will be critically evaluated. Additionally, the generalizability of using animals in research as well as the ethical implications will be debated.
However, the most significant aspect to be evaluated is why some individuals are more susceptible to displaying the physical symptoms of stress. This indicates that there is a cognitive element involved which determines the onset of illness. These questions have widespread implications as stress becomes a prominent part of our lives and the government, medical professions and individuals must consider the future outcomes. – More of an indication into the sources used needed? Numerous interpretations of stress exist and several models and theories attempt to determine what it is. The transactional model of stress defines it as: a lack of fit between perceived demand of the external and internal environment and perceived ability to cope to stay in equilibrium, thus it can affect one’s physical and psychological wellbeing (Lazarus & Cohen, 1977).
The fundamental principle is that there is a cognitive element, meaning certain individuals perceive the threat to be more unmanageable and are unable to cope with the environmental demands. Therefore, a physiological response occurs affecting the immune system or leading to direct illness like cardiovascular disease. The American Psychological Association considers stress to be a ‘feeling of being overwhelmed, worried or run-down’; which can impact people of ‘all ages, genders and circumstances and can lead to both physical and psychological health issues’.
Additionally, Baum (1990) perceives stress to be an intolerable quantity of pressures and a ‘negative emotional experience accompanied by predictable biochemical, physiological and behavioural changes that are directed toward adaptation either by manipulating the situation to alter the stressor or by accommodating its effects.’ Stress may be short-lived or long term, it can take many different forms from acute, episodic acute stress or chronic stress which all have discrete characteristics, symptoms, duration and treatment approaches. There has been compelling evidence which recognises that a stress overload can cause ill health and serious health conditions such as anxiety, insomnia, muscle pain, high blood pressure and a weakened immune system as suggested by Baum (1999).
There are a number of social events known to take longer to readjust to and are highly correlated with the onset of illness. Holmes and Rahe (1967) created The Social Readjustment Rating Scale (SRRS), assigning a rating scale to several stressful life events to determine which life events have the highest stress score and are thus more likely to cause illness. It was concluded that the death of a spouse has a mean value of 100, divorces are second on the ranking with a mean value of 73 and major changes in working hours or conditions have a mean of 20 points.
According to the Physiological Society in 2017, measuring stress in modern Britain, they rank death of a spouse first, second imprisonment, separation and divorce in third and unexpected money problems in eighth which indicates that some events are more stressful than others and have a devastating individual burden. Fundamentally, in order to minimise stress levels, it is necessary to avoid stress triggers as stated by the stress inventory although it is very generalized and cannot be applied to all individuals. This is because certain people have different perceived ability to cope and minor event might be considered threatening events due to their psychological state.
The biological mechanism of stress
As different life events are associated with certain stress levels, high intolerable amounts of stress are shown to have profound biological consequences, which are a likely cause of mental symptoms. As examined by Adli (2011) there are two biological systems which play a role in controlling the stress response; one fast acting and another slow acting. Primarily, our body responds through physical means through the fast-acting system by using energy reserves to regulates the release of the hormones noradrenaline and adrenaline, increasing one’s breathing and heart rate, which is known as the ‘fight-or-flight’ response. This requires physiological preparation after a perceived threat or harmful scenario, so digestion is impaired and for our ancestors the threat would only have been short-lived. However, nowadays there can be long-term threat meaning it can be debilitating.
Furthermore, Adli mentions that ‘noradrenaline and adrenaline increase the heart rate and decrease the heart rate variability, dilate the respiratory airways and activate blood platelets to coagulate’. Although, ‘persistent stress-dependent dysregulation of the HPA system’ can have negative consequences as metabolic rate is impacted and body fat accumulates. Although cortisol is an anti-inflammatory agent constant cortisol levels lower serotonin production (responsible for sleep patterns), suppressing the immune system which can lead to auto-immune deficiency.