Stress is defined as the body’s response to pressures arising from life events or situations, known as stressors (Mental Health Foundation, 2018). Although everyone can experience stress, what serves as a stressor varies from one person to another based on their physiology, environment, genetic makeup, socioeconomic condition, and so on. Stressors initiate a stress response from our body- the brain stimulates the hypothalamic-pituitary-adrenal (HPA) axis to produce stress hormones (catecholamines and cortisol) that activate a fight or flight response. The immune system is also triggered to prepare for likely injuries.
Certain stress levels elicit appropriate and even beneficial response that enable individuals to overcome stressful situations and return to homeostatic baseline without any adverse effects on their health, especially if the stressor is short-lived (Oken, Chamine & Wakeland, 2015). Thus, individuals are able to develop resilience (resistance or tolerance to stressors) and use it to enhance their performance or overcome lethargy. This is known as positive stress (eustress). Eustress forces individuals to adapt by increasing their strength and coping mechanisms, and warns if they are not coping well and if a lifestyle change may be necessary to maintain normal health (Selye, 1956).
However, stress can also be negative or harmful. This is known as distress and occurs when the exposure to stressors is prolonged or too intense, such that it fatigues the body and surpasses its ability to cope, and results in physical or behavioral problems. Distress also causes people to be confused, overreact, lose concentration, experience performance anxiety and register poor performance (Salleh, 2008). The inability to deal with distress often results from repeated activation or persistence of the stress response, over time without recovery periods, resulting in physiological effects that increase the body’s cumulative wear and tear (allostatic load); this causes people to feel like they are in a permanent fight-or-flight state (Mental Health Foundation, 2018). This essay will therefore explore the link between stress and stress coping mechanisms and illness.
Stress and Illness
Although stress is not in itself a mental illness, experiencing overwhelming (chronic or long-term) stress significantly impacts on mental and physical health. Researchers strongly associate stress with poor physical and mental health (Cohen, Janicki-Deverts & Miller, 2007; Slavich et al., 2010). There exists a complex link between stress and health problems, with susceptibility varying from person to person, as influenced by factors such as the nature, number and persistence of stressors, and the individual’s genetic and constitutional vulnerability, and learned coping patterns.
If left unmanaged, stress can result in behavioral problems. It causes individual’s sleep and memory being affected, a change in their eating habits or a decline in their inclination to exercise or take care of themselves. A study by Mental Health Foundation (2018) found that 46% of those who reported experiencing stress admitted that stress caused them to eat too much or to eat unhealthy, while 29% started or increased their drinking, and 16% started or increased their smoking. Eating unhealthy, drinking or smoking are behaviors that are strongly associated with the onset of various chronic illnesses such as obesity, heart diseases, and early death.
A study by Shaw (2003) found that experiencing overwhelming stress for long periods during the developmental years resulted in long-lasting neurobiological effects, and increased a person’s risk of mood disorders, anxiety, hypo-immune dysfunction, aggressive dyscontrol problems, structural changes in the central nervous system, medical morbidity and early death. Major negative life events are widely acknowledged as resulting in the development of depressive symptoms (Paykel, 2001), and evidence suggests that stressful life events result in the onset of major depression (Hammen, 2005; Stroud, Davila & Moyer, 2008). Stressful life events have also been linked to suicidal thoughts and suicide (Liu & Miller, 2014), as well as self-harm (O’Connor, Rasmussen & Hawton, 2012). Kessing et al. (2003), in their study of patients diagnosed with depression, found that most had recently experienced stressful life events such as unemployment, divorces and suicide by relatives.
A study by Mental Health Foundation (2018) also found that 51% of the adults they surveyed who reported being stressed also admitted to feeling depressed, while 61% felt anxious, 32% reported having suicidal thoughts, and a further 16% reported having self-harmed. Besides resulting in mental health problems, stress also results in an exacerbation of existing mental health problems by, for example, precipitating symptoms and potentially triggering relapse. Day et al. (1987) associate stressful life events with acute relapse of schizophrenia. This link between stress and mental health has been attributed to the interaction between stress and physiological, biological and social risk factors that produces a cumulative effect that culminates in the development of mental health problems (Salomon & Jin, 2013; Swartz et al., 2015). The implication of this is that certain individuals may be more susceptible to mental illnesses arising from chronic stress compared to others, either because they encounter more stressors or have various risk factors, such as lower socioeconomic status, disability, social isolation or belonging to minority communities such as LGBTQ or ethnic minorities. Financial stress, which is mostly experienced by people living in poverty, is a common contributor to mental health problems (Meltzer et al., 2012), and is associated with the poor mental health outcomes among people in lower socioeconomic status (Evans & Kim, 2007; Kim et al., 2013). Poverty causes people to get into debts and experience increased financial insecurity that results in a high likelihood of poor housing conditions, experiencing job stress, having reduced social support and more negative life events which, in combination, deteriorate their mental health (Clark et al., 2011).
Additionally, chronic stress, and the related stress response, impacts on physical health in various ways. For example, stress causes stomach ulcers due to its impact on the gastrointestinal system functioning, that arises from the close inter-connectedness between the gut and brain activity. Physiological stressors, which include money problems, work-related stressors, and lack of social support, among others, have also been associated with irritable bowel syndrome (Konturek, Brzozowski & Konturek, 2011). The interheart study, which investigated the link between stress and cardiovascular diseases in 52 countries, established that physiological stress was strongly associated with heart attack (myocardial infarction) to degrees that compared to the effect of hypertension and smoking (Yusuf et al., 2004). Stressful working and living conditions, and other physiological stressors, have also been demonstrated to result in the onset of diabetes, high blood pressure, and angina, among other ischemic heart diseases (Brotman, Golden & Wittstein, 2007).
The immune system is the other area that is affected by stress. This is because chronic stress results in prolonged or intense activation of stress response and a general immunosuppressive effect that in turn affect the optimal functioning of the immune system by suppressing or disrupting its prompt, efficient responses (Huebner, 1992). The disruption of the immune system response is particularly problematic among older people given that the immune function deteriorates with age, thus making it difficult for individuals with stress to fight off viral infections, hypersensitivity, cancer or autoimmunity which people are prone to suffer as they get older (Graham, Christian & Kiecolt-Glaser, 2006). The impact of chronic stress on the immune system therefore leads to frequent short illnesses, as well as inflammation of the body which Bell et al. (2017) and Slavich & Irwin (2014) have recently suggested to be a risk factor for depression.
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Conclusion
Stress is a key concept that contributes to the understanding of life in terms of the threat they pose to creatures’ homeostasis. As such, it is important that humans develop their ability to adapt to and cope with stressful situations in order to prevent the multiple physical and mental health problems that arise from chronic stress and the inability to effectively cope.
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