STRESS:
H ow M uch
Is Too M u c h ?
by Patrick Caplis, ti£>.
' In a recent interview from Lewis
Thomas, author o f Lives o f a Cell, was
queried about the role o f m icroorganism s
in disease: You m ean to say that we
ourselves cause disease, not the bugs?’
Tha t s rightf he replied. 7 believe that
m icrobes are m ostly am iable and useful.’ "
— from H olistic M edicine, Kenneth Pelletier
Medicine, like many other disciplines, is
som ewhat faddish. W hen Louis Pasteur and
Robert Koch revealed the existence of
tuberculosis bacilli to their colleagues in the
1890s they were rebuked because according
to the prevailing opinion o f that period
tuberculosis was caused by urban over
crow ding and poor living standards. By con
trast, m odem technologically oriented
W esterners are so used to attributing most
illness to som e multi-syllabic virus or
bacterium that it is well nigh impossible to
convince them otherwise, everyone “ knows”
that m icroorganism s attack and invade our
bodies, and that's why people get sick. It is
stHI relatively uncom m on to find individuals
willing to view their health m ore holistically.
I believe that what we experience subjec
tively as health or disease is a com plex
multicausal phenom enon. Genetic, psycho
social, environmental and biological factors
all play a role in determining the state o f our
health. And within this multicausal framework,
stress appears to be the single most
important factor predisposing an individual
toward the developm ent o f a disorder. But
what is it exactly that stress does to us that
can make us becom e sick?
About an hour ago, I was driving along 1-5
when suddenly a metallic silver object, later
identified as a wrench, fell o ff the hood o f a
truck in front o f me, twanged several times
against the pavement and then landed smack
in the middle o f my windshield cracking it A
som ewhat frightening and certainly stressful
experience. The other driver and I exchanged
the usual information, and then both o f us
returned to our vehicles and drove off. Over
and done with.
This is an example o f a situation in which
the source o f stress is immediate, identifiable
and resolvable. In this case, the mind and
body react in what is known as a Type I Stress
Response: the pulse quickens, blood pres
sure goes up, as do serum levels o f glucose,
free fatty acids and corticosteroids. This
perfectly normal response o f brief duration is
m ediated primarily by certain parts o f the
nervous system and by the adrenal glands.
W hen the situation is resolved, there is a
period o f com pensatory relaxation, popular
ized as the “ relaxation response” by Herbert
Benson. Unfortunately, in mid-twentieth
century America, most stressors are not of
this type. More often we must cope with a
vague and threatening uneasiness and an
unremitting low level anxiety. This m ore long
tim e and less easily resolvable type o f stress
m ay be due to: the creation or breakup of
relationships, the birth or death o f loved
ones, struggling with personal success or
failure, the fear o f being attacked verbally or
physically, or the silent dread that each o f us
must feel knowing that at any m om ent our
entire planet could be totally consum ed in a
nuclear Arm ageddon.
W hen stress is prolonged, the result may
be what is called a Type 11 Stress Response, in
which each o f the above-cited bodily changes
rem ans abnormally elevated over time. There
is no outward discharge o f tension, nor is
there any com pensatory relaxation phase. In
stead, we establish a long-term adaptation to
the stress which allows us to continue func
tioning as best we can. But we bury the ten
sion deep within our musculature and our
guts, and our breathing tends to be shallow
which m eans less oxygen enters the blood
stream. Oxygen is the vital nutrient We can
live for weeks without food, we can live with
out water for several days, but after several
minutes o f oxygen deprivation, we die.
A faster pulse and long-term elevated blood
pressure causes dam age to the inner lining
o f arteries which can accelerate the process
o f atherosclerosis, com m only known as
"hardening o f the arteries,” which may in turn
result in cardiovascular disease, tissue
degeneration (including cancers), and pre
mature aging. Recent epidem iological data
suggest that psychosocial stress factors may
actually be o f greater consequence in athero
sclerosis than those which are now consider
ed to be the leading culprits, such as high fat
diet, high blood pressure and cigarette
sm oking.
The corticosteroids released during a
long-term stress o f Type II inhibit certain
functions o f the immune system, particularly
T-cell com petence. T-cells are a group of
white blood cells in the body which serve a
key function in the im m unological system in
that they switch other immune responses on
and off. Cancer researchers are excited about
these findings because if stress is one major
way o f shutting down the immune system,
perhaps stress managem ent will in the future
be an important means o f maintaining or
perhaps even enhancing function o f the im
mune system, thus providing one m ore link
in an overall approach to the prevention and
cure o f cancer.
In sum, m ore and m ore research is ac
cumulating which suggests that we have
greatly underestimated the role which stress
plays in the generation o f disease. Stress it
self is not inherently destructive, but too
much stress over a short or long tim e period
m ay lead to a poor mind/body adaptation to
the situation. The list o f “ stress-linked" dis
eases is a long one: high blood pressure,
diseases o f the heart and blood vessels, cer
tain diseases o f the kidney, rheumatoid ar
thritis, skin inflammations, cancer, allergies,
nervous and mental disordrs, spastic colitis
and peptic ulcer disease, am ong others. In
som e measure, all o f the above disorders are
caused by an individual's faulty personal re
sponse to stress.
A key point to keep in mind is that the
stress factor is double-edged. S om e indivi
duals thrive on stress, others buckle under it
S om e o f us m anage fine when we are younger
but m anage stress less well as we age. Stress
ful events in them selves may be less signific
ant than the individual’s strategy for dealing
with them. Som e people are "confronters”
who actively prepare to m eet and deal with
stress; other individuals are "avoiders" who
sim ply attempt to escape the situation
through denial or focusing their reaction in
ward upon themselves. Either approach can
be overdone. The point being that the abso
lute quantity o f stress appears to be less im
portant than the personal tem peram ent o f
the individual experiencing the stress.
And so, we com e full circle: bugs alone
don ’t cause disease and neither does stress,
per se. W e control our health by the con
scious or unconscious decisions we make
about ourselves and our lifstyie. And keep in
mind that the very attempt to alter self-
destructive patterns may actually induce
further stress. Any approach to stress man
agem ent is probably an effective m eans o f
curbing the onset o f psychosom atic disor
ders, but it cannot substitute for the ancient
dictum to know ourselves as fully as possible.
How much stress is too much? The answer
depends on you.
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