Carmen Bowen-Wright
WHEN I was a medical student, the famous Cecil and Loeb Internal Medicine Book, the gold standard of the day, said clearly that stress caused elevation of blood sugar in diabetes and hypertension. However, this text did not explain what stress was; no doubt because it was not understood.
Today, we know that when faced with stressors (for example, the loss of a loved one or being unable to pay a great financial debt), we get anxious. A small organ, called the adrenal or the suprarenal gland which sits atop the kidney, begins to produce chemicals including adrenaline and cortisol into our bloodstream. The whole body becomes perfused with these chemicals. The longer or more chronic the stressor, the more of these chemicals the body is subjected to.
Interestingly enough, these are the same chemicals which trigger the 'flight or fight' response in us. What this means is, when faced with an acute stressful situation, these same chemicals (adrenaline for sure) give a sudden surge of strength. Hence, if one was being attacked, one might get unusual strength to flee or stay and fight (as we say in the Jamaican vernacular - 'mi no know weh mi get the strength from, but mi know se mi tek mi foot inna mi han and run to rahtid or fight him off.')
In fact, those who did high school biology will remember having been taught that ancient man got some means of protection from attacking beasts due to this reflex.
It is the excess of these chemicals, especially cortisol, which gives rise to ill health. The mechanism is not well understood but anecdotal information does suggest that stressors affect the mind, the body and the spirit. Hence, in my experience, it is very common to meet patients who give a history of one to as many as six or more minor illnesses they cannot 'throw off' despite repeated visits to doctors.
COMMON COMPLAINTS
Some of the commoner complaints include 'sinusitis', stiff neck, pain in shoulders and various limbs; headache, muscular cramps, palpitations, 'shortness of breath' and many others. All are stress-related conditions, although there are non-psychosomatic causes as well.
While I never fail to exclude a serious underlying physical problem by thorough, careful history taking, examination and at times investigations, my level of suspicion for what I call a 'stress-related syndrome' is always high. These illnesses cause secondary symptoms such as depression, sexual dysfunction, weight loss or gain and others. They cause dislocations in people's lives and contribute to loss of time at work.
Look out next week for part three on managing stress. Until next week, no stress!
Dr. Carmen Bowen-Wright is a preventive medicine
specialist and wellness practitioner; email: yourhealth@gleanerjm.com.
