Stress - the enemy within

MANY PEOPLE who seek medical care are left undiagnosed or inadequately treated because physical examinations and tests alone did not find the cause of their illness.

The illnesses and the symptoms they suffer are perfectly real, but the underling cause is related to psychological and emotional factors. The real problem in many of these individuals is stress.

The word stress is in common use. Everyone complains about it and blames it for everything - from flu and headaches to high blood pressure and cancer. According to Healthy People 2000, a report from the United States Department of Health and Human Services, stress has an enormous impact on our health and in the United States contributes to 50 per cent of all illness. It is estimated that 70 to 80 per cent of all visits to the doctor are for stress-related and stress-induced illnesses. Today, the greatest challenge to health is not heart disease or cancer or diabetes or AIDS, but stress. Researchers at Cornell University Medical College in New York called stress "the most debilitating medical condition in the United States".

Sadly, a lot of time and money is squandered treating these symptoms while failing to recognise and address the underlying cause - stress! Job-related stress alone costs the US an estimated US$200 billion annually, including costs of absenteeism, lost productivity, and insurance claims. What are the figures here in Jamaica?

What is stress?

It critical to understand that stress is not a thing but a response! Stress is the internal response that the individual has to an external stimulus. We are very good at finding scapegoats to blame for the way we feel. I am sorry: stress is not your spouse or your financial situation. It is not what is happening on the outside. It is how we choose to respond internally to those external instigating factors. The external circumstances are called stressors while your internal reaction to them is the stress. The enemy is within.

This distinction between stress and stressor is very important. Very often, we cannot change the external factors (stressors), but we can learn to control our internal response to those stressors. We don't have to be victims. We have the power and the ability to choose how we respond. Stress is an internal phenomenon. It is a response. Understanding this simple distinction is crucial to effective stress management.

How does stress affect us?

Doctors are becoming more aware of how powerfully the mind and its thoughts affect the body. Common manifestations of stress are:

Sleep disorders - too little, too much or a poor quality of the sleep.

Sexual problems - impotence, low libido, an inability to experience orgasm.

Digestive problems - gas, bloating, diarrhoea or constipation, irritable bowel syndrome.

Depression, low energy, emotional and mental disturbances, difficulty in concentration, ringing in the ears, chest pain, backache.

Awareness of heartbeat, high blood pressure, difficulty in breathing, tingling or numbness in the hands and/or feet.

Menstrual disturbance, infertility and hormone imbalances.

Accident proneness, phobias, poor performance e.g. on examinations.

Can stress develop into an anxiety disorder?

Almost everyone experiences some anxiety, which is normal. Anxiety disorders are different because they are more severe and can persist and interfere with a person's daily life. Common anxiety disorders include:

Panic disorder - a condition where a wave of sudden panic overtakes the person for no apparent reason.

Specific phobias - fears of particular situations or things: for example, a fear of heights, open spaces, spiders, snakes or blood.

Obsessive-compulsive disorder - an uncontrollable urge to repeat a certain act, behaviour or intrusive thoughts.

Post-traumatic stress disorder - experienced as ongoing distress and reliving of experiences as flashbacks or nightmares months after experiencing or witnessing a very distressing event, such as a disaster, accident, violent death or crime.

But stress is not necessarily a bad thing. Our stressors can make us stronger and wiser if we can handle them well. They can serve to stimulate us to greater accomplishments.

How to manage stress?

Good stress management is not simply trying to avoid stressors. The idea is to learn how to handle and deal with them effectively. Just as how the body has a stress reaction - the 'flight or fight response', there is also a relaxation response, where the body calms and releases its tensions and the brain produces its own tranquilisers (endorphins) in the right amount at the right time and without side effects. Learning how to elicit this relaxation response is the key to good stress management.

Identify your main stressors. Become aware of your reactions to them. Learn to observe yourself in stressful situations so you can begin to choose how you respond instead of an unconscious reaction. Don't react. Respond.

A major source of your stress may be subconscious. Trauma experienced in early childhood is often suppressed and locked away in the subconscious mind. Later in life these unhealed psychological wounds surface in a variety of ways as symptoms that often mystify both the patient and their doctor. Much unnecessary suffering frequently results from failing to identify the underlying cause.

Elicit your relaxation response. Different people use different activities to relax them, e.g. music, hobbies, social work, etc. I recommend my audio CD programme, 'A Time to Relax', which is designed to teach you how to put yourself into deep relaxation.

Regular (daily) exercise particularly yoga, deep breathing, meditation, self hypnosis and visualisation exercises are most beneficial. Emotional release therapy is an excellent self-help tool.

Seek professional help for counselling or psychotherapy when necessary. This helps you to identify the underlying source of your stress and to develop better ways of releasing it.

Be extremely careful about using drugs to alleviate stress symptoms. This includes recreational drugs like alcohol and marijuana as well prescription tranquiliser medicines like Valium and Ativan. They only give temporary relief and are all addicting.

A proper diet is extremely important. Aim to include five or more servings of fresh fruit and vegetables daily along with an optimal protein intake. I recommend the Cellular Nutrition Programme with nutritional supplements like fish oils with omega 3 fats, magnesium and the B vitamins. Avoid sugar, artificial sweeteners, MSG, hydrogenated oils and fried foods.

The herbs Tang Quei, Chamomile, Kava, St John's Wort and Valerian, lemon balm and treanine from green tea are excellent non-drug alternatives to tranquiliser medication. The advice of a qualified health-care professional on the choice, combinations and use of these herbs is important, especially in individuals with significant anxiety and/or depression.

Email Dr Tony Vendryes at tonyvendryes@gmail.com or listen to 'An Ounce of Prevention' on Power 106FM on Fridays at 8 p.m. His new book 'An Ounce of Prevention, Especially for Women' is available locally and on the Internet.