Wednesday, 14 October 2015

Stress – Watch out for it as it hunts for you !

Stress is that unhealthy feeling inside, the uncomfortable factor refusing to budge and going unnoticed by self. It is often accompanied by a sense of impending disaster at times, expecting relentlessly for the worst to occur or fearful of what the future holds, nervousness, tense or a perpetual worried demeanour, jittery feeling….Anxiety !


Stress is the strain and hardships the Syrian civilians are going through, felt equally by those trying to accommodate or refuse entry to them.

As the modern age and day bring us technology and a glut of knowledge, they charge us for it too with serious mind and body conditions such as Stress. As time passes by Stress is acquiring more and more significance and attention. It is a problem of each one of us as we negotiate through the rigmaroles of everyday life, glued to our cell phones.
In a country like India the sheer number of people in every sphere of life including a hospital bed can in itself be over stressing, individual reasons causing stress notwithstanding. Trying for school admissions, bill payment lines, any government institution interface, traffic policeman, traffic itself , Boss at workplace, pollution, corruption, rising cost of living, shopping lists, noisy markets and roads, hostile city environs and smart phones are all habitat related causes of stress.
In the words of rock star David Bowie, “ a brain like a ware house it had no room to spare, I had crammed in so many things in store, everything in there, and all the fat skinny people, and all the tall short people, and all the somebody people, and all the nobody people, I never thought I need… so many people.
Stress has been defined by many. Dr. Hans Seyle, an authority on stress defines it as “ the rate of wear and tear caused by life.” Stress has both positive and negative shades. The medical dictionary defines stress as an organism's total response to environmental demands or pressures. Miller-Keane Encyclopaedia and Dictionary of medicine defines stress as “ reactions of the body to forces of a deleterious  nature, infections, and various abnormal states that tend to disturb its normal physiologic equilibrium (homeostasis).”


Farlex Partner Medical Dictionary defines it as “forcibly exerted influence; pressure.
state of physiological or psychological strain caused by adverse stimuli, physical, mental, or emotional, internal or external, that disturb the functioning of an organism and which the organism naturally desires to avoid.
In mechanics stress is defined as the force per unit area applied to a body or object, measured in pascals (pa) or newtons (N.m-2)
Stress is defined as the Psychological and/or physiological response of an organism to any demand made upon it by agents threatening its physical or emotional well being. Stressor is any factor or reason or instigator that causes a stress response. 


Stress types are many, such as physical, caused in the body, could be due to a sudden change in body condition. Chronic stress could be due to an illness or changes in the body due to time.
Emergency Stress caused by external agents, such as an accident or foreseeing one involves the adrenal gland, which releases the hormone epinephrine into the blood. This pumps up the heart rate and blood pressure, pumping all sugar supplies into the blood and dilating all blood vessels in the muscles to receive the energy such as the dilating of the pupils of the eye upon witnessing or hearing something horrific. The hormone supply remains steady and continuous in case of prolonged injury or disease thereby creating possibilities of an adrenal exhaustion, a fatal condition.

Lack of appetite before an exam, goose pimples while watching a thriller or the thought of danger are all forms of psychological stress.

Stress in practical terms , one that we all can co relate to is work related stress. Irrationally demanding superior, peers, target pressure, inefficient time management, poor team handling, inability to perform multi tasking, inability to meet organisational expectations, negligent growth or increments, insecure future, threat of losing the job are all pertinent to this category. As one grows older and travels up the corporate ladder, stress increases further with every increase in designation and responsibility.
Options to tackle this kind of stress are to go for a job change or downgrade to a lesser pressure position within the same organisation. Hectic work ethic often results in lack of time for family and friends and loved ones. This is a major reason for stress too.
Indecision at appropriate moments, inaction and feeling of helplessness are major causes of stresses as well. Ignorance is not bliss in the case of stress. It in itself shall cause unknown stress.
Domestic Stressors include negative self esteem, loss of confidence and not addressing pressing issues, marital discord, ineffective parenting or lack of parenting skills; and lack of family support concept and inadequate resources and funds.
In some cases, anxiety is produced by physical responses to stress, or by certain disease patterns and medications.
Anxiety can be safely defined as a bye product of stress and distinctly different from it. To understand both we must understand anxiety as well.
Anxiety is being anxious, in the context without reason, due to fear, figments of imagination working overtime.
According to the Farlex medical dictionary anxiety is a multi system response to a percieved threat or danger. It reflects a combination of biochemical changes in the body, depending upon the patient’s personal history, memory and social situation in terms of intensity and frequency of anxiety attacks.
Anxiety is related to fear. It  is often unfocussed, vague and hard to pin down to a specific cause. In this form it is called free floating anxiety. It is a multidimensional response to stimuli in the person’s environment, or a response to internal stimulus.

Anxiety can be a symptom of certain medical conditions as well such as the dysfunction of the endocrine system, hypo thyroidism, respiratory distress syndrome, mitral valve porphyria and angina pain ( angina pectoris, when pain occurs in chest or left arm due to blocked arteries and inadequate supply of blood to the heart).
Certain medications also cause anxiety as a side effect, such as drugs meant to treat asthmatic or thyroid conditions, psychotropic drugs, local anaesthetics and anti inflammatory drugs such as flurbiprofen and ibuprofen. Caffeine consumed in good quantities can cause anxiety. Withdrawal from certain prescription drugs, primarily beta blockers and corticosteroids, can cause anxiety. Withdrawal from drugs ofabuse, including LSD, cocaine, alcohol, and opiates, can also cause anxiety.
Sigmond Freud believed that all phobias and internal conflicts give rise to anxiety.
Symptoms of anxiety are headaches, dizziness, nausea, diarrhoea, tingling sensation in the feet or hands, sweating, numbness, blankness of the mind, tight breathing, clutching sensation in the shoulder blades and chest, trembling hands etc. Cognitive symptoms of anxiety include recurrent or obsessive thoughts, feelings of doom, morbid or fear-inducing thoughtsor ideas, and confusion, or inability to concentrate.
The diagnosis of anxiety is complex because of the variety of its causes and the highly personalized and individualized nature of its symptom formation. There are no medical tests that can be used to diagnose anxiety by itself. However sometimes medical practitioners use the Hamilton Anxiety scale and the Anxiety disorders interview schedule and or check blood sugar and thyroid levels.
Medications include anxiolytics or tranquilizers. These are either benzodiazepines or barbiturates which are now not in common use since they have to do with the slowing of the nervous impulses. Benzodiazepines relax the skeletal system and soothen the limbic one. Drugs under this category include chlordiazepoxide and diazepam. Such druga may be addictive in nature. Since anxiety often co exists with depression, doctors often use anti depressants for treatment such as escitalopram oxalate with imipramine with a combination of ormonoamine oxidase inhibitors.
Beta blockers which block the body’s reaction to stress harmones glucocorticoids and catecholamines are also used for treatment of anxiety such as propranolol, atenolol etc.
We can safely conclude that anxiety is a bye product of stress. This suggests that stress is a condition which needs to be identified and treated since it is deeply linked with disease. Recently results of many ongoing or concluded studies trying to establish a connection has revealed that certain diseases such as atherosclerosis, coronary artery disease, respiratory disorders, body pains, hyper tension or blood pressure, bowel diseases such as infections and diarrhea,asthma, allergies, colitis, migraine headaches, and peptic ulcers are caused by stress. Although there is no conclusive data to support the link, however in studies stress subjects had enhanced symptoms of aforementioned diseases relatively to normal ones, suggesting that stress catalyses the onset of disease and aids in disease development in humans.

High levels of stress cause constant release of stress hormones, such as adrenaline, cortisol, and dehydroepiandrosterone, which stresses the endocrine glands and may result in hormonal imbalances and adrenal dysfunction. This can translate into anxiety disorders, insomnia or sleeplessness, depression, skin allergies, rashes and weakened immune system.
Stress is linked to high blood pressure, abnormal heartbeat (arrhythmia), blood clotting, and hardening of the arteries (atherosclerosis). Eminent researchers such as Hsu et al. investigated whether insomnia is linked with higher risks for heart attacks and strokes. Researchers compared the frequency of cardiovascular events in 22,040 adults diagnosed with insomnia and 22,040 without it. During a10-year follow-up, the insomnia group had a significantly higher incidence of myocardial infarction and stroke. These findings are consistent with the growing evidence that poor sleep quality is a risk factor for adverse cardiovascular outcomes.
Depression is an independent predictor of adverse outcomes in patients with heart failure (HF), Analyzing data from 457 patients, Hwang et al. found that worsening somatic depressive symptoms, but not cognitive-affective symptoms, were independently associated with increased mortality of Heart Failure patients. The results although clearly point out to a connection between stress, depression and heart function.
Recent research suggests that self-esteem may be associated with improved parasympathetic nervous system functioning. In a large sample of healthy adults who wore ambulatory monitoring devices and completed electronic diaries, Edmondson et al. as reported by Forbes found that momentary increases in anxiety were associated with acute increases in ambulatory systolic blood pressure and that high self-esteem buffered this association between momentary anxiety and blood pressure. Thus, high self-esteem may confer cardiovascular benefit by reducing the acute cardiotoxic effects of anxiety.
Muscle tension due to stress can cause back and shoulder blade pains and cause bowel related gastroesophageal reflux disease to worsen. It can also result into painful menstrual periods, erectile dysfunction and low fertility.
       A person suffering from stress can feel helpless and irritable ( cranky), frustrated, ill tempered,       having constant negative thoughts, tense all the time with a feeling of impending doom, tiredness or fatigue,sleeping disorder or over sleeping and Lack of energy or focus.

Treating Stress – Many ways and techniques of treating stress have been propounded. Meditation and practicing Mindfulness in particular have proved to be effective in reducing stress and depression, improving attention and cognitive performance, and even increasing grey matter density in the brain. Exercises, workouts and doing things which build up confidence and health may also help.
We shall mainly focus on the main three, meditation, mindfulness practice and relaxation.

Meditation involves focusing the mind on an object or word combined with a passive attitude and a comfortable physical position. It involves concentrating on an intrinsic visual or thought and dwelling upon it for as long as possible to relax the mind and free it of clutter. Meditation is aprogressive process and involves many stages in it’s cycle, slowly exhibiting capability to de clutter the mind, increased capacity to concentrate and control thoughts and automatically brings feelings of more control and thus has an overall distressing effect on the mind.
Rationale-Meditation is believed to produce a state of relaxation that is incompatible with feelings of anxiety to induce a “trance state” that elicits positive mood and/or to provide a period of “rest”.
Meditation has been propounded by sages and ascetics in the Indian mythology and used as a tool for spiritual upliftment and used as a practice by those pursuing intellectual or spiritual goals.

Mindfulness on the other hand  is a mental practice used to focus attention on the present moment, rather than on the usual “chatter” that’s going on in our heads. It also helps a person learn to not get caught up in his or her thoughts, but instead simply to acknowledge them and let them go.
Jon Kabat-Zinn, the founder of mindfulness-based stress reduction (MBSR) at UMass, has described mindfulness as paying attention, on purpose, to the present moment, curiously and non-judgmentally.

. “More and more people report using meditation practices for stress reduction, but we know very little about how much you need to do for stress reduction and health benefits,” said lead author J. David Creswell. While conducting research studies on two groups to evaluate effects of mindfulness on stress they observed-“When you initially learn mindfulness mediation practices, you have to cognitively work at it — especially during a stressful task,” said Creswell. “And, these active cognitive efforts may result in the task feeling less stressful, but they may also have physiological costs with higher cortisol production. However mindfulness practice has a positive controlling effect on stress.”
In the words of Alice.G.Walton, a contributor to Forbes, on mindfulness- “In principle, the answer is beautifully simple – thoughts don’t have to be believed. You can just acknowledge the ridiculous or negative thoughts that pop into your head, chuckle at them, and then release them. This is the essence of mindfulness.”
That’s the fundamental first step: Realizing the uselessness of most of our thoughts and how much negativity and sorrow they bring. “We often can’t see how painful the everyday chatter is. That chatter actually takes a lot of effort. But when we try to suppress it, it usually backfires, and makes things worse. The key to changing the cycle is that we HAVE to become disenchanted with it, and realize how painful it is.” Once we do this, getting out of it is, for the most part, easier.
In the words of Judson Brewer, MD, PhD, “It’s kind of like beating your head against tree vs. eating chocolate,” says Brewer. “You realize, ‘wow, there’s something better than banging my head against the tree; guess I’ll eat more chocolate.’” When we have something to compare our normal thought process to (like chocolate, or, in reality, a better mental state), we realize how painful our norm has been. It’s just a matter of seeing that difference (the head-banging vs.the  chocolate or self-obsession vs. mindfulness), and we naturally become disenchanted. We can’t force it, it just happens.
“Mindfulness essentially means moment-to-moment awareness. Although it originated in the Buddhist tradition, you don’t have to be Buddhist to reap its benefits,” says Drew Hansen, a Forbes contributor. Mindfulness includes a broad spectrum of informal activities in addition to meditation.
Here are a few simple techniques that can be incorporated every day, even at work:
Spend at least 5 minutes each day doing nothing
Getting in touch with one’s senses by noticing the temperature of one’s skin and background sounds around.
Paying attention to walking by slowing the pace and feeling the ground against one’s feet.

Another approach is the “There is a way - Alternative De-stressing Approach”-(TADA). In this when ever stress symptoms appear one is required to step aside into observance mode and observe oneself or others, pay attention to how one is reacting and behaving and feeling. This is nothing but observing what one is doing, saying, thinking, and feeling. However not passing judgement but accepting behaviour is an important aspect of this technique, since acceptance is not agreement. If you find yourself being out of control then you accept the fact that you are out of control without judgement
Stating that you are accepting the event is necessary at first. However, as you use the TADA technique you will find it to be more spontaneous. The last aspect of the TADA technique is the trust factor. The element of trust implies that the stressful events that are happening and recurring in your life are there for a perfect reason-and that reason is good.

This approach helps de-stress and has gathered a lot of steam and popularity in handling stress techniques world over.
Clarity leads serenity. If you’re stressed with work, get clear about exactly what tasks must be done and pen them down to prioritise. They will actually turn out to be much lesser than when thought and perceived in the mind to be a handful. Avoid Learned Helplessness – failing to respond or act to improve our circumstances.
Feeling of control and tidiness also improves stress levels. We always must have our home, office and car for example in proper order and shape. As the esteemed behavioural psychologist Martin Seligman has shown, there’s a strong correlation between feelings of control and well being.
Focus on helping other people. This brings about a feeling of satisfaction and adds meaning and variance to the mind helping in de stressing.
Taking wholesome and multipronged action to improve habitat or surroundings or while addressing a problem situation also works wonders. It results in some things working out wonderfully and encourages one to keep moving on, tasting more success, confidence and satisfaction all of which are stress busters.

Relaxation techniques are also useful for reducing stress. People use progressive relaxation which involves doing exercises which relax a particular set of muscle or muscle clusters.

All said and done stress needs to be recognised mostly by self evaluation and treated as good as any other body condition. After all life is just to be lived once. Who knows how long there is to live but he who desires quality of life more than quantum of life shall better reap the joys of life.
At the end of it all stress handling or stress management is more of an art and requires conscious, sustained and guided effort. We all will agree that in life all that will matter in the end is what prepared us better for the end and made the end as stress free as possible, where the end is nothing but to be seen as a new beginning.
Disclaimer: The opinions and suggestions given in the write up are our own and should not be interpreted as a prescription for any drug or diagnosis of disease, for which readers should visit specialist medical practitioner only. There is no intent to duplicate any content from anywhere, quotes or specific knowledge is taken for education and non commercial objectives.
For Queries or registration for blog to be sent on E mail visit http://anushveda.com/enquiry/

#StressStrain #Anxiety #StressTreatmentControl