Stress the Malady of Modernization

Dr. K. N.Rama,
S.M.O,
Wazirpur Ph 111 Dispensary.
Stress stress stress...........
One can hardly pick up a newspaper or magazine or watch TV without seeing or hearing some
reference to .
Stress the Malady Of Modernisation, this is mainly due to changing life styles, environment,
thinking etc.
Now the stress has emerged as a major concern no wonder it is being referred as the malady of
urbanisation or globalisation.
Life in the 21
st
Century is infinitely far more complex than it has ever been. We live in a
crowded, noisy society, our lives are run by deadlines, demands and pressures, many of us have
too many tasks to accomplish under pressure with too little time to manage.
It's very much like the stress on a violin string. Not enough produces a dull, raspy sound. Too
much tension makes a shrill, annoying noise or snaps the string. However, just the right degree
can create a magnificent tone. Similarly, we all need to find the proper level of stress that allows
us to perform optimally and make melodious music as we go through life.
What is stress?
Stress is defined as state of mental or emotional strain or tension resulting from adverse or
demanding circumstances. (Good or bad).
Stress is often thought to be "tension" or "anxiety," but it is really beyond these concepts. Stress
can be positive or negative; it is more simply put to the way we respond to changes.
The term stress often refers to a situation that cause people to react in a particular way.
DEFINITION OF STRESS: According to HANS SELYE the Father of Stress Theory defined
stress as The non specific response of the body to any demand made upon it. The demand can be
a challenge or any kind of change which requires the body to adapt, the response is automatic,
immediate.
Any factor that causes stress is called Stressor
Physically or psychologically challenging events or circumstances are called stressors.
Atkinson and Terry locar and others classified stress into 4 Types
Eustress: It is a type of positive short-term stress that arises when motivation and inspiration
are needed, provides immediate strength.
Distress: Distress is a negative stress brought about by constant readjustments or alterations
in a routine. Distress creates feelings of discomfort and unfamiliarity.
Hyperstress: Hyperstress occurs when an individual is pushed beyond what he or she can
handle. Hyperstress results from being overloaded or overworked, even little things can
trigger a strong emotional response.
Hypostress: Hypostress is the opposite of hyperstress. Hypostress occurs when an individual
is bored or unchallenged. People who experience hypostress are often restless and
uninspired.
The sources that arises with in person, family, community and society.
According to Hans Selye there are two kinds of stressors: external and internal.
External stressors include physical environment (like noise, bright lights, heat etc.),
organizational rules, regulations, deadlines, daily hassles; major life events like death of a
relative, lost job, promotion, etc.
Internal stressors include lifestyle choices, not enough sleep, negative self-talk, Pessimistic
thinking, self-criticism, over-analyzing mind trap, unrealistic expectations, taking things
personally, all-or-nothing thinking, exaggerating etc.
Conditions that I nfluence the Effects of Stress.
Early nurturing. Abusive behaviour towards children, Genetic factors. Stressful personality
traits, perfectionist, workaholic are more susceptible to stress. Immune regulated diseases etc.
The Length and Quality of Stressors: Naturally the longer the duration and more intense the
stressors, the more harmful the effects.
Factors that leads to stressful appraisal:
Appraising events as stressful depends on two types of factors- those that relates to the
Person, those that relates to the Situation.
Personal factors include intellectual, motivational, and personality characteristics.
Situation: A stimulus which is pleasant to one individual may be very stressful to another.
Different people find quite different situations and circumstances to be stressful.
Another way stress arises within the person is through the appraisal of opposing
motivational forces, when a state of conflict exists. Conflict occurs when two or more
motives cannot be satisfied because they interfere with one another, when we are
forced to make difficult decisions or meet impossible demands.
There are 4 major kinds of conflicts.
a. Approach - Approach Conflict: Arises when we are attracted towards two
appealing goals that are incompatible. In which the individual must choose between
two positive goals of approximately equal value.
b. Avoidance/ Avoidance conflict: It occurs when we are to face with a choice
between two undesirable situations. In which the individual must choose between two
negative outcomes of approximately equal value. .
c. Approach avoidance conflict: Arises when we see attractive and unattractive
features in a single goal or situation. In which achieving a positive goal will produce a
negative outcome as well. This type of conflict can be stressful and difficult to resolve.
d. Double Approach Avoidance Conflict: Conflict that require the individual to
choose between two alternatives that each contain both positive and negative
consequences.
Physiology of stress:
The primitive survival mechanism is known as Fight/ Flight response. Every human has
a habitual response to stress that is either learned or genetically programmed. When we face a
stressful situation the body changes its inner balance and priorities into a high physiological
arousal to enable these two functions .
The manifestations of fight/ flight are mainly through two channels
Sympathetic branches of ANS
Endocrine branches of ANS
The role of the hypothalamus-pituitary-adrenal (HPA) axis (grouping) in stress:
The HPA axis and the systemic sympathetic and adrenomedullary (sympathetic) system are the
peripheral limbs of the stress system. The central components of the systems are located in the
hypothalamus and brain stem. Any stress lasting longer than few minutes results increased
levels cortisol being releaswd from adrenal cortex. In addition to cortisol, the adrenal cortex also
releases DHEA, a precursor to the sex hormones testosterone and Oestrogen, and aldosterone, a
mineralocorticoid that maintains blood volume and pressure by controlling the sodium/potassium
balance of the blood. Both DHEA and cortisol are released in response to ACTH stimulation, but
aldosterone is relatively independent of HPA axis stimulation.

The ratio of cortisol to DHEA depends on a number of factors. During acute
stress and illness, the balance shifts towards cortisol and away from DHEA. Interestingly, mental
attitude has been shown to influence the DHEA/cortisol ratio, with high DHEA-to-cortisol ratios
corresponding to feelings of warm-heartedness, and low ratios corresponding to feelings of being
stressed. During normal, non-stress situations, a certain level of cortisol is maintained in the
bloodstream. There is a circadian rhythm. The circadian pattern of cortisol release is controlled
by the suprachiasmatic nucleus (SCN) of the hypothalamus, also known as the body clock. Both
the amplitude and frequency of CRH pulses can vary to change the overall pattern of HPA axis
activation. During physiological arousal normal levels of cortisones are maintained by the
negative feed back mechanism.
SIGNS AND SYMPTOMS OF CRITICAL INCIDENT STRESS.
PHYSICAL COGNITIVE EMOTIONAL BEHAVIORAL
Chills Confusion Fear Withdrawal
Thirst Nightmares Guilt Antisocial acts
Fatigue Uncertainty Grief Inability to rest
Nausea Hyper vigilance Panic Intensified pacing
Fainting Suspiciousness Denial Erratic movements
Twitches Intrusive images Anxiety Change in social
activity
Vomiting Blaming someone Agitation Change in speech
patterns
Dizziness Poor problem solving Irritability Loss of / increase in
appetite
Weakness Poor abstract thinking Depression Hyper alert to
environment
Chest pain Poor attention/ decisions Intense anger Increased alcohol
consumption
Headaches Poor concentration/memory
disorientation of time, place or
person
Apprehension Change in usual
communications
Elevated Blood
Pressure
Difficulty in identifying
objects or people heightened or
lowered alertness
Emotional shock etc...
Rapid heart rate Increased or decreased
awareness of surroundings
Emotional outbursts
Muscle tremors etc... Feeling overwhelmed
Grinding of teeth Loss of emotional
control

Shock symptoms Inappropriate
emotional response

Visual difficulties etc...
Profuse sweating
Difficult
breathing. Etc

GENERAL MANAGEMENT OF STRESS
Tips for Dealing with Stress and Tension on managing the stress in your life.
Recognize your symptoms of stress.
Look at your lifestyle and see what can be changed -- in your work situation, your family
situation, or your schedule.
Follow relaxation techniques - yoga, meditation, deep breathing, or massage.
Exercise - Physical activity is one of the most effective stress remedies around.
Time management - Do essential tasks and prioritize the others. Consider those who may
be affected by your decisions, such as family and friends. Use a check list so you will
receive satisfaction as you check off each job as it is done.
Watch your diet - Alcohol, caffeine, sugar, fats and tobacco all put a strain on your body's
ability to cope with stress. A diet with a balance of fruits, vegetables, whole grains and
foods high in protein but low in fat will help create optimum health.
Get enough rest and sleep.
Talk with others - Talk with friends, professional counsellors, support groups or relatives
about what is bothering you.
Help others - Volunteer work can be an effective and satisfying stress reducer.
Get away for awhile - Read a book, watch a movie, play a game, listen to music or go on
vacation. Leave yourself some time thats just for you.
Work off your anger - Get physically active, dig in the garden, start a project, get your
spring cleaning done.
Give in occasionally - Avoid quarrels whenever possible
Tackle one thing at a time - Don't try to do too much at once.
Don't try to be too perfect.
Ease up on criticism of others.
Don't be too competitive.
Make the first move to be friendly.
Have some fun!! Laugh and be with people you enjoy.
Stop living beyond our means: Living beyond our means can actually make us sick.

In severe stress professional counselling and support, psychotherapy and psychoanalysis
are required.

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Homoeopathic concept:
The Contemporary concept of stress and its manifestations are akin to the Homoeopathic
concept. The science of homoeopathy demands perceiving the individual as a whole, his psyche
and soma, evolution, stressful life experiences, multiple layers of dispositions and temperamental
traits, through all ramifications focusing on unique individual pattern is the centrality of
homoeopathic approach. It is a method of excellency in dealing with stress.
Stress as a stimulus can be an exciting cause, maintaining cause, or it may even arouse
the latent psora. As a response it involves mental, emotional and physical reactions leading to
psychosomatic or somatopsychic illness which Hahnemann clearly mentioned in Sec: 210-230.
We Homoeopathic physicians not only consider the causative factors, also the unique
expression of the patient while treating a case. Though our Materia Medica contains umpteen
remedies, which cover the causative factors and manifestations of stress. The basis of
homoeopathic prescription is totality of the symptoms as no two individuals are alike in health as
well as in disease. As a stress is a perceived discrepancy which is predominantly psychic in
nature hence the detailed information regarding the patient is essential to elicit the cause and
effect relationship. We have to draw a line between cause and effect to select the similimum.
References:
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th
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2. Edward Sarafino P. Health Psychology. Biophysical interaction, John, wiely &
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Concept: Stress, Stress Hormones and the Immune system. Publisher/year
Chichester : John Wiley & Sons, c1997.
4. Terry Looker & Olga Gregson Teach Yourself- Managing Stress.
Publisher/year. London : Teach Yourself, 2003.
5. www.icisf.org/CIS.html stress reactions
6. www.mentalhealth.com/p.html David B. Posen, MD Stress Management for
Patient and Physician- The Canadian Journal of continuing medical Education ,
April 1955
7. www.thehealthcenter.info/adult-stress/types-of-stress.