Stress is an important part of life but when the stressors overwhelm ability to respond, become chronic and unrelieved it has physical, psychological and emotional effects. Stress can arise from external factors or events or be internal when it is termed cognitive dissonance. Cognitive dissonance is the result of the mental conflict that occurs when real world facts differ from a belief that developed either as a result of learning or from limited personal experience. To relieve this source of stress requires replacing the belief with another that reflects the real world. Stress is considered to be the precursor to depression and is the cause of burnout.
Recent reports indicate a specific centre in the brain involved in a rapid response to stress and another related to modulating that response unfortunately the second modulating centre is slower to react hence the delay in reducing the stress response. This pathway developed during the Pleistocene Epoch (ended 11500 years ago) when the world was a dangerous place with woolly mammoths and sabre toothed tigers but serves little useful purpose in today’s world.
Since the demise of the life threatening mega fauna the stress response that served us well in the past remains in out genes. For the majority stressors today are not life threatening but related to present day lifestyles and environment. Work occupies a significant proportion of our lives and is a major source of stress. Two models of workplace stress have been developed, an effort-reward imbalance model and job strain in which high demands give rise to low control.
Stressors of the modern era are unique to an individual. What one person finds stressful another person may feel no stress. These stressors are often related to learning or the irrational fear of an outcome which is not life threatening (the reason the stress response was originally developed). Techniques can be learnt that reduce the level of stress felt and create a more comfortable life.
Stress has physical, psychological and emotional effects. Physical effects include increased susceptibility to minor infections, suppressed immune responses and an increase in risk cardiovascular disease and some malignancies. Psychological effects include increased irritability, tunnel vision, reduced problem solving ability and an increased desire to isolate oneself as well as loss of communicating skills resulting in destroyed relationships. Emotional effects include low self value, relationship breakdown and an increased risk of depression.
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We vaccinate our patients to prevent disease and make only a token effort to learn coping and resilience skills to prevent our dis-ease.