HOME   HYGIENE LIBRARY CATALOG   CHAPTER 9

   Stress is the effect upon a subject when a situation requires them to adapt to it or to take avoiding action. The influence can be emotional or physical but not necessarily harmful or threatening. Whatever the cause, stress evokes physiological responses in the body. Factors which cause stress are called stressors.

   Dr Hans Selye, author of The Stress of Life and Stress Without Distress and perhaps the most experienced researcher on the subject, says factors such as fear, sorrow, joy, excitement, heat, cold or drugs, elicit in the body identical bio-chemical reactions. Whether the influence is pleasant or unpleasant is immaterial, the reaction depends only upon the intensity of the demand to adapt and the duration of the demand. However, the stress caused by elation, which Dr Selye calls Eustress (eu = good), causes less damaging effects because the body readily adapts.

   In his evolutionary past, man always had to contend with a certain amount of stress of one kind or another and his body evolved to react properly to it as a normal event. just as man's body over eons of primitive environment developed to function on simple natural food, so it developed to cope with the stresses of a simple natural lifestyle. These no doubt would often have been quite severe but usually of brief duration and never in great profusion. Not only can the body easily contend with a moderate or normal amount of stress, it actually thrives upon its stimulating effect.

   When levels of stress reach a point where the body can no longer cope easily, the effect becomes harmful and as Dr Selye says, the condition becomes one of distress. Thus to refer to stress as being harmful is misleading. It is the condition of distress which is harmful.

   Whether a stress influence actually produces stress depends upon how a person reacts to it. People react to stress influences in different degrees depending on their knowledge and past experience. For instance a person making their first flight in a plane or their first attempt to drive a car will be more highly stressed than when again they fly or drive. Other stressors, such as money or health worries, will be more consistent in degree and more prolonged.

   The most important factor in how someone reacts to stress influences is their personality type. Regardless of their capability to cope with degrees of stress, which depends enormously on physical fitness, some people driven by ambition, curiosity, creativity, adventure, etc. find themselves always in countless situations of stress, resulting from over-commitment, excitement, frustration and fatigue. Others plod happily along, unruffled by traffic lights and petty restrictions, with time to relax and read the paper. They are not more resistant to stress, probably less resistant, they simply do not go looking for it. Very broadly, people fall into one or other of these categories, the former being called type 'A' and the latter, type 'B'.

   There is a prodigious assortment of stress influences to which we are all exposed in our modern way of life. Many are routine and unavoidable, some unexpected, some big and some small, perhaps momentary, perhaps continuous. They can be physical, such as injury or cold, but mainly they are mental, i.e. emotional.

   Apart from obvious stress factors, the very nature of our society ensures continuous "built-in" stress for many people. The rules of society are often very frustrating in that they insist that everybody, regardless of intelligence, emotions and physical drives, must conform--or adopt a "double standard". Double standards, in themselves stress-inducing, thus have become an essential part of modern life.

   And, because the rules are generally discriminating against women, women tend to suffer more from built-in stress, particularly women of high intelligence. It is significant that women, generally, suffer a higher incidence of diseases such as asthma, rheumatoid arthritis, diabetes, migraine and multiple sclerosis, all of which are accentuated by stress.

   Stress may also arise from a continuous state of maladjustment and insecurity stemming from situations in childhood. This built-in stress may be very harmful, but with the acquisition of confidence and the establishment of happy relationships, the condition may alleviate entirely.

   Dr Taggart of the Middlesex Hospital noticed that even relaxed drivers may double their heart rates in everyday driving situations, particularly when passing other vehicles. Dr Lennart Levi in Stockholm has demonstrated that such diverse stimuli as office work and watching exciting films can produce stress effects.

   Regardless of the type of stressor and its individual intensity, each effect is additive, producing in the body a total stress effect and reaction.

   The most significant forms of stress are those of a prolonged emotional nature, some of which alone produce distress. Over-stressed, or distressed people, according to the severity of their distress, are very prone to infection and diseases of any kind and these of course act in a vicious way to further increase distress.

   Drs Holmes and Rahe of the University of Washington Medical School found that stress factors could be evaluated and used as an accurate predictor of disease. They devised a "Social Readjustment Scale" which graduated major stress factors on a points system.

   Highest on the scale was death of spouse which rated 100, followed by divorce 73, marital separation 65, jail term 63, death in the family 63, personal injury or illness 53, marriage 50, job dismissal 47, marital reconciliation 47, retirement 45 and so on. Christmas was No. 42 with 12 points. A total of 150 within the last year was shown to equate with a 51% probability of becoming ill within the next two years and with a total of 300 the probability was 80%.

   Apart from susceptibility to infection, stress is a strong influencing factor in the metabolic (degenerative) diseases, very notably in heart disease, hypertension, diabetes, cancer, multiple sclerosis, asthma, ulcers and arthritis where the effect is quite obvious as is described later.

   Depression and despair resulting from rejection by a person's family and peers can produce distress severe enough to cause death as occurs in "bone pointing" rituals of Australian Aborigines. On the other hand moral support enables a person to survive intense stress, and sincerely religious people find this support from their faith.

   Stress factors which are frequently not considered but which are very significant by their effect on the nervous system and bloodstream, include refined carbohydrates such as alcohol, sugar and white flour products in the diet, and nicotine and carbon monoxide from smoking, and caffeine in coffee and tea. If these factors were taken into consideration, the predictive accuracy of the stress scale to disease would no doubt be much greater.

The physiological effects of stress

   In the primitive environment, stress was caused mainly by danger, the immediate reaction to which is to prepare the body for action, perhaps to fight or perhaps to run away. Capillaries to muscles open up to provide a greater blood flow to them, and capillaries supplying organs unessential to physical action close. Digestion ceases and, stimulated by hormones, the heart increases its rate and output, increasing the blood pressure and breathing speeds up. Fats and sugars are released from body stores into the bloodstream to provide fuel to the muscles, cholesterol levels rise and the blood composition changes to promote rapid clotting in case of injury. A healthy body, whether the danger results in action or whether a false alarm, quickly regains composure.

   In our modern environment, stress produces exactly the same physiological responses but rarely is physical action required. The body constantly receives stress stimuli to which it must respond, and sooner or later the capability to respond becomes exhausted, leaving the body overstressed or distressed. In this condition the thymus gland, which controls the body's immune system, becomes shrunken and ineffectual and the lymphocytes (the white cells which defend the body against infection and abnormal cells) become impotent. The viscosity of the blood remains high, the blood flow sluggish, and oxygen delivery to the body tissues is poor. With lowered defenses, disease of some sort is almost inevitable, particularly those of viruses and germs which are ever present awaiting their opportunity.

   The Greek philosopher, Plato, suggested "that all diseases of the body proceed from the mind or soul". The great British physician James Paget said "fatigue has a larger share in the promotion and transmission of disease than any other single condition you can name".

   Degenerative diseases can be induced by stress in people with lipotoxemia (blood toxemia and high blood viscosity). With oxygen supply to the tissues at a borderline level because of these other factors, stress can upset the delicate neurohormonal balance of the body and aggravate the blood condition and increase its viscosity, causing the onset of related diseases such as angina, congestive heart failure, hypertension, ulcers, arthritis, cancer, eczema, migraine, diabetes, multiple sclerosis etc.

   This explains the mysterious reversal of such diseases sometimes--cures by faith healers, yoga, hypnosis, acupuncture, mountain spas, country walks or anything else that reduces stress and restores peace of mind. The beneficial effect of "dummy" medicine containing no medicine at all is well known and is called the placebo effect. In all probability conventional medicine, when it works, often works by this effect anyhow.

   Once the stress is removed, the blood fats reduce, the blood viscosity lessens, and the oxygen transport to the cells improves. The oxygen supply may still be borderline but sufficient to reverse disease symptoms, and with hormonal balance restored, the immune system reactivates.

   Although principles of natural health are against the use of drugs and medications, to eliminate or reduce stress is not as simple as changing the diet and giving up smoking. Therefore any possibility of benefit should not be rejected, and hence this reference to a substance called Eleutherococcus may be helpful. The information is from an article in New Scientist (21 August 1980) written by Dr Stephen Fulder.

   Eleutherococcus is a substance derived from a plant called Eleutherococcus senticosus which belongs to the same family of plants as Ginseng. It is referred to as a drug but acts like a tonic in that it counters the effects of stress and improves mental processes, stamina and resistance without any adverse side effects. The active components of the substance are called glycosides meaning that the specific molecules are linked to sugar molecules.

   Russian tests in which animals were severely stressed disclosed that damage to the stomach, spleen and thymus was largely absent from the treated animals. Ginseng, a Chinese herbal remedy, contains glycosides which are different to eleutherococcus glycosides, but which achieve similar benefits.

   Dr Fulder added that similar results had been confirmed at the University of California in Los Angeles. Eleutherococcus is widely used throughout Russia in all manner of occupations which are stressful and was used by cosmonauts Vladimir Lyakhov and Valery Ryumin. It is used by Russian athletes, not only when in competition, but throughout their constant training. It is also widely used in hospitals in the treatment of patients.

   It should be clearly understood that stress-related disease conditions occur readily to people who are physically unfit due to bad diet and lack of exercise. People who suffer illness because of stress in their job, instead of claiming compensation and resorting to tonics, should get fit or get another job, maybe both.

Faith healing and hypnotherapy

   In his book, Anatomy of an Illness, Norman Cousins describes his recovery from ankylosing spondylitis, a disease of "unknown etiology" with a survival chance of one in 500. In a desperate bid to survive, Cousins rejected his drug therapy, hired a projector and amused himself watching old movie comedies. He was following a hunch he had acquired from reading Dr Selye's book The Stress of Life, and his changed state of mind, helped by laughter, improved diet and his own determination, was the turning point from which he recovered full health in a few months.

   Faith healing is a subject of interest in all parts of the world. In one form or another, it is employed by primitive witch doctors and sophisticated physicians with all sorts of practitioners in between. Unquestionably, many people have benefited to some degree by its use in all sorts of cases which have defied medical treatment.

   Just as stress is capable of disrupting hormonal production and balance, promoting disease of all kinds, so must the relief of stress have the opposite effect. Faith healing, and also hypnotherapy, appear to work exactly in this fashion. In addition, by removing "mental blocks" which may exist, recovery may sometimes be achieved from what appears to be a completely physical problem. Showmanship often forms part of the faith healing routine (probably a very important part), and dramatic cures have been claimed. Dr Louis Rose of England spent 15 years diligently investigating, with a completely open mind, the claims of many faith healers and their patients. His book, Faith Healing (Victor Gollancz Ltd) was published in 1968. He concluded that genuine improvement was achieved in many cases, but almost invariably the improvement was only temporary. He did not in all that time find one case which could be called a cure. It is known that of the millions of pilgrims to Lourdes in France over the years, only a handful of sufferers have achieved even temporary relief.

   Cancer is one of the disease conditions tremendously influenced by stress of any kind. This is more fully discussed in Chapter 20.

   Many doctors who are aware of the importance of psychological factors try and instil confidence and hope in their patients which they know will assist recovery. This concern for patients is a form of faith healing although only an accessory to conventional methods.

   It is fairly plain why faith healing, at its best, can achieve only limited success. The alleviation of distress is enormously beneficial, but if only temporary, then the physical response will only be temporary. Stress is only one factor in the development of disease and if full recovery is to be achieved the factors of nutrition and physical exercise must also be corrected.

"Quacks"

   A quack is somebody who proclaims the ability to cure various diseases when in fact he cannot, and whose motive is to make money by callously exploiting sick people.

   Milan Brych, the self proclaimed cancer specialist, achieved fame in New Zealand and later in the Cook Islands, having apparently achieved in some people, at least temporary remissions of cancer. Some of his patients have stoutly defended him because of the benefits they gave him credit for.

   Brych was expelled from New Zealand, having been stripped of the medical status of a fully qualified doctor accorded to him in 1972 by the New Zealand medical authorities. It had been discovered that not only had he never received medical training, but had been in jail in Czechoslovakia on a charge of robbery at the time he claimed to have been in medical school.

   How on earth did this man get his medical status approved and then practise as a cancer specialist in the Auckland Hospital? It would appear that the subject of cancer was not very well understood by the doctors who were later embarrassed. Two questions then arise: Was Brych a quack? Can orthodox medicine do any better?

   The dividing line between a faith healer and a quack may sometimes be impossible to denote. How many quacks have found to their own surprise they have become accepted as faith heaters? And for that matter, how much did you spend on medicine last year? Did it work?

Can stress cause coronary heart disease?

   Note that the question relates to heart disease, not heart attack. Heart disease is a condition, whereas heart attack is an event. A heart attack is actually a symptom of heart disease. I have earlier included stress as a factor only insofar as it can aggravate cardiovascular disease (CVD)* in conjunction with other factors. This represents one school of thought.

*Cardiovascular disease and coronary heart disease can be considered as interchangeable terms.

   However, Drs Meyer Friedman and Ray Rosenman of San Francisco are cardiologists who believe stress to be the main cause of coronary heart disease (CHD) if the stress is continuous. Their book, Type 'A Behavior and Your Heart is very interesting. "Type A" is the designation they apply to a person of drive and aggression with a constant sense of urgency to accomplish things, with never enough time. Such a person is under stress most of the time.

   The reason Friedman and Rosenman reached their conclusion is that in testing many subjects they, time and again, found a much higher incidence of CHD and a higher incidence of heart attacks among type A subjects compared to type B subjects. Does this mean that the "type A" behavioral pattern (stress) is the main cause of CHD?

   Here are several excerpts from their book:

1. "As a group, type A subjects show a higher serum cholesterol, a higher serum fat, more diabetic-like tracts or precursors, smoke more cigarettes, exercise less (because they cannot find the time to do so), are overdriving certain of their endocrine glands in a manner that can be expected to damage their coronary arteries, eat meals rich in cholesterol and animal fat, and also suffer more from high blood pressure than type B subjects."
2. "For example, most type A subjects not only exhibit a higher serum cholesterol level (as do our rats suffering from experimentally induced type A behavioral pattern) than type B subjects, they also take three to four times longer ridding their blood of dietary cholesterol after each meal than type B subjects. Thus the inner lining of their coronary arteries is exposed continuously to large amounts of cholesterol in its most dangerous form."
3. "Apparently because of the hypothalamus-induced over-stimulation of the sympathetic nervous system, excess insulin begins to accumulate in the blood. Now, of all known conditions that may lead to the disease of the coronary arteries, none is recognized as more devastating than any state associated with an excess of insulin in the blood."

Comments

1. Leaving stress right out of it, the type A subjects referred to, simply by their diet, smoking and lack of exercise, would be expected to acquire severe heart disease.
2. The higher exhibited serum cholesterol levels stem largely from stressrelated cholesterol production which in itself need not be harmful. However the prolonged exposure to dietary cholesterol would indeed present greater risk.
3. The reason for increased levels of insulin in the blood is that high blood fat levels prevent the normal interaction of insulin and glucose (blood sugar) and so the blood sugar level increases. In an effort to metabolize the sugar, the pancreas releases more insulin into the bloodstream, perhaps double the normal amount. If the body cannot produce sufficient insulin to "control" the sugar level, this is when the symptoms of diabetes appear. This explains the relationship between heart disease and diabetes. (See Chapter 21--Diabetes.)

   Friedman and Rosenman are absolutely right in saying that type A stress is sometimes dangerous but it has not been shown that such stress is a major or common causative factor in cardiovascular disease. Dr Selye, probably the most experienced and informed researcher in the study of stress, was able to show in laboratory experiments with all kinds of animals, including monkeys, that an excess of stress hormones could cause severe cardiovascular disease throughout the body. In order to do so, however, it was necessary to administer large amounts of hormone and include large quantities of salt in the diet.

   There is no doubt that under certain conditions stress could be considered a causative factor in heart disease but not frequently enough to be blamed for the common incidence of the disease in the general population.

   When we consider heart attacks, which are not diseases, but events that occur to people who already have heart disease, then stress is a dangerous factor. In other words, stress may have had nothing to do with the formation of the disease, but much to do with triggering a heart attack.

Stress versus heart attack

   In the case of a person with CHD so severe the coronary arteries are almost closed, the effect of sudden or abnormal stress could trigger a heart attack. This is because, as I have explained, the effect of stress is to rapidly increase the viscosity of the blood so it cannot flow freely through the blocked section.

   Thus if you have two people, one type A and one type B, both with the same degree of artery closure, and both subjected to the same stressful situation, the reaction of the type A may eventuate in heart attack, whereas the lesser reaction of the more placid type B may not be so likely to.

   An interesting report from Dr Simon Rabkin of Canada, in the American Medical News, said the majority of fatal heart attacks occur on Mondays. Of the 3,893 cases studied, he found 75% of heart attack deaths among men at work, and 47% of those at home, occurred on a Monday. He thought that reintroduction of occupational stress after the weekend was the probable factor.

   Stress is capable of causing a kind of heart attack known as ventricular fibrillation. Dr James Skinner, a neurophysiologist at the Baylor College of Medicine, said in three different studies it was found that 15% of people who drop dead of so-called heart attacks do not suffer any heart-related disease but die of ventricular fibrillation. He said it had been shown that a brain factor alone can cause this. "In the 1930s," said Dr Skinner, "Physiologist Walter Cannon travelled the world studying voodoo curse deaths in primitive cultures. His conclusion was that mental stress was sufficient to cause these deaths".

   A Sydney newspaper report of 28 February, 1979 said:

   "A man accused of a $180,000 armed bank robbery died in the cells Yesterday while a District Criminal Court jury was considering its verdict at the end of his three-week trial. The man, 27 years old, collapsed in the cells of the Darlinghurst Courts and was taken to nearby St Vincents Hospital. He had suffered cardiac arrest and despite immediate treatment, had failed to respond."

Personality and diet

   Personality and diet are not unrelated.

   A hyperactive child would, no doubt, be classified as a type A personality although the hyperactive behavior was caused by dietary factors.

   Whether by comfort deriving from their religious beliefs or perhaps from their vegetarian diet, the Seventh Day Adventists at the Sydney Adventist Hospital seem all to be good-natured and friendly. Strangers passing in the corridors smile and say hello.

   Other people say they feel less aggressive and more placid since becoming vegetarians.

   It is possible that some "A Type" people on high meat, fat and sugar diets are basically placid folk whose type A behavior as well as their circulatory problems, are caused by the food they eat.

   Other factors aside, there is no doubt that moderating a frantic lifestyle has benefited many people and extended their lifespan.

Funny stress

   "I can't find anything organically wrong with you," the doctor said. "As you know, many illnesses come from worry. You probably have some business or social problem that you should talk over with a good psychiatrist. A case similar to yours came to me only a few weeks ago. The man had a $5,000 debt due and couldn't pay it. Because of his money problems, he had worried himself into a state of nervous exhaustion."

   "And did you cure him?" asked the patient. "Yes," said the doctor. "I just told him to stop worrying, that life was too short to make himself sick over a scrap of paper. Now he's back to normal. He has stopped worrying entirely".

   "Yes I know, " the patient replied sadly. "I'm the one he owes the $5,000 to."