Museum of Health Care Blog

The following blog post was written by Varsha Jayaraman, Curatorial Assistant. 

April 16^th marks National Stress Awareness Day. Stress often accompanies difficult situations or circumstances that a person undergoes. Psychological, emotional and mental stress can lead to negative consequences on one’s physiological stability.  As a student at Queen’s University, stress is not a foreign concept to me. Between volunteering, working, graduate studies applications, studying and keeping up with what some might not even call a social life, stress management can be quite a daunting task…and it is not going to get any easier with exams looming.

A Short History of the Science of Stress:

The term stress comes from the Middle English term destresse, derived from the Latin stringere, which means “to draw tight.”  Prior to the twentieth century, stress was a term used in physics, referring to the internal distribution of a force exerted on a material body, resulting in strain.  Stress later evolved to describe mental strains or circumstantial disruptions that cause physiological disturbances or illness in the body.

Although the experience of what we now call “stress” predated the term’s entry into medical terminology, scientific studies on the physiological problems caused by mental stress began in the nineteenth century. Then, French physiologist Claude Bernard recognized the importance of maintaining balance in the internal environment of the body, the milieu interieur.  Bernard described the principles of dynamic equilibrium in the body.  He posited that in order to survive as human beings, our internal states must be in perfect balance to maintain regular functionality.  By this, Bernard meant that one’s mental state must be stable in order for the rest of the body’s physiological mechanisms to function properly.  External changes in the environment force changes that the internal environment then reacts to and compensates for.

Bernard’s milieu interieur was the origin for what Walter Cannon later called “homeostasis”.  Wisconsin-born Cannon popularized the term in his book The Wisdom of the Body in 1932.  He was the first to recognize that stressors could be emotional as well as physical.  According to Cannon, the brain coordinates body systems with the aim of maintaining a set of goal values for key internal variables.  Any internal or external threats to homeostasis that cause large enough deviations from goal values arouse internal nervous and hormone systems.  These induce emotional and motivational states, and then generate externally observable behaviours, which ultimately re-establish a state of homeostasis.  Cannon relates this concept to what he famously called the “fight or flight” response, an animal’s reactionary changes of state during pain, hunger, fear or rage.  Later, scientists found that these bodily reactions Cannon described can be traced to the release of powerful neurotransmitters from a part of the adrenal gland called the medulla.  The adrenal medulla secretes two neurotransmitters in response to stress: epinephrine (adrenaline) and norepinephrine (noradrenaline).  The release of these transmitters leads to the physiological effects observed during “fight or flight” and in general, in response to stress (i.e. rapid heart rate, increased alertness, etc.).

Scientist Hans Selye extended Cannon’s observations by including the pituitary gland in his stress studies.  He stated that during stress, the pituitary gland secretes hormones (i.e. cortisol) that are important in the physiological response to stress.  He found that a stereotypical pathological response pattern occurs during stress that includes the enlargement of the adrenal glands, shrinkage of the thymus gland (leading to inhibition of the immune system), and gastrointestinal ulcers.

Based on these foundational theories of stress, in 1967, psychiatrists Thomas Holmes and Richard Rahe examined medical records of over 5,000 patients in order to determine whether stressful events might cause illness.  They compiled and weighted a list of forty-three stressful “life events” that can contribute to physiological disturbances in stressed individuals.  This list was known as the “Social Readjustment Rating Scale (SRRS)”, or more commonly, the “Holmes and Rahe Stress Scale.”

Several scientists succeeding Bernard, Cannon and Selye concluded that stress was caused by distinct, measurable life stressors that are beyond the control of those experiencing the stress; however, this has been recently contested.  In November 2012, researchers from Pennsylvania State University found that stress is based on an individual’s reaction to potentially stressful situations and that this reaction determines whether they will suffer negative health effects.  It was argued that external circumstances do not have the capacity to produce stress but that stress is caused when an individual is unable to mediate the effects of the stressful situation due to low mental and emotional adaptability.  The key to living with stress, they said, lies not in reducing exposure to potential stressors but in managing them better.  Although this topic has been greatly debated among researchers, it bears some interesting questions about stress management and the effectiveness of various techniques to cope with stress.

Strategies to Cope with Stress:

Throughout history, stress relief has differed based on time and place.  Stress management strategies have varied from therapeutic natural remedies to medical prescriptions.  Some examples of stress management techniques include autogenic training, social activity, cognitive therapy, conflict resolution, exercise, meditation, deep breathing, yoga, nootropics, spas, artistic expression, and time management strategies, among others.  One of the most common forms of stress management on a global scale is the use of intoxicants and narcotics; however, despite their popularity, each of these can have many adverse side effects.  The Museum of Health Care does not endorse any of the following as stress management techniques.

Alcohol is commonly used in various parts of the world due to its ability to promote temporary mental relaxation. Ethanol is the primary component of alcohol that alters our brain function by stimulating the cortex, hippocampus and nucleus accumbens, the parts of the brain that are responsible for thinking and pleasure seeking.  It thus decreases anxiety in addition to increasing euphoria and self-confidence, shortening attention span, impairing judgment, and causing lethargy and confusion.   Although alcohol can assist many with temporary stress relief, it can be addictive if taken excessively and can lead to adverse short-term and long-term effects.  Short-term effects include nausea, vomiting, upset stomach, dizziness, confusion, mental instability, and body pain.  Long-term effects include liver dysfunction, brain shrinkage, dementia, cognitive disorders, gastrointestinal disease and weight gain, and several more.

Cannabis is one of the oldest modes of stress relief, dating back to the 3^rd millennium BCE.  It is used as a stimulant, depressant and hallucinogen.  Many use it to relax and as a mode of pain suppression.  Cannabis induces a state of relaxation from its main psychoactive compound, tetrahydocannabinol.  Often, it reduces the consumer’s anxiety and leads to temporary states of relaxation and lethargy; however, cannabis can cause short-term memory loss, lowered attention span, impaired motor skills, and slowed reaction time.  In some, it also causes heightened anxiety and panic reactions.  Long-term effects of chronic drug use include respiratory illnesses, lowered reproductive success, and possible neural impairment.

Other stimulants include “Atropa belladonna.”  Although some parts of the plant are considered highly toxic, historically it has been used as a pain reliever, anti-inflammatory and a relaxant.  Belladonna is quite a controversial mode of stress relief as it causes extreme hallucinations.

Some other forms of stress relief employ scientific principles to alleviate anxiety.  German psychiatrist Johannes Heinrich Schultz developed autogenic training, a method of influencing one’s autonomic nervous system (ANS), in 1932.  A practitioner repeats a set of visualizations that induce a state of relaxation in the patient, who holds one of several recommended body poses similar to yoga positions.  This training aims to restore the balance between activities of the sympathetic and parasympathetic branches of the ANS, which have important health benefits such as the regulation of digestion and bowel movements, lowering blood pressure, slowing the heart rate and promoting the functioning of the immune system.

Another mode of stress management is called “nootropics,” “smart drugs,” or “neuro enhancers” – drugs or supplements that claim to improve one’s mental functions, such as cognition, memory, intelligence, motivation, and attention span.  These drugs are thought to work by altering the availability of the brain’s supply of neurochemicals by improving the brain’s oxygen supply or stimulating nerve growth. Many have found that they instilled a positive effect on users’ stress levels; however, these drugs are controversial since many are not approved by federal drug boards and  their side effects are understudied.

Stress management remedies vary across the globe.  In Eastern Medicine, for example, herbal remedies are often recommended to aid relaxation and the reduction of anxiety.  Many Eastern medical professionals also recommend acupuncture, tai chi, simplified diets and quiet self-reflection.

Although many individuals use various drastic modes of relief to deal with everyday life stressors, stress can often be coped with in a number of minimally intrusive ways.  Many take up a hobby, meditate, do yoga, exercise, read, bake, etcetera, to escape their life stressors.  Traditional societies recommend prayer and religious rituals to combat their stress.  There is no general consensus on the best mode of stress relief but, ultimately, most medical professionals recommend the relaxation technique that works best for your lifestyle and personality.

The best way to manage stress is ultimately by means of prevention.  Prepare for stressful situations by developing healthy coping or management mechanisms.  Use a stress ball to keep anxiety under control, meditate, take regular walks, maintain a healthy diet… Unmanaged stress can lead to various health problems and significant negative effects on one’s psyche.  Manage your stress and you’ll ultimately live a happier, healthier life.

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