Stress— "The Silent Killer"

IN HIS book From Stress to Strength, Dr. Robert S. Eliot thus describes his brush with death more than 20 years ago. Earlier that morning he had attended a conference and had given a lecture—ironically, on the subject of heart attacks. Suddenly, Dr. Eliot, a cardiologist, found himself on what he calls "the wrong side of the sheets in a coronary care unit." To what does he attribute his unexpected crisis? "On the inside," says Dr. Eliot, "my own physical reactions to stress were killing me."

As Dr. Eliot's experience illustrates, stress can have life-threatening consequences. Indeed, in the United States, it has been linked to some of the leading causes of death. The effects of stress can accumulate quietly over time and then surface without warning. It is thus for good reason that stress has been called "the silent killer."

Surprisingly, those with type-A personalities—characterized by impatience, aggressiveness, and competitiveness—are not the only ones who are vulnerable to stress-related catastrophes. Those with seemingly serene personalities may also be at risk, especially if their calmness is merely a fragile facade, like a weak lid sitting atop a pressure cooker. Dr. Eliot feels this to be true in his case. He now warns others: "You could drop dead today—unaware that for years you've had a time bomb strapped to your heart."

But heart attack and sudden death are not the only problems that have been linked to stress, as the following article will show.

Stress and Your Immune System

Current research shows that stress can suppress your immune system, perhaps opening the door to a number of infectious diseases. "Stress doesn't make you sick," says virologist Ronald Glaser. "But it does increase your risk of being sick because of what it does to your immune system." There is particularly compelling evidence linking stress to colds, the flu, and herpes. Although we are continually exposed to such viruses, our immune system normally fights them off. But some experts say that when a person is under emotional distress, these defenses can fail.

The biological mechanisms involved are not yet fully understood, but some theorize that the hormones that gear you up for action when you are under stress can hamper your immune functioning as they surge through the bloodstream. Usually, this is not a cause for concern, since these hormones are only on a temporary mission. Nevertheless, some say that if a person faces stress that is ongoing and intense, his immune system may be compromised to the extent that he becomes susceptible to illness.

This might help to explain why Canadian doctors estimate that some 50 to 70 percent of the office visits they handle are stress-related, typically involving headaches, insomnia, fatigue, and gastrointestinal problems. In the United States, the figure is estimated at between 75 and 90 percent. Dr. Jean King feels that she is not exaggerating when she says: "Chronic stress is like slow poison."

Some Ailments That Have Been Linked to Stress

• allergies
• arthritis
• asthma
• back, neck, and shoulder pain
• colds
• depression
• diarrhea
• flu
• gastrointestinal problems
• headaches
• heart problems
• insomnia
• migraine
• peptic ulcers
• sexual dysfunction
• skin problems

Three Kinds of Stress

Just as there are different degrees of stress, there are also different types.

Acute stress results from the strains of everyday life. Often, it involves unpleasant situations that need to be resolved. Since these are incidental and only temporary, the stress can usually be managed. Of course, there are some who jump from one crisis to another—indeed, chaos seems to be part of their personality. Even this level of acute stress can be brought under control. The sufferer may resist change, however, until he realizes the effect that his tumultuous life-style is having on him and on those around him.

While acute stress is temporary, chronic stress is long-term. The sufferer sees no way out of a stressful situation, be it the woes of poverty or the misery of a despised job—or no job. Chronic stress can also result from ongoing family problems. Caring for an infirm relative can bring on stress as well. Whatever the cause, chronic stress grinds away at its victim day after day, week after week, month after month. "The worst aspect of chronic stress is that people get used to it," says one book on the subject. "People are immediately aware of acute stress because it's new; they ignore chronic stress because it's old, familiar, and, sometimes, almost comfortable."

Job Stress—A "Global Phenomenon"

A United Nations report says: "Stress has become one of the most serious health issues of the 20th century." Its presence in the workplace is palpable.

• The number of stress claims made by government workers in Australia increased 90 percent in just a three-year period.
• A survey in France revealed that 64 percent of nurses and 61 percent of teachers say that they are upset about the stressful environment in which they work.
• Stress-related illnesses cost the United States an estimated $200 billion each year. It is reckoned that 75 to 85 percent of all industrial accidents are related to stress.
• In country after country, women were found to suffer more from stress than men, likely because they juggle more duties between home and work.

Stress on the job certainly is, as the UN report calls it, a "global phenomenon."

Traumatic stress is the impact of an overwhelming tragedy, such as rape, accident, or natural disaster. Many war veterans and concentration camp survivors suffer from this type of stress. Symptoms of traumatic stress may include vivid memories of the trauma, even years later, along with an increased sensitivity to minor events. Sometimes the sufferer is diagnosed with a condition called post-traumatic stress disorder (PTSD).

Sensitized to Stress

Some say that the way we respond to stress in the present largely depends on how much and what kind of stress we have encountered in the past. They say that traumatic events can actually alter the brain's chemical "wiring," leaving a person much more sensitive to stress in the future. For example, in a study of 556 veterans of World War II, Dr. Lawrence Brass found that risk of stroke was eight times higher among those who had been prisoners of war than among those who had not—even 50 years after the initial trauma. "The stress of being a POW [prisoner of war] was so severe it changed the way these folks responded to stress in the future—it sensitized them."

Stressful events experienced in childhood should not be underestimated, experts say, since these can have a substantial impact. "Most kids who suffer a trauma are not brought to the doctor," says Dr. Jean King. "They get through the problem, go on with their lives, and wind up in our offices years later, suffering from depression or heart disease." Consider, for example, the trauma of losing a parent. "Stress of that magnitude occurring when you are young may permanently rewire the brain's circuitry," says Dr. King, "leaving it less able to handle normal, everyday stress."