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Paediatrics => Allergy => Stress-Related Disorders
Stress-Related Disorders
INTRODUCTION
Stress-Related Disorders, diseases or injuries brought on or worsened by psychological stress. These psychosomatic disorders commonly involve the autonomic nervous system, which controls the body's internal organs. Some kinds of headache and facial pain, asthma, stomach ulcers, high blood pressure, and certain kinds of injury, such as repetitive strain injury and backache, are examples of stress-related disorders.
Doctors have long recognized that people are more susceptible to diseases of all kinds when they are subjected to great stress. Some research studies are aimed at how stress affects the immune system. Negative events such as the death of a loved one seem to cause enough distress to lower the body's resistance to disease. Positive circumstances and events creating even mild stress, however, such as starting a new job or having a new baby in the house, can also upset a person's normal ability to fend off disease. Social scientists have devised a list of life events and rated the relative stressfulness of each. Thus: the death of a partner rates 100 on the scale, whereas trouble with one's employer rates 23; being dismissed from a job, 47; going to jail, 63; a change in sleeping habits, 16; and getting divorced, 73.
CAUSES
Although stress can exert some influence on an individual's susceptibility to, and the progress of, any disease, such as a cold and perhaps even cancer, it affects some disorders directly. Scientists attribute at least part of this effect to evolutionary history, reasoning that at one time people had to live with constant physical threats from wild animals and the elements, as well as from one another, and that the body developed in a way that helped it cope with these physical stresses. The heart beats faster, blood pressure rises, and other body systems prepare to meet the threat. When a person does something active to cope with a threat, these systems return to normal. Running away or fighting-the so-called fight or flight reaction-are both successful ways of coping with many physical threats.
Problems arise, however, when the body is prepared, as described, to cope with danger but cannot do so. Being caught in a traffic jam, for example, can cause the body to prepare for a fight-or-flight response, but when no action can be taken, the body's systems remain overly active. Similar repeated experiences of this frustrating nature can lead to conditions such as high blood pressure.
Many other determinants also may lead to stress-related disorders. Among those under investigation is a certain type of behaviour that scientists used to call type A, a term originally applied to people who are prone to coronary artery disease. Some researchers claim that the type-A lifestyle, which is characterized by competitive, hard-driving intensity, is associated with an increased incidence of several stress-related disorders. Type A people are sometimes called "workaholics". However, more recent studies indicate that the unemployed and overworked individuals may be equally prone, whether they behave competitively or not, and that some people can take far more stress than others without becoming ill.
KINDS
High blood pressure, or hypertension, is one of the most common disorders made worse by stress. Although it has no noticeable symptoms, hypertension can damage the kidneys and can lead to a stroke.
Other stress-related disorders that are even more common are gastrointestinal problems. More serious are peptic ulcers, which are caused by an excess of gastric juices, or unusual sensitivity, or by the bacterium Helicobacter pylosi in an area of the stomach lining, causing nausea and pain. Other stress-related gastrointestinal disorders include inflammatory diseases of the colon and bowel, such as ulcerative colitis and regional enteritis.
Respiratory disorders also can be affected by stress. Most common of these is asthma, which may be caused by emotional upsets. Asthma attacks are characterized by wheezing, panting, and a feeling of being suffocated. In addition, emotional stress can cause or aggravate many skin disorders, from those that produce itching, tickling, and pain to those that cause rashes and pimples.
Major traumatic events such as accidents, catastrophes, or battle experiences may bring on a condition now called post-traumatic stress disorder (PTSD). Once known under war conditions as shell-shock or battle fatigue, PTSD gained its current name after it appeared in many veteran soldiers returning from the Vietnam War as they tried to readjust to civilian life, and it has been linked to the so-called shell-shock suffered by World War I veterans. Its symptoms, which may take months to appear after an initial state of numbness, include nervous irritability, difficulty in relating to surroundings, and depression.
TREATMENT
Treatment of stress-related disorders is sometimes limited to relieving the particular physical symptom involved; for example, hypertension may be controlled with drugs. Therapies involving meditation, yoga, and other relaxation methods may help the person to relieve the source of stress or else to learn to cope more effectively with it. Combinations of physical excercise and psychological therapy are sometimes recommended, but more often permanent changes in lifestyle or working methods or even a temporary change, such as a holiday, may be helpful in alleviating stress.
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