Defining the Link Between Stress and Illness

In the psychological and medical world there is much interest in a possible link between stress, or life events and illness in humans. Many studies have been conducted and articles written, with theories and results being promoted as the definite answer. Firstly, before we can say stress is one thing or another, we must address problems that seem to be overlooked when drawing up conclusions. Firstly there’s the question of what stress actually is, and whether it’s actually a bad thing in moderation- in primal time’s stress was essential to stay alive.

It kicks the human body into action, operating the ‘fight or flight’ response where hormones are released; preparing the body to either confront the danger it faces, or flee from it, to safety from physical or mental harm. These days however, when such ‘flight or fight’ action is not needed as much in the modern world, people view stress as a serious problem, and can be brought on by such trivial things, or major life stressors. Is stress a stimulus or a response, or a mixture of the two?

By which I mean is it something that makes us something else, or does it only comes into play after an event? It can be used to describe a situation, object or a person or any other living thing causing stress, so one can only assume these all cause varying types and levels off stress- nothing can be pin-pointed. And what exactly do we mean by the illnesses caused by stress- there’s so many kinds- mild infections, disease, and common everyday ailments.

Other things could effect this, for example genetics and lifestyle, not just stress, so how can it be effectively measured? Everybody is different and so would perceive so-called ‘stressful’ events very differently, depending on a range of factors, internal, such as mental stability, or external, everyday things like financial situations. Of course practises and beliefs change dramatically across the world, over different cultures, so its only common sense to assume stressor’s would vary greatly also.

In my opinion, I do believe stress has a high impact on people’s susceptibility to certain illnesses, but we need to effectively research how different things apply to different people, and work out a theory or group of theory’s that can be generalised across the board. Useful, universal terms have been applied to different factors and areas of stress and researching into it, which helps identify problems people may have, and will also help me greatly in my own research.

For example a ‘stressor’ is an event that individuals would see as harmful to their state of mind of physical wellbeing, being either internal (something wrong with the body itself) or external (something wrong with the environment the individual is in). A stress response refers to the reaction or action taken by the person stressed- whether it’s something they consciously do, or a change in their body’s biochemistry (thus preparing the body- for example the flood of hormones involved in ‘fight or flight’).

The history of stress and how it was handled is dramatically different to how we deal with these problems in today’s world. In the seventeenth century, stress was ignored as a major worry, and supposed ‘unavoidable’ illnesses were not linked to it at all. Medicine was not widely available, and they wouldn’t have known what to use to treat with anyway. It was treated much like a mental disorder- unfair and not at all helpful to he individual with the problems. It was something unexplored and not very well known; those with symptoms did not admit or disclose them.

These days, however, people are trained as councillors, doctors and psychologists to determine the root of the problem and solve it- for a hefty price tag though! People understand more about the many types of stress and its causes, and how to help themselves or where to get professional help. It seems that because of this more and more people have admitted they’re having problems and have sought help; however it could be thought that it isn’t necessarily an increase in the amount of stressed people; more individuals go running to a professional at the first sign of trouble, a ‘nip it in the bud’ reaction.

However, good things have come out of this increased awareness and knowledge of stress, illnesses and infections, diseases such as tuberculosis and meningitis have decreased rapidly. Research by many people has shown that stress has been linked with a range of physical illnesses such as headaches, influenza and rheumatoid arthritis, as part of a biomedical model which is the main model used by people involved with most psychology and health issues. The immune system is a particularly vulnerable part of the human biology, and is often first hit when an individual experiences stressful problems.

It causes the suppression of this vital biological ‘machine’ which is distributed all through the body, made up of mainly leucocytes, which are white blood cells, all with the aim of dispelling infection and strange things in the body. However, as I mentioned earlier, different types of stress can occur, and so one single label can’t be put on it and its effects. Evans et al in 1997 conducted a study into the effects of psychology on the nervous and immune systems. They said that the assumed link between stress and a suppressed nervous system was far too simplistic.

They said that whether the systems were suppressed or not was to do with factors of the stress, for example when it happened, how strong it was etc. This shows that we cannot simply look at whether there is a relationship or not, as there are many different areas and factors to look at that could affect the outcome. Evans also suggested that the immune system is constantly striving for a state of balance, called a homeostasis, where the body releases varying amounts of lymphocyte cells to deal with the changing levels of bacteria or viruses.

A study I found which supports the idea of stress affecting the immune system was conducted by Kiecolt-Glaser et al in 1995. They used medical students to show the effects of examination stress on the participant’s health (who were all volunteers). A blood sample was taken from 49 males and 26 females, one moth before the examinations began, and on the first day of the final examinations, when it’s though stress levels should have been at their highest. The results were conclusive; showing that natural killer cell activity had declined in the period of time between the blood tests.

This shows that, as others have suggested and researched into, stress is associated with a decreased response from the immune system. The study did have many strengths, including the ability to positively say that stress and immune response are negatively correlated (as stress goes up immune response goes down). However we cannot say one was a direct cause of the other. A good point about this study was that the stress experienced by the students was naturally induced -in other experiment’s participants have been placed into stressful situations by the examiner (like Palmblad in 1979 who restricted sleep patterns).

This could end up having unwanted effects on the results-for example some people may be used to certain situations whilst it is totally new to others, and other extraneous variables. At least with this study by Kiecolt-Glaser et al we can say that each participant was put in the same situation and had to do the same amount of work to achieve their goal. However I feel that this study is not necessarily fair as some participants may be suffering stress for other reasons, such as funding problems, existing health issues or family arguments.

However I feel that this study, although relative to examinations students, could only be applied to them, and not generalised because not everyone in the world is a medical student taking their exams. A good study though, and one that I feel applies well to my hypothesis. What exactly do we mean by a relationship or link between two things? In the past models have been simple, and we have not looked at the fact that stress and illness are not officially defined, and that they two-way things, not operating just on one single level, but many.

Firstly, mediators and moderators need to be distinguished. A mediator is a variable that is part of events from the cause to the effect, or the stimulus to the response, possibly contributing to an overall effect, be it in a large way or a small way. For example in this case of stress and illness, we could say that a mediator in illness could be the diet you had as a child, or your family background. A moderator is almost the opposite in effect- its something that has an immediate effect on the outcome by changing the experience and its effects.

Support in times of anxiety can have a great effect on the outcome. It can either decrease or increase the factors involved, thus we are starting to see the complicated and complex link present between stress and illness, which seems to run deeper after every study done into it. Mediators and moderators can swap to each other, depending on the effects they the variables have had. It has been suggested that health habits may be altered by stress, thus causing illness, helping to outline a relationship between stress and illness.

Conway et al in 1981 developed this idea, saying that it may not be the actual stressor itself causing health problems, but rather other factors such as how the event is interpreted, whether we change our behaviour because of it and how we try to cope. Coping comes in many forms-whether the person chooses to get help or help themselves, there are many ‘solutions’ to the problem, often that only take away the visible signs, and don’t solve the problem at the root.

For example, if you take medicated drugs to help you deal with a difficult co-worker, they’re still going to be there when you get back, whereas assertiveness training and other related types of help means you can learn to tackle the problem head-on and solve it yourself. Lots of techniques are available these days, but often people with problems don’t effectively evaluate them to see which is best, often leading to more problems. And as stress cannot be specifically outlines, there’s no real telling which type of treatment is suitable for which type of person. Drugs are the most commonly used and prescribed treatment for stressed people.

Antianxiety agents are most often found in the drugs, which target the areas of the brain thought to produce the increased levels of anxiety when faced with stressors. However, they work only on a short term basis, and once the prescribes amount has run out, the problem often returns, which has meant more people are now combining drugs (to work in the short term) with psychological approaches to continue the less-stress on into the long term. Drugs do work quickly, but they can lead to unwanted side effects, such as drug dependency, and over 40% of patients do not respond to them.

Plus, in the case of illnesses like high blood pressure, stress isn’t the only cause of it, but still they’re treated with anti-stress drugs. Biofeedback is the practise of measuring and recording electrodes and physiological responses in order to learn how to control and reduce blood pressure or muscle tension, through very effective short term solutions like meditation, muscle relaxation, or imagery, which are all excellent for solving problems on-the-spot. Biofeedback helps the person to learn new, effective techniques that in the long term will help them to have a better feel of control over their own lives and a more positive attitude.

However it is costly and time consuming, and tests show that it doesn’t actually do all that much good as relaxation training. Cognitive-behavioural approaches show to be the most effective treatment for stress, if the patient is motivated, eager to apply himself or herself and willing to analyse their own life. It doesn’t suit everyone, isn’t always widely available and costs time and money, but in the long run it is definitely a good idea. It tackles the heart of the issue, rather than skimming the surface, and means that the problem is addressed and solved for long-term benefits.

A therapist discusses problems with the patient, the coping of the patient in the past is analysed, and specific problems are discussed. The therapist then takes the individual through a series of coping strategies, practice and training, in the end resulting in a more confident, stress-coping efficient person, ready to face up to any problems. Although many people seem to moan and groan about having to do exercise, it has become much more popular in the last few years, being seen as a form of weight control, lowering anxiety levels, boosting self esteem and good moods.

However, on the stress front, although many do feel it is a great way of stress busting, there is little evidence to show it actually contributes in some specific way. It can’t be done by everyone- for example somebody with cardiovascular problems would have to take great care, as exercise increases heart rate and blood pressure. It can also result in muscle and ligament damage and other related ailments, and as exercise needs to be done regularly to reap the benefits, this doesn’t show itself as being the best treatment of stress. It also can be time consuming, and costly.

As you can see, each of these few stress reducing techniques has both its good and its bad points, and so it would be wisest to combine a few of these. For example drugs for the short-term help, and cognitive-behavioural techniques for the long term, and for tackling the root of the problem. As everybody is individual, I think the idea of talking to a therapist is one of the best, it means that a treatment can be tailored to suit each person, they have a ‘should to cry on’. Talking about problems does seem to be one of the best ways of dealing with them.