|
In the 1930’s, Hans Selye, a physician, recognized the mind-body
connection with stress. He was the first to note that many illnesses
(e.g., cancer, infections, etc.) shared many common symptoms of
"sickness"
He recognized that the body responds to different demands or "stressors"
in a similar manner. His experiments, showing exposure to different
(even opposite) stressors (i.e., heat/cold, excessive exercise,
toxins), all led to the same symptoms/bodily response shown above.
Extensive and more recent research has shown us that many elements
of the nervous system play a key role in the body’s response,
including the
- hypothalamic-pituitary axes (HPA)
- autonomic nervous system (ANS)
- pain processing systems
How do I know what is causing my symptoms?
The challenge for individuals and health care providers is to determine
whether the symptoms an individual is experiencing are due to a
disease with identifiable cause and specific treatment (e.g., cancer,
infection), or due to non-specific causes. Studies have shown that
approximately 50-60% of visits to primary care physicians have no
identifiable cause, even with exhaustive testing.
What is it called when people with symptoms
have no identifiable cause?
Most patients do not like to hear that their doctor doesn't know
what is wrong with them.
When this is the case however, sometimes the doctor will simply
identify the person’s
symptom, but put a medical term before or after that symptom,
to indicate
that
we
don’t know the cause. For example, a person with muscle pain
with no clear cause, might be called "idiopathic"
(we don’t know the cause) myalgia (muscle pain), or myalgia
NOS (Not Otherwise Specified).
In other instances, doctors just indicate the area of the body
where an individual has pain; for example:
- Headache
- Low back pain
- Chronic pelvic pain
More recently, we have identified a number of constellations of
symptoms, which have been terned "syndromes," so
that these conditions may be more easily diagnosed and treated.
What have we learned about the causes
of these syndromes?
Many individuals who become ill do so after being exposed to one
or more different types of stressors, including:
- Physical trauma
- Infections
- Drugs or chemicals
- Emotional stress
Not all stress is equal. It appears as though the environment or
setting in which an organism (whether it is human, monkey, or mouse)
experiences a "stressor" is as important as the stressor
itself.
For example, stressors are much more likely to have adverse health
effects if the exposure occurs in a setting where there is
- No control (e.g., this isn’t something you want to do,
it is something you are being forced to do)
- No support (you are not around family, friends, etc., that
offer you support)
- No predictability (you can’t anticipate when the stressor
is going to occur)
How can these different types of stress make
this happen?
As Selye taught us, the body has a limited number of ways to express
itself.
The systems that "sense" and "respond" to stress
are all interconnected in the central nervous system (i.e., brain
and spinal cord) and respond in much the same manner to a number
of different insults.
These systems are extremely powerful and have widespread effects
throughout the body; scuh as controlling levels of pain, influencing
arousal (i.e.,
having energy versus feeling tired or fatigued), altering memory
and concentration, and regulating the function of internal organs.
How can stress make people
continue to feel sick long after the strerss has passed?
We’re not quite certain, but we know that in animals, exposure
to stressors early in life can permanently change the way their
central nervous system, especially the parts involved in stress,
functions for the rest of their lives.
It is also possible that much of the reason that people feel poorly
after being exposed to a stressor is because this makes them change
behaviors that then lead to illness.
How can changing my behavior make me
feel bad?
Let’s say you are a healthy, normal person who exercises
regularly, has a busy social life, and has a fulfilling job. You
are involved
in a motor vehicle accident. As a result of the pain and injuries
from the accident, you must stop exercising, curtail your normal
social activities, and because of the pain and having to take pain
medication, you are less effective at work.
We know that regular exercise is a very powerful analgesic (pain
reducer) and stimulant (keeps one feeling energetic). Most people
have heard about endorphins, the body’s natural pain killers,
being released during exercise. Stopping regular exercise may
increase
pain and fatigue.
Stopping regular social activities can reduce happiness and contentment,
and can cause worsening of mood, irritability, etc.
As a result of performing less well in your job, this may create
tensions with your boss, co-workers, etc. who are used to you performing
at a certain level, and upset that they may have to "pick up
the slack."
These are but a few of the seemingly subtle changes in behavior
that might occur because of an acute stressor, that could theoretically
cause continued symptoms, well after the stressor has passed.
A similar scenario may occur in individuals deployed to war.
|
