Stress

We live in a highly stressful world. Some temporary forms of stress are beneficial to us and help us to survive; however, stress becomes an issue when it is chronic. Chronic stress not only has direct negative consequences on our health, but when we are stressed and overwhelmed we are less likely to engage in healthy habits (1). Whilst we cannot always eliminate the stresses of life, having a stress management plan can help to lower the effects of stress and prevent the return of stress symptoms. It can mean the difference between having a stress reaction vs a stress response. 

A stress reaction: An event that leads to alarm, activation of the sympathetic nervous system, overstimulation and internalization of the situation, all of which leads to maladaptive coping and a breakdown of emotions

A stress response: An event that leads to a conscious internal processing that allows a person to be mindful of the situation, to recognize influences and chain of event reactions, and to make a deliberate choice. This conscious response allows a person to better maintain control over their emotions; keep a greater sense of calmness and balance; recover mentally; and regain equilibrium faster.

Screening for stress

Screening for stress can be carried out successfully by healthcare workers as a brief intervention. It can help to identify which people need closer follow up and more intense interventions. One method of screening is the “perceived stress scale assessment”, which was originally developed in 1983 by Dr Sheldon Cohen.

The link between emotional distress and poor health

Mental illness has a complex aetiology, of both modifiable and non modifiable factors. Lifestyle medicine aims to address as many of these modifiable factors as possible. Stress is a major modifiable factor in the development of mental distress and illness. Depression has been linked to (2):

  • Coronary Artery Disease 

  • Stroke 

  • Cancer 

  • Type 2 Diabetes 

  • Mean lifespan reduction of between 25-30 years

  • Negative job performance 

The World Health Organization predicts that by the year 2030, depression will result in more years of life lost to disability than any other illness. (3)

Several mechanisms have been identified that may potentially link depression to negative health outcomes, such as immune mediated inflammation, HPA Axis dysregulation, and increased thrombogenesis. (2)

Lifestyle Medicine and emotional wellbeing

There are a number of techniques that lifestyle medicine utilises to improve mental and emotional wellbeing and reduce stress. These include:

  • Exercise Therapy

  • Nutrition

  • Positive Psychology and Cognitive Restructuring

  • Stress reduction techniques such as mindfulness and meditation

  • Sleep management

  • Positive relationships and social support

These techniques can be used as a primary treatment modality, or in combination with psychological treatments and pharmacotherapy.

References:

  1. Americal Psycholoigical Association. Key Findings Stress in America. 2010 (cited 2017 9/9); Available from: https://www.apa.org/news/press/releases/stress/2010/key-findings. Accessed 27th June 2022. 

  2. Voiniv, B., W.D. Richie, and R.K. Bailey, Depression and Chronic Diseases: It Is Time for a Synergistic Mental Health and Primary Care Approach. The Primary Care Companion for CNS Disorders, 2013. 15(2): p. PCC. 12r01468.

  3. World Health Organization. (‎2008)‎. The global burden of disease: 2004 update. Part 4, Burden of Disease, DALYs. World Health Organization. https://apps.who.int/iris/handle/10665/43942. Accessed 27th of June 2022.