Stress In Today's World
“Without stress, there would be no life.”
Real People, Real Stories
Nicole was about to graduate, but reflecting back on her first year of college still brought some painful memories. Here is Nicole's story.
“My first year of nursing school proved to be more stressful and more challenging than I had bargained for. In addition to my 18 credits that first semester, I had 6 lab hours each week. It wasn't just the academics that had me floundering. I was also working 20 – 30 hours per week at a local grocery store and trying to maintain a social life.
Early in the semester I began to feel the stress. I soon began cutting back on my social life because I needed to study or work. Day after day I kept reminding myself that this situation was `just for this semester' and that `I can get through this'
My stress started affecting me physically. By the first week in October I had lost 15 pounds and was starting to have stomach cramps nearly every day. My weight loss and stomach cramps were mainly caused by my not eating. I would get stressed out and skip a meal, which would turn into two meals, or at the worst, three meals. My sleep patterns started changing too. I started needing to sleep more and more just to be able to function. Some days I would sleep 14 to 16 hours but still feel tired. And then other days I could not sleep at all. By Thanksgiving break I had lost 20 pounds and was taking prescribed muscle relaxants and ulcer medications.
My emotions started changing too. I would cry at the drop of a hat, sometimes over nothing. I would take long, hot showers so that my roommates wouldn't see me crying. I would also get angry very easily. It wasn't uncommon for me to shout obscenities and start throwing things. I couldn't seem to `get happy’ about anything. I quit caring about my appearance, so I quit wearing makeup and fixing my hair.
School was my main stressor and my grades began to show it. As my grades initially began to slip, I became even more stressed out. I was worried that I would fail a class and be out of the nursing program. I would study more and more.
I tried so hard to conceal my problems, because I didn't want to admit that I couldn't get through this. I didn't want people to think that I was stressed out and such a mess, but I just couldn't handle things any more. I told my family and friends what I was going through. It was really difficult for me to do. I did not want to admit that I couldn't handle things the way they were.
With help from my family and friends, I made several changes in my life. The first major change came with the end of my busy, class-loaded semester. When registering for classes the next semester, I cut back my class load. I also found a new job that would pay more per hour so I could work less. My parents helped me out financially as much as they could. My boyfriend maintained a 24-hour, 7 days a week `hotline' for me. Whenever I felt stressed, I could call him. I started riding my bicycle and doing yoga as a means to `de-stress' I also set aside time each day just for me when I could do anything I wanted.
I am still learning how to handle my stress, but I think my first year in nursing school taught me a great deal about myself and how I handle stress. I learned what my actual limits are and what can happen if I don't deal with my stress appropriately. I will graduate in one month and I know I will still have stress, but now I know how to deal with stress in a healthier way.”
Stress In Today's World
“It was the best of times, it was the worst of times,” Charles Dickens wrote of 18th century France in his masterpiece A Tale of Two Cities. Could the same be said for you, today's college student? Never before have college students been faced with such vast opportunities, such freedom of choice, and such an array of information. Yet these opportunities, these many choices, and this information overload can be the factors that leave you feeling overwhelmed and stressed. Will this be the best of times or the worst of times for you? As you will learn in the chapters to come, the decision is yours. With the right skills and the right information, you will be in control of your destiny.
Stress - What Is It?
Stress, stressors, eustress, distress, good stress, bad stress - it can be confusing and downright stressful to understand what stress is all about. As Hans Selye, the noted stress researcher, once said, “Stress is a scientific concept which has suffered from the mixed blessing of being too well known and too little understood.”
Coming up with an accepted definition of stress is not easy. Nurses and physicians, psychologists, biologists, engineers, and students may each have a different meaning in mind when they talk about stress. One useful definition of stress is stress is a demand made upon the adaptive capacities of the mind and body. This definition helps us understand three important aspects of stress:
1. Stress depends on your personal view of the stressor and can be both a positive and a negative factor in your life.
2. It is your reaction to the events in life, rather than the actual events, that determine whether the outcome is positive or negative.
3. Your capacities determine the results. Stress is a demand made upon the body's capacities. When your capacities for handling stress are strong and healthy, the outcome is positive. When you lack the ability to handle the demands, the outcome is negative.
While we often think of stress as something negative, it is important to remember that stress can be stimulating and helpful. Think of how boring life would be without some changes and challenges to push you along, to provide opportunities for you to help you learn and grow, and to provide the impetus for accomplishing your goals in life. We can relate managing stress to building muscle. To build bigger biceps, you faithfully perform arm curls with gradually increasing weight. Over time your muscles respond to the overload and become bigger, stronger biceps. The key is in finding the right balance. Too little weight will not produce the desired results; too much weight may result in injury and will not produce the desired results. You need to overload the muscle just enough so that it will become stronger. So it is with stress: too little stress leads to boredom and lethargy; too much stress leads to physical and emotional breakdown. The right balance leads to a productive, healthy life.
Harvard's Robert M. Yerkes, M.D. and John D. Dodson, M.D. first described this relationship between stress and performance in 1908. The Yerkes-Dodson Principle implies that to a certain point, a specific amount of stress is healthy, useful, and even beneficial. This usefulness can be translated not only to performance but also to one’s health and well-being.
The stimulus of the stress response is often essential for success. We see this commonly in various situations such as sporting events, academic pursuits and even in many creative and social activities. As stress levels increase, so does performance. However, this relationship between increased stress and increased performance does not continue indefinitely. As shown in Figure 1.1, the Yerkes-Dodson Curve illustrates that to a point, stress or arousal can increase performance. Conversely, when stress exceeds one’s ability to cope, this overload contributes to diminished performance, inefficiency, and even health problems.
When you are feeling bored or lethargic, the leftmost part of the curve will likely represent your performance levels. The right side of the curve indicates potential performance levels when you feel excessive pressure and anxiety. A good image to remind us that there is an ideal amount of stress for each of us is that of the tension that exists in the strings of a piano, violin, or guitar. When a guitar string is strung too tightly (too much tension), it will sound a note higher than is desirable. The guitar string, when tightened to its maximum and beyond is likely to snap. The same string, if not tightened sufficiently, will play a note that is lower than is desirable. If it is strung without any tension, no sound will come from it at all. The right amount of tension results in a perfectly desirable sounding note. The same image can be used to depict the healthiness of one’s body with too little or too much stress.
For peak performance, you want to stay at the top of the curve. It would be simple if this optimal level was the same for everyone, but it's not. For this reason, the focus of an effective stress management program is two-fold. First, a stress management program can teach you where this optimal level of stress is for you personally, so that it can be used to your advantage. Second, a stress management program can help reduce physical arousal levels using both coping skills and relaxation techniques so you can stay out of the danger zone created by too much stress.
Good and Bad Stress
A stressor is any event or situation that is perceived by an individual as a threat causing us to either adapt or initiate the stress response. Therefore, a stressor is a stimulus and stress is a response. To think of it another way, the stressor is the cause and stress is the effect.
Dr. Hans Selye, one of the first to study the effects of stress, coined the term eustress to explain the positive, desirable stress that keeps life interesting and helps to motivate and inspire. Events like going off to college, getting married, starting a new job, or having a baby can be happy, joyous, and stress-producing occasions. Eustress also involves successfully managing stress even if one is dealing with a negative stressor. On the Yerkes-Dodson Curve eustress is represented on the curve where stress level and performance increase simultaneously. Eustress implies that a certain amount of stress is useful, beneficial and even good for our health, much likely the perfectly strung guitar string.
Distress refers to the negative effects of stress that drain us of energy and surpass our capacities to cope. Very often when we are talking about stress, we are referring to distress. Notice on the Yerkes-Dodson Curve where stress continues to increase, yet performance begins to decline. This downward curve represents distress.
Acute and Chronic Stress
Stress can be acute or chronic. Acute stress is the result of short-term stressors. Acute stress occurs, is usually quite intense, and then disappears quickly. Imagine being out for a leisurely evening stroll when suddenly, from out of nowhere, a large, mangy dog leaps from the bushes, growling, with teeth bared. The response to this event is acute stress. Have you ever been cruising down the highway, relaxing to your favorite tunes when you glance in your rearview mirror to see the flashing lights of a police car bearing down from behind? If so, chances are you have experienced acute stress. If you ever wanted to feel alert and clear-thinking, this is the moment. Acute stress can be exciting and invigorating in small doses, but too much is exhausting.
The soothing sound of the engine hummed in my ears as the small Cessna airplane slowly climbed to 3,000 feet over Lincoln, Nebraska. I was about to make my first parachute jump - and I was feeling anything but soothed. I have a list of “Things To Do Before I Die” and parachuting was on the list. At this moment I couldn't remember why.
My heart was racing, my jaws were clenched, and I was having trouble thinking clearly. Suddenly the small door flew open and a blast of noisy, cold air brought me to my senses. I knew what to do. I rather awkwardly maneuvered my parachute-laden body so I was sitting in the door with my legs dangling in the wind. I tried not to think about the fact that it was 3,000 feet between my dangling boots and the earth below. I slowly eased forward to balance precariously on the extremely small step and held on for dear life to the bar attached under the wing of the airplane.
Every cell in my body was shouting, “Whatever you do, don't let go of this airplane!” Somewhere in the distance I heard my jumpmaster, Gary, shout loudly over the tremendous wind, “Margie, let go!” There it was, the moment of decision. With a deep breath, I released my grip, pushed off, arched my back, spread my arms and legs, and began to fall.
Seconds later my parachute popped open and there I was, floating in the sky. It was exhilarating! I have never felt more alive. There was no doubt my stress response was fully engaged. The powerful stress hormones were surging through my body. As I touched down, my knees shaking, I understood fully the feeling of an adrenaline high. My body had served me well. This is acute stress. MH
Episodic Acute Stress
We probably all know someone who seems perpetually in the clutches of acute stress. This is the person who elicits the response “What now?” when you see them racing toward you. It seems they are always in a rush, but usually late. If something can go wrong, it will. They just can't seem to get their act together and can't organize the many self-inflicted demands and pressures clamoring for their attention. They often blame their problems on other people and external events. This is called episodic acute stress.
People experiencing these frequent episodes of acute stress tend to be over-aroused, short-tempered, irritable, anxious, and tense. They may describe themselves as having “a lot of nervous energy.” As you can imagine, the symptoms of episodic acute stress are the symptoms of extended over-arousal including persistent tension headaches, migraines, digestive problems, hypertension, chest pain, and heart disease.
Chronic stress is long-term stress resulting from those nagging problems that just don't seem to go away. This is the grinding stress that can wear you down day after day, year after year. Chronic stress can result from credit card debt that just keeps growing, from long-term health problems, from emotionally draining relationships, or from staying in an unfulfilling, energy-draining job.
Chronic stress results from the unrelenting demands and pressures that go on for interminable periods of time. The danger of chronic stress is that some people just get used to it, lose hope, and give up searching for solutions. Physical and mental resources are depleted. Chronic stress kills through suicide, heart attack, and violence. You will learn in later chapters that it is this chronic, long-term stress that results in stress-related disease and reduces the quality of life.
Put The Glass Down
There is a story about a professor who is presenting a lecture on stress management to his students. He raised a glass of water and asked the class, “How heavy do you think this glass of water is?” The students guessed about 6 ounces. “It doesn't matter what the absolute weight is. It depends on how long you hold it,” the professor replied. “If I hold it for a minute, it is ok. If I hold it for an hour, my arm will start to ache. If I hold it for a day, you will have to call an ambulance. It is the exact same weight, but the longer I hold it, the heavier it becomes.”
If you carry your burdens all the time, sooner or later, you will not be able to carry on, the burden will be too heavy. What you have to do is put the glass down and rest for a while before holding it up again. You have to put down the burdens from time to time, so that you can be refreshed and able to carry on. Whatever burden you are carrying on your shoulders, let it down. Take a rest. If you must, you can pick it up again later when you have rested. Rest and relax (Unknown source).
“Modern man is sick because he is not whole.”
-Carl Gustav Jung
To really understand how stress affects you and to learn how to increase your capacity for handling the demands of life, it is important to understand the relationship between health and stress. Here are two important points about health:
1. Health is more than just the absence of disease.
When you look at the relationship between stress and health, understand that the focus of this book is on more than just controlling stress to prevent disease and the other negative consequences of stress. The focus is on increasing your capacities for dealing with stress so you can enjoy optimal health and well-being. This is important! The text also focuses on promoting good health and improving the quality of life today and in the years to come.
2. Health is more than just physical. Health includes the physical, intellectual, emotional, spiritual, and social dimensions. Imbalance in any of these dimensions will affect your health.
Holistic health encompasses the physical, intellectual, emotional, spiritual, and social components of health. Even broader definitions of health may include occupational and environmental dimensions. We will discuss these last two dimensions and how they relate to stress in later chapters. The important message here is that the holistically healthy person functions as a total, balanced person.
Each dimension of health relates directly to stress. Understanding each of these dimensions will help in planning for a more balanced approach to managing stress.
Dimensions of Health
When the cells, tissues, organs, and systems that function together to form your body are in good working order, you experience physical health. You are able to minimize disease and injury and function at an optimal level. Physical characteristics include things like body weight, visual acuity, skin integrity, and level of endurance. Taking care of your body through healthy nutrition and exercise, adequate sleep, avoidance of alcohol and drug abuse, and regular health screenings are examples of promotion of health in the physical dimension.
There is a strong relationship between physical health and stress. You will learn that stress is a risk factor for many of the serious health problems that plague our society today. Stress has been shown to weaken the immune system resulting in increased susceptibility to a variety of health problems. A strong, healthy body is better able to resist many of the damaging physiological changes that might otherwise result from excessive stress. It works both ways: stress can cause disease and illness and disease and illness can cause stress.
Intellectual, or mental, health relates to your ability to think and learn from experiences, your ability to assess and question new information, and your openness to new learning. Your mind, and how and what you think, has a powerful impact on your health and well-being. In this text, you will learn about exciting new research that helps us understand this connection between the body and the mind.
Learning about stress is an important first step in preventing and managing stress. Wise decision-making skills will allow you to process the information you learn and apply this information to a plan to improve your health and well-being. You will be presented with a variety of stress prevention and stress management techniques in this book. Through critical thinking and informed choice, you will decide on the tools and techniques that work best for you. Your ability to process and act on the new information you learn will strengthen the intellectual dimension of your health.
While mental health encompasses thoughts and the mind, emotional health pertains to feelings. It involves experiencing and appreciating a wide range of feelings and an ability to express these feelings and emotions in a healthy manner. The ability to remain flexible and to cope with the ups and downs of life is an indication of emotional wellness.
The relationship between stress and emotional health is strong. While we are all affected by feelings such as anger, fear, happiness, worry, love, guilt, or loneliness, the emotionally healthy individual uses healthy coping skills to keep from becoming overwhelmed by these feelings. Dealing successfully with stress means you take control of your emotions, rather than your emotions taking control of you.
Spiritual health relates to the morals and values that guide you and that give meaning, direction, and purpose to your life. A conviction that your life is meaningful and a belief that your life is guided by a reality greater than yourself are indications of spiritual health. Spiritually healthy people believe their life has value and that they are here for a reason. The spiritual dimension may be the foundation for all other dimensions of health.
Stress, especially chronic stress, is often caused by a sense of aimlessness or lack of purpose. Much of stress in today's society relates to being out of touch with our values and beliefs. Living your life and making choices that are not consistent with your core values can be very stressful. For example, if you highly value family and yet find that demands of work and school leave very little time for family, you will likely experience distress. In later chapters, you will learn how techniques, such as values clarification, can contribute to spiritual peace.
Nurturing your spiritual dimension through religion, volunteer work, nature, art, music, or other avenues above and beyond your own immediate needs will most certainly reduce stress and promote health. Chapter 10 will discuss spirituality as a key component toward stress management.
Social health refers to the ability to relate to others and express care and concern for others. The ability to interact effectively with others, to develop satisfying interpersonal relationships, and to fulfill social roles is important for social health. Relationships with others, particularly family and friends, affect social well-being. When you are socially healthy, you feel accepted by others and see yourself as an important part of your world.
A strong social support system increases the capacity for handling the demands of life. As you will learn in the chapter on social support, study after study shows that people who have the support of friends and family are better able to deal with the ups and downs of life.
Holistic Health: Putting It All Together
Review Nicole's story in the opening vignette. You will see that stress affected every dimension of her health. Physically, she had trouble eating and sleeping. She developed ulcers and required medication for muscle tension. Intellectually, as she became more overwhelmed by all the demands, her grades began to fall. Emotionally, she felt like she just could not handle all the pressure. She felt depressed and like a failure. Spiritually, she began to question her purpose and meaning in life. She doubted her value as a person, stating, “How could I ever be a good nurse and help other people if I couldn't even help myself?” Nicole initially withdrew from her friends and family. She cut back on her social life to study and work. She found it difficult to admit she needed help and support from others.
Everyone is unique. Your unique genetic makeup, your unique experiences in life, your unique environment as you were growing and developing, all play a part in how stressors affect you and how you respond to the inevitable stressors of life. Read the Research Highlight: Stress and the Developing Brain to learn how even the early days of life may influence how stress affects you. You will find in this book a toolbox of different techniques and strategies for managing stress, and you will determine what works best for you. Understanding the holistic model of health will guide you in assessing all dimensions of health.
Research Highlight: Stress and the Developing Brain
It is well known that the early months and years of life are critical for brain development. But the question remains, just how do early influences act on the brain to promote or challenge the developmental process? Researchers have suggested that both positive and negative experiences, chronic stressors, and various other environmental factors may affect a young child's developing brain. Now studies involving animals are revealing in greater detail how this may occur.
One important line of research has focused on brain systems that control stress hormones, such as cortisol. Cortisol and other stress hormones play an important role in emergencies: they help make energy available to enable effective responses, temporarily suppress the immune response, and sharpen attention. Excess cortisol may cause shrinking of the hippocampus, a brain structure required for the formation of certain types of memory.
In experiments with animals, scientists have shown that a well-defined period of early postnatal development may be an important determinant of the capacity to handle stress throughout life. In one set of studies, rat pups were removed each day from their mothers for a period as brief as 15 minutes and then returned. The natural maternal response of intensively licking and grooming the returned pup was shown to alter the brain chemistry of the pup in a positive way, making the animal less reactive to stressful stimuli. While these pups are able to mount an appropriate stress response in the face of threat, their response does not become excessive or inappropriate.
Striking differences were seen in rat pups removed from their mothers for periods of 3 hours a day, a model of maternal neglect, compared to pups that were not separated. After 3 hours, the mother rats tended to ignore the pups, at least initially, upon their return. In sharp contrast to those pups that were greeted attentively by their mothers after a short absence, the “neglected” pups were shown to have a more profound and excessive stress response in subsequent tests. This response appeared to last into adulthood.
Another study recently reported that infant monkeys raised by mothers who experienced unpredictable conditions in obtaining food showed markedly high levels of corticotrophin releasing factor (CRF) in their cerebrospinal fluid and, as adults, abnormally low levels of cerebrospinal fluid cortisol. This is a pattern often seen in humans with post-traumatic stress disorder and depression. The distressed monkey mothers, uncertain about finding food, behaved inconsistently and sometimes neglectfully toward their offspring. The affected young monkeys were abnormally anxious when confronted with separations or new environments. They were also less social and more subordinate as adult animals.
It is too early to draw firm conclusions from these animal studies about the extent to which early life experience produces a long-lived or permanent set point for stress responses. However, animal models that show the interactive effect of stress and brain development deserve serious consideration and continued study.
Sources of Stress
FYI: Percentage of Freshmen Who Felt Frequently Overwhelmed
Do you think college students today feel more stressed than in the past? Do you think college men or women perceive they have higher stress? Here are some fascinating findings from The American Freshman: National Norms for Fall 2000.
Stress levels among college freshmen have reached record levels, with 30.2 percent of first-year students saying that they feel frequently overwhelmed by all they have to do. Many more women than men report high stress. Among the class of 2002, 38.5 percent of women say they felt frequently overwhelmed, compared with 19.2 percent of men.
Nobody has to tell you that the college years can be high stress years. While the sources and causes of stress will be unique for each person, there are some common sources of stress that relate to many college students. Here are some of the potential sources of stress. See if any of these apply to you.
Do you have too much to do? No matter how hard you work, do you feel like you never get caught up? If you are like most people, the answer is “yes.” You will learn in the chapter on time management that it isn't so much that we need to manage time; we need help managing ourselves.
Are you your greatest stressor? Do you put demands on yourself that may be unrealistic? Do you experience feelings of low self-esteem or feelings that your life is out of control? Do you take on more than you should? Would you be better off if you learned to say “no” more often?
Family Expectations and Family Life
“So, what are you going to do for the rest of your life?” Do you find well-intentioned family members about to drive you crazy with their desire to help you find direction in your life?
Family life stressors can include health problems, substance abuse, disagreements, loss of family, stepparent problems, homesickness, and divorce.
Employment Decisions and Finances
Do you work more so you can pay your tuition, or go even deeper in debt so you have more time to study?
Deciding on a major, teachers that expect too much, and failing a test are just the start of a list of school pressures. Do the demands and pressures of school leave you feeling overwhelmed?
Figure: Data from the American College Health Association survey reflects students' self-reported data from the Spring 2003 survey (n = 19,497).
What do you do with the “roommate from hell”? Would you be better off moving out of the dorm and into an apartment? Maybe you should consider a fraternity or sorority. How do you find some quiet time for yourself when you are constantly surrounded by people?
You get a “Dear John” letter from your girlfriend back home. Your best friend meets another best friend. You are left behind when the gang goes out for an evening of fun. University counseling services report that relationship problems are one of the top reasons that students seek professional help.
Physical health Issues
Lack of sleep, poor nutrition, hormonal fluctuations, and no time to exercise are just a few of the physical challenges facing college students. Is it any wonder colds and flu plague students, especially during finals? And what about more serious health problems like sexually transmitted infections, drug, tobacco, and alcohol abuse, anorexia, depression and the list goes on?
Noise, crowding, traffic, weather, pollution, and violence are all stressors that you live with. As a sign of the times, terrorism has been added to the list of things that students most fear.
Never before in history has there been access to such tremendous amounts of information. In today's world, with technology and computers, you have more information available then could have possibly been imagined 20 years ago. A recent computer search for information on “stress in college students” yielded 357,405 results. Don't forget cell phones, pagers, palm pilots, email - you have information coming at you 24/7. All this information has had such an impact on stress that it has been given a name, technostress. You will learn more about technostress and how you can control it in a later chapter.
The world of today's college student is filled with choice, much of it consequential. This explosion of choice in the university is a reflection of a pervasive social trend. Americans are overwhelmed with choices in virtually every area of life from what products to buy (300 kinds of cereal, 50 different cell phones, thousands of mutual funds) to where to go for spring break and how to pay for that vacation (credit card, debit card, check, loan, or even cash).
Finally, we cannot forget those hundreds of small, but significant, hassles that can creep into your day and cause hassles that you just don't need and that can absolutely put you over the edge: a flat tire, dead cell phone, computer crash, toothache, the dog ate your homework, and the list goes on.
Identifying the cause of your stress can be an important first step in developing a plan to reduce or eliminate the stress. In Chapter 2 you will have an opportunity to assess your personal stress levels. Throughout the chapters of this book, you will find helpful information and proven strategies to help you deal with many of these common sources of stress.
The key lesson is to strive for balance in your life. Stress can be challenging and useful. However, it can also become chronic and excessive to the point where you are no longer able to adapt and cope with the pressures. Consider the analogy of a violin. When the violin strings are too tight or too loose, the music will be distorted. When the tension is “just right,” the violinist is able to play beautiful music. An optimal level of stress is characterized by high energy, mental alertness, high motivation, calmness under pressure, thorough analysis of problems, improved memory and recall, sharp perception, and a generally optimistic outlook.
You are about to embark on an exciting journey of discovery. You will learn about stress in your life. What are the factors that are causing negative stress for you? You will learn how stress affects you physically, emotionally, mentally, spiritually, and socially. But most important, you will learn how to increase your capacity for handling the demands that are part of today's world. You will learn how to prevent stress. You will learn how to manage and cope successfully with the stress you can't prevent. So what will it be for you? Will these be the best of times, or the worst of times? The decision is yours. Let the journey begin.
Additional Quotes appropriate for this chapter:
A man’s health can judged by which he takes two at a time – pills or stairs. - Joan Welsh
Whatever you can do, or dream you can, begin it. Boldness has genius, power and magic in it. - Johann Wolfgang Goethe
The hardest victory is the victory over self. - Aristotle
There’s only one corner of the world you can be sure of improving and that is your own self. - one day at a time in Al-Anon
A journey of a thousand miles begins with a single step. - Lao tsu
A man too busy to take care of his health is like a mechanic too busy to take care of his tools. - Spanish proverb
The world is all gates, all opportunities, strings of tension waiting to be struck. - Ralph Waldo Emerson