Stress or Disease. You Choose.
I read an interesting study in the British Journal of Psychiatry that found, quite remarkably, that people undergoing life events – relatively ordinary stresses and emotional losses such as relationship issues and work problems that would not qualify them for a formal diagnosis – suffered more PTSD-like symptoms such as bad dreams or emotional numbing than more obviously traumatized people who had endured war or disaster (Saskia et al., 2005). This old article shocked me and had me wondering about my own life events and mental status.
I explored the origin of all this stress and its relationship to disease. The HPA axis is the centre of our body's system for efficiently and effectively managing stress. This abbreviation refers to the pathways and feedback loops that connect the pituitary gland at the top of the brain stem, the adrenal gland that sits atop our kidneys, and the hypothalamus, a small, crucial area in the centre of our brain that is responsible for maintaining our body in a healthy, balanced state (Guilliams & Edwards, 2010).
The term "allostasis," made popular by renowned American stress researcher Bruce McEwen (1998), describes the body's effort to maintain internal homeostasis in the face of changing conditions. Combining the Greek terms allo, which means "varying," and stasis, which means "standing" or "stoppage," we get the phrase "staying the same amid change." Our bodies will go to tremendous efforts to maintain it since we cannot live without it, even to the point of long-term wear and tear if tensions do not abate (McEwen, 1998). Such strain on our bodies' regulatory mechanisms, dubbed "allostatic load" by McEwen (1998), results in an excessive and prolonged release of the stress hormones cortisol and adrenaline, nervous tension, immune dysfunction, and, in many cases, exhaustion of the stress apparatus itself.
For many people, it goes without saying that managing stress, attending to emotions, whether they are expressed or suppressed, and caring for our psychic wellbeing can all have significant effects on our physical health (Ray, 2004). However, despite their impressive physiological and technical knowledge, healthcare professionals are typically not initiated by their training into the age-old knowledge and cutting-edge field of body-mind unity. Medical experts frequently do nothing to promote – and may even discourage – individuals from trusting their own instincts, which tend to synthesize information from both the mind and the body (Ray, 2004).
Despite this, a clear picture is forming as contemporary research validates conventional thought. Psychoneuroimmunology, a (relatively) new science, maps the numerous pathways of the body-mind unity; its field of research includes the connections between emotions and our nervous and immunological systems, as well as how stress can trigger disease. Even the term "connection" is deceptive, as only distinct entities may be connected, yet reality only knows unity (Lusk & Lash, 2005). What we think, believe consciously or unconsciously, feel, or are prevented from feeling – powerfully affect our bodies, for better or worse. Conversely, what our bodies experience from conception onward cannot but affect how we think, feel, perceive, and behave. This, in a nutshell, is psychoneuroimmunology’s (or PNI for short) core lesson.
So why in the world am I putting myself through all this stress? I entered the profession with a strong desire to support the healing process of others, recognizing that this is the most rewarding aspect of my work; however, I find that I am are not adequately prepared in academic and professional healthcare settings to engage and support patients in their healing processes. Nurses are responsible for caring for patients during their most vulnerable moments of disease, as well as assisting all individuals in maintaining or enhancing their health. As our training and practice settings have become unduly medicalized, the nursing profession and its supporting systems have failed to promote nurses' self-care and healing practices. The current structures do not permit nurses to implement our guiding care beliefs and adhere to nursing's ethical standards. Similarly, the work environments of nurses are so burdened with medical-technical expectations and have grown so stressful that the process of developing caring-healing environments appears unreachable to many. When one analyzes low new graduate nurse retention rates and the issue of nursing burnout, it is evident that the stress of professional responsibilities and the inability of nurses to provide a caring-healing atmosphere led to costly recurring problems.
So much of what makes people either well or not is not coming from within themselves, it’s coming from their circumstances. It makes me think much more about social justice and the bigger issues that go beyond individuals. -Elizabeth Blackburn, PhD
I will leave you with one last thought. Australian researchers found that a bad job is worse for mental heal than being out of work (Butterworth et al., 2011). So, the next time a co-worker tells you, “This job is killing me,” you tell them they may be right.
References
Butterworth, P., Leach, L.S., Strazdins, L., Olesen, S.C., Rodgers, B., & Broom, D.H. (2011). The psychosocial quality of work determines whether employment has benefits for mental health: Results from a longitudinal national household panel survey. Occupational and Environmental Medicine, 68(11), 806-812. https://doi.org/10.1136/oem.2010.059030
Guilliams, T.G. & Edwards, L. (2010). Chronic stress and the HPA axis: clinical assessment and the therapeutic considerations. The Standard, 9(2). Retrieved from https://www.pointinstitute.org/wp-content/uploads/2012/10/standard_v_9.2_hpa_axis.pdf
Lusk, B., & Lash, A. A. (2005). The stress response, psychoneuroimmunology, and stress among ICU patients. Dimensions of Critical Care Nursing, 24(1), 25-31. https://doi.org/10.1097/00003465-200201000.00004
McEwen, B. (1998). Stress, adaptation, and disease: Allostatic load. Annals of the New York Academy of Sciences, 840(1), 33-44. https://doi.org/10.1111/j.1749-6632.1998.tb09546.x
Ray, O. (2004). How the mind hurts and heals the body. American Psychologist, 59(1), 29-40. https://doi.org/10.1037/0003-066X.59.1.29
Saskia, L., Mol et al. (2005). Symptoms of post-traumatic stress disorder after non-traumatic events: Evidence from an open population study. British Journal of Psychiatry, 186, 494-499. https://doi.org/10.1192/bjp.186.6.494
