What is Stress?
We all need some stress and too much causes us to buckle under the strain. But what is it?
In any situation, our mind takes information in through our senses, analyses it, reacts to what it has found and then comes up with a response. This usually all happens automatically.
Take for example waking up in the morning and walking out to the kitchen. We are still half asleep, but manage to fill the kettle with water, turn the kettle on, get our cup out, put a teabag in the cup, fill with boiled water, go to the fridge and add some milk, then sit down to drink.
This process is so absent-minded. We don’t ask whether we would prefer coffee or tea, does the water really need to be boiling, how much milk do we add, and so on. Instead, we already have answers and responses all lined up. Fortunately, much of this processing happens unconsciously in our emotional domain.
However, when we meet a new situation, our reactions and responses are yet to be processed. Imagine how stressful life would be if we actually had to make a heap of choices each morning.
As a doctor we learn many facts and theories, and hopefully we also learn how to think. But thinking is not enough. Experience requires that we also learn to practice with feeling to gain the wisdom we need.
Stress is an accumulation of both a cognitions and emotions which are yet to be resolved. Doctors are better at processing the cognitive issues, so much of our stress lies in the emotional domain. However, those studying for exams can also certainly attest to suffer from cognitive overload.
Years ago, researchers studied students anxiety before an exam and matched this against their exam performance. Interestingly, those with too little or too much anxiety did worst:
This is also true of stress. On the left side of the curve, we can control the stress more easily, but we achieve very little. On the right side, our stress levels are so high that our emotions remains unprocessed and raw, leading to us acting instinctually in a fight or flight manner. However, if we can keep the stress below to peak, we can manage to balance our mental activities and achieve our maximum.
If stress continues, we begin to suffer from symptoms of burnout, which we often hide until our emotions cause damage both internally and externally.
What is Burnout?
Being burnt-out seems to suggest we have been on fire then run out of fuel – and this is probably a good analogy. If our emotional load continues to grow, our fight or flight mechanisms begin to cause an increasing effect on our biological systems, causing increasing tiredness, withdrawal or negativity, and reduced achievement. This is expressed in many differing ways through peoples differing personalities. Some just sit in a corner and cry, others become more cranky and intolerant, and others may just find things all too much.
Help may simply come from taking time out and taking time to “smell the roses”. However most of us wait far too long to get any help. Healing comes through the support of others and healthy relationships – not drugs (of the legal or illegal kind).
The most important thing we can all do is to become more aware of ourselves and the warning signs that we are becoming too stressed.
Trauma
Trauma, I believe, comes from an overwhelming emotional overload that usually comes from an event or series of events. Trauma causes a catastrophic response from our biology in a similar manner to “shock” with severe blood loss, and no less damaging. It is the last attempt of our bodies to protect itself.
Some people successfully negotiate this crisis, others learn to put it into a box on the shelf, while others continue to have long lasting effects.
In childhood this can also cause us to even mentally separate ourselves from our bodies, leading to repeating patterns during development.
Treatment still requires other people, but specific help needs to be tailored to individual person.