Does smoking induce stress:
The relationship between tobacco and stress has long been an area for controversy. The paradox is, although adult smokers state smoking help them feel relaxed, at the same time they report feeling more stressed than nonsmokers. Research shows that nicotine dependency actually increases stress levels in smokers-adults and adolescence alike. Adolescent smokers report increasing levels of stress as they develop regular patterns of smoking. They gradually become less stressed over a time when they manage to quit smoking. Whatever may be the personal accounts of the smokers, clinical evidence reaffirms that smoking is associated with heightened stress.
The Research Results on Smoking and Stress
• Contrary to the belief that smoking is an aid for mood control; it actually heightens tension, irritability and depression, during nicotine depletion in body. This mood swing arises between smokes or during periods of nicotine abstinence. And dependent smokers need nicotine to remain feeling normal.
Studies reveal more than 80 per cent of adult smokers respond positively to statements such as "Smoking relaxes me when I am upset or nervous," and cigarette smoking was "relaxing" or "pleasurable." Interestingly, when nicotine abstinence is monitored in smokers they typically report a pattern of repetitive mood fluctuations, with normal moods during smoke inhalation followed by periods of increasing stress between cigarettes. These mood fluctuations also tend to be strongest in the most dependent smokers.
EFFECTS OF STRESS:
The effects of stress are numerous and can be both positive and negative.
First, the desirable results:
1. We need and enjoy a certain level of stimulation...a certain number of thrills. It would be boring if we had no stresses and challenges. Some people even make trouble for themselves to keep from getting bored.
2. Stress is a source of energy that can be directed towards useful purposes. How many of us would study or work hard if it were not for anxiety about the future?
3. Mild to moderate anxiety makes us more perceptive and more productive, e.g. get better grades or be more attentive to our loved ones.
4. By facing stresses and solving problems in the past, we have learned skills and are better prepared to handle future difficulties.
5. Anxiety is a useful warning sign of possible danger--an indication that we need to prepare to meet some demand and a motivation to develop coping skills.
The negative effects or consequences of stress are:
1. Several unpleasant emotional feelings are generated--tension feelings of inadequacy, depression, anger, dependency and others.
2. Preoccupation is with real or often exaggerated troubles--worries, concerns about physical health, obsessions, compulsions, jealousy, suspiciousness, fears, and phobias.
3. Most emotional disorders are related to stress; they either are caused by stress and/or cause it or both. Interpersonal problems can be a cause or an effect of stress--feeling pressured or trapped, irritability, fear of intimacy, sexual problems, feeling lonely, struggling for control, and others.
4. Feeling tired is common—i.e. stress saps our energy.
5. Many bad habits are the results of stress e.g. procrastination and much wasted time are attempts to handle anxiety. They may help relieve anxiety temporarily but we pay a high price in the long run.
6. Psychosomatic ailments result from stress--a wide variety of disorders are caused by psychological factors, maybe as much as 50% to 80% of all the complaints treated by physicians. Stress can cause headaches, irritable bowel syndrome, eating disorder, allergies, insomnia, backaches, frequent cold and fatigue to diseases such as hypertension, asthma, diabetes, heart ailments, migrane, and even cancer.
7. Stress/stresssful life events can precipitate a number of psychiatric disorders including conversion disorder, adjustment disorder, acute stress reaction, and post- traumatic stress disorder, generalized anxiety disorder, depression and somatization disorder.
8. A study has shown 96% of subjects reported dissociative ( conversion) symptoms in response to acute stress during U.S. Army survival training. Another study found that people experiencing acute stress disorder in response to a traumatic experience have stronger ability to experience dissociative phenomena than people who do not develop acute stress disorder.
9. High stress almost always interferes with one's performance (unless it is a very simple task). It causes inefficiency at school and on the job, poor decision-making, accidents, and even sexual problems. Anxiety and fear causes us to avoid many things we would otherwise enjoy and benefit from doing. People avoid taking hard classes, trying out for plays or the debate team, approaching others, trying for a promotion, etc. because they are afraid.
Optimum levels of stress
Experts tell us that stress, in moderate doses, is necessary in our life. Stress responses are one of our body's best defence systems against outer and inner dangers. In a risky situation (in case of accidents or a sudden attack on life), body releases stress hormones that instantly make us more alert and our senses become more focused. The body is also prepared to act with increased strength and speed in a pressure situation. It is supposed to keep us sharp and ready for action. Research suggests that stress can actually increase our performance. Instead of wilting under stress, one can use it as an impetus to achieve success. Under stress the brain is emotionally and biochemically stimulated to sharpen its performance.
The approach to optimising stress depends on the sort of stress being experienced. Strategies to deal with short term stresses focus on managing adrenaline to maximise performance. Short-term stresses may be difficult meetings, sporting or other performances, or confrontational situations. With long term stress, fatigue and high adrenaline levels over a long period can seriously reduce your performance
STRATEGIES FOR COPING WITH STRESS
There are three basic strategies for coping with stress (other than ignoring or denying your problems). These are:
1. The Band-Aid Approach: using alcohol, drugs (prescription or illegal), cigarettes, food, sex, or anything else to temporarily relieve the symptoms of "stress." While these coping strategies "work" in the short-run, they have harmful long-term effects, which make them undesirable.
2. The Stress Management Approach: using diet, exercise, meditation, biofeedback, behavioural techniques or other relaxation exercises to cope with your "stress." While these coping strategies have definite advantages over band-aid methods, they still focus mainly on just the symptoms of your problems.
Eat sensibly. A well balanced diet will improve your ability to respond to stress appropriately.
Sleep-make sure you get an adequate sleep each night.
Exercise-Aerobic exercise can reduce anxiety by up to 50 %.
Relax-Learn and practice relaxation techniques regularly.
Take time off---Go for a walk, listen to music, take a bath .you will feel better.
Prioritise-If you have multiple stress factors (deadlines, financial worries illness problems) concentrate on the ‘must ‘first and put ‘shoulds' to the back of your mind for the moment.
3. The Ideal Approach: making stress disappear, quickly and naturally, by modifying or correcting its underlying causes. While this is by far the best way to deal with problems in life, most people fail to use this approach because they incorrectly understand what causes their stress to occur.
In recent years, new insights about the causes of human stress have emerged. These new insights focus on the difference between obvious and non-obvious causes. Obvious causes of stress include the things that happen to us and around us--i.e. the things we easily see. Non-obvious causes include conversations and behaviour patterns that become triggered within our bodies. These include expectations, judgements, evaluations, needs for control, needs for approval, and many others.
The more you learn to recognise and deal with these non-obvious causes of your problems, the less stress, tension, and physical ailments you will likely experience.
Thus, methods of coping with stress are aplenty. The most significant or sensible way out is a change in lifestyle. Relaxation techniques such as physical exercises, listening to soothing music,deep breathing, various and alternative methods personal growth techniques, and massages are some of the most effective of the known non-invasive stress busters.
Cognitive-Behavioral Techniques
Cognitive-behavioral methods are the most effective ways to reduce stress. They include identifying sources of stress, restructuring priorities, changing one's response to stress, and finding methods for managing and reducing stress. This approach my be particularly helpful when the source of stress is chronic pain or other chronic diseases.
Identifying Sources of Stress. It is useful to start the process of stress reduction with a diary that keeps an informal inventory of daily events and activities. While this exercise might itself seem stress producing, it need not be done in painstaking detail. A few words accompanying a time and date will usually be enough to serve as reminders of significant events or activities.
- The first step is to note activities that put a strain on energy and time, trigger anger or anxiety, or precipitate a negative physical response (eg, a sour stomach or headache).
- Also note positive experiences, such as those that are mentally or physically refreshing or produce a sense of accomplishment.
- After a week or two, try to identify two or three events or activities that have been significantly upsetting or overwhelming.
Questioning the Sources of Stress. Individuals should then ask themselves the following questions:
- Do these stressful activities meet their own goals or someone else's?
- Have they taken on tasks that they can reasonably accomplish?
- Which tasks are in their control and which ones aren't?
Restructuring Priorities: Adding Stress Reducing Activities. The next step is to attempt to shift the balance from stress-producing to stress-reducing activities. Eliminating stress is rarely practical or feasible, but there are many ways to reduce its impact. One study indicated, in fact, that adding daily pleasant events has more positive effects on the immune system than reducing stressful or negative ones. In most cases, small daily decisions for improvement accumulate and reconstruct a stressed existence into a pleasant and productive one.
Discuss Feelings. The concept of communication and "letting your feelings out" has been so excessively promoted and parodied that it has nearly lost its value as good psychologic advice. Nevertheless, feelings of anger or frustration that are not expressed in an acceptable way may lead to hostility, a sense of helplessness, and depression.
The primary goal is to explain and assert one's needs to a trusted individual in as positive a way as possible. Direct communication may not even be necessary. Writing in a journal, writing a poem, or composing a letter that is never mailed may be sufficient.
Expressing one's feelings solves only half of the communication puzzle. Learning to listen, empathize, and respond to others with understanding is just as important for maintaining the strong relationships necessary for emotional fulfillment and reduced stress.
Keep Perspective and Look for the Positive. Reversing negative ideas and learning to focus on positive outcomes helps reduce tension and achieve goals. The following steps using an example of a person who is alarmed at the prospect of giving a speech may be useful:
- First, identify the worst possible outcomes (forgetting the speech, stumbling over words, humiliation, audience contempt).
- Rate the likelihood of these bad outcomes happening (probably very low or that speaker wouldn't have been selected in the first place).
- Envision a favorable result (a well-rounded, articulate presentation with rewarding applause).
- Develop a specific plan to achieve the positive outcome (preparing in front of a mirror, using a video camera or tape recorder, relaxation exercises).
- Try to recall previous situations that initially seemed negative but ended well.
Use Humor. Research has shown that humor is a very effective mechanism for coping with acute stress. Keeping a sense of humor during difficult situations is a common recommendation from stress management experts. Laughter not only releases the tension of pent-up feelings and helps keep perspective, but it appears to have actual physical effects that reduce stress hormone levels. It is not uncommon for people to recall laughing intensely even during tragic events, such as the death of a loved one, and to remember this laughter as helping them to endure the emotional pain
BIOFEEDBACK:
Biofeedback is a process increasingly used to combat stress. Biofeedback training teaches how to consciously change and control the body's vital functions that are normally unconscious, such as breathing, heart rate, and blood pressure, through information provided by electronic devices.
Biofeedback is a relatively new field. It was only during the late 1960's that scientists believed that these normally unconscious, autonomic functions could be voluntarily controlled. Barbara Brown, Ph.D., at the Veterans Administration Hospital in California, Elmer Green, Ph.D, and Alyce Green of the Menninger Foundation in Kansas first used EEG biofeedback to observe the various states of people practicing yoga. Another person who was instrumental in bringing biofeedback to the public attention is Joe Kamiya, who taught subjects how to attain states of euphoria without drugs.
Biofeedback is currently used by physicians, physiologists, kinesiologists, and psychologists.
How Biofeedback Works
Electrodes, which look like stickers with wires attached to them, are placed on the client's skin. The client is then instructed to use relaxation, meditation, or visualization to bring about the desired response, whether it is muscle relaxation, lowered heart rate, or lower temperature. The biofeedback device reports progress by a change in the speed of beeps or flashes, or pitch or quality of the tone. The results of biofeedback are measured in the following ways:
- skin temperature
- electrical conductivity of the skin, called the glavanic skin response
- muscle tension, with an electromyograph (EMG)
- heart rate, with an electrocardiograph (ECG)
- brain-wave activity, with an electroencephalograph{EEG)
Conditions Treated by Biofeedback
Biofeedback is particularly useful with can help with stress-related conditions where there is sympathetic or adrenal stress. It is also useful for conditions where there is inadequate control over muscle groups or muscle dysfunction. Conditions treated with biofeedback include:
- stress
- headaches
- asthma
- muscle injury
- pain relief
- insomnia
- TMJ
- high blood pressure
- digestive disorders
- attention deficit disorder
- incontinence
- poor posture
- tennis elbow
- golfer's elbow
- irritable bowel syndrome
- hyperactivity
- Raynaud's disease
- ringing of the ears
- constipation
- twitching of the eyelids
- esophageal dysfunction
POST TRAUMATIC STRESS DISORDER
Post-traumatic stress disorder (PTSD) identifies a specific emotional distress that can follow a major psychologically traumatic event. This uncommon event would typically produce fear and anxiety in anyone who experienced it. Examples are
- rape or assault
- a natural disaster
- being part of or observing a serious accident
- major surgery
-
wartime combat duty.
Symptoms may begin immediately or not surface for six months, a year, or even longer.
Severe anxiety and panic may be only two of several symptoms. The person will have recurring images of the traumatic event, often with the same degree of anxiety as during the event itself. Or, he will suddenly feel as though the event is occurring in the present. Recurring nightmares of the trauma are dramatic and disturbing. Nightmares, anxiety, or depression can disturb sleep. The person may remain tense and anxious throughout the day, and may startle easily. As they become more mentally involved with these experiences, the traumatized individuals begin to withdraw from the world, show less emotion, and become disinterested in people and activities that were once important. They avoid any situations that might stimulate memories of the traumatic event. Guilt, depression, and sudden outbursts of aggressive behavior may also surface. Drug and alcohol abuse develop in some as they attempt to manage these responses.
Treatment of PTSD
Fortunately PTSD can be effectively treated. Behavior therapy may play a useful role by helping modify the way a patient acts and reducing avoidance behavior. Behavior therapy is often combined with cognitive therapy, which is intended to change underlying thought patterns. These approaches may be used in a group or in an individual setting. Family therapy can help close relatives understand and cope with the illness. Through such counseling, family members can learn that any apparent rejection by a relative with PTSD is the result of the disorder. Family counseling can repair communications and help restore normal interaction. Support groups of individuals who experience PTSD can show victims that their reactions to trauma are shared by many. By discussing common experiences and emotions, groups of survivors can help each other rebuild confidence. Medication can be a valuable complement to other treatment by relieving many of the most debilitating symptoms, and enabling other therapy to go forward. The use of medication may be required only for a few weeks, but in severe cases it may be needed for several years.
Self-Help
A self-help program for PTSD, primarily because of the complexity of the disorder. If you or someone you love is suffering from these symptoms, it is encouraged that you seek help from a mental health professional who specializes in PTSD.
An example - Vietnam Veteran
The largest subgroup to experience this problem is the combat veteran. In the United States, the Vietnam War has produced the largest percentage of PTSD cases. In fact, it was after studies of Vietnam veterans were added to studies of civilian post-trauma sufferers that the American Psychiatric Association created, in 1980, the diagnostic category: post-traumatic stress disorder (acute, chronic, and/or delayed).
The major task in overcoming this problem is to incorporate the traumatic event into a person's sense of the world and into his understanding of his personal life. It is possible that the nightmares and spontaneous reliving of the trauma are unconscious attempts to heal the psychic wounds.
The singular experience of Vietnam combat veterans illustrates how traumatic changes can be difficult for the mind to incorporate and how this "working through" process is essential. The Vietnam War was like no other in American history. The average age of the combat soldier was nineteen, not twenty-six as in World War II. The military flew soldiers into duty as individuals, not as teams. Once there, nothing seemed straightforward. Those already fighting did not readily accept arriving soldiers. The enemy was not easily identifiable or necessarily in uniform; women and children could kill you in the streets. Women and children civilians were therefore sometimes killed by U.S. soldiers. There was no "front line," and soldiers had to win the same territory over and over again. Leadership was young and inexperienced. The object was to kill as many people as possible and survive.
The coming home process of the Vietnam soldier failed to account for the mind's need to assimilate this experience in a slow-paced manner. After twelve to thirteen months of combat duty, the military flew soldiers back to the States in a matter of hours and, again, as isolated individuals rather than as teams. In forty-eight hours the Vietnam combat soldier could go from a unit assault in which he killed four North Vietnamese soldiers with an M-16 to sitting on the front steps of his parents' house in the U.S.
It is no wonder that some Vietnam veterans have continued to experience chronic post-traumatic stress disorder, since the primary cause of the disorder is an inability to assimilate the experience into current life. A combat veteran needs time and the support and understanding of other people to assimilate a trauma of this significance. The person with post-traumatic stress disorder must have an opportunity to talk about the traumatic experience and, eventually, to feel the emotions associated with it. As he works through these feelings, he can begin to connect the trauma with the rest of his life.
PIA SETHI
8th March, 2004
