At the present time there are many books, essays, monographs and academic notes circulating, aimed at describing and interpreting the nature of stress, as a starting point to offer possible therapeutic solutions.
In general, it is usually presented as a form of defense of the organism in specific situations of tension or external conditions that disturb the psychic or emotional balance of the individual; or your physical well-being.
However, it is almost always clarified that - if this condition persists in time - what was in principle good (the protective reaction of the organism against danger, urgency, fear or anxiety), it may well become a harmful pathology for the person considered globally; and difficult to predict in terms of the depth of its psychological or somatic consequences.
According to this, while in the first case it would seem that a momentary picture of stress would have a certain benevolent character, since it enables the healthy activation of several opportune mechanisms that prepare the person for action (such as those of the sympathetic nervous system1, which determines a fight or flight behavior, according to the extent of the danger); or the secretion of substances that are then essential for survival, such as adrenaline (a hormone and neurotransmitter also known as epinephrine); in the second, if the situation is not satisfactorily solved, it could generate prolonged or permanent pathological symptoms, although usually easily diagnosed by medicine.
Among them, by way of illustration, may be hypertension, gastritis or stomach ulcers, physical and intellectual exhaustion, sleep disturbance, kidney and liver function difficulties, abnormal visual capacity, decreased libido (or sexual desire) , male impotence or female frigidity, etc.
In this line is framed, for example, the work of the Austro-Hungarian Hans Hugo Bruno Selye (1907-1982) 2, in which he addressed the complex world involved in the phenomenon of anxiety, and reached conclusions similar to those mentioned.
That is to say, stress, which is good (Eustrés3) and healthy because it expresses the capacity of the organism to react to adverse situations, can turn into something harmful if it is prolonged over time.
Currently, this second type of stress (the one that harms the health), is often called distés4.
It is obvious that this raises several questions.
To begin with, would there then be two types of stress, a good and healthy one, which manifests sufficient conditions of the organism to face difficult and aggressive situations for its balance and correct them as soon as possible, thus eliminating the respective symptoms; and another bad and pernicious, which lasts over time, which exceeds the natural capacity of the body to counteract it, so that the symptoms do not disappear in the short term and -even- can last for much of the person's life?
On this, taking into account the usual way in which the concept of cultural, social and professional stress is understood, it must be said that the distinction between a positive (eustress) and a detrimental (distress) stress is, at least, useless. that most people, even those who hold a profession related to the diagnosis or treatment of it, identify in practice, without further ado, the term 'stress' only with its aspect that is harmful to health5.
But in addition, another question deserves to be answered. If it is already common (as it is) to relate an important situation of stress with the appearance of specific symptoms, for example hypertension6, how far the mere disappearance of such signs harmful to the health of the affected person can be considered as a sufficiently accurate indicator , that allows to affirm that someone has overcome with relative success the instance of a stress scenario?
The question is not idle. An eventual therapy for the management of stress has as its main task that stress situations, external or internal, are minimized as much as possible in terms of their stressful impact on the individual; as well as train him for similar events in the future. The eventual disappearance of symptoms is a consequence, undoubtedly, very desired and expected.
However, we can not ignore the fact that some stress tables can cause such damage in the psycho-affective sphere and the affected person's immune system that, even when the stressors disappear, the damage persists and must necessarily be treated by the clinical professional. competent.
This would be, normal, appropriate and unavoidable.
But also what happens when the stress results in some of the so-called 'asymptomatic'7 conditions? as some types of depression8, arterial hypertension9, or primary glaucoma10 (at least in its initial stages), to name a few.
Here the subject becomes a bit more delicate. The person, not noticing any important symptom, in his privacy finds no reason to appeal to the clinician and, even less, hardly even suspect the possibility of suffering from a significant stress.
On the other hand, a doctor who attends hundreds of patients every year is usually limited to evaluating and weighing the symptoms of the convalescent, indicating the relevant laboratory practices if necessary, analyzing the results and proceeding according to the diagnosis reached. The 'stress' factor is usually not considered, except in some cases.
This explains, in part, the important development that during the last decades have achieved some disciplines that relate the psychological and emotional well-being of people with physical health.
For the 'Psychology of Health', a branch of applied psychology, for example, physical illness has ceased to be only physical, even when it involves chronic and important pathologies, such as cancer or cardiovascular diseases.
It starts from the premise that at the origin of a bodily affection, in its evolution and in its resolution, many other factors intervene, such as emotions, thoughts, quality of life, relationship with family members, satisfactory or insufficient interaction social, etc. In this context, stress plays a decisive role.
In an interesting article, the psychologist Libertad Martín Alfonso11, published in the Cuban Journal of Public Health, synthesizes the essential aspects of Health Psychology, which deserves its literal transcription: "Health Psychology is the product of a new form of health thinking, which considers the psychosocial dimension in the health-disease process at the conceptual, methodological and organizational levels of the services for the population. It has been a natural result of the limitations of the biomedical model, of the failure of health systems with a restrictive and decontextualizing conception of health and of the possibility that is increasingly open to understanding how social and personal variables mediate this process " .
In this way, it seems that it is appropriate to redefine the concept and the nature of the phenomenon that (scientifically, socially and culturally) is called 'stress'.
In this context, it is necessary to say that a stress picture must be understood as a harmful and prolonged existential reality over time, which occurs despite the powerful natural conditions of the organism to face difficult and aggressive situations for the integral balance of the person; and -eventually- correct them as soon as possible.
In other words, and with a certain discrepancy of the traditional doctrine, there is -in fact- a good and a bad stress. Stress is always pernicious, devastating and extremely dangerous.
It entails the possibility (as already discussed and will be seen later) of causing serious physical and mental disorders; It can even reach the point of inducing or encouraging the end of life of the affected person in extreme cases12.
Furthermore, given the ambiguity of its symptoms, it can often confuse the clinical specialist in the diagnosis, leaving the patient without the possibility of accessing any appropriate form of therapy.
If one wishes to express the real nature of stress, it should be said that, strictly speaking, what happens in a stressed person is nothing more than the manifestation of the severe qualitative limitations of the body's defense systems in different situations and combined stress. , those who are overwhelmed and exhausted in their healthy potencies, so that they can no longer avoid the production and combination of harmful phenomena for the psyche and the body.
"Stress, from this perspective, is not the result of a mere point disorder limited to a specific situation of tension, but actually involves a pathological stage persistent and cumulative over time in terms of their effects, whether or not they correspond to a perceptible symptomatology ."
(1) The hypothalamus, a small gland located at the base of the brain, controls various vital functions of the body and receives nerve impulses that imply a warning signal. From there, this gland acts basically in two directions. On the one hand, using the sympathetic nervous system, which - after receiving the order of the hypothalamus - communicates the alarm message through nerve channels to various muscles and to the inner medulla of the adrenal gland; and second, it intervenes through the bloodstream to reach the cortical system of the adrenal glands.
(2) Nationalized Canadian, physiologist and doctor, considered as 'the father of stress' as a result of one of his books entitled precisely like this: Stress (1935). He was director of the Institute of Medicine and Experimental Surgery of the University of Montreal, and the first to apply the word "stress" to psychology, defining it as "the syndrome of adaptation."
(3) In recent times the consensus has been reached that eustress is the same stress as always but in its positive dimension, since it favors the emotional and organic balance of the person.
(4) This term refers to the psychological, emotional, and physical problems that arise when an individual is subjected to situations of stress that are too acute and prolonged over time. In this case, the natural physiological and psychological defensive systems of the organism are no longer sufficient for the person to recover their equilibrium situation, so it becomes necessary to remedy the exhaustion by means, even if it is not a mini-therapy, that includes the rest of the affected, some consecutive days of tranquility, and the use of some concrete means to cause the recovery of the lost energy.
(5) To cite only a few examples, the Stress Test, by Dr. Luis de Rivera, of the Psychotherapy and Psychosomatics Research Institute of Madrid, can be examined; or the survey of the American Psychological Association, which shows that stress in adolescents is similar to that of adults; or the joint indications on work stress, developed by the International Labor Organization and the World Health Organization.
(6) Blood pressure is the force exerted by the blood against the inner walls of the arteries, and reaches its highest level (systolic pressure) when the heart beats; both when it pumps the blood low in oxygen to the lungs in order to oxygenate it, and when it propels it towards the aorta, to oxygenate the tissues of the whole body; whereas when the heart is at rest (between one heartbeat and another) blood pressure decreases (diastolic pressure). To measure blood pressure these two values are taken into account, and 'Systolic pressure / diastolic pressure' is usually recorded. For example, 120/80.
(7) An asymptomatic condition is one that, without presenting any symptoms, silently and negatively affects the psyche or the body of a person; or when a disease can only be detected from a study, even when the individual does not feel anything strange.
(8) Indeed, there is a form of asymptomatic depression that can be triggered by a very large range of factors. One of the main ones is stress, and it consists in that the affected person maintains a cheerful, relaxed attitude, without leaving room for doubt (judging by the mere observation of his behavior after a stressful incident) that he feels well, and without greater difficulty to speak fluently of anything harmful that has happened to him. Moreover, it feels good despite all the bad things that can happen in the world (epidemics, disastrous climatic phenomena, etc.). This condition comes from an increasingly noxious strain of depression, which is very difficult to spot. Its scientific name is 'poena occultus' (hidden pain), and it constitutes a serious and lasting mental illness over time.
(9) Depending on the case, arterial hypertension may behave as an asymptomatic condition for months or years without causing any discomfort (such as headaches, fatigue, tinnitus or ringing in the ears, blurred vision, etc.), notwithstanding that , progressively, can cause significant damage, such as coronary heart disease, stroke or kidney failure, to mention.
But beyond the common causes that provoke it (certain excess in the consumption of sodium or alcohol, tobacco, obesity, apnea during sleep, the increase - usually due to age - of the number of collagen fibers in the arterial walls that returns more rigid to the blood vessels), the truth is that there are epidemiological evidences that relate to stress not only with acute attacks of hypertension and with chronic arterial hypertension, but also with the obtaining of negative results at the time of treatment.
(10) Primary-type glaucoma is an eye condition that evolves very slowly, with no symptoms in the early stages, except for an imperceptible but continuous dimensioning of vision over time. One of the main factors that influence its appearance is intraocular pressure, which in turn often occurs and continues after a stressful situation.
(11) Libertad Martín Alfonso holds a Master's degree in Health Psychology and is a professor at the National School of Public Health of Cuba. The article in question was published in 2003.
(12) See, for example, the document 'Prevention of Suicide', prepared by the Department of Mental Health and Substance Abuse of the World Health Organization, published in 2006.
