“When I use a word,” Humpty Dumpty said, in rather a scornful tone, “it means just what I choose it to mean—neither more nor less.”
Lewis Carroll
Stress is not a mental illness.
Until the 1950s the term ‘stress’ was rarely used to refer to psychological issues or pressures that could lead to mental illness.
In 1956 Hans Selye published “The Stress of Life” [1]. He set out to describe what medicine had demonstrated about stress. Outlining the background to illnesses caused by stress, Selye set out some applications and implications for day-to-day living. This book, probably above all others, set the agenda for thinking about psychological stresses.
Two decades previously Selye had produced a short article in the journal Nature in which he set out his theory of a ‘general adaptation syndrome’ [2]. Following experiments on rats, he concluded that when the animals were subjected to physical trauma or deprivation, a syndrome would develop through three stages.
In his view, this represented the usual response of an organism to stimuli such as temperature changes, drugs, injury, and muscular exercise.
The syndrome developed in stages which he termed ‘general alarm’, ‘resistance’ and ‘exhaustion’.
In the general alarm stage the organism is seen to react negatively to the stressor, in the second it develops a resistance to the external threat or demand and then, when the demands are extended, the organism falls into a state of exhaustion.
It seems the choice of the term ‘stress’ was based on a linguistic misunderstanding on Selye’s part and had he known the implications of the use of this word generally he probably would have opted for the term ‘strain’. The concept originated around the mid 1930s when Water Cannon was considering the nature of what he termed the ‘flight and flight’ response [3].
The engineering formula for stress (stress = force/area), can be helpful in thinking about the mechanical aspects of psychological stress. If we’re subjected to an excessive overload of demands for a long period of time then the pressure mounts and eventually something will give.
Think of a stiletto shoe: weight is put on the sole and the heel of the shoe; it’s the heel that penetrates grass.
Or cutting butter with a knife; you can’t do it with the flat of the knife.
After a period of extended pressure we may begin to experience headaches, muscle tension or pain, exhaustion, upset stomach, sleep problems, chest pain, and mood changes such as general anxiety, lack of motivation, irritability, anger, sadness or depression.
These can also be precipitated by a trauma that is experienced briefly, but is sufficiently shocking to put us off balance.
In part, because of the stigma associated with mental illness, it is far easier to say to someone that we feel ‘stressed’ and ‘under pressure’ rather than to say that we feel anxious, depressed, or that we have been at self-medicating excessively.
It is easier to use the convenient euphemism ‘stress’ as a blanket term for other stigmatising experiences that we would prefer not to articulate.
Today the term ‘stress’ is used in a number of ways.
An engineer will use the word to describe pressure or tension that is exerted on a material object when it is squeezed or pulled.
We use the word to refer to a particular emphasis or significance in something that we are describing.
When we talk about psychological stress, we generally mean a state of mental or emotional tension or strain resulting from adverse or very demanding circumstances.
The word ‘stress’ derived from the word ‘distress’.
The Latin word strictus means being drawn tight. The French word estresse implies narrowness or oppression.
These words are pretty good metaphors for the experience of anxiety and depression.
A doctor might write a sick note giving the reason for absence as ‘stress’, rather than ‘anxiety’ or ‘depression’, to help the patient present it to an employer. I’m using the term ‘stress’ in this conventional sense, but also recognising that it is a general cover-all term for a variety of common psychological illnesses …
(Next)
[1] Selye, H. (1956). The Stress of Life. New York, NY: McGraw-Hill.
[2] Selye, H. (1936). A Syndrome produced by Diverse Nocuous Agents. Nature, July 4, 32.
[3] Cannon, W. B. (1935). Stresses and Strains of Homeostasis. The American Journal of the Medical Sciences, 189, 13-14.
(This is an edited excerpt from my book A Lawyer’s Guide to Wellbeing and Managing Stress published by ARK Group in 2015.)
