Stress: Are we coping?

This content mentions anxiety, depression and trauma, which some people may find triggering.

Mental Health Awareness Week is a time to ask big questions. Here is a BIG question that keeps me awake at night: what is the single greatest thing we could do to prevent mental health problems?

Many of you reading this will have gone through periods of mental ill-health or walked through it with the person you love most. I know I have. And that's why there is an urgency to find answers. I think this generation has a window of opportunity to call for change and to discover a new way forward.

As a species, we've been around for 200,000 years. For most of that time, mental health has not been on our radar. Too busy surviving. But we are starting to understand that mental health is essential to make life worth surviving.

What is stress?

Stress is not a mental health problem itself. The stress response is a survival strategy to keep us safe. It was a vital adaption when looking to survive being eaten on the savannah.

Humans won the evolutionary game of thrones because when we sensed threat or danger, our amygdala (the part of our brain controlling emotions like fear and anxiety) switched on like a light. When that happens, the brain shuts down any unnecessary functions and hormones, like cortisol, and floods the blood with glucose, giving a power surge to the body’s muscles to respond in two ways: flight or fight.

The social scientist Michael Marmot describes stress as what happens when we can't control what is happening to us. And today, our brain cannot distinguish between a lion’s menacing presence and the affront of a rude person who pushes past you in the queue. The physiological response is the same. Many of us are triggering our stress response repeatedly every day – day in, day out.

It leads to what the experts call the allostatic overload. Instead of out-witting the lion and then retreating to a nearby cave, repeated stressful events is like being chased all day by a lion on repeat. Sound like one of your days? It turns out that this is very bad for us. It makes us sick.

What does stress do to us?

Researchers at the Yale Stress Center found that when stress becomes a way of life - rushing from pillar to post (reading emails as you fly past) - the prefrontal cortex part of our brain begins to shut down and even reduces in size. The prefrontal cortex is the most recently evolved part of our brains – it regulates our amygdala, blood pressure and heart beat but also enables us to learn, plan, concentrate and make judgements.

Chronic stress increases our risk of addictive and destructive behaviour, of developing anxiety, depression and other mental health problems. It can also increase risks of physical health problems including heart disease, insomnia, muscle pain and damages our immune system...the list goes on. Stress has also been linked to cancer, both through increasing inflammation in the body which can aid in the spread of cancer, and through greater risk of central obesity. Interestingly, it is our perception of stress in our lives added to actual stressful event that predicts its impact on us.

We also know that exposure to trauma will produce long-term effects. A summary of the available evidence by Professor Mark Edwards in Mental Elf recently found that the stress of emotional neglect is a causal factor behind the development of a condition called functional neurological disorder. In other words, if you can prevent the stressful event, you can prevent the onset of ill-health.

In one of life's bitter ironies, our stress response - which has done so much to keep us alive - now threatens to drastically reduce the quality of our lives.

What is equally alarming is that stress does not fall equally among us. Marmot's famous study of the health of the UK civil service found that health outcomes improved at every level as you went up the hierarchy. Status Syndrome debunks the myth that it is tough at the top.

Marmot demonstrates that power and resources protect you from stress and its impact. The lower your place on the social hierarchy, the more vulnerable you are to the impact of stress. In fact, you can plot a person’s life expectancy by using the postcode of where somewhere lives. Talk about a postcode lottery.

Final thought

21st-century life holds many opportunities for us. Life will always have its challenges and no-one wants to go back to living in caves. But unless we step back and find alternative approaches to a life of repeated stressful events, we can’t expect the tide of poor mental health to turn.

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