The immune system vs. stress.

• Author: DeVito, Paul L.

Psychological distress can suppress the body's defenses to the point of inducing physical illness.

A college student suffers from a strep throat infection while studying for final exams. A corporate executive loses her voice prior to an important presentation to stockholders. A high school senior wakes up with a horrible headache on the morning of the prom. Both parents come down with the flu. after several sleepless nights with their sick child. Virtually everyone has experienced similar reactions.

Who hasn't pondered why illness strikes precisely when it can be afforded least? Often, people wonder if these maladies are real or just "psychological." Consider the following: Johnny may be faking sickness to avoid an exam. Is Melissa unconsciously postponing a date with a popular football star through her asthma attacks because she's scared to death? Is David's drinking prior to a sexual experience with his wife due to uncertainty about his performance - or guilt about an office affair? These situations are complex and require analysis in order to determine the physical and emotional sources. The diagnosis is not always simple and straightforward.

For centuries, physicians, philosophers, and psychologists have noted the apparent relationship among stress, illness, and health. Recently, medical scientists firmly have established causal relationships between them and have shown how our minds and emotions can influence the course of a disease.

Some historians have traced the word "stress" to the Latin words strictus (tight or narrow) and stingere (to tighten). Until the 19th century, stress referred more to external forces on physical objects than to internal psychological states; for instance, the stress of extreme weight on a bridge platform, rather than the stress of balancing family and professional pressures. Contemporary use of the term can be traced to 20th-century physiological psychologist Walter Cannon and Canadian physician Hans Seyle. Cannon defined the classic "fight-or-flight" reaction: When faced with stress, the body prepares for the emergency through the sympathetic portion of the autonomic nervous system. Adrenalin, a hormone, is released into the bloodstream through the adrenal glands and generates the energy to cope with the stressors, not unlike an army ready to defend its territory against an invader.

Cannon maintained that this hormonal reaction was a remnant of humans' ancient past, when most stressors could be handled only through radical and robust actions. In order to survive, our ancestors fought prey and fled from predators. Such intense reactions are not required in modem society; in fact, this kind of response potentially could be harmful to one's health and well-being. Consider how inefficient it would be to rely on "fight-or-flight" in order to pay bills, change a flat tire during rush hour, or ask a supervisor for a raise. Burnout may be the result of such overreactions to stress.

Seyle studied stress by identifying those situations in which it occurs. A stressor is an event that places inordinate demands on the body and, in turn, sets off natural adaptive bodily defenses to cope with it. The process that he labeled the General Adaptation Syndrome includes three stages: the alarm reaction, resistance, and exhaustion.

During the alarm reaction, there are increases in hormone levels, strong physical arousal, and severe emotional upheavals. When the alarm reaction is not sufficient to cope, the stressor maintains its attack. Enter resistance. During this stage, when successful, the stressor is tamed and normality returns. If coping is not successful, however, hormonal reserves become depleted, fatigue sets in, and the stage of exhaustion takes over, during which adaptation to the stressor breaks down completely. Depression and anxiety are common. Serious illness, even death, becomes likely.

Illnesses associated with stress once were known as psychosomatic...