Stress-Related Diseases

Dr Swami Karmananda Saraswati, MB, BS (Syd.)

Today there is an epidemic of stress-related disease in the technologically advanced countries, and the developing countries are inheriting the same problems as they adopt the faster western lifestyle. Hypertension, coronary atherosclerosis and cancer are by far the biggest killers in western societies, and each is known to be causally related to stressful living. Add to these the myriad other stress disorders: asthma, allergic phenomena, peptic ulceration, ulcerative colitis, thyrotoxicosis and thyroid deficiency, obesity, diabetes, arthritis, mental illnesses and many more, and you begin to see the dimensions of the stress problem we are facing today.

In dealing with this epidemic, the doctors of the world are adopting a new systematic approach to the classification, diagnosis and treatment of stress-induced illnesses in their patients. Doctors now realize that the major diseases which they encounter every day are the end result of poor adaption to stress.

Stress disorders are now recognized as a continuum spanning a number of years. In a recent study, Dr K. N. Udupa of the Institute of Medical Sciences, Banaras Hindu University, Varanasi, India has proposed the following classification of stress disorders.^*1

Psychic phase
Here the individual develops psychological changes resulting from excessive psychic trauma. As a result the central nervous system becomes overactive. He becomes irritable and hyperactive and may develop mild tremors. His sleep patterns are disturbed and he becomes increasingly anxious. He looks worried and may dwell on impending disasters. The state can be objectively measured by estimating levels of the neurotransmitter acetylcholine in the blood, which are usually remarkably elevated. This phase can extend from a few days to a few months, depending on the type and severity of stress phenomena, and on the type of body constitution and personality.
Psychosomatic phase
Here certain physical manifestations become evident such as palpitations, tremor, raised blood pressure and rapid pulse.
Somatic phase
Here there is an increased function of the target organs. The stress disease usually settles upon a particular organ, depending on a person's hereditary background and environmental factors. One individual will develop a hyperthyroid state, another an elevated heart rate and high blood pressure, another hypercholrhydria or elevated acid level in the stomach, and so on. This phase can be objectively measured by recording elevated levels of catctcholamines (adrenalin and noradrenalin) in the blood.
Organic phase
Here disease fully settles down into a particular organ. The earlier psychosomatic and somatic excessive functions settle down and chronic inflammation and organ destruction begins. The individual develops the signs and symptoms of coronary insufficiency, thyrotoxicosis, bronchial asthma, peptic ulceration or some other clinical condition. There is plasma cell and lymphocyte infiltration in the target organ and tissue destruction. Fibrosis progressively impedes the function and destroys the organ. The end result is that disease states such as diabetes mellitus, myxoedema (chronic thyroid insufficiency), emphysema and cardiac insufficiency develop.

These diseases are well known clinical entities and medical and/or surgical treatment is indicated. However, the background of stress is often overlooked, whereas with awareness of the disease continuum from phase 1 through 4, earlier therapy can arrest the disease at a less serious stage. In this light, greater emphasis is now being placed on preventive and community health as a way of confronting the stress problem before it manifests in irreversible disease states. Doctors are taking the lead in this direction, for they have both the respect of the community and the best knowledge of the overall dimensions of the stress problem in our lives. Doctors are responsible for the health care of the community in the widest sense, and with them rests the responsibility of leading the community back towards a more healthy lifestyle and of providing more effective methods of coping with stress.

Dr Udupa has found yoga therapy, programs of asanas and pranayamas combined with relaxation in shavasana or yoga nidra, to be most effective in treating psychic, psychosomatic and somatic phases of stress disorders. When these techniques are combined with competent psychotherapy (using tranquillizing drugs on a short term basis in extreme exacerbations of stress symptoms), most disease processes can be arrested in the earlier phases before the irreversible organic phase begins. This is an infinitely preferable course of action to the necessary medical or surgical intervention which alleviates symptoms once the organic phase is manifest. Even in these cases it is noted that psychotherapy and yoga therapy produce marked subjective improvement in the patient's condition.

Many doctors are becoming familiar with yoga. But if the stress epidemic is to be arrested, more doctors must know how to utilize yoga in their medical practices. They have a duty to their patients who look to them for guidance and help with their difficulties and problems. The long term use of tranquillizing and psychoactive drugs does not get to the root of the problem, but yoga does. With instruction in the correct yoga practices during the early phase of illness, both doctor and patient can come to terms with the harmful effects of stress, paving the way for a happier, more fulfilled life while nipping a major stress illness in the bud.

References

*1. K. N. Udupa, "Pathogenesis and Management of Stress Disorders", Quarterly Journal of Surgical Sciences, Banaras Hindu University, Vol. 13, no. 2, June 1977.