Stress, the Individual, Wellbeing, Performance & the Workplace Part 2
The effects of sustained, long-term "Stress"
As a brief recap of the first article “Stress, the Individual, Wellbeing, Performance and the Workplace (Part One)" the author covered:-
- The physiological and psychological changes that occur as part of the Human “Fight, Flight and Freeze” stress response.
- Discussed what a “stressors” is and how “perception” of stress plays a huge part in the human stress response.
- How the stress response instantaneously affects a wide variety of the systems throughout the body, both short and possibly longer term via the release of hormones.
- That one can divide the Central Nervous System into smaller parts or sub-systems.
- How the “Sympathetic Nervous System (SNS)” is constantly running at a base-level, even while the “Parasympathetic Nervous System (PSNS)” is operating.
- The Sympathetic Nervous System (SNS) is associated with the “Fight, Flight or Freeze” stress response.
- That the Parasympathetic Nervous System (PSNS) is associated with “Rest, Digest and or Feed and Breed” bodily functions.
- How the Sympathetic Nervous System (SNS) inhibits the functions of the Parasympathetic Nervous System (PSNS), during the “fight, flight or freeze” stress response.
Stress is not all bad and can be good
Stress is not all bad, and it can be extremely positive and even performance enhancing. The human body is extremely good at adapting (see adaption article), be it to physiological or psychological loads. It would be fair to say that the principles relating to tissue adaption equally apply to “stress” and the ability for one to adapt. The “Basic Running Injury Preventive Measures” article goes into tissue adaption in more detail and covers Wolff’s Law (bone adaption) and Davis’s Law (soft tissue adaption). In essence, if one had little to no stress, then one is likely to be either inactive or laid back, as there is no motivation to do anything. However, that said one's personality is another influencing factor. If one has some degree of stress or an optimum stress level, then one is more likely to have drive and focus, up to the point of fatigue. Performance, also improves with an optimum level of stress, before starting to decline after the fatigue point. If one were to go beyond fatigue inducing levels of stress and have too much stress, then one can rapidly become exhausted. Too much stress and exhaustion are not sustainable and frequently lead to physical and psychological burn-out, which can include a complete breakdown, anger, anxiety or panic type behaviours. As with tissue adaption, one can view stress as a load/loading. The body needs time to adapt to a load and this depends on a number of variables or factors such as; genetics, general health, fitness, diet, perception of given stressors, number and types of stressors involved, level of stress induced by stressor, duration of dealing with stressor, coping mechanisms and more.
Besides the psychological aspects of dealing with prolonged stress, there are many physiological aspects, which can play a part in chronic pain. Furthermore, the mental side will affect the physical and vice versa over time, and the body even becomes less capable of dealing with or managing the stressors overall. The Parasympathetic Nervous System (PSNS) plays a crucial part in the day-to-day maintenance of a wide variety of bodily functions. The “fight, flight and freeze” response, effectively turns off the Parasympathetic Nervous System (PSNS) as there is a perceived threat to life. Each time there is a perceived threat to life (a stressor), the Sympathetic Nervous System (SNS) will activate, taking priority over everything else and using a sizeable quantity of resources. However, the body cannot entirely replace the used resources, as the inhibition of the Parasympathetic Nervous System (PSNS) negatively impacts the body’s ability to digest and absorb nutrients from foods. Stress hormones and the effect on the PSNS often results in highly stressed people suffering from stomach or bowel problems, though there are many other causes. All bodily functions require and utilise various resources such as nutrients (vitamins, minerals and energy) to function and for maintenance/repair purposes. The continual stress cycle prevents tissues, which enable functions to operate correctly from being maintained. In essence, the demands on the body are the same or increased and yet there is a lack of resources and degraded equipment to meet those demands. It is purely a matter of time before something breaks, physically, physiological or both.
There are many signs of “Stress”
There are multiple well-known signs of “Stress”, and these very signs can lead to many issues that can be found in the workplace and indeed longer-term individual health.
The following is just a short list possible stress related symptoms (there are many more signs):-
- Becoming withdrawn / less social
- Changes in Eating Habits (types of foods, quantities)
- Chest pain (get it checked to be safe).
- Easily getting sick (colds, flu etc.)
- Emotional changes (Irritability, Anger, Feeling Tearful, Panic)
- Loss of Libido
- Muscle Tension (including grinding teeth or clenching fists)
- Racing thoughts
- Trouble sleeping (insomnia)
- Unable to concentrate
Effects of stress on the Employee and Employers
Both individuals/employees and corporates/employers should have a vested interest in the management of “stress” and health and wellbeing in general. The individual should be concerned for reasons of self-preservation, general health, life and wellbeing. There are also compelling Morale, Legal and Financial reasons, as to why Corporates should be interested in "stress" within the workplace. The financial point of view relates to the associated benefits of having a happy and healthy workforce, which includes productivity benefits.
Studies have shown that negative employee wellbeing has undesirable consequences, which have human, financial and social implications and include:-
- Reduced productivity.
- Increased sickness and absenteeism.
- Increased mistakes and errors.
- Increased labour turnover.
- Increased disciplinary and grievance incidents.
- Lower quality of customer service.
- Lower morale and a more negative company atmosphere.
- Increased internal conflicts.
- Unhappy workers tend to be less healthy in general.
When one looks at the specific long-term effects of excessive and prolonged “stress”, it is fairly easy to see why studies have identified the above findings. As previously, mentioned the human stress response results in a rapid release of hormones. These hormones affect a wide variety of the body's systems and longer term the routine maintenance and repair of said systems. Many conditions have links to high levels of long-term “stress” and the associated increased levels of “stress” related hormones (Adrenaline, Cortisol and Epinephrine).
Cardiovascular System: (Heart Disease, Hypertension, Stroke)
Blood pressure increases as per the “fight, flight, freeze” response and this puts additional load on all aspects of the cardiovascular system. The respiratory system and associated musculoskeletal system also have to work harder due to the increased cardiovascular demand.
Endocrine System: (Type II Diabetes)
Blood sugar levels increase as cortisol acts on the liver via gluconeogenesis, which enables protein stores to release glucose. The body carefully monitors blood glucose levels and releases insulin as and when needed. However, tissues within the body can in effect become immune to the impact of insulin over a prolonged period and due to constant high blood glucose levels. Furthermore, the production of insulin requires resources, which may be in shorter supply in a long-term stress response situation.
Gastrointestinal System: (Eating habits, Diarrhoea, Constipation, Nausea, Stomach ache, Acid Reflux, Heartburn)
Stress can make people more or less hungry and crave certain foods or drinks. Furthermore, the speed at which food can pass through the body can change and be faster or slower. Increases, in certain types or quantities of food or drink, can result in changes to the balance of the Microbiome or Microbiota (bacteria fungi, archaea, bacteria, viruses) within the gut.
Immune System: (weakened immune system)
The “stress” response has a suppressing effect on the immune system, making one more susceptible to infection and disease.
Integumentary system: (Skin, Hair and Nails)
Hormones released during prolonged stress can cause excessive levels of sebum production. Sebum plays a significant roll in our skin's immunity, and too much can make our hair and skin greasy. Equally, sebum is relevant to ear wax production. Too much sebum can result in the shedding of hair, skin irritations and overproduction of ear wax. Nails can also be affected by prolonged stress.
Musculoskeletal System: (General Muscle Tension, Tension Headaches, (some) Migraines, Musculoskeletal pain)
As part of the “stress response,” muscles become tenser (armoured) and ready for action. Over time, such tension can become chronic and produce pain, restrict movement and affect other joints, structures and functions within the body.
Nervous System: (Autonomic (ANS), Sympathetic (SNS) and Parasympathetic (PSNS)
Prolonged stimulation of the “stress” response, prevents other aspects of the Central Nervous System (CNS), its division and other systems from being maintained and repaired properly. The “Fight, Flight or Freeze” response can also have an impact on sleep and lead to Insomnia. Sleep is a crucial part of the body's daily repair processes and associated with memory formation.
Reproductive System: (Infertility problems, Low libido, Erectile dysfunction, Missed periods)
Hormones and hormone levels are a vital aspect of the reproductive system and can also have a substantial impact on emotional health and mood. The “stress” hormones can have profound effects on both the male hormone Testosterone and the female hormones Oestrogen and Progesterone. Some studies have even shown that these hormones can negatively impact cognitive abilities.
Respiratory System: (Shortness of Breath)
The shortness of breath over time is likely to be due to the constant initiation of the respiratory muscles, which can become hypertonic (shortened) and therefore less functional. The cardiovascular, respiratory and musculoskeletal system are all linked, and a change in demand in one will have a direct effect on the other systems.
Mental, Emotional, Social: (Depression, Anxiety, Panic Attacks, Anger, Breakdown, the formation of Memories)
There are many Psychological related conditions which have links to prolonged and high levels of “stress”. Evidence would suggest that there are various and not fully understood relationships between the “stress” response to hormones and the effect of said hormones on other hormones and bodily systems. The hormones; Testosterone, Estrogen, Progesterone, Serotonin, Dopamine are negatively affected by excessive stress levels. These hormones have a significant effect on aspects of social, emotional and mental health, and yet will equally impact other aspects of health too. High levels of long-term stress have been shown to lead to Depression, Anxiety, Panic Attacks, Anger, Breakdown, Memory formation, concentration and Schizophrenia.
Health is multifaceted and "we" are not machines.
The majority of the potential consequences/conditions associated with long-term stress, are also “stressors” themselves and can easily compound the effects of “stress” for the individual and those around the individual. Furthermore, there are multiple areas of health, and again each area can affect the next, be it, Physical, Mental, Environmental, Emotional, Social, Spiritual.
In many, respects there are similarities between long-term and prolonged stress and running any piece of machinery at absolute maximum capacity, with no breaks and little to no maintenance or repair. Inevitably, operating any piece machinery in such a manner is likely to cause a catastrophic and expensive failure at some point. However, most people would not operate equipment in such a reckless manner and yet treat their bodies entirely differently. Usually, one would look to maximise the life and productivity of such a piece of machinery and thus return on investment, through a combination of risk management strategies, operations management and planned maintenance. One can apply similar principles to employees and Elite military, and top-level sports teams from around the world have been implementing such ideas in the form of “human performance” to their people most effectively for several years.
Stress In Summary
In summary, “stress” is not all bad and there is a lot that can be done to combat “stress”, even when the levels have become chronic. The third and final part of this article “Stress, the Individual, Wellbeing, Performance and the Workplace (Part Three)”, will look in more detail at techniques that one can employ to help reduce stress and or build resilience.
The article was written by Terry Davis MChiro, BSc (Hons), Adv. Dip. Rem. Massag., Cert. WHS.
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About the Author
As of December 31st 2020, the author chose to leave the Chiropractic profession and pursue studies within the Physiotherapy field. He no longer works as a Chiropractor and works as a Myotherapist in Morningside, Brisbane. The author possesses an unusual background for somebody who trained as a Chiropractor (McTimoney). His education, training, and practical experience span over two decades and relate to both health's physical and mental aspects. He has also needed to push his own body and mind to the limits of physical and psychological endurance as part of his time serving in Britain's elite military forces. His education includes a bachelor of science degree in Business Management, with a specialisation in psychology and mental health in the workplace, an Integrated Masters in Chiropractic, MChiro and a multitude of soft-tissue therapy qualifications (see the about section for more details). His soft tissue qualifications range from certificate level right through to a BTEC Level 5 Advanced Diploma in Clinical Sports and Remedial Massage Therapy. Terry also has extensive experience in security, work, health and safety and holds relevant certifications. He has also taught as a senior course coach at Advanced Diploma level (Myotherapy / Musculoskeletal Therapy) in Australia, both theoretical and practical aspects including advanced Myofascial Release Techniques and has certification in training and assessment. Terry will have taught many of the first students to train as Myotherapists in Brisbane. Terry's combination of knowledge through education, training, elite military service, and personal injury history has paid dividends for the consumers he sees and has treated over the last 15 years. He has extensive experience treating chronic pain and work and sports-related musculoskeletal injuries. Terry is still very active and enjoys distance running, kayaking, mountain biking and endurance-type activities.