The stress that can kill

Can stress reach such levels that it leads to depression and its consequent complications?

YOUR workplace a living hell?

Your spouse causing you sleepless nights?

Your bank balance always in the negative?

Such situations can naturally cause stress. Nonetheless, stress is as natural as breathing, and it’s an inbuilt mechanism that puts us in the “fight or flight” (also called hyperarousal or acute stress response) mode, which equips us with the necessary physiological responses to react to a threatening situation.

Dr Esther Sternberg, a leading stress researcher and the chief of neuroendocrine immunology and behaviour at the National Institute of Mental Health in the United States, in an article in WebMd, said: “Like email and email spam, a little stress is good, but too much is bad; you’ll need to shut down and reboot.”

Yes, unfortunately, too much stress puts the body into a constant state of hyper-responsiveness, resulting in sustained physiological reactions that affect the body and mind.

In particular, chronic stress results in the elevation of certain hormones such as cortisol (the “stress” hormone), and the reduction of others, such as serotonin and dopamine (the “happy” hormones), which has been linked to depression.

The connection between stress and depression is complex and circular.

Acute stress directly affects mood, and this could result in being irritable, reduced concentration levels and even disrupted sleep. However, sustained and chronic stress levels can lead to depression.

There are a few reasons for this:

● Disrupts coping mechanisms If you’re stressed, you often stop doing some of the things you carry out to reduce stress, such as exercise or going to the movies.

For example, if you’re stressed at work, you’re less likely to exercise, which can often lead you to becoming more moody and irritable.

● Vicious cycle of bad mood and even more stress

Yes, a bad mood can make you even more stressed, and the cycle can repeat endlessly.

For example, you’re in a bad mood at work, and because you can’t concentrate well, you make a mistake. The bosses yell at you, and guess what? You’re in an even darker mood.

● Bad coping strategies Some tend to drink more; others tend to partake in dangerous behaviours. All this leads to further problems down the road.

● Stress creates havoc in relationships

Be it co-workers, friends or loved ones, if you’re stressed and in an irritable mood, arguments are bound to happen. And that can go on and on.

There’s a structure in our lives that we’re comfortable with, a sort of “living discipline” that helps us manage our lives.

Stress and its consequences can affect this, leading us to abandon the structure that has helped us cope with daily living.

This can lead us to a downward spiral of loss of control and burdensome moods that can eventually lead to depression.

Dr Bruce McEwen, author of The End of Stress as We Know It, wrote: “Stress, or being stressed out, leads to behaviours and patterns that in turn can lead to a chronic stress burden and increase the risk of major depression.”

Stress cannot be avoided. It’s a part of life – taking care of a loved one with chronic illness; suffering illness yourself; job stresses; the threat of retrenchment; taking exams; the loss of a loved one; even driving in KL traffic.

But when it becomes too much, it is time to seek help, or suffer the consequences.

Take KC Ho (not his real name), 45, who was caught in the grip of stress and depression 20 years ago.

“I had just graduated from university and had successfully applied for this job, which had both prestige and good pay.

“Then reality set in. The job was as stressful as anything anyone can face, and as the days slowly turned to weeks, the never-ending stress finally got to me.

“I wasn’t sleeping well; I had cut off all social interaction with my friends, even my family and girlfriend; I was eating irregularly.

“And one day, as I was driving to work, the thought suddenly came to me, ‘If I have an accident now, I don’t have to go to the office.’

“That was when I decided to get some help,” he recalled.

Credit to Ho, he sought the help of a psychiatrist, and was subsequently diagnosed with depression.

He was given counselling and medications.

It took about six months for him to recover.

“I know my doctor said not to make any hasty decisions when I was depressed, but I took a good look at my life, assessed my strengths and weaknesses, and decided that my career choice was a wrong one.

“It was scary, but I decided to quit that job even though I had spent all those years in university slogging for that degree that would help ensure my future.”

Today, Ho is enjoying his other career, one he never studied for, and is contented.

“The renumeration isn’t great, but I’m happy,” said Ho. “I’ve learnt to cope with the stresses of this ‘new’ job. We can’t ever escape stress, but if we’re happy doing what we do, and find good coping strategies, we’ll be just fine,” he offered.

“And I’ve never had another episode of depression. I have a network of family and friends who provide me the support I need.”

“It’s important that people suffering from depression not blame themselves – it’s partly your genetic makeup, partly your current environment, and partly your early environment that led to the depression,” said Dr Sternberg. “If you’re depressed, seek help. You can’t beat it on your own.”