Column: 2020 Stress

by Joanne M. Flanders, MS, RN Professor Emeritus, Midwestern State University

2020 has been stressful! We constantly hear people talk about getting back to “normal.” What does that really mean? Does that mean you have “homeostasis”? Homeostasis is an ideal set point reached through a local regulatory mechanism. Or is it “allostasis”? Allostasis is constancy through change.
The most well-known authority on homeostasis is Hans Selye, who in his research findings described General Adaptation Syndrome (GAS) which most of us learned as “fight or flight”. That’s what leads me to return to Why Zebras Don’t Get Ulcers by Robert M. Sapolsky, a neuroendocrinologist at Stanford University. The title was intriguing and I jumped in to find it a very interesting book.
The subtitle of the book is “The Acclaimed Guide to Stress, Stress-Related Disease and Coping.” The professor’s research centers on stress and its relationship to glucocorticoids. He further explains that this focus links stress and an increased risk for certain types of disease. It is well-known that the leading causes of death are no longer pneumonia, tuberculosis, flu; or childbirth. Today, the causes are all linked to our behaviors.
Sapolsky tells us “the aging process can be influenced by the amount of stress experienced over a lifetime” and that “the link between stress and depression” is certain.
So, we’ve had numerous changes since March that don’t feel “normal” to us. Are these changes “stressors” as Selye described? Are we “fighting” or “running from” our stressors? What exactly is a “stressor”? Sapolsky defines stressors as “anything that throws your body out of allostatic balance.” When you examine your stressors, are you also examining how your body is responding to the stressor? Your body secretes certain hormones, inhibits other hormones, and activates parts of the nervous system during times of stress. It increases the risk of our defenses being overwhelmed by disease. Sapolsky says “Stress can wreak havoc with your metabolism, increase your blood pressure, increase your white blood cells, make you flatulent and, possibly, damage your heart.”

Some physiological changes are due to the slow accumulation of damage, such as heart disease, cerebral vascular disorders. In addition, extreme emotional disturbances can produce adverse effects. The point is stress can be either caused by or made worse by stressors. Research has evolved into the rigorous science of stress physiology (the study of how the body responds to stressful events). It has identified factors that affect real body events, e.g. emotional turmoil, psychological characteristics, our position in society and how people in that position are treated.
The bottom line is how have recent events: changes precipitated by COVID-19, street demonstrations, and leadership behaviors affected our stress levels and our body disorders?
As we do our best to “stay safe”, how are we managing the stress in our lives at this time? Are we wallowing in the solitude of our homes? Are we perpetually cleaning because of the virus present? Are we living in fear of the no longer “normal” world?

Recently I participated in a webinar “Focus on Aging: Social Isolation and Loneliness.” It was an interesting presentation to say the least. The presenters identified that social isolation is “observable” while loneliness is subjective—a “feeling.” The panel identified the relationship between these two concepts and a variety of research projects they are conducting which relate to the concepts. Additionally, they described several assessment tools used to identify problems with the concepts. Eventually, they applied the concepts to those who live alone. Their research identifies that living alone can be a source of major stress and thus makes us more vulnerable to disease. A conclusion to be drawn is that those living alone and who are socially distancing can begin to develop loneliness. This situation can progress to an increase in the inflammatory process of the body and any “co-morbidities” (underlying health conditions, e.g. hypertension, heart disease, diabetes) can be exacerbated by the lack of human interaction.
So—what do we do about all of this? How do we decrease the effects of the stress we’re facing from the “not normal” situation we’re experiencing? Have we accumulated so much stress from the many major challenges we’ve experienced over the years? What have these major stressors—The “Spanish” Flu, The Depression, World War II, The Korean Conflict, The Polio Virus, The Viet Nam War, Watergate—done to our bodies and our minds? Actually, I believe we’ve developed coping skills and survived but somehow this time seems different. Are we tired? Are we more impatient? Does this time seem worse? Is our support system unavailable? I believe we’ll overcome these challenges just as we did the others. Here are a few ideas for managing our time at home:
• We can distance ourselves from others—not “isolate” but protect ourselves from the droplets that spread the COVID-19 virus;

• We can avoid large groups;

• We can clean surfaces that are frequently touched;

• We can use the time for self-reflection;

• We can find comfort in religious writings;

• We can be aware of the civil unrest and, if the TV scenes are upsetting, we can turn the TV off or turn to a program that’s cheery, funny or non-news;

• We can encourage those who are depressed to seek professional help;

• We can read a NOVEL that transports us to another land or clime for a while;

• We can reconnect with “long lost” friends using cards and letters or electronic devices; or

• We can seek out help and/or accurate information from the National Association of Area Associations on Aging, the CDC (a very reliable source of information regarding the virus) or the National Institutes on Aging.
Remember: we ARE all in this together!