BE OUR GUEST: AWARENESS NEEDED ON ROLE OF STRESS, HEALTH

With all the hoopla in the media about the rising health care cost, I, a psychiatrist, could not resist throwing my two cents in. Let me tell ya: when all the laboratory tests are negative; when every type of scan one can think of has failed to reveal anything; when every cavity in the body has been explored; when every organ system has been visualized; when there are not more tests left to do, no more specialists left in the Yellow Pages, and the insurance has run out, they come to me with their pockets turned inside out.

Boy are they mad at the world! They have some real physical symptoms and yet the doctors can't find anything to explain them. They are hurting somewhere in the body, or are having some type of organ dysfunction such as flipflopping of heart or shortness of breath or stomach problem. They start out with their family physician. They then go on a doctor-shopping spree. After spending hundreds of thousands of dollars on fruitless tests, they are frustrated to hear from the doctors the same old tune, "We can't find anything wrong with you! This is probably stress induced. You should see a psychiatrist."

Their reaction? "Oh, no! No, no!! Noo, noo, no, no, no, no, no!!! This is not in my head!!!! I am not looney, not yet. I am not imagining this! This is real!!! I have no more stress than anyone else."

They act as if they have just been certified crazy, fit to be committed to a lunatic asylum forever. Not content with wasting all the money on tests in this area, they now decide to go to Barnes Hospital, Mayo Clinic or some such place, knowing for sure that the local doctors "surely must have missed something." More tests, more money down the tubes. They are bent on proving all these ignorant doctors wrong.

Over half a trillion dollars are burned every year on the altar of this madness.

What is the real story here? The real story is very simple. Stress simply means getting upset. When we are upset for any reason, physical symptoms appear in the body in addition to mental, emotional and behavioral symptoms. If you are driving a car on the highway and suddenly you see flashing lights of a State Patrol Car in your rear view mirror, you get scared, and instantly your heart skips a beat, you feel fullness in your chest, your face gets red, your hand trembles and you can have many other symptoms, especially if the Trooper stops you and slaps you with a $120 ticket. In this case you were upset by the Trooper and you experienced instant stress symptoms. Your fear was processed by your brain and transmitted to various body organs by nerves and hormones resulting in stress symptoms.

However, some people are able to bury their painful emotions rapidly in their mind and act as if they are not upset at all when bad things are happening to them. These people deny that they are upset about the bad events and problems, but they experience many physical symptoms days, week or even months later. These symptoms are called delayed symptoms. Because of this unfortunate delay in appearance, one fails to make the connection between the symptoms and the original stress, leading to the disastrous medical "wild goose chase" noted in the beginning part of this article.

Let us take the example of a woman who lost her husband in a car accident. She is shocked by the death. She goes through the funeral bravely, putting on a strong front. Everybody thinks she "handled herself very well." She does not grieve, does not talk about her feelings with anyone. She had to be "strong for the kids."

Three months later she developed symptoms (say, headaches) for which doctors can't find any cause. She thinks she has a brain tumor. Then she starts her rounds with specialists. When asked if her husband's death was upsetting to her, she replies, "No. I handled it well! This is not in my mind. This pain is real. I am not imagining it ... blah...blah...blah..."

She acts as if her mind is floating about four feet above her head, not connected with her body. She has to be reminded that her mind is inside her brain and her brain is connected to the rest of the body and any emotion she feels, any thought she thinks can affect her entire body. Especially, if she buried emotions inside her mind and did not express them at the time of the event, these emotions will come back in the form of various body symptoms.

You might ask, why are doctors not doing anything about it? Most people get terribly angry when told to get help with a mental health specialist. They fire their doctors and go to other doctors. Besides, when the patient keeps coming back with one complaint after another, the doctors want to make sure that they have not missed anything. You know what flak they can get if they missed something. So they cover all their sides as well as they can.

This is not all. The common inappropriate stress-coping activities such as drinking, smoking, abusing drugs, overeating, promiscuous sex, driving recklessly, etc., probably cost the public another one half-trillion dollars a year. This, not taking into account the human misery associated with them. Stress-related illnesses such as depression, anxiety disorders, psychotic illnesses, etc., add another few billion dollars, give or take a few cents.

What is the solution for this? Public education starting with elementary school and all the way through high school and college. Education about stress, stress symptoms, consequences of stress, stress-related illnesses, how to identify them, how to prevent them, and how to cope with it. It is time educators, health care providers, insurance agencies, and a concerned public join hands in creating awareness about the role of stress in our lives.