Manufacturing Stress in the Age of Anxiety

Why is this problem widespread when the standard of living has improved significantly?

Twenty-first Century living has produced two major health epidemics. The first is obesity, which has its origins in overconsumption and reduced activity. The second is the inability to cope with the perceived demands of modern life; stress is affecting an ever-increasing proportion of the population.

Why is this problem widespread when the standard of living has improved significantly? In times gone by populations coped through war and natural disasters in ways that seems unthinkable now.

Even minor events today seem capable of triggering acopia — the inability to cope with activities of daily living. The values of self-control and self-sacrifice have given way to emotionalism and immediate gratification. Whatever happened to “keep calm and carry on”?

In medical terms stress occurs when the adaptive capacity of an individual is overwhelmed by events, whether physical or psychological, to produce an in-built primitive response from the body.

The cause of stress is subjective and the response is a function of individual personality and physiology. The adrenal gland responds to produce hormones, such as adrenalin and cortisol, which stimulate the heart, muscles and brain. These hormones increase survival when we are threatened, by improving the ability to fight, or take flight; they can also give us a boost needed for productivity and problem solving. Unwanted side effects include the loosening of bowels, being so scared that immobility occurs (freeze), or even being scared to death.

This self-preservation reaction is beneficial if transient, but is counter-productive if it persists and can lead to a variety of psychiatric disorders such as anxiety, depression, irritability, fear, and physical symptoms such as palpitations, breathing difficulty or panic attacks. It can also lead onto a variety of physical ailments such as heart attacks, peptic ulcers, possibly even predispose to cancer and infections.

The long-term consequences of exposure to threat were first recognised in the First World War when the phenomenon of shell-shock was described. In the modern era the term post-traumatic stress disorder (PTSD) is used, its reported incidence being highest in ex-military personnel. Vietnam veterans are particularly prone, (when compared with military in other combat situations), resulting in problems with drug and alcohol abuse, crime, failed marriages as well as the symptoms above.

This term is now increasingly being applied to civilians whose trauma may relate to accidents, or problems such as child abuse or domestic violence. Those exposed to trauma in their work are particularly at risk: police, fire service, emergency services, and medical staff.

Australian Bureau of Statistics (ABS) figures suggest around 12% of Australians will experience PTSD in their life-times, with serious accidents being a leading cause.

As is the case with many medical conditions which are difficult to measure, the incidence of stress is increasing, but is this because of changing environment, or changing definition of the condition?

Are people more stressed than before, or is the label more freely applied? That there is an increase in diagnosis is beyond doubt; Medibank research showed a continued rise with the number of Australians affected rising from 3.7millon in 2007-08 to over 4.9 million in 2016-17. Poor sleep was self-reported as a factor in 44%, poor time management in 36%, work pressures in 39%, housing affordability in 17%, and social media pressures in 12%.

Another study by the Australian Psychological Society (APS) found personal finances, family issues and personal health to be the major contributing factors. Positive factors for stress reduction included being employed, living with a partner, having children and a better education.

According to the ABS, 1 in 7 Australians experience an anxiety disorder each year, in their lifetimes 1 in 3 women and 1 in 5 men. Originally stress was considered a short- term phenomenon resulting from too much mental pressure; in the longer this could lead to anxiety with its persistent unease. Anxiety can also occur without stress, but there is now some overlap in usage of terminology and these terms are often interchanged.

These numbers are increasing, as is the incidence of suicide.

In 2017, 3,128 people took their own lives, an increase of 9.1%, this equates to 12.6 deaths per 100,000 and is now the leading cause of death in those aged 15-44. Even more disturbingly, this is an increasing problem in the young, accounting for 36% of deaths of those 15-24.

The COVID pandemic has exacerbated the incidence still further, with roughly half complaining of stress. The number of under 18’s taking anti-depressants increased from 30,000 in 2007 to 100,000 in 2018, and the count in 2020 was 175,000.

America, as always leads the way with this epidemic. Studies from New York showed a 62% increase in admissions of adolescent girls with self-harm from 2009 to 2015. Even more disturbingly the problem is occurring at a younger age, with 189% increase in pre-teens over the same period. In these cases, addiction to social media seems to be an important factor.