Stress appears to be an increasing problem in the industrialised world, and can have long-lasting effects on health. So what can be done about it?
Stress is a common condition that can affect sleep and weight loss, but recent studies have shown it can also have more serious, long-term effects on our health, sometimes leading to inability to work, writes Patricia Carswell
You don't have to go far in the UAE to find someone suffering from stress. Nicholas Paillart is typical. A hard-working 30-year-old based in Dubai, he is the managing director of a company that develops and distributes advanced loyalty schemes for businesses and is building an intelligent dining network called DineDubai.ae. His work regularly spills over into the evenings and he has frequent deadlines to meet. Not surprisingly, Paillart gets stressed by other people's inefficiencies and delays.
"People do not realise that everything is a chain and that one thing not done pushes back the next thing, and so on," he says. "Stress takes over as the deadline approaches and I start feeling on-edge and cranky."
Paillart knows that his stress levels affect his health. "My stomach goes into a knot, I feel bloated and I am unable to eat, my sleep gets disrupted as I dream of the issue and the thousand (or none, depending on the issue) ways that I can resolve the issue."
The physical effects of Paillart's stress will come as no surprise to most of us. It has long been known that long-term stress can be bad for our health. When we feel stressed, our physiology changes: our heart rate, breathing and blood pressure rise and over a protracted period this can lead to cardiovascular disease and high blood pressure.
Generally speaking, though, unless our stress tips over into full-blown anxiety or depression or results in a more serious physical condition, it is not something we tend to bother much about; we simply accept it as part of the cost of living in a fast-paced world.
Two studies published in March, however, indicate that stress is something that ought to be taken more seriously from the outset.
A paper published in the International Journal of Obesity by the Kaiser Permanente Center for Health Research in Portland, Oregon, US, suggests that stress can hamper successful weight loss.
Almost 500 obese adults took part in a two-phase study in which they took part in a weight-loss programme, with reduced-calorie intake coupled with an exercise regime. The participants were required to report on, among other things, their sleep time, screen time, stress and depression levels.
The study found a direct connection between the stress levels of participants and their success in losing weight.
Dr Charles Elder, the lead author of the paper, explains: "The more stress you had, the less likely you were to succeed in losing 10 pounds - the more stress you had, the less weight you lost."
Elder considers it probable that there are both behavioural and physiological reasons for this.
"People will turn to comfort food when they're stressed, but I also think that losing weight is a big effort; it requires changes in lifestyle, increased exercise and changes in diet, and this takes focus. When people are stressed they are less able to focus on those behavioural changes.
"There is also evidence that there are direct physiologic links between chronic stress and obesity; that is to say that chronic stress can activate the hypothalamic/pituitary/adrenal axis which can lead to visceral fat deposition."
It is not just the risk of obesity that is a problem for sufferers of stress. Another study, conducted by experts at the University of Bristol, in the UK, and the Karolinska Institute in Sweden and published in the Journal of Epidemiology and Community Health, shows that stress may have more serious long-term effects, too, resulting in sufferers becoming unable to work.
The research involved more than 17,000 Swedish adults who were asked a series of standard questions about their state of mind; they also reported on factors such as their exercise regimes and socio-economic status.
The study went on to examine over a period of years how many people went on to claim disability payments. The results were startling. Even those suffering from mild distress of a kind that would not normally be recognised as amounting to any kind of condition had a significantly increased risk of ending up on a long-term disability pension.
Dr Dheeraj Rai, of the University of Bristol, one of the authors of the study, considers that there is enough of a connection for us to be looking more carefully at what we might term "normal" stress.
"When do you call a disorder a disorder?" he asks. "If we're saying that symptoms that really are mild are associated with disability, then it's time for a slight rethink in how disorders are classified or defined. It's a public health issue, where societies need to think whether they need to invest a little more on researching these long term effects and also maybe giving it more importance."
The UAE ought to take stress particularly seriously, according to Dr Yousef Abouallaban, the director of the American Center for Psychiatry and Neurology in Abu Dhabi. He runs courses on recognising and dealing with workplace stress and believes that there are many factors that make stress in the UAE higher than elsewhere.
"The country has expanded so fast in so many aspects except the emotional and psychological ones," he says, pointing to a careless attitude towards people's emotions in both businesses and in schools, most of which have no counsellors, together with the fact that so many residents are expatriates whose home countries are politically or economically unstable.
So what can be done to tackle people's stress? Elder recommends exercising more, cutting back on hectic schedules and learning a meditation or yoga programme. This has certainly helped Paillart.
"[My wife and I] have taken up yoga and meditation," he says, "which allows us to clear our minds and rechannel the negative energy into constructive energy, allowing us to think clearly and act smart."
That sounds like a solution that will be good not just for stressed individuals, but for their employers too.
Tips for managing stress from the American Center for Psychiatry and Neurology, Abu Dhabi (www.americancenteruae.com)
To deal with stress more effectively, try to:
• Understand what situations make you feel stressed
• Understand what situations you can and cannot control
• Prepare for stressful events in advance by thinking about the future
• Keep yourself healthy with good nutrition, exercise and regular relaxation
You should see your doctor if:
• You often feel stressed and particular things stress you beyond your control
• You feel your reactions to stress are extreme
• You feel anxious or depressed about stress