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Understanding General and Traumatic Stress
Whether due to experiencing an unexpected shocking incident, such as a serious road traffic accident, physical violence, earthquake, or due to general stressors, such as work pressure, or worrying about a 30 year mortgage, both can trigger a stress reaction that entails activation of the autonomic systems emergency alarm state. However, while there are many similarities in the immediate stress reaction to both general and specific (traumatic) stressors, there are also some notable differences. These are important to understand, particularly for effective diagnosis and treatment.
The Stress Response
Research indicates that the stress response begins in the brain, whereby appraising stimuli as threatening can trigger a cascade of mental, emotional and physiological reactions, causing the psycho-biological system to be on high alert. In humans, the most common manifestations of this state can include obsessive thinking, fear, increased heart rate, elevated blood pressure, rapid breathing, heightened alertness, and increased capacity to make quick decisions. The release of hormones facilitate fight, flight, freeze, or other responses deemed essential for survival. These stress reactions are designed to be an adaptive way for people to survive and cope with actual threatening and dangerous situations effectively.
General Stress
Studies have uncovered an intriguing aspect of stress: its ability to manifest in response to any perceived danger, whether it stems from a specific life threatening diagnosis, or everyday stressors like looming deadlines. There are however significant differences between these types of stress that merit attention. Unlike sudden and unexpected shocks, general stress can often arise from anticipatory worry about potential future threats that may concern work, debt, difficulties in relationships, or health. Compared to acute shocks, the symptoms of general stress tend to be less severe, and the impact on daily functioning may be strained, but often times maintained. Typical symptoms of general stress can include feeling overwhelmed, irritability, mood fluctuations, changes in appetite, fatigue, tension, difficulty concentrating and sleep disturbance. Whilst specific therapies can work quite effectively for addressing psychological and physiological symptoms of general stress, it is commonly effectively treated with various types of lifestyle medicines.
Assessing the impact of general stress on health and wellbeing poses challenges, as most of the literature does not differentiate between the effects of specific traumatic stress and everyday stressors on disease and mortality rates. However, there appears to be some good evidence highlighting that chronic stress that occurs in response to stressors such as neighbourhood environment, interpersonal difficulties, financial strain, work stress, and caregiving are linked to poor health outcomes. Thus, whether it’s specific or general, persistent, especially severe stress, can have detrimental effects on health and wellbeing.
Specific (Traumatic) Stress
Very specific traumatic stress, on the other hand, elicits other distinct effects that set it apart from general stress responses. Firstly, it occurs in response to witnessing or experiencing one or more highly threatening incidents that are shocking, and tend to catch individuals completely off guard. These incidents may include natural disasters, physical or sexual violence, medical diagnosis of a terminal illness, or severe road accidents. The immediate aftermath of such traumatic events can also induce overwhelming distress, often leaving individuals feeling helpless and immobilised. Unaddressed traumatic stress can manifest in a myriad of debilitating symptoms such as flashbacks, intrusive memories, avoidance behaviours, persistent perceptions of threat and dissociation. Importantly, if trauma is not properly addressed, then encountering everyday stressors, such as meeting deadlines, may impair one’s ability to cope and result in chronic symptoms of stress. Other important differences include treatment approach. Treating traumatic stress symptoms requires a personalised and comprehensive approach, tailored to the individual’s needs. Modalities such as EMDR, Exposure Therapy, and Somatic Therapy are commonly employed to effectively transform negative cognitions, emotions, sensations and behaviours, associated with specific trauma(s).
Stress, Stressors and Health Implications
The term ‘stress’ is often used interchangeably across settings to describe various experiences, including trauma, depression, anxiety, even everyday external stressors. Whilst stress may be a common factor across different types of mental and physical health conditions, conflating the term stress with other conditions adds to challenges regarding measurement and assessing its impact on health outcomes. Furthermore, research indicates that stress is a specific set of psychological and physiological symptoms that occur in reaction to particular stimuli (i.e. stressors). Thus, a clear distinction between ‘stress’ and ‘stressors’ is made. Recognising this distinction is important for a number of reasons. Firstly, it acknowledges individual differences in the stress response – meaning not everyone encountering a stressor, whether general or specific, will experience stress. Secondly, it helps to better identify what the stressors are and provide targeted treatment. For instance, anticipatory stress, where symptoms arise without any apparent threat, might be better addressed by altering negative thought patterns and relaxation exercises, rather than making unnecessary environmental changes.
The stress of worrying about future events, such as a long-term mortgage, differs markedly from the immediate shock of an unexpected incident, like an earthquake. Emotional shocks can cause immediate and long-term severe distress and disability with specific symptom presentations, whereas general stress from ongoing worries typically does not result in such symptoms. Chronic stress, regardless of its cause, is undeniably harmful to health, as research has shown. However, for those dealing with mental or physical disorders, potentially caused by stress, understanding whether these issues occur in response to very specific or general stressors is crucial for effective and targeted treatment. Proper diagnosis and comprehension are therefore vital. Without this, determining the appropriate treatment approach can become a prolonged process of trial and error, which can extend suffering and incur significant costs.
Coping Strategies and Resilience
General stress can be effectively addressed by applying relaxation exercises, such as deep breathing or meditation. Additionally, adopting healthy lifestyle habits such as practicing yoga, maintaining a balanced diet, and establishing a healthy work-life balance can reduce stress and bolster resilience. Seeking support from family, friends or the community, or implementing practical solutions such as moving from a toxic person or workplace, can also get rid of stress. While these same practices may effectively manage less severe symptoms of traumatic stress, it’s crucial to recognise that unaddressed specific stress may require specialised treatment. Traumatic experiences, particularly those stemming from abuse or violence, can have profound mind-body effects that necessitate targeted interventions for healing and recovery. In such cases, personalised treatment approaches that address different aspects of trauma(s) and transform maladaptive cognitions, would be more effective than applying generic lifestyle medicines.
Conclusion
Often times people may experience traumatic and/or general stress and assume they are both the same, however there are important differences, particularly in terms of the nature of the stressor, symptom severity, after effects and treatment options. Whilst chronic stress, whatever the cause, is detrimental to health, getting specialised care for unaddressed traumatic symptoms is often essential, whereas self-care methods may be sufficient for addressing general stress.
I hope you found this article useful. If you have any questions, or to discuss treatment and support options then feel free to get in touch.
With best wishes,
Sadaf
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