Stress has an image problem, said psychiatrist Christiaan Vinkers during the speech with which he took office as a professor at the University Hospital of Amsterdam. Everyone wants to live ‘stress-free’, ‘de-stress’. ‘But we pay too little attention to its positive aspects.’
What is stress?
Christiaan Vinkers: “Stress is the constant attempt to stay in balance with everything that happens around you. There are challenges in your life, unpredictable situations, a daily list of what to do, who to talk to, when to be where and on time. We deal with those kinds of things without thinking about it, and we can because we conduct our own stress orchestra all day long. That goes without saying.
“That stress orchestra only starts popping when it needs to – your adrenaline goes up, you start sweating, you get a higher heart rate, your bowel activity goes down, your memory flashes, your attention is sharpened – and returns to a calm rhythm when you finds that the car stops just in time while you are crossing the road. A beautiful process.
“Of course there are negative sides to too much stress, but we pay too little attention to our innate defense line, which often works very well. We should grumble less about stress.”
We have many reasons to be stressed these days. Climate crisis, covid, war, poverty… Our stress seems to be increasing.
“Society can cause a lot of stress, but that doesn’t mean it’s worse now than it used to be. People like to think that everything was better in the past. But then there was also war, hunger and death. In the 1980s, young people were just as concerned about their future as they are today. They were unemployed, they were afraid of the atomic bomb, they were worried about how the world would turn out. Humans are condemned to stress and the increased prosperity does little to change that.
“If we’re under more stress than ever, why haven’t the depression rates gone up? Why do we rate our mental health more and more? Why did most people survive the corona crisis well? I think a lot of things are going wrong in society. But I also think it’s very speculative to think it used to be better, and that’s why we’re under more stress now than we were then.”
Some argue that we are left with an old brain that is not well equipped for this day and age. The greater the distance between that brain and the now, the more stress.
“That sounds interesting and plausible, but it cannot be tested in any way. In five hundred years they will look back and say: look at that journalist, zooming in at home with plain paper books in the background, she could just do her thing, I wish I had her life. Society changes, so the sources of stress also change, which makes sense.”
Are you saying: we focus on how the sources of stress change, while what matters is whether the stress itself changes in intensity and frequency?
“Exactly. Plus, it’s okay to get a little off balance. That is normal. During your life you will have to deal with obstacles. Sometimes life really is a sour bomb, and we can handle that pretty well. People are naturally resilient. It only becomes problematic if you have too much or prolonged stress. Because that means that your dynamic stress system no longer returns to a stable equilibrium in time; that you can no longer bounce back. Then your stress stays on for too long and you can get into psychological and physical problems.”
You argue in favor of giving stress a central place in medicine. Why?
“Stress affects both the mind and the body. We are now going to investigate stress and the autoimmune disease multiple sclerosis; Stress directly affects your immune system. In Germany, studies of stress among television viewers of the 2006 World Cup showed that Germans were almost three times more likely to have heart attacks when their country played. People have been deliberately infected with cold viruses and it turned out that the more stress you are, the more likely you are to get sick.
“Biology, psychology, but also our experiences, environment and personality, together determine how we deal with stress. Stress breaks all boundaries between molecule, feeling and society. Stress certainly does not only play a role in psychiatry, but in medicine as a whole. That’s why it’s so important to work with all disciplines, because that gives people the opportunity to give people a treatment that is tailored to what they need as a unique individual. Every individual needs such a tailor-made treatment, because every person has a unique dynamic stress balance.”
You say we can do prevention and recognition ourselves. But don’t we always see that we’ve gone too far until it’s already too late?
“The great thing about stress is that you can easily determine for yourself whether it is too much. Are you feeling stressed? Has that been going on for a week or three? Then discuss this with your friends and family: ‘I have a lot of stress, can you see that in me too?’
“You can then look for causes and solutions that suit you. For example, if you don’t sleep well, check your sleep hygiene. Do you sit behind a screen until late? Do you drink too much alcohol? Is your workload too high? Then you try, with the help of your environment, whether you can tackle those sources of stress. If that is not possible or not enough, seek professional help. Because even with so-called mild psychological complaints you should not continue to walk around, do not let yourself be fooled that they are part of life. Such a view only reinforces prejudices about psychological complaints and does not help the people who struggle with them at all, on the contrary.”
Vinkers’ book will be published in September Under the spell of burnout: beyond the limits of stress at publisher Prometheus.