The word stress (synonyms: Strain; Disstress; Eustress; Stressors; Type A Personality; Type A Behavior; ICD-10: Z73 – Problems Relating to Difficulties in Coping with Life) has entered the vocabulary of everyday life. Patients complain about stress on a daily basis: overwork, lack of free time, hardships and worries in the family, in the partnership or at work. But loneliness also leads to stress for many. Psychology summarizes the burdens from these different areas of life as stress. As far as stress concerns negative aspects, we speak of distress. Even pleasant experiences can lead to stimulating “stress”; the term for this is eustress. An example of this is performance stress during active activities in nature or sports. Stress is not a disease in the medical sense. There is no diagnosis of stress or distress. Consequently, stress is not listed as a disease in the ICD 10 classification. There is also no exact symptom description, as we know it from depression or anxiety disorders or from physical disease syndromes. Stress is present according to Lazarus (1999), if the requirements from the environment or the internal requirements stress or overtax the reaction possibilities of a person. Stress can lead, if it is not mastered and processed, to load consequences. These include stress disorders in the narrower sense, such as adjustment disorder, acute stress disorder, post-traumatic stress disorder (PTSD) or burnout syndrome – see pyschometric test procedures. However, many physical and mental illnesses can also result from chronic stress – the constant stress – especially the psychosomatic illnesses, which are now largely grouped under the term somatoform disorders. Finally, recent research findings are increasingly drawing attention to a third category of disease:
Diseases, whose development process is causally caused by stress, only examples like myocardial infarction, atherosclerosis (hardening of the arteries) and hypertension or depression should be mentioned here. In these diseases, chronic stress is often one of several causative factors, a co-factor. If cardiovascular disease and depression have an important common causative factor in stress, then the stress factor has not only a psychological and medical dimension, but also a public health dimension. A major study commissioned by the WHO and the World Bank was conducted by the Harvard School of Public Health, in which mortality (number of deaths in a given period, relative to the number of the population in question) and disease-related disability, as well as risk factors, were recorded globally in 1990 and then projected to 2020. Accordingly, coronary heart disease and depression will represent the highest burden of disease worldwide in 2020. Modern psychology is concerned with emphasizing “salutogenesis” (Antonovsky 1987) in the context of stress research. Emphasis is placed on the maintenance and restoration of health rather than disease. According to the WHO definition, health is a “state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” Health, then, must not be defined merely as the absence of symptoms. Thus, in the context of the most recent health policy in particular, preventive medicine (synonym: preventive medicine) is logically gaining a special role. Accordingly, the stress factor in patients must also be recognized and, if necessary, reduced in everyday medical practice in order to prevent important diseases. An important step in this process is “stress diagnostics”. Using a detailed list of questions, it is possible to measure the degree of stress and the consequences of stress on the patient. The patient answers questions in the computer program independently, which are calculated analogously and give him and you an insight into his stress analysis. The most important results are summarized in each case in a score; they are finally evaluated individually and can be printed out. Within the framework of “stress diagnostics”, stress management strategies take on a special position; the positive and negative processing strategies in stress states – the so-called coping behavior – is described in detail below.With knowledge of the degree of strain – stress -, the possibilities of processing stress and the extent of the consequences of strain on the patient, the physician has a sound basis for initiating preventive measures to reduce stress. If the results show pronounced stress consequences, psychotherapeutic counseling is urgently indicated. Further measures, such as special stress management training, can then also be recommended and followed up.
