Survey underlines stress role in sickness

Press, 19 December 1985, Page 15

Survey underlines stress role in sickness

By

DENIS DWYER,

information officer,

Canterbury Hospital Board

The businessman who is perpetually tired, the teacher having dizzy spells, the child with stomach pain, the housewife who has an ulcer, the engineer with frequent heart palpitations and headaches who is always overworked and rushed — behind the physical disorder may well be some emotional problems. In a Canterbury survey of patients attending their family doctor, a small minority went for reasons they considered psychological; doctors thought the reasons were psychological in three times that number. Most went because there was something wrong with their body. Mrs Jill Nuthall, social worker at Papanui Medical Centre, says stress may be the original cause of physical problems in a much higher percentage of visits to the doctor. Not only can stress cause physical illness, but even when people have serious diseases they Manage their painswtter if their

relationships are in good order. She recalls the young athletic woman with the bad back who had been subject to great emotional demands and was trying to do too much. Many treatments had been tried. “The body,” says Jill Nuthall,” was sending out warning signs that she was overdoing it.” When the family sorted out the work and the differences, her back improved dramatically.

Often, people put pressure on themselves, she says, especially high achievers, but if they get too many stresses they get depressed and anxious and have physical symptoms. The blood pressure often rises for example. “Permission from self to slow down for a while is important,” she adds.

Sometimes fear is the cause of physical disorders. She cites the situation of women in violent marriages whose fear may be so intense that tisy have heart palpi-

tations, headaches and stomach problems, besides in many cases wounds and broken limbs. Sometimes people’s physical health is affected by another’s drinking. A full family assessment, might uncover how serious it is and reveal that each member of the family has been pretending it was not worrying them. A parent’s drinking affects the health of thenchildren for many years, well into adulthood. Of the people Jill Nuthall sees (average age 34 years) between 30 to 40 per cent have a parent who is alcoholic. A survey of these families at the Medical Centre showed the inter-relationship of physical and psychological problems. Psychosomatic. symptoms were found in 45.5 per of patients,

physical problems in 61.8 per cent, disturbed psychological state in 74.5 per cent, and other social . problems in 57.8 per cent, the same patients often haying two or more of these conditions. Dr Calder Botting, a senior lecturer in general practice at the Christchurch Clinical School, finds the common division between mind and body is usually a hindrance. “We have all experienced the emotional ‘lump in the throat’ or the nervous stomach ‘butterflies,’ but people still have difficulty accepting pains as being caused by stress or emotion. The doctor may also have a problem in reaching a true diagnosis and gets there after many often expensive tests have proved negative — a diagnosis by exclusion.” y

He explains that if a psychosomatic cause can be clinically suspected early on then an assessment by a suitably skilled person such as a trained and experienced social worker can be obtained. This enables an earlier diagnosis, saves money, and gives a diagnosis by demonstrating a positive link between something in the patient’s life and the symptom. This is preferable to reaching a diagnosis by exclusion where there can always be the doubts that something very rare has been overlooked. Even more important, a major part of the treatment had already been carried out.

Besides the counselling provided at the centre this year, there have been two seven-week courses for young women who have' recently had their first or second child. Many had had medical visits and tests for various physical disorders. Two hundred and twenty-one people have attended relaxation.

classes since 1979. In a random survey of people who had attended, 45 per cent reported fewer visits to the doctor. In groups such as these, people learn about the effects on their bodies that stress and feeling can produce and how to be healthier.

Jill Nuthall and Calder Botting say it is normal for our bodies to act as barometers of strain. “In our search for the cause of physical problems,” they say, “we should consider our whole situation and where possible make changes to reduce pressures especially by improving our relationships with others.”

Jill Nuthall is seconded to the Papanui Medical Centre from the Canterbury Hospital Board community health care services. Counselling and relaxation courses are also provided by the Canterbury, Hospital Board-funded family’ health counselling centres at Bishopdale, Rangiora, and Hornby.