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Stress – what is it, anyway?

Stress – what is it, anyway?

The term “stress” as used today was coined by Hans Selye1, a Hungarian-Canadian clinician who defined it as "the non-specific response of the body to any demand for change". Selye once called stress the "physical expression of a general mobilization of the defense forces in the organism." We perceive stress as a state of pressure characterized by tension and resistance to stimuli (stressors). Conditions that trigger stress don’t have to be "big", rare events, and are often minor everyday annoyances – daily hassles.

Digital stress

Always available. Always connected. Whatever the time or place. Welcome to the stress of the digital age. Digital stress comes from being permanently available for – basically whatever, no matter how important or how trivial. We are bombarded with information non-stop. The urge to respond immediately is getting stronger. Many people find themselves slipping into permanent work mode. Switching off becomes impossible.

Stress generates headache

Everyone experiences stress differently. Stress tolerance thresholds also vary from person to person. Although definitions exist, stress is diffuse, a shape-shifter that depends on numerous factors, internal and external. But one thing seems to be the same for everyone who experiences stress: it hurts us mentally and physically. One complication consistently linked to stress in many studies is headache, a phenomenon the World Health Organization (WHO) ranks among the world’s most disabling illnesses.

Stress and evolution

A look at the evolutionary history of our species shows that stress started out as a biological response to threatening situations. The stress response helped our ancestors to survive. Not just our human predecessors, either. The fight or flight response probably helped ensure the survival of the first mammals more than 250 million years ago. Stress still has its uses today. It helps us respond fast in high-risk situations.

Hard to define

Although research into stress goes back almost a hundred years, science has struggled to define the phenomenon. A paper by Walter Bradford Cannon (1932)3, a professor of physiology at Harvard Medical School, classifies stress as a basic physiological mechanism of human behavior and traces it far back into evolutionary history. Many scientists have contributed to stress research since then. Although numerous studies on the relationship between stress and headaches point in the same direction, there is still no consensus on what stress really is.

Multiple research approaches

The stress-headache link has been investigated in a large number of studies using various methods and with some very sophisticated designs. Subjects may be instructed to complete arithmetic problems or solve puzzles using logic. Additional tasks and difficulty levels may be added to make the challenges harder and pile pressure on the subjects. In addition to the actual work instructions, tests may include components designed to provide insight into the subjects’ psychological processes, for example to discover how well they think they are doing during the experiment. The investigations may also obtain information about participants’ individual stress coping behavior.

Headache risks

Factors likely to increase your risk of a headache are grouped into two categories. The first consists of factors also implicated in burnout syndrome: being overwhelmed, tight deadlines, frustration, conflict with coworkers or fellow students, or tension in the air at work.4 Tension-type headaches are common in these scenarios. The second category consists of physical stressors, more particularly: musculoskeletal risk factors5: You spend hours sitting in an unergonomic posture that tenses the muscles near the head. Your shoulders and neck start hurting, then your upper back. The student life is full of headache risk factors that most students are unaware of.

And it hurts the economy too

Stress-related headache causes a huge economic burden in the working population, resulting in disability and low productivity in every part of the labor force. Absenteeism and lost productivity cost billions each year. Exact figures are scarce, but estimates suggest that the annual economic burden of headache across Europe may be as high as €170 billion. Stress accounts for a major part of that.

The sleep factor

Sleep quantity and quality play a role in causing stress and headaches. Migraineurs in particular should make an effort to go to bed and get up at about the same time every day. Many headache sufferers believe that not getting enough sleep is a major trigger for an attack7,8. Studies have shown that factors such as lack of sleep, poor sleep, periods of stress throughout the day, exams, and worries about getting a job can add up to a perfect storm. No wonder people end up with a headache.

Less stress!

Stress reduction is an active process that requires effort on your part. The first step is to work on time management. Carve out free time for yourself. Demand it and make use of it. Even small changes in your handling and perception of your stress triggers can make a big difference and encourage you to do even better. Get a handle on your internal stress – the demands you make on yourself — and reduce your expectations to a realistic level. The same goes for demands made on you by other people. And, very important: never start several projects at the same time. Arrange tasks in an order that makes sense and set realistic deadlines. Otherwise, you end up feeling stressed before you’ve even started.

How you deal with setbacks and shortcomings is crucial too. A sensible response to failure is hard, but it’s also the most important step of all. If things go wrong, remember not everything is under your control and not everything is your fault.  Finding the “positives” in failure is hard, no question. Involving people you are close to helps with stress relief. Long experience shows that sharing the burden usually helps us deal with problems and get over things. A problem shared is a problem halved, they say.

  • 1. Selye, H.: Stress. Bewältigung und Lebensgewinn. Aus dem Englischen von Hans Th. Asbeck. München/Zürich 1974.

    2. De Benedittis G, Lorenzetti A. The role of stressful life events in the persistence of primary headache: major events vs. daily hassles. 1992 Oct; 51(1): 35–42. doi.org/10.1016/0304-3959(92)90006-W.

    3. Cannon, Walter B.: Wut, Hunger, Angst und Schmerz: Eine Physiologie der Emotionen, aus d. Engl. übers. von Helmut Junker. Hrsg. von Thure von Uexküll. München/Berlin/Wien 1975 (Erste engl. Ausgabe 1915).

    4. González-Quintanilla V, Toriello-Suárez M, Gutiérrez-González S, Rojo-López A, González-Suárez A, Viadero-Cervera R, Palacio-Portilla EJ, Oterino-Durán A. Stress at work in migraine patients: differences in attack frequency. 2015 Mar; 30(2): 83–9. doi: 10.1016/j.nrl.2013.10.008. Epub 2013 Dec 12. English, Spanish.

    5. Albers L, Ziebarth S, von Kries R. Potenziell vermeidbare Risikofaktoren für primäre Kopfschmerzen. Ein systematischer Review. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2014 Aug; 57(8): 952–60. doi: 10.1007/s00103-014-1997-1. Review. German.

    6. Linde M, Gustavsson A, Stovner LJ, Steiner TJ, Barré J, Katsarava Z, Lainez JM, Lampl C, Lantéri-Minet M, Rastenyte D, Ruiz de la Torre E, Tassorelli C, Andrée C. The cost of headache disorders in Europe: the Eurolight project. Eur J 2012 May; 19(5): 703–11. doi: 10.1111/j.1468-1331.2011.03612.x. Epub 2011 Dec 5.

    7. Barbanti P, Fabbrini G, Aurilia C, Vanacore N, Cruccu G. A case-control study on excessive daytime sleepiness in episodic migraine. 2007 Oct; 27(10): 1115–9. Epub 2007 Aug 24.

    8. Boardman HF, Thomas E, Millson DS, Croft PR. Psychological, sleep, lifestyle, and comorbid associations with headache. Headache. 2005 Jun; 45(6): 657–69.

    9. Jiang XL, Zheng XY, Yang J, Ye CP, Chen YY, Zhang ZG, Xiao ZJ. A systematic review of studies on the prevalence of insomnia in university students. Public Health. 2015 Dec; 129(12): 1579–84. doi: 10.1016/j.puhe.2015.07.030. Epub 2015 Aug 20. Review.

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