Where does stress come from? 

Scenario One: I'm in the hospital emergency department with a belligerent patient who's giving me a menacing look.  He's standing between the door and me - I'm trapped.  Feeling threatened and in danger, I experienced an immediate stress reaction.  I calm him down while I move toward the door.

Scenario Two: I'm taking a taxi to the airport at 6:00 in the morning.  I'm totally relaxed, almost dozing off.  Suddenly, I remember something I've forgotten to do the day before.  Boom! A stress reaction.  I'm worried about the oversight and the consequences.

Two cases, two stress reactions - both short-lived, one stronger than the other.  Note though, that they were triggered by totally different situations: one an external threat, the other a spontaneous, internal thought.

In my last column I asked, "How do you know when you're having stress?" The next important question is: "Where's the stress coming from?"

Dr.  Hans Selye called these "stressors" or "triggers." Here's a helpful classification.

1.  Physical or environmental causes

First and foremost is any physical threat to your safety.  Other physical stressors may include loud noise, big crowds or cluttered surroundings.  I've had patients who walk the four flights of stairs to my office because they feel claustrophobic on the elevator.  Some people experience stress in airplanes.  Others find heights to be stressful.  When I was nine, I climbed a 100-ft.-high ranger tower in Haliburton, Ontario.  I was fine till the 75-ft.  mark when I made the mistake of looking out over the forests below.  Suddenly I was paralyzed with fear.  That was the last time I climbed a 100-ft.  ranger tower!

I also find it stressful to work in basements or in rooms without windows.

Note that some people are bothered by certain circumstances while others are not.  Just as we get different stress symptoms, so also our stress is triggered by different situations.  What is comfortable to one person can be terrifying to another.

2.  Social stressors

Don't you just love it when people talk your ear off and won't let you get a word in edgewise?  Or how about people who are rude and condescending and treat you like a speck of dust on their sleeve?  One of the most common sources of stress is interaction with other people.

This includes relationship problems, conflict with co-workers or bosses, feuds with neighbours, or people around whom you just feel stressed.  Often it's a particular individual, but sometimes it's general characteristics: people who are aggressive, critical, arrogant, loud, unreliable, negative or even boring.  It's a wonder we get along as well as we do.

3.  Institutional stressors

These are the rules and regulations of organizations or society at large.  They include arbitrary restrictions, bureaucratic red tape, constant deadlines, chains of command or pointless formalities.  Office politics and too-many long meetings are high on this list.

4.  Major life events

These are changes in life circumstances that can have a stressful impact for months or years.

At the top of this list is the death of a spouse, child or parent.  But it also includes losing a job, moving to a new city, separation or divorce, being a victim of crime or a serious car accident.

Major life events can be stressful even when they're positive.  In a 14-month period, I got married, we bought a house, had a child, and I changed careers - all good stuff, but still stressful.

In addition, effects from different events are cumulative.  So, losing a job and suffering a death in the family has a much greater impact than either of these by itself.

5.  Daily hassles

If you want to see a classical stress reaction, watch someone at the moment they realize they've just lost their keys or wallet.  There's a look of shock on their face.  They go ballistic as they scurry around, retracing their steps and trying to find the lost item.  This is hardly a major event, and yet it can trigger a pretty impressive stress reaction.

In the 1970's, psychologist Richard Lazarus coined the phrase, "daily hassles" to describe relatively small or repeated situations in day-to-day living.  Research showed that these were a better predictor of stress reactions and health problems than major life events.  Examples include concern about weight, worry about the health of a family member, rising prices, home maintenance, having too much to do, fear of crime, driving in rush hour traffic, or repetitive house chores.