The amount of blood available in the body is, however, limited. In order to deliver extra blood to select areas—the muscles, heart, lungs, kidneys and the brain—there is a temporary cutoff in blood supply to non-priority areas. Consequently, the digestive system slows or stops altogether, the salivary glands stop secreting, blood vessels in the kidneys and the abdomen constrict and the immune system slows down.

These physiological effects are categorized as 'arousal'. Concomitant emotional manifestations like fear, apprehension and worry are termed 'anxiety'.

Once the Neanderthal dealt with the threat-usually an animal, which he fought off or fled from—the body's reactions quickly returned to normal. All of which was fine in the good old days of yore.

"Unfortunately," says corporate consultant Santhosh Babu, "this wonderful survival tool hasn't adapted to modern forms of stress. Today we react the same way with the boss as our ancestors reacted to a tiger-despite the fact that we have choices other than fighting or fleeing!"

Medically, stress is defined as a perturbation of the body's homeostasis. The common indices of stress include changes in:
(i) biochemical parameters such as epinephrine and adrenal steroids,
(ii) physiological parameters such as heart rate and blood pressure and
(iii) behavioral effects such as anxiety, fear and tension. In essence, stress is an umbrella term that encompasses physical trauma, strenuous exercise, metabolic disturbances and anxiety as they produce challenges to the body's homeostasis. The wear and tear that stressors subject our body too is termed as stress.

Says Dr Chugh: "Stress is how people react to demands placed on them and arises when there is worry about one's capacity to cope. Seventy-five to 90 per cent of adult visits to primary care physicians are for stress-related problems."

For the lay person, however, the word stress has mental rather than physiological connotations. As Anandi Iyer, Deputy Director at German Technical Cooperation (GTZ) says: "Stress occurs when you are incapable of handling a given situation. For instance, for soldiers constantly at the border, the situation is no longer so stressful. But for others, it would be."

Stress affects your body's ability to handle various kinds of foods because it causes a sudden constriction of your blood vessels. This raises blood pressure and reduces the amount of blood flowing to the stomach and intestines. The flow of enzymes is slowed as well so that much of the food you eat, particularly if it has a high fat content, is poorly digested. Instead of being broken down properly, it ferments in the intestine, causing gas and distention.

Another thing that happens right away in a stress reaction is a hormonal alert that your blood needs more glucose. In other words, you feel hungry all the time. This may prompt you to eat a lot of carbohydrates, either in the form of sugar or starch. The reaction is an appropriate one if you are facing strenuous physical exertion, but it gives you only surplus calories if the stress is psychological.

There are some helpful pointers you can follow for an anti-stress diet:

• Cut down on table salt and other sources of sodium because of their link with high blood pressure. Remember that preservatives may also contain sodium.

• Drink only moderate amounts of coffee and tea and remember that caffeine is present in both. Caffeine, nicotine and alcohol are stress-stimulants.

• You should have eight big glasses of fluids every day. This helps to flush waste products out of the body.

• Eat foods rich in potassium, like oranges and bananas. Potassium is essential for maintaining the balance of minerals within body fluids and plays a key role in muscle contraction.

• Be sure to get enough calcium, as you tend to lose it when you are stressed. Try to have at least two glasses of skimmed milk a day.

• Vitamin C is important as it keeps the walls of the capillaries flexible. The blood vessels constrict at the first sign of stress, and this results in the depletion of vitamin C in the body.

• Vitamin B serves as a catalyst in the production of energy, and in the metabolism of protein and fats. It is also necessary for the central nervous system. In conditions of stress (especially physical), supplements are advisable. Increase the intake of green leafy vegetables, eggs, milk, whole grains and yeast.

• Nitrogen, the base of the body's protein, is excreted under stress. So protein intake should be increased by 10 per cent during a period of stress.

Five small meals are easier on the digestive system than three big ones. The additional small meals can take the form of afternoon or bedtime snacks.

However, this phenomenon is not as simplistic as it sounds. Different individuals subjected to the same stressful event may react differently, with responses ranging from extreme to mild to absent.

Although the causes of stress are myriad, we could loosely categorize these into common and uncommon stressors. Common stressors comprise disease, academic stress (heightened during examinations), marital discord, separation or divorce, career stress, bereavement and unemployment.

The uncommon ones include overcrowding, commuting, sleep deprivation, shifts (home, school, career), malnutrition, drug abuse, phobias, excessive exercise, noise pollution, et al.

It isn't just adults who fall prey to stress. Modern lifestyles are exacting a toll on impressionable kids and unsuspecting teenagers too. In the words of Dr Chugh: "A fairly large number of children have stress problems related to studies and unrealistic parental expectations. And there are huge numbers of stressed teenagers. These are cases related to academics, relationships, parental expectations, drug and alcohol abuse and even sexual experimentation that backfires. Examination stress is phenomenally high, especially during board exams."

Frustration through sexual deprivation, social or peer pressure to conform, and the struggle for professional advancement all cause stress. It was Sigmund Freud (1856-1939) who pointed out that if psychic energy is unable to meet its original objective, it fixes upon an alternative. This impulse leads to sublimation. It can also lead to stress. While the individual adapts to the situation, if pressures become unbearable or persistent, he may enter a state of chronic stress.

Earl Wilson drove this point home laterally in his pithy observation on hypertension: "One way to get high blood pressure is to go mountain climbing over molehills."

Stress can be the culprit in palpitations, heart attacks, migraine and tension headaches, eating disorders, ulcers, irritable bowel syndrome, colitis, diabetes, backache, chronic fatigue syndrome, dermatitis, allergies, colds and coughs, asthma, insomnia, stammering, phobias, depression, premature aging…

The list is endless.

In many illnesses, however, there may be multiple pathways by which symptoms occur, and stress may act as a predisposing, precipitating, and/or sustaining factor. Not surprisingly, many of these ailments are associated with immune alterations. The influence of stress may also be complex and indirect. In his study of gout, H. Weiner (1977) discovered that exacerbation were connected to dietary habits. Flare-ups typically occurred during periods of stress when patients exhibited less dietary control, guzzled greater amounts of alcohol, took medication less regularly and got insufficient sleep.

Can stress really cause illness? The ecumenical belief holds that an individual's emotional state can directly affect his well being. Empirical evidence demonstrates that a variety of personality traits and stressful life events are correlated with both the provocation and the increased incidence of many psychosomatic disorders, including cancer.

B.H. Fox (1978) hypothesizes two primary cancer-causing mechanisms. The first, 'carcinogenesis', involves an agent or mechanism which produces cancer by overcoming the body's natural resistance. The second, 'lowered resistance to cancer', permits a potential carcinogen normally insufficient to produce cancer to do so due to a weakened emotional state, for example.

Researchers like D.M. Kissen (1969) have argued that the stress of adverse circumstances and the loss of a loved one can lead to cancer by psychological mechanisms of "despair, depression and hopelessness".

Some researchers have linked the theory of learned helplessness to health. Helplessness has been defined as "the psychological state that frequently results when events are uncontrollable". It is used interchangeably with hopelessness, describing a feeling that a situation is without solution. Hopelessness has often been associated with early relapse and mortality in cancer studies. Examining survival rates of patients post-surgery and 10 years after a psychological interview, S. Greer (1985) found telling conclusions. Those displaying a helpless attitude or a stoic acceptance had recurrent disease or died earlier than those responding with 'denial' or a 'fighting spirit'.

In the 1950s, Dr Franz Alexander of Chicago found that strong but inhibited aggressive impulses led to increased muscle tension, a contributing factor in rheumatoid arthritis. Along with anxiety, it raised blood pressure, as though the body "were constantly in preparation for a fight which never takes place". Dr Alexander showed that high blood pressure is rare among African blacks, but frequent in American blacks-an incontrovertible proof of the damaging effects of a more stressful environment.

So is there something like positive stress? Well, yes and no. It depends on whom you're speaking with! And how they perceive stress.

"Anything that takes you away from the quality of existence is stress. I don't believe that a person needs stress to perform well. A stressed-out individual will not be able to perform well. It's like being constantly driven in life," emphasizes Sukhdeepak Malvai.

Says D.D. Rajdev of Fibcom India: "One has to take stress in a positive way. There has to be some stress in life to motivate you so that you put your best foot forward. But I'm not talking about the kind of stress that breaks one down. There is something like positive stress."

"Some amount of stress is good as it drives you. But if it can't be handled beyond a point, it's negative. I personally need some amount of stress. I need the challenge. Or else I end up procrastinating," laughs Anandi Iyer of GTZ.

"Yes, some stress is good. For example, the stress students feel before examinations helps them study better and pass," agrees hypnotherapist Santhosh Babu.

Although the word is normally thought to have negative implications, it need not always be so. All stress doesn't cause immuno-suppression. Studies show that specific stressors actually increase host resistance to some pathogenic organisms, besides augmenting certain immune responses. Research indicates that the stress-induced, immuno-suppressive properties of adrenal glucocorticoids are counterbalanced by the stress-induced increase in prolactin and growth hormone.

The explanation illustrates the awesome power of mind over matter.

The cholera bacillus flourishes in an alkaline medium that, when taken into the body, is normally killed by stomach acids. But fear and worry can alter the rate of acid secretion in the stomach. In a cholera epidemic, young people worry the most, being the breadwinners. Tragically, the worry created by their sense of responsibility alters the acid content of their stomachs, allowing the cholera bacilli to slip through into the alkaline haven of the small intestine. Babies who are oblivious to their illness and the aged who aren't bothered about whether they live or not, survive because their stomachs continue to secrete acid normally.

Reviewing the relationship between personality, stress and death from cancer and heart disease, H.J. Eysenck (1988) found that stress was a potent cause of death-stressed individuals having a 40 per cent higher death rate than non-stressed ones.

Response to stress is not static. It fluctuates and changes as the person interacts with and responds to the stressor. At the workplace, stressed people could be prone to 'desk rage'-flinging whatever comes to hand at colleagues, across the room or on their tables.

"Stress can be subdivided into constructive stress and destructive stress. The former is positive and a good motivator. It increases productivity and efficiency, besides providing stimulation. Destructive stress is counterproductive and detrimental to both psyche and body," Dr Chugh elaborates.

"Statistics don't really bear this out though my personal and professional opinion is that females handle stressors better than men do," opines Dr Chugh.

Sukhdeepak Malvai, a corporate consultant, firmly believes that: "Men seem to be more stress prone. They are more likely to get into other things that add to stress-like alcoholism or smoking. Of course, I'm not implying that women don't indulge in these. Women are better equipped to deal with emotional issues. Men find it difficult to express anxiety and sorrow; women are more apt to do so. On the other hand, women undergo a lot more stress of another kind as they have to constantly prove they are as good as their male peers."

Agrees D.D. Rajdev, the CEO of Fibcom India Ltd: "I feel women are much better at handling stress, with a higher level of tolerance. Most men end up expressing stress in some other way."

Ex-journalist Anandi Iyer echoes similar sentiments: "Women tend to have more stress because they have to manage two worlds, home and career. So they are stretched and stressed a little more. But women manage to balance both worlds and have more tenacity. Men tend to flap, while women deal with stress more rationally."

Malvika Joshi, a general manager at Fibcom India, thinks otherwise: "I feel men handle stress equally well as women. Men are more composed and don't show stress. Women show it."

If you constantly seek to control the situation and achieve a 'perfect ten', don't. Delegate tasks to subordinates. Strive for excellence, not perfection. Excellence is a positive aspiration. Except in a high-precision industry, perfectionism can be a very negative attribute that induces stress in oneself and others.

A positive attitude can dramatically reduce stress and transform an individual's life. Ask Anandi Iyer. "A perfectionist who couldn't tolerate any imperfection, I was always crabby and snapping at everyone. I had a short tolerance level. All this made my job stressful and affected me physically. I had constant headaches.

"A year ago I came across C.B. Satpathy who showed me the path to Shirdi Sai Baba," says the lady, smiling and indicating, with an expansive wave of her arm, Sai Baba's pictures all over her cabin. "After the spiritual connection began, realization dawned and my life changed. Now I'm more relaxed. I realize that stress occurs when you are incapable of handling a given situation. Of course, I'm still a workaholic and find it difficult to take leave. But I've developed a positive outlook. Earlier, I could blast the staff if my printer didn't work. I don't anymore. Life offers choices. Nothing is the ultimate. Earlier, I wanted everything to be perfect. Today, I'm more tolerant and less stressed."

To lead a more or less stress-free existence, Dr Sanjay Chugh has a practical recipe: "Redefine priorities, reassess abilities and potential, have realistic and flexible expectations, regular exercise, a healthy lifestyle and a balanced diet."

According to Joe Rodrigues, the Director of Breakthrough Communication Services in Mumbai: "The pillars of stress management are meditation, physical exercise and proper eating habits. I hold a three-day workshop on stress management which takes a body-mind-spirit approach to handling stress."

In daily life, people use two kinds of coping strategies-positive or negative. Positive coping includes time management, proper nutrition, healthy relationships and social support, regular exercise, recreational activities, sufficient sleep, vacations, meditation, relaxation techniques, a sense of humor, auto-suggestion, self-hypnosis, creative visualization, massage and yoga, to name a few.

Negative coping includes smoking, drinking, drugs, food, tranquilizer and stimulants like tea and coffee.

There are specific stresses related to specific situations or problems that are sorted out once the situations get over. But then there are certain stresses that are part of the teenage years. Identity crisis is one of them. What do I want from life? What should I be? It is not only regarding career prospects but a much bigger concern of a teenager about fitting into the adult world. When a teenager leaves the safe world of childhood, his/her personality can develop in any direction and this is the time of identity crisis.

Teenagers want independence and parents are forever wavering between treating them as adults and/or children. A typical stress in such a situation is, as my daughter tells me: "I am scared Papa will get angry."

Sometimes teenagers feel that their parents are imposing the personality traits they do not have or do not want to have, upon them. For instance, you must have noticed that professionals like doctors and architects want their children to follow in their footsteps. Sometimes the reason might be practical, for instance a parent owning a hospital would naturally expect his child to become a doctor and run the hospital.

But the child may not have the aptitude for the same profession, and may want to do something totally different in life, and parental or family pressures may be such that s/he may succumb. This causes acute stress and worsens the already existing identity crisis.

Take the case of Sangita, the daughter of a doctor couple. A bright student, Sangita grew up believing that her parents' profession was the best profession in the world. Naturally, she took up science in school and started preparing for entrance examinations to various medical colleges. That was the time she realized that she could not handle the subjects, but it was too late. She appeared for all the entrance tests and failed each one.

Her parents were shattered. They visited holy shrines and organized private coaching classes for her. She was made to appear for the entrance tests again. By this time Sangita was absolutely certain that the medical profession was not for her and wanted to try her hand at business management, but her parents would hear nothing of it. Sangita failed yet again.

Now their relatives stepped in. Her father's elder brother finally managed to convince them that it was not at all mandatory for the child to follow her parents' footsteps. Sangita did her MBA and joined a multinational bank, subsequently settling down happily in life. The four years of her life wasted in studying subjects she had no aptitude for were lost, but fortunately they were only four years. In some cases a lot more time is wasted.

What about those teenagers, who get the subjects they want, yet lack the clarity to achieve their goal? Parents play a key role in developing their teenager's self-esteem. Parental indifference to their child's success or failure results in a lack of initiative in the child. Such teenagers are not motivated to try anything new or challenging, including making new friends.

On the other hand, some parents are overprotective and end up stifling their child's efforts to grow up. If parents set high but achievable standards and express support for their teenager's abilities, children would be quite confident of succeeding.

Friends also play an important role in a teenager's life, as they can learn more about their identity away from the family. And conforming to the customs of a group can make a teen feel like s/he fits in. This sense of belonging is an important need as teens traverse the difficult years of being no longer children but not yet adults.