The recent emergence of Severe Acute Respiratory Syndrome (SARS) has been distressing for health care workers, people directly affected by the disease, and people who have not been directly affected but are concerned about the potential danger of SARS.

SARS is a serious health problem that we should all be concerned about. Hospitals and public health authorities are taking reasonable precautions to contain the disease and protect the health of the general public, patients and families directly affected by the disease, and health care professionals. However, intensive media coverage and strong messages from hospital and public health officials can also produce extra concern and stress for some people.

Concern and Anxiety

It's normal in times of a serious threat to public health for people to be concerned. People with SARS and their families are extremely concerned, and health care workers are also reasonably concerned. It even makes sense for people in the community who are currently unaffected by SARS to be at least somewhat concerned.

Some concern due to a threat like SARS is a normal healthy reaction. Concern can help motivate us to think about problems and make decisions that will help us cope. However, at some point too much anxiety can make things worse.

Stigma

It's not uncommon for people with a new infectious disease to be stigmatized. It's very important to remember that SARS is not confined to a particular ethnic community, group, profession, life-style or religion.

What is Stress?

Stress is what we experience when our body responds to a change in our environment. People often experience an extreme stress response as a reaction to immediate life-threatening events. For example, if your life is threatened your immediate stress response might include an increased heart rate, breathing, alertness, fear and arousal as you body prepares a "fight or flight" response to the danger.

Symptoms of Stress

There are a number of symptoms of stress including:

Psychological Symptoms: Worry Anxiety Panic Attacks Sadness, Crying, Depression Anger Irritability Agitation Easily Startled Hopelessness Helplessness Problems Concentrating

Physical Symptoms: Lack of Energy Changes in Sleep Changes in Appetite Aches and Pains Poor Physical Health Feeling "run down" Frequent Urination or Bowel Movements Stomach Aches, Headaches, Backaches Nausea

Unusual Behaviours: Avoiding People, Places or Situations Increased use of Alcohol/Prescription Drugs

Stress and Life Events

Any change in your life, even a positive change, can result in the experience of stress. So, for example, the death of a loved one, loss of a job or end of a relationship is often considered to be significant negative stressful events. However, even more "positive" changes such as marriage, promotion at work, or moving to a new home can cause stress.

Some people may be more vulnerable to stress because of their experiences in childhood, personality, social supports, or coping style. However, in general, more life change results in more stress. A moderate amount of stress may be good for us as stress can help motivate us to make positive changes in our lives. However, the experience of too much stress can lead to feelings of loss of control (panic), excessive anxiety (worry), as well as anger, irritability or feelings of sadness (depression). In addition, too much stress can result in increased risk for a number of stress-induced illnesses including headaches, stomach problems and lower back pain.

In addition to your concern about SARS, you may have experienced other recent life changes that have contributed to your current level of stress.

Life events that cause stress include:

Death of a spouse of partner Divorce Separation for spouse or partner Serving jail time or probation Death of a close family member Serious personal injury or illness Getting married or establishing a partnership Getting fired or laid off Retirement Pregnancy Problems with sex life Birth or other addition of anew family member Major changes in workplace or job description Major change in financial status (for better or worse) Death of a close friend Change in number of arguments with spouse or partner (more or less) New mortgage or loan Foreclosure of mortgage or loan Son or daughter leaving home

Trouble with in-laws Outstanding personal achievement Change in work or employment status of spouse or partner Starting or ending school Major changes in living conditions (renovations, new roommates) Change in personal habits (diet, exercise, quitting smoking) Trouble or dispute with boss Moving to a new home or residence Change to a new school Major change in amount or type of exercise/recreation Major change in religious or spiritual activities Major change in social activities (more or less) Major change in sleeping habits Change in number of family get-togethers Vacation or holiday Christmas or other major religious/cultural holiday or festival Minor violation of the law (traffic tickets, parking tickets)

Adapted from: Holmes TH & Rahe, RH (1967) The Social Readjustment Scale, Journal of Psychomatic Research , 11, 213-218

Vulnerability to Stress

While the number and significance of changes in your life over the past year may affect how you are responding to other recent changes, including SARS, there are a number of other important variables that determine our reactions to life changes, including lifestyle and social support.

The Stress Scale

How vulnerable are you to stress? This stress scale was created largely on the basis of results compiled by clinicians and researchers who tried to identify how people effectively cope with stress. Please read carefully and check those boxes that apply to you.

*Adapted from a stress assessment test created by Dr. George Everly Jr. of the University of Maryland. It is reprinted from a U.S. Public Health Service pamphlet, "What Do You Know About Stress" (DHHS Publication No. PHS79-50097) and is in the public domain.

Calculate Your Score:

If your total score is less than 50: Your score indicates that as a result of a number of lifestyle and social factors you are likely at increased risk for experiencing significant stress symptoms.

If your total score is greater than 50 but less than 60: Your score indicates that as a result of a number of lifestyle and social factors you are likely at moderate risk for experiencing significant stress symptoms.

If your total score is more than 60: Your score indicates that there are a number of lifestyle and social factors that may protect you from experiencing significant stress symptoms.

Next Section: Your Coping Style