Pressure creates stress. It is an individual's response to this pressure that is important. An inappropriate response may lead to stress, and this may be due to the individual's own shortcomings, as heredity, lifestyle and diet can all affect the response. This makes the coping strategy very important. When the stressor is confronted successfully by applying relevant coping strategies, all is fine. It is where unsuccessful coping strategies lead to continued stress that stress-related illness may occur.

Stress can be brought on by the individual's personality characteristics and attitudes, but it is also possible that the stress is initiated by external pressures, such as work situation, world events and sudden and unexpected lifestyle changes. This means there is an interaction between external factors and their effects on the individual due to the manner in which the events are perceived and internalised by the individual. Each person will react differently to the same event; some may experience chronic stress, others go unaffected.

Therefore it seems appropriate to conclude that stress can be brought on by an individual's reaction to outside events, which is clearly an interaction between the individual's inherent shortcomings and the outside influences.

There are large numbers of physical illnesses which may have stress as a major contributory factor. Anything that causes fear, anxiety, worry, anger or even excitement can cause physical responses and disease. Part of this is due to evolutionary history as at one time people had to live with the constant physical threat from wild animals, each other, and natural elements. As a consequence, man adapted to be able to cope with these physical stresses. The 'fight or flight' mechanism with its physiological changes is well documented. Modern man still has these mechanisms which are alerted when a threat, real or imagined is perceived and the body is prepared for danger but situations often demand there is no outlet, and so where no action can be taken, the body's systems remain active.

It is well accepted that exposure to prolonged stress can lead to hypertension, or raised blood pressure. A physical illness, such as asthma, may stem from emotional upsets. Such attacks tend to be characterised by wheezing, panting and a feeling of being suffocated.

As a result of these physical symptoms, the individual may become more distressed and this in turn will lead to a greater degree of the typical wheezing, panting etc. which creates a spiralling effect.

It can be helpful in such cases if the factors creating the emotional stress can be reduced or even eliminated.