Stressed? You've never had it so good

The Health and Safety Executive (HSE) reports that there has been a significant increase in the rate of self-reported work-related stress, anxiety and depression in Scotland in the last five years. Stress and related conditions account for 12.8 million lost working days per year in Britain, and cost British companies 1.24 billion.

For the first time, stress is overtaking back pain as the single biggest cause of long-term sickness absence. According to the Chartered Institute of Personnel and Development (CIPD) it is fast becoming one of the biggest issues facing employers. In our increasingly litigious culture, compensation payouts for stress-related problems are growing.

Meanwhile, de-stressing has become a multi-million-pound industry. We buy lavender oil, Chinese herbal capsules, whale music CDs. We can have our neuro-linguistics reprogrammed, our deep tissues massaged, our chakras rebalanced. Stress might be costing the country a fortune, but it's also a growth industry.

All this may sound indisputable... it isn't. A controversial new book to be published on 23 January attacks these ideas at their foundations. In The Truth About Stress, former Fulbright International Scholar Angela Patmore argues that stress is a myth, and the "stress industry" is an elaborate sham.

In a newspaper article last year Patmore, an expert who has advised the Metropolitan Police on stress, described the "stress epidemic" of the last two decades as "not only bogus, but deeply harmful to society. Rather than encouraging individuals to confront routine concerns and thus overcome them, it turns them into 'sufferers'..."

Her book will criticise the "laughable logic which has medicalised perfectly normal human emotions and mechanisms". In other words, life is stressful. Stop malingering and get on with it.

Cary Cooper, professor of organisational psychology and health at Lancaster University Management School, disagrees. "It's silly to say in our day and age that stress doesn't exist. It has always been there in the human condition. Sometimes the pressure on us reaches a point where we can't cope. That's not debatable, it just is the case."

The problem, according to Patmore, is that there is no scientific definition for "stress". In her research, she found more than 600 different ones. "Stress" is part of our daily parlance, used to describe everything from a bad day at the office to the loss of a life partner.

Dr Dean Marshall, a Dalkeith GP, says he is seeing increasing numbers of patients who use the word "stress" to describe their symptoms. "In a significant number of consultations, it is either the main presenting issue or is a background issue to what the person is dealing with."

The positive side of this is that people are more prepared than they once were to discuss aspects of their psychological health. The challenge he faces is to discern what stress can be dealt with easily, what might lead to a more serious mental illness, and what is simply a smokescreen for a few days gardening leave.

"It does happen, because like back pain it's hard to prove," he says, "but there are not nearly as many as you might think."

However, "stress" is a blanket term which is helpful only up to a point. "It's useful in the first instance because it's a term patients recognise. But there is no medical definition of stress. If you asked different people what they meant by stress you'd get quite different answers. It's not very scientific, so as doctors we try not to use it. We might use other terms like anxiety, psychological distress, minor depressive illness."

Angela Patmore goes further. She says that if there is no scientific definition for stress, it does not exist. This is also the conclusion reached by American psychologist Serge Doublet in his book The Stress Myth. "People feel stressed because they believe in the first place that feeling stressed is a legitimate condition. Without such a belief, the subjective feeling is not possible."

Another stress debunker is Dr Rob Briner of London's Birkbeck College. "People pathologise ordinary responses to work, like getting angry or depressed. If you go on a course that says these things are killing you, it could make things worse."

None of these experts would deny that traumatic events, or even the relentless pressure of everyday ones, can damage our mental health. But they do query the use of "stress" as a constant in our vocabularies - children are "stressed" by too much homework, teenagers "stressed" by exams, soldiers "stressed" by conflict situations they have been trained for. They also question the idea that life today is more stressful than it has ever been.

During the Blitz, for example, everyone lived under daily threat of enemy bombs. They worried about loved ones in the front lines, about rationing, and about what might happen if the Nazis invaded. Or take the Victorian age, when half of all children in poor families died before the age of five and families lived constantly with bereavement.

Dr Trevor Griffiths, senior lecturer in economic and social history at Edinburgh University, says that during the Industrial Revolution, people worked "more intensively" than we do today. "People at that time must have lived through much more fundamental change than we've ever experienced, and they took to popular religion as a means of seeking emotional solace. There were a lot of very radical religious sects which clearly fulfilled a need.

"In theory at least, life is rather easier now, certainly materially. The threat of direct involvement in things like armed conflict is rather less, so in theory we should be less stressed."

Phillip Hodson, a fellow of the British Association for Counselling and Psychotherapy disagrees. "Peasant life was physically stressful, but it was psychologically good. The kind of stress we have got now is the stress that comes from being wired all the time. We are stressed by the technology that has developed, we are over-stimulated for far too long."

Cary Cooper says another key factor is the breakdown of traditional support structures. "In close-knit communities and extended families, people would support one another. In wartime, everyone pulled together, facing a common enemy. In the last two decades we have moved away from the extended family, we have no sense of community.

"The other factor is that jobs are no longer secure. From shop floor to top floor there is constant change. Stress isn't about hunger, it's about feeling insecure, dealing with constant change, not having anybody to turn to. Now there is more pressure on people probably than ever before."

But it is not enough to say work in the 21st century is making us ill. Personality types cope differently with stress. People who experience more serious difficulties will do so because of a complex range of factors, personal and professional.

Research suggests that being unemployed is worse for one's mental health than having a stressful job.

Many experts will make a distinction between positive and negative stress. With no stress at all, we'd never get anything done. The average newspaper office wouldn't contain much activity if there were no deadlines.

Success expert Robin Sieger, author of Natural Born Winners, says: "Stress is part of the balance of life, it draws attention to things that need attention.But I would never say that stress is good. It can eat away at the core of yourself."

Angela Patmore has said that using the word "stress" in the workplace can do more harm than good. If the problem is bad management, poor training or overwork, calling it "stress" can lead to the action necessary to improve the situation not being taken.

Phillip Hodson says: "There's a lot of nonsense talked about workplace stress. Hard work never hurt anybody.

"As far as the evidence goes, there are two factors which do cause problems - if you have no control over what you do, and if your hard work is not appreciated. There is such a thing as overload, but life without pressure is called death."