STRESS A

ND HEALT

H

STRESSStress is the physiological and psychological

responses to situations or events that disturb the equilibrium of an organism.

Stress results when demands placed on an organism cause unusual physical, psychological, or emotional responses. In humans, stress originates from a multitude of sources and causes a wide variety of responses, both positive and negative.

Despite its negative connotation, many experts believe some level of stress is essential for well-being and mental health.

STRESS AND ILLNESS

To study how stress and healthy and unhealthy behaviors influence health and illness, psychologists and physicians created the interdisciplinary field of behavioral medicine, integrating behavioral and medical knowledge. Health psychology provides psychology’s contribution to behavioral medicine. For psychologists, health is more than “merely the slowest possible rate at which one can die”.

Health psychologists ask: How do our emotions and personality influence our risk of disease? What attitudes and behaviors help prevent illness and promote health and wellbeing? How do our perceptions of a situation determine the stress we feel? How can we reduce or control stress?

PERSON’S NEEDS

A MOMENTARY STRESS

A momentary stress can mobilize the immune system for fending off infections and healing wounds. Stress also arouses and motivates us to conquer problems. Championship athletes, successful entertainers, and great teachers and leaders all thrive and excel when aroused by a challenge.

Having conquered cancer or rebounded from a lost job, some people emerge with stronger self-esteem and a deepened spirituality and sense of purpose. Indeed, some stress early in life is conducive to later emotional resilience.

STRESSORS

Stressors—events or situations that cause stress— can range from everyday hassles such as traffic jams to chronic sources such as the threat of nuclear war or overpopulation.

Much research has studied how people respond to the stresses of major life changes. The Life Events Scale lists these events as the top ten stressors: death of spouse, divorce, marital separation, jail term, death of close family member, personal injury or illness, marriage, loss of job through firing, marital reconciliation, and retirement.

It is obvious from this list that even good things—marriage, retirement, and marital reconciliation— can cause substantial stress.

FAZES OF STRESS REACTION

TOP TEN STRESSFUL EVENTS

Death of spouseDivorceMarital separationJail term or death of close family memberPersonal injury or illnessMarriageLoss of job due to terminationMarital reconciliation or retirementPregnancyChange in financial state

THE STRESS RESPONSE SYSTEM

Medical interest in stress dates back to Hippocrates. Walter Cannon confirmed that the stress response is part of a unified mind-body system. He observed that extreme cold, lack of oxygen, and emotion-arousing incidents all trigger an outpouring of the stress hormones epinephrine and norepinephrine from the central core of the adrenal glands. This is but one part of the sympathetic nervous system’s response.

When alerted by any of a number of brain pathways, the sympathetic nervous system, as we have seen, increases heart rate and respiration, diverts blood from digestion to the skeletal muscles, dulls pain, and releases sugar and fat from the body’s stores—all to prepare the body for the wonderfully adaptive response that Cannon called fight or flight.

THE “FIGHT OR FLIGHT” RESPONSE

The “fight or flight” response involves a complex pattern of innate responses that occur in reaction to emergency situations. The body prepares to handle the emergency by releasing extra sugar for quick energy; heart rate, blood pressure, and breathing increase; muscles tense; infection-preventing systems activate; and hormones are secreted to assist in garnering energy.

The hypothalamus, often called the stress center of the brain, controls these emergency responses to perceived life-threatening situations.

Photographs of Hans Selye at work in 1951, at his International Institute of Experimental Medicine and Surgery at the University of Montreal

THREE VIEWS OF STRESSFocus on the environment: stress as a stimulus (stressors)

(The SRRS)Reaction to stress: stress as a response (distress) (F/F)Relationship between person and the environment: stress

as an interaction (coping)Fight or Flight Response and its physiological

consequences: Increase in Epinephrine & Cortisol, Heart rate & blood pressure, Levels & mobilization of free fatty acids, cholesterol etc

Selye’s General Adaptation Syndrome (1956, 1976, 1985)

Alarm Reaction Fight or flight

Exhaustion Limited physical resources; resistance to disease collapses; Disease/death

Resistance Arousal high as body tries todefend and adapt.

Perceived Stressor

COGNITIVE MODEL OF STRESS (LAZARUS & FOLKMA)Potential stressor (external event) Primary appraisal – is this event positive, neutral

or negative; and if negative, how bad? Secondary appraisal – do I have resources or

skills to handle event? If No, then distress.Primary appraisal – Is there a potential threat? Outcome – Is it irrelevant, good, or stressful?

If stressful, evaluate further: Harm-loss – amount of damage already caused. Threat – expectation for future harm. Challenge – opportunity to achieve growth, etc

STRESS CAUSES

The following are risk factors for uncontrollable stress:

Social and financial problems

Medical illness

Lack of social support

Family history

AFFECTING THE INNER EMOTIONS

Stress usually first affects the inner emotions. Initial symptoms may include the following feelings:

Anxiousness

Nervousness

Distraction

Excessive worry

Internal pressure

AFFECTING A PERSON'S OUTWARD APPEARANCE

These emotional states can then begin to affect a person's outward appearance:

Unusually anxious or nervous

Distracted

Self-absorbed

Irritable

EMOTIONAL OR PHYSICAL EFFECTS Excessive fatigue Depression Sometimes even think of hurting yourself or others Headaches Nausea and vomiting Diarrhea Chest pain or pressure Heart racing Dizziness or flushing Tremulousness or restlessness Hyperventilation or choking sensation

In most cases, these symptoms are very minor and don’t last very long. If they become more severe or increase in frequency and severity, seek medical help.

REACTIONS TO STRESS

Reactions to stress vary by individual and the perceived threat presented by it.

Psychological responses may include cognitive impairment—as in test anxiety, feelings of anxiety, anger, apathy, depression, and aggression.

Behavioral responses may include a change in eating or drinking habits.

STRESS AND THE HEART

Elevated blood pressure is just one of the factors that increase the risk of coronary heart disease, the closing of the vessels that nourish the heart muscle.

Although infrequent before 1900, this condition became by the 1950s North America’s leading cause of death, and it remains so today. In addition to hypertension and a family history of the disease, many behavioral and physiological factors—smoking, obesity, a high-fat diet, physical inactivity, and an elevated cholesterol level—increase the risk of heart disease. The psychological factors of stress and personality also play a big role.

STRESS AND PATHOLOGY

A relatively new area of behavioral medicine, psychoimmunology, has been developed to study how the body’s immune system is affected by psychological causes like stress.

While it is widely recognized that heart disease and ulcers may result from excess stress, psychoimmunologists believe many other types of illness also result from impaired immune capabilities due to stress. Cancer, allergies, and arthritis all may result from the body’s weakened ability to defend itself because of stress.

COPING WITH STRESS

Coping with stress is a subject of great interest and is the subject of many popular books and media coverage.

One method focuses on eliminating or mitigating the effects of the stressor itself. For example, people who experience extreme stress when they encounter daily traffic jams along their route to work may decide to change their route to avoid the traffic, or change their schedule to less busy hours.

Instead of trying to modify their response to the stressor, they attempt to alleviate the problem itself. Generally, this problem-focused strategy is considered the most effective way to battle stress.

BIOLOGICAL FEEDBACK FOR COPING STRESS

EMOTION-FOCUSED METHODS

Another method, dealing with the effects of the stressor, is used most often in cases in which the stress is serious and difficult to change.

Major illnesses, deaths, and catastrophes like hurricanes or airplane crashes cannot be changed, so people use emotion-focused methods in their attempts to cope. Examples of emotion-focused coping include exercise, drinking, and seeking support from emotional confidants.

DEFENSE MECHANISMS

Defense mechanisms are unconscious coping methods that help to bury, but not cure, the stress.

Sigmund Freud considered repression— pushing the source of stress to the unconscious— one way of coping with stress. Rationalization and denial are other common emotional responses to stress.

DISCOVERING OF STRESS IN EXPERIMENT