UNIT 1

STRESS

Stress is a psychological and physiological response to events that upset our personal balance in some way. When
faced with a threat, whether to our physical safety or emotional equilibrium, the body's defenses kick into high gear
in a rapid, automatic process known as the “fight-or flight” response. We all know what this stress response feels
like, heart pounding in the chest, muscles tensing up, breath coming faster, and every sense on red alert.

• Eustress is a term for positive stress—stimuli that push us to act, take on challenges, meet deadlines.

• Distress is a term for Negative stress, dangers, and seemingly insurmountable problems

The Body’s Stress Response

**The “fight-or-flight” stress response involves a cascade of biological changes that prepare us for emergency
action. When danger is sensed, a small part of the brain called the hypothalamus sets off a chemical alarm.
Through a combination of nerve and hormonal signals, this system prompts the adrenal gland to release adrenaline
and cortisol. Adrenaline increases the heart rate, elevates blood pressure and boost energy supplies. It races through
the bloodstream, readying us to either flee the scene or battle it out. Heart rate and blood flow to the large muscles
increase so we can run faster and fight harder. Blood vessels under the skin constrict to prevent blood loss in case
of injury, pupils dilate so we can see better, and our blood sugar ramps up, giving us an energy boost and speeding
up reaction time. Cortisol the primary stress hormone increases sugar level in the blood stream enhances your
brain’s use of glucose and increase the availability of substances that repair tissues.

At the same time, body processes not essential to immediate survival is suppressed. The digestive and
reproductive systems slow down, growth hormones are switched off, and the immune response is inhibited. The
biological stress response is meant to protect and support us. It’s what helped our ancestors survive the life-or-
death situations they commonly faced. But in the modern world, most of the stress we feel is in response to
psychological rather than physical threats. Whether we’re stressed over a looming deadline, an argument with a
friend, or a mountain of bills, the warning bells ring. And just like a caveman confronting a saber-toothed tiger, we
go into automatic overdrive.

If you have a lot of responsibilities and worries, you may be running on stress a good portion of the time—
launching into emergency mode with every traffic jam, phone call from the in-laws, or segment of the evening
news. But the problem with the stress response is that the more it’s activated, the harder it is to shut off. Instead of
leveling off once the crisis has passed, your stress hormones, heart rate, and blood pressure remain elevated.
Furthermore, extended or repeated activation of the stress response takes a heavy toll on the body. Prolonged
exposure to stress increases your risk of everything from heart disease, obesity, and infection to anxiety,
depression, and memory problems. Because of the widespread damage it can cause, it’s essential to learn how to
deal with stress in a more positive way and reduce its impact on your daily life.

Signs and Symptoms of Stress

To get a handle on stress, you first need to learn how to recognize it in yourself. Stress affects the mind, body, and
behavior in many ways— all directly tied to the physiological changes of the fight-or-flight response. The specific
signs and symptoms of stress vary widely from person to person. Some people primarily experience physical
symptoms, such as low back pain, stomach problems, and skin outbreaks. In others, the stress pattern centers on
emotional symptoms, such as crying or hypersensitivity. For still others, a change in the way they think or behave
predominates. The following table lists some of the common warning signs and symptoms of stress. Use it to
identify the symptoms you typically experience when you’re under stress. If you know your red flags, you can take
early steps to deal with the stressful situation before it—or your emotions— spiral out of control.

Stress Warning Signs and Symptoms

Cognitive Symptoms
• Memory problems
• Indecisiveness
• Inability to concentrate
• Trouble thinking clearly
• Poor judgment
• Seeing only the negative
• Anxious or racing thoughts
• Constant worrying
• Loss of objectivity
• Fearful anticipation

Emotional Symptoms
• Moodiness
• Agitation
• Restlessness
• Short temper
• Irritability, impatience
• Inability to relax
• Feeling tense and “on edge”
• Feeling overwhelmed
• Sense of loneliness and isolation
• Depression or general unhappiness

Physical Symptoms
• Headaches or backaches
• Muscle tension and stiffness
• Diarrhea or constipation
• Nausea, dizziness
• Insomnia
• Chest pain, rapid heartbeat
• Weight gain or loss
• Skin breakouts (hives, eczema)
• Loss of sex drive
• Frequent colds

Behavioral Symptoms
• Eating more or less
• Sleeping too much or too little
• Isolating yourself from others
• Procrastination, neglecting
responsibilities
• Using alcohol, cigarettes, or drugs to
relax
• Nervous habits (e.g. nail biting, pacing)
• Teeth grinding or jaw clenching
• Overdoing activities (e.g. exercising,
shopping)
• Overreacting to unexpected problems
• Picking fights with others
Keep in mind that the signs and symptoms of stress can also be caused by other psychological and medical
problems. If you’re experiencing any of the warning signs of stress, it’s important to see a doctor for a full
evaluation. Your doctor can help you determine whether or not your symptoms are stress-related.

STRESSOR
A stressor is a chemical or biological agent, environmental condition, external stimulus or an event that causes
stress to an organism. Stressors have physical, chemical and mental responses inside of the body. Physical stressors
produce mechanical stresses on skin, bones, ligaments, tendons, muscles and nerves that cause tissue deformation
and in extreme cases tissue failure. Chemical stresses also produce biomechanical responses associated with
metabolism and tissue repair. Physical stressors may produce pain and impair work performance. Chronic pain and
impairment requiring medical attention may result from extreme physical stressors or if there is not sufficient
recovery time between successive exposures.

Stressors may also affect mental function and performance. One possible mechanism involves stimulation of the
hypothalamus, CRF (corticotropin release factor) -> pituitary gland releases ACTH (adrenocorticotropic hormone)
-> adrenal cortex secretes various stress hormones (e.g., cortisol) -> stress hormones (30 varieties) travel in the
blood stream to relevant organs, e.g., glands, heart, intestines -> flight-or-fight response. Between this flow there is
an alternate path that can be taken after the stressor is transferred to the hypothalamus, which leads to the
sympathetic nervous system. After which, the adrenal medulla secretes epinephrine. Mental and social stressors
may affect behavior and how individuals respond to physical and chemical stressors.
An event that triggers the stress response may include:

• Environmental stressors (hypo or hyper-thermic temperatures, elevated sound levels, over-illumination,

overcrowding) Your physical surroundings can set off the stress response. Examples of environmental stressors
include an unsafe neighborhood, pollution, noise (sirens keeping you up at night, a barking dog next door), and
uncomfortable living conditions. For people living in crime-ridden areas or war-torn regions, the stress may be
unrelenting.

• Daily stress events (e.g., traffic, lost keys, money, quality and quantity of physical activity) While major life
changes are stressful, they are also relative rarities. After all, it’s not every day that you file for divorce or have a
baby. However, you may battle traffic, argue with your family members, or worry about your finances on a daily
basis. Because these small upsets occur so regularly, they end up affecting us the most.

• Family and relationship stressors

Problems with friends, romantic partners, and family members are common daily stressors. Marital disagreements,
dysfunctional relationships, rebellious teens, or caring for a chronically-ill family member or a child with special
needs can all send stress levels skyrocketing.

• Life changes (e.g., divorce, bereavement) Major life events are stressors. Whether it be a divorce, a child
leaving home, a planned pregnancy, a move to a new town, a career change, graduating from college, or a
diagnosis of cancer, the faster or more dramatic the change, the greater the strain. Furthermore, the more major life
changes you’re dealing with at any one time, the more stress you’ll feel.

• Workplace stressors (e.g., high job demand vs. low job control, repeated or sustained exertions, forceful
exertions, extreme postures) In our career-driven society, work can be an ever-present source of stress. Work stress
is caused by things such as job dissatisfaction, an exhausting workload, insufficient pay, office politics, and
conflicts with your boss or co-workers.

• Chemical stressors (e.g., tobacco, alcohol, drugs])

• Social stressor (e.g., societal and family demands) your social situation can cause stress. For example,
poverty, financial pressures, racial and sexual discrimination or harassment, unemployment, isolation, and a lack of
social support all take a toll on daily quality of life.

Internal Causes of Stress

Not all stress is caused by external pressures and demands. Your stress can also be self-generated.

Internal causes of stress include:

• Uncertainty or worries
• Pessimistic attitude
• Self-criticism
• Unrealistic expectations or
beliefs
• Perfectionism
• Low self-esteem
• Excessive or unexpressed anger
• Lack of assertiveness

Risk Factors for Stress

The presence of a stressor doesn’t automatically result in disabling stress symptoms. The degree to which any
stressful situation or event impacts your daily functioning depends partly on the nature of the stressor itself and
partly on your own personal and external resources.

Stress: How vulnerable are you?

The nature of the stressor Stressors that involve central aspects of your life (your marriage, your job) or are chronic
issues (a physical handicap, living from paycheck to paycheck) are more likely to cause severe distress. A crisis
experience Sudden, intense crisis situations (being raped, robbed at gunpoint, or attacked by a dog) are
understandably overwhelming. Without immediate intervention and treatment, debilitating stress symptoms are
common.
Multiple stressors or life changes

Stressors are cumulative, so the more life changes or daily hassles you're dealing with at any one time, the more
intense the symptoms of stress. Your perception of the stressor The same stressor can have very different effects on
different people. For example, public speaking stresses many out, but others thrive on it. Additionally, if you’re
able to see some benefit to the situation—the silver lining or a hard lesson learned—the stressor is easier to
swallow.

Your knowledge and preparation

The more you know about a stressful situation, including how long it will last and what to expect, the better able
you’ll be to face it. For example, if you goin to surgery with a realistic picture of what to expect post-op, a painful
recovery will be less traumatic than if you were expecting to bounce back immediately. Your stress tolerance Some
people roll with the punches, while others crumble at the slightest obstacle or frustration. The more confidence you
have in yourself and your ability to persevere, the better able you’ll be to take a stressful situation in stride.
Your support network

A strong network of supportive friends and family members is an enormous buffer against life’s stressors. But the
more lonely or isolated you are, the higher your risk of stress.

Effects of Chronic Stress

Chronic stress wears you down day after day and year after year, with no visible escape. Under sustained or severe
stress, even the most well-adjusted person loses the ability to adapt. When stress overwhelms our coping resources,
our bodies and minds suffer.

Health Effects

Recent research suggests that anywhere from 60 to 90 percent of illness is stress-related. The physical wear and
tear of stress includes damage to the cardiovascular system and immune system suppression. Stress compromises
your ability to fight off disease and infection, throws your digestive system off balance, and makes it difficult to
conceive a baby, and can even stunt growth in children.

Stress and Your Health

Many medical conditions are caused or exacerbated by stress, including:

• Chronic pain
• Migraines
• Ulcers
• Heartburn
• High blood pressure
• Heart disease
• Diabetes
• Asthma
• PMS
• Obesity
• Infertility
• Autoimmune diseases
• Irritable bowel syndrome
• Skin problems

Emotional Effects

Chronic stress grinds away at your mental health, causing emotional damage in addition to physical ailments.
Long-term stress can even rewire the brain, leaving you more vulnerable to everyday pressures and less able to
cope. Over time, stress can lead to mental health problems such as:
• anxiety
• depression
• eating disorders, and
• substance abuse.

Severe Stress and Trauma

Severe stress reactions can result from sudden, catastrophic events or traumatic experiences such as a natural
disaster, sexual assault, life-threatening accident, or participation in combat. After the initial shock and emotional
fallout, many trauma victims gradually begin to recover fromits effects. But for some people, the stress symptoms
don't go away, the body doesn’t regain its equilibrium, and life doesn’t return to normal. This severe and persisting
reaction to trauma is known as post-traumatic stress disorder (PTSD).

Common symptoms of PTSD include:

• Flashbacks, intrusive thoughts, or nightmares about the trauma
• Avoidance of places and things associated with the trauma
• Hypervigilance for signs of danger
• Chronic irritability and tension
• Depression.
PTSD is a serious disorder that requires professional intervention.

STRESS REACTIVITY
` It refers to the disposition of a person to respond to stressors with immediate, intense and long lasting stress
response characteristics

The Stress Reaction Cycle

It may seem like stress is an external force — something that happens to you, such as a rude driver, a work
deadline, or the illness of a loved one. As a result, it may seem like there’s really nothing you can do about your
stress, but this simply isn’t the case. You may not be able to shape the world so that nothing stressful ever happens
to you again, but you can change the way you respond to stress, and that can make all the difference in how you
feel.

The most fundamental thing to understand about stress is that it isn’t a one-time event with one cause and one
reaction. It’s actually a cycle with many phases, which means there are multiple opportunities to interrupt it before
it turns into a full-blown chain reaction. As you’ll discover as you this, there is no one right way to reduce stress.
There are many options available to you, and understanding your own personal version of the cycle of stress will
help you find the ones that work for you.

Each of these occurrences are links that add up to form a chain that’s known by health professionals as the stress
reaction cycle.

Step 1: External stressor

This is the triggering event — the snarky comment from your teenager, the car that almost hits you when you cross
the street, the layoffs that are happening at work, or the suspicious looking person walking toward you in the
parking lot. This is actually the only part of the stress reaction cycle that your mind and body don’t play a direct
role in.

Step 2: Internal appraisal

This comes either just before, during, or just after the actual trigger occurs. Your senses — such as your sight, your
hearing, as well as what’s commonly known as your intuition or your gut — take in the information that
something’s not right. Your body is exquisitely wired to scan for danger and assess safety. This ability to know
when your environment is safe or not-safe is called neuroception, and it happens without your being conscious of
it.

When your senses detect something that they perceive to be a threat, they send a signal to your amygdala, which is
an almond-sized and -shaped part of your brain that is responsible for processing emotions, particularly strong
emotions such as fear and pleasure. When the amygdala is triggered, it then sends a signal to the hypothalamus and
the pituitary gland, two other sections of the brain responsible for maintaining homeostasis in the body. They
communicate with the rest of the body through the autonomic nervous system, the part of your nervous system that
regulates the many processes that occur without your conscious awareness, such as your heart rate, blood pressure,
metabolism, respiration, and sleep.
Step 3: Physiological response

Once the hypothalamus and the pituitary receive the call that there’s danger present, they activate the sympathetic
nervous system, which is the half of the autonomic nervous system that rules the flight or fight response. They do
this by cueing the adrenal glands, which are located right above your kidneys in your lower back, to release stress
hormones such as adrenaline and cortisol. The flight or fight response stimulates the cardiovascular system
(accelerating the heart rate and diverting blood to the extremities) and the musculoskeletal (priming you to be able
to get out of there or to stay and fight).

Whenever the SNS is activated, it means the other half of the autonomic nervous system — the parasympathetic
nervous system, which governs the “rest and digest” functions of the body — is suppressed, because they can’t
both be activated at the same time. As a result, your immune system and digestive systems are given the “stand
down” signal and you are left in a state of hyperarousal.

Up to this point, much of the stress reaction cycle is outside your control, although if you typically exist in a state
of hyperarousal because of some of the things that happen farther down the stress reaction cycle, you can have a
larger physiological response, with more stress hormones released and a bigger impact on the major systems of the
body. It’s really about what happens after this point that determines how much stress you’re under at any given
time and how big of a response you’ll have to each successive stressor.

Step 4: Internalization

This is where your response to stress starts to become something that you are at least partially aware of. You may
notice that your heart is racing, your stomach is upset, or your back is aching. And then you may start to worry
about how you feel and how well or how poorly you perceive yourself to be handling the stress.

This is when you may start thinking things like, Just calm down, Why is this happening?, or, Nothing ever works
out for me! These types of thoughts can lead to mental symptoms such as worry, anxiety, or dread. Any of these
thought patterns are unpleasant, and a desire to not feel the emotional effects of those thoughts leads to the next
step in the cycle.

Step 5: Maladaptive coping

Once you start to notice that you are in physical and/or emotional distress, you will choose to do something to
alleviate that discomfort. What methods you choose in this moment dictate whether the stress response lessens, or
whether it gets worse.

Whether you realize it or not, you have a habitual response to stress. And for the overwhelming majority of us, this
habitual response isn’t actually helpful. The technical term for a response that doesn’t relieve the triggering
problem is maladaptive. Nearly everyone alive on the planet engages in at least one maladaptive coping
mechanism in the face of stress, and most of us have several that we turn to regularly.

Maladaptive coping mechanisms can rely on outside substances, such as food, alcohol, cigarettes, caffeine,
pharmaceutical or recreational drugs. Or, they may be more behavioral — perhaps you pour yourself into your job
and overwork, or you distract yourself with mindless media and constantly checking your phone, or you become
hyperactive and just can’t seem to sit still. Or your reactions may have an emotional component and you jump to
anger, worry, or overwhelm.

Whichever maladaptive coping mechanism you choose, the irony is that the thing you’re hoping will help make
you feel better actually makes you feel worse — typically, much worse. They perpetuate the physiological stress
response in the body so that you stay in a hyperaroused state — which means that you will subconsciously perceive
more potential stressors of greater danger because your sympathetic nervous system stays on high alert and it takes
less stimulation from the amygdala, hypothalamus, and pituitary to spring in to action. In addition, all those high-
calorie comfort foods, alcoholic drinks, cigarettes, and drugs have physical side effects that can push your body
from homeostasis into full-on breakdown.