ABNORMAL

PSYCHOLOGY
STRESS, COPING AND MALADAPTIVE BEHAVIOR
 WHAT IS STRESS?

 Stress can be defined as any type of change that causes physical, emotional, or
psychological strain. Stress is your body's response to anything that requires
attention or action.
 Stress can sometimes be a positive, motivating force that can improve the quality
of our lives. This kind of stress, which Selye called eustress (from the Greek eu =
“good”), is a good kind of stress associated with positive feelings, optimal health,
and performance. A moderate amount of stress can be beneficial in challenging
situations. For example, athletes may be motivated and energized by pregame
stress, and students may experience similar beneficial stress before a major exam.
Indeed, research shows that moderate stress can enhance both immediate and
delayed recall of educational material.
 When stress levels reach an optimal level (the highest point of the curve),
performance reaches its peak. A person at this stress level is colloquially at the
top of his game, meaning he feels fully energized, focused, and can work with
minimal effort and maximum efficiency.
 But when stress exceeds this optimal level, it is no longer a positive force—it
becomes excessive and debilitating, or what Selye termed distress (from the
Latin dis = “bad”). People who reach this level of stress feel burned out; they are
fatigued, exhausted, and their performance begins to decline. If the stress
remains excessive, health may begin to erode as well.
 GAS MODEL

 The GAS model was discovered by HANS SELYE.

 Selye identified three distinct stages of general adaptation syndrome — the

initial alarm reaction stage which occurs shortly after the stressful event,
followed by a resistance stage, during which body's Autonomic Nervous
System (ANS) resists the impact of the stressful stimulus, and finally, if the
stress continues, the exhaustion stage, when the body fails to cope with the
distressing stimulus.
 STAGE 1 - Alarm Reaction Stage

The alarm reaction stage of general adaptation syndrome is the body’s initial response to
stress. The sympathetic nervous system is activated by the sudden release of hormones. This
stage is known as fight-or-flight response stage.
Physical signs of being in the alarm response stage include:
• Dilated pupils
• Increased heart rate
• Rapid breathing
• Trembling
• Pale or flushed skin
• Heightened senses
STAGE 2 - Resistance Stage

 The resistance stage of general adaptation syndrome is when your body tries to
repair itself after the initial shock of stress. If the stressful situation is no longer
present and you can overcome the stress, your heart rate and blood pressure will
start to return to prestress levels during this stage.
 Prolonged levels of high stress can cause disturbances in the immune, digestive,
cardiovascular, sleep, and reproductive systems. You might have symptoms such
as:
• Feelings of fear, anger, sadness, worry, numbness, or frustration
• Irritability
• Changes in appetite, energy, desires, and interests
• Stomach problems
• Headaches
• Body pains or skin rashes
• Trouble concentrating or making decisions
• Sleeplessness or nightmares

 Prolonged stress that is not resolved leads to the third stage (exhaustion).
STAGE 3 - Exhaustion Stage

 Prolonged or chronic stress leads to the last stage of general adaptation

syndrome—exhaustion. Enduring stressors without relief drains your physical,
emotional, and mental resources to the point where your body is no longer able
to cope with stress.
 Signs that you are in the exhaustion stage include:
• Fatigue
• Burnout
• Decreased stress tolerance
The physical effects of prolonged stress can weaken your immune system and
increase your risk of heart disease, high blood pressure, diabetes, and other chronic
health conditions, including mental health disorders such as depression or anxiety.
 Any kind of stressor—both unpleasant and rewarding, dangerous or thrilling—
can trigger general adaptation syndrome.
 Selye discovered general adaptation syndrome after studying how the human
body reacted to physical stressors, such as being exposed to cold temperatures or
physical overexertion.
SOCIAL SUPPORT

 In human studies, low social support has been associated with physiological and
neuroendocrine indices of heightened stress reactivity, including elevated heart
rate, increased blood pressure and exaggerated cardiovascular and
neuroendocrine responses to laboratory stressors.
 Social isolation and low levels of social support have been shown to be
associated with increased morbidity and mortality in a host of medical illnesses.
 Strong social support has been shown to be an important factor in decreasing
functional impairment in patients with depression and in increasing the
likelihood of recovery.47 Further, the risk of developing PTSD upon exposure to
combat trauma is inversely correlated with social support.
 A number of large-scale studies have found that individuals with low levels of social support
are at greater risk of mortality, especially from cardiovascular disorders (Brummett et al.,
2001). Further, higher levels of social supported have been linked to better survival rates
following breast cancer and infectious diseases, especially HIV infection.
 In fact, a person with high levels of social support is less likely to contract a common cold. In
one study, 334 participants completed questionnaires assessing their sociability; these
individuals were subsequently exposed to a virus that causes a common cold and monitored
for several weeks to see who became ill. Results showed that increased sociability was
linearly associated with a decreased probability of developing cold.
SRESSFUL SITUATIONS AND LIFE
TRANSITIONS

• Life transitions are significant changes that can be overwhelming, requiring effective
coping strategies.
• Effective coping strategies for life transitions include journaling, therapy, and hobbies.

Understanding Life Transitions:

 Life transitions are sharp discontinuities with previous events, encompassing identifiable
beginnings, turning points, and endings. Coping skills learned earlier play a crucial role in
managing the transition process.
 Coping skills, including support networking, cognitive restructuring, problem-solving, and
stress management, mediate the transition's course and emotional intensity. Attitudes
influencing the process include perceived control, perceptions of challenge, and
commitment to change. Viewing the change as a normal part of life helps alleviate distress.
Examples of Life Transitions
 Life transitions manifest in various forms, such as living independently, experiencing a
divorce, getting married, becoming a parent, dealing with grief, health changes, career
shifts, and graduating from school. Each transition brings its own set of challenges,
requiring unique coping strategies.
 WAYS TO MANAGE LIFE
TRANSITIONS

1. Journaling :
 Journaling provides a structured outlet for processing emotions and thoughts associated with life
transitions. It reduces anxiety, enhances self-awareness, and helps reframe negative thought
patterns. Consistent or sporadic journaling focused on gratitude, or emotional processing can be
stress-relieving.
2. Mindfulness :
 Mindfulness, through meditation and breathing exercises, promotes awareness of the present
moment, reducing stress and exhaustion. Practices like box breathing can be incorporated into
daily routines to foster a calm and focused mind.
3. Therapy :
 Seeking therapy during life transitions offers valuable insight, perspective, and coping
strategies. A trained mental health professional can guide individuals through various
transitions, providing tools to navigate challenges and understand oneself better.
4. Explore a new hobby :
 As revealed by research, engaging in creative activities contributes to improved mental
health. Exploring hobbies like cooking, language learning, gardening, or playing an
instrument can be a positive addition to overall well-being.
6. Improve Sleep Hygiene :
 Quality sleep is crucial for mental well-being. Establishing a consistent sleep schedule and
incorporating a "sleep toolkit" can enhance sleep hygiene, contributing to improved mental
health.
7. Practice Healthy Eating Habits :
 Cultivating a positive relationship with food and practicing mindful eating is essential to well-
being. Understanding how food choices affect individual health and the environment contributes
to a holistic approach to self-care.
 CLINICAL REACTIONS TO STRESS

 Stress reactions are often short-lived and respond to support from friends and family. However,
particularly severe stresses can lead to the condition of post-traumatic stress disorder (PTSD), an
important source of morbidity and disability, whose clinical features, psychology, neurobiology, and
treatment are described in detail.
 Adjustment to threatening and traumatic life events, such as childhood abuse, sexual assault in
women, the refugee experience, serious physical illness, and bereavement can produce various kinds
of adverse psychological consequences over the lifespan.
 Exceptionally stressful life events can cause severe psychological symptoms, including anxiety,
feelings of derealization and depersonalization, and hyperarousal.
 ADJUSTMENT DISORDER

 Adjustment disorder, sometimes referred to as situational depression, is a lengthy, abnormal,

and excessively negative reaction to an identifiable life stressor. The reaction is more severe
than would normally be expected and can result in significant impairment in social,
occupational, or academic functioning.
 Adjustment disorder is typified by symptoms such as depression, anxiety, difficulty moving
past the stressful event, and reckless behavior.
 The mental and physical symptoms associated with adjustment disorder usually occur during
or immediately after you experience a stressful event. While the disorder lasts no longer than
six months, your symptoms may continue if the stressor isn’t removed.
The mental symptoms of adjustment disorders can include:
• rebellious or impulsive actions
• anxiousness
• feelings of sadness, hopelessness, or being trapped
• crying
• withdrawn attitude
• lack of concentration
• loss of self-esteem
• suicidal thoughts
There is one type of adjustment disorder that is associated with physical symptoms as
well as psychological ones. These physical symptoms can include:
• insomnia
• muscle twitches or trembling
• fatigue
• body pain or soreness
• indigestion
 What causes adjustment disorders?

A variety of stressful events can cause an adjustment disorder. Some common causes in
adults include:
• death of a family member or friend
• relationship issues or divorce
• major life changes
• illness or a health issue (in you or someone you’re close with)
• moving to a new house or place
• sudden disasters
• money troubles or fears
Typical causes in children and teenagers include:
• family fights or problems
• problems in school
• anxiety over sexuality
 ACUTE STRESS DISORDER

 Acute stress disorder can develop following a person’s exposure to one or

more traumatic events. Symptoms may develop after an individual either experiences or
witnesses a disturbing event involving a threat of or actual death, serious injury, or physical
or sexual violation.
 Symptoms begin or worsen after the trauma occurs and can last from three days to one
month. If symptoms persist after one month, a diagnosis of post-traumatic stress disorder is
given.
 Experiencing, witnessing, or being confronted with one or more traumatic events can cause
ASD. The events create intense fear, horror, or helplessness. Traumatic events that can
cause ASD include a:
• death
• threat of death to oneself or others
• threat of serious injury to oneself or others
• threat to the physical integrity of oneself or others
 In the weeks after a traumatic event, you may develop an anxiety disorder called
acute stress disorder (ASD). ASD typically occurs within one month of a
traumatic event. It lasts at least three days and can persist for up to one month.
People with ASD have symptoms similar to those seen in post-traumatic stress
disorder(PTSD).
 DISSOCIATIVE DISORDER

Dissociative disorders involve a loss of awareness of your surroundings or self. There are five
types of dissociative disorders.
 According to the
Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-
TR)
, there are five types of dissociative disorders:
• dissociative identity disorder (DID)
• depersonalization/derealization disorder
• dissociative amnesia
• unspecified dissociative disorder
• other specified dissociative disorder
 DISSOCIATIVE IDENTITY
DISORDER

 Dissociative identity disorder (DID) is rare. DID was previously known as multiple personality
disorder.
 Individuals with DID experience two or more distinct personality states or identities that often
present as uncontrollable to the person experiencing them.
Symptoms of DID include:
• intense dissociation: people with DID often experience dissociation from their memory, self,
thoughts, sense of agency, perception, and motor functioning
• changes in behavior: they may act differently due to intense dissociation
• gaps in memory: It may be hard to recall events, trauma, or personal information
• distress: the person or people affected by this disorder often experience troubles at work,
school, or in social settings
 Depersonalization/derealization disorder

 Depersonalization/derealization disorder (DPDR) is a dissociative disorder with two distinct

elements:
• Depersonalization: The feeling of losing your identity or feeling you aren’t real. It may feel
like you’re watching yourself from outside your body.
• Derealization: Feeling detached from your experiences. It may feel like people and objects
around you are distant or unreal.
Common symptoms of DPDR include:
• disconnection from yourself
• disconnection from your environment
• forgetfulness
• amnesia
• distortions of the environment
• feeling like you’re watching yourself in a movie
• perceptions of leaving your body and coming back into your body through flashes of light
• feeling connected to dream experiences
• feeling like familiar situations are completely new, or unfamiliar situations are familiar
• tactile sensations and imagery when describing something that you can see visually
• blunted emotions
 Dissociative amnesia

 Dissociative amnesia is a condition in which you may have difficulty recalling important
information about yourself and your life. It is the most common dissociative disorder,
occurring in approximately 1.8% of the population.
Symptoms of dissociative amnesia include:
• trouble recalling information from your life
• the information that is difficult to recount is often traumatic
• the information that is forgotten is usually easily remembered
• inability to recall information isn’t due to substance use
• amnesia can be about specific events or life history
 Dissociative amnesia can cause problems with relationships or work. Forgetting
information can last for a short period or several years and usually happens
suddenly.
 Some people with dissociative amnesia may experience dissociative fugue,
meaning they travel away from home due to forgetting information about where
they usually live.
 Unspecified dissociative disorder

 Unspecified dissociative disorder refers to individuals with dissociative symptoms

— or symptoms consistent with a dissociative disorder — but who do not meet the
full criteria for a dissociative disorder.
 This diagnosis is most often used in settings such as emergency rooms where there
may not be enough information for a clinician to make a complete diagnosis.
 Other specified dissociative disorder

 Other specified dissociative disorder is listed in the DSM-5-TR as a disorder where the
person is experiencing dissociative symptoms but their symptoms do not meet the full
criteria for any other dissociative disorder.
There are four common presentations of other specified dissociative disorder:
• mixed dissociative symptoms: disturbances of identity without amnesia
• identity disturbances due to chronic and extreme persuasion: disturbances of identity
due to brainwashing, being involved with a cult, or being subjected to torture
• dissociative reactions to stress: dissociation as a result of stressful events that last a few
hours to less than one month
• dissociative trance: an uncontrollable loss of awareness of their surroundings
When it comes to managing stress, making simple changes can go a long way in improving
your overall health and reducing stress. Having tools and strategies you can turn to
in stressful situations can prevent your stress levels from escalating.

1.Find a balance
 It’s important to structure some of your time so that you can be comfortably busy without
being overwhelmed, Brown says. “Working hard does not usually equate with working
efficiently,” he said. In fact, working too much can reduce productivity.
2.Be kind to yourself
 Understanding that you aren’t weak because you’re feeling stress is important. Stress is a
very normal reaction to the stressors in your life.
3.Keep a journal
 Set aside time to reflect on your day. Write down any thoughts or feelings you’re having.
This can be a useful tool to help you better understand your stressors and how you react
to stress.
4.Lean on the people you trust
 Before your stress levels escalate, reach out to someone you trust, such as a friend, family
member, or coworker. Sharing your feelings or venting your concerns may help to reduce
your stress.
5.Eat well-balanced, regular meals
 When it comes to managing stress, proper nutrition is your friend. Skipping meals can lower your
blood sugar, which can depress your mood. In some cases, this can also trigger intense feelings of
anger and frustration.
6.Exercise regularly
 Engaging in regular physical activity can improve your overall health and reduce your stress
levels. When you exercise, your body releases endorphins. These feel-good hormones can also
ease symptoms of depression and anxiety.
7.Get plenty of rest
 Your ability to manage stress decreases when you’re tired. Try to get a recommended seven to nine
hours each night. If you have insomnia, aim to get as much sleep as you can, then build in periods
of rest during the day.