Stress

Stress: Definition

Stress is something that everyone experiences; however, how we react to it differs from person to person. But how we respond to stress can affect our health in the short and long term.

Our stress response differs not only from person to person but also based on the stimuli causing us to have a stress response.

Fig 1. The amount of workload we are exposed to can affect our stress levels.

Stress: Symptoms

The way our bodies respond to stress is different for everyone, but some of the most common symptoms of stress are:

• Headache.

• Chest pain/heartburn.

• Weight gain/weight loss.

• Fatigue/sleep problems.

• Tension in the body.

• Stomach problems, e.g., difficulty digesting food.

• Mood swings, e.g., irritability.

• Anxiousness.

Stress: Types

There are different types of stress. The type of stress experienced depends on how often the individual is exposed to the stressors and how long the stress symptoms last.

• Acute stress occurs quickly but does not last long, such as during a job interview.

• Episodic acute stress occurs when someone suffers frequent episodes of acute stress.

• Chronic stress – the stress symptoms last for a long time and constantly occur, e.g. in a divorce.

The type of stress someone experiences is associated with specific health problems.

• Acute stress – although it causes physiological changes in the body, such as increased heart rate, this type of stress has no lasting effects on the body.

• Episodic acute stress – exposure to acute stressors has been linked to certain health problems, such as panic attacks, high blood pressure, weight gain and headaches.

• Chronic stress – constant stress can lead to serious health problems such as heart disease, heart attacks, gastrointestinal problems, and mental illness.

Bodily Response to Stress

When we experience stressful situations, our body’s physiology changes in response; if this happens frequently and the physiological symptoms last for a long time, they can cause physical illnesses.

Two pathways are activated when we experience stressful situations: the hypothalamic-pituitary-adrenal (HPA) system and the sympathomedullary pathway (SAM).

When we experience stressful situations, the hypothalamus is activated, which then activates the pituitary gland. The pituitary gland secretes a hormone responsible for the production of cortisol.

In stressful situations, the hypothalamus also activates the adrenal medulla; this region works as part of the autonomic nervous system (ANS). This region causes the release of adrenaline, which is responsible for the “fight-and-flight” mode we encounter when stressed.

The activation of the adrenal medulla results in increased activity of the sympathetic nervous system and decreased activity of the parasympathetic nervous system, known as the SAM pathway.

Stress Hormones

In stressful situations, the body secretes adrenaline. This hormone is responsible for the ‘fight-or-flight’ response. Adrenaline is the cause of the increase in heart rate and blood pressure that is likely to occur when we are stressed. The purpose of this hormone is to prepare our bodies to cope with or run away from a situation.

Being constantly stressed is demanding on the heart as it has to work hard to pump more blood/oxygen through the body. This can damage the heart and the overall function of the cardiovascular system.

The body needs a balanced amount of cortisol to function properly. Too much cortisol can lead to immunosuppression, which occurs when chronic stress levels cause cells to become resistant to cortisol.

Cortisol is less effective at preventing cells/hormones from triggering inflammatory responses, thus compromising immune system function. And too little can lead to fatigue, muscle weakness, weight loss and low blood pressure.

Measuring Stress

Stress is measured in two main ways: self-report scales and physiological tests.

Self-report scales rely on participants to answer questions honestly to measure stress levels.

• The Social Readjustment Rating Scale lists potential stressors to which values are assigned (a numerical value indicates how stressful the stressor is).

• Respondents must indicate how often and which stressors they have experienced in the past year or expect to experience in the near future.

• The Hassles and Uplift Scale – respondents must rate negative and positive things in their daily lives. The scale was developed to determine how everyday annoyances affect health, such as traffic or losing things.

Physiological tests are considered more empirical to measure stress levels as it collects and measures physical changes to measure how stressed an individual is. E.g. changes in heart rate.

Skin Conductance Response is an objective method of measuring sweat, which the sympathetic nervous system regulates.

Combatting Stress

Since stress over a long period can lead to serious illness, those affected must find effective ways to cope. One can cope with stress, for example, through drug therapy, stress inoculation therapy (SIT), or biofeedback.

Drug therapy is sometimes used to treat people who have suffered from chronic stress for a long time or who have mental illnesses such as post-traumatic stress disorder. The goal of drug therapy is to reduce the physiological symptoms of stress. The different types of anti-stress medications are:

• Benzodiazepines slow down the activity of the central nervous system.

• Beta-blockers minimise the activity of adrenaline and noradrenaline.

Various forms of therapy have been developed to help people cope with stress, including:

• SIT– teaching people how to manage and cope with stress, such as using a therapist to teach them how to interpret events positively.

• Biofeedback – uses technology such as the EEG (electroencephalogram - measures brain activity), etc., to help the patient recognise when they are stressed while learning and using relaxation techniques. When the patient experiences that the relaxation techniques reduce their stress symptoms, the likelihood of using them during subsequent stressful events increases (operant conditioning).

Fig. 2. A human relaxing by meditating in nature.