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Stress (medicine)
Encyclopedia
Stress is a term in psychology
and biology
, borrowed from physics and engineering and first used in the biological context in the 1930s, which has in more recent decades become commonly used in popular parlance
. It refers to the consequence of the failure of an organism
—human
or other animal
—to respond adequately to mental, emotional, or physical demands, whether actual or imagined.
When the person perceives a threat, their nervous system responds by releasing a flood of stress hormones, including adrenaline and cortisol. These hormones rouse the body for emergency action. The stress response is the body’s way of protecting the person. When working properly, it helps in staying focused, energetic, and alert.
in the 1930s. He later broadened and popularized the concept to include inadequate physiological response to any demand. In his usage stress refers to a condition and stressor to the stimulus causing it. It covers a wide range of phenomena, from mild irritation to drastic dysfunction that may cause severe health
breakdown.
Physiologists define stress as how the body reacts to a stressor, real or imagined, a stimulus that causes stress. Acute stressors affect an organism in the short term; chronic stressors over the longer term.
Selye researched the effects of stress.
Alarm is the first stage. When the threat or stressor is identified or realized, the body's stress response is a state of alarm. During this stage, adrenaline will be produced in order to bring about the fight-or-flight response
. There is also some activation of the HPA axis
, producing cortisol
.
Resistance is the second stage. If the stressor persists, it becomes necessary to attempt some means of coping with the stress. Although the body begins to try to adapt to the strains or demands of the environment, the body cannot keep this up indefinitely, so its resources are gradually depleted.
Exhaustion is the third and final stage in the GAS model. At this point, all of the body's resources are eventually depleted and the body is unable to maintain normal function. The initial autonomic nervous system
symptoms may reappear (sweating, raised heart rate, etc.). If stage three is extended, long-term damage may result, as the body's immune system becomes exhausted, and bodily functions become impaired, resulting in decompensation
.
The result can manifest itself in obvious illnesses such as ulcers
, depression
, diabetes, trouble with the digestive system, or even cardiovascular problems, along with other mental illnesses.
and distress
. Where stress enhances function (physical or mental, such as through strength training
or challenging work), it may be considered eustress. Persistent stress that is not resolved through coping or adaptation, deemed distress, may lead to anxiety
or withdrawal (depression) behavior.
The difference between experiences that result in eustress and those that result in distress is determined by the disparity between an experience (real or imagined) and personal expectations, and resources to cope with the stress. Alarming experiences, either real or imagined, can trigger a stress response.
Both personal and environmental factors influence this primary appraisal, which then triggers the selection of coping processes. Problem-focused coping is directed at managing the problem, whereas emotion-focused coping processes are directed at managing the negative emotions. Secondary appraisal refers to the evaluation of the resources available to cope with the problem, and may alter the primary appraisal.
In other words, primary appraisal includes the perception of how stressful the problem is and the seconday appraisal of estimating whether one has more than or less than adequate resources to deal with the problem that affects the overall appraisal of stressfulness. Further, coping is flexible in that, in general, the individual examines the effectiveness of the coping on the situation; if it is not having the desired effect, s/he will, in general, try different strategies.
secrete corticotropin-releasing hormone
(CRH) and arginine-vasopressin (AVP) into the hypophyseal portal system
.
The locus ceruleus
and other noradrenergic
cell groups of the adrenal medulla
and pons
, collectively known as the LC/NE system, also become active and use brain epinephrine
to execute autonomic and neuroendocrine responses, serving as a global alarm system.
The autonomic nervous system
provides the rapid response to stress commonly known as the fight-or-flight response
, engaging the sympathetic nervous system
and withdrawing the parasympathetic nervous system
, thereby enacting cardiovascular, respiratory, gastrointestinal, renal, and endocrine changes. The HPA axis, a major part of the neuroendocrine system involving the interactions of the hypothalamus
, the pituitary gland
, and the adrenal gland
s, is also activated by release of CRH and AVP.
This results in release of adrenocorticotropic hormone
(ACTH) from the pituitary into the general bloodstream, which results in secretion of cortisol
and other glucocorticoid
s from the adrenal cortex
. The related compound cortisone is frequently used as a key anti-inflammatory component in drugs that treat skin rashes and in nasal sprays that treat asthma and sinusitis. Recently, scientists realized the brain also uses cortisol to suppress the immune system and reduce inflammation within the body. These corticoids involve the whole body in the organism's response to stress and ultimately contribute to the termination of the response via inhibitory feedback.
can significantly affect many of the body's immune systems, as can an individual's perceptions of, and reactions to, stress. The term psychoneuroimmunology
is used to describe the interactions between the mental state, nervous and immune systems, and research on the interconnections of these systems. Immune system changes can create more vulnerability to infection, and have been observed to increase the potential for an outbreak of psoriasis
for people with that skin disorder.
Chronic stress has also been shown to impair developmental growth
in children by lowering the pituitary gland
's production of growth hormone, as in children associated with a home environment involving serious marital discord, alcoholism
, or child abuse
.
Chronic stress is seen to affect parts of the brain where memories are processed through and stored. When people feel stressed, stress hormones get over-secreted, which affects the brain. This secretion is made up of glucocorticoids, including cortisol
, which are steroid hormones that the adrenal gland
releases.
Studies of female monkeys at Wake Forest University
(2009) discovered that individuals suffering from higher stress have higher levels of visceral fat in their bodies. This suggests a possible cause-and-effect link between the two, wherein stress promotes the accumulation of visceral fat, which in turn causes hormonal and metabolic
changes that contribute to heart disease and other health problems.
. Diagnostic symptoms for PTSD include re-experiencing the original trauma(s) through flashbacks or nightmares, avoidance of stimuli associated with the trauma, and increased arousal – such as difficulty falling or staying asleep, anger, and hypervigilance. Formal diagnostic criteria (both DSM-IV-TR and ICD-10) require that the symptoms last more than one month and cause significant impairment in social, occupational, or other important areas of functioning.
attempted to isolate the effects of personalities on ability to handle stress in a laboratory environment. Other psychologists, however, proposed measuring stress indirectly, through self-tests.
Because the amount of stressors in a person's life often (although not always) correlates with the amount of stress that person experiences, researchers combine the results of stress and burnout self-tests. Stress tests help determine the number of stressors in a person's life, while burnout tests determine the degree to which the person is close to the state of burnout. Combining both helps researchers gauge how likely additional stressors will make him or her experience mental exhaustion.
, anxiety
, and depression
. Over the long term, distress can lead to diminished health and/or increased propensity to illness; to avoid this, stress must be managed.
Stress management encompasses techniques intended to equip a person with effective coping mechanisms for dealing with psychological stress, with stress defined as a person's physiological response to an internal or external stimulus that triggers the fight-or-flight response. Stress management is effective when a person uses strategies to cope with or alter stressful situations.
There are several ways of coping with stress, such as controlling the source of stress or learning to set limits and to say "No" to some demands that bosses or family members may make.
A person's capacity to tolerate the source of stress may be increased by thinking about another topic such as a hobby, listening to music, or spending time in a wilderness
.
destresse, derived via Old French
from the Latin
stringere, "to draw tight."
It had long been in use in physics
to refer to the internal distribution of a force exerted on a material body, resulting in strain
. In the 1920s and 1930s, the term was occasionally being used in psychological circles to refer to a mental strain or unwelcome happening, and by advocates of holistic medicine to refer to a harmful environmental agent that could cause illness. Walter Cannon used it in 1934 to refer to external factors that disrupted what he called homeostasis
.
The novel usage arose out of Selye's 1930s experiments. He started to use the term to refer not just to the agent but to the state of the organism as it responded and adapted to the environment. His theories of a universal non-specific stress response attracted great interest and contention in academic physiology
and he undertook extensive research programs and publication efforts.
However, while the work attracted continued support from advocates of psychosomatic medicine, many in experimental physiology concluded that his concepts were too vague and unmeasurable. During the 1950s, Selye turned away from the laboratory to promote his concept through popular books and lecture tours. He wrote for both non-academic physicians and, in an international bestseller entitled Stress of Life, for the general public.
A broad biopsychosocial concept of stress and adaptation offered the promise of helping everyone achieve health and happiness by successfully responding to changing global challenges and the problems of modern civilization
. He coined the term "eustress
" for positive stress, by contrast to distress
.
He argued that all people have a natural urge and need to work for their own benefit, a message that found favor with industrialists and governments. He also coined the term stressor
to refer to the causative event or stimulus, as opposed to the resulting state of stress.
From the late 1960s, academic psychologists started to adopt Selye's concept; they sought to quantify "life stress" by scoring "significant life events
," and a large amount of research was undertaken to examine links between stress and disease of all kinds. By the late 1970s, stress had become the medical area of greatest concern to the general population, and more basic research was called for to better address the issue.
There was renewed laboratory research into the neuroendocrine, molecular, and immunological bases of stress, conceived as a useful heuristic
not necessarily tied to Selye's original hypotheses. By the 1990s, "stress" had become an integral part of modern scientific understanding in all areas of physiology and human functioning, and one of the great metaphors of Western life. Focus grew on stress in certain settings, such as workplace stress
. Stress management
techniques were developed.
Its psychological uses are frequently metaphorical rather than literal
, used as a catch-all for perceived difficulties in life. It also became a euphemism, a way of referring to problems and eliciting sympathy
without being explicitly confessional, just "stressed out."
It covers a huge range of phenomena from mild irritation
to the kind of severe problems that might result in a real breakdown of health
. In popular usage, almost any event or situation between these extremes could be described as stressful.
The most extreme events and reactions may elicit the diagnosis of posttraumatic stress disorder (PTSD), an anxiety disorder that can develop after exposure to one or more terrifying events that threatened or caused grave physical harm. PTSD is a severe and ongoing emotional reaction to an extreme psychological trauma; as such, it is often associated with soldiers, police officers, and other emergency personnel.
This stressor may involve viewing someone's actual death, a threat to the patient's or someone else's life, serious physical injury, or threat to physical or psychological integrity, overwhelming usual psychological defenses coping. In some cases, it can also be from profound psychological and emotional trauma, apart from any actual physical harm. Often, however, the two are combined.
The US military became a key center of stress research, attempting to understand and reduce combat neurosis
and psychiatric casualties.
as a marker for stress has surfaced. Yamaguchi M, Yoshida H (2005) have analyzed a newly introduced hand-held device called the Cocorometer developed by Nipro Corp., Japan. They state that this can be reliably used to analyze the amylase levels and is definitely a cheaper alternative as compared to the more expensive ELISA kits. The working consists of a meter and a saliva collecting chip, which can be inserted into the meter to give the readings. The levels of amylase obtained have been calibrated according to standard population, and can be categorized into four levels of severity.
Psychology
Psychology is the study of the mind and behavior. Its immediate goal is to understand individuals and groups by both establishing general principles and researching specific cases. For many, the ultimate goal of psychology is to benefit society...
and biology
Biology
Biology is a natural science concerned with the study of life and living organisms, including their structure, function, growth, origin, evolution, distribution, and taxonomy. Biology is a vast subject containing many subdivisions, topics, and disciplines...
, borrowed from physics and engineering and first used in the biological context in the 1930s, which has in more recent decades become commonly used in popular parlance
Vernacular
A vernacular is the native language or native dialect of a specific population, as opposed to a language of wider communication that is not native to the population, such as a national language or lingua franca.- Etymology :The term is not a recent one...
. It refers to the consequence of the failure of an organism
Organism
In biology, an organism is any contiguous living system . In at least some form, all organisms are capable of response to stimuli, reproduction, growth and development, and maintenance of homoeostasis as a stable whole.An organism may either be unicellular or, as in the case of humans, comprise...
—human
Human
Humans are the only living species in the Homo genus...
or other animal
Animal
Animals are a major group of multicellular, eukaryotic organisms of the kingdom Animalia or Metazoa. Their body plan eventually becomes fixed as they develop, although some undergo a process of metamorphosis later on in their life. Most animals are motile, meaning they can move spontaneously and...
—to respond adequately to mental, emotional, or physical demands, whether actual or imagined.
When the person perceives a threat, their nervous system responds by releasing a flood of stress hormones, including adrenaline and cortisol. These hormones rouse the body for emergency action. The stress response is the body’s way of protecting the person. When working properly, it helps in staying focused, energetic, and alert.
Origin and terminology
The term stress was first employed in a biological context by the endocrinologist Hans SelyeHans Selye
Hans Hugo Bruno Selye, CC was a pioneering endocrinologist. Selye did much important scientific work on the hypothetical non-specific response of an organism to stressors. While he did not recognize all of the many aspects of glucocorticoids, Selye was aware of their role in the stress response...
in the 1930s. He later broadened and popularized the concept to include inadequate physiological response to any demand. In his usage stress refers to a condition and stressor to the stimulus causing it. It covers a wide range of phenomena, from mild irritation to drastic dysfunction that may cause severe health
Health
Health is the level of functional or metabolic efficiency of a living being. In humans, it is the general condition of a person's mind, body and spirit, usually meaning to be free from illness, injury or pain...
breakdown.
Cognitive symptoms
- Memory problems
- Inability to concentrate
- Poor judgment
- Seeing only the negative
- Anxious or racing thoughts
- Constant worrying
Emotional symptoms
- Moodiness
- Irritability or short temper
- Agitation, inability to relax
- Feeling overwhelmed
- Sense of loneliness and isolation
- Depression or general unhappiness
Physical symptoms
- Aches and pains
- Diarrhea or constipation
- Nausea, dizziness
- Chest pain, rapid heartbeat
- Loss of sex drive
- Frequent colds
- Chest pains
Behavioural symptoms
- Eating more or less
- Sleeping too much or too little
- Isolating yourself from others
- Procrastinating or neglecting responsibilities
- Using alcohol, cigarettes, or drugs to relax
- Nervous habits (e.g. nail biting, pacing)
General adaptation syndrome
Selye researched the effects of stress.
Alarm is the first stage. When the threat or stressor is identified or realized, the body's stress response is a state of alarm. During this stage, adrenaline will be produced in order to bring about the fight-or-flight response
Fight-or-flight response
The fight-or-flight response was first described by Walter Bradford Cannon....
. There is also some activation of the HPA axis
Hypothalamic-pituitary-adrenal axis
The hypothalamic-pituitary-adrenal axis , also known as thelimbic-hypothalamic-pituitary-adrenal axis and, occasionally, as the hypothalamic-pituitary-adrenal-gonadotropic axis, is a complex set of direct influences and feedback interactions among the hypothalamus, the pituitary gland ,...
, producing cortisol
Cortisol
Cortisol is a steroid hormone, more specifically a glucocorticoid, produced by the adrenal gland. It is released in response to stress and a low level of blood glucocorticoids. Its primary functions are to increase blood sugar through gluconeogenesis; suppress the immune system; and aid in fat,...
.
Resistance is the second stage. If the stressor persists, it becomes necessary to attempt some means of coping with the stress. Although the body begins to try to adapt to the strains or demands of the environment, the body cannot keep this up indefinitely, so its resources are gradually depleted.
Exhaustion is the third and final stage in the GAS model. At this point, all of the body's resources are eventually depleted and the body is unable to maintain normal function. The initial autonomic nervous system
Autonomic nervous system
The autonomic nervous system is the part of the peripheral nervous system that acts as a control system functioning largely below the level of consciousness, and controls visceral functions. The ANS affects heart rate, digestion, respiration rate, salivation, perspiration, diameter of the pupils,...
symptoms may reappear (sweating, raised heart rate, etc.). If stage three is extended, long-term damage may result, as the body's immune system becomes exhausted, and bodily functions become impaired, resulting in decompensation
Decompensation
In medicine, decompensation is the functional deterioration of a previously working structure or system. Decompensation may occur due to fatigue, stress, illness, or old age. When a system is "compensated," it is able to function despite stressors or defects. Decompensation describes an inability...
.
The result can manifest itself in obvious illnesses such as ulcers
Peptic ulcer
A peptic ulcer, also known as PUD or peptic ulcer disease, is the most common ulcer of an area of the gastrointestinal tract that is usually acidic and thus extremely painful. It is defined as mucosal erosions equal to or greater than 0.5 cm...
, depression
Clinical depression
Major depressive disorder is a mental disorder characterized by an all-encompassing low mood accompanied by low self-esteem, and by loss of interest or pleasure in normally enjoyable activities...
, diabetes, trouble with the digestive system, or even cardiovascular problems, along with other mental illnesses.
Selye: eustress and distress
Selye published in 1975 a model dividing stress into eustressEustress
Eustress is a term coined by endocrinologist Hans Selye which is defined in the model of Richard Lazarus as stress that is healthy, or gives one a feeling of fulfillment or other positive feelings. Eustress is a process of exploring potential gains....
and distress
Distress (medicine)
In medicine, distress is an aversive state in which an animal is unable to adapt completely to stressors and their resulting stress and shows maladaptive behaviors...
. Where stress enhances function (physical or mental, such as through strength training
Strength training
Strength training is the use of resistance to muscular contraction to build the strength, anaerobic endurance, and size of skeletal muscles. There are many different methods of strength training, the most common being the use of gravity or elastic/hydraulic forces to oppose muscle contraction...
or challenging work), it may be considered eustress. Persistent stress that is not resolved through coping or adaptation, deemed distress, may lead to anxiety
Anxiety
Anxiety is a psychological and physiological state characterized by somatic, emotional, cognitive, and behavioral components. The root meaning of the word anxiety is 'to vex or trouble'; in either presence or absence of psychological stress, anxiety can create feelings of fear, worry, uneasiness,...
or withdrawal (depression) behavior.
The difference between experiences that result in eustress and those that result in distress is determined by the disparity between an experience (real or imagined) and personal expectations, and resources to cope with the stress. Alarming experiences, either real or imagined, can trigger a stress response.
Lazarus: cognitive appraisal model
Lazarus argued that, in order for a psychosocial situation to be stressful, it must be appraised as such. He argued that cognitive processes of appraisal are central in determining whether a situation is potentially threatening, constitutes a harm/loss or a challenge, or is benign.Both personal and environmental factors influence this primary appraisal, which then triggers the selection of coping processes. Problem-focused coping is directed at managing the problem, whereas emotion-focused coping processes are directed at managing the negative emotions. Secondary appraisal refers to the evaluation of the resources available to cope with the problem, and may alter the primary appraisal.
In other words, primary appraisal includes the perception of how stressful the problem is and the seconday appraisal of estimating whether one has more than or less than adequate resources to deal with the problem that affects the overall appraisal of stressfulness. Further, coping is flexible in that, in general, the individual examines the effectiveness of the coping on the situation; if it is not having the desired effect, s/he will, in general, try different strategies.
Neurochemistry and physiology
Although the basic neurochemistry of the stress response is now well understood, much remains to be discovered about how the components of this system interact with one another, in the brain, and throughout the body. In response to a stressor, neurons with cell bodies in the paraventricular nuclei (PVN) of the hypothalamusHypothalamus
The Hypothalamus is a portion of the brain that contains a number of small nuclei with a variety of functions...
secrete corticotropin-releasing hormone
Corticotropin-releasing hormone
Corticotropin-releasing hormone , originally named corticotropin-releasing factor , and also called corticoliberin, is a polypeptide hormone and neurotransmitter involved in the stress response...
(CRH) and arginine-vasopressin (AVP) into the hypophyseal portal system
Hypophyseal portal system
The hypophyseal portal system is the system of blood vessels that link the hypothalamus and the anterior pituitary in the brain.It allows endocrine communication between the two structures. It is part of the hypothalamic-pituitary-adrenal axis. The anterior pituitary receives releasing and...
.
The locus ceruleus
Locus ceruleus
The locus coeruleus , is a nucleus in the brainstem involved with physiological responses to stress and panic. It was discovered in the 18th century by Félix Vicq-d'Azyr....
and other noradrenergic
Norepinephrine
Norepinephrine is the US name for noradrenaline , a catecholamine with multiple roles including as a hormone and a neurotransmitter...
cell groups of the adrenal medulla
Adrenal medulla
The adrenal medulla is part of the adrenal gland. It is located at the center of the gland, being surrounded by the adrenal cortex. It is the innermost part of the adrenal gland, consisting of cells that secrete epinephrine , norepinephrine , and a small amount of dopamine in response to...
and pons
Pons
The pons is a structure located on the brain stem, named after the Latin word for "bridge" or the 16th-century Italian anatomist and surgeon Costanzo Varolio . It is superior to the medulla oblongata, inferior to the midbrain, and ventral to the cerebellum. In humans and other bipeds this means it...
, collectively known as the LC/NE system, also become active and use brain epinephrine
Epinephrine
Epinephrine is a hormone and a neurotransmitter. It increases heart rate, constricts blood vessels, dilates air passages and participates in the fight-or-flight response of the sympathetic nervous system. In chemical terms, adrenaline is one of a group of monoamines called the catecholamines...
to execute autonomic and neuroendocrine responses, serving as a global alarm system.
The autonomic nervous system
Autonomic nervous system
The autonomic nervous system is the part of the peripheral nervous system that acts as a control system functioning largely below the level of consciousness, and controls visceral functions. The ANS affects heart rate, digestion, respiration rate, salivation, perspiration, diameter of the pupils,...
provides the rapid response to stress commonly known as the fight-or-flight response
Fight-or-flight response
The fight-or-flight response was first described by Walter Bradford Cannon....
, engaging the sympathetic nervous system
Sympathetic nervous system
The sympathetic nervous system is one of the three parts of the autonomic nervous system, along with the enteric and parasympathetic systems. Its general action is to mobilize the body's nervous system fight-or-flight response...
and withdrawing the parasympathetic nervous system
Parasympathetic nervous system
The parasympathetic nervous system is one of the two main divisions of the autonomic nervous system . The ANS is responsible for regulation of internal organs and glands, which occurs unconsciously...
, thereby enacting cardiovascular, respiratory, gastrointestinal, renal, and endocrine changes. The HPA axis, a major part of the neuroendocrine system involving the interactions of the hypothalamus
Hypothalamus
The Hypothalamus is a portion of the brain that contains a number of small nuclei with a variety of functions...
, the pituitary gland
Pituitary gland
In vertebrate anatomy the pituitary gland, or hypophysis, is an endocrine gland about the size of a pea and weighing 0.5 g , in humans. It is a protrusion off the bottom of the hypothalamus at the base of the brain, and rests in a small, bony cavity covered by a dural fold...
, and the adrenal gland
Adrenal gland
In mammals, the adrenal glands are endocrine glands that sit atop the kidneys; in humans, the right suprarenal gland is triangular shaped, while the left suprarenal gland is semilunar shaped...
s, is also activated by release of CRH and AVP.
This results in release of adrenocorticotropic hormone
Adrenocorticotropic hormone
Adrenocorticotropic hormone , also known as 'corticotropin', 'Adrenocorticotrophic hormone', is a polypeptide tropic hormone produced and secreted by the anterior pituitary gland. It is an important component of the hypothalamic-pituitary-adrenal axis and is often produced in response to biological...
(ACTH) from the pituitary into the general bloodstream, which results in secretion of cortisol
Cortisol
Cortisol is a steroid hormone, more specifically a glucocorticoid, produced by the adrenal gland. It is released in response to stress and a low level of blood glucocorticoids. Its primary functions are to increase blood sugar through gluconeogenesis; suppress the immune system; and aid in fat,...
and other glucocorticoid
Glucocorticoid
Glucocorticoids are a class of steroid hormones that bind to the glucocorticoid receptor , which is present in almost every vertebrate animal cell...
s from the adrenal cortex
Adrenal cortex
Situated along the perimeter of the adrenal gland, the adrenal cortex mediates the stress response through the production of mineralocorticoids and glucocorticoids, including aldosterone and cortisol respectively. It is also a secondary site of androgen synthesis.-Layers:Notably, the reticularis in...
. The related compound cortisone is frequently used as a key anti-inflammatory component in drugs that treat skin rashes and in nasal sprays that treat asthma and sinusitis. Recently, scientists realized the brain also uses cortisol to suppress the immune system and reduce inflammation within the body. These corticoids involve the whole body in the organism's response to stress and ultimately contribute to the termination of the response via inhibitory feedback.
Impact on disease
Chronic stressChronic stress
Chronic stress is the response to emotional pressure suffered for a prolonged period over which an individual perceives he or she has no control. It involves an endocrine system response in which occurs a release of corticosteroids...
can significantly affect many of the body's immune systems, as can an individual's perceptions of, and reactions to, stress. The term psychoneuroimmunology
Psychoneuroimmunology
Psychoneuroimmunology is the study of the interaction between psychological processes and the nervous and immune systems of the human body...
is used to describe the interactions between the mental state, nervous and immune systems, and research on the interconnections of these systems. Immune system changes can create more vulnerability to infection, and have been observed to increase the potential for an outbreak of psoriasis
Psoriasis
Psoriasis is an autoimmune disease that appears on the skin. It occurs when the immune system mistakes the skin cells as a pathogen, and sends out faulty signals that speed up the growth cycle of skin cells. Psoriasis is not contagious. However, psoriasis has been linked to an increased risk of...
for people with that skin disorder.
Chronic stress has also been shown to impair developmental growth
Developmental psychology
Developmental psychology, also known as human development, is the scientific study of systematic psychological changes, emotional changes, and perception changes that occur in human beings over the course of their life span. Originally concerned with infants and children, the field has expanded to...
in children by lowering the pituitary gland
Pituitary gland
In vertebrate anatomy the pituitary gland, or hypophysis, is an endocrine gland about the size of a pea and weighing 0.5 g , in humans. It is a protrusion off the bottom of the hypothalamus at the base of the brain, and rests in a small, bony cavity covered by a dural fold...
's production of growth hormone, as in children associated with a home environment involving serious marital discord, alcoholism
Alcoholism
Alcoholism is a broad term for problems with alcohol, and is generally used to mean compulsive and uncontrolled consumption of alcoholic beverages, usually to the detriment of the drinker's health, personal relationships, and social standing...
, or child abuse
Child abuse
Child abuse is the physical, sexual, emotional mistreatment, or neglect of a child. In the United States, the Centers for Disease Control and Prevention and the Department of Children And Families define child maltreatment as any act or series of acts of commission or omission by a parent or...
.
Chronic stress is seen to affect parts of the brain where memories are processed through and stored. When people feel stressed, stress hormones get over-secreted, which affects the brain. This secretion is made up of glucocorticoids, including cortisol
Cortisol
Cortisol is a steroid hormone, more specifically a glucocorticoid, produced by the adrenal gland. It is released in response to stress and a low level of blood glucocorticoids. Its primary functions are to increase blood sugar through gluconeogenesis; suppress the immune system; and aid in fat,...
, which are steroid hormones that the adrenal gland
Adrenal gland
In mammals, the adrenal glands are endocrine glands that sit atop the kidneys; in humans, the right suprarenal gland is triangular shaped, while the left suprarenal gland is semilunar shaped...
releases.
Studies of female monkeys at Wake Forest University
Wake Forest University
Wake Forest University is a private, coeducational university in the U.S. state of North Carolina, founded in 1834. The university received its name from its original location in Wake Forest, north of Raleigh, North Carolina, the state capital. The Reynolda Campus, the university's main campus, is...
(2009) discovered that individuals suffering from higher stress have higher levels of visceral fat in their bodies. This suggests a possible cause-and-effect link between the two, wherein stress promotes the accumulation of visceral fat, which in turn causes hormonal and metabolic
Metabolic syndrome
Metabolic syndrome is a combination of medical disorders that, when occurring together, increase the risk of developing cardiovascular disease and diabetes. It affects one in five people in the United States and prevalence increases with age...
changes that contribute to heart disease and other health problems.
Post traumatic stress disorder
Post traumatic stress disorder (PTSD) is a severe anxiety disorder that can develop after exposure to any event that results in psychological trauma. This event may involve the threat of death to oneself or to someone else, or to one's own or someone else's physical, sexual, or psychological integrity, overwhelming the individual's ability to cope. As an effect of psychological trauma, PTSD is less frequent and more enduring than the more commonly seen acute stress responseAcute stress reaction
Acute stress reaction is a psychological condition arising in response to a terrifying or traumatic event...
. Diagnostic symptoms for PTSD include re-experiencing the original trauma(s) through flashbacks or nightmares, avoidance of stimuli associated with the trauma, and increased arousal – such as difficulty falling or staying asleep, anger, and hypervigilance. Formal diagnostic criteria (both DSM-IV-TR and ICD-10) require that the symptoms last more than one month and cause significant impairment in social, occupational, or other important areas of functioning.
Common sources
Both negative and positive stressors can lead to stress. The intensity and duration of stress changes depending on the circumstances and emotional condition of the person suffering from it (Arnold. E and Boggs. K. 2007). Some common categories and examples of stressors include:- Sensory input such as painPainPain is an unpleasant sensation often caused by intense or damaging stimuli such as stubbing a toe, burning a finger, putting iodine on a cut, and bumping the "funny bone."...
, bright lightOver-illuminationOver-illumination is the presence of lighting intensity beyond that required for a specified activity. Over-illumination was commonly ignored between 1950 and 1995, especially in office and retail environments; only since then has the interior design community begun to reconsider this practice.The...
, noise, temperatures, or environmental issues such as a lack of control over environmental circumstances, such as foodFoodFood is any substance consumed to provide nutritional support for the body. It is usually of plant or animal origin, and contains essential nutrients, such as carbohydrates, fats, proteins, vitamins, or minerals...
, air and/or water quality, housingHouseA house is a building or structure that has the ability to be occupied for dwelling by human beings or other creatures. The term house includes many kinds of different dwellings ranging from rudimentary huts of nomadic tribes to free standing individual structures...
, healthHealthHealth is the level of functional or metabolic efficiency of a living being. In humans, it is the general condition of a person's mind, body and spirit, usually meaning to be free from illness, injury or pain...
, freedomLibertyLiberty is a moral and political principle, or Right, that identifies the condition in which human beings are able to govern themselves, to behave according to their own free will, and take responsibility for their actions...
, or mobility. - Social issues can also cause stress, such as struggles with conspecific or difficult individuals and social defeatSocial defeatSocial defeat refers to losing a confrontation among conspecific animals, or any kind of hostile dispute among humans, in either a dyadic or in a group-individual context, generating very significant consequences in terms of control over resources, access to mates and social...
, or relationship conflict, deceptionDeceptionDeception, beguilement, deceit, bluff, mystification, bad faith, and subterfuge are acts to propagate beliefs that are not true, or not the whole truth . Deception can involve dissimulation, propaganda, and sleight of hand. It can employ distraction, camouflage or concealment...
, or break upBreak UpBreak Up may refer to:* relationship breakup* Break Up , also known as The Man with the Balloons, an Italian film directed by Marco Ferreri* Break Up , starring Bridget Fonda, Kiefer Sutherland, and Steven Weber...
s, and major events such as birthBirthBirth is the act or process of bearing or bringing forth offspring. The offspring is brought forth from the mother. The time of human birth is defined as the time at which the fetus comes out of the mother's womb into the world...
and deathDeathDeath is the permanent termination of the biological functions that sustain a living organism. Phenomena which commonly bring about death include old age, predation, malnutrition, disease, and accidents or trauma resulting in terminal injury....
s, marriageMarriageMarriage is a social union or legal contract between people that creates kinship. It is an institution in which interpersonal relationships, usually intimate and sexual, are acknowledged in a variety of ways, depending on the culture or subculture in which it is found...
, and divorceDivorceDivorce is the final termination of a marital union, canceling the legal duties and responsibilities of marriage and dissolving the bonds of matrimony between the parties...
. - Life experiences such as povertyPovertyPoverty is the lack of a certain amount of material possessions or money. Absolute poverty or destitution is inability to afford basic human needs, which commonly includes clean and fresh water, nutrition, health care, education, clothing and shelter. About 1.7 billion people are estimated to live...
, unemploymentUnemploymentUnemployment , as defined by the International Labour Organization, occurs when people are without jobs and they have actively sought work within the past four weeks...
, clinical depressionClinical depressionMajor depressive disorder is a mental disorder characterized by an all-encompassing low mood accompanied by low self-esteem, and by loss of interest or pleasure in normally enjoyable activities...
, obsessive compulsive disorder, heavy drinking, or insufficient sleepSleepSleep is a naturally recurring state characterized by reduced or absent consciousness, relatively suspended sensory activity, and inactivity of nearly all voluntary muscles. It is distinguished from quiet wakefulness by a decreased ability to react to stimuli, and is more easily reversible than...
can also cause stress. Students and workers may face performance pressure stress from exams and project deadlines. - Adverse experiences during developmentDevelopmental psychologyDevelopmental psychology, also known as human development, is the scientific study of systematic psychological changes, emotional changes, and perception changes that occur in human beings over the course of their life span. Originally concerned with infants and children, the field has expanded to...
(e.g. prenatal exposure to maternal stress, poor attachment histories, sexual abuseSexual abuseSexual abuse, also referred to as molestation, is the forcing of undesired sexual behavior by one person upon another. When that force is immediate, of short duration, or infrequent, it is called sexual assault. The offender is referred to as a sexual abuser or molester...
) are thought to contribute to deficits in the maturity of an individual's stress response systems. One evaluation of the different stresses in people's lives is the Holmes and Rahe stress scale.
Stress tests
Measuring stress level independent of differences in people's personalities has been inherently difficult: Some people are able to process many stressors simultaneously, while others can barely address a few. Such tests as the Trier Social Stress TestTrier Social Stress Test
The Trier Social Stress test is a psychological procedure that allows experimenters to induce stress under laboratory conditions. What is unique about the procedure is that it also allows experimenters to compare people's stress levels, despite individual differences The Trier Social Stress test...
attempted to isolate the effects of personalities on ability to handle stress in a laboratory environment. Other psychologists, however, proposed measuring stress indirectly, through self-tests.
Because the amount of stressors in a person's life often (although not always) correlates with the amount of stress that person experiences, researchers combine the results of stress and burnout self-tests. Stress tests help determine the number of stressors in a person's life, while burnout tests determine the degree to which the person is close to the state of burnout. Combining both helps researchers gauge how likely additional stressors will make him or her experience mental exhaustion.
Adaptation
Responses to stress include adaptation, psychological coping such as stress managementStress management
Stress management is the alteration of stress and especially chronic stress often for the purpose of improving everyday functioning.Stress produces numerous symptoms which vary according to persons, situations, and severity. These can include physical health decline as well as depression. According...
, anxiety
Anxiety
Anxiety is a psychological and physiological state characterized by somatic, emotional, cognitive, and behavioral components. The root meaning of the word anxiety is 'to vex or trouble'; in either presence or absence of psychological stress, anxiety can create feelings of fear, worry, uneasiness,...
, and depression
Depression (mood)
Depression is a state of low mood and aversion to activity that can affect a person's thoughts, behaviour, feelings and physical well-being. Depressed people may feel sad, anxious, empty, hopeless, helpless, worthless, guilty, irritable, or restless...
. Over the long term, distress can lead to diminished health and/or increased propensity to illness; to avoid this, stress must be managed.
Stress management encompasses techniques intended to equip a person with effective coping mechanisms for dealing with psychological stress, with stress defined as a person's physiological response to an internal or external stimulus that triggers the fight-or-flight response. Stress management is effective when a person uses strategies to cope with or alter stressful situations.
There are several ways of coping with stress, such as controlling the source of stress or learning to set limits and to say "No" to some demands that bosses or family members may make.
A person's capacity to tolerate the source of stress may be increased by thinking about another topic such as a hobby, listening to music, or spending time in a wilderness
Attention Restoration Theory
Attention Restoration Theory asserts that people can concentrate better after spending time in nature, or even looking at scenes of nature. Natural environments abound with "soft fascinations" which a person can reflect upon in "effortless attention", such as clouds moving across the sky, leaves...
.
History and usage
The term stress had none of its contemporary connotations before the 1950s. It is a form of the Middle EnglishMiddle English
Middle English is the stage in the history of the English language during the High and Late Middle Ages, or roughly during the four centuries between the late 11th and the late 15th century....
destresse, derived via Old French
Old French
Old French was the Romance dialect continuum spoken in territories that span roughly the northern half of modern France and parts of modern Belgium and Switzerland from the 9th century to the 14th century...
from the Latin
Latin
Latin is an Italic language originally spoken in Latium and Ancient Rome. It, along with most European languages, is a descendant of the ancient Proto-Indo-European language. Although it is considered a dead language, a number of scholars and members of the Christian clergy speak it fluently, and...
stringere, "to draw tight."
It had long been in use in physics
Stress (physics)
In continuum mechanics, stress is a measure of the internal forces acting within a deformable body. Quantitatively, it is a measure of the average force per unit area of a surface within the body on which internal forces act. These internal forces are a reaction to external forces applied on the body...
to refer to the internal distribution of a force exerted on a material body, resulting in strain
Strain (materials science)
In continuum mechanics, the infinitesimal strain theory, sometimes called small deformation theory, small displacement theory, or small displacement-gradient theory, deals with infinitesimal deformations of a continuum body...
. In the 1920s and 1930s, the term was occasionally being used in psychological circles to refer to a mental strain or unwelcome happening, and by advocates of holistic medicine to refer to a harmful environmental agent that could cause illness. Walter Cannon used it in 1934 to refer to external factors that disrupted what he called homeostasis
Homeostasis
Homeostasis is the property of a system that regulates its internal environment and tends to maintain a stable, constant condition of properties like temperature or pH...
.
The novel usage arose out of Selye's 1930s experiments. He started to use the term to refer not just to the agent but to the state of the organism as it responded and adapted to the environment. His theories of a universal non-specific stress response attracted great interest and contention in academic physiology
Physiology
Physiology is the science of the function of living systems. This includes how organisms, organ systems, organs, cells, and bio-molecules carry out the chemical or physical functions that exist in a living system. The highest honor awarded in physiology is the Nobel Prize in Physiology or...
and he undertook extensive research programs and publication efforts.
However, while the work attracted continued support from advocates of psychosomatic medicine, many in experimental physiology concluded that his concepts were too vague and unmeasurable. During the 1950s, Selye turned away from the laboratory to promote his concept through popular books and lecture tours. He wrote for both non-academic physicians and, in an international bestseller entitled Stress of Life, for the general public.
A broad biopsychosocial concept of stress and adaptation offered the promise of helping everyone achieve health and happiness by successfully responding to changing global challenges and the problems of modern civilization
Civilization
Civilization is a sometimes controversial term that has been used in several related ways. Primarily, the term has been used to refer to the material and instrumental side of human cultures that are complex in terms of technology, science, and division of labor. Such civilizations are generally...
. He coined the term "eustress
Eustress
Eustress is a term coined by endocrinologist Hans Selye which is defined in the model of Richard Lazarus as stress that is healthy, or gives one a feeling of fulfillment or other positive feelings. Eustress is a process of exploring potential gains....
" for positive stress, by contrast to distress
Distress
Distress may refer to:*Distress , occurring when an individual cannot adapt to stress*Suffering*Distress signal, an internationally recognized means for obtaining help...
.
He argued that all people have a natural urge and need to work for their own benefit, a message that found favor with industrialists and governments. He also coined the term stressor
Stressor
Stressor is a chemical or biological agent, environmental condition, an external stimulus or an event that causes stress to an organism. An event that triggers the stress response may include for example:...
to refer to the causative event or stimulus, as opposed to the resulting state of stress.
From the late 1960s, academic psychologists started to adopt Selye's concept; they sought to quantify "life stress" by scoring "significant life events
Life-Events and Difficulties Schedule
The Life Events and Difficulties Schedule is a psychological measurement of the stressfulness of life events. It was created by Brown and Harris in 1978....
," and a large amount of research was undertaken to examine links between stress and disease of all kinds. By the late 1970s, stress had become the medical area of greatest concern to the general population, and more basic research was called for to better address the issue.
There was renewed laboratory research into the neuroendocrine, molecular, and immunological bases of stress, conceived as a useful heuristic
Heuristic
Heuristic refers to experience-based techniques for problem solving, learning, and discovery. Heuristic methods are used to speed up the process of finding a satisfactory solution, where an exhaustive search is impractical...
not necessarily tied to Selye's original hypotheses. By the 1990s, "stress" had become an integral part of modern scientific understanding in all areas of physiology and human functioning, and one of the great metaphors of Western life. Focus grew on stress in certain settings, such as workplace stress
Workplace stress
Workplace stress is the harmful physical and emotional response that occurs when there is a poor match between job demands and the capabilities, resources, or needs of the worker....
. Stress management
Stress management
Stress management is the alteration of stress and especially chronic stress often for the purpose of improving everyday functioning.Stress produces numerous symptoms which vary according to persons, situations, and severity. These can include physical health decline as well as depression. According...
techniques were developed.
Its psychological uses are frequently metaphorical rather than literal
Literal
Literal may refer to:*Literal and figurative language, taken in a non-figurative sense*Literal translation, the close adherence to the forms of a source language text...
, used as a catch-all for perceived difficulties in life. It also became a euphemism, a way of referring to problems and eliciting sympathy
Sympathy
Sympathy is a social affinity in which one person stands with another person, closely understanding his or her feelings. Also known as empathic concern, it is the feeling of compassion or concern for another, the wish to see them better off or happier. Although empathy and sympathy are often used...
without being explicitly confessional, just "stressed out."
It covers a huge range of phenomena from mild irritation
Irritation
Irritation or exacerbation, in biology and physiology, is a state of inflammation or painful reaction to allergy or cell-lining damage. A stimulus or agent which induces the state of irritation is an irritant...
to the kind of severe problems that might result in a real breakdown of health
Health
Health is the level of functional or metabolic efficiency of a living being. In humans, it is the general condition of a person's mind, body and spirit, usually meaning to be free from illness, injury or pain...
. In popular usage, almost any event or situation between these extremes could be described as stressful.
The most extreme events and reactions may elicit the diagnosis of posttraumatic stress disorder (PTSD), an anxiety disorder that can develop after exposure to one or more terrifying events that threatened or caused grave physical harm. PTSD is a severe and ongoing emotional reaction to an extreme psychological trauma; as such, it is often associated with soldiers, police officers, and other emergency personnel.
This stressor may involve viewing someone's actual death, a threat to the patient's or someone else's life, serious physical injury, or threat to physical or psychological integrity, overwhelming usual psychological defenses coping. In some cases, it can also be from profound psychological and emotional trauma, apart from any actual physical harm. Often, however, the two are combined.
The US military became a key center of stress research, attempting to understand and reduce combat neurosis
Neurosis
Neurosis is a class of functional mental disorders involving distress but neither delusions nor hallucinations, whereby behavior is not outside socially acceptable norms. It is also known as psychoneurosis or neurotic disorder, and thus those suffering from it are said to be neurotic...
and psychiatric casualties.
Diagnosis
A renewed interest in salivary alpha amylaseAmylase
Amylase is an enzyme that catalyses the breakdown of starch into sugars. Amylase is present in human saliva, where it begins the chemical process of digestion. Food that contains much starch but little sugar, such as rice and potato, taste slightly sweet as they are chewed because amylase turns...
as a marker for stress has surfaced. Yamaguchi M, Yoshida H (2005) have analyzed a newly introduced hand-held device called the Cocorometer developed by Nipro Corp., Japan. They state that this can be reliably used to analyze the amylase levels and is definitely a cheaper alternative as compared to the more expensive ELISA kits. The working consists of a meter and a saliva collecting chip, which can be inserted into the meter to give the readings. The levels of amylase obtained have been calibrated according to standard population, and can be categorized into four levels of severity.
See also
- Amygdala hijackAmygdala hijackAmygdala hijack is a term coined by Daniel Goleman in his 1996 book Emotional Intelligence: Why It Can Matter More Than IQ. Drawing on the work of Joseph E...
- Burnout (psychology)Burnout (psychology)Burnout is a psychological term for the experience of long-term exhaustion and diminished interest. Research indicates general practitioners have the highest proportion of burnout cases; according to a recent Dutch study in Psychological Reports, no less than 40% of these experienced high levels of...
- Compassion fatigueCompassion fatigueCompassion fatigue is a condition characterised by a gradual lessening of compassion over time. It is common among trauma victims and individuals that work directly with trauma victims. It was first diagnosed in nurses in the 1950s...
- Chronic stressChronic stressChronic stress is the response to emotional pressure suffered for a prolonged period over which an individual perceives he or she has no control. It involves an endocrine system response in which occurs a release of corticosteroids...
- Defense PhysiologyDefense PhysiologyDefense physiology is a term used to refer to the symphony of body function changes which occur in response to a stress or threat....
- Depression (differential diagnoses)Depression (differential diagnoses)Depression, one of the most commonly diagnosed psychiatric disorders, is being diagnosed in increasing numbers in various segments of the population worldwide. Depression in the United States alone affects 17.6 million Americans each year or 1 in 6 people. Depressed patients are at increased risk...
- GriefGriefGrief is a multi-faceted response to loss, particularly to the loss of someone or something to which a bond was formed. Although conventionally focused on the emotional response to loss, it also has physical, cognitive, behavioral, social, and philosophical dimensions...
- Hypothalamic-pituitary-adrenal axisHypothalamic-pituitary-adrenal axisThe hypothalamic-pituitary-adrenal axis , also known as thelimbic-hypothalamic-pituitary-adrenal axis and, occasionally, as the hypothalamic-pituitary-adrenal-gonadotropic axis, is a complex set of direct influences and feedback interactions among the hypothalamus, the pituitary gland ,...
- Psychological resiliencePsychological resilienceResilience in psychology refers to the idea of an individual's tendency to cope with stress and adversity. This coping may result in the individual “bouncing back” to a previous state of normal functioning, or using the experience of exposure to adversity to produce a “steeling effect” and function...
- Self-medicationSelf-medicationSelf-medication is a term used to describe the use of drugs or other self-soothing forms of behavior to treat untreated and often undiagnosed mental distress, stress and anxiety, including mental illnesses and/or psychological trauma...
- Stress (disambiguation)
- Stress managementStress managementStress management is the alteration of stress and especially chronic stress often for the purpose of improving everyday functioning.Stress produces numerous symptoms which vary according to persons, situations, and severity. These can include physical health decline as well as depression. According...
- Trier Social Stress TestTrier Social Stress TestThe Trier Social Stress test is a psychological procedure that allows experimenters to induce stress under laboratory conditions. What is unique about the procedure is that it also allows experimenters to compare people's stress levels, despite individual differences The Trier Social Stress test...
- Workplace stressWorkplace stressWorkplace stress is the harmful physical and emotional response that occurs when there is a poor match between job demands and the capabilities, resources, or needs of the worker....
- Work-life balanceWork-life balanceWork–life balance is a broad concept including proper prioritizing between "work" on the one hand and "life" on the other. Related, though broader, terms include "lifestyle balance" and "life balance".-History:The work-leisure dichotomy was invented in the mid 1800s...
External links
- The American Institute of Stress
- University of Massachusetts Medical School Stress Reduction Program
- "Research on Work-Related Stress", European Agency for Safety and Health at WorkEuropean Agency for Safety and Health at WorkThe European Agency for Safety and Health at Work was set up in 1996 in Bilbao, Spain. Its mission is "to make Europe's workplaces safer, healthier and more productive...
(EU-OSHA) - "Working on Stress", European Agency for Safety and Health at WorkEuropean Agency for Safety and Health at WorkThe European Agency for Safety and Health at Work was set up in 1996 in Bilbao, Spain. Its mission is "to make Europe's workplaces safer, healthier and more productive...
(EU-OSHA) - "Taming Stress", Scientific American, September 2003
- Self help guide (NHS Direct)