Stress- Exam Review: The Constant Challenge CHAPTER OBJECTIVES • • • • Describe the stress response. Describe the impact of stress on health. Identify sources of stress. Identify strategies for managing stress. KEY TERMS AND DEFINITIONS stressor Any physical or psychological event or condition that produces physical and psychological reactions. stress response The physical and emotional reactions to a stressor. stress The general physical and emotional state that the stressor produces. nervous system The brain, spinal cord, and nerves. autonomic nervous system The part of the nervous system that controls certain basic body processes; consists of the sympathetic and parasympathetic divisions. parasympathetic division The part of the autonomic nervous system that moderates the excitatory effect of the sympathetic division, slowing metabolism and restoring energy supplies. sympathetic division Division of the autonomic nervous system that reacts to danger or other challenges by accelerating body processes. endocrine system The system of glands, tissues, and cells that secrete hormones into the bloodstream to influence metabolism and other body processes. hormone A chemical messenger produced in the body and transported in the bloodstream to target cells or organs for specific regulation of their activities. cortisol A steroid hormone secreted by the cortex (outer layer) of the adrenal gland; also called hydrocortisone. epinephrine A hormone secreted by the medulla (inner core) of the adrenal gland that affects the functioning of organs involved in responding to a stressor; also called adrenaline. endorphins Brain secretions that have pain-inhibiting effects. fight-or-flight reaction A defense reaction that prepares an individual for conflict or escape by triggering hormonal, cardiovascular, metabolic, and other changes. homeostasis A state of stability and consistency in an individual’s physiological functioning. personality The sum of behavioral, cognitive, and emotional tendencies. resilience A personality trait associated with the ability to face adversity and recover quickly from difficulties. gender role A culturally expected pattern of behavior and attitudes determined by a person’s sex. general adaptation syndrome (GAS) A pattern of stress responses consisting of three stages: alarm, resistance, and exhaustion. eustress Stress resulting from a stressor perceived to be pleasant. distress Stress resulting from a stressor perceived to be unpleasant. allostatic load The “wear and tear” on the body that results from long-term exposure to repeated or chronic stress. psychoneuroimmunology (PNI) The study of the interactions among the nervous, endocrine, and immune systems. acute stress Stress immediately following a stressor; may last only minutes or may turn into chronic stress. chronic stress Stress that continues for days, weeks, or longer. mindfulness The intentional cultivation of attention in a way that is nonjudging and nonstriving. LECTURE OUTLINE This chapter defines stress and the stress response, and it describes ways to cope with stress to minimize its negative health effects and improve wellness. I. What Is Stress? A. Situations that trigger physical and emotional reactions are termed stressors, and the reactions themselves are termed the stress response. B. Stress is the general physical and emotional state that accompanies the stress response. C. Physical Responses to Stressors 1. Two systems are responsible for physical responses to stressors: the nervous system and the endocrine system. 2. The Nervous System a. The nervous system consists of the brain, spinal cord and nerves. b. The autonomic nervous system, the part of the nervous system not under conscious supervision, controls the stress response. It has two divisions: i. The parasympathetic division is in control when you are relaxed. ii. The sympathetic division is activated when your body is stimulated. 3. How the Nervous and Endocrine Systems Work Together a. The endocrine system is a system of glands, tissues, and cells that helps control body systems by releasing hormones and other chemical messengers into the bloodstream. b. The nervous system handles very short-term (acute) stress. The endocrine system handles both acute stress and long-term (chronic) stress. c. In a stressful situation, the nervous and endocrine systems activate the adrenal glands. d. The adrenal glands release the hormones cortisol and epinephrine (adrenaline), which trigger physiological changes. i. Increased heart and respiration rates ii. Hearing and vision becomes more acute iii. Liver releases extra sugar into bloodstream to boost energy iv. Perspiration increases v. Brain releases endorphins e. As a group, these physiological changes constitute the fight-or-flight reaction. 4. The Return to Homeostasis a. When a stressful situation ends, the parasympathetic division of the autonomic nervous system strives to return the body to its normal state, homeostasis. 5. The Fight-or-Flight Reaction in Modern Life a. The fight-or-flight reaction prepares the body for physical action regardless of the stressor. D. Cognitive and Psychological Responses to Stressors 1. Unlike the physical fight-or-flight reaction, cognitive and psychological responses to stressors vary. 2. Cognitive Responses a. Cognitive appraisal or perception of a potential stressor affects how a particular stressor is viewed. 3. Psychological Responses a. Psychological responses to stressors are cognitive but tend to indicate more emotion. b. Emotional responses, such as anxiety, depression, and fear, are determined in part by inborn personality and temperament but also can be regulated with coping techniques. c. Some coping techniques are positive. Ineffective coping techniques can impair wellness and include overeating and using tobacco, alcohol, and other drugs. 4. Personality a. Personality, the sum of cognitive, behavioral, and emotional tendencies, affects how a person perceives and reacts to stressors. b. Some personality traits, like hardiness, help people deal more effectively with stress. c. Personality Traits i. People with the personality trait of hardiness can cope more positively with stress. They are committed to their activities, have a sense of inner purpose, and an inner locus of control. ii. Two types of motivation have been related to stress and health: (1) Stressed power motivation is associated with people who are aggressive and argumentative, who tend to get sick when their need for power is threatened. (2) Unstressed affiliation motivation is associated with people who are drawn to others; these people report less illness. iii. Resilience refers to personality traits associated with social and academic success in at-risk populations, such as people from low-income families and those with mental and physical disabilities. (1) Resilient people tend to face adversity by accepting reality and holding the view that life is meaningful. d. Research indicates you can change some basic elements of your personality and your typical behaviors and patterns of thinking using positive stress-management techniques. 5. Cultural Background a. A clash of cultures can be a source of stress. i. It is important to accept and appreciate different cultural backgrounds. 6. Gender a. Strict adherence to gender roles can limit one’s response to stress and can itself become a source of stress. It can also affect one’s perception of a stressor. b. According to the results of the “Stress in America” survey, women report higher levels of stress than men. 7. Experience a. Good or bad experiences in the past will color how people respond to similar situations in the future. II. Stress and Health A. Evidence suggests that stress, in combination with other factors, can increase vulnerability to various illnesses and ailments. B. The General Adaptation Syndrome 1. The term general adaptation syndrome (GAS) describes what many believe is the universal and predictable response pattern to all stressors. 2. The three stages of GAS can be triggered by a pleasant stressor, eustress, or by an unpleasant stressor, distress. a. The alarm stage is the fight-or-flight reaction. This stage makes the body vulnerable by mobilizing it to cope with a crisis. b. The resistance stage occurs with continued stress. The body develops a new level of homeostasis to cope with the added stress, increasing resistance to illness. c. The exhaustion stage results in the depletion of resources that leave the body vulnerable to disease. C. Allostatic Load 1. Researchers have termed the long-term wear and tear of the stress response the allostatic load. A high allostatic load is linked to a greater risk of disease. Greater susceptibility to disease after repeated or prolonged stress may be due to the stress response itself rather than depletion of resources (exhaustion stage of GAS). D. Psychoneuroimmunology 1. Psychoneuroimmunology (PNI) studies the interactions among the nervous, endocrine, and immune systems. Hormones and other chemical messengers released during the stress response may inhibit or strengthen the immune system. 2. Acute stress can cause a movement of immune cells, which enhances the immune response. 3. Chronic stress causes prolonged secretion of cortisol, which negatively affects the immune system and causes an acceleration of diseases associated with inflammation, including multiple sclerosis, heart disease, type 2 diabetes, and clinical depression. 4. Cardiovascular Disease a. Blood pressure rises during the stress response, and chronic high blood pressure leads to atherosclerosis, a major component in cardiovascular disease. Emotional responses that include anger and hostility seem to be especially harmful. 5. Psychological Disorders a. Stress contributes to psychological problems such as depression, panic attacks, anxiety, eating disorders, and post-traumatic stress disorder (PTSD). 6. Altered Immune Function a. Health problems linked to impaired immune functioning include colds and other infections, asthma, allergy attacks, and flare-ups of chronic diseases. 7. Headaches a. Headaches have been linked to stress. There are three categories of headaches: tension, migraine, and cluster headaches. i. Tension headaches account for about 90% of all headaches. The pain is dull and steady, on both sides of the head. Psychological stress, poor posture, and immobility are leading causes of tension headaches. Treatment can include OTC painkillers, massage, acupuncture, relaxation, hot or cold showers, and rest. ii. Migraine headaches produce throbbing pain that starts on one side and spreads, heightened sensitivity to light, visual disturbances, nausea, dizziness, and fatigue. Triggers may be menstruation, stress, fatigue, atmospheric changes, bright light, sounds, odors, or certain foods. More migraine headaches occur in females. Evidence that exercise lowers stress and can thereby prevent migraines is mixed. Exercise may trigger a migraine in some. iii. Cluster headaches are extremely severe, causing intense pain in and around one eye. More cluster headaches occur in males. No one knows what causes cluster headaches. During cluster periods, it is important to avoid smoking cigarettes or drinking alcohol. 8. Other Health Problems a. Other health concerns with demonstrated links to stress are digestive problems, asthma, cancer, skin disorders, fibromyalgia, insomnia and fatigue, injuries, menstrual irregularities, impotence, and pregnancy complications. b. Stress can sometimes mask other underlying health problems that should be treated separately and differently. III. Common Sources of Stress A. Major Life Changes 1. Any major life change that requires adjustment and accommodation can be stressful. Personality and coping skills are important moderating influences. B. Daily Hassles 1. Each of life’s daily hassles, such as losing your keys or wallet, can be a greater source of stress than major life changes, because they occur more often. 2. For people who perceive hassles negatively, this may provoke a moderate stress response that cumulatively may have a significant effect on health. C. College Stressors 1. College is a time of major changes and minor hassles. Nearly all students suffer from some form of academic stress, interpersonal stress, time pressure, financial concern, and worry about the future. D. Job-Related Stressors 1. Stress from work was the third highest reported source of stress in 2017. Chronic job stress can lead to burnout. Improved schedules, communication, job goals, and time management can help. E. Social Stressors 1. Real Social Networks a. Social aspects of a person’s life can be both helpful and a source of stress. b. In real social networks, prejudice and discrimination are forms of stress created by the community and society in which a person lives. 2. Digital Social Networks a. The technology of digital social networks, although helpful in bringing instantaneous information, can impinge on personal space, waste time, and cause stress. F. Other Stressors 1. Conditions or events in the physical environment are environmental stressors. These can range from unavoidable inconveniences to major life stressors. 2. Environmental stressors can include anything from a noisy restaurant to natural disasters. 3. Internal stressors, such as unrealistic expectations of yourself, can cause stress and damage self-esteem. 4. Other internal stressors are physical and emotional states such as illness and exhaustion; these can be both a cause and an effect of unmanaged stress. 5. Traumatic stressors are extreme stressors that result from exposure to events that are life-threatening and can cause bodily injury. Some of these, like PTSD, should not be handled on your own; contact a counselor to help. IV. Managing Stress A. Social Support 1. Social support systems are one tool many people can use to buffer themselves against the damaging effects of stress. 2. People who have family and friends to help them through times of stress, or who are very involved in groups, often stay healthier and recover faster than those who do not. 3. Tips for strengthening social ties include fostering friendships, keeping family ties strong, and getting involved with a group. B. Volunteering 1. Consider volunteering to help build your social support system and enhance your spiritual wellness. a. Choose an activity that puts you in contact with people. b. Volunteer with a group. c. Know your limits. C. Communication 1. Assertive communication skills that help people respect the rights of others while protecting one’s own rights can help stressful situations from getting out of control. 2. Suppressing feelings or expressing feelings aggressively can lead to problems with relationships. D. Exercise 1. Regular exercise helps maintain a healthy body and mind and can even stimulate the birth of new brain cells. 2. Exercise can also reduce many of the negative effects of stress by allowing one to expend the nervous energy built up from daily stressors, and by training the body to return to homeostasis more readily after stressful situations. E. Nutrition 1. A healthful diet provides energy stores for use in stressful situations; eating wisely also improves feelings of self-control and self-esteem. F. G. H. I. 2. Limiting or avoiding caffeine may be helpful in stress management. 3 Many people overeat in response to stress. Time Management 1. Learning to manage your time can help you cope with everyday stressors. a. Set priorities, focusing on essential and important tasks. b. Schedule tasks for times of peak efficiency. c. Set realistic goals and commit to achieving them by writing them down. d. Budget enough time to achieve goals by making a reasonable estimate and then adding another 10% to 15%, or even 25%, as a buffer. e. Break up long-term goals into short-term ones. f. Visualize the achievement of goals; mentally rehearse the performance of tasks. g. Keep track of the tasks you put off, to analyze your reasons for procrastinating. h. Consider tackling the least pleasurable tasks first. i. Consolidate tasks when possible. j. Identify quick transitional tasks. k. Delegate responsibility—asking for help as appropriate and necessary. l. Say “no” when necessary without feeling guilty. m. Take breaks and allow for real free time to enjoy other activities. n. Avoid your personal “time sinks,” such as watching TV, surfing the internet, and talking on the phone. o. Stop thinking about getting started—just do it! Cultivating Spiritual Wellness 1. Spiritual wellness is associated with more effective coping skills and higher levels of overall wellness. 2. Develop spiritual wellness by seeking out activities that are meaningful to you. a. Look inward. b. Spend time in nature. c. Notice art, architecture, and music. d. Engage in a personal spiritual practice like prayer, meditation, or yoga. e. Reach out to others by sharing writings that inspire you, performing small acts of kindness, or engaging in community service. Confiding in Yourself through Writing 1. Confide in yourself through writing in a diary or journal. Thinking and Acting Constructively 1. Mindfulness, the intentional cultivation of attention in a way that is nonjudging and nonstriving, can help you reduce stress levels. 2. Think and act in a constructive way about things that can be controlled rather than those that cannot. 3. Take Control a. The feeling that the environment is out of control creates stress. 4. Problem-Solve a. Define the problem. b. Identify the causes. c. Consider multiple solutions. d. Weigh the pros and cons of possible solutions. e. Choose a solution. f. Make a list of the tasks involved in your solution. g. Carry out the tasks. h. Evaluate the outcome and revise if necessary. 5. Modify Your Expectations a. Focus on keeping self-expectations reasonable; and avoid expecting things of others or trying to meet their expectations of you. 6. Stay Positive 7. Practice Affirmations a. Practice repeating positive thoughts, or affirmations, to yourself. 8. Cultivate Your Sense of Humor a. Laughter induces both physiological and psychological relaxation. 9. Focus on What’s Important a. Ignore unimportant details and try to “chunk” important material into categories, creating a mental outline that allows you to move from general to specific details. J. Body Awareness Techniques 1. Practicing mindfulness leads to better problem-solving skills, emotional self-regulation, and resilience. 2. Yoga a. Hatha yoga emphasizes physical balance and breath control through a system of physical postures. b. It can be a powerful way to cultivate body awareness, ease, muscular endurance, and flexibility. 3. Tai Chi a. Tai chi (in Chinese, taijiquan) is a system of self-defense consisting of a series of slow, fluid, elegant movements that promote relaxation and concentration, moving with rather than against the stressors of everyday life. 4. Biofeedback a. Biofeedback can help reduce stress levels by using light, sound, or a metered dial to give feedback to some electronically-monitored bodily measure of stress, like perspiration or heartbeat. K. Counterproductive Coping Strategies 1. Tobacco Use a. Tobacco products are highly addictive and contain nicotine, a chemical that increases the actions of neurotransmitters. The negative consequences far outweigh any beneficial effects. 2. Use of Alcohol and Other Drugs a. Use of alcohol and other drugs to deal with stress places a person at risk for all the short-term and long-term problems associated with drug use. i. Many college students have patterns of alcohol consumption that detract from wellness. b. Stimulants such as amphetamines can activate the stress response. c. Marijuana use can elicit panic attacks with repeated use. Physiological effects show that it does not cause relaxation; and withdrawal from marijuana may be associated with an increase in stress hormones. d. Opioids such as morphine and heroin can mimic the effects of your body’s natural pain killers and act to reduce anxiety. However, tolerance to opioids develops quickly, and many users become dependent. e. Tranquilizers such as Valium and Xanax mimic some of the functions of the parasympathetic nervous system. Tolerance develops quickly, causing dependency and toxicity. 3. Unhealthy Eating Habits a. Food can be psychologically rewarding, but regular use of eating as a mechanism to cope with stress can lead to unhealthy eating habits. b. Dietary supplements marketed for stress reduction do not have to meet the same standards of safety, effectiveness, and manufacturing as medications. L. Getting Help 1. If self-help techniques do not provide enough relief, it may be helpful to read about specific approaches, consult a peer counselor, join a support group, or participate in a few psychotherapy sessions.