Stress is a common problem in the modern world, it is a problem that most people face on a daily basis. The definition of stress can vary, psychologists define stress “as any uncomfortable, emotional experience accompanied by predictable biochemical, physiological and behavior change.” Stress can be defer depending on an individual, stress can be beneficial as one may take it for motivation however, too much stress can be harmful to our health. In this essay, I will be looking at a case study on stress, as well as looking at factors that can influence health.
The flight or fight response, otherwise known as “acute stress response” (short-lived), was first described by Walter Cannon (American physiologist) in 1920, used to describe animals’ reaction to a threat. This theory was then recognized as the first stage of the general adaptation syndrome. The fight or flight response is a response, triggered by the release of hormones in the body in preparation for a fight (to deal with the problem), or flight (run away) in which can be both physical and mental. As a response to acute stress, the body’s sympathetic nervous system is active by the sudden release of hormones, in which the nervous system stimulates the adrenal gland to trigger catecholamines, which include adrenaline and noradrenaline. The catecholamines cause the body to immediately react causing increase heart rate, blood flow, and breathing rate. Once the threat is over, the body takes 20-60 minutes to return back to its pre-arousal level.
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In case study one, the patient experienced cognitive stressors. A cognitive stressor is the inability to solve a problem or coming up with a creative project. The stressor was triggered by a conflict between her boyfriend regarding the future and her manager over a marketing complaint. To deal with the confrontation, the patient immediately perceived these two events as a threat triggering her flight or fight response. The sympathetic nervous system caused her body to immediately react to the potential threat so in this case confrontation, to experience hyperventilation, palpitations, chest pain, dizziness, anxiety, and a dreadful sense of doom in which she interpreted her symptoms as a heart attack. However, what the patient thinks is having a heart attack, is actually stress as confirmed by her cardiologist. The flight or fight response can play a critical role in how we deal with a certain situation, it how prehistoric man survived and in modern-day era, can actually be helpful depending on how someone copes.
Holmes and Rahe (1967) devised a questionnaire called the social readjustment rating scale (SRRS), this questionnaire was used to identify major stressful events. This questionnaire included life events that were either severe such as the death of a spouse, to mild such as changing school which happened within a 12-month period, with the mean value. If someone is scared with less than 150, they have a 30% chance of suffering from stress, and anything over 300 would be an 80% chance of suffering from stress. The aim of the study using the SRRS, was to be able to correlate the result with the onset of illness. The questionnaires were used on 2500 male sailors, the result was that the researchers concluded that life changes had a strong correlation with increased chance of stress and health breakdown. Although the questionnaire had a strong link between the higher SRRS score and illness, it did not take into consideration people’s differences. It was highly problematic, as it either overestimated/underestimated people’s stress levels and may not have any correlations to increase health breakdown.
Lazarus et al (1981) devised a questionnaire called the Daily Hassles and Uplifts Scale. This questionnaire was composed of 117 items of daily events. The participants were asked to complete the questionnaire only at end of the day in which they had experienced the previous month, the items were rated on a scale of 0-3, 0 being no applicable and 3 being a big deal. The total score is calculated and used as an indicator of stress. The result was that the hassle scale tended to be more accurate with predicting stress such as anxiety and depression rather than life events. However, this questionnaire did not take into consideration individual problems and may over/underestimate their stress levels.
Hans Selye, a medical doctor, and researcher (1956) came up with a theory called the general adaptation syndrome (GAS) to explain the short-term effects of exposure to stressors with lab rats. He did this by observing a series of physiological changes in the rats after they were exposed to stressful situations. Selye identified these stages as alarm, resistance, and exhaustion. The alarm stage is the initial symptom that the body experiences under stress, otherwise known as the fight or flight response. This reaction causes the heart rate to increase and the adrenal gland to release a substance called cortisol. The resistance stage is when the body starts to repair itself after the initial shock, which causes the body/hormones to settle and normalize. If the situation does not settle and the body remains on high alert, it results in the body eventually adapting to the higher stress level. The body unconsciously attempts to cope with the situation and continues to secret hormones, which leads to the exhaustion stage. The exhaustion stage is the result of prolonging or chronic stress for a long period of time resulting in negative consequences such as emotional, physical, and psychological stress. “Every stress leaves an indelible scar, and the organism pays for its survival after a stressful situation by becoming a little older.” (Selye, H. 1956)
Richard Lazarus (1966) transactional theory of stress and coping (TTSC). This occurs between a person and the environment. The TTSC consist of stressor, primary appraisal, secondary appraisal, and coping response. The stressor is a stimulus that causes stress, which can come in a variety of forms such as biological, environmental, cognitive, and life change stressors. When confronted by the stressor, the body's initial immediate response to the threat (fight or flight), is the body's way of responding to the threat which is the primary appraisal either as a threat, challenge, or loss. This follows by the secondary appraisal of the how-to body that can best deal with the situation. This can be done through internal/external options, internal options could be through willpower, inner strength, or meditation, external options could be seeking help through family/friends and healthcare professions. The outcome can either be beneficial or harmful. The coping response can be either beneficial or harmful called problem-based control, in which you feel in control of the situation by learning different strategies such as new skills. Emotional-based coping is when the person fails to cope with the situation or feels in little control, thus not being able to solve the problem which results in emotional distress.
The treatments I would recommend to the patient would be biofeedback (biological/behavior techniques) and stress inoculation theory SIT (cognitive theorphy0. Biofeedback theory offers the patient information on the state of their health, such as high blood pressure and how to manage it. SIT theory was developed by Donald Meichenbaum (1985) and as a basic idea to cope with stressors. The treatment consists of three phases, conceptualization, skill application, and rehearsal, and application and follow-through of the phrase. Both of these tests have shown to be very effective in helping people with stressful jobs. This will help with our patient as she often mistakes her symptom for a heart attack, the biofeedback theory will help reassure the patient. This will help the patient, in terms of her job and pressure from her boyfriend and mother about her future to take control of her stress.
In conclusion, stress can have a massive influence on our health. However, with appropriate treatments and methods, many people are able to get the right help needed.
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