Stress ... Anxiety, Depression, Stress

Stress is a term in psychology and biology, first coined in the 1930s, which has in more recent decades become a commonplace of popular parlance. It refers to the consequence of the failure of an organism – human or animal – to respond appropriately to emotional or physical threats, whether actual or imagined.

Stress symptoms commonly include a state of alarm and adrenaline production, short-term resistance as a coping mechanism, and exhaustion, as well as irritability, muscular tension, inability to concentrate and a variety of physiological reactions such as headache and elevated heart rate.

Origin and terminology
The term stress was first employed in a biological context by the endocrinologist Hans Selye in the 1930s. He later broadened and popularized the concept to include inappropriate 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.

Signs of stress may be cognitive, emotional, physical or behavioral. Signs include poor judgment, a general negative outlook, excessive worrying, moodiness, irritability, agitation, inability to relax, feeling lonely, isolated or depressed, aches and pains, diarrhea or constipation, nausea, dizziness, chest pain, rapid heartbeat, eating too much or not enough, sleeping too much or not enough, social withdrawal, procrastination or neglect of responsibilities, increased alcohol, nicotine or drug consumption, and nervous habits such as pacing about or nail-biting.

Models
General Adaptation Syndrome
Stress is 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 on rats and other animals by exposing them to unpleasant or harmful stimuli. He found that all animals display a similar sequence of reactions, manifesting in three distinct stages. He labeled this universal response to stressors the general adaptation syndrome or GAS.

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. At this point 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 capacity of glands, especially the adrenal gland, and the immune system is exhausted and function is 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.

Selye: eustress and distress
Selye published in 1975 a model dividing stress into eustress 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 which result in eustress or distress is determined by the disparity between an experience (real or imagined), 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 [9] 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, a challenge, or is benign.

This primary appraisal is influenced by both person and environmental factors, and triggers the selection of coping processes. Problem-focused coping is directed at managing the problem, while 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 also includes the perception of how stressful the problem is; realizing that one has more than or less than adequate resources to deal with the problem affects the appraisal of stressfulness. Further, coping is flexible in that the individual generally examines the effectiveness of the coping on the situation; if it is not having the desired effect, s/he will generally try different strategies.

Neurochemistry and physiology
The neurochemistry of the stress response is now believed to be well understood, although much remains to be discovered about how the components of this system interact with one another, in the brain and throughout in the body. In response to a stressor, corticotropin-releasing hormone (CRH) and arginine-vasopressin (AVP) are secreted into the hypophyseal portal system and activate neurons of the paraventricular nuclei (PVN) of the hypothalamus.

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 hypothalamic-pituitary-adrenal axis (HPA), a major part of the neuroendocrine system involving the interactions of the hypothalamus, the pituitary gland, and the adrenal glands, 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 glucocorticoids 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.

Impact on disease
Stress 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, as well as 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.

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.

Common sources
Both negative and positive stressors can lead to stress. Some common categories and examples of stressors include: sensory input such as pain, bright light, or environmental issues such as a lack of control over environmental circumstances, such as food, housing, health, freedom, or mobility.

Social issues can also cause stress, such as struggles with conspecific or difficult individuals and social defeat, or relationship conflict, deception, or break ups, and major events such as birth and deaths, marriage, and divorce.

Life experiences such as poverty, unemployment, depression, obsessive compulsive disorder, heavy drinking, or insufficient sleep can also cause stress. Students and workers may face stress from exams, project deadlines, and group projects.

Adverse experiences during development (e.g. prenatal exposure to maternal stress, poor attachment histories, sexual abuse) 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 Test
While some tests, such as the Trier Social Stress Test, attempt to compare people's stress levels despite differences in their personalities, testing for stress in a standardized manner has been inherently difficult. Some people may be able to process many stressors at the same time, while others start to feel burned out just from managing a few. Because the amount of stressors in one’s life often (although not always) correlates with the amount of stress the person experiences, some psychologists propose measuring stress directionally: by determining the number of stressors in a person’s life and combining that data with how close the person is to the state of burnout (typically estimated in a burnout test), researchers conclude how likely the person to becoming fully stressed with additional stressors.

Adaptation
Main article: Stress management
Responses to stress include adaptation, psychological coping such as stress management, 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.

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