UNIT V

Stress, Coping and Health

 Stress - Definition
• A psychological and physical response
of the body that occurs whenever we
must adapt to changing conditions,
whether those conditions be real or
perceived, positive or negative.
• People experience stress when they
perceive that there is an imbalance
between the demands made of them
and the resources they have available to
cope with those demands.
• Although the experience of stress is
psychological, stress also affects people’s
physical health.
• Short-term stress –isn’t usually a
problem.
• Stress becomes a risk to safety and
health when it is protracted.
• There are two types of stress,
• Eustress(good stress).
• Distress (not so good stress).
 Eustress
• Eustress - the positive response one has
to a stressor, which can depend on one's
current feelings of control, desirability,
location, and timing of the stressor.
• Potential indicators of eustress may
include responding to a stressor with a
sense of meaning, hope, or vigor.
• Eustress is positively correlated with life
satisfaction and well-being.
 Distress
• Distress is the most commonly referred
to type of stress.
• This occurs when the demands upon us
are so great that they lead to bodily and
mental damage.
• Distress is damaging, excessive or
pathogenic (disease producing) stress.
 Two types of Distress
• Acute stress – intense stress that arrives
and disappears quickly.
–Meeting with a minor accident
–Searching for something you have
misplaced
• Chronic stress – prolonged stress that
exists for weeks.
• Poverty
• Chronic illness
• Both eustress and distress can be
equally taxing on the body, and are
cumulative in nature, depending on a
person's way of adapting to the stressor
that caused it.
• The body cannot differentiate between
distress or eustress. It is dependent on
one's perception of the stress.
• The same stressor may cause both
eustress and distress
• Hyperstress – occurs when an individual
is pushed beyond what he or she can
handle. It results from being overworked
or overloaded. This can trigger strong
emotional reactions for minor incidents.
• Hypostress – occurs when an individual
is bored or unchallenged. This can lead
to restlessness. For example – any one
doing repetitive work.
 Sources of Stress
• Stress is caused by:
• Poor match between us and our work
• Poor relationships
• Presence of psychological or physical
violence
• By conflicts between our roles at work and
outside it. 
 Different Sources of Stress
Sources within a person
–Illness
–Unrealistic self-expectations
–Conflict – simultaneous existence of
incompatible demands, opportunities.
• Approach/approach conflict.
• Approach/ avoidance conflict.
• Approach/ avoidance conflict.
2. Survival stress – occurs when our survival
is threatened. This is controlled mainly by
the release of adrenaline, flight/ fight.
3. Change – resistance to change. Success
depends on adaptation to and anticipation
of change.
4. Environmental stress – noise, pollution,
dirty conditions, invasion of personal space.
5. Family – personality of each member of a
family impacts other members of the
family. Divorce, illness, disability, death.
6. Community and society – interpersonal
contacts, neighbours, friends etc.
7. Job stress – time pressures, deadlines,
too much work, lack of job security etc.
8. Hormonal factors – puberty, pre-
menstrual syndrome, menopause etc.
 Symptoms
• At the college/ organisationlevel:
–Absenteeism,
–Poor time-keeping,
–Disciplinary problems,
–Harassment,
–Reduced productivity,
 At the individual level:
• Emotional reactions (irritability, anxiety, sleep
problems, depression, hypochondria, alienation,
burnout)
• Cognitive reactions (difficulty in concentrating,
remembering, learning new things, making decisions)
• Behavioural reactions (abuse of drugs, alcohol, and
tobacco; destructive behaviour)
• Physiological reactions (back problems, weakened
immunity, peptic ulcers, heart problems,
hypertension).
• THE OFFICAL LIST OF SYMPTOMS OF Stress as listed by the
American Institute of Stress.
• Frequent headaches, jaw clenching or pain
• Gritting, grinding teeth
• Difficulty concentrating, racing thoughts
• Stuttering or stammering
• Trouble learning new information
• Tremors, trembling of lips, hands
• Forgetfulness, disorganization, confusion
• Neck ache, back pain, muscle spasms
• Difficulty in making decisions.
• Light headedness, faintness, dizziness
• Feeling overloaded or overwhelmed.
• Ringing, buzzing or "popping" sound
• Frequent crying spells or suicidal thoughts
• Frequent blushing, sweating
• Feelings of loneliness or worthlessness
• Cold or sweaty hands, feet
• Little interest in appearance, punctuality
• Dry mouth, problems swallowing
• Nervous habits, fidgeting, feet tapping
• Frequent colds, infections, herpes sores
• Increased frustration, irritability, edginess
• Rashes, itching, hives, "goose bumps”
• Overreaction to petty annoyance
• Unexplained or frequent "allergy" attack
• Increased number of minor accidents
• Heartburn, stomach pain, nausea
• Obsessive or compulsive behavior
• Excess belching, flatulence
• Reduced work efficiency or productivity
• Constipation, diarrheaLies or excuses to
cover up poor work
• Difficulty breathing, sighing
• Rapid or mumbled speech
• Sudden attacks of panic
• Excessive defensiveness or suspiciousness
• Chest pain, palpitations
• Problems in communication, sharing
• Frequent urination
• Social withdrawal and isolation
• Poor sexual desire or performance
• Constant tiredness, weakness, fatigue
• Excess anxiety, worry, guilt, nervousness
• Frequent use of over-the-counter drugs
• Increased anger, frustration, hostility
• Weight gain or loss without diet
• Depression, frequent or wild mood swings
• Increased or decreased appetite
• Insomnia, nightmares, disturbing dreams
• Feeling Tired all the Time
• Increased smoking, alcohol or drug use
• Excessive gambling or impulse buying
 Biopsychosocial aspects of stress
• Sympathetic nervous system and endocrine system are
aroused.
• All energy and blood goes to the skeletal muscles, because
of the fight-or-flight reaction: you are ready to run away.
• There is hardly any energy or blood for the digestive system.
• Two major stress hormones are adrenalin (epinephrine) and
noradrenalin (norepinephrine).
• These are made in the adrenal glands and affect the
sympathetic nervous system; they accelerate the heart rate,
increase respiration and ensure that energy is released.
• They make that the body gets to an increased state of
alertness, and so begins the first phase of the
general adaptation syndrome.
 Biopsychosocial aspects of stress
• Hans Selye - 'the father of stress research,'
developed the theory that stress is a
major cause of disease because chronic
stress causes long-term chemical changes.
• He observed that the body would respond
to any external biological source of stress
with a predictable biological pattern in an
attempt to restore the body’s internal
homeostasis.
• He introduced the General Adaptation
Syndrome model in 1936 showing in
three phases what the alleged effects of
stress has on the body.
–Alarm stage
–Resistance stage
–Exhaustion stage.
• ALARM STAGE –recognition of danger and prepares to deal with
the threat, a.k.a. the fight or flight response.
• Activation of the HPA axis, the nervous system (SNS) and the
adrenal glands take place.
• The main stress hormones cortisol, adrenaline, and
noradrenaline, are released to provide instant energy.
• If this energy is not used by physical activity, it can become
harmful.
• Too much adrenaline results in a surge of blood pressure that can
damage blood vessels of the heart and brain – a risk factor in
heart attack and stroke.
• The excess production of the cortisol hormone can cause damage
to cells and muscle tissues.
• Stress related disorders and disease from cortisol include
cardiovascular conditions, stroke, gastric ulcers, and high blood
sugar levels.
• At this stage the body alarms with a sudden jolt of hormonal
changes, and the person is immediately equipped with enough
energy to handle it.
• RESISTANCE STAGE -The body shifts into this second
phase with the source of stress being possibly
resolved.
• Homeostasis begins restoring balance and a period
of recovery for repair and renewal takes place.
• Stress hormone levels may return to normal but
reduced defenses and adaptive energy may be left.
• If a stressful condition persists, the body adapts by a
continued effort in resistance and remains in a state
of arousal.
• Problems begin to manifest when this process
repeats too often with little or no recovery.
Ultimately this moves the person into the final stage.
• EXHAUSTION STAGE -At this phase, the stress has continued
for some time. The body’s ability to resist is lost because its
adaptation energy supply is gone. Often referred to as
overload, burnout, adrenal fatigue, maladaptation or
dysfunction.
• Here is where stress levels go up and stay up!The adaptation
process is over and not surprisingly; this stage of the general
adaptation syndrome is the most hazardous to ones health.
• Chronic stress can damage nerve cells in tissues and organs.
Particularly vulnerable is the hippocampus section of the
brain.
• Thinking and memory are likely to become impaired, with
tendency toward anxiety and depression.
• There can also be adverse function of the autonomic nervous
system that contributes to high blood pressure, heart disease,
rheumatoid arthritis, and other stress related illness.
Psychosocial aspects of Stress
Cognition and stress – stress can impair our
cognitive functions. High stress levels=poor
memory and attention.
Emotion and stress – emotions accompany
stress. Fear, depression, anger.
Social behaviour and stress – stress changes
people’s behaviour. People become helpful –
earthquakes or hostile - riots
 Coping with stress
• Emotional and physical strain
accompany stress.
• To avoid this people are motivated to
reduce the stress levels.
• Some withdraw from the problem
whereas others confront.
• This is called coping with a stressful
situation.
• Coping is defined as the constantly
changing cognitive and behavioural
efforts to manage specific external/
internal demands appraised as taxing or
exceeding the resource of the person.
• It is a process by which people try to
manage the perceived discrepancy
between the demands and the resources
they see in a stressful situation.
• Coping may not necessarily lead to
resolution of the problem – avoidance.
 Types of Coping
• Emotion focussed coping – its to regulate
emotions experienced because of the
stressful event.
–Releasing pent up emotions
–Distracting oneself
–Managing hostile feelings
–Relaxation procedures
–Meditating
–Defense mechanisms
• Problem-focused coping – Dealing
directly with the stressor to
eventually eliminate it.
–Doing something constructive
–Finding information about the
problem and learning new skills to
manage the problem.
 Coping strategies
• When an individual chooses one of the
coping types and puts it into operation it
is referred to as “Coping Strategy”.
• An individual who is aware of more typs
of coping has the advantage of choosing
a strategy that is most suitable in a given
context.
 Types of coping
• Confrontive coping – taking the bull by its
horn – standing your ground in an argument
or discussion.
• Painful problem solving – marked by
objectivity – absence of emotions – the
person chalks out a definite plan of action
and follows it.
• Seeking social support – tapping resources
from ones interpersonal relationships –
shoulder to cry on.
• Accepting responsibility – blaming oneself.
• Positive reappraisal – attaining goals through
another way – it is all for my own good
• Distancing – making light of the situation –
refusal to think too much about it.
• Self-control – relieving the stress covertly –
keeping things to themselves – keeping others
from knowing how bad things are.
• Escape – avoidance – focus is shifted from
the problem and is fixed elsewhere.
 Stress and illness
• Stress can be defined as a process in
which environmental demands
strain an organisms adaptive
capacity, resulting in both
psychological as well as biological
changes that could place a person at
risk for illness
• Stressful life events are related to the risk of
infected individuals developing an illness.
• Traumatic stressful events may trigger either
behavioral or biological processes that contribute
to the onset of disease.
• Chronic stress has been associated with increased
reports of illness.
• Long-term exposure to chronic stress may
facilitate the development of illness during
exposure to stress.
• Exposure to chronic stress may results in
permanent or at the very least long-term
psychological, biological, or behavioral
responses that alter the progression of
illness.
• Those who had either a work related or
interpersonal chronic stressors (defined as stress
lasting one month or longer) had an increased risk
of developing colds compared to those who had no
chronic stressor.
• In addition, the longer the stress endured, the
more likely a person was to become ill.
• Psychological stress predicted a greater expression
of illness.
• However, life experiences were significantly
correlated with somatic symptomIs and energy
level.
• Overall health status was highly correlated with
somatic symptoms.