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Who is most vulnerable to stress? * What is the healthy response to stress? * How does the response to stress work? * What is the role of the hypothalamus-pituitary-adrenal (HPA) axis (grouping) in stress? * What is the role of the locus coeruleus in stress? * How do the connections in the brain work in stress? * What do we know about using (activating) and overusing our internal systems that respond to stress? * What are the effects of stress on medical and psychological conditions? * Conclusions about the effects of stress * What's in the future for stress? * Stress At A Glance * Diet for Stress Management Slideshow Diet for Stress Management Slideshow * Take the Stress Quiz! Take the Stress Quiz! * Tips for Exercise, Diet and Stress Reduction Slideshow Tips for Exercise, Diet and Stress Reduction Slideshow * Patient Discussions: Stress - Management * Patient Discussions: Stress - Physical Symptoms What is the effect of the stress response on my body? Who is most vulnerable to stress? Stress comes in many forms and affects people of all ages and all walks of life. No external standards can be applied to predict stress levels in individuals -- one need not have a traditionally stressful job to experience workplace stress, just as a parent of one child may experience more parental stress than a parent of several children. The degree of stress in our lives is highly dependent upon individual factors such as our physical health, the quality of our interpersonal relationships, the number of commitments and responsibilities we carry, the degree of others' dependence upon us, expectations of us, the amount of support we receive from others, and the number of changes or traumatic events that have recently occurred in our lives. Some generalizations, however, can be made. People with adequate social support networks report less stress and overall improved mental health in comparison to those without adequate social support. People who are poorly nourished, who get inadequate sleep, or who are physically unwell also have a reduced capacity to handle pressures and stresses of everyday life and may report higher stress levels. Some stressors are particularly associated with certain age groups or life stages. Children, teens, working parents, and seniors are examples of the groups who often face common stressors related to life transitions. What is the healthy response to stress? A key aspect of a healthy adaptational response to stress is the time course. Responses must be initiated rapidly, maintained for a proper amount of time, and then turned off to ensure an optimal result. An over-response to stress or the failure to shut off a stress response can have negative biological consequences for an individual. Healthy human responses to stress involve three components: * The brain handles (mediates) the immediate response. This response signals the adrenal medulla to release epinephrine and norepinephrine. * The hypothalamus (a central area in the brain) and the pituitary gland initiate (trigger) the slower maintenance response by signaling the adrenal cortex to release cortisol and other hormones. * Many neural (nerve) circuits are involved in the behavioral response. This response increases arousal (alertness, heightened awareness), focuses attention, inhibits feeding and reproductive behavior, reduces pain perception, and redirects behavior. The combined results of these three components of the stress response maintain the internal balance (homeostasis) and optimize energy production and utilization. They also gear up the organism for a quick reaction through the sympathetic nervous system (SNS). The SNS operates by increasing the heart rate, increasing blood pressure, redirecting blood flow to the heart, muscles, and brain and away from the gastrointestinal tract, and releasing fuel (glucose and fatty acids) to help fight or flee the danger. How does the response to stress work? While the complete story is not fully known, scientists understand much about how the response to stress works. The two main systems involved are the hypothalamic-pituitary-adrenal (HPA) axis and the SNS. (These systems are described later.) Triggered (activated) primarily by an area in the brain stem (lowest part of brain) called the locus coeruleus, the SNS secretes epinephrine and norepinephrine. The following are the five most important concepts to remember about these two systems: 1. They are governed by a feedback loop to regulate their response. (In a feedback loop, increased amounts of a substance -- for example, a hormone -- inhibit the release of more of that substance, while decreased amounts of the substance stimulate the release of more of that substance.) 2. They interact with each other. 3. They influence other brain systems and functions. 4. Genetic (inherited) variability affects the responses of both systems. (That is, depending on their genes, different people can respond differently to similar stresses.) 5. Prolonged or overwhelming responses of these systems can be harmful to an individual. What is the role of the hypothalamus-pituitary-adrenal (HPA) axis (grouping) in stress? The HPA axis is a grouping of responses to stress by the brain and the pituitary and adrenal glands. First, the hypothalamus (a central part of the brain) releases a compound called corticotrophin releasing factor (CRF), which was discovered in 1981. The CRF then travels to the pituitary gland, where it triggers the release of a hormone, adrenocorticotrophic hormone (ACTH). ACTH is released into the bloodstream and causes the cortex of the adrenal gland to release the stress hormones, particularly cortisol, which is a corticosteroid hormone. Cortisol increases the availability of the body's fuel supply (carbohydrate, fat, and glucose), which is needed to respond to stress. However, if cortisol levels remain elevated for too long, then muscle breaks down, there is a decreased inflammatory response, and suppression of the immune (defense) system occurs. Because they suppress the immune system, corticosteroids in measured doses are used to treat many illnesses that are characterized by inflammation or an overactive immune system, such as asthma and inflammatory bowel disease. For the same reason, they are used to help reduce the chances that our body will immunologically reject a transplanted organ. Corticosteroids also can cause fluid retention and high blood pressure. Therefore, it is critical that the response to corticosteroids be carefully controlled (modulated). This control usually is accomplished by a feedback mechanism in which increased cortisol levels feeding back to the hypothalamus and pituitary turn off production of ACTH. In addition, extremely high levels of cortisol can cause mental changes, including depression and psychosis, which disappear when the levels return to normal. Next: What is the role of the locus coeruleus in stress? What is the role of the locus coeruleus in stress? The locus coeruleus has many connections to other parts of the brain, particularly areas that bring in and process sensory information (information from sight, hearing, smell, taste, and touch). The locus coeruleus secretes norepinephrine and stimulates other brain centers to do the same. It is like the pacemaker (meaning it controls the tempo) of the brain. Thus, it increases arousal (heightened awareness, alertness) and vigilance (watchfulness, carefulness), and adjusts (modulates) the action of the autonomic nervous system, which includes the SNS. The autonomic nervous system regulates blood flow, heart rate, blood pressure, and breathing (respiration). It can also temporarily shut down the gastrointestinal (GI) and sexual systems until the crisis is over. These initial reactions, to get our blood flowing, heart pumping, and muscles energized, occur very quickly and automatically. How do the connections in the brain work in stress? The HPA axis and the locus coeruleus systems are linked through the hypothalamus and an area of the brain known as the limbic system. The limbic system is the control area for emotion and the processing area for memory. These linkages are critical. For example, if you see the bushes rustling, your locus coeruleus immediately starts things (the stress response) rolling. However, when you see that it is not a mountain lion but a golden retriever in the bushes, your memory of the tameness of the dog will turn off the stress response. Similarly, if a person is nervous before a public-speaking engagement and the first minute or two goes well, this happy feeling will turn down the activity of the locus coeruleus. These internal adjustments are why experienced public speakers often start off with a joke. It's as much to calm themselves (if the joke goes well) as it is to entertain you. The connections also include the endogenous (within the body) opiate (opium-like) system and the reward (dopamine) system. Thereby, during stress, pain is reduced and an extremely happy feeling (euphoria) may result. These connections partially account for "runner's high" and have a great deal to do with why we like roller coasters and scary movies. Here's how the connections work. The limbic system performs an emotional analysis and memory review of the information provided by the senses. Then, the multiplicity of connections allows us to determine whether the current stress is * one that has been mastered in the past and successfully adapted to, * not a threat at all, or * a clear and present danger. All of this internal activity must occur in milliseconds, and it does. What do we know about using (activating) and overusing our internal systems that respond to stress? Animal and human research has taught us much about our internal stress systems. When laboratory animals are exposed to a prolonged stress (usually food deprivation, mild electrical stimulation of the foot, or handling), they develop a stress syndrome. This syndrome consists of high blood pressure (hypertension), loss of appetite, weight loss, muscle wasting, gastrointestinal ulcers, loss of reproductive function, suppression of the immune system, and depression. Researchers also noticed that stress of long duration (chronic stress) sensitizes the stress system (makes it more responsive to stress). That is, the system then overresponds to new stressors. They further noticed that the administration of certain drugs, such as amphetamines or cocaine, could also sensitize the stress response. Moreover, constant stress increases the self-administration of drugs in laboratory animals. So, a vicious cycle is induced. The more stress there is, the more mice seek the drugs, and the more the sensitivity (increased responsiveness) to stress is increased! Early separation from the mother has also been seen as another potent stressor in animals. Such separation has been linked to increased levels of the stress hormones that cause the stress syndrome, which includes depression. Studies in humans are underway to evaluate how maternal stress, even early in the pregnancy, can affect the developing fetus. Why might maternal stress affect the fetus? The answer is the communication of the blood circulations of the mother and the fetus. From the mother's blood, the fetus gets both the good (for example, nutrients and oxygen) and the bad. The bad components of the blood can include alcohol, nicotine, illicit drugs, prescription drugs, and stress chemicals such as cortisol and norepinephrine. These animal and human studies seem to indicate that stress leads to depression. In other words, chronic stress in the mother's womb (in utero) or early deprivation (separation from the mother) might even predispose a person to developing the psychiatric syndrome of clinical depression in later life. Furthermore, other experiments show that the administration of stress hormones can actually decrease brain connections and even the number of brain cells in crucial areas, such as the limbic system. This loss of brain connections and cells then can lead to further maladaptive (inadequate adjustment) responses to stress. What's more, some particular kinds of stress seem to be even more detrimental than other types. That is, some types of stress can actually lead to diseases. For example, stresses that are unpredictable and uncontrollable seem to be the greatest culprits. On the other hand, stresses with which we can cope and master are not necessarily bad. In fact, we can learn from these stresses, predict their recurrence, and develop action plans to reduce or avoid them in the future. In this way, some stresses can actually trigger new personality growth and biologically induced adaptive (healthy adjustment) changes. Indeed, much of psychotherapy is empirically (guided by practical experience rather than theory) based upon this concept. What are the effects of stress on medical and psychological conditions? There is now evidence that points to abnormal stress responses as causing various diseases or conditions. These include anxiety disorders, depression, and substance abuse. Stress can affect virtually any organ system, being associated with conditions as diverse as skin rashes high blood pressure, cardiovascular disease, certain gastrointestinal diseases, some cancers, and even the process of aging itself. Stress also seems to increase the frequency and severity of migraine headaches, episodes of asthma, and fluctuations of blood sugar in diabetics. There also is scientific evidence showing that people experiencing psychological stress are more prone to developing colds and other infections than their less-stressed peers. Overwhelming psychological stress (such as the events of 9-11) can cause both temporary (transient) and long-lasting (chronic) symptoms of a serious psychiatric illness called posttraumatic stress disorder (PTSD). Conclusions about the effects of stress Uncontrollable, unpredictable, and constant stress has far-reaching consequences on our physical and mental health. Stress can begin in the womb and recur throughout life. One of the pathological (abnormal) consequences of stress is a learned helplessness that leads to the hopelessness and helplessness of clinical depression, but in addition, many illnesses, such as chronic anxiety states, high blood pressure, heart disease, and addictive disorders, to name a few, also seem to be influenced by chronic or overwhelming stress. Nature, however, has provided us with wonderful processes (mechanisms) to cope with stressors through the HPA axis and the locus coeruleus/sympathetic nervous system. Furthermore, research has shown us the biological processes (mechanisms) that explain what we all intuitively know is true -- which is, that too much stress, particularly when we cannot predict it or control its recurrence, is harmful to our health. Next: How can we manage stress? Stress - Physical Symptoms Question: Symptoms of stress can vary greatly from patient to patient. What were your physical symptoms? What are the effects of stress on medical and psychological conditions? There is now evidence that points to abnormal stress responses as causing various diseases or conditions. These include anxiety disorders, depression, and substance abuse. Stress can affect virtually any organ system, being associated with conditions as diverse as skin rashes high blood pressure, cardiovascular disease, certain gastrointestinal diseases, some cancers, and even the process of aging itself. Stress also seems to increase the frequency and severity of migraine headaches, episodes of asthma, and fluctuations of blood sugar in diabetics. There also is scientific evidence showing that people experiencing psychological stress are more prone to developing colds and other infections than their less-stressed peers. Overwhelming psychological stress (such as the events of 9-11) can cause both temporary (transient) and long-lasting (chronic) symptoms of a serious psychiatric illness called posttraumatic stress disorder (PTSD). Conclusions about the effects of stress Uncontrollable, unpredictable, and constant stress has far-reaching consequences on our physical and mental health. Stress can begin in the womb and recur throughout life. One of the pathological (abnormal) consequences of stress is a learned helplessness that leads to the hopelessness and helplessness of clinical depression, but in addition, many illnesses, such as chronic anxiety states, high blood pressure, heart disease, and addictive disorders, to name a few, also seem to be influenced by chronic or overwhelming stress. Nature, however, has provided us with wonderful processes (mechanisms) to cope with stressors through the HPA axis and the locus coeruleus/sympathetic nervous system. Furthermore, research has shown us the biological processes (mechanisms) that explain what we all intuitively know is true -- which is, that too much stress, particularly when we cannot predict it or control its recurrence, is harmful to our health. What's in the future for stress? Stress is part of life and will always be around. The keys to dealing with stress are appropriate control of stressors and management of our physical (physiological) and mental (psychological) responses. In this regard, critical incident stress debriefing (CISD) involves discussing the traumatic event as soon as possible after the event. Although it is thought to help lessen extreme (pathological) reactions to stress and often prevent PTSD in its worst forms for some individuals, other research has called its effectiveness into question. Hopefully, of the circumstances in which CISD can be useful can be clearly delineated and this approach to stress management can be translated into helpful strategies for managing the more common (normal) types of stress. Stress At A Glance * Stress is a normal part of life that can either help us learn and grow or can cause us significant problems. * Stress releases powerful neurochemicals and hormones that prepare us for action (to fight or flee). * If we don't take action, the stress response can create or worsen health problems. * Prolonged, uninterrupted, unexpected, and unmanageable stresses are the most damaging types of stress. * Stress can be managed by regular exercise, meditation or other relaxation techniques, structured timeouts, and learning new coping strategies to create predictability in our lives. * Many behaviors that increase in times of stress and maladaptive ways of coping with stress -- drugs, pain medicines, alcohol, smoking, and eating -- actually worsen the stress and can make us more reactive (sensitive) to further stress. * While there are promising treatments for stress, the management of stress is mostly dependent on the ability and willingness of a person to make the changes necessary for a healthy lifestyle. What is the effect of the stress response on my body? The heart rate increases, the blood pressure increases, muscles tense in preparation for action, and adrenaline pumps through the body. As critical systems are activated, the redirection of hormones and blood flow dampens other systems such as the digestive and reproductive systems, which are not essential for a quick escape. Perceived "threats" or even expectations, like the anticipation of a hot flash during a speaking engagement or anxiety about a pending deadline, can trigger the same physiologic response. Over time, stress hormones pulsing through the body can affect our health. http://www.sharecare.com/question/what-effect-stress-response-body http://www.medicinenet.com/stress/article.htm |