Understanding Stress: Causes and Effects
Understanding Stress: Causes and Effects
STRESS
WHO has dubbed Stress as the Ilenlth Epidemic of the 21 't Century. — A global
phenomena that is constantly rising.
(Epidemic: Epidemic refers to an increase, often sudden, in the number of cases of a disease
above what is normally expected in that population in that area.)
• About one-third of people around the world reported feeling stressed, worried and/or
• Approximately 284 million people worldwide have an anxiety disorder (Our World in
Data, 2017).
• According to the APA, US adults surveyed in 2020 reported that increased stress has o
Negatively affected their behaviour (49%) o Increased tension in their bodies (21 o
Caused them to snap out of anger (20%) o Caused unexpected mood swings (20%)
In 2019, a global well-being study conducted by Cigna corporation reported that
about 82% Indians are suffering from stress on an account of work, health, and
finance-related concerns which is higher than other developed and emerging
countries such as the USA, UK, Germany, France and Australia.
WHAT IS STRESS?
"Stress can be defined as a state of worry or mental tension caused by a difficult
situation. It is a natural human response that prompts us to address challenges and
threats in our lives" (WHO),
"Stress is that which happens to the man, not that which happens in him; it is a set of
causes not a set of symptoms" (Symonds, 1947).
2. Response-based definition of stress: This refers to the response to the stressful stimuli
as the actual stress itself
"Stress is the non-specific response Of the body to any demand for change" (Hans Selye).
This definition suggests that whenever the body encounters a situation that requires
adaptation, adjustment, or coping, it triggers a set of physiological and psychological
responses collectively known as the stress response.
Appraisals of stress explain how different individuals have different reactions to the
same stimulus based on their mental interpretation of the [Link] may find an
event/action as stressful, other may find it exciting and yet others maybe unaffected. (Public
speaking)
TRANSACTIONAL MODEL OF STRESS - LAZARUS AND FOLKMAN
Lazarus and Folkman (1984) proposed a three-process cognitive
appraisals o Primary Appraisal o Secondary Appraisal o Reappraisal
• Primary Appraisal: Judging a particular event/situation as positive or negative. Events
can be appraised during the primary appraisal in 3 possible ways. o Irrelevant (No
influence) o Relevant but not threatening o Stressful
• Secondary Appraisal: When you've judged the situation as positive or negative, then the
interpretation happens on whether you have the necessary resources to deal with the
stressful situation. This involves evaluation and assessment of your resources.
• Stress reappraisal: The stressful situation is reappraised based on the ongoing feedback
front the situation along with the person's self-assessment of how well he/she is dealing
with the situation.
The process of stress reappraisal involves reevaluating and potentially modifying how you
initially perceive a stressful situation. The goal of this process is to decrease the perceived
level of threat or emotional impact associated with the stressor. The process of stress
reappraisal involves consciously shifting your perspective from perceiving the presentation
as n threat to recognizing it as an opportunity for growth and positive contribution.
This change in appraisal leads to a reduction in the emotional impact of the stressor, allowing
you to approach the situation with more confidence and less distress.
commuting, technology glitch, financial concerns, household chores, etc, , are minor,
everyday stressors that can accumulate over time and contribute to overall stress levels.
A major stress fill event can trigger a cascade of many minor stressors While each hassle
may appear small on its own, their cumulative effect can impact mental and
3. Research
shows that minor daily hassles can be more strongly related to mental health issues
that major stressful events. Because they are getting accumulated without being
released. While individual stressors might be manageable on their own, their
combined impact can become overwhelming when they accumulate.
Cumulative stress takes into account the additive nature of stress. These additive
effects may have serious negative consequences when an individual experiences
multiple stressors frequently in his/her lives.
beliefs and behaviour of a group. Culture plays a significant role in influencing how Individuals
perceive, experience, and cope with stress.
Stress is not just a universal physiological response; it's also a psychological and
emotional phenomenon that is shaped by the cultural context in which it occurs.
Different cultures may prioritize or emphasize certain stressors over others.
What is considered stressful in one culture might not be the same in another.
For example, in some cultures, job-related stress might be particularly significant due
to a strong work ethic, while in others, family and social relationships might take precedence.
In some families, getting good grades might be very important, causing stress for students
who feel pressure to perform well in school. Others might have more relaxed attitudes,
where doing your best is valued, but not at the cost of constant stress.
•Stress spillover effect refers to the process where stress in one domain spillover to
create stress in another domain. Stress from work or personal relationships can spill
over into other areas of your life.
For example, Inability to maintain work-life balance.
High levels of stress can lead to unhealthy coping behaviours, such as overeating,
excessive alcohol consumption, or neglecting exercise. These behaviours can spill over
into other domains and contribute to further stress or health-related issues.
Stress can affect your interpersonal interactions. For example, if you're stressed about a
project at work, you might unintentionally take out your frustrations on your loved ones,
causing conflicts and strain in your relationships.
MAJOR TYPES OF STRESS
• Acute stress refers to a short-term and immediate reaction to a specific event or
situation. It is cu e e s a normal and natural response that helps the body and mind quickly
react to challenges or threats. This type of stress can be both positive (eustress) and negative
(distress), depending on the circumstances and the individual's perception of the situation.
• Eustress: A term coined by Hans Selye to describe a type of stress that has a positive or beneficial
effect on an individual. Eustress refers to stress that is experienced as motivating, exciting, and
challenging in a positive way.
For example: Starting a New Job: The excitement and anticipation of a new
job,along with the challenge of learning new skills and responsibilities, can lead to
eustress. This positive stress can motivate you to perform well and make a positive
impression.
• Distress: Distress is a tern used to describe a negative or harmful type of stress
that can have adverse effects on an individual's physical, emotional, and
mental well-being. Unlike eustress, distress is characterized by feelings of
overwhelm, anxiety, and an inability to cope with challenging situations.
Examples of distress could be:
• Coping with the loss of a loved one.
Experiencing chronic financial difficulties or job insecurity,
o Going through a traumatic event, such as a natural disaster or accident.
o Struggling with chronic health conditions or severe illness.
• High levels of pressure and demand in a work or academic setting that exceeds
one's coping abilities,
2. stress is a long-term, prolonged and constant feeling of
stress that can negatively affect your health if it goes untreated. It can be caused by the
everyday pressures of family and work or by traumatic [Link] can be
cumulative, which means that when a number of stressors occur at the same time or
Stressful experiences are associated with various physiological changes in the body. The
fight and flight response Coined by Walter Cannon in 1932, is the body's reaction to
stress. It is also known as acute stress response.
Fight & Flight response is the Physiological reaction of the body as a result of any threat
or stressful situations, The fight & flight response, mobilizes and prepares the body to either fight
or flee When confronted by a threat. The fight & flight response is mediated by the autonomic
nervous system — specifically, the sympathetic nervous system.
The sympathetic nervous system activates/arouses or stimulates the body to
mobilize all the resources Whenever our body response is activated or we feel a lot of
energy when there is a threat in front of us, this is primarily done by the sympathetic
nervous system. Under any stressftll situation — the sympathetic nervous system gets
activated and it activates all the physiological aspects such as heart rate, perspiration, etc.
When the body gets aroused by the sympathetic nervous system, the parasympathetic
nervous system tries to maintain balance in the body by decreasing the arousal of the body
system. It tries to conserve bodily resources such as it slows heart rate and so on
dealing with a threat,lt helps us to survive in a stressful situation and it happens rapidly and
unconsciously. Under threat — the sympathetic nervous system automatically activates and mobilizes
energy.
Physical symptoms during the fight and flight response:
• Heartbeat increases
Tensed tnuscles
• Dryness of mouth
• Dilation of pupils
• Sweating of the palm
When the threat is over, the parasympathetic nervous system tries to return the body to the
normal relaxed state because the body cannot stay in the arouse state for a long [Link]
Cannon termed this phenomenon as Homeostasis mechanism. Our body always tries to
maintain its equilibrium by bringing it to a normal state. This is carried out by the
parasympathetic nervous system which tries to maintain the balance.
adaptation syndrome is the body's initial response to stress. The alarm reaction stage of
the GAS prepares a person to respond to the stressor they are experiencing. This is often
known as a "fight or flight" response. The sympathetic nervous system is activated by the
sudden release of hormones. The sympathetic nervous system is a part of the autonomic
nervous system, which regulates the functions of your heart, stomach, bladder, and
intestines, as well as your muscles. When the sympathetic nervous system is activated, it
stimulates the adrenal glands. The glands, in turn, trigger the release of certain hormones,
including adrenaline and noradrenaline Physical signs of being in the alarm response
stage include,
• Dilated pupils
• Increased heart rate
• Rapid breathing
• Trembling
• Pale or flushed skin
P2
syndrome is when your body tries to repair itself after the initial shock of stress. If the
stressfiil situation is tio longer present and you can overcome the stress, your heart rate and
blood pressure will start to return to prestress levels during this stage. However, if the
stressfül situation continues for a long time or if you do not resolve the stress, your body
will never receive a clear signal to return to normal functioning levels. This means it will
continue to secrete the stress hormones and your blood,
Prolonged
sta
ge of general adaptation syndrome—exhaustion.
drains your physical, emotional, and mental resources to the point where your body is
no longer able to cope with Stress. Signs that you are in the exhaustion stage include:
The General
Adaptation One enters a period of chronl(, mabated
Syndrome
strzsfd—
stress (Joss of)ob death of loved
Time
STRESS MANAGEMENT - COPING STRATEGIES
Coping skills help us to tolerate and adjust to negative events or situations and to maintain
emotional equilibrium and positive self-image.
Coping strategies are essential/important due to the following reasons;
• Coping strategies include thoughts and behaviours that we use to manage the demands
of stressfill situations. (Folkman & Lazarus)
• Stress accounts for a significant proportion of physical and mental disorders.
• Unhealthy/ineffective coping strategies are major contributors to these stress related
diseases.
• Stress cannot be removed for our life,
involves tackling or dealing with the problem that is causing stress such as generating options to
solve the problem or implementing steps2 to solve the problem.
Emotion focused coping are aimed nt tnnnnging the feelings of distress associated with
the stressiill situations rather than the nctunl problem or the source Of [Link] includes n
wide range of responses such as'. o Self-soothing o Expression of negative emotion o
Focus on negative thoughts (or positive thoughts) o Avoidance, denial, wishful thinking
people tend to engage in excessive negative thoughts and self-blame which may
be maladaptive and counterproductive.
Some common healthy/adnptive coping strategies include:
o Relaxation: Relaxation has many benefits, including decreased heart rate,
respiration, blood pressure, muscle tension, and analytical thinking.
Abdonlinal breathing, progressivc tnusclc relaxation, visualization, yoga, listening to callhing tnusic,
physical exercise, and timc management o Mindfulness and Meditation:
Engaging in mindfulness practices and meditation can help you stay grounded
in the present moment, reducing the i Inpact of stressors.
o Coping Statements: Coping statements are positive affirmations that help reframe
negative mindsets. It can also be helpful to talk to a supportive person, stay in the
present moment, and use diversionary tactics o Physical Activity: Regular
exercise helps release endorphins, which are natural mood lifters. It can also
provide a healthy outlet for stress and tension.
o Engaging in Hobbies: Dedicate time to activities you enjoy, whether it's
reading, painting, cooking, or playing a musical instrument. Hobbies can offer a creative
outlet and a break from stress, o Engaging in Self-Care: Prioritize self-care activities
that bring you joy, whether it's taking a bath, reading, or simply relaxing.
feelings. it's your body's way of encouraging you to drop your guard and relax. As this
happens, your nervous system returns to a more normal and balanced state
e Emotional Support. Emotional support involves expressing care, empathy, love, and
understanding. It provides individuals with a sense of being valued and accepted When
individuals feel emotionally supported, they are better equipped to cope with stressful
situations. knowing that there are people who care about their well-being can mitigate the
emotional impact of stressors, e Instrumental Support, Instrumental support involves
practical assistance, such as tangible help, resources, or advice, that can directly address the
stressor. Having access to instrumental support can ease the burden of stress by providing
practical solutions to problems, Whether it's financial assistance, guidance, or hands-on
help, instrumental support can enhance an individual's ability to cope challenges.
of stressors.
• Health Benefits: Strong social connections have been linked to better physical and
mental health. Individuals with supportive relationships may experience lower levels
of stress-related illnesses and a faster recovery from health challenges.
• Proluoting Coping Stratcgics: Social support can provide individuals with diverse
perspectives and coping strategies, Sharing expericnccs and learning from others can
broaden one's repertoire of effective coping mechanisms, enhancing overall stress
resilience.
Eustress is a form of stress that's positive for our well-being, mental health, and
behaviors. Eustress is a kind of stress that encourages us to try a new hobby, learn new skills,
and even step outside our comfort zone. It makes us feel good while we work toward our
goals, go through significant life changes, or start new chapters in our lives, It's a stress
response that benefits us.
some examples of eustress to help you identify it. Here are a few quick scenarios where you
might experience eustress:
• tun tnincnt chnnge: Before you start new job or move to a new city, there's n period of
anticipation. Youire so focused on the change that you're about to experience how
exciting it is that etistfess helps you adjust when the time comes, e Seeing progress:
While you're working so hard on your short-term or long-term goals or even just n big
task on your daily to-do list, you'll feel motivated to going. After seeing some
progress, you'll know that youire almost done in reach.
• Leaving your conifort zone: You're learning whenever you leave YQULCOLf-OSt--
ZOL)-e. You're taking risk, but it's showing you how something to do often.
WAYS TO HARNESS EUSTRESS:
• Mindset Shift: Reframe how you perceive stress. Instead of seeing it as solely
negative, view it as an opportunity for growth and development. Embrace challenges
with a positive mindset.
• Set Realistic Goals: Break down larger goals into smaller, manageable tasks. This
approach can make challenges seem jess Overwhelming and more achievable, turning
potential distress into eustress.
• Cultivate a Growth Mindset: Adopt a growth mindset, where challenges are viewed as
opportunities to learn and improve. Embrace the idea that abilities can be developed
• Items and Scoring: The scale consists of several statements reflecting thoughts and
feelings related to stress. Participants rate each statement based on their
experiences over a specified time frame (e.g., the last month). Responses are
typically given on a Likert scale, with options ranging from "0 1' (never) to "4"
(very often). Some versions of the scale may use a 5-point scale,
• Reversed Scoring: To minimize response bias, some items on the scale are worded
in the opposite direction. This means that for certain statements, a higher score
indicates a lower level of perceived stress, ensuring that respondents carefully
consider each item,
• Validity and Reliability: The PSS has demonstrated good psychometric properties,
including reliability and validity, It has been used in various populations and
settings, making it a versatile tool for assessing perceived stress,
• Interpretation: The total score on the PSS can range from 0 to the maximum score,
with higher scores indicating a higher level of perceived stress. A higher score
suggests a greater perception of stress, while a lower score indicates a lower
perception of stress.
• Applications: The Perceived Stress Scale is widely used in both research and clinical
settings. It has been employed in studies examining the relationship between stress and
health outcomes, as well as in interventions aimed at reducing perceived stress.
STRESS AND IIEALTII
Stress plays a significant role in the development and exacerbation of various health
issues. While the body's stress response is a natural and adaptive mechanism, chronic or
excessive stress can have detrimental effects on physical and mental well-being-Studies
have found many health problems related to stress. Stress seems to worsen or increase the
risk of conditions like obesity, heart disease, Alzheimer's disease, diabetes, depression,
gastrointestinal problems, and asthma.
CHRONIC STRESS
Chronic stress, or a constant stress experienced over a prolonged period of time, can
contribute to long-term problems for heart and blood vessels. The consistent and ongoing
increase in heart rate, and the elevated levels of stress hormones and of blood pressure, can
take a toll on the body. This long-term ongoing stress can increase the risk for hypertension,
heart attack, or stroke.
Repeated acute stress and persistent chronic stress may also contribute to inflammation in the
circulatory system, particularly in the coronary arteries, and this is one pathway that is
thought to tie stress to heart attack. It also appears that how a person responds to stress can
affect cholesterol levels.
IMPACT ON HEALTH
• Immune System Suppression: Prolonged stress can weaken the immune system, making
individuals more susceptible to infections and illnesses. For example, people under
chronic stress may experience more frequent colds or other infections due to a
compromised immune response.
Digestive Problems: Stress can affect the digestive system, leading to issues such as
irritable bowel syndrome (IBS), and acid reflux, The gut-brain
connection is well-established, and stress can disrupt the balance of bacteria in the
gut, influencing digestion,
W • Mental Health Disorders: Chronic stress is a significant risk factor for the
development and exacerbation of mental health disorders such as anxiety and
depression. the constant activation of the stress response can lead to changes in the
brninis structure and fünction, impacting mood regulation,
• Insomnin nnd Sleep Disorders: Stress can interfere with sleep patterns, leading to
difficulties falling asleep, staying asleep, or achieving restorative sleep. Chronic sleep
disturbnnces can contribute to a range Of health problems, including impaired cognitive
fUtictiOn, Weakened immune system, and increased risk of chronic conditions,
Examples of stress-related illnesses include:
Stress-related cardiovascular diseases: Hypertension, heart disease, and stroke.
e Gastrointestinal issues:lrritable bowel syndrome (IBS), indigestion, and
gastroesophageål reflux disease (GERD).
• Mental health disorders:Anxiety disorders, depression, and post-traumatic stress disorder
(PTSD).
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