12 - Stress

Question 1

When does stress occur?

Answer 1

• When challenging situations exceed people’s resources and endangers their well-being
• Also an inevitable part of life

Question 2

What are some basic physiological reactions to stress (that are the same for men and women)?

Answer 2

• Sudden and severe stress generally produces (activation in sympathetic nervous system):
  → Increase in heart rate
  → Increase in breathing (lungs dilate)
  → Decrease in digestive activity (don’t feel hungry)
  → Liver released glucose for energy
• Firstly, our body judges a situation and decides whether or not it is stressful. This decision is made based on sensory input and processing (i.e. the things we see and hear in the situation) and also on stored memories (i.e. what happened the last time we were in a similar situation).
• If the situation is judged as being stressful, the hypothalamus (at the base of the brain) is activated
  → the body is preparing to run and fight essentially

Question 3

What is the stress response happening in the brain?

Answer 3

• The hypothalamus in the brain is in charge of the stress response. When a stress response is triggered, it sends signals to two other structures: the pituitary gland, and the adrenal medulla.
• These short term responses are produced by The Fight or Flight Response via the Sympathomedullary Pathway (SAM).
  –> Long term stress is regulated by the Hypothalamic Pituitary-Adrenal (HPA) system.
• The adrenal cortex releases stress hormones called cortisol
  –> This has a number of functions including releasing stored glucose from the liver (for energy) and controlling swelling after injury (hence, Epipens). The immune system is suppressed while this happens (because your body has other priorities)

Question 4

Explain what happens in the hypothalamic pituitary-adrenal system during the stress response.

Answer 4

• The stressor activates the Hypothalamic Pituitary Axis
• The hypothalamus stimulates the pituitary gland
• The pituitary gland secretes adrenocorticotropic hormone (ACTH)
• ACTH stimulates the adrenal glands to produce the hormone corticosteroid
• Cortisol enables the body to maintain steady supplies of blood sugar
  → Adequate and steady blood sugar levels help person to cope with prolonged stressor, and helps the body to return to normal

Question 5

Explain what happens in the sympathomedullary pathway during the stress response.

Answer 5

• The SAM activates the fight or flight response via the sympathetic nervous system
• The hypothalamus also activates the adrenal medulla. The adrenal medulla is part of the autonomic nervous system (ANS).
• The ANS is the part of the peripheral nervous system that acts as a control system, maintaining homeostasis in the body. These activities are generally performed without conscious control.
• The adrenal medulla secretes the hormone adrenaline. This hormone gets the body ready for a fight or flight response. Adrenaline creates changes in the body such as decreases (in digestion) and increases (sweating, increased pulse and blood pressure).
• Adrenaline leads to the arousal of the sympathetic nervous system (the excited! one) and reduced activity in the parasympathetic nervous system (the relaxed one). Once the ‘threat’ is over the parasympathetic branch takes control and brings the body back into a balanced state. No ill effects are experienced from the short-term response to stress and it further has survival value in an evolutionary context

Question 6

What is the physical logic behind long term stress?

Answer 6

• In healthy people, the two branches of the ANS maintain a balance — action followed by relaxation
• Unfortunately many people’s sympathetic ANS stays on guard (chronic stress), making them unable to relax and let the parasympathetic system take over
• If this situation becomes chronic, a whole variety of stress-related symptoms and illnesses can follow

Question 7

What are some physical effects of long term stress?

Answer 7

1) Heart problems: This risk particularly is linked to people who tend to be excessively competitive, impatient, hostile, and move and talk quickly.
→ Those “type A” symptoms may be more strongly correlated with CVD in men. Women are more likely than men to have an “overworked caregiver” pattern of heart problems
2) High blood pressure: Stress increases blood pressure in the short term, so chronic stress may contribute to a permanently raised blood pressure
3) Impaired immune system: Allergies and autoimmune diseases (including arthritis and multiple sclerosis) may be exacerbated by stress. Being stressed also slows the rate at which you recover from any illnesses you already have
4) Skin problems: acne, psoriasis, eczema, rashes, etc.
5) Pain: Continued stimulation of muscles through prolonged stress can lead to muscular pain such as backache and migraines
6) Diabetes: Chronic stress may lead to insulin-dependant diabetes
7) Infertility: Couples trying to conceive naturally are more likely to succeed during periods of low stress

Question 8

The field of psychoneuroimmunology did research on the links between the immune and the nervous system and how it can impact people’s mental health; what were the findings?

Answer 8

• PNI research suggests that chronic stress can lead to (or exacerbate) mood disorders such as depression and anxiety, bipolar disorder, cognitive (thinking) problems, personality changes, and problem behaviors (like a problem child who acts out, will be worst in situations of stress)
  → p.ex: someone who is trying to quit smoking but gets stressed, will turn to smoking

Question 9

How can stress lead to depression?

Answer 9

• Byproducts of stress hormones can act as sedatives (chemical substances which cause us to become calm or fatigued)
• When such hormone byproducts occur in large amounts (which will happen under conditions of chronic stress), they may contribute to a sustained feeling of low energy or depression
• Habitual patterns of thought which influence appraisal and increase the likelihood that a person will experience stress as negative (such as low self-efficacy, or a conviction that you are incapable of managing stress) can also increase the likelihood that a person will become depressed
  → p.ex: if you have a chronic stressor (uncertain about a job), this will constantly be flooding you with cortisol, the byproduct of those things make you feel lethargic (tired, achy, miserable), and that further increases negative thoughts, so these thoughts affect how you evaluate challenges you face (feeling more pessimistic), thus normal stressors become worse in your mind, you then are in a negative cycle

Question 10

How can stress influence bipolar disorder?

Answer 10

• Stress can trigger either a depressive or manic mood state in someone with a genetic vulnerability to Bipolar Disorder. Stress can also worsen a Bipolar mood episode once it has begun, increasing it’s intensity and/or extending it’s duration across time

Question 11

How can stress influence anxiety disorders?

Answer 11

• Some people who are stressed may show relatively mild outward signs of anxiety, such as fidgeting, biting their fingernails, tapping their feet, etc.
• In other people, chronic activation of stress hormones can contribute to severe feelings of anxiety (e.g., racing heartbeat, nausea, sweaty palms, etc.), feelings of helplessness and a sense of impending doom. Thought patterns that lead to stress can also leave people vulnerable to intense feelings of anxiety
• Anxiety or feelings of dread that persist for an extended period of time; which cause people to worry excessively about upcoming situations (or potential situations); which lead to avoidance; and cause people to have difficulty coping with everyday situations may be symptoms of one or more Anxiety Disorders

Question 12

How can stress influence cognitive functioning?

Answer 12

• The continuous presence of stress hormones in the body may alter the operation and structure of some aspects of the nervous system
• Stress hormones may decrease the functioning of neurons in a region of the brain known as the hippocampus (a part of the brain that is important for laying down new long-term memories) and in the frontal lobes (the part of the brain that is necessary for paying attention, filtering out irrelevant information, and using judgment to solve problems)
  → stress makes it harder to learn and form new memories
• As a result, people who are chronically stressed may experience confusion, difficulty concentrating, trouble learning new information, and/or problems with decision-making

Question 13

How can stress influence personality changes?

Answer 13

• Due to stress hormones, some people experience personality changes, such as:
  –> Irritability; hostility; frustration; anger; aggressive feelings and behaviour; decreased interest in appearance; decreased concern with punctuality; obsessive compulsive behaviour; social withdrawal and isolation; problems with communication, etc.

Question 14

What are the 4 main sources of stress for men and women?

Answer 14

• Family roles
• Violence
• Discrimination
• Poverty

Question 15

How can family roles can be a source of stress?

Answer 15

• Marriage
  → Related to lower levels of mental disorders in men and women
  → Perceived support of partner is important
• Parenthood
  → Good if you’re married and employed
  → you have to feel as though you’re able to take care of your children
  → Unmarried women with children at increased risk of mental health problems
  → Burdens of family care, especially when perceived to be unfair, are risk factors for both genders
• Employment
  → A positive factor for both men and women
  → A spouse’s employment can cause stress for someone if they perceive their homecare burden to be greater as a result

Question 16

How can violence be a source of stress?

Answer 16

• Linked to mental health problems
• Both men and women are vulnerable
  → Men are the more frequent targets (and perpetrators) of overall violence
  → Women are the more frequent targets of interpersonal violence: more likely to be the victims of family and friends than strangers, and more likely to be injured in violence from people they know than by strangers
• Forms of violence
  → E.g., intimate partner violence, sexual abuse, childhood abuse, bullying. All of these significantly increase the risk of mental disorders in both genders

Question 16

How can discrimination be a source of stress?

Answer 16

• Occurs due to a variety of reasons
  → E.g., skin color, ethnicity, gender, gender identity/orientation, illness
• Klonoff (2000) found that women who experienced high amounts of sexist discrimination had more depression, anxiety and physical complaints than others. Women with low amounts had levels similar to men’s
  → so men and women at the base level have similar rates of stress, but when taking into account sexism, women do inherently have higher levels of stress
• Effects on health
  → Creates stigma, which creates distress: People ruminate on the experience (feedback loop), heightened stress response, avoidance of health-enhancing behaviours, increase in unhealthy behaviours
  → feelings of exclusion creates internal stress but also general health is negatively affected

Question 17

How can poverty be a source of stress?

Answer 17

• Lowest income group: 2.5 times the risk for diagnosis of a mental disorder when compared to those in the highest income group. A history of poverty increases the risk even in people who are no longer poor (permanent damage from the chronic stress of living in poverty)
  → This risk difference is much sharper in the states than in other more socialized countries
• Other factors, such as divorce and unemployment, violence and discrimination, are risks for mental health problems and co-occur with poverty
  → Environment of poverty (Claire Ulrich, 2002): Poor housing, diet, access to services, resources to deal with stressors, violence, unemployment, dependency (on government, other people), lack of control