Mental Health Flashcards
What is the definition of stress
Perceived or anticipated threats that disrupts a persons well being or homeostasis
What are the triggers of stress?
 Psychological: emotional (fear, social rejection)
Physical (dramatic temperature changes, abuse)
Physiological (infection, inflammation)
What did Hans Selye find in his experiments with mice?
Physiological stress causes
enlargement of the adrenal gland
Decrease lymphocytes level
Development of bleeding ulcers
What was Hans Selye’s conclusions on his mice experiments
Psychological stress, impair, ability to resist future stressors
What did Dr. Hans Selye call the general stress response
General adaptation syndrome
What are the three stages of adaptation syndrome?
Alarm stage
Resistance/ adaptation stage
Exhaustion stage (allostatic overload)
The alarm stage of the general adaptation syndrome involves what?
Stressor triggers the hypothalamic pituitary adrenal (HPA) axis
Activate, sympathetic, nervous system
Arousal of all body defences
what happens in the resistance adaptation stage of general adaptation syndrome?
It begins with the action of Adrenal hormones mobilization contributes to the fight or flight
If the resistance is successful, and the individual goes to the homeostasis state is called what?
Allostasis
What is allostatic overload .
When adaptation to stress is not successful
What is the consequences of exhaustion stage/allostatic overload
Stress related disorders
What are the centres in the body that react to stress?
Autonomic nervous system
Hypothalamus pituitary Adrenal axis
How does the HPA axis response to stress?
Stimulation of hypothalamus in turn stimulates Pituitary which then stimulate adrenal cortex to release cortisol
How do stress affect the autonomic nervous system?
It can affect Sympathoneural (SN) limb releasing Noradrenaline
Synpatho- adrenomedullary limb releasing adrenaline (+Noradrenaline)
In the Hypothalamus Pituitary Adrenal Axis
Hypothalamus secrets corticotropin releasing hormone CRH which stimulate
Pituitary to release adrenocorticotrophic hormone ACTH which act on adrenals to secrete cortisol and catecholamines
Cortisol release due to stress can cause what?
Increase blood pressure and cardiac output
Increased blood levels of amino acids
Increased lipolysis
Atrophy of lymphoid tissues
Increased lipogenesis in face and trunk
Anti-inflammatory or pro inflammatory
Immunosuppression or enhancers humoral immunity
Cortisol released due to stress
Stimulate Gluconeogenesis
Elevated the blood glucose level
Affect protein metabolism
Powerful anti inflammatory or immunosuppressive agent
Abnormal levels of cortisol is linked to what?
Obesity
Sleep deprivation
HTN
Diabetes
Atherosclerosis
Loss of bone density
What’s effect of cortisol on immune system
Cortisol influence all immune cells
Elevated level, may decrease innate immunity an increase auto immune response
What is the therapeutic effect of cortisol?
Is a powerful Anti-inflammatory, immunosuppressive agent
What is the effect of childhood acute traumatic experience?
Increased odds of adult psychiatric disorders a negative functional outcomes
Impact normal brain development in childhood
What are the consequences of traumatic experience?
Individual who experienced trauma at risk of developing
Anxiety disorder
Depression
Post traumatic stress disorder
Serious mental illness
What are the impacts of having stress as an early age?
Neural connections and brain development can negatively be affected
Stress in pregnancy has been shown to impact early childhood development
Increased risk of cardiovascular disorders and metabolic disorder in later life
taught to be related to activation of the HPA axis and release of cortisol
Fetal exposure to, pro inflammatory cytokines is linked to Neuro compromised of cognitive function
How do stress impact the aged
Excitability changes in limbo system and hypothalamus
Increased catecholamines, ADH, ACTH, and cortisol
Decreased testosterone, thyroxine and other hormone
Alterations of opioid peptides
In the aged, stress causes catecholamines, ADH, ACTH and Cortisol what?
A. Increase
B decrease
Answer: A increase
Stress in the aged cause —— in testosterone, thyroxine and other hormone
A: increase
B: decrease
Answer: decrease
True or false-
Excitability changes in the limbic system and hypothalamus with stress
True
True or false
Stress cause alteration of opioid peptide and lipoproteins
True
True or false
Stress can cause immunosuppression and chronic inflammation
True
True or false
Stress can cause Hypercoagulation of blood and free radicals damage of cells
True
What are impact of stress in early age?
It can affect neuronal connections and brain development negatively
Stress in pregnancy affect early child development
Increase risk of Cardiovascular and metabolic disorder later in life
Fetal exposure to pro inflammatory cytokines is linked to neuro compromise of cognitive function
What’s the impact of stress during pregnancy
Impact early child development
Individuals who experience trauma are at risk for developing
Anxiety disorders
Depression
PTSD
And serious mental illness
Stress response affect which areas of the body?
Autonomic Nervous system and HPA axis
Stress impact on the autonomic nervous systems result in what
SN system will produce Noradrenaline
SAM will produce adrenaline with small noradrenaline
Stress impact on HPA axis will result in what?
Hypothalamus secreate corticotrophin-releasing hormone (CRH) which act on pituitary to release adenocorticotrophic hormone (ACTH) which act on adrenal cortex to release cortisol and catacholamines
Effect of stress on sympathetic nervous system result in production of what
Norepinephrine and epinephrine
Norepinephrine released due to stress result in what
Increase BP
Increase pupil dilation
Incread sweat gland action(armpit and palms)
Increased arterials smooth muscles contraction
Pilerection(goosebumps)
Vasoconstriction, vascular growth factor, angiogenic factor
Epinephrine released due to stress cause
Bronchodialatiion
Increased force and rate of cardiac contraction- increase cardiac output
Increased lipolysis - increased circulating free fatty acids
Epinephrine released due to stress acts on pancreas resulting in
Decreased insulin- decrease glucose uptake in skeletal muscle and adipose - increased blood glucose
Increase glucagon- increased gluconeogenesis - increase blood glucose
Epinephrine release due to stress act on liver will result in what?
Decrease glycogen synthesis
Increased glyconolysis and increased gluconeogenesis resulting in increased blood glucose
Stress impact CNS which impact hypothalamus in turn cause CRH which act on what areas
Posterior pituitary and anterior pituitary
Effect of stress on posterior pituitary result in what
Increase ADH and vasopressin
Which increase water retention
Cortisol released due to stress impact on adrenal cortex cause what
Increased BP and cardiac output
Increased lipolysis extremities
Increased blood levels of amino acids
Increased lypogenesis face and trunk
Decrease luteinizing hormones, estradiol and testosterone
Atrophy of lymphoid tissues - anti-inflammation or pro inflammation and immunosuppression or enhanced humoral immunity
Cortisol secreted due to stress cause
Gluconeogenesis
Elevated blood glucose
Affects protein metabolism
It’s powerful anti- inflammatory and immunosuppressive agent
Cortisol due to stress cause T cell apoptosis
true or false
True
Elevated cortisol is linked with what?
Obesity
Sleep deprivation
Lipid abnormalities
HTN
Diabetes
Atherosclerosis
Loss of bone density
Elevated cortisol affect which immunity?
Decrease innate immunity and increase autoimmune responses
Catecholamines released due to stress
Release from adrenal medulla- epinephrine released
Alpha adrenergic receptor 1 &2
Beta adrenergic receptor 1&2
Mimic direct stimulation of Sympathetic stimulation
Increase pro inflammatory cytokines production
PTSD session
What is PTSD
Pathological stress response to a memory
Considered a mental illness
Cause by intrusive symptoms such as reexperiencing traumatic event
People have flashbacks, nightmares and intrusive thoughts
Physical brain changes
What occupation is PTSD common
First responders, doctors, nurses and military
PTSD in children 6 and under
Avoidance and negative symptoms may be internalized
Only one symptom required
Extreme temper tantrum is included under arousal symptoms
May manifest with social withdrawal and constricted play
What are the xtics of PTSD in all age groups
Sleep disturbances
Depression
Other maladaptive symptoms
What are the impact of PTSD
Decreased QoL
Impact relationship
Can Impact normal activity e.g employment
10% occurrence in Canadian veterans
What will be screening question
In your life have you ever had any experience that was so frightening, horrible or upsetting that in the past month you have had nightmares about it or thought about it when you did not want to?
Treatment
Counselling
- Relaxation
- CBT
- Exposure therapy
- support groups
What is the hallmark of PTSD
Reduced hypocampal volume
What’s the role of hypocapus in stress response
Control stress responses, declarative memory and contextual aspects of fear conditioning
What’s the role of amygdala in stress
It’s involved with n emotional processing and critical for acquisition of fear responses
Amygdala mediate stress response and emotional learning role in pathophysiology of PTSD
Imaging show hyper responsiveness in PTSD during presentation of stressful stript/stories
No clear evidence of structural changes in amygdala due to PTSD
What’s the effect of PTSD on cortex?
Decreased volume of frontal cortex
What’s treatment of PTSD
Behavioural therapies and medication shown to increase hypocampus volume
Anti anxiety
Anti depressants
ADHD
