Stress Flashcards
Stress
refers to an internal or external event or demand of life experienced by the individual that is perceived and appraised for scope and meaning on a continuum to determine whether resources and abilities for management are available, exceeded, or exhausted.
Coping
Represents an individuals response to stress
Stress can stem from
Psychosocial, emotional, physical or physiological stimuli
Many experience what with stress
Anxiety, depression and grief
Stress treatment
Psychotherapy and short term drug treatment
Long term therapy may be required
Walter B. Cannon discovered
The flight or fight response
Hans Selye work showed…
physiological stress invloed enlargement of the adrenal gland, decreased lymphocyte levels, development of bleeding ulcers
Stress impairs the ability to…
Resist future stressors
Alarm stage
Stressor triggers the hypothalamic pituitary adrenal axis
Activates sympathetic nervous system
Arousal of body defences
Resistance / Adaptation stage
Begins with the actions of adrenal hormones
Mobilization contributes to “fight or flight”
Exhaustion Stage
Occurs only if stress continues and adaptation is not successful
Leads to stress-related disorders
3 stages of general adaptation syndrome
Alarm stage
Resistance/ Adaptation stage
Exhaustion stage
Sources of stress
Physiological
Psychological/ Emotional
Physiological stress
Originates from a physiological trigger and is associated with injury or illness
Psychological/ Emotional stress
More common, encountered on a regular basis and generates a star of unpleasant arousal
3 types of stress
Acute
Episodic
Chronic
Acute stress
Most common, usually for a short period of time, occurs in reaction to a real or perceived demand, threat or pressure
Episodic stress
Self-inflicted stress, taking on unrealistic assignments beyond what is reasonably expected
Chronic stress
Sustained demand, threat or pressure that is harmful, to health and wears on individuals continuously
Allostasis
Stability through change
Brain continuously monitors for future events and anticipates what is required from neuroendocrine and automatic systems
Allostatic overload
Over activation of adaptive systems
Highly individualized
Hypothalamus secretes
Corticotropin- releasing hormone (CRH)
Pituitary releases
Adrenocorticotropic hormone
Adrenal secretes
Cortisol and catecholamines
Cortisol
Secreted during stress Reaches all tissues Affects protein metabolism Promotes resolution and repair Elevates blood glucose level Shown to induce T-cell apoptosis
What does cortisol stimulate
Gluconeogenesis
What is an example of a powerful anti-inflammatory and immunosuppressive agent
Cortisol
Abnormal elevations linked to cortisol are
Obesity Sleep deprivation Lipid abnormalities Hypertension (HTN) Diabetes Atherosclerosis Loss of bone density
Cortisol secretion during stress inhibits what
initial inflammatory effects
Catecholamines are released from
The adrenal medulla
Catecholamines
Mimic direct sympathetic stimulation
Increases pro inflammatory cytokine production
Increases HR, BP and impairs wound healing
a- adrenergic receptors
a1 and a2
B- adrenergic receptors
B1 and B2
Neuropeptide Y (NPY)
sympathetic neurotransmitter
Growth factor
Histamines
pro inflammatory
Target mast cells
Induces acute inflammation and allergic reaction while suppressing Th1 and promoting Th2 activity
Role of immune system
Stress directly related to pro inflammatory
Link between stress, immune function, and disease/ cancer
Immune system affected by neuroendocrinefactors
Stress response decreases T-cell cytotoxicity and B- cell function
Psychosocial stress manifests as
physiological, emotional, cognitive, and behavioural changes
Psychosocial stress puts the individual at risk for
immunological defecits
Psychosocial distress aggression associated with…
Changes in T- and B- cell in numbers
Psychosocial distress is linked to
Chronic disorders if severe
Coping with Psychosocial distress may be…
adaptive or maladaptive
Maladaptive coping may contribute to
adverse health effects
Individual risk factors
Impaired cognition Chronic health conditions including mental health issues Multiple significant life changes Socioeconomic status Caregiver Individual in a foreign country Limited resources Age Changes in health conditions
Stress-age syndrome
Excitability changes in the limbic system and hypothalamus
Stress- age syndrome increases
Catecholamines, ADH, ACTH, and Cortisol
Stress- age syndrome decreases
Testosterone, thyroxine, and other hormones
Consequences of Chronic stress
Heightened responses
Exhaustion of resources leads to a loss of homeostasis
Primary prevention of stress
Stress management
Counselling
Maintenance of positive relationships
Maintenance of optimal health
Collaborative interventions
A patient interview is completed in order to determine what therapy will be ordered
Many patients related to stress require
A combination of behavioural and drug therapy
Pharmacological therapy
Anxiolytics Hypnotics Antidepressants Psychotherapeutics Muscle relaxants Antimigraine agents Selective serotonin reuptake inhibitors
What is the goal of pharmacological treatment
Reduce anxiety by reducing the overactivity in the CNS, improve coping skills
Anxiolytics action
reduce anxiety by reducing overactivity in the CNS; binds to GABA receptors
Anxiolytics Indication
Ethanol withdrawal, insomnia, muscle spasms, seizure disorders, anxiety
Anxiolytics contraindication
Known drug allergy
Narrow angle glaucoma, pregnancy
Anxiolytics Adverse effects
CNS depression, hypotension, drowsiness, dizziness, lethargy, headache, ataxia, slurred speech, depression, bradycardia, hypotension, constipation, diarrhea, nausea, vomiting
Anxiolytics Prototype class
Benzodiazepines
Anxiolytics prototype drug
Lorazempam
