Basic Psychology, Psychopathology

Using the Relaxation Response to Relieve Stress – Starting a regular relaxation practice

Learning the basics of these relaxation techniques isn’t difficult, but it takes regular practice to truly harness their stress-relieving power. Most stress experts recommend setting aside at least 10 to 20 minutes a day for your relaxation practice. If you’d like to maximize the benefits, aim for 30 minutes to an hour.

Set aside time in your daily schedule. If possible, schedule a set time once or twice a day for your practice. If your schedule is already packed, remember that many relaxation techniques can be practiced while you’re doing other things. Try meditating while commuting on the bus or train, taking a yoga or tai chi break at lunchtime, or practicing mindful walking while exercising your dog.

Make use of smartphone apps and other aids. Many people find that smartphone apps or audio downloads can be useful in guiding them through different relaxation practices, establishing a regular routine, and keeping track of progress.

Don’t practice when you’re sleepy. These techniques are so relaxing that they can make you very sleepy. However, you will get the most benefit if you practice when you’re fully alert. Avoid practicing close to bedtime or after a heavy meal or alcohol.

Expect ups and downs. Sometimes it can take time and practice to start reaping the full rewards of relaxation techniques such as meditation. The more you stick with it, the sooner the results will come. If you skip a few days or even a few weeks, don’t get discouraged. Just get started again and slowly build up to your old momentum.

Basic Psychology, Psychopathology

Using the Relaxation Response to Relieve Stress – Visualization

Visualization, or guided imagery, is a variation on traditional meditation that involves imagining a scene in which you feel at peace, free to let go of all tension and anxiety. Choose whatever setting is most calming to you, whether it’s a tropical beach, a favorite childhood spot, or a quiet wooded glen.

You can practice visualization on your own or with a therapist (or an app or audio download of a therapist) guiding you through the imagery. You can also choose to do your visualization in silence or use listening aids, such as soothing music or a sound machine or recording that matches your chosen setting—the sound of ocean waves if you’ve chosen a beach, for example.

Practicing visualization

Close your eyes and imagine your restful place. Picture it as vividly as you can—everything you can see, hear, smell, taste, and feel. Just “looking” at it like you would a photograph is not enough. Visualization works best if you incorporate as many sensory details as possible.

For example, if you are thinking about a dock on a quiet lake:

  • See the sun setting over the water
  • Hear the birds singing
  • Smell the pine trees
  • Feel the cool water on your bare feet
  • Taste the fresh, clean air

Enjoy the feeling of your worries drifting away as you slowly explore your restful place. When you are ready, gently open your eyes and come back to the present.

Don’t worry if you sometimes zone out or lose track of where you are during a visualization session. This is normal. You may also experience feelings of heaviness in your limbs, muscle twitches, or yawning. Again, these are normal responses.

Basic Psychology, Psychopathology

Using the Relaxation Response to Relieve Stress – Rhythmic movement and mindful exercise

The idea of exercising may not sound particularly soothing, but rhythmic exercise that gets you into a flow of repetitive movement can be very relaxing. Examples include:

  • Running
  • Walking
  • Swimming
  • Dancing
  • Rowing
  • Climbing

For maximum stress relief, add mindfulness to your workout

While simply engaging in rhythmic exercise will help you relieve stress, if you add a mindfulness component on top, you’ll get even more benefit.

As with meditation, mindful exercise requires being fully engaged in the present moment—paying attention to how your body feels right now, rather than your daily worries or concerns. In order to “turn off” your thoughts, focus on the sensations in your limbs and how your breathing complements your movement, instead of zoning out or staring at a TV as you exercise. If you’re walking or running, for example, focus on the sensation of your feet touching the ground, the rhythm of your breath, and the feeling of the wind against your face. If you’re resistance training, focus on coordinating your breathing with your movements and pay attention to how your body feels as you raise and lower weights. And when your mind wanders to other thoughts, gently return your focus to your breathing and movement.

Basic Psychology, Psychopathology

Using the Relaxation Response to Relieve Stress – Meditation

Body scan meditation

This is a type of meditation that that focuses your attention on various parts of your body. Like progressive muscle relaxation, you start with your feet and work your way up. But instead of tensing and relaxing muscles, you simply focus on the way each part of your body feels, without labeling the sensations as either “good” or “bad”.

  • Lie on your back, legs uncrossed, arms relaxed at your sides, eyes open or closed. Focus on your breathing for about two minutes until you start to feel relaxed.
  • Turn your focus to the toes of your right foot. Notice any sensations you feel while continuing to also focus on your breathing. Imagine each deep breath flowing to your toes. Remain focused on this area for one to two minutes.
  • Move your focus to the sole of your right foot. Tune in to any sensations you feel in that part of your body and imagine each breath flowing from the sole of your foot. After one or two minutes, move your focus to your right ankle and repeat. Move to your calf, knee, thigh, hip, and then repeat the sequence for your left leg. From there, move up the torso, through the lower back and abdomen, the upper back and chest, and the shoulders. Pay close attention to any area of the body that causes you pain or discomfort.
  • After completing the body scan, relax for a while in silence and stillness, noting how your body feels. Then slowly open your eyes and stretch, if necessary.

Mindfulness meditation

Rather than worrying about the future or dwelling on the past, mindfulness meditation switches the focus to what’s happening right now, enabling you to be fully engaged in the present moment.

Meditations that cultivate mindfulness have long been used to reduce stress, anxiety, depression, and other negative emotions. Some of these meditations bring you into the present by focusing your attention on a single repetitive action, such as your breathing or a few repeated words. Other forms of mindfulness meditation encourage you to follow and then release internal thoughts or sensations. Mindfulness can also be applied to activities such as walking, exercising, or eating.

A basic mindfulness meditation:

  1. Find a quiet place where you won’t be interrupted or distracted.
  2. Sit on a straight-backed chair or cross-legged on the floor.
  3. Find a point of focus, such as your breathing—the sensation of air flowing into your nostrils and out of your mouth or your belly rising and falling—or an external focus, such as a candle flame or a meaningful word that you repeat throughout the meditation.
  4. Don’t worry about distracting thoughts that go through your mind or about how well you’re doing. If thoughts intrude during your relaxation session, don’t fight them, just gently turn your attention back to your point of focus.
Basic Psychology, Psychopathology

Using the Relaxation Response to Relieve Stress – Progressive Muscle Relaxation (PMR)

Progressive muscle relaxation is a two-step process in which you systematically tense and relax different muscle groups in the body. With regular practice, it gives you an intimate familiarity with what tension—as well as complete relaxation—feels like in different parts of the body. This can help you to you react to the first signs of the muscular tension that accompanies stress. And as your body relaxes, so will your mind.

Progressive muscle relaxation can be combined with deep breathing for additional stress relief.

Practicing progressive muscle relaxation

Consult with your doctor first if you have a history of muscle spasms, back problems, or other serious injuries that may be aggravated by tensing muscles.

Start at your feet and work your way up to your face, trying to only tense those muscles intended.

  1. Loosen clothing, take off your shoes, and get comfortable.
  2. Take a few minutes to breathe in and out in slow, deep breaths.
  3. When you’re ready, shift your attention to your right foot. Take a moment to focus on the way it feels.
  4. Slowly tense the muscles in your right foot, squeezing as tightly as you can. Hold for a count of 10.
  5. Relax your foot. Focus on the tension flowing away and how your foot feels as it becomes limp and loose.
  6. Stay in this relaxed state for a moment, breathing deeply and slowly.
  7. Shift your attention to your left foot. Follow the same sequence of muscle tension and release.
  8. Move slowly up through your body, contracting and relaxing the different muscle groups.
  9. It may take some practice at first, but try not to tense muscles other than those intended.

Progressive muscle relaxation sequence

  1. Right foot, then left foot
  2. Right calf, then left calf
  3. Right thigh, then left thigh
  4. Hips and buttocks
  5. Stomach
  6. Chest
  7. Back
  8. Right arm and hand, then left arm and hand
  9. Neck and shoulders
  10. Face
Basic Psychology, Psychopathology

Using the Relaxation Response to Relieve Stress – Deep Breathing

With its focus on full, cleansing breaths, deep breathing is a simple yet powerful relaxation technique. It’s easy to learn, can be practiced almost anywhere, and provides a quick way to get your stress levels in check. Deep breathing is the cornerstone of many other relaxation practices, too, and can be combined with other relaxing elements such as aromatherapy and music. While apps and audio downloads can guide you through the process, all you really need is a few minutes and a place to stretch out.

How to practice deep breathing

The key to deep breathing is to breathe deeply from the abdomen, getting as much fresh air as possible in your lungs. When you take deep breaths from the abdomen, rather than shallow breaths from your upper chest, you inhale more oxygen. The more oxygen you get, the less tense, short of breath, and anxious you feel.

  • Sit comfortably with your back straight. Put one hand on your chest and the other on your stomach.
  • Breathe in through your nose. The hand on your stomach should rise. The hand on your chest should move very little.
  • Exhale through your mouth, pushing out as much air as you can while contracting your abdominal muscles. The hand on your stomach should move in as you exhale, but your other hand should move very little.
  • Continue to breathe in through your nose and out through your mouth. Try to inhale enough so that your lower abdomen rises and falls. Count slowly as you exhale.

If you find it difficult breathing from your abdomen while sitting up, try lying down. Put a small book on your stomach, and breathe so that the book rises as you inhale and falls as you exhale.

Basic Psychology, Psychopathology

Using the Relaxation Response to Relieve Stress – Introduction

For many of us, relaxation means zoning out in front of the TV at the end of a stressful day. But this does little to reduce the damaging effects of stress. To effectively combat stress, we need to activate the body’s natural relaxation response. You can do this by practicing relaxation techniques such as deep breathing, meditation, rhythmic exercise, and yoga. Fitting these activities into your life can help reduce everyday stress, boost your energy and mood, and improve your mental and physical health.

What is the relaxation response?

When stress overwhelms your nervous system, your body is flooded with chemicals that prepare you for “fight or flight.” This stress response can be lifesaving in emergency situations where you need to act quickly. But when it’s constantly activated by the stresses of everyday life, it can wear your body down and take a toll on your emotional and physical health.

No one can avoid all stress, but you can counteract its detrimental effects by learning how to produce the relaxation response, a state of deep rest that is the polar opposite of the stress response. The relaxation response puts the brakes on stress and brings your body and mind back into a state of equilibrium.

When the relaxation response is activated, your:

  • heart rate slows down
  • breathing becomes slower and deeper
  • blood pressure drops or stabilizes
  • muscles relax
  • blood flow to the brain increases

In addition to its calming physical effects, the relaxation response also increases energy and focus, combats illness, relieves aches and pains, heightens problem-solving abilities, and boosts motivation and productivity. Best of all, anyone can reap these benefits with regular practice. And while you may choose to pay for a professional massage or acupuncture session, for example, most relaxation techniques can be done on your own or with the aid of free audio downloads or inexpensive smartphone apps.

The important thing to remember is that simply laying on the couch, reading, or watching TV—while sometimes relaxing—isn’t enough to produce the physical and psychological benefits of the relaxation response. For that, you’ll need to actively practice a relaxation technique.

Finding the relaxation technique that’s best for you

There is no single relaxation technique that is best for everyone. The right relaxation technique is the one that resonates with you, fits your lifestyle, and is able to focus your mind and interrupt your everyday thoughts to elicit the relaxation response. You may even find that alternating or combining different techniques provides the best results. How you react to stress may also influence the relaxation technique that works best for you:

The “fight” response. If you tend to become angry, agitated, or keyed up under stress, you will respond best to stress relief activities that quiet you down, such as meditation, progressive muscle relaxation, deep breathing, or guided imagery.

The “flight” response. If you tend to become depressed, withdrawn, or spaced out under stress, you will respond best to stress relief activities that are stimulating and energize your nervous system, such as rhythmic exercise, massage, mindfulness, or power yoga.

Do you need alone time or social stimulation?

If you crave solitude, solo relaxation techniques such as meditation or progressive muscle relaxation will help to quiet your mind and recharge your batteries. If you crave social interaction, a class setting will give you the stimulation and support you’re looking for—and may also help you stay motivated.

Basic Psychology, Psychopathology

The Effects of Stress on Your Body

You’re sitting in traffic, late for an important meeting, watching the minutes tick away. Your hypothalamus, a tiny control tower in your brain, decides to send out the order: Send in the stress hormones! These stress hormones are the same ones that trigger your body’s “fight or flight” response. Your heart races, your breath quickens, and your muscles ready for action. This response was designed to protect your body in an emergency by preparing you to react quickly. But when the stress response keeps firing, day after day, it could put your health at serious risk.

Stress is a natural physical and mental reaction to life experiences. Everyone expresses stress from time to time. Anything from everyday responsibilities like work and family to serious life events such as a new diagnosis, war, or the death of a loved one can trigger stress. For immediate, short-term situations, stress can be beneficial to your health. It can help you cope with potentially serious situations. Your body responds to stress by releasing hormones that increase your heart and breathing rates and ready your muscles to respond.Yet if your stress response doesn’t stop firing, and these stress levels stay elevated far longer than is necessary for survival, it can take a toll on your health.

1 . Musculoskeletal System

When the body is stressed, muscles tense up. Muscle tension is almost a reflex reaction to stress — the body’s way of guarding against injury and pain.With sudden onset stress, the muscles tense up all at once, and then release their tension when the stress passes. Chronic Stress causes the muscles in the body to be in a more or less constant state of guardedness. When muscles are taut and tense for long periods of time, this may trigger other reactions of the body and even promote stress-related disorders. For example, both tension-type headache and migraine headache are associated with chronic muscle tension in the area of the shoulders, neck and head.

Millions of individuals suffer from chronic painful conditions secondary to musculoskeletal disorders. Often, but not always, there may be an injury that sets off the chronic painful state. What determines whether or not an injured person goes on to suffer from chronic pain is how they respond to the injury. Individuals who are fearful of pain and re-injury, and who seek only a physical cause and cure for the injury, generally have a worse recovery than individuals who maintain a certain level of moderate, physician-supervised activity. Muscle tension, and eventually, muscle atrophy due to disuse of the body, all promote chronic, stress-related musculoskeletal conditions.Relaxation techniques have been shown to effectively reduce muscle tension, decrease the incidence of certain stress-related disorders, such as headache, and increase a sense of well-being.

2 . Respiratory System

Stress can make you breathe harder. That’s not a problem for most people, but for those with asthma or a lung disease such as emphysema, getting the oxygen you need to breathe easier can be difficult.And some studies show that an acute stress — such as the death of a loved one — can actually trigger asthma attacks, in which the airway between the nose and the lungs constricts.In addition, stress can cause the rapid breathing — or hyperventilation — that can bring on a panic attack in someone prone to panic attacks.Working with a psychologist to develop relaxation and breathing strategies can help.

3 . Cardiovascular

The heart and blood vessels comprise the two elements of the cardiovascular system that work together in providing nourishment and oxygen to the organs of the body. The activity of these two elements is also coordinated in the body’s response to stress. Acute stress — stress that is momentary or short-term such as meeting deadlines, being stuck in traffic or suddenly slamming on the brakes to avoid an accident — causes an increase in heart rate and stronger contractions of the heart muscle, with the stress hormones — adrenaline, noradrenaline and cortisol — acting as messengers for these effects. In addition, the blood vessels that direct blood to the large muscles and the heart dilate, thereby increasing the amount of blood pumped to these parts of the body and elevating blood pressure. This is also known as the fight or flight response. Once the acute stress episode has passed, the body returns to its normal state.

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.

The risk for heart disease associated with stress appears to differ for women, depending on whether the woman is pre- or post-menopausal. Levels of estrogen in pre-menopausal women appears to help blood vessels respond better during stress, thereby helping their bodies to better handle stress and protecting them against heart disease. Postmenopausal women lose this level of protection due to loss of estrogen, therefore putting them at greater risk for the effects of stress on heart disease.

4 . Endocrine

When the body is stressed, the hypothalamus signals the autonomic nervous system and the pituitary gland and the process is started to produce epinephrine and cortisol, sometimes called the “stress hormones.”

Adrenal Glands (near kidneys)

Stress signals from the hypothalamus cause the adrenal cortex to produce cortisol and the adrenal medulla to produce epinephrine. This starts the process that gives your body the energy to run from danger.

Liver

When cortisol and epinephrine are released, the liver produces more glucose, a blood sugar that would give you the energy for “fight or flight” in an emergency. For most of you, if you don’t use all of that extra energy, the body is able to reabsorb the blood sugar, even if you’re stressed again and again. But for some people — especially people vulnerable to Type 2 diabetes — that extra blood sugar can mean diabetes. Who’s vulnerable? The obese and races more inclined to diabetes, such as Native Americans.Studies show that if you learn how to manage stress, you can control your blood sugar level, sometimes nearly as much as with medication.

5 . Gastrointestinal

Esophagus

When you’re stressed, you may eat much more or much less than you usually do. If you eat more or different foods, or increase your use of alcohol or tobacco, you can experience heartburn or acid reflux. Stress or exhaustion can also increase the severity of heartburn pain.

Stomach

When you’re stressed, your brain becomes more alert to sensations in your stomach. Your stomach can react with “butterflies” or even nausea or pain. You may vomit if the stress is severe enough. And, if the stress becomes chronic, you may develop ulcers or severe stomach pain even without ulcers.

Bowel

Stress can affect digestion, and what nutrients your intestines absorb. It can also affect how fast food moves through your body. You may find that you have either diarrhea or constipation.

6 . Nervous System

The nervous system has several divisions: the central division involving the brain and spinal cord and the peripheral division consisting of the autonomic and somatic nervous systems. The autonomic nervous system (ANS) has a direct role in physical response to stress and is divided into the sympathetic nervous system (SNS), and the parasympathetic nervous system (PNS).

When the body is stressed, the SNS generates what is known as the “fight or flight” response. The body shifts all of its energy resources toward fighting off a life threat, or fleeing from an enemy. The SNS signals the adrenal glands to release hormones called adrenalin and cortisol. These hormones cause the heart to beat faster, respiration rate to increase, blood vessels in the arms and legs to dilate, digestive process to change and glucose levels (sugar energy) in the bloodstream to increase to deal with the emergency.

The SNS response is fairly sudden in order to prepare the body to respond to an emergency situation or acute stress, short term stressors. Once the crisis is over, the body usually returns to the pre-emergency, unstressed state.Chronic stress, experiencing stressors over a prolonged period of time, can result in a long-term drain on the body. As the SNS continues to trigger physical reactions, it causes a wear-and-tear on the body. It’s not so much what chronic stress does to the nervous system, but what continuous activation of the nervous system does to other bodily systems that become problematic.

7 . Male Reproductive System

The male reproductive system is influenced by the nervous system. The parasympathetic part of the nervous system causes relaxation whereas the sympathetic part causes arousal. In the male anatomy, the autonomic nervous system, also known as the fight or flight response, produces testosterone and activates the sympathetic nervous system which creates arousal.

Stress causes the body to release the hormone cortisol, which is produced by the adrenal glands. Cortisol is important to blood pressure regulation and the normal functioning of several body systems including cardiovascular, circulatory and male reproduction. Excess amounts of cortisol can affect the normal biochemical functioning of the male reproductive system.Chronic stress, ongoing stress over an extended period of time, can affect testosterone production, sperm production and maturation, and even cause erectile dysfunction or impotence.Also, when stress affects the immune system, the body can become vulnerable to infection. In the male anatomy, infections to the testes, prostate gland and urethra, can affect normal male reproductive functioning.

8 . Female Reproductive System

Menstruation

Stress may affect menstruation among adolescent girls and women in several ways. For example, high levels of stress may be associated with absent or irregular menstrual cycles, more painful periods and changes in the length of cycles.

Premenstrual Syndrome (PMS)

Stress may make premenstrual symptoms worse or more difficult to cope with and pre-menses symptoms may be stressful for many women. These symptoms include cramping, fluid retention and bloating, negative mood (feeling irritable and “blue”) and mood swings.

Menopause

As menopause approaches, hormone levels fluctuate rapidly. These changes are associated with anxiety, mood swings and feelings of distress. Thus menopause can be a stressor in and of itself. Some of the physical changes associated with menopause, especially hot flashes, can be difficult to cope with. Furthermore, emotional distress may cause the physical symptoms to be worse. For example, women who are more anxious may experience an increased number of hot flashes and/or more severe or intense hot flashes.

Sexual Desire

Women juggle personal, family, professional, financial and a broad range of other demands across their lifespan. Stress, distraction, fatigue, etc., may reduce sexual desire — especially when women are simultaneously caring for young children or other ill family members, coping with chronic medical problems, feeling depressed, experiencing relationship difficulties or abuse, dealing with work problems, etc. 

Basic Psychology, Psychopathology

STRESS – Types

Stress management can be complicated and confusing because there are different types of stress — acute stress, episodic acute stress, and chronic stress — each with its own characteristics, symptoms, duration and treatment approaches. Let’s look at each one.

Acute stress

Acute stress is the most common form of stress. It comes from demands and pressures of the recent past and anticipated demands and pressures of the near future. Acute stress is thrilling and exciting in small doses, but too much is exhausting. A fast run down a challenging ski slope, for example, is exhilarating early in the day. That same ski run late in the day is taxing and wearing. Skiing beyond your limits can lead to falls and broken bones. By the same token, overdoing on short-term stress can lead to psychological distress, tension headaches, upset stomach and other symptoms.Fortunately, acute stress symptoms are recognized by most people. It’s a laundry list of what has gone awry in their lives: the auto accident that crumpled the car fender, the loss of an important contract, a deadline they’re rushing to meet, their child’s occasional problems at school and so on.Because it is short term, acute stress doesn’t have enough time to do the extensive damage associated with long-term stress. The most common symptoms are:

  • Emotional distress — some combination of anger or irritability, anxiety and depression, the three stress emotions.
  • Muscular problems including tension headache, back pain, jaw pain and the muscular tensions that lead to pulled muscles and tendon and ligament problems.
  • Stomach, gut and bowel problems such as heartburn, acid stomach, flatulence, diarrhea, constipation and irritable bowel syndrome.
  • Transient over arousal leads to elevation in blood pressure, rapid heartbeat, sweaty palms, heart palpitations, dizziness, migraine headaches, cold hands or feet, shortness of breath and chest pain. 

Acute stress can crop up in anyone’s life, and it is highly treatable and manageable.

Episodic acute stress

There are those, however, who suffer acute stress frequently, whose lives are so disordered that they are studies in chaos and crisis. They’re always in a rush, but always late. If something can go wrong, it does. They take on too much, have too many irons in the fire, and can’t organize the slew of self-inflicted demands and pressures clamoring for their attention. They seem perpetually in the clutches of acute stress.It is common for people with acute stress reactions to be over aroused, short-tempered, irritable, anxious and tense. Often, they describe themselves as having “a lot of nervous energy.” Always in a hurry, they tend to be abrupt, and sometimes their irritability comes across as hostility. Interpersonal relationships deteriorate rapidly when others respond with real hostility. The workplace becomes a very stressful place for them.

The cardiac prone, “Type A” personality described by cardiologists, Meter Friedman and Ray Rosenman, is similar to an extreme case of episodic acute stress. Type A’s have an “excessive competitive drive, aggressiveness, impatience, and a harrying sense of time urgency.” In addition there is a “free-floating, but well-rationalized form of hostility, and almost always a deep-seated insecurity.” Such personality characteristics would seem to create frequent episodes of acute stress for the Type A individual. Friedman and Rosenman found Type A’s to be much more likely to develop coronary heat disease than Type B’s, who show an opposite pattern of behavior.Another form of episodic acute stress comes from ceaseless worry. “Worry warts” see disaster around every corner and pessimistically forecast catastrophe in every situation. The world is a dangerous, unrewarding, punitive place where something awful is always about to happen. These “awfulizers” also tend to be over aroused and tense, but are more anxious and depressed than angry and hostile.

The symptoms of episodic acute stress are the symptoms of extended over arousal: persistent tension headaches, migraines, hypertension, chest pain and heart disease. Treating episodic acute stress requires intervention on a number of levels, generally requiring professional help, which may take many months.Often, lifestyle and personality issues are so ingrained and habitual with these individuals that they see nothing wrong with the way they conduct their lives. They blame their woes on other people and external events. Frequently, they see their lifestyle, their patterns of interacting with others, and their ways of perceiving the world as part and parcel of who and what they are.Sufferers can be fiercely resistant to change. Only the promise of relief from pain and discomfort of their symptoms can keep them in treatment and on track in their recovery program.

Chronic stress

While acute stress can be thrilling and exciting, chronic stress is not. This is the grinding stress that wears people away day after day, year after year. Chronic stress destroys bodies, minds and lives. It wreaks havoc through long-term attrition. It’s the stress of poverty, of dysfunctional families, of being trapped in an unhappy marriage or in a despised job or career. It’s the stress that the never-ending “troubles” have brought to the people of Northern Ireland, the tensions of the Middle East have brought to the Arab and Jew, and the endless ethnic rivalries that have been brought to the people of Eastern Europe and the former Soviet Union.

Chronic stress comes when a person never sees a way out of a miserable situation. It’s the stress of unrelenting demands and pressures for seemingly interminable periods of time. With no hope, the individual gives up searching for solutions.Some chronic stresses stem from traumatic, early childhood experiences that become internalized and remain forever painful and present. Some experiences profoundly affect personality. A view of the world, or a belief system, is created that causes unending stress for the individual (e.g., the world is a threatening place, people will find out you are a pretender, you must be perfect at all times). When personality or deep-seated convictions and beliefs must be reformulated, recovery requires active self-examination, often with professional help.

The worst aspect of chronic stress is that people get used to it. They forget it’s there. People are immediately aware of acute stress because it is new; they ignore chronic stress because it is old, familiar, and sometimes, almost comfortable.Chronic stress kills through suicide, violence, heart attack, stroke and, perhaps, even cancer. People wear down to a final, fatal breakdown. Because physical and mental resources are depleted through long-term attrition, the symptoms of chronic stress are difficult to treat and may require extended medical as well as behavioral treatment and stress management.

Basic Psychology, Psychopathology

STRESS – General Adaptation Syndrome (GAS)

Hans Selye, an Austrian-Canadian endocrinologist who published more than 39 books and 1,700 articles on stress, is often referred to as the Father of stress research. He is credited with coining the term ‘stress’, and identifying the hypothalamus-pituitary-adrenal (HPA) axis system, which is the system that is employed by the human body to cope with stress.

Dr. Hans Selye (1907-1982) defined stress as the nonspecific response of the body to any demand made on it. General adaptation syndrome (GAS), which is a popular stress response model propounded by Selye, is based on the premise that every biological organism tries to maintain an internal balance (homeostasis) in response to continued exposure to stressors. According to Selye, the body could experience stress due to pleasant and unpleasant events. He coined the term ‘eustress’ to represent stress that occurs due to a pleasant event. The term ‘distress’ refers to stress that arises due to an unpleasant event. He used the term ‘stressors’ for factors or events that trigger stress.

According to his stress response theory, the human body elicits a reaction, when the internal balance of the body (homeostasis) is disturbed. This response occurs in three stages. The reactions to stress are basically the body’s attempt to defend, resist, or adapt itself to the demands placed on the body. If the body is unable to respond to the stimulus, it becomes susceptible to the diseases of adaptation.

Hans Selye’s 3-Stage Stress Response Model
Initially, Selye had described stress as a non-specific neuroendocrine response of the body. However, he later omitted the term ‘neuroendocrine’, as he found that continued exposure to stressors affected most organ systems. He also conducted certain animal studies to study the stress response. In one of the animal studies conducted by Selye, mice were repeatedly injected with insulin. According to Selye, this triggered a stress reaction, which was represented by elevated levels of corticoids and catecholamines, along with some changes that he referred to as the ‘triad of stress’ (enlargement of the adrenal gland; atrophy of the thymus, spleen and other lymphoid tissue; and gastric ulceration). He initially thought that he was on the verge of discovering a new hormone, but he was proven wrong.

During his second year of medical school, Selye observed that several patients experienced common symptoms such as fatigue, appetite disturbance, sleep problems, mood swings, gastrointestinal problems, and diminished concentration and recall, even though they were affected by different illnesses. Thereafter, he attributed these reactions to the body’s reaction to the stress caused by the disease. He referred to this collection of symptoms as the stress syndrome. He formulated the General Adaptation Syndrome on the basis of stress syndrome, referring to stress as the common denominator of all adaptive reactions of the body.

According to Selye’s theory, the presence of a stressor brings about a psychological and physiological state of disruption, which in turn is followed by a series of physiological responses. Dr. Selye was greatly influenced by Walter B. Cannon, which is quite evident from the inclusion of Cannon’s concepts of ‘fight-or-flight response’ and ‘homeostasis’ in his model. He named his three-stage model of the body’s reaction to stress as ‘General adaptation syndrome’, as the stressors have a general effect on several parts of the body, and the body adapts to stress with the help of its defense mechanism. The use of the term ‘syndrome’ is attributed to the dependence of the individual manifestations on each other. The adaptive response to stress is divided into three stages. The general adaptation syndrome stages include:

✦ The alarm reaction
✦ The stage of resistance
✦ The stage of exhaustion

The Alarm Reaction
When the body identifies the presence of a stressor, the HPA axis gets activated. The HPA axis consists of a system of feedback interactions among the hypothalamus, pituitary gland, and adrenal glands. The activated HPA system reacts by producing the flight-or-fight response. During this stage, the hypothalamus stimulates the adrenal-cortical system by releasing the Corticotropin-releasing Factor (CRF), which stimulates the pituitary gland to release adrenocorticotropic hormone (ACTH). This is followed by the release of corticoids, such as cortisol and cortisone, by the adrenal cortex of the adrenal glands. The hypothalamus also activates the sympathetic nervous system, which is followed by the release of adrenaline and noradrenaline by the adrenal medulla. The secretion of these hormones brings about the fight-or-flight response that prepares the body to deal with the perceived threat. This response is characterized by:

✦ An increase in the heart rate
✦ Higher blood pressure
✦ An increase in blood glucose levels
✦ Dilation of the pupils
✦ Increased blood flow to the muscles
✦ Increased muscle tension
✦ Suppression of the immune system by cortisol and cortisone
✦ Increased alertness
✦ Reduced production of hormones by the reproductive glands

Cortisol, which is also known as the stress hormone, plays a vital role in the stress response of the body. Cortisol is also a part of the inhibitory feedback loop. Once the underlying cause of stress is removed, it blocks the secretion of corticotropin-releasing hormone, thereby preventing the HPA axis interactions. Thus, normalcy can be restored.

Stage of Resistance
While the alarm reaction involves the activation or mobilization of the defense mechanisms of the body, the second stage of resistance or adaptation is the stage wherein the body tries to adapt to the stressful stimulus. The body tries to resist the perception of threat with calmness, thereby trying to adapt or cope with the situation in an effective manner. The aim is to achieve homeostasis or the internal balance by reducing the intensity of endocrine and sympathetic activity, which is still higher than normal, but lower than the alarm reaction. During this phase, the affected person tries to adapt to the stressor. This is achieved with the help of the release of glucocorticoids by the adrenal cortex to sustain energy for dealing with the stressor. The body tries to maintain the heart rate, blood pressure, and cardiac output.

However, if this phase continues for an extended period, in the absence of periods of rest or relaxation, the body’s adaptive energy reserves could get depleted. This can make the affected individual susceptible to disease. As a result, one might experience symptoms such as:

✦ Fatigue
✦ Irritability
✦ Loss of concentration
✦ Lethargy

If the stress does not get resolved, one enters the third stage that is called exhaustion.

Stage of Exhaustion
This is the third stage wherein the body’s energy reserves and the immunity become exhausted. According to Selye, the continued exposure to stress leads to adrenal exhaustion. The body’s defenses become weak, which in turn has an adverse effect on one’s physical and emotional health. Chronic stress is associated with high levels of circulating cortisol in the body, which can have an adverse effect on the immune system, digestive system, circulatory system, etc. It can make one susceptible to fatigue and depression. According to Selye, the affected individual is at an increased risk of developing diseases of adaptation at this time. Adrenal exhaustion has an adverse effect on the blood glucose levels. Low blood glucose levels and reduced energy levels are bound to give rise to the following symptoms:

✦ Reduced tolerance to stress
✦ Extreme mental and physical exhaustion
✦ Susceptibility to diseases of adaptation (ulcers, high blood pressure, and heart attacks)

On a concluding note, the response to stress can vary, depending on the personality of the individual, perception of the stressor, or the availability of the resources for coping. There’s no denying the fact that chronic stress is extremely detrimental to one’s physical and emotional well-being. It can lead to the suppression of the HPA system, thereby making one susceptible to diseases. Therefore, every individual must ensure that stress is dealt with adequately, so as to prevent the stage of exhaustion from setting in.