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STRESS
Definition
Stress is defined as an organism's total response to environmental demands or pressures. When stress was first studied in the 1950s, the term was used to denote both the causes and the experienced effects of these pressures. More recently, however, the word stressor has been used for the stimulus that provokes a stress response. One recurrent disagreement among researchers concerns the definition of stress in humans. Is it primarily an external response that can be measured by changes in glandular secretions, skin reactions, and other physical functions, or is it an internal interpretation of, or reaction to, a stressor; or is it both?
Description
Stress in humans results from interactions between persons and their environment that are perceived as straining or exceeding their adaptive capacities and threatening their well- being. The element of perception indicates that human stress responses reflect differences in personality, as well as differences in physical strength or general health.
Risk factors for stress-related illnesses are a mix of personal, interpersonal, and social variables. These factors include lack or loss of control over one's physical environment, and lack or loss of social support networks. People who are dependent on others (e.g., children or the elderly) or who are socially disadvantaged (because of race, gender, educational level, or similar factors) are at greater risk of developing stress-related illnesses. Other risk factors include feelings of helplessness, hopelessness, extreme fear or anger, and cynicism or distrust of others.
Causes and symptoms
Causes
The causes of stress can include any event or occurrence that a person considers a threat to his or her coping strategies or resources. Researchers generally agree that a certain degree of stress is a normal part of a living organism's response to the inevitable changes in its physical or social environment, and that positive, as well as negative, events can generate stress as well as negative occurrences. Stress-related disease, however, results from excessive and prolonged demands on an organism's coping resources. It is now believed that 80-90% of all disease is stress-related.
Recent research indicates that some vulnerability to stress is genetic. Scientists at the University of Wisconsin and King's College London discovered that people who inherited a short, or stress-sensitive, version of the serotonin transporter gene were almost three times as likely to experience depression following a stressful event as people with the long version of the gene. Further research is likely to identify other genes that affect susceptibility to stress.
One cause of stress that has affected large sectors of the general population around the world since 2001 is terrorism. The events of September 11, 2001, the sniper shootings in Virginia and Maryland and the Bali nightclub bombing in 2002, the suicide bombings in the Middle East in 2003, have all been shown to cause short-term symptoms of stress in people who read about them or watch television news reports as well as those who witnessed the actual events. Stress related to terrorist attacks also appears to affect people in countries far from the location of the attack as well as those in the immediate vicinity. It is too soon to tell how stress related to episodes of terrorism will affect human health over long periods of time, but researchers are already beginning to investigate this question. In 2004 the Centers for Disease Control and Prevention (CDC) released a report on the aftereffects of the World Trade Center attacks on rescue and recovery workers and volunteers. The researchers found that over half the 11,700 people who were interviewed met threshold criteria for a mental health evaluation. A longer-term evaluation of these workers is underway.
A new condition that has been identified since 9/11 is childhood traumatic grief, or CTG. CTG refers to an intense stress reaction that may develop in children following the loss of a parent, sibling, or other loved one during a traumatic event. As defined by the National Child Traumatic Stress Network (NCTSN), "Children with childhood traumatic grief experience the cause of [the loved one's] death as horrifying or terrifying, whether the death was sudden and unexpected (for example, due to homicide, suicide, motor vehicle accident,drug overdose, natural disaster, war, terrorism, and so on) or due to natural causes (cancer, heart attack, and so forth). Even if the manner of death does not appear to others to be sudden, shocking, or frightening, children who perceive the death in this way may develop childhood traumatic grief. In this condition, even happy thoughts and memories of the deceased person remind children of the traumatic way in which the deceased died." More information on the identification and treatment of childhood traumatic grief can be obtained from the NCTSN web site,.
Symptoms
The symptoms of stress can be either physical or psychological. Stress-related physical illnesses, such as irritable bowel syndrome, heart attacks, arthritis, and chronic headaches, result from long-term overstimulation of a part of the nervous system that regulates the heart rate, blood pressure, and digestive system. Stress-related emotional illness results from inadequate or inappropriate responses to major changes in one's life situation, such as marriage, completing one's education, becoming a parent, losing a job, or retirement. Psychiatrists sometimes use the term adjustment disorder to describe this type of illness. In the workplace, stress-related illness often takes the form of burnout-a loss of interest in or ability to perform one's job due to long-term high stress levels. For example, palliative care nurses are at high risk of burnout due to their inability to prevent their patients from dying or even to relieve their physical suffering in some circumstances.
Diagnosis
When the doctor suspects that a patient's illness is connected to stress, he or she will take a careful history that includes stressors in the patient's life (family or employment problems, other illnesses, etc.). Many physicians will evaluate the patient's personality as well, in order to assess his or her coping resources and emotional response patterns. There are a number of personality inventories and psychological tests that doctors can use to help diagnose the amount of stress that the patient experiences and the coping strategies that he or she uses to deal with them. A variation on this theme is to identify what the patient perceives as threatening as well as stressful. Stress-related illness can be diagnosed by primary care doctors, as well as by those who specialize in psychiatry. The doctor will need to distinguish between adjustment disorders and anxiety or mood disorders, and between psychiatric disorders and physical illnesses (e.g., thyroid activity) that have psychological side effects.
Treatment
Recent advances in the understanding of the many complex connections between the human mind and body have produced a variety of mainstream approaches to stress-related illness. Present treatment regimens may include one or more of the following:
· Medications. These may include drugs to control blood pressure or other physical symptoms of stress, as well as drugs that affect the patient's mood (tranquilizers or antidepressants).
· Stress management programs. These may be either individual or group treatments, and usually involve analysis of the stressors in the patient's life. They often focus on job or workplace-related stress.
· Behavioral approaches. These strategies include relaxation techniques, breathing exercises, and physical exercise programs including walking.
· Massage. Therapeutic massage relieves stress by relaxing the large groups of muscles in the back, neck, arms, and legs.
· Cognitive therapy. These approaches teach patients to reframe or mentally reinterpret the stressors in their lives in order to modify the body's physical reactions.
· Meditation and associated spiritual or religious practices. Recent studies have found positive correlations between these practices and stress hardiness.
Alternative treatment
Treatment of stress is one area in which the boundaries between traditional and alternative therapies have changed in recent years, in part because some forms of physical exercise (yoga, tai chi, aikido) that were once associated with the counterculture have become widely accepted as useful parts of mainstream stress reduction programs. Other alternative therapies for stress that are occasionally recommended by mainstream medicine include aromatherapy, dance therapy, biofeedback, nutrition-based treatments (including dietary guidelines and nutritional supplements), acupuncture, homeopathy, and herbal medicine. Tags: psychoarticle
Stress is defined as an organism's total response to environmental demands or pressures. When stress was first studied in the 1950s, the term was used to denote both the causes and the experienced effects of these pressures. More recently, however, the word stressor has been used for the stimulus that provokes a stress response. One recurrent disagreement among researchers concerns the definition of stress in humans. Is it primarily an external response that can be measured by changes in glandular secretions, skin reactions, and other physical functions, or is it an internal interpretation of, or reaction to, a stressor; or is it both?
Description
Stress in humans results from interactions between persons and their environment that are perceived as straining or exceeding their adaptive capacities and threatening their well- being. The element of perception indicates that human stress responses reflect differences in personality, as well as differences in physical strength or general health.
Risk factors for stress-related illnesses are a mix of personal, interpersonal, and social variables. These factors include lack or loss of control over one's physical environment, and lack or loss of social support networks. People who are dependent on others (e.g., children or the elderly) or who are socially disadvantaged (because of race, gender, educational level, or similar factors) are at greater risk of developing stress-related illnesses. Other risk factors include feelings of helplessness, hopelessness, extreme fear or anger, and cynicism or distrust of others.
Causes and symptoms
Causes
The causes of stress can include any event or occurrence that a person considers a threat to his or her coping strategies or resources. Researchers generally agree that a certain degree of stress is a normal part of a living organism's response to the inevitable changes in its physical or social environment, and that positive, as well as negative, events can generate stress as well as negative occurrences. Stress-related disease, however, results from excessive and prolonged demands on an organism's coping resources. It is now believed that 80-90% of all disease is stress-related.
Recent research indicates that some vulnerability to stress is genetic. Scientists at the University of Wisconsin and King's College London discovered that people who inherited a short, or stress-sensitive, version of the serotonin transporter gene were almost three times as likely to experience depression following a stressful event as people with the long version of the gene. Further research is likely to identify other genes that affect susceptibility to stress.
One cause of stress that has affected large sectors of the general population around the world since 2001 is terrorism. The events of September 11, 2001, the sniper shootings in Virginia and Maryland and the Bali nightclub bombing in 2002, the suicide bombings in the Middle East in 2003, have all been shown to cause short-term symptoms of stress in people who read about them or watch television news reports as well as those who witnessed the actual events. Stress related to terrorist attacks also appears to affect people in countries far from the location of the attack as well as those in the immediate vicinity. It is too soon to tell how stress related to episodes of terrorism will affect human health over long periods of time, but researchers are already beginning to investigate this question. In 2004 the Centers for Disease Control and Prevention (CDC) released a report on the aftereffects of the World Trade Center attacks on rescue and recovery workers and volunteers. The researchers found that over half the 11,700 people who were interviewed met threshold criteria for a mental health evaluation. A longer-term evaluation of these workers is underway.
A new condition that has been identified since 9/11 is childhood traumatic grief, or CTG. CTG refers to an intense stress reaction that may develop in children following the loss of a parent, sibling, or other loved one during a traumatic event. As defined by the National Child Traumatic Stress Network (NCTSN), "Children with childhood traumatic grief experience the cause of [the loved one's] death as horrifying or terrifying, whether the death was sudden and unexpected (for example, due to homicide, suicide, motor vehicle accident,drug overdose, natural disaster, war, terrorism, and so on) or due to natural causes (cancer, heart attack, and so forth). Even if the manner of death does not appear to others to be sudden, shocking, or frightening, children who perceive the death in this way may develop childhood traumatic grief. In this condition, even happy thoughts and memories of the deceased person remind children of the traumatic way in which the deceased died." More information on the identification and treatment of childhood traumatic grief can be obtained from the NCTSN web site,
Symptoms
The symptoms of stress can be either physical or psychological. Stress-related physical illnesses, such as irritable bowel syndrome, heart attacks, arthritis, and chronic headaches, result from long-term overstimulation of a part of the nervous system that regulates the heart rate, blood pressure, and digestive system. Stress-related emotional illness results from inadequate or inappropriate responses to major changes in one's life situation, such as marriage, completing one's education, becoming a parent, losing a job, or retirement. Psychiatrists sometimes use the term adjustment disorder to describe this type of illness. In the workplace, stress-related illness often takes the form of burnout-a loss of interest in or ability to perform one's job due to long-term high stress levels. For example, palliative care nurses are at high risk of burnout due to their inability to prevent their patients from dying or even to relieve their physical suffering in some circumstances.
Diagnosis
When the doctor suspects that a patient's illness is connected to stress, he or she will take a careful history that includes stressors in the patient's life (family or employment problems, other illnesses, etc.). Many physicians will evaluate the patient's personality as well, in order to assess his or her coping resources and emotional response patterns. There are a number of personality inventories and psychological tests that doctors can use to help diagnose the amount of stress that the patient experiences and the coping strategies that he or she uses to deal with them. A variation on this theme is to identify what the patient perceives as threatening as well as stressful. Stress-related illness can be diagnosed by primary care doctors, as well as by those who specialize in psychiatry. The doctor will need to distinguish between adjustment disorders and anxiety or mood disorders, and between psychiatric disorders and physical illnesses (e.g., thyroid activity) that have psychological side effects.
Treatment
Recent advances in the understanding of the many complex connections between the human mind and body have produced a variety of mainstream approaches to stress-related illness. Present treatment regimens may include one or more of the following:
· Medications. These may include drugs to control blood pressure or other physical symptoms of stress, as well as drugs that affect the patient's mood (tranquilizers or antidepressants).
· Stress management programs. These may be either individual or group treatments, and usually involve analysis of the stressors in the patient's life. They often focus on job or workplace-related stress.
· Behavioral approaches. These strategies include relaxation techniques, breathing exercises, and physical exercise programs including walking.
· Massage. Therapeutic massage relieves stress by relaxing the large groups of muscles in the back, neck, arms, and legs.
· Cognitive therapy. These approaches teach patients to reframe or mentally reinterpret the stressors in their lives in order to modify the body's physical reactions.
· Meditation and associated spiritual or religious practices. Recent studies have found positive correlations between these practices and stress hardiness.
Alternative treatment
Treatment of stress is one area in which the boundaries between traditional and alternative therapies have changed in recent years, in part because some forms of physical exercise (yoga, tai chi, aikido) that were once associated with the counterculture have become widely accepted as useful parts of mainstream stress reduction programs. Other alternative therapies for stress that are occasionally recommended by mainstream medicine include aromatherapy, dance therapy, biofeedback, nutrition-based treatments (including dietary guidelines and nutritional supplements), acupuncture, homeopathy, and herbal medicine.
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