About stress

What is stress?

Stress is a normal part of life that can either help us learn and grow or can cause us significant problems.

  • Stress releases powerful neurochemicals and hormones that prepare us for action (to fight or flee).
  • If we don't take action, the stress response can create or worsen health problems.
  • Prolonged, uninterrupted, unexpected, and unmanageable stresses are the most damaging.
  • Stress can be managed by seeking support from loved ones, regular exercise, meditation or other relaxation techniques, structured timeouts, and learning new coping strategies to create predictability in our lives.
  • Many behaviors that increase in times of stress and maladaptive ways of coping with stress -- drugs, pain medicines, alcohol, smoking, and eating -- actually worsen the stress and can make us more reactive (sensitive) to further stress.
  • While there are promising treatments for stress, the management of stress is mostly dependent on the ability and willingness of a person to make the changes necessary for a healthy lifestyle.

What is stress?

Stress is a fact of nature in which forces from the inside or outside world affect the individual. The individual responds to stress in ways that affect the individual, as well as their environment. Due to the overabundance of stress in our modern lives, we usually think of stress as a negative experience, but from a biological point of view, stress can be a neutral, negative, or positive experience.

In general, stress is related to both external and internal factors. External factors include the physical environment, including your job, your relationships with others, your home, and all the situations, challenges, difficulties, and expectations you're confronted with on a daily basis. Internal factors determine your body's ability to respond to, and deal with, the external stress-inducing factors. Internal factors which influence your ability to handle stress include your nutritional status, overall health and fitness levels, emotional well-being, and the amount of sleep and rest you get.

Stress has driven evolutionary change (the development and natural selection of species over time). Thus, the species that adapted best to the causes of stress (stressors) have survived and evolved into the plant and animal kingdoms we now observe.

Man is the most adaptive creature on the planet because of the evolution of the human brain, especially the part called the neo-cortex. This adaptability is largely due to the changes and stressors that we have faced and mastered. Therefore, we, unlike other animals, can live in any climate or ecosystem, at various altitudes, and avoid the danger of predators. Moreover, we have learned to live in the air, under the sea, and even in space, where no living creatures have ever survived. So then, what is so bad about stress?

A brief history of stress

A key to the understanding of the negative aspects of stress is the concept of milieu interieur (the internal environment of the body), which was first advanced by the French physiologist Claude Bernard. In this concept, he described the principles of dynamic equilibrium. In dynamic equilibrium, constancy, a steady state (situation) in the internal bodily environment, is essential to survival. Therefore, external changes in the environment or external forces that change the internal balance must be reacted to and compensated for if the organism is to survive. Examples of such external forces include temperature, oxygen concentration in the air, the expenditure of energy, and the presence of predators. In addition, diseases are also stressors that threaten the constancy of the milieu interieur.

The neurologist Walter Cannon coined the term homeostasis to further define the dynamic equilibrium that Bernard had described. He also was the first credited with recognizing that stressors could be emotional, as well as physical. Through his experiments, he demonstrated the "fight or flight" response that man and other animals share when threatened. Further, Cannon traced these reactions to the release of powerful neurotransmitters from a part of the adrenal gland, the medulla. (Neurotransmitters are the body's chemicals that carry messages to and from the nerves.) The adrenal medulla secretes two neurotransmitters, epinephrine (also called adrenaline) and norepinephrine (noradrenaline), in the response to stress. The release of these neurotransmitters leads to the physiologic effects seen in the fight or flight response, for example, a rapid heart rate, and increased alertness.

Hans Selye, another early scientist who is known for his studies of stress, extended Cannon's observations. He included the pituitary gland, a small gland at the base of the brain, as part of the body's stress response system. He described how this gland controls the secretion of hormones (for example, cortisol) that are important in the physiological response to stress. Additionally, Selye actually introduced the term stress from physics and engineering and defined it as "mutual actions of forces that take place across any section of the body, physical or psychological."

In his experiments, Selye induced stress in rats in a variety of ways. He found typical and constant psychological and physical responses to the adverse situations that were imposed on the rats. In rats exposed to constant stress, he observed enlargement of the adrenal glands, gastrointestinal ulcers, and a wasting away (atrophy) of the immune (defense) system. He called these responses to stress the general adaptation (adjustment) or stress syndrome. He discovered that these processes, which were adaptive (healthy, appropriate adjustment) and normal for the organism in warding off stress, could become much like illnesses. That is, the adaptive processes, if they were excessive, could damage the body. This observation, then, was the beginning of an understanding of why stress, really overstress, can be harmful, and why the word stress has earned such a bad name.

What are the symptoms for stress?

Just as we each have different things that stress us out, our symptoms can also be different.

Although you’re unlikely to have them all, here are some things you may experience if you’re under stress:

  • pain
  •  and other  problems
  • lower sex drive
  • problems
  • eating too much or too little
  • concentrating and  decisions

You might feel overwhelmed, irritable, or fearful. Whether you’re aware of it or not, you may be drinking or smoking more than you used to.  a better understanding of the signs and symptoms of too much stress.

What are the causes for stress?

Factors that can increase your risk of developing an anxiety disorder include the following.

Stress

Everyone encounters stress, but excessive or unresolved stress can increase your chances of developing chronic anxiety.

In 2019, the authors of a  review examined evidence of neurobiological links between stress and anxiety from various studies. They concluded that neural features in specific parts of the brain, such as the amygdala — which plays a role in processing fearful and threatening stimuli — may help explain how stress contributes to anxiety.

Genetic factors

If someone in your family has an anxiety disorder, you may have a greater risk of developing one too. Social and economic factors can play a role, but growing evidence suggests that genetic features might also contribute.

2019 study looked at links between genetic features and anxiety and stress-related disorders. The authors concluded that if you have specific genetic features, you might be more prone to anxiety. These features could be hereditary.

Personality type

Certain personality traits may affect your risk of developing anxiety and anxiety disorders.

A group of  followed 489 first-year university students for 6 years to see how certain outlooks — such as a tendency to experience negative feelings, extraversion, and introversion — might affect their risk of developing anxiety and depression.

They found that those who were hypercritical of themselves, had difficulty with criticism, or experienced a lot of negative thoughts and feelings as young adults were also more likely to develop panic disorder, agoraphobia, generalized anxiety disorder (GAD), and major depressive disorder over time.

Agoraphobia was also more common among those who scored high on a scale for introversion, rather than extroversion.

While these may act as “vulnerability factors,” the authors suggest that they are probably part of a far more complex picture.

Trauma

A recent or past  event, such as experiencing abuse or participating in military combat, can increase your risk of developing anxiety. It can also happen if you are close to someone who’s the victim of trauma or have witnessed something traumatic.

Many people experience anxiety after a shocking or frightening incident; this is known as acute distress disorder (ASD). But ongoing symptoms could be a sign of -traumatic stress disorder (PTSD). Symptoms usually start within 3 monthsTrusted Source of the event, but they can appear months or years later.

They include:

  • flashbacks
  • bad dreams
  • feeling constantly on edge
  • difficulty sleeping
  • angry outbursts
  • avoiding places or situations that could trigger stress symptoms

In some cases, ASD  become PTSD, but this does not always happen.

Racism

People who experience racial discrimination have a higher risk of developing anxiety and anxiety disorders, even after taking genetic factors into account.

Authors of a  published in 2021 concluded that discrimination is a risk factor for anxiety. The authors called for greater awareness of how racism and other forms of discrimination and social exclusion can affect people’s mental health.

Health America (MHA) notes that, in the United States, Black people and Indigenous People of Color are at risk of race-based traumatic stress injury (RBTS).

RBTS can affect you if you have experienced an “emotionally painful, sudden, and uncontrollable racist encounter.” Symptoms are similar to those of PTSD and can affect a wider community. MHA points out that, unlike PTSD, RBTS refers to a mental injury rather than a mental health disorder.

Sex

Studies suggest that females are more likely than males to experience anxiety and develop an anxiety disorder, although this may depend to some extent on the disorder.

Rates of the following appear to be  among females than males:

  • panic disorder
  • agoraphobia
  • generalized anxiety disorder
  • phobias
  • separation anxiety
  • post-traumatic stress disorder (PTSD)

However, males and females may be equally prone to social anxiety disorder (SAD) and obsessive-compulsive disorder (OCD). OCD and SAD are also the most likely anxiety disorders to affect males.

The reason is likely to be a combination of biological and social or cultural factors, and there is still more work to do to find out how each contributes, say the experts.

Gender dysphoria

For people with gender dysphoria, the gender people assigned them at birth does not match with the gender they identify with.

This can lead to turmoil and anxiety, but it can also increase your risk of conflict with people around you, especially if those around you have rigid perceptions of male and female roles.

show that many people with gender dysphoria are at risk of:

  • anxiety and anxiety disorders
  • depression
  • thoughts of suicide
  • substance use

Medical causes

There are various ways in which a person’s health can contribute to stress, such as:

  • past and present experience of mental and physical well-being
  • having a chronic illness that poses challenges to daily living
  • having a disease that causes very challenging symptoms, such as palpitations
  • having a condition where anxiety is a symptom, such as a hormonal imbalance

These will not necessarily lead to an anxiety disorder.

Life events

As with trauma, life events can increase your risk of stress and anxiety, according to the  Institute of Stress.

Examples include:

  • losing a loved one
  • divorce or separation
  • spending time in the criminal justice system
  • injury or illness
  • financial pressures or a loss of employment
  • major changes, such as moving in a new house or getting married

A person can experience these events without developing an anxiety disorder, although some may do so.

Medications

Some drugs can cause anxiety as a side effect, or they may cause symptoms that feel like anxiety.

Examples include:

  • drugs containing caffeine, such as  Migraine, which can cause irritability
  • drugs to treat ADHD, such as 
  • corticosteroids, such as 
  • some asthma medications, such as -salmeterol (Advair Diskus), which can cause tremors
  •  (Dilantin), an anti-seizure medication
  • , a drug for Parkinson’s disease

What causes anxiety attacks?

Triggers for anxiety vary widely between individuals. Different anxiety disorders will also have different triggers. Things that can cause feelings of anxiety in some people include:

  • health issues
  • the use of some substances, such as drugs or caffeine
  • lifestyle factors, such as financial worries
  • either being alone or being with a lot of people
  • conflict
  • reminders of past trauma

What are the treatments for stress?

A key aspect of a healthy adaptational response to stress is the time course. Responses must be initiated rapidly, maintained for a proper amount of time, and then turned off to ensure an optimal result. An over-response to stress or the failure to shut off a stress response can have negative biological and mental-health consequences for an individual. Healthy human responses to stress involve three components:

  • The brain handles (mediates) the immediate response. This response signals the adrenal medulla to release epinephrine and norepinephrine.
  • The hypothalamus (a central area in the brain) and the pituitary gland initiate (trigger) the slower maintenance response by signaling the adrenal cortex to release cortisol and other hormones.
  • Many neural (nerve) circuits are involved in the behavioral response. This response increases arousal (alertness, heightened awareness), focuses attention, inhibits feeding and reproductive behavior, reduces pain perception, and redirects behavior.

The combined results of these three components of the stress response maintain the internal balance (homeostasis) and optimize energy production and utilization. They also gear up the organism for a quick reaction through the sympathetic nervous system (SNS). The SNS operates by increasing the heart rate, increasing blood pressure, redirecting blood flow to the heart, muscles, and brain and away from the gastrointestinal tract, and releasing fuel (glucose and fatty acids) to help fight or flee the danger.

What are the risk factors for stress?

Many factors can increase the severity of anxiety symptoms. Some may be specific to an anxiety disorder, but risk factors overall can include the following, according to the  Source:

  • personality traits, such as shyness in childhood
  • past experience of traumatic events
  • a family history of mental health challenges
  • some physical conditions, such as a thyroid disorder

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