Occasional stress is a normal part of life. However, chronic (long-term) stress may contribute to or worsen a range of health problems. Chronic stress negatively impacts every organ in the body, down to our cells and molecules. Read about the impacts of long-term stress and ways to cope with it.
Chronic Stress and Cortisol
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What Is Stress?
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Fight Or Flight
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Fight Or Flight
The stress response likely developed in our early ancestors to help them survive. A real or perceived threat causes a cascade of stress hormones to be released throughout the body. Glucose, for energy, is released into the blood stream. Muscles prepare to work hard. Systems unnecessary for our short-term survival, such as digestion or reproduction, slow down. These physical changes give a person enough energy to run away from a fierce predator, or fight another person for food.
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What Is Stress?
Stress is how your brain and body respond to a challenge or demand. When you are stressed, your body releases chemicals called hormones. The hormones make you alert and ready to act. They can raise your blood pressure, heart rate, and blood sugar levels. This response is sometimes called a "fight or flight" response.
Everyone gets stressed from time to time. There are different types of stress. It can be short-term or long-term. It can be caused by something that happens once or something that keeps happening.
Not all stress is bad. In fact, it can help you survive in a dangerous situation. For example, one kind of stress is the jolt you may feel when a car pulls out in front of you. This jolt of hormones helps you quickly hit the brakes to avoid an accident. A little short-term stress can sometimes be helpful. For example, the stress of having a deadline for school or your job may push you to get your work done on time. Once you finish it, that stress goes away.
But stress that lasts a long time can harm your health.
Source: National Institute of Mental Health (NIMH)
Additional Materials (11)
What Is Stress?
What Is Stress? : The physical sensations we feel when stress strikes are rooted in our prehistoric ancestors` drive to survive. Stress hormones temporarily boost our strength, speed and alertness-qualities that could help us outrun a saber-tooth tiger. Energy is sapped from our digestive, reproductive and other systems that are not necessary for immediate survival. We are ready for "flight or fight."
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Physical evidence of chronic stress
The physical evidence of chronic stress appears in the cardiovascular system, brain, nerves, immune response, and psychological health of those who have inescapable stressors. Some people are better equipped than others to handle stress. Women tend to respond to stress by reaching out to other women and engaging in community-forming behaviors. Men are less likely to respond in this way.
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Man with visible Anatomy in Distress
Side view of a man, wearing a blue T-shirt, holding his head in his hand in a position of stress. The man has some visible anatomy, including the brain and partial enervation of the head and torso as well as the rib bones and some cardiovascular anatomy. The image supports content on the damaging effects of stress on the brain and nerves.
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Stress - What is Stress - Why Is Stress Bad - What Causes Stress - How Stress Works
Video by Whats Up Dude/YouTube
The United States of Stress: The Shocking Rise of Chronic Stress
Video by Everyday Health/YouTube
How to understand stress | Stress Patterns | British Red Cross
Video by British Red Cross/YouTube
Your Brain on Stress and Anxiety
Video by Dr John Kenworthy/YouTube
Can Stress Actually Kill You?
Video by AsapSCIENCE/YouTube
Emotion, Stress, and Health: Crash Course Psychology #26
Video by CrashCourse/YouTube
What is Acute Stress Disorder? (Traumatic Exposure)
Video by healthery/YouTube
Cortisol Molecules
The hippocampus is rich in receptors for cortisol. So cortisol is very active in the hippocampus. But sustained high levels of cortisol cause damage to neurons. Cortisol disrupts cellular metabolism of hippocampal neurons and increases the vulnerability of neurons to a variety of insults.5,6 In addition, when cortisol is elevated chronically, there is a reduction in neurogenesis.7 In a nutshell, the damage from cortisol in the hippocampus has been suggested to be an example of sacrificing long-term function (i.e., memory function) for the sake of short-term survival.
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What Is Stress?
TheVisualMD
Physical evidence of chronic stress
TheVisualMD
Man with visible Anatomy in Distress
TheVisualMD
3:20
Stress - What is Stress - Why Is Stress Bad - What Causes Stress - How Stress Works
Whats Up Dude/YouTube
8:18
The United States of Stress: The Shocking Rise of Chronic Stress
Everyday Health/YouTube
1:33
How to understand stress | Stress Patterns | British Red Cross
British Red Cross/YouTube
4:42
Your Brain on Stress and Anxiety
Dr John Kenworthy/YouTube
3:08
Can Stress Actually Kill You?
AsapSCIENCE/YouTube
10:20
Emotion, Stress, and Health: Crash Course Psychology #26
CrashCourse/YouTube
2:29
What is Acute Stress Disorder? (Traumatic Exposure)
healthery/YouTube
Cortisol Molecules
TheVisualMD
5 Things to Know
Before / After
Chronic Stress Can Cause Neuron Shrinkage
Interactive by TheVisualMD
Before / After
Chronic Stress Can Cause Neuron Shrinkage
Stress causes a cascade of hormones to be released. These stress hormones trigger many adverse physical reactions. Chronic stress can cause neuron shrinkage, see its effects on the brain.
Interactive by TheVisualMD
5 Things You Should Know About Stress
Everyone feels stressed from time to time, but what is stress? How does it affect your overall health? And what can you do to manage your stress?
Stress is how the brain and body respond to any demand. Any type of challenge—such as performance at work or school, a significant life change, or a traumatic event—can be stressful.
Stress can affect your health. It is important to pay attention to how you deal with minor and major stressors, so you know when to seek help.
Here are five things you should know about stress.
1. Stress affects everyone.
Everyone experiences stress from time to time. There are different types of stress—all of which carry physical and mental health risks. A stressor may be a one-time or short-term occurrence, or it can happen repeatedly over a long time. Some people may cope with stress more effectively and recover from stressful events more quickly than others.
Examples of stress include:
Routine stress related to the pressures of school, work, family, and other daily responsibilities.
Stress brought about by a sudden negative change, such as losing a job, divorce, or illness.
Traumatic stress experienced during an event such as a major accident, war, assault, or natural disaster where people may be in danger of being seriously hurt or killed. People who experience traumatic stress may have very distressing temporary emotional and physical symptoms, but most recover naturally soon after.
2. Not all stress is bad.
In a dangerous situation, stress signals the body to prepare to face a threat or flee to safety. In these situations, your pulse quickens, you breathe faster, your muscles tense, and your brain uses more oxygen and increases activity—all functions aimed at survival and in response to stress. In non-life-threatening situations, stress can motivate people, such as when they need to take a test or interview for a new job.
3. Long-term stress can harm your health.
Coping with the impact of chronic stress can be challenging. Because the source of long-term stress is more constant than acute stress, the body never receives a clear signal to return to normal functioning. With chronic stress, those same lifesaving reactions in the body can disturb the immune, digestive, cardiovascular, sleep, and reproductive systems. Some people may experience mainly digestive symptoms, while others may have headaches, sleeplessness, sadness, anger, or irritability.
Over time, continued strain on your body from stress may contribute to serious health problems, such as heart disease, high blood pressure, diabetes, and other illnesses, including mental disorders such as depression or anxiety.
4. There are ways to manage stress.
If you take practical steps to manage your stress, you may reduce the risk of negative health effects. Here are some tips that may help you to cope with stress:
Be observant. Recognize the signs of your body’s response to stress, such as difficulty sleeping, increased alcohol and other substance use, being easily angered, feeling depressed, and having low energy.
Talk to your health care provider or a health professional. Don’t wait for your health care provider to ask about your stress. Start the conversation and get proper health care for existing or new health problems. Effective treatments can help if your stress is affecting your relationships or ability to work.
Get regular exercise. Just 30 minutes per day of walking can help boost your mood and improve your health.
Try a relaxing activity. Explore relaxation or wellness programs, which may incorporate meditation, muscle relaxation, or breathing exercises. Schedule regular times for these and other healthy and relaxing activities.
Set goals and priorities. Decide what must get done now and what can wait. Learn to say “no” to new tasks if you start to feel like you’re taking on too much. Try to be mindful of what you have accomplished at the end of the day, not what you have been unable to do.
Stay connected. You are not alone. Keep in touch with people who can provide emotional support and practical help. To reduce stress, ask for help from friends, family, and community or religious organizations.
Consider a clinical trial. Researchers at the National Institute of Mental Health (NIMH) and other research facilities across the country are studying the causes and effects of psychological stress as well as stress management techniques.
5. If you’re overwhelmed by stress, ask for help from a health professional.
You should seek help right away if you have suicidal thoughts, are overwhelmed, feel you cannot cope, or are using drugs or alcohol more frequently as a result of stress. Your doctor may be able to provide a recommendation.
Source: National Institute of Mental Health (NIMH)
Additional Materials (10)
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Coping with stress during a COVID-19
Coping with stress during a COVID-19
Interactive by National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral Diseases
Meditation and Chromosome showing Telomerase Activity
The stress and strife of daily life can take a toll and even our chromosomes may be affected. Chromosomes are capped at their ends by protective structures called telomeres, which play a key role in cell division. Telomeres shorten, however, every time a cell divides, which ultimately sets a limit on cellular lifespan; the telomeres of individuals under great stress unravel even faster. An enzyme called telomerase, however, helps maintain and repair telomeres and a recent study suggests that intensive meditation training may increase telomerase activity in immune cells.
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Wellness Rule 1: Measure Yourself to Track Your Health
Wellness Rule 2: Change Your Habits, Change Your Brain
Wellness Rule 3: Eat Whole Foods for Total Well-Being
Wellness Rule 4: Exercise for Complete Health
Wellness Rule 5: Stop Smoking to Avoid Deadly Damage
Wellness Rule 6: Change Your Behaviors Through Moderation
Wellness Rule 7: Sleep Well to Optimize Brain Function and Control Your Appetite
Wellness Rule 8: Reduce Stress, Embrace Health and Joy
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The Wellness Continuum
Being in good health doesn't happen overnight; it's a journey. Here's your roadmap. Begin with Wellness Rule 1, Measure Yourself to Track Your Health, and continue on to learn how to turn around bad habits one by one. As you start practicing good health habits, you'll find they reinforce one another. By getting enough sleep, for instance, you'll more effectively manage stress and be less likely to overeat.
Interactive by TheVisualMD
A description of scientific research on links between the amygdala and PTSD.
A description of scientific research on links between the amygdala and PTSD.
Image by EternallyOptimistic
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Inheriting Stress
One effect of stress that is especially concerning to researchers is that some damage may be passed down to the next generation. Evidence is building that some epigenetic changes in gene expression can be inherited. For example, the children of mothers who had chronic stress during pregnancy have higher-than-normal rates of mood and behavior ailments as adults. The offspring of those who lived through a grave famine were found to have altered genes for obesity. These epigenetic effects, caused by stressful life events, have prompted researchers to explore what other stress damage may be inherited.
Video by TheVisualMD
5 Things to Know About Stress
Everyone feels stressed from time to time. It's important to pay attention to how you deal with minor and major stressors, so you know when to seek help.
Image by NIMH
What Does Stress Do To Your Body?
Video by Seeker/YouTube
Practical Steps to Ease Stress and Anxiety During COVID-19 | Susan Albers, PsyD
Video by Cleveland Clinic/YouTube
Acute vs. chronic stress: Signs it's time to seek professional help
Video by Demystifying Medicine/YouTube
90:10 The Single Most Important Thing You Can Do For Your Stress
Video by DocMikeEvans/YouTube
Coping with stress during a COVID-19
National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral Diseases
Meditation and Chromosome showing Telomerase Activity
TheVisualMD
The Wellness Continuum
TheVisualMD
A description of scientific research on links between the amygdala and PTSD.
EternallyOptimistic
0:58
Inheriting Stress
TheVisualMD
5 Things to Know About Stress
NIMH
3:20
What Does Stress Do To Your Body?
Seeker/YouTube
20:11
Practical Steps to Ease Stress and Anxiety During COVID-19 | Susan Albers, PsyD
Cleveland Clinic/YouTube
7:43
Acute vs. chronic stress: Signs it's time to seek professional help
Demystifying Medicine/YouTube
11:01
90:10 The Single Most Important Thing You Can Do For Your Stress
DocMikeEvans/YouTube
Causes of Stress
Common causes of long and short term stress.jpg
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Common causes of long and short term stress.jpg
Common causes of long and short term stress - Man suffering in a sea of cortisol
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What Causes Long-Term Stress?
Long-term stress, or chronic stress, lasts for weeks, months, or longer. As you go about your life, your body is acting as if you're being threatened.
Causes of long-term stress include:
Routine stress from the demands of work, school, family needs, money problems, and other daily pressures that don't stop.
Stress from sudden, difficult changes in your life, such as divorce, illness, losing your job, or other unhappy life events that often have a long impact.
Traumatic stress, which may happen when you're in danger of serious harm or death. Examples include being in a bad accident, a war, a flood, earthquake, or other frightening event. This type of stress can cause a long-lasting problem called post-traumatic stress disorder (PTSD).
Source: National Institute of Mental Health (NIMH)
Additional Materials (2)
What Causes Stress?
We all know that stressed-out feeling: clenched jaw, frayed nerves, pounding heart, tense muscles. When a challenge in our environment seems overwhelming, beyond our control, the body releases stress hormones that prepare us to react. The problem arises when stress is constant, or too frequent. Excessive stress hormones can cause serious damage to our health. Stress is linked to cardiovascular disease, digestive ailments, reduced immunity, headaches, muscle tension and more. Learning to avoid stress and minimize our reactions to it is vital to our longevity.
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Your Genes & Stress
Your Genes & Stress : Your genes are the permanent "recipe" of your traits, your uniqueness. External factors do not affect your genome. However, external factors can affect whether or not certain genes are expressed. Stress can cause a change in a network of compounds that do their work outside the genome, called the epigenome. Your genome is permanent. But your epigenome determines how the genome really works.
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What Causes Stress?
TheVisualMD
Your Genes & Stress
TheVisualMD
Effects on Health
Stress Harms the Immune System
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Stress Harms the Immune System
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How Can Long Term-Stress Harm My Health?
People respond to stress in different ways. If you're stressed for a long time you may notice that you are:
Getting sick more often than usual because stress weakens your body's ability to fight germs
Having stomach problems or trouble digesting food
Having trouble sleeping
Having headaches
Feeling sad, angry, or easily upset
When stress keeps going, your body acts as if you're always in danger. That's a lot of strain that may play a part in developing serious health problems, including:
Depression
Anxiety
Heart disease
High blood pressure
Diabetes (high blood sugar)
It's possible to get used to the symptoms of stress and not even realize there's a problem. So when there's a lot of stress in your life, it's important to pay attention to how it affects you so you can do something about it.
Source: National Institute of Mental Health (NIMH)
Additional Materials (21)
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Fight Or Flight
The stress response likely developed in our early ancestors to help them survive. A real or perceived threat causes a cascade of stress hormones to be released throughout the body. Glucose, for energy, is released into the blood stream. Muscles prepare to work hard. Systems unnecessary for our short-term survival, such as digestion or reproduction, slow down. These physical changes give a person enough energy to run away from a fierce predator, or fight another person for food.
Video by TheVisualMD
Stress Harms the Heart & Blood Vessels
Image by TheVisualMD
This browser does not support the video element.
Stress Takes a Toll
The way we are programmed to react to stress is no match for the modern world. So many things trigger our stress response! When the stress response is rare, damage is minimal. When our bodies are flooded with stress hormones repeatedly, damage is unavoidable. Because stress increases our blood pressure and heart rate, cardiovascular strain results. Stress also slows down digestion, causing ailments including ulcers. Repeated suppression of the immune system, reproductive system and parts of the brain that deal with short-term memory also cause problems in those functions.
Video by TheVisualMD
Burnout (psychology)
Stress Compromises Memory Learning : The telomere at the end of each chromosome prevents the genetic material from unraveling. In recent years, researchers have found that people under extreme stress tend to have shortened telomeres, a sign that stress prematurely ages our cells. Now, researchers are delving into the mysteries of telomeres. They want to find out why some people under great stress do not seem to have shorter telomeres.
Image by TheVisualMD
Inheriting Stress
One effect of stress that is especially concerning to researchers is that some damage may be passed down to the next generation. Evidence is building that some epigenetic changes in gene expression can be inherited. For example, the children of mothers who had chronic stress during pregnancy have higher-than-normal rates of mood and behavior ailments as adults. The offspring of those who lived through a grave famine were found to have altered genes for obesity. These epigenetic effects, caused by stressful life events, have prompted researchers to explore what other stress damage may be inherited.
Image by TheVisualMD
Stressed Out! Signs & Symptoms
Stress is stealthy. Its negative effects may appear to be caused by an acute illness. Stress may just seem like fatigue. But it wears away at you physically and emotionally if you don't recognize the warning signs and find a way to manage it.
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Stress Causes Psychological Problems
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Stressed Out! Signs & Symptoms
Stress is stealthy. Its negative effects may appear to be caused by an acute illness. Stress may just seem like fatigue. But it wears away at you physically and emotionally if you don't recognize the warning signs and find a way to manage it.
Image by TheVisualMD
This browser does not support the video element.
Stress & Aging
Scientists are making great strides in learning how stress ages us. At the very ends of each chromosome is a zone called the telomere. It has been likened to the tip of a shoelace, keeping the end material from unraveling. Each time a cell divides, the telomere becomes a bit shorter, which means that as we age the telomeres are fraying. In recent years, researchers have found that people under extraordinary stress tend to have shortened telomeres, a sign that stress prematurely ages our cells.
Video by TheVisualMD
This browser does not support the video element.
Inheriting Stress
One effect of stress that is especially concerning to researchers is that some damage may be passed down to the next generation. Evidence is building that some epigenetic changes in gene expression can be inherited. For example, the children of mothers who had chronic stress during pregnancy have higher-than-normal rates of mood and behavior ailments as adults. The offspring of those who lived through a grave famine were found to have altered genes for obesity. These epigenetic effects, caused by stressful life events, have prompted researchers to explore what other stress damage may be inherited.
Video by TheVisualMD
Sleep Helps Control Stress
Your stress hormone levels plummet when you sleep. Those who get enough sleep report fewer negative moods and less stress.
Image by TheVisualMD
Stress and a Newborn
Stress and a Newborn
Image by TheVisualMD / Pete Linforth
Stress Takes a Toll
The way we are programmed to react to stress is no match for the modern world. So many things trigger our stress response! When the stress response is rare, damage is minimal. When our bodies are flooded with stress hormones repeatedly, damage is unavoidable. Because stress increases our blood pressure and heart rate, cardiovascular strain results. Stress also slows down digestion, causing ailments including ulcers. Repeated suppression of the immune system, reproductive system and parts of the brain that deal with short-term memory also cause problems in those functions.
Image by TheVisualMD
Stress & The Growing Brain
The brain is the main stress processor, so it stands to reason that a developing brain would be especially sensitive to its effects. Multiple studies have shown that babies and children who grow up under profoundly stressful circumstances actually have less density in certain areas of the brain. The hippocampus, the part of the brain connected with memory and learning, is particularly vulnerable to the effects of stress. That is the area where most damage shows up.
Image by TheVisualMD
Stress Makes You Age Faster
At the very ends of each chromosome is a zone called the telomere. It has been likened to the tip of a shoelace, keeping the end material from unraveling. Each time a cell divides, the telomere becomes a bit shorter, which means that as we age the telomeres are fraying. In recent years, researchers have found that people under extraordinary stress tend to have shortened telomeres, a sign that stress prematurely ages our cells. Now, many researchers are delving into the mysteries of telomeres. They want to find out why some people under great stress do not seem to have shorter telomeres. Through analyzing the telomeres in immune cells from 63 women, they found that vigorous physical activity was associated with normal telomere length in those under great stress. In fact, the non-exercisers showed a 15-fold increase in the odds of having short telomeres for every point of increase on a stress scale, compared with the exercisers.
Image by TheVisualMD
Calming Diabetes
Many people don’t realize that stress can greatly increase blood glucose levels. There are different types of stress. Stress may be physical, like having a cold or an injury. It may be mental, like worrying about finances. Stress causes the release of numerous hormones, like cortisol and epinephrine, and they in turn raise blood sugar levels. Because insulin doesn’t function properly in someone with diabetes, the excess glucose isn’t admitted into target cells and blood sugar levels continue to rise. Chronic stress keeps glucose continuously elevated. In addition, stress may cause someone to not take care of themselves—for instance, to start smoking again, drink too much alcohol or not check their glucose levels.
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Stress Harms the Brain & Nerves
Part of the fight-or-flight reaction affects short-term memory recall. Stress hormones suppress activity in the prefrontal cortex, which also processes concentration, inhibition and rational thought. The social and intellectual brain tasks that might come to you automatically under normal conditions are also temporarily shelved when you are facing acute stress. Your powers of observation and focus are heightened, but calling up short-term memories is not high on the list of operations necessary for survival.
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Stress & Aging
Stress & Aging : Scientists are making great strides in learning how stress ages us. At the very ends of each chromosome is a zone called the telomere. It has been likened to the tip of a shoelace, keeping the end material from unraveling. Each time a cell divides, the telomere becomes a bit shorter, which means that as we age the telomeres are fraying.
Image by TheVisualMD
Stress management
Beat Stress with Exercise : Endorphins, the body`s home-grown pain relievers, are known to block pain signals to the brain, which brings about their feel-good effect. Just as endorphins are the body`s version of morphine, endocannabinoids are its homemade version of the active ingredient in cannabis, or marijuana. Both are released into the bloodstream in great volume after intense aerobic exercise.
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Burnout (psychology)
Stress Harms the Brain & Nerves : The brain`s hippocampus, is more active when you are under stress. When you are experiencing an intense, emotional episode, neurotransmitters signal the hippocampus to store it away in long-term memory. Back in prehistoric times, this memory task would have been essential to avoiding stress-provoking environmental factors in the future. ("Note to self: Remember to run from the tiger!)
Image by TheVisualMD
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Stress & The Growing Brain
The brain is the main stress processor, so it stands to reason that a developing brain would be especially sensitive to its effects. Multiple studies have shown that babies and children who grow up under profoundly stressful circumstances actually have less density in certain areas of the brain. The hippocampus, the part of the brain connected with memory and learning, is particularly vulnerable to the effects of stress. That is the area where most damage shows up.
Video by TheVisualMD
3:09
Fight Or Flight
TheVisualMD
Stress Harms the Heart & Blood Vessels
TheVisualMD
1:23
Stress Takes a Toll
TheVisualMD
Burnout (psychology)
TheVisualMD
Inheriting Stress
TheVisualMD
Stressed Out! Signs & Symptoms
TheVisualMD
Stress Causes Psychological Problems
TheVisualMD
Stressed Out! Signs & Symptoms
TheVisualMD
1:11
Stress & Aging
TheVisualMD
0:58
Inheriting Stress
TheVisualMD
Sleep Helps Control Stress
TheVisualMD
Stress and a Newborn
TheVisualMD / Pete Linforth
Stress Takes a Toll
TheVisualMD
Stress & The Growing Brain
TheVisualMD
Stress Makes You Age Faster
TheVisualMD
Calming Diabetes
TheVisualMD
Stress Harms the Brain & Nerves
TheVisualMD
Stress & Aging
TheVisualMD
Stress management
TheVisualMD
Burnout (psychology)
TheVisualMD
0:54
Stress & The Growing Brain
TheVisualMD
Stress and Illness
Burnout (psychology)
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Burnout (psychology)
Stress Harms the Immune System : Researchers believe that chronic stress shifts the immune response by changing the "recipe" for the kinds of immune cells produced. Immune cells called cytokines have a range of roles, and there are different categories of cytokines. In the presence of excess cortisol, some cytokines that protect against infection are produced at very low levels. This throws off the overall balance of immune cells.
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Stress and Illness
The stress response consists of a coordinated but complex system of physiological reactions that are called upon as needed. These reactions are beneficial at times because they prepare us to deal with potentially dangerous or threatening situations (for example, recall our old friend, the fearsome bear on the trail). However, health is affected when physiological reactions are sustained, as can happen in response to ongoing stress.
Psychophysiological Disorders
If the reactions that compose the stress response are chronic or if they frequently exceed normal ranges, they can lead to cumulative wear and tear on the body, in much the same way that running your air conditioner on full blast all summer will eventually cause wear and tear on it. For example, the high blood pressure that a person under considerable job strain experiences might eventually take a toll on his heart and set the stage for a heart attack or heart failure. Also, someone exposed to high levels of the stress hormone cortisol might become vulnerable to infection or disease because of weakened immune system functioning (McEwen, 1998).
Physical disorders or diseases whose symptoms are brought about or worsened by stress and emotional factors are called psychophysiological disorders. The physical symptoms of psychophysiological disorders are real and they can be produced or exacerbated by psychological factors (hence the psycho and physiological in psychophysiological). A list of frequently encountered psychophysiological disorders is provided in Table.
Types of Psychophysiological Disorders (adapted from Everly & Lating, 2002)
Type of Psychophysiological Disorder
Examples
Cardiovascular
hypertension, coronary heart disease
Gastrointestinal
irritable bowel syndrome
Respiratory
asthma, allergy
Musculoskeletal
low back pain, tension headaches
Skin
acne, eczema, psoriasis
In addition to stress itself, emotional upset and certain stressful personality traits have been proposed as potential contributors to ill health. Franz Alexander (1950), an early-20th-century psychoanalyst and physician, once postulated that various diseases are caused by specific unconscious conflicts. For example, he linked hypertension to repressed anger, asthma to separation anxiety, and ulcers to an unconscious desire to “remain in the dependent infantile situation—to be loved and cared for” (Alexander, 1950, p. 102). Although hypertension does appear to be linked to anger (as you will learn below), Alexander’s assertions have not been supported by research. Years later, Friedman and Booth-Kewley (1987), after statistically reviewing 101 studies examining the link between personality and illness, proposed the existence of disease-prone personality characteristics, including depression, anger/hostility, and anxiety. Indeed, a study of over 61,000 Norwegians identified depression as a risk factor for all major disease-related causes of death (Mykletun et al., 2007). In addition, neuroticism—a personality trait that reflects how anxious, moody, and sad one is—has been identified as a risk factor for chronic health problems and mortality (Ploubidis & Grundy, 2009).
Below, we discuss two kinds of psychophysiological disorders about which a great deal is known: cardiovascular disorders and asthma. First, however, it is necessary to turn our attention to a discussion of the immune system—one of the major pathways through which stress and emotional factors can lead to illness and disease.
Stress and the Immune System
In a sense, the immune system is the body’s surveillance system. It consists of a variety of structures, cells, and mechanisms that serve to protect the body from invading toxins and microorganisms that can harm or damage the body’s tissues and organs. When the immune system is working as it should, it keeps us healthy and disease free by eliminating bacteria, viruses, and other foreign substances that have entered the body (Everly & Lating, 2002).
Immune System Errors
Sometimes, the immune system will function erroneously. For example, sometimes it can go awry by mistaking your body’s own healthy cells for invaders and repeatedly attacking them. When this happens, the person is said to have an autoimmune disease, which can affect almost any part of the body. How an autoimmune disease affects a person depends on what part of the body is targeted. For instance, rheumatoid arthritis, an autoimmune disease that affects the joints, results in joint pain, stiffness, and loss of function. Systemic lupus erythematosus, an autoimmune disease that affects the skin, can result in rashes and swelling of the skin. Grave’s disease, an autoimmune disease that affects the thyroid gland, can result in fatigue, weight gain, and muscle aches (National Institute of Arthritis and Musculoskeletal and Skin Diseases [NIAMS], 2012).
In addition, the immune system may sometimes break down and be unable to do its job. This situation is referred to as immunosuppression, the decreased effectiveness of the immune system. When people experience immunosuppression, they become susceptible to any number of infections, illness, and diseases. For example, acquired immune deficiency syndrome (AIDS) is a serious and lethal disease that is caused by human immunodeficiency virus (HIV), which greatly weakens the immune system by infecting and destroying antibody-producing cells, thus rendering a person vulnerable to any of a number of opportunistic infections (Powell, 1996).
Stressors and Immune Function
The question of whether stress and negative emotional states can influence immune function has captivated researchers for over three decades, and discoveries made over that time have dramatically changed the face of health psychology (Kiecolt-Glaser, 2009). Psychoneuroimmunology is the field that studies how psychological factors such as stress influence the immune system and immune functioning. The term psychoneuroimmunology was first coined in 1981, when it appeared as the title of a book that reviewed available evidence for associations between the brain, endocrine system, and immune system (Zacharie, 2009). To a large extent, this field evolved from the discovery that there is a connection between the central nervous system and the immune system.
Some of the most compelling evidence for a connection between the brain and the immune system comes from studies in which researchers demonstrated that immune responses in animals could be classically conditioned (Everly & Lating, 2002). For example, Ader and Cohen (1975) paired flavored water (the conditioned stimulus) with the presentation of an immunosuppressive drug (the unconditioned stimulus), causing sickness (an unconditioned response). Not surprisingly, rats exposed to this pairing developed a conditioned aversion to the flavored water. However, the taste of the water itself later produced immunosuppression (a conditioned response), indicating that the immune system itself had been conditioned. Many subsequent studies over the years have further demonstrated that immune responses can be classically conditioned in both animals and humans (Ader & Cohen, 2001). Thus, if classical conditioning can alter immunity, other psychological factors should be capable of altering it as well.
Hundreds of studies involving tens of thousands of participants have tested many kinds of brief and chronic stressors and their effect on the immune system (e.g., public speaking, medical school examinations, unemployment, marital discord, divorce, death of spouse, burnout and job strain, caring for a relative with Alzheimer’s disease, and exposure to the harsh climate of Antarctica). It has been repeatedly demonstrated that many kinds of stressors are associated with poor or weakened immune functioning (Glaser & Kiecolt-Glaser, 2005; Kiecolt-Glaser, McGuire, Robles, & Glaser, 2002; Segerstrom & Miller, 2004).
When evaluating these findings, it is important to remember that there is a tangible physiological connection between the brain and the immune system. For example, the sympathetic nervous system innervates immune organs such as the thymus, bone marrow, spleen, and even lymph nodes (Maier, Watkins, & Fleshner, 1994). Also, we noted earlier that stress hormones released during hypothalamic-pituitary-adrenal (HPA) axis activation can adversely impact immune function. One way they do this is by inhibiting the production of lymphocytes, white blood cells that circulate in the body’s fluids that are important in the immune response (Everly & Lating, 2002).
Some of the more dramatic examples demonstrating the link between stress and impaired immune function involve studies in which volunteers were exposed to viruses. The rationale behind this research is that because stress weakens the immune system, people with high stress levels should be more likely to develop an illness compared to those under little stress. In one memorable experiment using this method, researchers interviewed 276 healthy volunteers about recent stressful experiences (Cohen et al., 1998). Following the interview, these participants were given nasal drops containing the cold virus (in case you are wondering why anybody would ever want to participate in a study in which they are subjected to such treatment, the participants were paid $800 for their trouble). When examined later, participants who reported experiencing chronic stressors for more than one month—especially enduring difficulties involving work or relationships—were considerably more likely to have developed colds than were participants who reported no chronic stressors (Figure).
Other studies have demonstrated that stress slows down wound healing by impairing immune responses important to wound repair (Glaser & Kiecolt-Glaser, 2005). In one study, for example, skin blisters were induced on the forearm. Subjects who reported higher levels of stress produced lower levels of immune proteins necessary for wound healing (Glaser et al., 1999). Stress, then, is not so much the sword that kills the knight, so to speak; rather, it’s the sword that breaks the knight’s shield, and your immune system is that shield.
Cardiovascular Disorders
The cardiovascular system is composed of the heart and blood circulation system. For many years, disorders that involve the cardiovascular system—known as cardiovascular disorders—have been a major focal point in the study of psychophysiological disorders because of the cardiovascular system’s centrality in the stress response (Everly & Lating, 2002). Heart disease is one such condition. Each year, heart disease causes approximately one in three deaths in the United States, and it is the leading cause of death in the developed world (Centers for Disease Control and Prevention [CDC], 2011; Shapiro, 2005).
The symptoms of heart disease vary somewhat depending on the specific kind of heart disease one has, but they generally involve angina—chest pains or discomfort that occur when the heart does not receive enough blood (Office on Women’s Health, 2009). The pain often feels like the chest is being pressed or squeezed; burning sensations in the chest and shortness of breath are also commonly reported. Such pain and discomfort can spread to the arms, neck, jaws, stomach (as nausea), and back (American Heart Association [AHA], 2012a) (Figure).
A major risk factor for heart disease is hypertension, which is high blood pressure. Hypertension forces a person’s heart to pump harder, thus putting more physical strain on the heart. If left unchecked, hypertension can lead to a heart attack, stroke, or heart failure; it can also lead to kidney failure and blindness. Hypertension is a serious cardiovascular disorder, and it is sometimes called the silent killer because it has no symptoms—one who has high blood pressure may not even be aware of it (AHA, 2012b).
Many risk factors contributing to cardiovascular disorders have been identified. These risk factors include social determinants such as aging, income, education, and employment status, as well as behavioral risk factors that include unhealthy diet, tobacco use, physical inactivity, and excessive alcohol consumption; obesity and diabetes are additional risk factors (World Health Organization [WHO], 2013).
Over the past few decades, there has been much greater recognition and awareness of the importance of stress and other psychological factors in cardiovascular health (Nusair, Al-dadah, & Kumar, 2012). Indeed, exposure to stressors of many kinds has also been linked to cardiovascular problems; in the case of hypertension, some of these stressors include job strain (Trudel, Brisson, & Milot, 2010), natural disasters (Saito, Kim, Maekawa, Ikeda, & Yokoyama, 1997), marital conflict (Nealey-Moore, Smith, Uchino, Hawkins, & Olson-Cerny, 2007), and exposure to high traffic noise levels at one’s home (de Kluizenaar, Gansevoort, Miedema, & de Jong, 2007). Perceived discrimination appears to be associated with hypertension among African Americans (Sims et al., 2012). In addition, laboratory-based stress tasks, such as performing mental arithmetic under time pressure, immersing one’s hand into ice water (known as the cold pressor test), mirror tracing, and public speaking have all been shown to elevate blood pressure (Phillips, 2011).
Are You Type A or Type B?
Sometimes research ideas and theories emerge from seemingly trivial observations. In the 1950s, cardiologist Meyer Friedman was looking over his waiting room furniture, which consisted of upholstered chairs with armrests. Friedman decided to have these chairs reupholstered. When the man doing the reupholstering came to the office to do the work, he commented on how the chairs were worn in a unique manner—the front edges of the cushions were worn down, as were the front tips of the arm rests. It seemed like the cardiology patients were tapping or squeezing the front of the armrests, as well as literally sitting on the edge of their seats (Friedman & Rosenman, 1974). Were cardiology patients somehow different than other types of patients? If so, how?
After researching this matter, Friedman and his colleague, Ray Rosenman, came to understand that people who are prone to heart disease tend to think, feel, and act differently than those who are not. These individuals tend to be intensively driven workaholics who are preoccupied with deadlines and always seem to be in a rush. According to Friedman and Rosenman, these individuals exhibit Type A behavior pattern; those who are more relaxed and laid-back were characterized as Type B (Figure). In a sample of Type As and Type Bs, Friedman and Rosenman were startled to discover that heart disease was over seven times more frequent among the Type As than the Type Bs (Friedman & Rosenman, 1959).
The major components of the Type A pattern include an aggressive and chronic struggle to achieve more and more in less and less time (Friedman & Rosenman, 1974). Specific characteristics of the Type A pattern include an excessive competitive drive, chronic sense of time urgency, impatience, and hostility toward others (particularly those who get in the person’s way).
An example of a person who exhibits Type A behavior pattern is Jeffrey. Even as a child, Jeffrey was intense and driven. He excelled at school, was captain of the swim team, and graduated with honors from an Ivy League college. Jeffrey never seems able to relax; he is always working on something, even on the weekends. However, Jeffrey always seems to feel as though there are not enough hours in the day to accomplish all he feels he should. He volunteers to take on extra tasks at work and often brings his work home with him; he often goes to bed angry late at night because he feels that he has not done enough. Jeffrey is quick tempered with his coworkers; he often becomes noticeably agitated when dealing with those coworkers he feels work too slowly or whose work does not meet his standards. He typically reacts with hostility when interrupted at work. He has experienced problems in his marriage over his lack of time spent with family. When caught in traffic during his commute to and from work, Jeffrey incessantly pounds on his horn and swears loudly at other drivers. When Jeffrey was 52, he suffered his first heart attack.
By the 1970s, a majority of practicing cardiologists believed that Type A behavior pattern was a significant risk factor for heart disease (Friedman, 1977). Indeed, a number of early longitudinal investigations demonstrated a link between Type A behavior pattern and later development of heart disease (Rosenman et al., 1975; Haynes, Feinleib, & Kannel, 1980).
Subsequent research examining the association between Type A and heart disease, however, failed to replicate these earlier findings (Glassman, 2007; Myrtek, 2001). Because Type A theory did not pan out as well as they had hoped, researchers shifted their attention toward determining if any of the specific elements of Type A predict heart disease.
Extensive research clearly suggests that the anger/hostility dimension of Type A behavior pattern may be one of the most important factors in the development of heart disease. This relationship was initially described in the Haynes et al. (1980) study mentioned above: Suppressed hostility was found to substantially elevate the risk of heart disease for both men and women. Also, one investigation followed over 1,000 male medical students from 32 to 48 years. At the beginning of the study, these men completed a questionnaire assessing how they react to pressure; some indicated that they respond with high levels of anger, whereas others indicated that they respond with less anger. Decades later, researchers found that those who earlier had indicated the highest levels of anger were over 6 times more likely than those who indicated less anger to have had a heart attack by age 55, and they were 3.5 times more likely to have experienced heart disease by the same age (Chang, Ford, Meoni, Wang, & Klag, 2002). From a health standpoint, it clearly does not pay to be an angry young person.
After reviewing and statistically summarizing 35 studies from 1983 to 2006, Chida and Steptoe (2009) concluded that the bulk of the evidence suggests that anger and hostility constitute serious long-term risk factors for adverse cardiovascular outcomes among both healthy individuals and those already suffering from heart disease. One reason angry and hostile moods might contribute to cardiovascular diseases is that such moods can create social strain, mainly in the form of antagonistic social encounters with others. This strain could then lay the foundation for disease-promoting cardiovascular responses among hostile individuals (Vella, Kamarck, Flory, & Manuck, 2012). In this transactional model, hostility and social strain form a cycle (Figure).
For example, suppose Kaitlin has a hostile disposition; she has a cynical, distrustful attitude toward others and often thinks that other people are out to get her. She is very defensive around people, even those she has known for years, and she is always looking for signs that others are either disrespecting or belittling her. In the shower each morning before work, she often mentally rehearses what she would say to someone who said or did something that angered her, such as making a political statement that was counter to her own ideology. As Kaitlin goes through these mental rehearsals, she often grins and thinks about the retaliation on anyone who will irk her that day.
Socially, she is confrontational and tends to use a harsh tone with people, which often leads to very disagreeable and sometimes argumentative social interactions. As you might imagine, Kaitlin is not especially popular with others, including coworkers, neighbors, and even members of her own family. They either avoid her at all costs or snap back at her, which causes Kaitlin to become even more cynical and distrustful of others, making her disposition even more hostile. Kaitlin’s hostility—through her own doing—has created an antagonistic environment that cyclically causes her to become even more hostile and angry, thereby potentially setting the stage for cardiovascular problems.
In addition to anger and hostility, a number of other negative emotional states have been linked with heart disease, including negative affectivity and depression (Suls & Bunde, 2005). Negative affectivity is a tendency to experience distressed emotional states involving anger, contempt, disgust, guilt, fear, and nervousness (Watson, Clark, & Tellegen, 1988). It has been linked with the development of both hypertension and heart disease. For example, over 3,000 initially healthy participants in one study were tracked longitudinally, up to 22 years. Those with higher levels of negative affectivity at the time the study began were substantially more likely to develop and be treated for hypertension during the ensuing years than were those with lower levels of negative affectivity (Jonas & Lando, 2000). In addition, a study of over 10,000 middle-aged London-based civil servants who were followed an average of 12.5 years revealed that those who earlier had scored in the upper third on a test of negative affectivity were 32% more likely to have experienced heart disease, heart attack, or angina over a period of years than were those who scored in the lowest third (Nabi, Kivimaki, De Vogli, Marmot, & Singh-Manoux, 2008). Hence, negative affectivity appears to be a potentially vital risk factor for the development of cardiovascular disorders.
Depression and the Heart
For centuries, poets and folklore have asserted that there is a connection between moods and the heart (Glassman & Shapiro, 1998). You are no doubt familiar with the notion of a broken heart following a disappointing or depressing event and have encountered that notion in songs, films, and literature.
Perhaps the first to recognize the link between depression and heart disease was Benjamin Malzberg (1937), who found that the death rate among institutionalized patients with melancholia (an archaic term for depression) was six times higher than that of the population. A classic study in the late 1970s looked at over 8,000 manic-depressive persons in Denmark, finding a nearly 50% increase in deaths from heart disease among these patients compared with the general Danish population (Weeke, 1979). By the early 1990s, evidence began to accumulate showing that depressed individuals who were followed for long periods of time were at increased risk for heart disease and cardiac death (Glassman, 2007). In one investigation of over 700 Denmark residents, those with the highest depression scores were 71% more likely to have experienced a heart attack than were those with lower depression scores (Barefoot & Schroll, 1996). Figure illustrates the gradation in risk of heart attacks for both men and women.
After more than two decades of research, it is now clear that a relationship exists: Patients with heart disease have more depression than the general population, and people with depression are more likely to eventually develop heart disease and experience higher mortality than those who do not have depression (Hare, Toukhsati, Johansson, & Jaarsma, 2013); the more severe the depression, the higher the risk (Glassman, 2007). Consider the following:
In one study, death rates from cardiovascular problems was substantially higher in depressed people; depressed men were 50% more likely to have died from cardiovascular problems, and depressed women were 70% more likely (Ösby, Brandt, Correia, Ekbom, & Sparén, 2001).
A statistical review of 10 longitudinal studies involving initially healthy individuals revealed that those with elevated depressive symptoms have, on average, a 64% greater risk of developing heart disease than do those with fewer symptoms (Wulsin & Singal, 2003).
A study of over 63,000 registered nurses found that those with more depressed symptoms when the study began were 49% more likely to experience fatal heart disease over a 12-year period (Whang et al., 2009).
The American Heart Association, fully aware of the established importance of depression in cardiovascular diseases, several years ago recommended routine depression screening for all heart disease patients (Lichtman et al., 2008). Recently, they have recommended including depression as a risk factor for heart disease patients (AHA, 2014).
Although the exact mechanisms through which depression might produce heart problems have not been fully clarified, a recent investigation examining this connection in early life has shed some light. In an ongoing study of childhood depression, adolescents who had been diagnosed with depression as children were more likely to be obese, smoke, and be physically inactive than were those who had not received this diagnosis (Rottenberg et al., 2014). One implication of this study is that depression, especially if it occurs early in life, may increase the likelihood of living an unhealthy lifestyle, thereby predisposing people to an unfavorable cardiovascular disease risk profile.
It is important to point out that depression may be just one piece of the emotional puzzle in elevating the risk for heart disease, and that chronically experiencing several negative emotional states may be especially important. A longitudinal investigation of Vietnam War veterans found that depression, anxiety, hostility, and trait anger each independently predicted the onset of heart disease (Boyle, Michalek, & Suarez, 2006). However, when each of these negative psychological attributes was combined into a single variable, this new variable (which researchers called psychological risk factor) predicted heart disease more strongly than any of the individual variables. Thus, rather than examining the predictive power of isolated psychological risk factors, it seems crucial for future researchers to examine the effects of combined and more general negative emotional and psychological traits in the development of cardiovascular illnesses.
Asthma
Asthma is a chronic and serious disease in which the airways of the respiratory system become obstructed, leading to great difficulty expelling air from the lungs. The airway obstruction is caused by inflammation of the airways (leading to thickening of the airway walls) and a tightening of the muscles around them, resulting in a narrowing of the airways (Figure) (American Lung Association, 2010). Because airways become obstructed, a person with asthma will sometimes have great difficulty breathing and will experience repeated episodes of wheezing, chest tightness, shortness of breath, and coughing, the latter occurring mostly during the morning and night (CDC, 2006).
According to the Centers for Disease Control and Prevention (CDC), around 4,000 people die each year from asthma-related causes, and asthma is a contributing factor to another 7,000 deaths each year (CDC, 2013a). The CDC has revealed that asthma affects 18.7 million U.S. adults and is more common among people with lower education and income levels (CDC, 2013b). Especially concerning is that asthma is on the rise, with rates of asthma increasing 157% between 2000 and 2010 (CDC, 2013b).
Asthma attacks are acute episodes in which an asthma sufferer experiences the full range of symptoms. Asthma exacerbation is often triggered by environmental factors, such as air pollution, allergens (e.g., pollen, mold, and pet hairs), cigarette smoke, airway infections, cold air or a sudden change in temperature, and exercise (CDC, 2013b).
Psychological factors appear to play an important role in asthma (Wright, Rodriguez, & Cohen, 1998), although some believe that psychological factors serve as potential triggers in only a subset of asthma patients (Ritz, Steptoe, Bobb, Harris, & Edwards, 2006). Many studies over the years have demonstrated that some people with asthma will experience asthma-like symptoms if they expect to experience such symptoms, such as when breathing an inert substance that they (falsely) believe will lead to airway obstruction (Sodergren & Hyland, 1999). As stress and emotions directly affect immune and respiratory functions, psychological factors likely serve as one of the most common triggers of asthma exacerbation (Trueba & Ritz, 2013).
People with asthma tend to report and display a high level of negative emotions such as anxiety, and asthma attacks have been linked to periods of high emotionality (Lehrer, Isenberg, & Hochron, 1993). In addition, high levels of emotional distress during both laboratory tasks and daily life have been found to negatively affect airway function and can produce asthma-like symptoms in people with asthma (von Leupoldt, Ehnes, & Dahme, 2006). In one investigation, 20 adults with asthma wore preprogrammed wristwatches that signaled them to breathe into a portable device that measures airway function. Results showed that higher levels of negative emotions and stress were associated with increased airway obstruction and self-reported asthma symptoms (Smyth, Soefer, Hurewitz, Kliment, & Stone, 1999). In addition, D’Amato, Liccardi, Cecchi, Pellegrino, & D’Amato (2010) described a case study of an 18-year-old man with asthma whose girlfriend had broken up with him, leaving him in a depressed state. She had also unfriended him on Facebook , while friending other young males. Eventually, the young man was able to “friend” her once again and could monitor her activity through Facebook. Subsequently, he would experience asthma symptoms whenever he logged on and accessed her profile. When he later resigned not to use Facebook any longer, the asthma attacks stopped. This case suggests that the use of Facebook and other forms of social media may represent a new source of stress—it may be a triggering factor for asthma attacks, especially in depressed asthmatic individuals.
Exposure to stressful experiences, particularly those that involve parental or interpersonal conflicts, has been linked to the development of asthma throughout the lifespan. A longitudinal study of 145 children found that parenting difficulties during the first year of life increased the chances that the child developed asthma by 107% (Klinnert et al., 2001). In addition, a cross-sectional study of over 10,000 Finnish college students found that high rates of parent or personal conflicts (e.g., parental divorce, separation from spouse, or severe conflicts in other long-term relationships) increased the risk of asthma onset (Kilpeläinen, Koskenvuo, Helenius, & Terho, 2002). Further, a study of over 4,000 middle-aged men who were interviewed in the early 1990s and again a decade later found that breaking off an important life partnership (e.g., divorce or breaking off relationship from parents) increased the risk of developing asthma by 124% over the time of the study (Loerbroks, Apfelbacher, Thayer, Debling, & Stürmer, 2009).
Tension Headaches
A headache is a continuous pain anywhere in the head and neck region. Migraine headaches are a type of headache thought to be caused by blood vessel swelling and increased blood flow (McIntosh, 2013). Migraines are characterized by severe pain on one or both sides of the head, an upset stomach, and disturbed vision. They are more frequently experienced by women than by men (American Academy of Neurology, 2014). Tension headaches are triggered by tightening/tensing of facial and neck muscles; they are the most commonly experienced kind of headache, accounting for about 42% of all headaches worldwide (Stovner et al., 2007). In the United States, well over one-third of the population experiences tension headaches each year, and 2–3% of the population suffers from chronic tension headaches (Schwartz, Stewart, Simon, & Lipton, 1998).
A number of factors can contribute to tension headaches, including sleep deprivation, skipping meals, eye strain, overexertion, muscular tension caused by poor posture, and stress (MedicineNet, 2013). Although there is uncertainty regarding the exact mechanisms through which stress can produce tension headaches, stress has been demonstrated to increase sensitivity to pain (Caceres & Burns, 1997; Logan et al., 2001). In general, tension headache sufferers, compared to non-sufferers, have a lower threshold for and greater sensitivity to pain (Ukestad & Wittrock, 1996), and they report greater levels of subjective stress when faced with a stressor (Myers, Wittrock, & Foreman, 1998). Thus, stress may contribute to tension headaches by increasing pain sensitivity in already-sensitive pain pathways in tension headache sufferers (Cathcart, Petkov, & Pritchard, 2008).
Your genes are the permanent "recipe" of your traits, your uniqueness. External factors do not affect your genome. However, external factors can affect whether or not certain genes are expressed. Stress can cause a change in a network of compounds that do their work outside the genome, called the epigenome. The study of epigenetics is relatively new. So far, scientists have found that certain nutritional choices, smoking, and stress are among the factors that can cause epigenetic changes.
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Mind Your Heart: Stress, Mental Health and Heart Disease
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Can Stress Actually Kill You?
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Stress, Fatigue, and Chronic Pain
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Does Stress Cause Prostate Cancer? | Ask a Prostate Cancer Expert, Mark Scholz, MD
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What Does Stress Do To Your Body?
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Stress Can Affect Brain Cells
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The Impact Of Stress On Your Heart
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Your Brain on Stress and Anxiety
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Stress and Heart Disease
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Stress & Epigenetics
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Mind Your Heart: Stress, Mental Health and Heart Disease
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Can Stress Actually Kill You?
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Stress, Fatigue, and Chronic Pain
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Does Stress Cause Prostate Cancer? | Ask a Prostate Cancer Expert, Mark Scholz, MD
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What Does Stress Do To Your Body?
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Terrible Symptoms Of Stress On The Body
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NCCIH
Stress and Aging
Stress Makes You Age Faster
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Stress Makes You Age Faster
At the very ends of each chromosome is a zone called the telomere. It has been likened to the tip of a shoelace, keeping the end material from unraveling. Each time a cell divides, the telomere becomes a bit shorter, which means that as we age the telomeres are fraying. In recent years, researchers have found that people under extraordinary stress tend to have shortened telomeres, a sign that stress prematurely ages our cells. Now, many researchers are delving into the mysteries of telomeres. They want to find out why some people under great stress do not seem to have shorter telomeres. Through analyzing the telomeres in immune cells from 63 women, they found that vigorous physical activity was associated with normal telomere length in those under great stress. In fact, the non-exercisers showed a 15-fold increase in the odds of having short telomeres for every point of increase on a stress scale, compared with the exercisers.
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Stress and Aging: a Tale of Telomeres
Have you ever wondered why people who are stressed often seem to have a haggard look about them? A pioneering study from 2004 suggests that the reason is because stress can actually accelerate the cell biology of aging.
Stress, it seems, can shorten telomeres, which are segments of DNA that protect the ends of chromosomes. Shortened telomeres can inhibit or block cell division, which includes growth and proliferation of new cells, thereby leading to more rapid aging (Sapolsky, 2004). In the study, researchers compared telomere lengths in the white blood cells in mothers of chronically ill children to those of mothers of healthy children (Epel et al., 2004). Mothers of chronically ill children would be expected to experience more stress than would mothers of healthy children. The longer a mother had spent caring for her ill child, the shorter her telomeres (the correlation between years of caregiving and telomere length was r = -.40). In addition, higher levels of perceived stress were negatively correlated with telomere size (r = -.31). These researchers also found that the average telomere length of the most stressed mothers, compared to the least stressed, was similar to what you would find in people who were 9–17 years older than they were on average.
Numerous other studies since have continued to find associations between stress and eroded telomeres (Blackburn & Epel, 2012). Some studies have even demonstrated that stress can begin to erode telomeres in childhood and perhaps even before children are born. For example, childhood exposure to violence (e.g., maternal domestic violence, bullying victimization, and physical maltreatment) was found in one study to accelerate telomere erosion from ages 5 to 10 (Shalev et al., 2013). Another study reported that young adults whose mothers had experienced severe stress during their pregnancy had shorter telomeres than did those whose mothers had stress-free and uneventful pregnancies (Entringer et al., 2011). Further, the corrosive effects of childhood stress on telomeres can extend into young adulthood. In an investigation of over 4,000 U.K. women ages 41–80, adverse experiences during childhood (e.g., physical abuse, being sent away from home, and parent divorce) were associated with shortened telomere length (Surtees et al., 2010), and telomere size decreased as the amount of experienced adversity increased (Figure).
Efforts to dissect the precise cellular and physiological mechanisms linking short telomeres to stress and disease are currently underway. For the time being, telomeres provide us with yet another reminder that stress, especially during early life, can be just as harmful to our health as smoking or fast food (Blackburn & Epel, 2012).
Source: CNX OpenStax
Additional Materials (15)
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Stress & Aging
Scientists are making great strides in learning how stress ages us. At the very ends of each chromosome is a zone called the telomere. It has been likened to the tip of a shoelace, keeping the end material from unraveling. Each time a cell divides, the telomere becomes a bit shorter, which means that as we age the telomeres are fraying. In recent years, researchers have found that people under extraordinary stress tend to have shortened telomeres, a sign that stress prematurely ages our cells.
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Burnout (psychology)
Stress Compromises Memory Learning : The telomere at the end of each chromosome prevents the genetic material from unraveling. In recent years, researchers have found that people under extreme stress tend to have shortened telomeres, a sign that stress prematurely ages our cells. Now, researchers are delving into the mysteries of telomeres. They want to find out why some people under great stress do not seem to have shorter telomeres.
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Stress & Aging
Stress & Aging : Scientists are making great strides in learning how stress ages us. At the very ends of each chromosome is a zone called the telomere. It has been likened to the tip of a shoelace, keeping the end material from unraveling. Each time a cell divides, the telomere becomes a bit shorter, which means that as we age the telomeres are fraying.
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Stress and Aging
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Why We Age - And How We Can Stop It
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The Science of Aging
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Stress less, age less: Study finds stress accelerates immune aging
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Stress Causes Gray Hair
Woman in distress
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Woman in distress
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How Stress Causes Gray Hair
A new study shows that stress really can give you gray hair. Researchers found that the body’s fight-or-flight response plays a key role in turning hair gray.
Your hair color is determined by pigment-producing cells called melanocytes. New melanocytes are made from melanocyte stem cells that live in the hair follicle at the base of your hair strand.
As we age, these stem cells gradually disappear. The researchers showed that stress also leads to the loss of these pigment-producing stem cells in mice.
Nerves in your sympathetic nervous system—which is responsible for the body’s fight-or-flight response—go throughout the body, including into hair follicles. The study showed that stress causes the release of the chemical norepinephrine into the follicle.
Norepinephrine affects the melanocyte stem cells living there. It causes them to rapidly turn into pigment cells and move out of the hair follicles. Without stem cells left to create new pigment cells, new hair turns gray or white.
“When we started to study this, I expected that stress was bad for the body—but the detrimental impact of stress that we discovered was beyond what I imagined,” says Dr. Ya-Chieh Hsu of Harvard University, who led the study. “After just a few days, all of the melanocyte stem cells were lost. Once they’re gone, you can’t regenerate pigments anymore. The damage is permanent.”
Source: NIH News in Health
Managing Stress
Managing stress and your cortisol - Making Choices
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Managing stress and your cortisol - Making Choices
Stress can be a major factor in depression and anxiety, which frequently occur together. If you have depression it makes sense to alleviate stress as much as possible. Physiological stress is brought on by the action of your sympathetic nervous system. When you feel threatened or are in a dangerous situation, the sympathetic nervous system’s “fight or flight” response takes over. This happens primarily through adrenergic stimulation, which involves the neurotransmitters epinephrine (adrenaline), norepinephrine (noradrenaline), and others. Activation of the hypothalamic-pituitary-adrenocortical (HPA) axis produces the “stress hormone,” cortisol.
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How Can I Manage Long-Term Stress?
Simple things that improve your mental health may be helpful in managing long-term stress, such as:
Get regular exercise. A 30-minute daily walk can help you feel better and help keep your immune system strong, so you don't get sick.
Try relaxing activities. You could look for an app or wellness program that uses breathing, meditation, or muscle relaxation exercises.
Get enough sleep every night.
Avoid too much caffeine.
Decide what you need to do now and what can wait. And focus on what you got done each day, not on what you weren't able to do.
Ask your family or friends for support.
Source: National Institute of Mental Health (NIMH)
Additional Materials (7)
Beat Stress with Better Sleep Habits
Beat Stress with Better Sleep Habits : We need sleep to cope with stress. Even if we miss a few hours of sleep one night, our natural stress response is affected, and our cortisol levels are higher than usual the next day. In one study, people deprived of sleep for 32 hours had a 45% increase in cortisol! Sleep has also been shown to help people rebound from stressful experiences. If you are over 18, aim to get at least 7 hours of sleep per night- 8 or 9 hours, if you don`t feel alert and energized when you wake up.
Image by TheVisualMD
Foods for Stress management
Beat Stress with Healthier Foods : Some foods rich in amino acids and vitamins that stimulate the release of the calming neurotransmitter serotonin can help alleviate stress. When you read the labels or check out nutrition information on your favorite foods, look for such ingredients as tryptophan, omega-3 fatty acids, vitamins B6 and B12 , folic acid, and melatonin.
Image by TheVisualMD
Beat Stress with Healthier Foods
Did you know that choosing the right foods can combat the effects of stress? Tryptophan - This amino acid is a precursor to the neurotransmitter serotonin and the hormone melatonin, two calming biochemicals. What food is richest in tryptophan? Sea lion kidneys. (If your tastes aren't that exotic, you can find it in seaweed, soy, eggs and sesame seeds.)Omega-3s - These fatty acids help control stress-related hormones and are nutritionally beneficial to your cardiovascular system as well. Find them in cold-water oily fishes (salmon, herring, mackerel, anchovies, sardines) as well as seaweed, walnuts, and flaxseeds.Vitamin B6 - This vitamin helps the body build such neurotranmitters as serotonin, and may help boost immunity. Find it in chicken breast, yellowfin tuna, bell peppers, spinach, peanuts, beans, legumes, and whole grains.Vitamin B12 - B12 is key to serotonin and melatonin production. Foods high in vitamin B12 include shellfish, liver, meats, and any of the fishes high in omega 3s.Folic acid - Also known as vitamin B9 or folate, folic acid is an essential vitamin (the body can't produce it alone). It helps fight depression and fatigue. Eat liver, herbs, sunflower seeds, edamame, dark leafy greens, and beans to get adequate B9.Melatonin - This hormone regulates your sleep-wake cycle and has calming effects. Oats, dairy foods and rice contain small amounts, but to really affect your melatonin levels you should also eat foods high in tryptophan, which is melatonin's precursor.L-theanine - This amino acid derivative is shown to lower blood pressure and reduce stress. Find it in green teas and bay bolete mushrooms.
Image by TheVisualMD
Beat Stress with Mindful Awareness
Meditation, yoga, group therapy—find the area of focus that helps you overcome stress. What is mindful awareness? It is, at heart, a catch-all term for many activities that emphasize focus on your physical, mental and emotional being. Yoga, various forms of meditation, tai chi, positive visualization, and different kinds of therapy all have in common the goal of quieting the mind, paying attention to the body, and restoring the spirit. That may sound unscientific, or even antiscientific, when in fact the scientific evidence for the benefits of mindful awareness practices are growing by the day. Group Therapy: One of the most stressed out populations in the modern world, military combat veterans with post-traumatic stress disorder, were found to benefit from a group therapy structure that required them to share their experiences with other vets. Groups of 9 to 11 troops spent a total of 60 or more hours together over 18 weeks, discussing their wartime memories and other aspects of their lives. Each gave two 2 ½-hour talks about their experience, and listened to recordings of their presentations 10 times. An impressive 81 percent of participants showed “clinically significant improvement” in stress symptoms after the group experience, an effect that remained steady six months after the group adjourned. For some, just hearing that others had frozen under fire or felt helpless alleviated the guilt or shame they had felt about doing the same. The power of group counseling is often in discovering that others who have faced the same kind of stress you face have found ways to cope, and are working to improve, just as you are. Meditation: In a study, 133 healthy adults volunteered to learn meditation techniques to reduce stress. They took a variety of mood and psychological assessments. Then they learned a simple meditation technique involving focusing on a single, meaningful word, called a mantra. The students met four times for one hour each meeting in small groups, and were instructed to practice the meditation for 15-20 minutes twice a day. After the instruction period, student scores on the mood and psychological assessments improved. Their perceived stress, mood states, anxiety inventory and brief symptom inventory scores all improved. Those who had practiced most frequently had the greatest improvement. Yoga: Emotionally distressed women volunteered to participate in a 3-month yoga program to relieve stress. The subjects took multiple assessment tools to measure their perceived stress, anxiety, mood, relative depression, well-being, physical status and more. Their levels of salivary cortisol, the stress hormone, were also measured. They met twice a week for a 90-minute Iyengar yoga class. Compared with volunteers who had been put on a waiting list for the class, the yoga students showed pronounced improvements in all of the assessment areas measured. Their cortisol levels dropped after participation in a class, and those who had suffered from headache or back pain reported significant pain relief. Choosing a Practice: Mindful awareness is about your individual mind, stressors and lifestyle. Find an approach that appeals to you, and see if you can sit in on a class or group meeting before committing to an intervention. The medical establishment has not always accepted the notion that some of these practices could improve your health and longevity. But all of that is changing in the face of compelling research about the connections between the mind and body.
Image by TheVisualMD
Managing Stress
Stress is all too natural. But here are some tips for keeping it under control.
Image by TheVisualMD
Stress management - Beat Stress with Mindful Awareness
Beat Stress with Mindful Awareness : Mindful awareness is a catch-all term for activities that emphasize focus on your physical, mental and emotional state. Yoga, various forms of meditation, tai chi, positive visualization, group counseling and therapy all have in common the goals of quieting the mind, focusing on the body, and restoring the spirit to relieve stress. The scientific evidence of the benefits of mindful awareness grow by the day.
Image by TheVisualMD
Stress management - Beat Stress with Friendship & Community
Beat Stress with Friendship & Community : Whether you spend time with your friends exercising, sharing a meal, or swapping stories about your stressful day, you are relieving stress. In a Dutch study, fourth-grade kids who had been excluded or rejected at school were found to have elevated levels of cortisol during the school day. They also had a smaller decline in cortisol over the course of a day than their peers who were hanging out with friends.
Image by TheVisualMD
Beat Stress with Better Sleep Habits
TheVisualMD
Foods for Stress management
TheVisualMD
Beat Stress with Healthier Foods
TheVisualMD
Beat Stress with Mindful Awareness
TheVisualMD
Managing Stress
TheVisualMD
Stress management - Beat Stress with Mindful Awareness
TheVisualMD
Stress management - Beat Stress with Friendship & Community
TheVisualMD
Relaxation Techniques
Sleep Helps Control Stress
Image by TheVisualMD
Sleep Helps Control Stress
Your stress hormone levels plummet when you sleep. Those who get enough sleep report fewer negative moods and less stress.
Image by TheVisualMD
5 Things To Know About Relaxation Techniques for Stress
When you’re under stress, your body reacts by releasing hormones that produce the “fight-or-flight” response. Your heart rate and breathing rate go up and blood vessels narrow (restricting the flow of blood). Occasional stress is a normal coping mechanism. But over the long-term, stress may contribute to or worsen a range of health problems including digestive disorders, headaches, sleep disorders, and other symptoms.
In contrast to the stress response, the relaxation response slows the heart rate, lowers blood pressure, and decreases oxygen consumption and levels of stress hormones. In theory, voluntarily creating the relaxation response through regular use of relaxation techniques could counteract the negative effects of stress.
Relaxation techniques are generally safe, but there is limited evidence of usefulness for specific health conditions. Research is under way to find out more about relaxation and health outcomes.
Relaxation techniques include a number of practices such as progressive relaxation, guided imagery, biofeedback, self-hypnosis, and deep breathing exercises. The goal is similar in all: to consciously produce the body's natural relaxation response, characterized by slower breathing, lower blood pressure, and a feeling of calm and well-being.
Relaxation techniques often combine breathing and focused attention to calm the mind and the body. These techniques may be most effective when practiced regularly and combined with good nutrition, regular exercise, and a strong social support system.
Most relaxation techniques can be self-taught and self-administered. Most methods require only brief instruction from a book or experienced practitioner before they can be done without assistance.
Do not use relaxation techniques as a replacement for conventional care or to postpone seeing a doctor about a medical problem. Talk to your health care providers if you are considering using a relaxation technique for a particular health condition. This will help ensure coordinated and safe care.
Source: National Center for Complementary and Integrative Health (NCCIH)
Additional Materials (10)
How to understand stress | Stress Patterns | British Red Cross
Video by British Red Cross/YouTube
How Chronic Stress Harms Your Body
Video by SciShow Psych/YouTube
The United States of Stress: The Shocking Rise of Chronic Stress
Video by Everyday Health/YouTube
Exercises for Stress Reduction & Deep Relaxation - Part 1 of 4 - Introduction
Video by UHNToronto/YouTube
Box breathing relaxation technique: how to calm feelings of stress or anxiety
Video by Sunnybrook Hospital/YouTube
How to relax | 8 relaxation tips for your mental health
Video by Mind, the mental health charity/YouTube
Reduce Stress through Progressive Muscle Relaxation (3 of 3)
Video by Johns Hopkins Rheumatology/YouTube
Keeping Blood Pressure Healthy
Being stressed all the time raises your blood pressure because stress elevates levels of corticosteroids, the "stress hormones." Stress management lowers blood pressure and glucose levels and also helps with depression and anxiety. Being overweight or obese makes hypertension worse. Losing as little as 5 lbs can have a significant effect, and losing 10 lbs or more can lower pressure as much as many blood pressure medications. Not getting enough sleep is linked to hypertension. Sleep helps to regulate stress hormones and maintains the health of the nervous system. If you don`t get 7-8 hours of sleep a night, make an effort to do so.
Image by TheVisualMD
Calming Diabetes
Many people don’t realize that stress can greatly increase blood glucose levels. There are different types of stress. Stress may be physical, like having a cold or an injury. It may be mental, like worrying about finances. Stress causes the release of numerous hormones, like cortisol and epinephrine, and they in turn raise blood sugar levels. Because insulin doesn’t function properly in someone with diabetes, the excess glucose isn’t admitted into target cells and blood sugar levels continue to rise. Chronic stress keeps glucose continuously elevated. In addition, stress may cause someone to not take care of themselves—for instance, to start smoking again, drink too much alcohol or not check their glucose levels.
Image by TheVisualMD
Calming Diabetes
Many people don’t realize that stress can greatly increase blood glucose levels. There are different types of stress. Stress may be physical, like having a cold or an injury. It may be mental, like worrying about finances. Stress causes the release of numerous hormones, like cortisol and epinephrine, and they in turn raise blood sugar levels. Because insulin doesn’t function properly in someone with diabetes, the excess glucose isn’t admitted into target cells and blood sugar levels continue to rise. Chronic stress keeps glucose continuously elevated. In addition, stress may cause someone to not take care of themselves—for instance, to start smoking again, drink too much alcohol or not check their glucose levels.
Image by TheVisualMD
1:33
How to understand stress | Stress Patterns | British Red Cross
British Red Cross/YouTube
5:36
How Chronic Stress Harms Your Body
SciShow Psych/YouTube
8:18
The United States of Stress: The Shocking Rise of Chronic Stress
Everyday Health/YouTube
10:43
Exercises for Stress Reduction & Deep Relaxation - Part 1 of 4 - Introduction
UHNToronto/YouTube
2:48
Box breathing relaxation technique: how to calm feelings of stress or anxiety
Sunnybrook Hospital/YouTube
4:45
How to relax | 8 relaxation tips for your mental health
Mind, the mental health charity/YouTube
5:54
Reduce Stress through Progressive Muscle Relaxation (3 of 3)
Johns Hopkins Rheumatology/YouTube
Keeping Blood Pressure Healthy
TheVisualMD
Calming Diabetes
TheVisualMD
Calming Diabetes
TheVisualMD
Coping Tips
Man with visible Anatomy doing Yoga
Image by TheVisualMD
Man with visible Anatomy doing Yoga
A man is shown outdoors, seated in a meditative pose, wearing dark shorts and shirt. His eyes are closed and his palms face upward as he sits cross-legged on a stone. He has some visible abdominal anatomy. The image supports content about the health benefits of mindful awareness, faith, focus on the spirit and other aspects of one's inner life.
Image by TheVisualMD
Coping With Stress
Many of us are facing challenges that can be stressful, overwhelming, and cause strong emotions in adults and children. Public health actions, such as social distancing, can make us feel isolated and lonely and can increase stress and anxiety.
After a traumatic event, people may have strong and lingering reactions. Learning healthy ways to cope and getting the right care and support can help reduce stressful feelings and symptoms.
The symptoms may be physical or emotional. Common reactions to a stressful event can include:
Disbelief
Feelings of fear, shock, anger, sadness, worry, numbness, or frustration
Changes in appetite, energy, desires, and interests
Difficulty sleeping or nightmares, concentrating, and making decisions
Physical reactions, such as headaches, body pains, stomach problems, and skin rashes
Worsening of chronic health problems
Worsening of mental health conditions
Increased use of tobacco, alcohol, and other substances
It is natural to feel stress, anxiety, grief, and worry during traumatic events such as mass shootings, natural disasters, or pandemics. Below are ways that you can help yourself, others, and your community manage stress.
Healthy Ways to Cope with Stress
Feeling emotional and nervous or having trouble sleeping and eating can all be normal reactions to stress. Here are some healthy ways you can deal with stress:
Take breaks from watching, reading, or listening to news stories, including those on social media. It’s good to be informed but hearing about the traumatic event constantly can be upsetting. Consider limiting news to just a couple of times a day and disconnecting from phone, tv, and computer screens for a while.
Take care of yourself. Eat healthy, exercise, get plenty of sleep, and give yourself a break if you feel stressed out.
Take care of your body.
Take deep breaths, stretch, or meditate.
Try to eat healthy, well-balanced meals.
Exercise regularly.
Get plenty of sleep.
Avoid excessive alcohol, tobacco, and substance use.
Continue with routine preventive measures (such as vaccinations, cancer screenings, etc.) as recommended by your healthcare provider.
Get vaccinated against COVID-19 as soon as possible; get a booster shot if you are age 18 or older.
Make time to unwind. Try to do some other activities you enjoy.
Talk to others. Talk with people you trust about your concerns and how you are feeling. Share your problems and how you are feeling and coping with a parent, friend, counselor, doctor, or pastor.
Connect with your community- or faith-based organizations.
Avoid drugs and alcohol. These may seem to help, but they can create additional problems and increase the stress you are already feeling.
Recognize when you need more help. If problems continue or you are thinking about suicide, talk to a psychologist, social worker, or professional counselor.
Helping Others Cope
Taking care of yourself can better equip you to take care of others. During times of social distancing, it is especially important to stay connected with your friends and family. Helping others cope with stress through phone calls or video chats can help you and your loved ones feel less lonely or isolated.
Helping Children and Youth Cope with Stress
Children and youth often struggle with how to cope with stress. Youth can be particularly overwhelmed when their stress is connected to a traumatic event—like a natural disaster, family loss, school shootings, or community violence. Parents, caregivers, and educators can take steps to provide stability and support that help young people feel better.
Tips
Tips for Parents and Caregivers It is natural for children to worry when scary or stressful events happen in their lives. Talking to your children about these events can help put frightening information into a more balanced setting. Monitor what children see and hear about stressful events happening in their lives. Here are some suggestions to help children cope:
Maintain a normal routine. Helping children wake up, go to sleep, and eat meals at regular times provide them a sense of stability.
Talk, listen, and encourage expression. Listen to your child’s thoughts and feelings and share some of yours. After a traumatic event, it is important for children to feel they can share their feelings and that you understand their fears and worries.
Watch and listen. Be alert for any change in behavior. Any changes in behavior may be signs that your child is having trouble and may need support.
Stressful events can challenge a child’s sense of safety and security. Reassure your child about his or her safety and well-being. Discuss ways that you, the school, and the community are taking steps to keep them safe.
Connect with others. Talk to other parents and your child’s teachers about ways to help your child cope. It is often helpful for parents, schools, and health professionals to work together for the well-being of all children in stressful times.
Tips for Kids and Teens After a traumatic event, it is normal to feel anxious about your safety and security. Even if you were not directly involved, you may worry about whether this type of event may someday affect you. Check out the tips below for some ideas to help deal with these fears.
Talk to and stay connected to others. Talking with someone you trust can help you make sense out of your experience. If you are not sure where to turn, call your local crisis intervention center or a national hotline.
Take care of yourself. Try to get plenty of sleep, eat right, exercise, and keep a normal routine.
Take information breaks. Pictures and stories about a disaster can increase worry and other stressful feelings. Taking breaks from the news, Internet, and conversations about the disaster can help calm you down.
Tips for School Personnel School personnel can help their students restore their sense of safety by talking with the children about their fears. Other tips for school personnel include:
Reach out and talk. Create opportunities to have students talk, but do not force them. You can be a model by sharing some of your own thoughts as well as correct misinformation.
Watch and listen. Be alert for any change in behavior. Are students withdrawing from friends? Acting out? These changes may be early signs that a student is struggling and needs extra support from the school and family.
Maintain normal routines. A regular classroom and school schedule can provide a sense of stability and safety. Encourage students to keep up with their schoolwork and extracurricular activities but do not push them if they seem overwhelmed.
Take care of yourself. You are better able to support your students if you are healthy, coping and taking care of yourself first. Eat healthy, exercise, get plenty of sleep, and give yourself a break if you feel stressed out.
Source: Centers for Disease Control and Prevention (CDC)
Additional Materials (13)
17 Science-Backed Ways to Relieve Stress Right Now!
Video by The Health Nerd/YouTube
Beat Stress with Mindful Awareness
Meditation, yoga, group therapy—find the area of focus that helps you overcome stress. What is mindful awareness? It is, at heart, a catch-all term for many activities that emphasize focus on your physical, mental and emotional being. Yoga, various forms of meditation, tai chi, positive visualization, and different kinds of therapy all have in common the goal of quieting the mind, paying attention to the body, and restoring the spirit. That may sound unscientific, or even antiscientific, when in fact the scientific evidence for the benefits of mindful awareness practices are growing by the day. Group Therapy: One of the most stressed out populations in the modern world, military combat veterans with post-traumatic stress disorder, were found to benefit from a group therapy structure that required them to share their experiences with other vets. Groups of 9 to 11 troops spent a total of 60 or more hours together over 18 weeks, discussing their wartime memories and other aspects of their lives. Each gave two 2 ½-hour talks about their experience, and listened to recordings of their presentations 10 times. An impressive 81 percent of participants showed “clinically significant improvement” in stress symptoms after the group experience, an effect that remained steady six months after the group adjourned. For some, just hearing that others had frozen under fire or felt helpless alleviated the guilt or shame they had felt about doing the same. The power of group counseling is often in discovering that others who have faced the same kind of stress you face have found ways to cope, and are working to improve, just as you are. Meditation: In a study, 133 healthy adults volunteered to learn meditation techniques to reduce stress. They took a variety of mood and psychological assessments. Then they learned a simple meditation technique involving focusing on a single, meaningful word, called a mantra. The students met four times for one hour each meeting in small groups, and were instructed to practice the meditation for 15-20 minutes twice a day. After the instruction period, student scores on the mood and psychological assessments improved. Their perceived stress, mood states, anxiety inventory and brief symptom inventory scores all improved. Those who had practiced most frequently had the greatest improvement. Yoga: Emotionally distressed women volunteered to participate in a 3-month yoga program to relieve stress. The subjects took multiple assessment tools to measure their perceived stress, anxiety, mood, relative depression, well-being, physical status and more. Their levels of salivary cortisol, the stress hormone, were also measured. They met twice a week for a 90-minute Iyengar yoga class. Compared with volunteers who had been put on a waiting list for the class, the yoga students showed pronounced improvements in all of the assessment areas measured. Their cortisol levels dropped after participation in a class, and those who had suffered from headache or back pain reported significant pain relief. Choosing a Practice: Mindful awareness is about your individual mind, stressors and lifestyle. Find an approach that appeals to you, and see if you can sit in on a class or group meeting before committing to an intervention. The medical establishment has not always accepted the notion that some of these practices could improve your health and longevity. But all of that is changing in the face of compelling research about the connections between the mind and body.
Image by TheVisualMD
Emotion, Stress, and Health: Crash Course Psychology #26
Video by CrashCourse/YouTube
This browser does not support the video element.
Managing Stress
If you want to reduce the impact of stress on your health, you have to do two things: Minimize your exposure to stressful factors, and improve your response to stress. Exercise combats the effects of stress by strengthening the cardiovascular system and stimulating feel-good hormones. Building your relationships with others, sharing life's burdens and enjoying their company, also helps you bounce back more quickly from stressful experiences. Getting quality sleep and making smart nutritional choices also play a part in regulating your stress hormones and minimizing the effects of stress.
Video by TheVisualMD
Coping With Stress - Biofeedback: Self-Mastery Beyond Pills
Video by University of California Television (UCTV)/YouTube
Coping With Stress & Caring for Mental Health During COVID-19
Video by Stanford Center for Health Education/YouTube
Meditation for Stress
Video by Psych Hub/YouTube
Stress management | Processing the Environment | MCAT | Khan Academy
Video by khanacademymedicine/YouTube
Managing Stress - Brainsmart - BBC
Video by BBC/YouTube
Managing Stress
Video by American Heart Association/YouTube
Biofeedback: Managing Stress
Video by Sutter Health/YouTube
Beat Stress with Healthier Foods
Did you know that choosing the right foods can combat the effects of stress? Tryptophan - This amino acid is a precursor to the neurotransmitter serotonin and the hormone melatonin, two calming biochemicals. What food is richest in tryptophan? Sea lion kidneys. (If your tastes aren't that exotic, you can find it in seaweed, soy, eggs and sesame seeds.)Omega-3s - These fatty acids help control stress-related hormones and are nutritionally beneficial to your cardiovascular system as well. Find them in cold-water oily fishes (salmon, herring, mackerel, anchovies, sardines) as well as seaweed, walnuts, and flaxseeds.Vitamin B6 - This vitamin helps the body build such neurotranmitters as serotonin, and may help boost immunity. Find it in chicken breast, yellowfin tuna, bell peppers, spinach, peanuts, beans, legumes, and whole grains.Vitamin B12 - B12 is key to serotonin and melatonin production. Foods high in vitamin B12 include shellfish, liver, meats, and any of the fishes high in omega 3s.Folic acid - Also known as vitamin B9 or folate, folic acid is an essential vitamin (the body can't produce it alone). It helps fight depression and fatigue. Eat liver, herbs, sunflower seeds, edamame, dark leafy greens, and beans to get adequate B9.Melatonin - This hormone regulates your sleep-wake cycle and has calming effects. Oats, dairy foods and rice contain small amounts, but to really affect your melatonin levels you should also eat foods high in tryptophan, which is melatonin's precursor.L-theanine - This amino acid derivative is shown to lower blood pressure and reduce stress. Find it in green teas and bay bolete mushrooms.
Image by TheVisualMD
Sleep Helps Control Stress
Sleep Helps Control Stress : Cortisol, a key stress hormone, is hypersensitive to sleep loss. Even if we miss a few hours of sleep one night, our natural stress response is affected, and our cortisol levels are higher than usual the next day. Short-term irritability and distress result from the disruption of stress hormones as well as frustration with fatigue`s effects on motor skills and memory.
Image by TheVisualMD
4:45
17 Science-Backed Ways to Relieve Stress Right Now!
The Health Nerd/YouTube
Beat Stress with Mindful Awareness
TheVisualMD
10:20
Emotion, Stress, and Health: Crash Course Psychology #26
CrashCourse/YouTube
2:51
Managing Stress
TheVisualMD
1:28:41
Coping With Stress - Biofeedback: Self-Mastery Beyond Pills
University of California Television (UCTV)/YouTube
2:30
Coping With Stress & Caring for Mental Health During COVID-19
Stanford Center for Health Education/YouTube
6:08
Meditation for Stress
Psych Hub/YouTube
7:20
Stress management | Processing the Environment | MCAT | Khan Academy
khanacademymedicine/YouTube
2:24
Managing Stress - Brainsmart - BBC
BBC/YouTube
3:00
Managing Stress
American Heart Association/YouTube
2:53
Biofeedback: Managing Stress
Sutter Health/YouTube
Beat Stress with Healthier Foods
TheVisualMD
Sleep Helps Control Stress
TheVisualMD
Stress Catcher
Stress Catcher
Document by NIMH
Stress Catcher
The Stress Catcher is a printable, “fortune teller” craft for children that offers coping strategies to help manage stress and other difficult emotions. Instructions on how to create and use the Stress Catcher are provided.
Document by NIMH
Stress Catcher
Life can get challenging sometimes, and it’s important for kids (and adults!) to develop strategies for coping with stress or anxiety. This stress catcher “fortune teller” offers some strategies children can practice and use to help manage stress and other difficult emotions.
Create Your Stress Catcher
Download and print the PDF template, and then follow these steps to create your own personal stress catcher.
Step 1. Color the stress catcher (on page 2), and cut out the square.
Step 2. Place the stress catcher face down. Fold each corner to the opposite corner and then unfold to create two diagonal creases in the square.
Step 3. Fold each corner toward the center of the square so that the numbers and colors are facing you. Turn over the square, and again fold each corner into the center so that the color names are visible.
Step 4. Fold the square in half so that the color names are touching, and the numbers are on the outside. Now open it and fold it in half the other way.
Step 5. Insert your thumb and first finger of each hand (pinching motion) under the number flaps.
Step 6. Close the stress catcher so only the numbers show.
Use Your Stress Catcher
Pick a number, and open and close the stress catcher that number of times.
Next, pick a color and spell out the color name, opening and closing the stress catcher for each letter.
Then pick a color that is visible and open that flap.
Read what it says, and practice the coping strategy.
This game can be played with one or two players and is a way to practice coping strategies.
Source: National Institute of Mental Health (NIMH)
When to Ask for Help
Beat Stress with Better Sleep Habits
Image by TheVisualMD
Beat Stress with Better Sleep Habits
Getting enough deep sleep keeps your stress hormones in balance We need sleep to cope with stress. Even if we miss a few hours of sleep one night, our natural stress response is affected, and our cortisol levels are higher than usual the next day. In one study, people deprived of sleep for 32 hours had a 45% increase in cortisol! Sleep has also been shown to help people rebound from stressful experiences. If you are over 18, aim to get at least 7 hours of sleep per night— 8 or 9 hours, if you don't feel alert and energized when you wake up. If you have trouble sleeping, develop a nightly routine of easing into sleep with soothing activities. Try to stick to a regular bedtime and wake-up time every day.
Image by TheVisualMD
When Should I Ask My Health Care Provider for Help with Stress?
Get help if you're having severe symptoms for 2 weeks or more, including:
Trouble sleeping
Changes in your eating that cause unwanted changes in your weight
Troubles getting out of bed because of your mood
Difficulty focusing your thoughts
Losing interest in things you usually enjoy
Not being able to do your usual daily activities
Always get help right away if stress is causing you to:
Have thoughts of harming yourself
Feel you can't cope
Use drugs or alcohol more often than usual
Your health care provider may refer you to a mental health professional such as a psychologist or social worker.
Source: National Institute of Mental Health (NIMH)
Additional Materials (5)
Depiction of a person suffering from Insomnia (sleeplessness)
Depiction of a person suffering from Insomnia (sleeplessness). The typical symptoms of Insomnia have been shown.
Image by https://www.myupchar.com
Keeping Blood Pressure Healthy
Being stressed all the time raises your blood pressure because stress elevates levels of corticosteroids, the "stress hormones." Stress management lowers blood pressure and glucose levels and also helps with depression and anxiety. Being overweight or obese makes hypertension worse. Losing as little as 5 lbs can have a significant effect, and losing 10 lbs or more can lower pressure as much as many blood pressure medications. Not getting enough sleep is linked to hypertension. Sleep helps to regulate stress hormones and maintains the health of the nervous system. If you don`t get 7-8 hours of sleep a night, make an effort to do so.
Image by TheVisualMD
Sleep Deprivation - Sleep Fights Weight Gain
Sleep Fights Weight Gain : Sleep plays a role in appetite regulation, energy use, and weight gain. Studies find that the less people sleep, the more likely they are to be overweight, and to eat foods high in calories and carbohydrates. People who report an average total sleep time of 5 or fewer hours a night are much more likely to become obese than people who sleep 7 to 8 hours a night.
Image by TheVisualMD
Sleep Helps Control Stress
Your stress hormone levels plummet when you sleep. Those who get enough sleep report fewer negative moods and less stress.
Image by TheVisualMD
Beat Stress with Better Sleep Habits
Beat Stress with Better Sleep Habits : We need sleep to cope with stress. Even if we miss a few hours of sleep one night, our natural stress response is affected, and our cortisol levels are higher than usual the next day. In one study, people deprived of sleep for 32 hours had a 45% increase in cortisol! Sleep has also been shown to help people rebound from stressful experiences. If you are over 18, aim to get at least 7 hours of sleep per night- 8 or 9 hours, if you don`t feel alert and energized when you wake up.
Image by TheVisualMD
Depiction of a person suffering from Insomnia (sleeplessness)
Send this HealthJournal to your friends or across your social medias.
Chronic Stress
Occasional stress is a normal part of life. However, chronic (long-term) stress may contribute to or worsen a range of health problems. Chronic stress negatively impacts every organ in the body, down to our cells and molecules. Read about the impacts of long-term stress and ways to cope with it.