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Stress Across Life: Biological
Biological Correlates of Stress
Prof. Hani Hamed Dessoki, M.D.Psychiatry
Chairman of Psychiatry Department
Beni Suef University
Supervisor of Psychiatry Department
Selye (1937) pioneered the field
Nonspecific, stereotypic responses to
General adaptation syndrome.
Relationship between stressors &
Association between increased
population density and activation of the
pituitary-adrenal axis .
Since then, growing awareness of influence
of stress on physiology and behavior.
Stress is an enescapable fact of life
What is STRESS ?
Stress is a state resulting from events
(stimuli) of external or internal origin,
real or imagined that tend to affect the
Overview of Terminology
Stress: A state of disharmony or a threat to
Physiological changes increase alertness, focus, and energy
Perceived demands may exceed the perceived resources
Coping: The ability to maintain control, think
rationally, and problem solve
Resilience: Resistant quality that permits a
person to recovery quickly and thrive in spite of
Manageable Stress can lead to growth and enhanced
Uncontrollable, prolonged, or overwhelming stress is
Immediate response to a threat or challenge
Ongoing exposure to stress, may seem unrelenting
Events having direct
toxic substance, etc.
Failure to achive
Dath of loved ones,
financial problems, etc.
Social : Financial problems, dominance , hierarchy
insult, loss of self esteem.
Occupational : Work place problems, insufficient pay, uneasy
relationship with coworkers.
Life stressors: Parking place problems, running late, dealing
Spouse/children, divorce, isolation.
Spiritual : Meaning and purpose of life,
belief in higher power, loss of values.
Physical and Psychological stressors are often intertwined.
GASTROINTESTINALMETABOLIC CARDIOVASCULAR REPRODUCTIVE GROWTH AND REPAIR IMMUNE
METABOLIC CARDIOVASCULAR GASTRO INTESTINAL GROWTH & REPAIR IMMUNE REPRODUCTIVE
Increased heart rate
and blood pressure to
speed delivery of
glucose and oxygen to
tissues that need it
glycogen and proteins
are degraded and
converted in to
How these changes are induced ?
CNS : Activation of Sympathetic nervous system,
catecholamines excite cells/tissues.
Endocrine: CRH, ACTH, Glucocorticoids, Adrenalin,
What is the role of
A natural pain killer.
Inhibits synaptic transmission to prevent pain
In the absence of -endorphin stress response
Stages of the Stress Response
General Adaptation Syndrome of Hans Selye (1907-1982)
Alarm—when one feels threatened
Activation of the fight or flight reaction
Resistance—mobilization of resources to solve
Continued stress causes adaptation
Adaptation fails and level of function decreases
Models for Understanding Stress
The General Adaptation Model
Maintaining stress and adaptive responses over the long term implies high
levels of activation of the homeostatic processes
This causes wear and tear, called 'allostatic load'.
See Selye's General Adaptation Syndrome diagram showing the level of
endocrine response mounted:
Body is at depleted state
Must rest in order to recover
If stress continues without recovery or exhaustion =
perpetuation of illness
Stahl S M, Essential
Stahl S M, Essential
Coping With Stress
Intentional efforts to change an uncomfortable situation
Acknowledging stress directly and initiating a solution
Choosing a more realistic goal when an ideal goal cannot be met
Avoiding a situation when other options are not practical
Notional model of emotions that arise from
the balance between level of challenge
and a person’s coping ability
The Role of Epigenetic Modulation
in Major Depression and Schizophrenia
Champagne et al. 2005; Copyright Elsevier (2005).
Maternal care Social experiences
Epigenetic modifications 1
AdultFertilization Pre-natal Postpartum Post-weaning
Epigenetic modifications 2
Stress and Ageing
Psychological stress is linked to oxidative
damage of DNA and other cellular components
Study of Blackburn & her colleagues
Selected 58, normal, healthy mothers
19 Controls : Problem free children
39 Stress group: Chronically ill child
Blood samples were drawn and 3 parameters of
cellular ageing analyzed:
1. Telomere length : Women with perceived
stress had shorter
telomeres, extent of
shortening was equal to
10 years of additional
About 50% less in
3. Oxidative stress : Higher in stressed
A telomere is a region of repetitive nucleotide sequences at each
end of a chromatid, which protects the end of the chromosome from
deterioration or from fusion with neighboring chromosomes. Its name
is derived from the Greek nouns telos (τέλος) 'end' and merοs
(μέρος, root: μερ-) 'part.' Telomere regions deter the degradation
of genes near the ends of chromosomes by allowing chromosome
ends to shorten, which necessarily occurs during chromosome
Without telomeres, the genomes would progressively lose
information and be truncated after cell division because the
synthesis of Okazaki fragments requires RNA primers attaching
ahead on the lagging strand.
Over time, due to each cell division, the telomere ends become
The study showed only an association between depression and shorter telomeres, and didn't prove a
cause-and-effect link. The researchers said they aren't entirely sure what the shorter telomeres
might mean in depression.
On one hand, study author Josine Verhoeven said, it could be that having shorter telomeres somehow
sets a person up for mental troubles. But it's more likely that depression causes damage that
leaves traces even at the cellular level, she said.
Depression is known to disrupt many physical systems. It alters hormones, suppresses the
immune function and changes how nerves work. People with a history of depression have
greater risks for diseases of aging, such as heart disease, type 2 diabetes, dementia and
"Results like ours suggest that psychological distress, as experienced by depressed persons, has a
large, detrimental impact on the wear and tear of a person's body, resulting in accelerated
biological aging," said Verhoeven, a doctoral researcher at VU University Medical Center in
study was published online Nov. 12 in the journal Molecular Psychiatry.
One expert said the study is significant in the number of people it involved.
"The strength of this report is its size," said Etienne Sibille, an associate professor of psychiatry at the University of
Pittsburgh. He is studying how depression ages the brain.
Sibille said previous research on the same question had mixed results -- probably because the studies were too limited
to pick up the effect, which is small and varies from person to person.
"It's a small effect, but it's real," he said.
The next question science needs to answer, Sibille said, is whether telomere shortening really matters and if reversing
it could improve health. Other studies have shown that a healthier diet, exercise and measures to control stress
may lengthen telomeres.
"It's just not known whether it has an impact on cell function," he said. "If that's the case, it has potential therapeutic
Head to the U.S. Centers for Disease Control and Prevention for more on healthy aging.
SOURCES: Josine Verhoeven, doctoral researcher, VU University Medical Center, Amsterdam, Netherlands; Etienne
Sibille, Ph.D., associate professor, department of psychiatry, University of Pittsburgh; Nov. 12, 2013, Molecular
1. Proper diet, exercise & relaxation.
Avoid hurry, Worry & curry.
2. Yoga: Flexing & bending of body parts along
with controlled breathing does not cause fatigue
like aerobic exercise.
3. Pranayama: Regulated deep breathing, rich
oxygen supply - relieves of stress.
4. Meditation: Relaxation of body & mind : reduces
5. Accept reality, accept you can not change.
6. Avoid personal confrontation.
7. Humor: Takes sting out of stress.
"Stress reactivity is better understood as the result of intertwined
biological and psychological processes that ultimately ensure an
"There is a cost to frequent physiological adjustments (allostatic
“One of the most interesting findings emerging from the research ...
is that in the absence of supportive care, stressors experienced
during sensitive periods of development can ... leave permanent
imprints in the neural substrate of emotional and cognitive
processes. ... the nervous system of mammals carries their singular
epigenetic history and expresses it in unique but predictable ways”.