stress, strssors, eustress vs distress, trauma, post-traumatic stress disorder, PTSD symptoms, burnout syndrome, burnout symptoms, doctor's burnout, broken heart syndrome, causes of broken heart syndrome

1. STRESS
DISEASES
K A R O L I N A
S Ę C Z KO W S K A

2. STRESS
Stress is defined as a state of mental
and emotional pressure or strain,
caused by challenging or unfavourable
circumstances. It is an outside force
that rules an individual’s feelings and
behaviour.
It is a person’s response to an external
factor (stimulus, known as the stressor)
in the environment and the outcome of
such reaction.

3. E U S T R E S S VS D I S T R E S S
Small amounts of stress may be desired,
beneficial, and even healthy. Positive stress
plays a factor in motivation, adaptation, and
reaction to the environment. Excessive
amounts of stress, however, may lead to
bodily harm. Stress can increase the risk of
strokes, heart attacks, ulcers, and mental
illnesses such as depression.
Is a non-specific response. It is neutral, and
what varies is the degree of response. It is all
about the context of the individual and how
they perceive the situation. A stressor is
inherently neutral meaning that the same
stressor can cause either distress or eustress. It
is individual differences and responses that
induce either distress or eustress.

4. E V E N T S O R O B J E C T S T H AT
M AY T R I G G E R A S T R E S S
R E S P O N S E M AY I N C LU D E :
1)environmental stressors: (hypo or hyper-
thermic temperatures, elevated sound levels,
over-illumination, overcrowding)
2)daily "stress" events: (e.g., traffic, lost keys,
money, quality and quantity of physical activity)
3)life changes: (e.g., divorce, bereavement)
4)workplace stressors: (e.g., high job demand
vs. low job control, repeated or sustained
exertions, forceful exertions, extreme postures,
office clutter)
5)chemical stressors: (e.g., tobacco, alcohol,
drugs)
6)social stresor: (e.g., societal and family
demands)

5. STRESS-RELATED DISORDERS AND
TRAUMA
• Stress-related disorders can include mental health disorders that are a result of an atypical
response to both short and long-term anxiety due to physical, mental, or emotional stress.
These disorders can include, but are not limited to obsessive-compulsive disorder and
posttraumatic stress disorder.
• It has long been understood that exposure to a traumatic event, particularly combat, causes
some individuals to display abnormal thoughts and behaviors that we today refer to as a
mental illness.
• The trauma- and stressor-related disorders are serious psychological reactions that develop
in some individuals following exposure to a traumatic or stressful event such as childhood
neglect, childhood physical/sexual abuse, combat, physical assault, sexual assault, natural
disaster, an accident or torture.

6. INTRUSION
SYMPTOMS
AVOIDANCE
SYMPTOMS
NEGATIVE
ALTERATIONS
HYPER-AROUSAL
SYMPTOMS
CHARACTERISTIC SYMPTOMS OF ALL OTHER TRAUMA- AND
STRESSOR-RELATED DISORDERS CAN BE PLACED INTO FOUR
BROAD CATEGORIES:

7. POST-TRAUMATIC STRESS DISORDER
(PTSD)
• Posttraumatic stress disorder (PTSD) is a psychiatric disorder that may occur in people who
have experienced or witnessed a traumatic event such as a natural disaster, a serious
accident, a terrorist act, war/combat, or rape or who have been threatened with death,
sexual violence or serious injury.
• PTSD has been known by many names in the past, such as “combat fatigue” after World
War II, but PTSD does not just happen to combat veterans. PTSD can occur in all people, of
any ethnicity, nationality or culture, and at any age. Women are twice as likely as men to
have PTSD.
• People with PTSD have intense, disturbing thoughts and feelings related to their experience
that last long after the traumatic event has ended. They may relive the event through
flashbacks or nightmares; they may feel sadness, fear or anger; and they may feel detached
or estranged from other people. People with PTSD may avoid situations or people that
remind them of the traumatic event, and they may have strong negative reactions to
something as ordinary as a loud noise or an accidental touch.

8. P T S D S Y M P TO M S
Symptoms of PTSD fall into four categories:
1)Intrusion: Intrusive thoughts such as repeated,
involuntary memories; distressing dreams; or
flashbacks of the traumatic event.
2)Avoidance: Avoiding reminders of the traumatic
event may include avoiding people, places, activities,
objects and situations that may trigger distressing
memories. People may try to avoid remembering or
thinking about the traumatic event.
3)Alterations in cognition and mood: Inability to
remember important aspects of the traumatic evet,
negative thoughts and feelings leading to ongoing
and distorted beliefs about oneself or others (e.g., “I
am bad,” “No one can be trusted”); ongoing fear,
horror, anger, guilt or shame; much less interest in
activities previously enjoyed; feeling detached or
estranged from others;
4)Alterations in arousal and reactivity: Arousal and
reactive symptoms may include being irritable and
having angry outbursts; behaving recklessly or in a
self-destructive way; being overly watchful of one's
surroundings in a suspecting way; being easily
startled; or having problems concentrating or

9. DIAGNOSOSIS OF PTSD
• For a person to be diagnosed with PTSD symptoms must last for more than a month
and must cause significant distress or problems n the ndividual's daily functioning.
• Many individuals develop symptoms within three months of the trauma, but symptoms
may appear later and often persist for months and sometimes years.
• PTSD often occurs with other related conditions, such as depression, substance use,
memory problems and other physical and mental health problems.
• The main focus of treatment is therapy, but medications are often a helpful component
of an overall plan.
• The most common types of medications used for PTSD are antidepressants. These
drugs help improve mood, decrease anxiety, and make it easier to concentrate and
even sleep. Anti-anxiety medications may also be used but less often.

10. B U R N O U T
S Y N D R O M E
According to the World Health
Organization (WHO),
occupational burnout is a
syndrome resulting from chronic
work-related stress, with
symptoms characterized by
"feelings of energy depletion or
exhaustion; increased mental
distance from one’s job, or
feelings of negativism or cynicism
related to one's job; and reduced
professional efficacy."
While burnout may influence
health and can be a reason for
people contacting health
services, it is not itself classified
by the WHO as a medical
condition or mental disorder.

11. M O S T CO M M O N
B U R N O U T
S Y M P TO M S :
Exhaustion.
Lack of energy.
Constant fatigue.
Sleep disorders.
Reduced performance.
Concentration and memory
problems.
Inability to make decisions.
Reduced initiative and
imagination

12. PHYSICIAN’S
BURNOUT
• Due to the nature of their work, physicians are exposed to chronic stress. This may
potentially lead to the widespread occurrence of occupational burnout syndrome.
• It is a three-dimensional set of symptoms that occurs fairly regularly in people employed in
occupations involving work in human services. It is characterized by emotional exhaustion,
depersonalization and a sense of low personal accomplishment.
• The increased demands on medical professionals results in decreased time spent with
patients. This reduces quality of interactions and ultimately, decline in patient care. The
average physician treats around 20 patients per day. Considering the vast range of
symptoms patients present with, the demands of the electronic health record, the business
of hospital/practice expectations, and an increasing level of responsibilities within the
workday (not to mention personal life), it makes sense that our physicians are making
diagnostic mistakes as a result of cognitive exhaustion.

13. W H AT D O E S
P H Y S I C I A N B U R N O U T
LO O K L I K E ?
Common symptoms of physician
burnout include emotional
exhaustion and detachment, high
stress, feeling useless, a sense
that work is taking over one’s life
and an increase in errors. In a
prolonged state these symptoms
can lead to depression, anxiety
and even suicidal ideation.
Approximately 300-400
physicians commit suicide yearly.
The rate of completed suicides
increases exponentially as
physicians age, compared to that
of the general public.

14. BROKEN HEART
SYNDROME
• Broken heart syndrome is a temporary heart condition that's often brought on by
stressful situations and extreme emotions. The condition can also be triggered by a
serious physical illness or surgery. It may also be called stress cardiomyopathy,
takotsubo cardiomyopathy or apical ballooning syndrome.
• People with broken heart syndrome may have sudden chest pain or think they're
having a heart attack. Broken heart syndrome affects just part of the heart, temporarily
disrupting your heart's normal pumping function. The rest of the heart continues to
function normally or may even have more forceful contractions.
• The symptoms of broken heart syndrome are treatable, and the condition usually
reverses itself in days or weeks.

15. C AU S E S O F B H S The exact cause of broken heart
syndrome is unclear. It's thought
that a surge of stress hormones,
such as adrenaline, might
temporarily damage the hearts of
some people. How these hormones
might hurt the heart or whether
something else is responsible isn't
completely clear.
A temporary constriction of the
large or small arteries of the heart
has been suspected to play a role.
People who have broken heart
syndrome may also have a
difference in the structure of the
heart muscle.
In rare cases, broken heart
syndrome is fatal. However, most
people who experience broken
heart syndrome quickly recover
and don't have long-lasting effects.
Broken heart syndrome is often preceded by an intense
physical or emotional event. Some potential triggers of
broken heart syndrome are:
• The death of a loved one
• A frightening medical diagnosis
• Domestic abuse
• Losing — or even winning — a lot of money
• Strong arguments
• A surprise party
• Public speaking
• Job loss or financial difficulty
• Divorce
• Physical stressors, such as an asthma attack, COVID-19
infection, a broken bone or major surgery! It's also
possible that some drugs, rarely, may cause broken
heart syndrome by causing a surge of stress hormones

16. H O W I S B R O K E N
H E A R T S Y N D R O M E
D I F F E R E N T F R O M A
H E A R T AT TA C K ?
Heart attacks are generally caused by a
complete or near complete blockage of a
heart artery. This blockage is due to a
blood clot forming at the site of narrowing
from fatty buildup (atherosclerosis) in the
wall of the artery. In broken heart
syndrome, the heart arteries are not
blocked, although blood flow in the
arteries of the heart may be reduced.
Prevention: Broken heart syndrome
sometimes happens again, though most
people won't experience a second event.
Many doctors recommend long-term
treatment with beta blockers or similar
medications that block the potentially
damaging effects of stress hormones on
the heart.

17. SOURCES
• https://en.wikipedia.org/wiki/Psychological_stress
• https://thriveglobal.com/stories/what-are-the-signs-and-symptoms-of-physicians-
burnout/
• https://en.wikipedia.org/wiki/Occupational_burnout#Classification
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6950131/
• https://en.wikipedia.org/wiki/Stress-related_disorders
• https://mentalhealthgateway.org/topics-resources/trauma-and-stress-related-
disorders/
• https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd
• https://en.wikipedia.org/wiki/Post-traumatic_stress_disorder#Symptoms
• https://www.bridgestorecovery.com/post-traumatic-stress-disorder/is-ptsd-curable/
• https://www.mayoclinic.org/diseases-conditions/broken-heart-syndrome/symptoms-
causes/syc-20354617

18. THANK YOU!
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