Stress is the human response to excessive demands (Stressor) which disturb physiological, social and psychological systems.

1. STRESS
Dr. P.Naina Mohamed PhD
Pharmacologist

2. INTRODUCTION
 Stress is the human response to excessive
demands (Stressor) which disturb physiological,
social and psychological systems.
 Depending on the stressor, stress can be either
negative or positive.
 Negative stress (Distress) is usually severe and is
beyond one’s control. It is characterized by physical
and mental signs and symptoms.
 Positive stress (Eustress) is always mild or
moderate. It results in to positive effects including
improved creativity, learning, efficiency at work and
a higher level of self-esteem.

3. TYPES OF STRESSORS
Internal Stressors (Emotional stressors):
 Internal stressors include anxiety, fear and personality traits.
 For example, too much worrying about the outcome of a job interview leads to
excessive perspiration, difficulty in sleeping, nail biting, etc.
External Stressors
 External stressors include Family stressors, Social stressors , Work stressors,
Change stressors, Chemical stressors, Disease stressors, Environmental stressors,
etc.
 Family stressors include family role expectations, parent-child relationships, sibling
relationships, financial struggles and ill family members.
 Social stressors include problems and challenges faced at work, school or other
places.
 Work stressors arise from workplace pressures such as an erratic boss or hectic
schedules and tight deadlines.
 Common examples of Change stressors include finding a job, moving, marriage
and pregnancy.
 Chemical stressors include alcohol, nicotine, caffeine, or tranquilizers.
 Disease stressors include being bed ridden or following a strict diet.
 Environmental stressors include pollution, noise, heat, congestion, etc.

4. ACUTE STRESS
 Acute stress is caused by the daily demands and
pressures and it occurs only at a very short period of
time.
 Acute stress brings excitement, joy and thrill. For
example, riding a roller coaster is a kind of acute stress
which brings excitement.
 The symptoms of Acute stress include:
 Emotional distress (Anger, anxiety, irritability,
and acute periods of depression)
 Physical problems (Headache, pain, stomach
upset, dizziness, heart palpitations, shortness of
breath, hypertension and bowel disorders)

5. EPISODIC STRESS
 The acute stress which is suffered too frequently is
termed Episodic stress.
 The people who have unrealistic or unreasonable
demands are suffered by episodic stress.
 Episodic stress ceases from time to time.
 The symptoms of Episodic stress include:
 Ceaseless worrying
 Longer periods of intermitted depression, anxiety
disorders and emotional distress
 Persistent physical symptoms similar to those
found in acute stress
 Coronary heart diseases, or other heart problems

6. CHRONIC STRESS
 Chronic stress is dangerous and unhealthy.
 Chronic stress is caused by long-term exposure to stressors, such as unhappy marriage, traumatic
experiences, unwanted career or job, stress of poverty, chronic illnesses, relationship conflicts, political
problems, and dysfunctional families.
 Chronic stress can induce serious illnesses like stroke, heart attack, cancer, and psychological
problems such as clinical depression and post-traumatic disorder.
 The Physical signs and symptoms of chronic stress include:
 Dry mouth
 Difficulty in breathing
 Pounding heart
 Stomach ache
 Headache
 Diaphoresis
 Frequent urination
 Tightening of muscles
 The Mental signs and symptoms of chronic stress include:
 Sudden irritability
 Tension
 Problems with concentration
 Difficulty in sleeping
 Narrowed perception
 Frequent feelings of fatigue

7. RESPONSES TO STRESS
 Physiological response to stress
 Immediate responses to stress
 Stimulation of Sympathetic adrenomedullary system
 General Adaption Syndrome
 Psychological response to stress
 Direct Action – Deal with actual problem
 Freezing (Anticipation of Threat)
 Aggression (Fight)
 Escape (Flight)
 Learned helplessness
 Hopelessness
 Indirect Action – Defensive strategies
 Displacement
 Repression
 Denial
 Projection
 Rationalisation
 Intellectual Isation
 Reaction formation

8. IMMEDIATE RESPONSE TO STRESS
Brain
Immediate response to stress
Stimulation of Adrenal Medulla
Release of Epinephrine and
Norepinephrine

9. SYMPATHETIC ADRENOMEDULLARY SYSTEM
Stress
Initiation of “Fight or Flight" response (Complex
reaction of neurologic and endocrinologic
systems)
Release of Catecholamine hormones
(Adrenaline or Noradrenaline)
Acceleration of heart and lung action
Paling or flushing
Vasoconstriction in many parts of the body
Liberation of nutrients for muscular action
Inhibition of the lacrimation and salivation
Dilation of pupil
Relaxation of bladder
Inhibition of erection
Auditory exclusion (Loss of hearing)
Tunnel vision (Loss of peripheral vision)
Shaking

10. GENERAL ADAPTATION SYNDROME (GAS)
 General Adaption Syndrome is connected with prolonged
stress.
 The GAS model was presented by by Hans Selye.
 Stages of GAS include…
 Alarm Stage - Increased sympathetic-medullary and
adrenocortical activity
 Resistance Stage - Repeated exposure to the source of
stress allows the organism to adapt to the situation.
There is an increase in adrenocortical activity.
 Exhaustion Stage – Continuous exposure to the same
source of stress, produces Exhaustion phase at the
final stage.

11. DIRECT ACTION
Freezing:
 A state of immobility occurs in freezing.
 Freezing arises in antlcipation of threat.
Aggression (Fight):
 Aggression occurs in response to noxious situations.
 Aggression may be directed towards an object, an individual or an
institution.
Escape (flight):
 Escape (flight) may include psychological variants such as day
dreaming, physical withdrawal from a stressful situation and
suppression of unpleasant thoughts and experiences.
 The child who runs out of the dentist's waiting room demonstrates
the fear escape syndrome.
 Aggression (fight) and Escape (flight) occur in the presence of threat.

12. DIRECT ACTION
 The responses such as learned helplessness and
hopelessness may be more suitable on some occasions,
than Aggressive (Fight) or Escape (Flight) behaviour.
Learned Helplessness:
 When a person perceives that he has no control of a
situation, the feelings of helplessness will develop.
Hopelessness (Depression):
 Chronic exposure to stress can lead to depression.
 Depressed people exhibit indifference, detachment and
inactivity, or at least partial inactivity.

13. INDIRECT ACTION
Displacement:
 The unattainable motive may be directed into different forms of
expression, in displacement.
 The displacement provides the most acceptable method of coping
with aggression and sex.
Repression:
 Repression is a form of defence against internal threat.
 In repression, the stressful memories are removed from conscious
awareness.
 Repression takes place unconsciously.
 The disturbing memories may be repressed for months or even years
in Amnesia following a sudden traumatic experience.
Denial:
 To reduce anxiety for a while, denial can be very useful.
 Denial provides brief opportunity to prepare for facing the fact.

14. INDIRECT ACTION
Projection:
 Projection is an unconscious mechanism which assists a
person’s unwillingness to acknowledge his undesirable
qualities and enables a person to transfer his own
undesirable qualities to other people.
 For example, when a person feels anxious due to
pressure placed on the ego, he will try to reduce his
anxiety by looking for external causes.
Rationalization:
 Rationalization means finding a suitable excuse for doing
something rejected by the superego.
 It also means replacing a socially unacceptable motive by
acceptable one.

15. INDIRECT ACTION
Intellectual Isation:
 Intellectual Isation is an emotional detachment obtained
from a threatening situation, by treating it in intellectual
terms.
 Surgeons cannot help close relatives due to their
emotional relationship.
Reaction Formation:
 Reaction formation is a mechanism which hides the
offensive impulse and promotes the opposite one.
 For example, a person uses love to conceal hatred.
 The mother of an unwanted child may lavish love on the
child, which enables the mother to mask her feelings of
guilt, and reassures her that she is being a good mother.

16. REFERENCES
 STRESS - The hidden adversary
Clifford B. Dobson
 Mechanisms of Physical and Emotional Stress
George P. Chrousos, D. Lynn Loriaux, Philip W. Gold
 Cytokines, Stress and Depression
Robert Dantzer, Emmanuelle E. Wollman, Raz Yirmiya
 Perspectives on Stress and Stress-Related
Topics
F. Lolas, H. Mayer