The document discusses stress, its causes, effects on health, and management. It defines stress and outlines the body's response mechanisms. It describes acute and chronic stress and their health impacts like cardiovascular diseases, diabetes, cancer, headaches and asthma. Occupational stress and post-traumatic stress disorder are also examined. Scales for measuring stress levels and life events are provided. The summary emphasizes managing stress at the individual, family, and community levels through various coping techniques.

1. Dr. Gulrukh Hashmi
STRESS AND
HEALTH

2. Stress is the spice of life….who
would enjoy a life of no runs, no
hits and no errors?
-Hans Selye, M.D.

3. Definition
 Types of stressors
Types of stress
Body response to stress
Stress and illness
Occupational stress
Post traumatic stress disorders
 Scales to measure stress
 Stress management
Summary

4. Stress is the process by
which we perceive and
respond to certain
events that we see as
threatening or
challenging.

5. Any event or circumstance that causes stress is called
stressor.
Stressor as such does not cause stress but our
perception of that event, the meaning we attach to it and
the way we react to it leads to symptoms or diseases of
stress.
STRESSOR

6. Types of stressors

7. Biological stressors
 Any illness or disease
Disabilities
Injuries
Environmental stressors
 Poverty
Overcrowding
Natural disasters

8.  Inability to solve a problem
Coming up with creative projects
Cognitive stressors
Life change stressors
 Death of loved ones
 Divorce
Trouble among family and friends

9. Types of stress

10.  Acute Stress
Acute stress is the reaction to an immediate threat,
commonly known as the fight or flight response. The threat
can be any situation that is experienced, even
subconsciously or falsely, as a danger.
Common acute stressors include:
• noise
• crowding
• hunger

11.  Chronic stress
Frequently, however, modern life poses on-going stressful
situations that are not short-lived and the urge to act (to fight
or to flee) must be suppressed. Stress, then, becomes chronic.
Common chronic stressors include:
• on-going highly pressured work,
• long-term relationship problems,
• loneliness, and
• persistent financial worries.

12. Eustress
 It is the “good” kind of stress
Something pleasing will result at the
end of the stressful situation
Examples:
• Planning a wedding
• Planning a party
• Completing your last semester before
graduation

13. Distress
 It is a displeasing kind of stress
It is the “bad” kind of stress
It causes the most harm to the body
Examples:
Death of a loved one
 Natural disasters like earthquakes, floods
Financial problems

14.  Stress resides neither in the person alone nor in the
situation alone, but rather in a transaction between
the two.
Subjective (cognitive) interpretation of stressful
events or life changes
Transaction model

16. Fight
/flight mechanism
Walter Cannon (1932)
 When an organism
perceives threat systems of the body get activated.

17. Responses to stress

18. Seyle’s general adaptation syndrome
There are 3 stages:
1. Alarm stage :- occurs when person recognizes threat
and mobilizes resources.
2. Resistance :- occurs when the stress is prolonged
3. Exhaustion :- occurs when body‟s resources are
depleted.

20. Stress and illnesses
 PSYCHOSOMATIC DISEASES are defined as
physical ailments with a genuine organic basis that are
caused in part by psychological factors, especially
emotional distress… hypertension, ulcers, asthma, eczema,
and migraine headaches
 EMOTIONAL PROBLEMS like anger, panic, fatigue,
sleep disorders, depression, suicide/attempted suicides.

21. Two fold effects of stress

23.  Stress weakens the immune system by diverting the
energy required for its functioning to deal with the
stress.
 Cortisol, a hormone released during stressful situations,
affects the immune system greatly by preventing the
production of cytokines.
 During chronic stress, cortisol is over produced, causing
fewer receptors to be produced on immune cells so
that inflammation cannot be ended.
Stress and immunity

24. Clogging of the vessels that nourish the heart
muscles.
 Chronic stress causes
- increase in the levels of lipids
- blood to become stickier (possibly in preparation
of potential injury), increasing the likelihood of an
artery-clogging blood clot.
Stress and chronic heart diseases

25. TYPE B
 Easygoing
 Relaxed
TYPE A
 Competitive
 Hard driving
 Impatient
 Verbally aggressive
 Anger prone
Types of personalities

26.  Essential Hypertension is a condition in which there
is chronic high blood pressure, usually with no
known biological cause.
 . An individual that shows an exaggerated cardiac
response to a variety of stimuli is more likely to
develop hypertension.
Stress and hypertension

27. Stress and diabetes mellitus
 Cortisol causes
increase in blood
sugar level to help
boost energy.
 This may be
compounded by
unhealthy eating
habits.

28. The hormones released during stress response
can alter the numbers and types of immune
cells, such as T-cells and natural killer (NK)
cells produced by the body and also increase
inflammation.
 Since immunity and inflammation affect
cancer, stress is extrapolated to affect
cancer on this basis.
Stress and cancer

29.  There is intense constriction of blood
vessels supplying to brain.
 This is followed by distension to allow blood to
flow back to the brain.
 These distended blood vessel pushes on the nerve
causing headaches
Stress and headaches

30. • Asthma: Chronic inflammatory disease of the airways
in the lungs, in which the airways become constricted,
making it difficult to empty the lungs and therefore
reducing the amount of air that can be inhaled.
• Psychological factors
Stressful situations
Negative family environment
Emotional arousal
Stress and asthma

31.  It has been suggested that there occurs disturbance
in gut-brain axis.
 The large intestine becomes irritated, and its
muscular contractions are spastic rather than
smooth and wave like. The abdomen is bloated and
the patient experiences cramping and alternating
periods of constipation and diarrhea.
Stress and irritable bowel syndrome

32.  Ulcers
 Chronic Fatigue Syndrome
 Menstrual cycle disorders
 Memory loss
 Insomnia
 Kidney disorders
Other stress related disorders

33. Social problems like
1. Drug and alcohol use
2. Gambling
3. Broken/ problem families
4. Accidental injuries
5. Suicides

34.  Childhood experiences
 Personality traits
 Genetic traits
 Immunological diseases like rheumatoid arthritis
 Older adults
 Caregivers
 Divorced or widowed individuals
Risk factors for stress

35. Occupational stress
Work-related stress is the response people may have
when presented with work demands and pressures
that are not matched to their knowledge and abilities
and which challenge their ability to cope

36. Competition and rivalries
Excessive work , long hours of work or night
shift work
Drab and monotonous jobs, job insecurity.
Lack of opportunities for advancement
Unpleasant physical conditions at work.
Causes:

37. Apart from health related problems there can
be
Increased absenteeism
Industrial accidents
Irresponsibility and violence
Effects of occupational stress

38. It is a disorder that follows exposure to a life
threatening or other extreme event that caused
feelings of horror or helplessness.
 Common after
 Sexual assault, rape,
 robbery, aggravated assault
 Combat veterans
 Survivors of disasters
Post traumatic stress disorder

39. Symptoms include
•Flashbacks
•Nightmares
• Impaired concentration
• Emotional numbing
• Depression.
• Symptoms can last for years

40. Measuring stress
1. Daily hassles scale: for minor but frequent stress
2. Social readjustment rating scales: it measures the
impact of various life events
3. Face to face interviews.
4. Life experience surveys

41. Social readjustment rating scale

42. Life Events Score
 Death of spouse 100
 Divorce 73
 Marital separation from mate 65
 Detention in jail, other institution 63
 Death of a close family member 63
 Major personal injury or illness 53
 Marriage 50
 Fired from work 47
 Marital reconciliation 45
 Retirement 45
 Major change in the health or
behavior of a family member 44
 Pregnancy 40
 Sexual difficulties 39
 Gaining a new family member 39
(e.g., through birth, adoption, oldster
moving, etc.)
 Major business re-adjustment 39
(e.g., merger, reorganization,
bankruptcy)
 Major change in financial status 38
 Death of close friend 37
 Change to different line of work 36
 Major change in the number of
arguments with spouse 35
 Taking out a mortgage or loan
for a major purchase 31
 Foreclosure on a mortgage or loan30
 Major change in responsibilities at
work 29

43. Less than 150 life change units = 30% chance of
developing a stress-related illness
150 - 299 life change units = 50% chance of illness
Over 300 life change units = 80% chance of illness

44. Richard Lazarus and his colleagues have suggested
that the petty annoyances, frustrations, and
unpleasant surprises we experience every day
reduce psychological well being.
 These may add up to more grief
worsening already present illnesses.
Daily hassles scale

45. It is important to recognize early signs of stress.
 If these signs are present all the efforts should be
directed towards strengthening the coping
strategies.
Early signs of stress

46.  Frustration
 Nervousness
 Boredom
 Mood swings
 Low self esteem
 Loneliness
Emotional effects Physical effects
Headaches
Diarrhea
Insomnia
Indigestion
Back pain
Ringing in ears
Nervous twitches

47.  Not eating/ over eating
 Verbal / physical
outburst
 Smoking
 Gambling
 Driving too fast
 Constant worry
 Obsessive thoughts
 Trouble thinking
 Unable to take
decisions
 Forgetfulness
Mental effects Behavioural effects

48. Individual level
Family level
Community level
Stress management

49. Learn decision making techniques
Developing time management skills
Undertaking regular
physical exercise
Progressive muscular relaxation
Yoga and meditation
Individual level

50. Family acts as the first support system for an
individual.
Children model their parent‟s behaviours, including
those related to managing stress.
Having regular conversations can help
a family work together to better
understanding and address any stress.
Family level

51.  Focus has been more on work related stress.
 Sakhi/saheli programme under Rajiv Gandhi
scheme for empowerment of adolescent girls.
 Stress management programme in colleges.
Community level

52. 1. WHO AFMC’s Textbook of Public health and
community medicine .
2. T Bhaskar Rao „s Textbook of Community
Medicine
3. Dr. B Sridhar Rao Principles of Community
Medicine.
4. WHO India work related stress.
6. Rajiv Gandhi Scheme for empowerment of
Adolescent (Sabla) Handbook.
References

53. 6. Frans pouwer, nina kupper, marcel C adriaanse. Does
emotional stress causes diabetes mellitus type
2?review from the European depression in diabetes
research consortium.published on feb 11,2010
http://www.discoverymedicine.com/Frans-
Pouwer/2010/02/11/does-emotional-stress-cause-
type-2-diabetes-mellitus-a-review-from-the-european-
depression-in-diabetes-edid-research-consortium/
7. Mc Ewen. BSProtection and damage from acute and
chronic stress: allostasis and allostatic overload and
relevance to the pathophysiology of psychiatric
disorders.-
http://www.ncbi.nlm.nih.gov/pubmed/1567733.