Stress occurs due to events beyond our control like frustrations, other people's behavior, work, health issues, and misunderstandings. The severity of the anxiety and emotional response to stress depends on how severe the stress is and an individual's ability to handle stress. Psychological interventions target stress through rational thinking and being flexible. The response to stress involves changes in neurophysiology and hormones like cortisol. There are three components to the psychological response to stress: an emotional response with physical symptoms, a coping strategy, and defense mechanisms. Coping strategies like problem solving or reducing emotions can be healthy or maladaptive like substance abuse. Defense mechanisms are unconscious responses used in stressful situations like repression, denial, or projection. Stress can lead

2. STRESS
HAPPENS
When events are
beyond our control

3. COMMON EVENTS
Little Frustrations
Other Peoples’
BehaviorWork
Health Issues
Money
Misunderstandings

4. Stress provokes anxiety and emotional
response in almost every individual
Severity of anxiety and emotional response
depends on two main determinants
• Severity of stress
• Individuals ability to handle stress

5. Psychological
interventions
target stress

6. Rational thinking

10. Be flexible
in life

12. But …. How the
therapy works?
And
what changes are
produced in
stress?

13. Responses to stress

20. Stress & Changes in Neurophysiology

21. Impact of stress

23. Diurnal variation of Stress hormones

24. Cortisol: Metabolic responses

25. Stress response

28. Psychological response to stress
Response to stressful event has 3
components
An emotional response (with some physical
symptoms)
A coping strategy
A defense mechanism

29. Emotional response and physical symptoms
Anxiety response
• Autonomic arousal
• Apprehension
• Irritability
• Tachycardia and
palpitation
• Increased muscle tension
• Dryness of mouth
Depressive response
• Pessimistic thinking
• Sadness of mood
• Reduced physical activity
Emotional responses are usually of two kinds.

30. Emotional response
•Events that pose
a threat
Anxiety responses
are usually
associated with
•events that
involve
separation or loss
Depressive
responses are
usually associated
with

31. Emotional response
Emotional
response of stress,
in long run lead to
•Anxiety disorders
•Depression

32. Coping strategy
•Attenuates the
emotional and
somatic response
•Maintains normal
performance in
time
Healthy
coping
strategy

33. Coping strategy
Coping strategies are of two types
Problem
solving
strategies
Emotion
reducing
strategies

34. Coping strategy
Problem solving strategies
Seeking help
Obtaining information or advice
Solving problems
Confrontation

35. Coping strategy
Emotion reducing strategies
Ventilation of emotion
Evaluation of problem
Positive reappraisal of the problem
Avoidance of the problem

36. Coping strategy
•Substance abuse
(alcohol /
benzodiazepine)
•Deliberate self-harm
•Unrestrained display of
feelings ( abusiveness)
•Aggressive behavior
Maladaptive
coping
strategy
leads to

37. Defense mechanisms
Defense mechanisms are
unconscious response to
external stressors as well
as anxiety arising from
internal conflict

38. Defense mechanisms
Defense
mechanisms
used in
stressful
situations-
• Repression – forgetting the
painful
thought/event/experience
• Denial – denying the painful
thought/event/experience
• Displacement – transfer of
emotions to a neutral source
• Projection –attributes to
another person for negative
emotions
• Regression – adoption of
childlike behaviour

39. Defense mechanisms
Excessive use of these
defense mechanisms
lead to maladaptive
behaviour pattern

40. Stress related physical disorders
Cardiovascular – hypertension , myocardial infarction
Respiratory – bronchial asthma
Endocrinal – thyroid abnormalities, diabetes
Gastro-intestinal – peptic ulcer, irritable bowel syndrome
Accidents
Others – cancers, rheumatoid arthritis, migraine, obesity

41. Stress related psychiatric disorders
Substance abuse disorders
Acute psychosis
Schizophrenia
Mood disorders ( depression / mania)
Anxiety disorders
Dissociative disorders
Somatoform disorder
Personality disorder
Sexual dysfunction
Conduct disorder
Oppositional defiant disorder
Memory disturbances

42. Management outlines
Pharmacological treatment
• Counseling
• Psychotherapy
• Behaviour therapy
• Biofeedback
Non –
pharmacological
treatment

43. Management outlines
Non pharmacological
management is the
mainstay of treatment