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In
psychology Psychology is the scientific Science () is a systematic enterprise that builds and organizes knowledge Knowledge is a familiarity or awareness, of someone or something, such as facts A fact is an occurrence in the real world. ...

psychology
, stress is a
feeling Feeling was originally used to describe the physical sensation of touch through either experience or perception. The word is also used to describe other experiences, such as "Emotion, a feeling of warmth" and of sentience in general. In psychology ...

feeling
of emotional strain and pressure. Stress is a type of
psychological pain Psychological pain, mental pain, or emotional pain is an unpleasant feeling (a suffering) of a psychological, non-physical origin. A pioneer in the field of suicidology, Edwin S. Shneidman, described it as "how much you hurt as a human being. It i ...
. Small amounts of stress may be beneficial, as it can improve athletic performance,
motivation Motivation is what explains why people or animals initiate, continue or terminate a certain behavior at a particular time. Motivational states are commonly understood as forces acting within the agent that create a disposition to engage in goal-d ...

motivation
and reaction to the environment. Excessive amounts of stress, however, can increase the risk of
stroke A stroke is a medical condition A disease is a particular abnormal condition that negatively affects the structure or function (biology), function of all or part of an organism, and that is not due to any immediate external injury. Di ...

stroke
s,
heart attack A myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow Hemodynamics American and British English spelling differences#ae and oe, or haemodynamics are the Fluid dynamics, dynamics of blood flow. The circulatory sys ...

heart attack
s,
ulcer An ulcer is a discontinuity or break in a bodily membrane that impedes normal function of the affected organ. According to Robins's pathology, "ulcer is the breach of the continuity of skin, epithelium or mucous membrane caused by sloughing ou ...

ulcer
s, and
mental illness A mental disorder, also called a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. Such features may be persistent, relapsing In internal medici ...
es such as depression and also aggravation of a pre-existing condition. Stress can be external and related to the environment, but may also be caused by internal perceptions that cause an individual to experience
anxiety Anxiety is an emotion Emotions are mental state, psychological states brought on by neurophysiology, neurophysiological changes, variously associated with thoughts, feelings, behavioural responses, and a degree of pleasure or suffering, disp ...
or other negative emotions surrounding a situation, such as pressure,
discomfort Comfort (or being comfortable'')'' is a sense of physical or psychological ease, often characterized as a lack of hardship. Persons who are lacking in comfort are uncomfortable, or experiencing discomfort. A degree of psychological comfort c ...
, etc., which they then deem stressful.
Hans Selye János Hugo Bruno "Hans" Selye (; hu, Selye János; January 26, 1907 – October 16, 1982) was a pioneering Hungarian-Canadian endocrinologist Endocrinology (from '' endocrine'' + '' -ology'') is a branch of biology Biology is the natur ...

Hans Selye
(1974) proposed four variations of stress. On one axis he locates good stress (eustress) and bad stress (distress). On the other is over-stress (hyperstress) and understress (hypostress). Selye advocates balancing these: the ultimate goal would be to balance hyperstress and hypostress perfectly and have as much eustress as possible. The term "
eustress Eustress means beneficial stress (disambiguation), stress—either psychological, physical (e.g., exercise), or biochemical/radiological (hormesis). The term was coined by endocrinologist Hans Selye, consisting of the Greek language, Greek prefix ...
" comes from the Greek root ''eu-'' which means "good" (as in "euphoria"). Eustress results when a person perceives a stressor as positive. "Distress" stems from the Latin root ''dis-'' (as in "dissonance" or "disagreement"). Medically defined distress is a threat to the
quality of life Quality of life (QOL) is defined by the World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations United Nations Specialized Agencies are autonomous organizations working with the United N ...

quality of life
. It occurs when a demand vastly exceeds a person's capabilities. Stress may cause
headache Headache is the symptom of pain Pain is a distressing feeling often caused by intense or damaging stimuli. The defines pain as "an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or ...

headache
.


Causes


Neutrality of stressors

Stress 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.
Hans Selye János Hugo Bruno "Hans" Selye (; hu, Selye János; January 26, 1907 – October 16, 1982) was a pioneering Hungarian-Canadian endocrinologist Endocrinology (from '' endocrine'' + '' -ology'') is a branch of biology Biology is the natur ...

Hans Selye
defined stress as “the nonspecific (that is, common) result of any demand upon the body, be the effect mental or somatic.” This includes the medical definition of stress as a physical demand and the colloquial definition of stress as a psychological demand. 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.


Types of stressors

A
stressor A stressor is a chemical or biological agent, environment (biophysical), environmental condition, Stimulus (physiology) , external stimulus or an event seen as causing Stress (biology), stress to an biological organism, organism. Psychologically sp ...
is any event, experience, or environmental stimulus that causes stress in an individual. These events or experiences are perceived as threats or challenges to the individual and can be either physical or psychological. Researchers have found that stressors can make individuals more prone to both physical and psychological problems, including
heart disease Cardiovascular disease (CVD) is a class of diseases that involve the heart The heart is a cardiac muscle, muscular Organ (biology), organ in most animals, which pumps blood through the blood vessels of the circulatory system. The pumped b ...
and
anxiety Anxiety is an emotion Emotions are mental state, psychological states brought on by neurophysiology, neurophysiological changes, variously associated with thoughts, feelings, behavioural responses, and a degree of pleasure or suffering, disp ...

anxiety
.Pastorino, E. & Doyle-Portillo, S. (2009). What is Psychology?. 2nd Ed. Belmont, CA: Thompson Higher Education. Stressors are more likely to affect an individual's health when they are "chronic, highly disruptive, or perceived as uncontrollable". In
psychology Psychology is the scientific Science () is a systematic enterprise that builds and organizes knowledge Knowledge is a familiarity or awareness, of someone or something, such as facts A fact is an occurrence in the real world. ...

psychology
, researchers generally classify the different types of stressors into four categories: 1) crises/catastrophes, 2) major life events, 3) daily hassles/microstressors, and 4) ambient stressors. According to Ursin (1988), the common factor between these categories is an inconsistency between expected events ("set value") and perceived events ("actual value") that cannot be resolved satisfactorily, which puts stress into the broader context of .


Crises/catastrophes

This type of stressor is unforeseen and unpredictable and, as such, is completely out of the control of the individual. Examples of
crises A crisis (plural: "crises"; adjectival form In linguistics Linguistics is the science, scientific study of language. It encompasses the analysis of every aspect of language, as well as the methods for studying and modeling them. The ...
and catastrophes include: devastating
natural disaster A natural disaster is a major adverse event An adverse event (AE) is any untoward medical occurrence in a patient or clinical investigation subject administered a pharmaceutical product and which does not necessarily have a causal relationsh ...
s, such as major
flood A flood is an overflow of water that submerges land that is usually dry. In the sense of "flowing water", the word may also be applied to the inflow of the . Floods are an area of study of the discipline and are of significant concern in , a ...

flood
s or
earthquake An earthquake (also known as a quake, tremor or temblor) is the shaking of the surface of the Earth resulting from a sudden release of energy in the Earth Earth is the third planet from the Sun and the only astronomical object known ...

earthquake
s,
war War is an intense armed conflict between states State may refer to: Arts, entertainment, and media Literature * ''State Magazine'', a monthly magazine published by the U.S. Department of State * The State (newspaper), ''The State'' (new ...

war
s,
pandemic A pandemic (from Greek#REDIRECT Greek Greek may refer to: Greece Anything of, from, or related to Greece Greece ( el, Ελλάδα, , ), officially the Hellenic Republic, is a country located in Southeast Europe. Its population is approx ...

pandemic
s, etc. Though rare in occurrence, this type of stressor typically causes a great deal of stress in a person's life. A study conducted by Stanford University found that after natural disasters, those affected experienced a significant increase in stress level. Combat stress is a widespread acute and chronic problem. With the rapid pace and the urgency of firing first, tragic episodes of accidentally killing friendly forces (“brother” killing “brother” or fratricide) may happen. Prevention requires stress reduction, emphasis on vehicle and other identification training, awareness of the tactical situation, and continual risk analysis by leaders at all echelons.


Major life events

Common examples of major life events include:
marriage Marriage, also called matrimony or wedlock is a culturally and often legally recognized union between people called spouse A religious marriage. A spouse is a significant other Significant other (SO) is colloquially used as a term ...

marriage
, going to
college A college (Latin Latin (, or , ) is a classical language A classical language is a language A language is a structured system of communication Communication (from Latin ''communicare'', meaning "to share" or "to be in rel ...

college
,
death Death is the permanent, irreversible cessation of all biological functions that sustain a living Living or The Living may refer to: Common meanings *Life, a condition that distinguishes organisms from inorganic objects and dead organi ...

death
of a loved one,
birth Birth is the act or process of bearing or bringing forth offspring, also referred to in technical contexts as parturition. In mammals, the process is initiated by hormones which cause the muscular walls of the uterus to contract, expelling the fe ...

birth
of a child,
divorce Divorce (also known as dissolution of marriage) is the optional process of terminating a marriage in Stockholm Marriage, also called matrimony or wedlock is a culturally and often legally recognized union between people calle ...

divorce
, moving houses, etc. These events, either positive or negative, can create a sense of uncertainty and fear, which will ultimately lead to stress. For instance, research has found the elevation of stress during the transition from high school to university, with college freshmen being about two times more likely to be stressed than final year students. Research has found major life events are somewhat less likely to be major causes of stress, due to their rare occurrences. The length of time since occurrence and whether or not it is a positive or negative event are factors in whether or not it causes stress and how much stress it causes. Researchers have found that events that have occurred within the past month generally are not linked to stress or illness, while chronic events that occurred more than several months ago are linked to stress and illness and personality change. Additionally, positive life events are typically not linked to stress and if so, generally only trivial stress while negative life events can be linked to stress and the health problems that accompany it. However, positive experiences and positive life changes can predict decreases in neuroticism.


Daily hassles/microstressors

This category includes daily
annoyance Annoyance is an unpleasant mental state that is characterized by irritation Irritation, in biology Biology is the natural science that studies life and living organisms, including their anatomy, physical structure, Biochemistry, chemi ...
s and minor hassles. Examples include: making decisions, meeting deadlines at work or school, traffic jams, encounters with irritating personalities, etc. Often, this type of stressor includes
conflict Conflict may refer to: Arts, entertainment, and media Films * ''Conflict'' (1936 film), an American boxing film starring John Wayne * ''Conflict'' (1938 film), a French drama film directed by Léonide Moguy * ''Conflict'' (1945 film), ...
s with other people. Daily stressors, however, are different for each individual, as not everyone perceives a certain event as stressful. For example, most people find public speaking to be stressful, nevertheless, a seasoned politician most likely will not. Daily hassles are the most frequently occurring type of stressor in most adults. The high frequency of hassles causes this stressor to have the most physiological effect on an individual. Carolyn Aldwin, Ph.D., conducted a study at the Oregon State University that examined the perceived intensity of daily hassles on an individual's mortality. Aldwin's study concluded that there is a strong correlation between individuals who rate their hassles as very intense and a high level of mortality. One's perception of their daily stressors can have a modulating effect on the physiological impact of daily stressors. There are three major psychological types of conflicts that can cause stress. * The approach-approach conflict, occurs when a person is choosing between two equally attractive options, i.e. whether to go see a movie or to go see a concert. * The avoidance-avoidance conflict, occurs where a person has to choose between two equally unattractive options, for example, to take out a second loan with unappealing terms to pay off the mortgage or to face foreclosure on one's house. * The approach-avoidance conflict, occurs when a person is forced to choose whether or not to partake in something that has both attractive and unattractive traits such as whether or not to attend an expensive college (meaning taking out loans now, but also meaning a quality education and employment after graduation). Travel-related stress results from three main categories: lost time, surprises (an unforeseen event such as lost or delayed baggage) and routine breakers (inability to maintain daily habits).


Ambient stressors

As their name implies, these are global (as opposed to individual) low-grade stressors that are a part of the background environment. They are defined as stressors that are "chronic, negatively valued, non-urgent, physically perceptible, and intractable to the efforts of individuals to change them". Typical examples of ambient stressors are pollution, noise, crowding, and traffic. Unlike the other three types of stressor, ambient stressors can (but do not necessarily have to) negatively impact stress without conscious awareness. They are thus low on what Stokols called "perceptual salience".


Organisational stressors

Studies conducted in military and combat fields show that some of the most potent stressors can be due to personal organisational problems in the unit or on the home front. Stress due to bad organisational practices is often connected to "Toxic Leadership", both in companies and in governmental organisations.


Stressor impact

Life events scales can be used to assess stressful things that people experience in their lives. One such scale is the
Holmes and Rahe Stress Scale The Holmes and Rahe stress scale () is a list of 43 stressful life events that can contribute to illness A disease is a particular abnormal condition that negatively affects the structure or function (biology), function of all or part of ...
, also known as the Social Readjustment Rating Scale, or SRRS. Developed by psychiatrists Thomas Holmes and Richard Rahe in 1967, the scale lists 43 stressful events. To calculate one's score, add up the number of "life change units" if an event occurred in the past year. A score of more than 300 means that individual is at risk for illness, a score between 150 and 299 means risk of illness is moderate, and a score under 150 means that individual only has a slight risk of illness. A modified version was made for non-adults. The scale is below. The SRRS is used in psychiatry to weight the impact of life events.


Measurement

Modern humans may attempt to self-assess their own "stress-level"; third parties (sometimes clinicians) may also provide qualitative evaluations. Quantitative approaches such as
Galvanic Skin Response A sample GSR signal of 60 seconds duration, 400px, right Electrodermal activity (EDA) is the property of the human body that causes continuous variation in the electrical characteristics of the skin Skin is the layer of usually soft, flexible o ...
or other measurements giving results which may correlate with perceived psychological stress include testing for one or more of the several
stress hormone Stress hormones are secreted by endocrine glands to modify one's internal environment during times of stress. By performing various functions such as mobilizing energy sources, increasing heart rate, and downregulating metabolic processes which a ...
s, for cardiovascular responses, or for immune response. There are some valid questionnaires to assess the stress level. such as, Higher Education Stress Inventory (HESI) is a valid questionnaire used in many communities for assessment the stress level of college students.


Physical effects

The body responds to stress in many ways. Readjusting chemical levels is just one of them. This section includes some examples of adjustments and changes. To measure the body's response to stress, psychologists tend to use Hans Selye's . This biological model, often referred to as the "classic stress response", revolves around the concept of
homeostasis In biology Biology is the natural science that studies life and living organisms, including their anatomy, physical structure, Biochemistry, chemical processes, Molecular biology, molecular interactions, Physiology, physiological mechanis ...
. General adaptive syndrome, according to this system, occurs in three stages: #The alarm reaction. This stage occurs when the stressor is first presented. The body begins to gather resources to deal with the stressor. The and
sympathetic nervous system The sympathetic nervous system (SNS) is one of two divisions of the autonomic nervous system, along with the parasympathetic nervous system. The enteric nervous system is sometimes considered part of the autonomic nervous system, and sometimes co ...
are activated, resulting in the release of hormones from the
adrenal gland The adrenal glands (also known as suprarenal glands) are endocrine glands that produce a variety of hormones including adrenaline and the steroids aldosterone and cortisol. They are found above the kidneys. Each gland has an outer adrenal cortex ...

adrenal gland
such as
cortisol Cortisol is a steroid hormone, in the glucocorticoid class of hormones. When used as a medication, it is known as hydrocortisone. It is produced in many animals, mainly by the ''zona fasciculata'' of the adrenal cortex in the adrenal gland. ...

cortisol
, adrenaline (
epinephrine Adrenaline, also known as epinephrine, is a hormone A hormone (from the Greek#REDIRECT Greek Greek may refer to: Greece Anything of, from, or related to Greece Greece ( el, Ελλάδα, , ), officially the Hellenic Republic, is a co ...

epinephrine
), and
norepinephrine Norepinephrine (NE), also called noradrenaline (NA) or noradrenalin, is an organic chemical , CH4; is among the simplest organic compounds. In chemistry Chemistry is the scientific discipline involved with Chemical element, elements and ...

norepinephrine
into the bloodstream to adjust bodily processes. These hormonal adjustments increase energy-levels, increase muscle tension, reduce sensitivity to pain, slow down the digestive system, and cause a rise in blood pressure.Gottlieb, Benjamin."Coping with Chronic Stress". Plenum Press. 1997. In addition, the
locus coeruleus The locus coeruleus () (LC), also spelled locus caeruleus or locus ceruleus, is a nucleus ''Nucleus'' (plural nuclei) is a Latin word for the seed inside a fruit. It most often refers to: *Atomic nucleus, the very dense central region of an atom ...
, a collection of norepinephrine-containing neurons in the
pons The pons (Latin for "bridge") is part of the brainstem The brainstem (or brain stem) is the posterior stalk-like part of the brain A brain is an organ Organ may refer to: Biology * Organ (anatomy) An organ is a group of Tissue (bi ...

pons
of the
brainstem The brainstem (or brain stem) is the posterior stalk-like part of the brain A brain is an organ Organ may refer to: Biology * Organ (anatomy) An organ is a group of Tissue (biology), tissues with similar functions. Plant life and anima ...

brainstem
whose axons project to various regions of the brain, is involved in releasing norepinephrine directly onto neurons. High levels of norepinephrine acting as a neurotransmitter on its receptors expressed on neurons in brain regions, such as the
prefrontal cortex In mammalian brain A brain is an organ that serves as the center of the nervous system In Biology, biology, the nervous system is a Complex system, highly complex part of an animal that coordinates its Behavior, actions and Sense, senso ...

prefrontal cortex
, are thought to be involved in the effects of stress on
executive functions Executive functions (collectively referred to as executive function and cognitive control) are a set of cognitive processes Cognition () refers to "the mental action or process of acquiring knowledge and understanding through thought, exper ...
, such as impaired
working memory Working memory is a cognitive system with a limited capacity that can hold information temporarily. Working memory is important for reasoning and the guidance of decision-making and behavior. Working memory is often used synonymously with short-te ...
. #The stage of resistance. The body continues building up resistance throughout the stage of resistance, either until the body's resources are depleted, leading to the exhaustion phase, or until the stressful stimulus is removed. As the body uses up more and more of its resources, it becomes increasingly tired and susceptible to illness. At this stage
psychosomatic Psychosomatic medicine is an interdisciplinary Interdisciplinarity or interdisciplinary studies involves the combination of two or more academic disciplines into one activity (e.g., a research project). It draws knowledge from several other ...
disorders first begin to appear. #The stage of exhaustion. The body is completely drained of the hormones and resources it was depending on to manage the stressor. The person now begins to exhibit behaviors such as anxiety, irritability, avoidance of responsibilities and relationships, self-destructive behavior, and poor judgment. Someone experiencing these symptoms has a much greater chance of lashing out, damaging relationships, or avoiding social interaction at all. This
physiological stress Stress, either physiological, biological, or psychological is an organism's response to a stressor such as an environmental condition. Stress is the body's method of reacting to a condition such as a threat, :wikt:challenge, challenge or physic ...
response involves high levels of
sympathetic nervous system The sympathetic nervous system (SNS) is one of two divisions of the autonomic nervous system, along with the parasympathetic nervous system. The enteric nervous system is sometimes considered part of the autonomic nervous system, and sometimes co ...
activation, often referred to as the "fight or flight" response. Th
response
involves pupil dilation, release of
endorphins Endorphins (contracted from "endogenous morphine") are endogenous opioid neuropeptides and peptide hormonePeptide hormones or protein hormones are hormones whose molecules are peptides or proteins, respectively. The latter have longer amino acid ...
, increased heart and respiration rates, cessation of digestive processes, secretion of adrenaline, arteriole dilation, and constriction of veins. This high level of arousal is often unnecessary to adequately cope with micro-stressors and daily hassles; yet, this is the response-pattern seen in humans, which often leads to health issues commonly associated with high levels of stress.


Cancer

Psychological stress does not appear to be a risk factor for the onset of cancer, though it may worsen outcomes in those who already have cancer. Research has found that personal belief in stress as a risk factor for cancer was common in
England England is a Countries of the United Kingdom, country that is part of the United Kingdom. It shares land borders with Wales to its west and Scotland to its north. The Irish Sea lies northwest of England and the Celtic Sea to the southwest. E ...

England
, though awareness of risk factors overall was found to be low.


Sleep

Sleep Sleep is a naturally recurring state of mind and body, characterized by altered consciousness Consciousness, at its simplest, is or of internal and external existence. Despite millennia of analyses, definitions, explanations and deba ...

Sleep
allows people to rest and re-energise for another day potentially filled with interactions and tasks. If someone is stressed it is extremely important for them to get enough sleep so that they can think clearly. However, chemical changes in the body caused by stress can make sleep a difficult thing. The body releases
glucocorticoid Glucocorticoids (or, less commonly, glucocorticosteroids) are a class of corticosteroid Corticosteroids are a class of steroid hormone A steroid hormone is a steroid that acts as a hormone. Steroid hormones can be grouped into two classes: cor ...
s in response to stress; this can disrupt sleep.


Other effects

There is likely a connection between stress and illness. Folkman, S., 2013. Stress: appraisal and coping. In ''Encyclopedia of behavioral medicine'' (pp. 1913–1915). Springer New York. Theories of a proposed stress–illness link suggest that both
acute Acute may refer to: Science and technology * Acute angle ** Acute triangle ** Acute, a leaf shape in the glossary of leaf morphology#acute, glossary of leaf morphology * Acute (medicine), a disease that it is of short duration and of recent onset. ...
and chronic stress can cause illness, and studies have found such a link. According to these theories, both kinds of stress can lead to changes in behavior and in physiology. Behavioral changes can involve smoking- and eating-habits and physical activity. Physiological changes can be changes in sympathetic activation or hypothalamic pituitary adrenocorticoid activation, and immunological function. However, there is much variability in the link between stress and illness.Ogden, J. (2007). Health Psychology: a textbook (4th ed.), pages 281–282 New York: McGraw-Hill Stress can make the individual more susceptible to physical illnesses like the common cold. Stressful events, such as job changes, correlate with insomnia, impaired sleeping, and health complaints. Research indicates the type of stressor (whether it is acute or chronic) and individual characteristics such as age and physical well-being before the onset of the stressor can combine to determine the effect of stress on an individual. An individual's personality characteristics (such as level of
neuroticism In the study of psychology Psychology is the science of mind and behavior. Psychology includes the study of consciousness, conscious and Unconscious mind, unconscious phenomena, as well as feeling and thought. It is an academic discipline o ...
), genetics, and childhood experiences with major stressors and traumas may also dictate their response to stressors. Chronic stress and a lack of coping resources available or used by an individual can often lead to the development of psychological issues such as
depression Depression may refer to: Mental health * Depression (mood), a state of low mood and aversion to activity * Mood disorders characterized by depression are commonly referred to as simply ''depression'', including: ** Dysthymia ** Major depressive ...
and
anxiety Anxiety is an emotion Emotions are mental state, psychological states brought on by neurophysiology, neurophysiological changes, variously associated with thoughts, feelings, behavioural responses, and a degree of pleasure or suffering, disp ...
(see below for further information). This is particularly true regarding chronic stressors. These are stressors that may not be as intense as an acute stressor like a natural disaster or a major accident, but they persist over longer periods of time. These types of stressors tend to have a more negative impact on health because they are sustained and thus require the body's physiological response to occur daily. This depletes the body's
energy In physics Physics is the that studies , its , its and behavior through , and the related entities of and . "Physical science is that department of knowledge which relates to the order of nature, or, in other words, to the regula ...
more quickly and usually occurs over long periods of time, especially when such microstressors cannot be avoided (for example: stress related to living in a dangerous neighborhood). See
allostatic load Allostatic load is "the wear and tear on the body" which accumulates as an individual is exposed to repeated or chronic stress. The term was coined by Bruce McEwen Bruce Sherman McEwen (January 17, 1938 – January 2, 2020) was an American ...
for further discussion of the biological process by which chronic stress may affect the body. For example, studies have found that caregivers, particularly those of dementia patients, have higher levels of depression and slightly worse physical health than non-caregivers. Studies have also shown that perceived chronic stress and the hostility associated with Type A personalities are often correlated with much higher risks of cardiovascular disease. This occurs because of the compromised immune system as well as the high levels of arousal in the sympathetic nervous system that occur as part of the body's physiological response to stressful events. However, it is possible for individuals to exhibit hardiness a term referring to the ability to be both chronically stressed and healthy. Chronic stress can correlate with psychological disorders such as
delusions A delusion is a fixed belief that is not amenable to change in light of conflicting evidence. As a pathology, it is distinct from a belief based on false or incomplete information, confabulation, dogma, illusion, or some other misleading eff ...

delusions
. Pathological anxiety and chronic stress lead to structural degeneration and impaired functioning of the
hippocampus The hippocampus (via Latin from Greek#REDIRECT Greek Greek may refer to: Greece Anything of, from, or related to Greece Greece ( el, Ελλάδα, , ), officially the Hellenic Republic, is a country located in Southeast Europe. Its popul ...

hippocampus
. It has long been believed that negative affective states, such as feelings of anxiety and depression, could influence the pathogenesis of physical disease, which in turn, have direct effects on biological process that could result in increased risk of disease in the end. However, studies done by the University of Wisconsin-Madison and other places have shown this to be partly untrue; although perceived stress seems to increase the risk of reported poor health, the additional ''perception'' of stress as something harmful increases the risk even further. For example, when humans are under chronic stress, permanent changes in their physiological, emotional, and behavioral responses are most likely to occur. Such changes could lead to disease. Chronic stress results from stressful events that persist over a relatively long period of time, such as caring for a spouse with dementia, or results from brief focal events that continue to be experienced as overwhelming even long after they are over, such as experiencing a sexual assault. Experiments show that when healthy human individuals are exposed to acute laboratory stressors, they show an adaptive enhancement of some markers of natural immunity but a general suppression of functions of specific immunity. By comparison, when healthy human individuals are exposed to real-life chronic stress, this stress is associated with a biphasic immune response where partial suppression of cellular and humoral function coincides with low-grade, nonspecific inflammation. Even though psychological stress is often connected with illness or disease, most healthy individuals can still remain disease-free after confronting chronic stressful events. Also, people who do not believe that stress will affect their health do not have an increased risk of illness, disease, or death. This suggests that there are individual differences in vulnerability to the potential pathogenic effects of stress; individual differences in vulnerability arise due to both genetic and psychological factors. In addition, the age at which the stress is experienced can dictate its effect on health. Research suggests chronic stress at a young age can have lifelong impacts on the biological, psychological, and behavioral responses to stress later in life.


Social impact


Communication

When someone is stressed, many challenges can arise; a recognized challenge being communication difficulties. Here are some examples of how stress can hinder communication. The cultures of the world generally fall into two categories; individualistic and collectivistic. * An
individualistic Individualism is the moral stance, political philosophy Political philosophy is the philosophical study of government, addressing questions about the nature, scope, and legitimacy of public agents and institutions and the relationships betwe ...
culture, like that of the United States, where everyone is an independent entity defined by their accomplishments and goals. * A
collectivistic Collectivism is a value that is characterized by emphasis on Group cohesiveness, cohesiveness among individuals and prioritization of the group over the self. Individuals or groups that subscribe to a collectivist worldview tend to find common val ...
culture, like that of many Asian countries, prefers to see individuals as interdependent on each other. They value modesty and family. These cultural differences can affect how people communicate when they are stressed. For example, a member of an individualistic culture would be hesitant to ask for pain medication for fear of being perceived as weak. A member of a collectivistic culture would not hesitate. They have been brought up in a culture where everyone helps each other and is one functional unit whereas the member of the individualistic culture is not as comfortable asking others for aid.


Language barriers

Language barriers can cause stress by making people feel uncomfortable because differences in syntax, vocabulary, different ways of showing respect, and different use of body language can make things difficult, and along with a desire for successful social interactions, being uncomfortable with the communication around a person can discourage them from communicating at all. The System 1 – System 2 model of Daniel Kahneman (Thinking Fast and Slow) and others would distinguish between automatic responses, such as one's native language would be, and a foreign language that required System 2 work to translate. System 2 can become "depleted" by conscious mental effort, making it more difficult and stressful.


Changes in the home

Divorce, death, and remarriage are all disruptive events in a household. Although everyone involved is affected by events such as these, it can be most drastically seen in children. Due to their age, children have relatively undeveloped coping skills. For this reason a stressful event may cause some changes in their behavior. Falling in with a new crowd, developing some new and sometimes undesirable habits are just some of the changes stress may trigger in their lives. A particularly interesting response to stress is talking to an
imaginary friend Imaginary friends (also known as pretend friends, invisible friends or made-up friends) are a psychological and socialogy, social phenomenon where a friendship or other interpersonal relationship takes place in the imagination rather than physica ...
. A child may feel angry with a parent or their peers who they feel brought this change on them. They need someone to talk to but it definitely would not be the person with whom they are angry. That is when the imaginary friend comes in. They “talk” to this imaginary friend but in doing so they cut off communication with the real people around them.


Social support and health

Researchers have long been interested in how an individual's level and types of
social support Social support is the perception and actuality that one is cared for, has assistance available from other people, and most popularly, that one is part of a supportive social network A social network is a social structure made up of a set of s ...
impact the effect of stress on their health. Studies consistently show that social support can protect against physical and mental consequences of stress. This can occur through a variety of mechanisms. One model, known as the "direct effects" model, holds that social support has a direct, positive impact on health by increasing positive affect, promoting adaptive health behaviors, predictability and stability in life, and safeguarding against social, legal, and economic concerns that could negatively impact health. Another model, the "buffering effect", says that social support exerts greatest influence on health in times of stress, either by helping individuals appraise situations in less threatening manners or coping with the actual stress. Researchers have found evidence to support both these pathways. Social support is defined more specifically as psychological and material resources provided by a social network that are aimed at helping an individual cope with stress. Researchers generally distinguish among several types of social support: instrumental support – which refers to material aid (e.g., financial support or assistance in transportation to a physician's appointment), informational support (e.g., knowledge, education or advice in problem-solving), and emotional support (e.g., empathy, reassurance, etc.). Social support can reduce the rate of stress during pregnancy.


Management

Stress managementStress management is a wide spectrum of techniques and psychotherapies aimed at controlling a person's level of stress, especially chronic stress, usually for the purpose of and for the motive of improving everyday functioning. Stress produces nume ...
refers to a wide spectrum of techniques and psychotherapies aimed at controlling a person's levels of stress, especially chronic stress, usually for the purpose of improving everyday functioning. It involves controlling and reducing the tension that occurs in stressful situations by making emotional and physical changes.


Prevention and resilience building

Decreasing stressful behaviors is a part of prevention. Some of the common strategies and techniques are: self-monitoring, tailoring, material reinforcement, social reinforcement, social support, self-contracting, contracting with significant other, shaping, reminders, self-help groups, and professional help. Although many techniques have traditionally been developed to deal with the consequences of stress, considerable research has also been conducted on the prevention of stress, a subject closely related to psychological resilience-building. A number of self-help approaches to stress-prevention and resilience-building have been developed, drawing mainly on the theory and practice of cognitive-behavioral therapy.
Biofeedback Biofeedback is the process of gaining greater awareness of many physiological functions of one's own body, commercially by using electronic or other instruments, and with a goal of being able to manipulate the body's systems at will. Humans cond ...

Biofeedback
may also play a role in stress management. A randomized study by Sutarto et al. assessed the effect of resonant breathing biofeedback (recognize and control involuntary heart rate variability) among manufacturing operators; depression, anxiety and stress significantly decreased.


Exercising to reduce stress

Studies have shown that exercise reduces stress.Anxiety and Depression Association of America. (n.d.). Exercise for Stress and Anxiety. Retrieved from https://adaa.org/living-with-anxiety/managing-anxiety/exercise-stress-and-anxiety Exercise effectively reduces fatigue, improves sleep, enhances overall cognitive function such as alertness and concentration, decreases overall levels of tension, and improves self-esteem. Because many of these are depleted when an individual experiences chronic stress, exercise provides an ideal coping mechanism. Despite popular belief, it is not necessary for exercise to be routine or intense in order to reduce stress; as little as five minutes of aerobic exercise can begin to stimulate anti-anxiety effects. Further, a 10-minute walk may have the same psychological benefits as a 45-minute workout, reinforcing the assertion that exercise in any amount or intensity will reduce stress. Cycling and walking activities have lower stress scores when compared to all other activities.


Theoretical explanations

A multitude of theories have been presented in attempts to explain why exercise effectively reduces stress. One theory, known as the time-out hypothesis, claims that exercise provides distraction from the stressor. The time out hypothesis claims that exercise effectively reduces stress because it gives individuals a break from their stressors. This was tested in a recent study of college women who had identified studying as their primary stressor. The women were then placed under four conditions at varying times: "rest," "studying," "exercising," and "studying while exercising." The stress levels of the participants were measured through self-assessments of stress and anxiety symptoms after each condition. The results demonstrated that the "exercise" condition had the most significant reduction in stress and anxiety symptoms. These results demonstrate the validity of the time-out hypothesis. It is also important to note that exercise provided greater stress reduction than rest.


Coping mechanisms

The Lazarus and Folkman model suggests that external events create a form of pressure to achieve, engage in, or experience a stressful situation. Stress is not the external event itself, but rather an interpretation and response to the potential threat; this is when the coping process begins. There are various ways individuals deal with perceived threats that may be stressful. However, people have a tendency to respond to threats with a predominant coping style, in which they dismiss feelings, or manipulate the stressful situation. There are different classifications for coping, or
defense mechanisms In psychoanalytic theory, a defence mechanism (American English: defense mechanism), is an Unconscious mind, unconscious psychological mechanism that reduces anxiety arising from unacceptable or potentially harmful stimuli. Defence mechanisms ...
, however they all are variations on the same general idea: There are good/productive and negative/counterproductive ways to handle stress. Because stress is perceived, the following mechanisms do not necessarily deal with the actual situation that is causing an individual stress. However, they may be considered coping mechanisms if they allow the individual to cope better with the negative feelings/anxiety that they are experiencing due to the perceived stressful situation, as opposed to actually fixing the concrete obstacle causing the stress. The following mechanisms are adapted from the DSM-IV Adaptive Functioning Scale, APA, 1994.


Highly adaptive/active/problem-focused mechanisms

These skills are what one could call as “facing the problem head on”, or at least dealing with the negative emotions experienced by stress in a constructive manner. (generally adaptive) * Affiliation ("
tend and befriendTend-and-befriend is a behavior exhibited by some animals, including humans, in response to threat. It refers to protection of offspring In biology, offspring are the young born of living organism, organisms, produced either by a single organism o ...
") – involves dealing with stress by turning to a social network for support, but an individual does not share with others in order to diffuse or avoid the responsibility.Levo, Lynn M. (2003, September.) Understanding Defense Mechanisms. ''Lukenotes''. 7(4). St. Luke Institute, MD.Adapted from DSM-IV Adaptive Functioning Scale, APA, 1994. *
Humour Humour (English in the Commonwealth of Nations, Commonwealth English) or humor (American English) is the tendency of experiences to provoke laughter and provide amusement. The term derives from the humorism, humoral medicine of the ancient Gr ...
– the individual steps outside of a situation in order to gain greater perspective, and also to highlight any comic aspect to be found in their stressful circumstances. ::“The Association for Applied and Therapeutic Humour defines therapeutic humour as ‘any intervention that promotes health and wellness by stimulating a playful discovery, expression or appreciation of the absurdity of or incongruity of life’s situations. This intervention may enhance health or be used as a complementary treatment of illness to facilitate healing or coping whether physical, emotional, cognitive, or spiritual”. ::
Sigmund Freud Sigmund Freud ( , ; born Sigismund Schlomo Freud; 6 May 1856 – 23 September 1939) was an Austrian neurologist Neurology (from el, νεῦρον (neûron), "string, nerve" and the suffix -logia, "study of") is a branch of medicine M ...

Sigmund Freud
, a well known neurologist, suggests the humour was an excellent defensive strategy in emotional situations. When one laughs during a tough situation they feel absent from their worries, and this allows them to think differently. When one experiences a different mind set, they feel more in control of their response, and how they would go about dealing with the event that caused stress. ::Lefcourt (2001) suggests that this perspective-taking humour is the most effective due to its ability to distance oneself from the situation of great stress. Studies show that the use of laughter and humour creates a sense of relief of stress that can last up to 45 minutes post-laughter. ::Also, most hospitalized children have been seen to use laughter and play to relieve their fear, pain and stress. It has been discovered that there is a great importance in the use of laughter and humour in stress coping. Humans should use humour as a means to transcend their original understanding of an external event, take a different perspective, in which their anxiety may be minimized by. * Sublimation – allows an "indirect resolution of conflict with neither adverse consequences nor consequences marked by loss of pleasure." Essentially, this mechanism allows channeling of troubling emotions or impulses into an outlet that is socially acceptable. * Positive reappraisal – redirects thoughts (cognitive energy) to good things that are either occurring or have not occurred. This can lead to
personal growth Personal development consists of activities that develop a person's capabilities and potential, build human capital Human capital is the stock of habits, knowledge Knowledge is a familiarity, awareness, or understanding of someone or som ...
,
self-reflection Self-reflection is the capacity of humans to exercise introspection and to attempt to learn more about their fundamental nature and essence. This capacity is thought to be an essential feature of self-awareness and depends on a variety of cognitive ...
, and awareness of the power/benefits of one's efforts. For example, studies on
veteran A veteran () is a person who has significant experience (and is usually adept and esteemed) and expertise in a particular job, occupation or Craft, field. A military veteran is a person who is no longer serving in a military. A military veter ...
s of war or peacekeeping operations indicate that persons who construe a positive meaning from their combat or threat experiences tend to adjust better than those who do not. The final path model fitted well (CF1 = 1, RMSEA = 0.00) and showed that direct quality of life paths with β = -0.2, and indirect social support with β = -0.088 had the most effects on reduction of stress during pregnancy. Other adaptive coping mechanisms include
anticipation Anticipation is an emotion involving pleasure or anxiety in considering or awaiting an Expectation (epistemic), expected event. As a defence mechanism Robin Skynner considered anticipation as one of "the mature ways of dealing with real stress... ...
,
altruism Altruism is the principle A principle is a proposition or value that is a guide for behavior or evaluation. In law Law is a system A system is a group of Interaction, interacting or interrelated elements that act according to a s ...

altruism
, and
self-observation In philosophy of self, self-awareness is the experience of one's own personality or individuality. It is not to be confused with consciousness in the sense of qualia. While consciousness is being aware of one's environment and body and lifestyle ...
.


Mental inhibition/disavowal mechanisms

These mechanisms cause the individual to have a diminished (or in some cases non-existent) awareness about their anxiety, threatening ideas, fears, etc., that come from being conscious of the perceived threat. *
Displacement Displacement may refer to: Physical sciences Mathematics and Physics *Displacement (geometry), is the difference between the final and initial position of a point trajectory (for instance, the center of mass of a moving object). The actual path c ...
– This is when an individual redirects their emotional feelings about one situation to another, less threatening one. * Repression – Repression occurs when an individual attempts to remove all their thoughts, feelings, and anything related to the upsetting/stressful (perceived) threat out of their awareness in order to be disconnected from the entire situation. When done long enough in a successful way, this is more than just denial. *
Reaction formationIn psychoanalytic theoryPsychoanalytic theory is the theory of personality organization and the dynamics of personality development that guides psychoanalysis, a clinical method for treating psychopathology. First laid out by Sigmund Freud in the lat ...
– An attempt to remove any “unacceptable thoughts” from one's consciousness by replacing them with the exact opposite. Other inhibition coping mechanisms include undoing, dissociation,
denial Denial, in ordinary English usage, has at least three meanings: asserting that any particular statement or allegation is not true (which might be accurate or inaccurate); the refusal of a request; and asserting that a true statement is not true. ...

denial
, projection, and
rationalization Rationalization may refer to: * Rationalization (economics), an attempt to change an ''ad hoc'' workflow into one based on published rules; also, jargon for a reduction in staff * Rationalisation (mathematics), the process of removing a square root ...
. Although some people claim that inhibition coping mechanisms may eventually increase the stress level because the problem is not solved, detaching from the stressor can sometimes help people to temporarily release the stress and become more prepared to deal with problems later on.


Active mechanisms

These methods deal with stress by an individual literally taking action, or withdrawing. *
Acting out In the psychology Psychology is the scientific Science (from the Latin Latin (, or , ) is a classical language belonging to the Italic languages, Italic branch of the Indo-European languages. Latin was originally spoken in the area ...
– Often viewed as counter-normative, or problematic behavior. Instead of reflecting or problem-solving, an individual takes maladaptive action. *
Passive aggression Passive-aggressive behavior is characterized by a pattern of passive hostility and an avoidance of direct communication. Inaction where some action is socially customary is a typical passive-aggressive strategy (showing up late for functions, stay ...
– When an individual indirectly deals with their anxiety and negative thoughts/feelings stemming from their stress by acting in a hostile or resentful manner towards others. Help-Rejecting Complaining can also be included in this category.


Health promotion

There is an alternative method to coping with stress, in which one works to minimize their anxiety and stress in a preventative manner. If one works towards coping with stress daily, the feeling of stress and the ways in which one deals with it as the external event arises becomes less of a burden. Suggested strategies to improve stress management include: # Regular exercise – set up a fitness program, 3–4 times a week # Support systems – to listen, offer advice, and support each other # Time management – develop an organizational system # Guided imagery and visualization – create a relaxing state of mind # Progressive muscle relaxation – loosen tense muscle groups #
AssertivenessAssertiveness is the quality of being self-assured and confident without being aggressive. In the field of psychology Psychology is the science of mind and behavior. Psychology includes the study of consciousness, conscious and Unconscious mi ...
training – work on effective communication # Journal writing – express true emotion, self-reflection # Stress management in the workplace – organize a new system, switch tasks to reduce own stress. Depending on the situation, all of these coping mechanisms may be adaptive, or maladaptive.


History

Prior to the introduction of the concept "stress" in the psychological sense 1955, people already identified a range of more nuanced ideas to describe and confront such
emotion Emotions are psychological state A mental state is a state of mind that an agent is in. Most simplistically, a mental state is a mental condition. It is a relation that connects the agent with a proposition. Several of these states are a comb ...

emotion
s as
worry Worry refers to the thoughts, images, emotions, and actions of a negative nature in a repetitive, uncontrollable manner that results from a proactive cognitive risk analysis made to avoid or solve anticipated potential threats and their poten ...

worry
,
grief Grief is the response to loss, particularly to the loss of someone or some living thing that has died Death is the permanent, Irreversible process, irreversible cessation of all biological process, biological functions that sustain a ...
, concern,
obsession Obsession may refer to: Psychology * Celebrity worship syndrome, obsessive addictive disorder to a celebrity's personal and professional life * Fixation (psychology), a persistent attachment to an object or idea * Idée fixe (psychology), a preoc ...

obsession
,
fear Fear is an intensely unpleasant emotion Emotions are psychological state A mental state is a state of mind that an agent is in. Most simplistically, a mental state is a mental condition. It is a relation that connects the agent with a pr ...

fear
,
annoyance Annoyance is an unpleasant mental state that is characterized by irritation Irritation, in biology Biology is the natural science that studies life and living organisms, including their anatomy, physical structure, Biochemistry, chemi ...
,
anxiety Anxiety is an emotion Emotions are mental state, psychological states brought on by neurophysiology, neurophysiological changes, variously associated with thoughts, feelings, behavioural responses, and a degree of pleasure or suffering, disp ...

anxiety
, distress,
suffering Suffering, or pain in a broad sense, may be an experience of unpleasantness and aversion associated with the perception of harm or threat of harm in an individual. Suffering is the basic element that makes up the negative valence of affective ...

suffering
and passion. "Stress" has subsequently become a mainstay of
pop psychology Popular psychology (sometimes shortened as pop psychology or pop psych) is the concepts and theories about human mental life and behavior that are purportedly based on psychology Psychology is the science of mind and behavior. Psychology i ...
. Though stress is discussed throughout history from many distinct topics and cultures, there is no universal consensus over describing stress. This has led to multiple kinds of research, looking at the different aspects of psychological stress and how it changes over a lifespan.


See also


References


Further reading

* * {{Authority control Psychological stress