{"id":32,"date":"2023-01-19T12:14:25","date_gmt":"2023-01-19T17:14:25","guid":{"rendered":"https:\/\/pressbooks.bccampus.ca\/rebootyourresiliencywithselfcare\/?post_type=chapter&p=32"},"modified":"2023-11-01T18:56:12","modified_gmt":"2023-11-01T22:56:12","slug":"what-is-stress-really","status":"web-only","type":"chapter","link":"https:\/\/pressbooks.bccampus.ca\/rebootyourresiliencywithselfcare\/chapter\/what-is-stress-really\/","title":{"raw":"What is Stress, Really?","rendered":"What is Stress, Really?"},"content":{"raw":"[caption id=\"attachment_102\" align=\"aligncenter\" width=\"1024\"]\"\"<\/a> Figure 1.1 Stressed Out[\/caption]\r\n\r\n\u201cI\u2019m so stressed!<\/em>\u201d \u201cI can\u2019t deal with this right now!<\/em>\u201d \u201cYou\u2019re stressing me out!<\/em>\u201d Have you ever uttered one of these phrases? We all have at one point or another.\r\n\r\nThe overall well-being of a person is comprised of many different spheres, including physical, emotional, spiritual, social, environmental, financial, occupational, and intellectual health. Figure 1.2 \"The 8 Dimensions of Wellness\" describes these spheres in a little more detail.\r\n\r\n \r\n\r\n[caption id=\"attachment_587\" align=\"aligncenter\" width=\"1024\"]\"\"<\/a> Figure 1.2 8 Dimensions of Wellness[\/caption]\r\n\r\nStress results from situations that tax these resources. In the short term, stress can be energizing and positive, and in general, [pb_glossary id=\"296\"]acute stress[\/pb_glossary] is related to physical, emotional, or psychological stimuli. However, our innate survival mechanisms are counter-productive in today\u2019s world. When stress is excessive, constant, or overwhelming, it leads to chronic stimulation of an evolutionary system that was meant to function only in emergencies. Eventually, that persistent stimulation can push any of us over the edge. When we stretch ourselves beyond our limits, it can seriously negatively impact all aspects of our lives, setting us up for potentially disastrous health consequences.[footnote]Yaribeygi, H., Panahi, Y., Sahraei, H., Johnston, T. P., Sahebkar, A. (2017). The impact of stress on body function: A review. EXCLI journal, 16, 1057\u20131072. Retrieved from: https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5579396\/[\/footnote] Figure 1.3 provides some examples of reactions that someone may experience in their physical body, mind, emotions and behavior when undergoing stress.\r\n\r\n \r\n\r\n[caption id=\"attachment_104\" align=\"aligncenter\" width=\"1024\"]\"\"<\/a> Figure 1.3 Stress Body Mind Emotions[\/caption]\r\n\r\nWhen we\u2019re confronted with a real or even imagined danger, our body mobilizes to prepare us for one of three survival responses: fight<\/strong>, flight<\/strong>, or freeze<\/strong>.[footnote]Nunez, K. (2020). Fight, Flight and Freeze: What this response means. Healthline. Retrieved from: https:\/\/www.healthline.com\/health\/mental-health\/fight-flight-freeze#how-to-cope[\/footnote]\u00a0 Evolutionarily, our stress hormones were programmed to activate in a time of serious threat such as an emergency or a fearful mental or physical situation. Ever have someone jump out and scare you? Many people cry out, their hearts race, and they start running or punching. This is a prime example of the fight or flight response. During this acute stress that lasts just seconds or minutes, we experience a release of hormones and neurotransmitters that prepare us to either stay and deal with the threat or to run away to safety. Sometimes people just freeze and become unable to speak or move.\r\n\r\nWatch the following 3 minute video of The Flight Fight Freeze Response<\/a>.\r\n\r\n \r\n\r\nhttps:\/\/www.youtube.com\/watch?v=jEHwB1PG_-Q\r\n\r\nThe most notable neurotransmitters and hormones that the body releases during the stress response are norepinephrine (noradrenaline), epinephrine (adrenaline), and cortisol.[footnote]Dhabhar F. S. (2018). The short-term stress response - Mother nature's mechanism for enhancing protection and performance under conditions of threat, challenge, and opportunity. Frontiers in neuroendocrinology, 49, 175\u2013192. Retrieved from: https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5964013\/[\/footnote] Adrenalines<\/span> are both neurotransmitters and hormones, and their purpose is to increase alertness, elevate our heart and breathing rates, and increase blood flow to our skeletal muscles and brain.[footnote]Cafasso, J. (2018). Adrenaline Rush: Everything You Should Know. Healthline. Retrieved from: https:\/\/www.healthline.com\/health\/adrenaline-rush[\/footnote] This allows us to run quickly if we need to, have extra strength, and have intuitive, automatic thinking. Cortisol<\/span> is a corticosteroid that has numerous functions in the body in addition to being an anti-inflammatory. During a stress response, cortisol gives us an immediate energy boost, sharp senses, and even a surge of\u00a0 immunity and lower sensitivity to pain.[footnote]WebMD Editorial Contributors. (2022). What is Cortisol? Retrieved from: https:\/\/www.webmd.com\/a-to-z-guides\/what-is-cortisol[\/footnote] In addition, cytokines<\/span>, which are small proteins that aid in cell-to-cell communication, are mobilized into our bloodstream to prepare our body for events such as injury or infection so it can destroy pathogens and initiate healing.[footnote]Paharia, P. (2022). What are Cytokines? News Medical Life Sciences. Retrieved from: https:\/\/www.news-medical.net\/health\/What-are-Cytokines.aspx[\/footnote]\r\n\r\nWhen stress persists for an extended period of time, or if it is severe in intensity, individuals can become in a state of imbalance. Some may overcompensate in some areas of life or completely neglect others. Knowing the stages of stress, also known as the General Adaptation Syndrome,<\/strong>[footnote]Higuera, V. (2018). What is General Adaptation Syndrome? Healthline. Retrieved from: https:\/\/www.healthline.com\/health\/general-adaptation-syndrome[\/footnote] can alert us to when we may be on the precipice of chronic stress.\r\n\r\n \r\n\r\n[caption id=\"attachment_317\" align=\"aligncenter\" width=\"1024\"]\"\"<\/a> Figure 1.4 Stages of Stress[\/caption]\r\n\r\n
\r\n
In the area of Good Health<\/strong>, individuals are generally engaged with living, and manage their relationships, home and work lives with ease as they are able to deal with stresses as they arise.\r\n\r\nIn the Alarm<\/strong> phase, the flight or fight response occurs. The heart races to give oxygen to the muscles and brain, and the nervous system is on high alert. Emotionally one can experience rage, fear, agitation, or intense crying. Some people even go numb and shut down.\r\n\r\nIf the stress is not resolved, the Resistance<\/strong> stage may find the person becoming disillusioned and overwhelmed. They may be irritable, frustrated, and start to avoid certain people or tasks with a loss of satisfaction in a variety of areas in their life. They can experience insomnia, headaches, and gastrointestinal disturbances. As the Resistance stage continues, the person finds themselves withdrawing even more, and finds both home and work life draining and in conflict. Addictions and compulsive coping patterns such as substance use, gambling and risky behaviors can begin to occur or increase in frequency.\r\n\r\nFinally, the Exhaustion<\/strong> stage involves burnout and complete disengagement. People often have a complete disdain for many people and tasks and are no longer able to cope with the demands of everyday life. They feel drained physically, mentally, and emotionally, and feel hopelessness. This is where depression, anxiety and chronic illness can begin to set in.<\/blockquote>\r\nChronic Stress<\/strong>\r\n\r\nCumulative stress is insidious, and for most of us, low levels of [pb_glossary id=\"298\"]chronic stress[\/pb_glossary] have unfortunately become an accepted way of life. Chronic stress can be real or imagined, and have physical, emotional, mental and\/or psychosocial components. It can be linked to work stressors, troubled relationships, having negative social interactions, and feeling lonely for example. Numerous studies have been done on how persistent low-grade stress can adversely affect regular lifestyle routines, causing us to exercise and sleep less, and eat, drink and smoke more.[footnote]Seiler, A., Fagundes, C.P., Christian, L.M. (2020). The Impact of Everyday Stressors on the Immune System and Health. In: Chouk\u00e8r, A. (eds) Stress Challenges and Immunity in Space. Springer, Cham.[\/footnote] [footnote]Illi, J., Miaskowski, C., Cooper, B., Levine, J.D., Dunn, L., West, C., Dodd, M., Dhruva, A., Paul, S.M., Baggott, C., Cataldo, J., Langford, D., Schmidt, B., Aouizerat, B.E. (2012) Association between pro- and anti-inflammatory cytokine genes and a symptom cluster of pain, fatigue, sleep disturbance, and depression. Cytokine 58:437\u2013447[\/footnote] Too much of the stress hormones and neurotransmitters circulating in our bodies over time makes higher cognitive functions suffer, impairing concentration, planning and decision making.[footnote]Porcelli, A. J., & Delgado, M. R. (2017). Stress and Decision Making: Effects on Valuation, Learning, and Risk-taking. Current opinion in behavioral sciences, 14, 33\u201339. Retrieved from: https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5201132\/[\/footnote]\r\n\r\nChronic stress also can lead to persistent low-grade inflammation<\/strong>.[footnote]Walsh, C. P., Bovbjerg, D. H., & Marsland, A. L. (2021). Glucocorticoid resistance and \u03b22-adrenergic receptor signaling pathways promote peripheral pro-inflammatory conditions associated with chronic psychological stress: A systematic review across species. Neuroscience and biobehavioral reviews, 128, 117\u2013135.[\/footnote] The effectiveness of cortisol is decreased over time because tissues and the immune system become desensitized to it as they are constantly being bombarded with it. In addition, the body\u2019s antibody response becomes impaired due to disruption of the cytokine balance, which results in the decrease of the number of\u00a0 B lymphocytes that become antibody producing cells, and decreased phagocytes that assist in neutralizing pathogens.[footnote]Seiler, A., Fagundes, C.P., Christian, L.M. (2020). The Impact of Everyday Stressors on the Immune System and Health. In: Chouk\u00e8r, A. (eds) Stress Challenges and Immunity in Space. Springer, Cham.[\/footnote] [footnote]McGregor, B. A., Murphy, K. M., Albano, D. L., & Ceballos, R. M. (2016). Stress, cortisol, and B lymphocytes: a novel approach to understanding academic stress and immune function. Stress (Amsterdam, Netherlands), 19(2), 185\u2013191. Retrieved from: https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4837014\/[\/footnote]\r\n\r\nNumerous studies have shown that people who had experienced chronic stress during the previous year were more likely to develop a cold after being exposed to viruses.[footnote]Cohen, S., Janicki-Deverts, D., Doyle, W.J., et al. (2012). Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk. Proc Natl Acad Sci U S A. 109(16):5995\u20135999.[\/footnote] [footnote]Cohen, S., Frank, E., Doyle, W.J., Skoner, D.P., Rabin, B.S., Gwaltney, J.M. Jr. (1998). Types of stressors that increase susceptibility to the common cold in healthy adults. Health Psychol. 17(3):214-23.[\/footnote] With decreased lymphocytes and immune resources, our body has a harder time combatting bacterial and viral antigens, resulting in increased susceptibility to infectious illnesses.[footnote]Yaribeygi, H., Panahi, Y., Sahraei, H., Johnston, T. P., Sahebkar, A. (2017). The impact of stress on body function: A review. EXCLI journal, 16, 1057\u20131072. Retrieved from: https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5579396\/ [\/footnote] Chronic stress has been shown to activate latent viruses such as Varicella Zoster (shingles), Herpes Virus I and II (cold sores and genital warts) and Epstein-Barr Virus (mononucleosis) [footnote]Takao, Y., Okuno, Y., Mori, Y., Asada, H., Yamanishi, K., Iso, H. (2018). Associations of Perceived Mental Stress, Sense of Purpose in Life, and Negative Life Events With the Risk of Incident Herpes Zoster and Postherpetic Neuralgia: The SHEZ Study, American Journal of Epidemiology, 187(2): 251\u2013259.[\/footnote] [footnote]Rahangdale, R.R., Tender, T., Balireddy, S., Pasupuleti, M., and Hariharapura, R.C. (2022). Interplay between stress and immunity triggers herpes zoster infection in COVID-19 patients: a review. Canadian Journal of Microbiology. 68(5): 303-314.[\/footnote] [footnote]Glaser, R., Pearson, G. R., Jones, J. F., Hillhouse, J., Kennedy, S., Mao, H. Y., & Kiecolt-Glaser, J. K. (1991). Stress-related activation of Epstein-Barr virus. Brain, behavior, and immunity, 5(2), 219\u2013232.[\/footnote] [footnote]WebMD. (1999). Long Term Stress May Trigger Herpes Outbreaks. Retrieved from: https:\/\/www.webmd.com\/balance\/stress-management\/news\/19991111\/long-term-stress-trigger-herpes-outbreaks[\/footnote]. Chronic stress has also been associated with delayed wound healing, and development of chronic disease conditions including arthritis, fibromyalgia, inflammatory bowel disease, and allergies. [footnote]Gupta, A., & Silman, A. J. (2004). Psychological stress and fibromyalgia: a review of the evidence suggesting a neuroendocrine link. Arthritis research & therapy, 6(3), 98\u2013106. Retrieved from: https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC416451\/[\/footnote] [footnote]Schwetlik, S. N., Baldock, K. L., Hill, C. L., & Ferrar, K. (2022). Chronic Stress and Arthritis: A Scoping Review. Arthritis care & research, 74(6), 982\u2013996.[\/footnote] [footnote][xiii] Cohen S, et al. (1991). Psychological stress and susceptibility to the common cold. New England Journal of Medicine. 325:606.[\/footnote] [footnote]Gouin J.P., Kiecolt-Glaser, J.K. (2011). The impact of psychological stress on wound healing: methods and mechanisms. Immunol Allergy Clin N Am 31:81\u201393[\/footnote] [footnote]Dave, N. D., Xiang, L., Rehm, K. E., & Marshall, G. D., Jr (2011). Stress and allergic diseases. Immunology and allergy clinics of North America, 31(1), 55\u201368. \u00a0Retrieved from: https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3264048\/[\/footnote] [footnote]Gao, X., Cao, Q., Cheng, Y., Zhao, D., Wang, Z., Yang, H., Wu, Q., You, L., Wang, Y., Lin, Y., Li, X., Wang, Y., Bian, J. S., Sun, D., Kong, L., Birnbaumer, L., & Yang, Y. (2018). Chronic stress promotes colitis by disturbing the gut microbiota and triggering immune system response. Proceedings of the National Academy of Sciences of the United States of America, 115(13), E2960\u2013E2969.[\/footnote] High stress levels also can cause depression and anxiety which in turn exacerbates the cycle. [footnote]Ross, R. A., Foster, S. L., & Ionescu, D. F. (2017). The Role of Chronic Stress in Anxious Depression. Chronic stress (Thousand Oaks, Calif.), 1, 2470547016689472. Retrieved from: https:\/\/pubmed.ncbi.nlm.nih.gov\/32440578\/[\/footnote]\r\n\r\nHave you ever been angry and thought \u201cmy head is going to explode\u201d or \u201cmy blood is boiling\u201d? \u00a0Our blood pressure rises during a stressful event. After the acute stress response is resolved, our blood pressure generally returns to normal. However, even momentary spikes in blood pressure can harm the blood vessels, heart, and kidneys.[footnote]Seaton, M. (2021). The effects of high blood pressure on your body. Retrieved from: https:\/\/www.webmd.com\/hypertension-high-blood-pressure\/high-blood-pressure-effects-on-body[\/footnote] In addition, chronically elevated cortisol levels also place strain on the cardiovascular system.[footnote]Lagraauw, H.M., Kuiper, J., Bot, I. (2015). Acute and chronic psychological stress as risk factors for cardiovascular disease: insights gained from epidemiological, clinical and experimental studies. Brain Behav Immun 50:18\u201330[\/footnote] [footnote]Yaribeygi, H., Panahi, Y., Sahraei, H., Johnston, T. P., Sahebkar, A. (2017). The impact of stress on body function: A review. EXCLI journal, 16, 1057\u20131072. Retrieved from: https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5579396\/[\/footnote]\r\n\r\nEveryone has varying perceptions of stress and different ways of responding to and coping with it. Stress management requires self-awareness. Recognizing that you are approaching that tipping point and intentionally stepping back from the edge is a sign of managing your stress well. Of course, making a commitment to yourself to decrease your stress is only helpful if you have some idea of how to do that. Reading this Stress Survival Guide is a great first step!\r\n\r\nThere is a plethora of information about specific stress management strategies, from mind\/body practices to time management, fitness programs and nutritional strategies. For an in-depth review of some of these approaches and more, refer to the various chapters available in the Resiliency and Self-Care<\/a> section.\r\n\r\n<\/div>","rendered":"
\"\"<\/a>
Figure 1.1 Stressed Out<\/figcaption><\/figure>\n

\u201cI\u2019m so stressed!<\/em>\u201d \u201cI can\u2019t deal with this right now!<\/em>\u201d \u201cYou\u2019re stressing me out!<\/em>\u201d Have you ever uttered one of these phrases? We all have at one point or another.<\/p>\n

The overall well-being of a person is comprised of many different spheres, including physical, emotional, spiritual, social, environmental, financial, occupational, and intellectual health. Figure 1.2 “The 8 Dimensions of Wellness” describes these spheres in a little more detail.<\/p>\n

 <\/p>\n

\"\"<\/a>
Figure 1.2 8 Dimensions of Wellness<\/figcaption><\/figure>\n

Stress results from situations that tax these resources. In the short term, stress can be energizing and positive, and in general, acute stress<\/a> is related to physical, emotional, or psychological stimuli. However, our innate survival mechanisms are counter-productive in today\u2019s world. When stress is excessive, constant, or overwhelming, it leads to chronic stimulation of an evolutionary system that was meant to function only in emergencies. Eventually, that persistent stimulation can push any of us over the edge. When we stretch ourselves beyond our limits, it can seriously negatively impact all aspects of our lives, setting us up for potentially disastrous health consequences.[1]<\/sup><\/a> Figure 1.3 provides some examples of reactions that someone may experience in their physical body, mind, emotions and behavior when undergoing stress.<\/p>\n

 <\/p>\n

\"\"<\/a>
Figure 1.3 Stress Body Mind Emotions<\/figcaption><\/figure>\n

When we\u2019re confronted with a real or even imagined danger, our body mobilizes to prepare us for one of three survival responses: fight<\/strong>, flight<\/strong>, or freeze<\/strong>.[2]<\/sup><\/a>\u00a0 Evolutionarily, our stress hormones were programmed to activate in a time of serious threat such as an emergency or a fearful mental or physical situation. Ever have someone jump out and scare you? Many people cry out, their hearts race, and they start running or punching. This is a prime example of the fight or flight response. During this acute stress that lasts just seconds or minutes, we experience a release of hormones and neurotransmitters that prepare us to either stay and deal with the threat or to run away to safety. Sometimes people just freeze and become unable to speak or move.<\/p>\n

Watch the following 3 minute video of The Flight Fight Freeze Response<\/a>.<\/p>\n

 <\/p>\n