Silvia Irina Briganti

Matteo Paolucci

Stress

What is stress and how can we

define it?

Stress is a condition of alarm characterized by

an excessive and persistent request of

psychological and physical energies that an

individual has to invest to realize his objectives

or to do his duties

In psychology, stress is considered as an

adaptive reaction, connected to emotions and

responsible of changes in physiological

regulation, conscience and everyday life

behaviour, in front of situations of emergency

or serious danger

Eustress & Distress

! " Eustress is a “positive” stress, temporary and

necessary to preserve human life;

! " Distress is “negative” stress, prolonged and

harmful for both human body and mind

Physiology vs stress

Two endocrine response systems are reactive to

psychological stress: the hypotalamic-pituitary-

adrenocortical axis (HPA) and the sympathetic-

adrenal-medullary (SAM) system

Hypotalamic-pituitary-

adrenocortical axis

Cortisol, the primary effective hormone of HPA, regulates a great range of physiological processes, like inflammatory responses, metabolism of macromolecules (proteins, lipids...) and gluconeogenesis

Sympathetic-adrenal-medullary

system

Catecholamines, released after SAM

activation, work with autonomic nervous

system to control cardiovascular and immune

systems, liver, lungs and skeletal muscles

Prolonged activation of HPA and SAM

produced by stress can have serious effects on

health: clinical depression, human

immunodeficiency (HIV), cancer,

hypertension, infectious and coronary arterie

deseases etc

Immune system is vulnerable more than the others: it can be struck directly, through the innervation of lymphatic tissue, wich carries immune cells, or indirectly, through the release of HPA and SAM hormones, wich alter immune cell functions

Stressors

Common factors of stress

•" Physical stressors Illness, disabilities…

•" Enviromental stressors Poverty, natural disasters, noise…

•" Life situations Events, responsabilities, social and financial problems, relationships…

•" Behaviors Habits, lifestyle, certain patterns of thinking…

Levels of stressors

Eustress

Distress Emotional states

Physical symptoms

Signs & symptoms

Inner emotional state

Outward appearance

Physical effects

Anxiousness, nervousness,

distraction, excessive worry,

internal pressure

Distracted, self-assorbed,

irritable

Excessive fatigue, depression,

headaches, nausea, vomiting,

diarrhea, chest pain, heart

racing, dizziness or flushing,

tremolousness or restleness

Symptoms are various and individuals; is possible to find out 3 levels

of symptoms correlated with the increasing of stress level

Does Stress cause diseases?

Stressful events & diseases

Direct Effects

Other Pathways

Behaviors

•" Increased smoking

•" Decreased exercise

•" Descreased sleep

•"Poorer adherence

to medical

regimens

High and persistant stress level

Hyperactivation of

HPA & SAM

Review “Psychological stress and diseases” 10/2007

•" Clinical depression

•" Cardiovascular disease (CVD)

•" Human immunodeficiency virus (HIV)/AIDS

•" Cancer

Depression CVD HIV/AIDS Cancer

Role of stress ++ ++ ++ ?

Review “Psychological stress and diseases” 10/2007

•" Upper respiratory tract infections

•" Asthma

•" Herpes viral infections

•" Autoimmune diseases

•" Wound healing

Stress treatments

First step: identification of the

source of stress

•" What type of stressors?

•" Illness can lead to stress

•" Emotional stress can lead to illness

!" friends, family, spiritual advisers

!" doctor (interview, lab tests, ECG)

! Is there need of a medical treatment?

Self-Care at home

! " Remove yourself from the source of your stress

•" Physically

•" Mentally ! time-out

•" Relax

•" Formulate a plane for dealing with the problem

Medical treatment

! " Stress affects you as an individual: everyone reacts in different ways

! " The treatment of your stress will vary greatly depending on the types of symptoms you are experiencing and how severe they are

•" In case of psycho-somatic disease, is reccomened a counseling by qualified mental health professionals

•" In case of physical disease, medical intervention can consist in a pharmacological treatment

•" Direct to the general perception (benzodiazepine, ephedrine)

•" Direct to the specific symptom

Prevention stress management

•" Set realistic goals and limit yourself

•" Put things into perspective and try not to get upset about insignificant or

relatively unimportant matters

•" Find activities that you enjoy and set aside time to participate them on a

regular basis

•" Participate in regular physical exercise

•" Mantain a positive outlook

•" Set goals and break them into easily achievable tasks

•" Manage your time

•" Reward yourself for the good things that you do each day

Thanks & Relax!