stress

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Definition

Stress is defined as an organism's total response to environmental demands or pressures. When stress was first studied in the 1950s, the term was used to denote both the causes and the experienced effects of these pressures. More recently, however, the word stressor has been used for the stimulus that provokes a stress response. One recurrent disagreement among researchers concerns the definition of stress in humans. Is it primarily an external response that can be measured by changes in glandular secretions, skin reactions, and other physical functions, or is it an internal interpretation of, or reaction to, a stressor; or is it both?

Description

Stress in humans results from interactions between persons and their environment that are perceived as straining or exceeding their adaptive capacities and threatening their well-being. The element of perception indicates that human stress responses reflect differences in personality, as well as differences in physical strength or general health.

Risk factors for stress-related illnesses are a mix of personal, interpersonal, and social variables. These factors include lack or loss of control over one's physical environment, and lack or loss of social support networks. People who are dependent on others (e.g., children or the elderly) or who are socially disadvantaged (because of race, gender, educational level, or similar factors) are at greater risk of developing stress-related illnesses. Other risk factors include feelings of helplessness, hopelessness, extreme fear or anger, and cynicism or distrust of others.

— Rebecca J. Frey

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n.

1. Importance, significance, or emphasis placed on something. See synonyms at emphasis.
2. Linguistics.
   1. The relative force with which a sound or syllable is spoken.
   2. The emphasis placed on the sound or syllable spoken most forcefully in a word or phrase.
3. 1. The relative force of sound or emphasis given a syllable or word in accordance with a metrical pattern.
   2. A syllable having strong relative emphasis in a metrical pattern.
4. Accent or a mark representing such emphasis or force.
5. Physics.
   1. An applied force or system of forces that tends to strain or deform a body.
   2. The internal resistance of a body to such an applied force or system of forces.
6. 1. A mentally or emotionally disruptive or upsetting condition occurring in response to adverse external influences and capable of affecting physical health, usually characterized by increased heart rate, a rise in blood pressure, muscular tension, irritability, and depression.
   2. A stimulus or circumstance causing such a condition.
7. A state of extreme difficulty, pressure, or strain: “He presided over the economy during the period of its greatest stress and danger” (Robert J. Samuelson).

tr.v., stressed, stress·ing, stress·es.

1. To place emphasis on: stressed basic fire safety.
2. To give prominence to (a syllable or word) in pronouncing or in accordance with a metrical pattern.
3. To subject to physical or mental pressure, tension, or strain.
4. To subject to mechanical pressure or force.
5. To construct so as to withstand a specified stress.

phrasal verb:

stress out Informal.

1. To subject to or undergo extreme stress, as from working too much.

[Middle English stresse, hardship, partly from destresse (from Old French; see distress) and partly from Old French estrece, narrowness, oppression (from Vulgar Latin *strictia, from Latin strictus, past participle of stringere, to draw tight; see strait).]

Generally, environmental events of a challenging sort as well as the body's response to such events. Of particular interest has been the relationship between stress and the body's adaptation to it on the one hand and the body's susceptibility to disease on the other. Both outcomes involve behavioral and brain changes as well as psychosomatic events, that is, changes in body function arising from the ability of the brain to control such function through neural output as well as hormones. One problem is that both environmental events and bodily responses have been referred to interchangeably as stress. It is preferable to refer to the former as the stressor and the latter as the stress response. The stress response consists of a cascade of neural and hormonal events that have short- and long-lasting consequences for brain and body alike. A more serious issue is how an event is determined to be a stressor. One view is to define a stressor as an environmental event causing a negative outcome, such as a disease. Another approach is to view stressors as virtually any challenge to homeostasis and to regard disease processes as a failure of the normal operation of adapative mechanisms, which are part of the stress response. With either view, it is necessary to include psychological stressors, such as fear, that contain implied threats to homeostasis and that evoke psychosomatic reactions. These are reactions that involve changes in neural and hormonal output caused by psychological stress. Psychosomatic reactions may lead to adaptive responses, or they may exacerbate disease processes. Whether the emphasis is on adaptation or disease, it is essential to understand the processes in the brain that are activated by stressors and that influence functions in the body. See also Homeostasis; Psychosomatic disorders.

Among the many neurotransmitter systems activated by stress is noradrenaline, produced by neurons with cell bodies in the brainstem that have vast projections up to the forebrain and down the spinal cord. Stressful experiences activate the noradrenergic system and promote release of noradrenaline; severe stress leads to depletion of noradrenaline in brain areas such as the hypothalamus. This release and depletion of noradrenaline stores results in changes at two levels of neuronal function: phosphorylation is triggered by the second-messenger cyclic AMP and occurs in the presynaptic and postsynaptic sites where noradrenaline is released and where it also acts; synthesis of new protein is induced via actions on the genome. Both processes enhance the ability of the brain to form noradrenaline when the organism is once again confronted with a stressful situation. Other neurotransmitter systems may also show similar adaptive changes in response to stressors. See also Noradrenergic system.

Stress also activates the neurally mediated discharge of adrenaline from the adrenal medulla and of hypothalamic hormones that initiate the neuroendocrine cascade, culminating in glucocorticoid release from the adrenal cortex. Thus, the activity of neurons triggered by stressful experiences, physical trauma, fear, or anger leads to hormone secretion that has effects throughout the body. Virtually every organ of the body is affected by stress hormones. The hypothalamic hormone (corticotrophin-releasing hormone) that triggers the neuroendocrine cascade directly stimulates the pituitary to secrete ACTH. In response to certain stressors, the hypothalamus also secretes vasopressin and oxytocin, which act synergistically with corticotrophin-releasing hormone on the pituitary to potentiate the secretion of ACTH. Various stressors differ in their ability to promote output of vasopressin and oxytocin, but all stressors stimulate release of corticotrophin-releasing hormone. Other hormones involved in the stress response include prolactin and thyroid hormone; the metabolic hormones insulin, epinephrine, and glucagon; and the endogenous opiates endorphin and enkephalin. See also Endorphins.

Of all the hormones in the endocrine cascade initiated by stress, the glucocorticoids are the most important because of their widespread effects throughout the body and in the brain. The brain contains target cells for adrenal glucocorticoids secreted in stress, and receptors in these cells are proteins that interact with the genome to affect expression of genetic information. Thus, the impact of stress-induced activation of the endocrine cascade that culminates in glucocorticoid release is the feedback of glucocorticoids on target brain cells. The effect is to alter the structure and function of the brain cells over a period of time ranging from hours to days.

In the case of noradrenaline, glucocorticoids have several types of feedback effects that modify how the noradrenergic system responds to stress. Glucocorticoids inhibit noradrenaline release, and they reduce the second-messenger response of brain structures such as the cerebral cortex to noradrenaline. Glucocorticoid feedback also affects the serotonin system, facilitating serotonin formation during stress but at the same time altering the levels of several types of serotonin receptors in different brain regions, which has the net effect of shifting the balance within the serotonergic system. Taken together, evidence points to a role of glucocorticoid secretion in leading to restoration of homeostatic balance by counteracting the acute neural events such as increased activity of noradrenaline and serotonin, which are turned on by stressful experiences. Other neurotransmitter systems may also respond to glucocorticoid action. Moreover, the other hormones activated by stress have effects on the brain and body that must be considered. See also Serotonin.

In general, stress hormones are protective and adaptive in the immediate aftermath of stress, and the organism is more vulnerable to many conditions without them. However, the same hormones can promote damage and accelerate pathophysiological changes, such as bone mineral loss, obesity, and cognitive impairment, when they are overproduced or not turned off. This wear-and-tear on the body has been called allostatic load. It is based upon the notion that allostasis is the active process of maintaining stability, or homeostasis, through change, and allostatic load is the almost inevitable cost to the body of doing so.

Stress hormone actions have important effects outside the brain on such systems as the immune response. Glucocorticoids and catecholamines from sympathetic nerves and the adrenal medulla participate in the mobilization and enhancement of immune function in the aftermath of acute stress. These effects improve the body's defense against pathogens but can exacerbate autoimmune reactions. When they are secreted chronically, the stress-related hormones are generally immunosuppressive; such effects can be beneficial in the case of an autoimmune disease but may compromise defense against a virus or bacterial infections. At the same time, glucocorticoids are important agents for containing the acute-phase response to an infection or autoimmune disturbance. In the absence of such containment, the organism may die because of the excessive inflammatory response. See also Immunology.

Besides affecting the immune response, stressors are believed to exacerbate endogenous depressive illness in susceptible individuals. Major depressive illness frequently results in elevated levels of cortisol in the blood. It is not clear whether the elevated cortisol is a cause or strictly a result of the brain changes involved in depressive illness. See also Affective disorders.

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Stress is a word derived from the Latin word stringere, meaning to draw tight, and was used in the seventeenth century to describe hardship and affliction. During the late eighteenth century (as Hinkle records), stress denoted ‘force, pressure, strain, or strong effort’, referring primarily to an individual, or to the individual's organs or mental powers.

Definitions of strain and load used in physics and engineering eventually began to influence our understanding of how stress affects individuals and their health. Under this concept, external forces (load) are seen as exerting pressure upon an individual, producing strain. Proponents of this view felt that they could measure the stress to which an individual is subjected, in the same way we can measure physical strain on a machine. While this concept looks at stress as an outside stimulus, an alternative concept defines stress as a person's response to a disturbance. As early as 1910, Sir William Osler explored the idea of stress and strain causing ‘disease’, when he saw a relationship between chest pains (angina pectoris) and a hectic pace of life. The idea that environmental forces could actually cause disease rather than just short-term ill health effects, and that people have a natural tendency to resist such forces, was seen in the work of Walter B. Cannon in the 1930s. Cannon studied the effects of stress in animals and people, and in particular studied the ‘fight or flight’ reaction. Through this reaction, people, as well as animals, will choose whether to stay and fight or try to escape when confronting extreme danger. Cannon observed that when his subjects experienced situations of cold, lack of oxygen, or excitement, he could detect physiological changes such as emergency adrenaline secretions. Cannon described these individuals as being ‘under stress’.

One of the first scientific attempts to explain the process of stress-related illness was made in 1946 by physician Hans Selye, who described three stages an individual encounters in stressful situations: (i) alarm reaction, in which an initial phase of lowered resistance is followed by countershock, during which the individual's defence mechanisms become active; (ii) resistance, the stage of maximum adaption and, hopefully, successful return to equilibrium for the individual. If, however, the stress agent continues or the defence mechanism does not work, he will move on to a third stage; (iii) exhaustion, when adaptive mechanisms collapse.

Critics of Selye's work say it ignores both the psychological impact of stress on an individual, and the individual's ability to recognize stress and act in various ways to change his or her situation.

Newer and more comprehensive theories of stress emphasize the interaction between a person and his or her environment, describing it as a response to internal or external pressures which reach levels that strain physical and psychological systems beyond their coping capacities.

In the 1970s Richard S. Lazarus suggested that an individual's stress reaction ‘depends on how the person interprets or appraises (consciously or unconsciously) the significance of a harmful, threatening, or challenging event.’ Lazarus' work disagrees with those who see stress simply as environmental pressure. Instead, the intensity of the stress experience is determined significantly by how well people feel they can cope with an identified threat. Any person who is unsure of his or her coping abilities, or is likely to feel helpless and overwhelmed.

Similarly, Tom Cox and colleagues in the late 1970s rejected the idea of looking at stress as simply either environmental pressures or physiological responses; they suggest that it can best be understood as ‘part of a complex and dynamic system of transaction between the person and his environment’ and criticize the mechanical model of stress: ‘Men and their organizations are not machines … Stress has to be perceived or recognized by man. A machine, however, does not have to recognize the load or stress placed upon it.’

By looking at stress as resulting from a misfit between an individual and his/her particular environment, we can begin to understand why one person seems to flourish in a certain setting, while another suffers. Tom Cummings and Cary Cooper in 1979 explored the stress process in a cybernetic framework as follows:

(i) Individuals, for the most part, try to keep their thoughts, emotions, and relationships with the world in a ‘steady state’.
(ii) Each factor of a person's emotional and physical state has a ‘range of stability’, in which that person feels comfortable. On the other hand, when forces disrupt one of these factors beyond the range of stability, the individual must act or cope to restore a feeling of comfort.
(iii) An individual's behaviour aimed at maintaining a steady state makes up his or her ‘adjustment process’, or coping strategies.

Accordingly, a stress is any force that puts a psychological or physical factor beyond its range of stability, producing a strain within the individual. Knowledge that a stress is likely to occur constitutes a threat to the individual. A threat can cause a strain because of what it signifies to the person.

Stress certainly involves a range of bodily reactions. Man is the product of many thousands of years of evolution, and to survive required a quick physical response to dangers. The body developed the ability to ‘rev-up’ for a short time. Cannon described this mobilization of forces as the ‘fight or flight’ reaction mentioned earlier. Primitive man expended this burst of energy and strength in physical activity, such as a life and death struggle or a quick dash to safety.

Modern man has retained his hormonal and chemical defence mechanisms through the millenia. But for the most part, the lifestyle in the Western world today does not allow physical reaction to the stress agents we face. As Albrecht pointed out, attacking the boss, hitting an insolent customer, or smashing an empty automatic cash dispenser are not solutions allowed by contemporary society. Even the non-aggressive ‘flight’ reaction would hardly be judged appropriate in most situations. The executive who flees from a tense meeting, and the assembly worker who dashes out in the middle of a shift, will likely suffer the consequences of their actions. Our long-evolved defence mechanisms prepare us for dramatic and rapid action, but find little outlet. The body's strong chemical and hormonal responses are then like frustrated politicians: all dressed up with nowhere to go, as Melhuish describes it.

It is this waste of our natural response to stress which may actually harm us. Although scientists do not fully understand this process, our thought patterns regarding ourselves and the situations we are in can trigger widespread physiological changes, acting through the hypothalamus — the part of the brain which co-ordinates a complexity of neural and hormonal mechanisms for taking care of bodily functions. In a situation of challenge, tension, or pressure, the hypothalamus activates both the sympathetic branch of the autonomic nervous system and certain hormone secretions from the pituitary gland. The resulting release of adrenaline and other hormones, together with other actions of sympathetic nerves, enhances the level of arousal and stimulates the cognitive, neural, cardiovascular, and muscular systems, whilst also mobilizing metabolic fuels to provide energy for an increase in muscular activity. These physiological changes are designed to improve the individual's performance: the heart speeds up and beats more strongly; this and widening of muscle blood vessels increase the blood supply of the muscles; breathing rate and depth increase. Blood pressure rises, and less blood flows to the stomach and the intestines, as well as the skin, resulting in the cold hands and feet often associated with a nervous disposition.

All of the body's ‘rev-up’ activity is designed to improve performance. But if the stress which launches this activity continues unabated, researchers believe, the human body begins to weaken as it is bombarded by stimulation and stress-related chemicals. As stress begins to take its toll on the body and mind, a variety of symptoms can result. We have identified physical and behavioural symptoms of stress occurring before the onset of serious stress-related illnesses; these include: insomnia, eating difficulties, breathlessness without exertion, a tendency to sweat with no good reason, frequent intestinal difficulties, loss of sense of humour, constant irritability with people, difficulty with making decisions, suppressed anger, difficulty in concentrating, the inability to finish one task before rushing on to the next, and so on. Many of these symptoms are the prelude to more serious illnesses, in which stress is one of the risk factors. Recent research has shown that the psycho-social or stress risk factors can be found in hypertension, chronic fatigue syndrome, coronary artery disease, mental disorders, and a range of other illnesses; also suppression of immune responses by the stress-related hormones may provide chemical explanations of links between environmental and emotional pressures and susceptibility to diseases.

— Cary L. Cooper

Bibliography

• Albrecht, K. (1979). Stress and the manager. Making it work for you. Prentice-Hall, New Jersey.
• Cooper, C. (ed.) (1996). Handbook of stress, medicine and health. CRC Press, Boca Raton, Florida.
• Hinkle, L. E. (1973). The concept of stress in the biological social sciences. Stress medicine and man 1, 31-48.
• Lazarus, R. E. (1976). Patterns of adjustment. McGraw-Hill, New York.
• Melhuish, A. (1978). Executive health. Business Books, London

See also autonomic nervous system.

A psychological condition occurring when individuals feel unable to cope with the demands being made on them. They also believe that this failure will have important consequences. This condition is sometimes called distress, to distinguish it from the positive or pleasant aspects of stressful situations (eustress). Stress is usually associated with feeling a lack of control and involvement in the decisions which affect life and work.

The jobs with the highest strain are those in which there is heavy pressure to perform, where hours and procedures are rigid, there is a threat of redundancy, there is little opportunity to learn new skills, and there is little involvement in decision making. Such jobs tend to be the least prestigious. Workers low in the hierarchy tend to experience the most stress. It is unclear how stress affects health, but one possibility is that it disturbs important systems in the body, such as the hormonal, nervous, or immune system.

Although it may not be possible to change jobs, the effects of stress can be relieved by exercise and a healthy diet. Regular aerobic exercise, consisting of a daily 40-minute brisk walk, can reduce anxiety by as much as 14 per cent. In stressful situations, those who exercise regularly tend to have less muscle tension and lower blood pressure than inactive people.

noun

1. Special weight placed upon something considered important: accent, accentuation, emphasis. See important/unimportant.
2. The act, condition, or effect of exerting force on someone or something: pressure, strain¹, tension. See push/pull.

verb

To accord emphasis to: accent, accentuate, emphasize, feature, highlight, italicize, play up, point up, underline, underscore. See important/unimportant.

n

Definition: physical or mental pressure
Antonyms: indifference, relaxation

v

Definition: accentuate, emphasize
Antonyms: attenuate, reduce, relax

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n

1. a force induced by or resisting an external force; measured in terms of force per unit area. 2. the force of energy directed against a tissue structure or against the function of tissue as the result of injury and trauma associated with fracture, burn, infection, surgical procedure, pharmacologic action, or anxiety states. The response to stress involves local metabolic function, the hormonal activity of the endocrine system regulated by the pituitary gland, and the autonomic and central nervous systems. The stress phenomenon is frequently associated with the general adaptation syndrome. 3. in prosthetic dentistry, forcibly exerted pressure (for example, the pressure of the upper teeth against the mandibular teeth or the pressure contact of a distorted removable partial denture on the supporting teeth or ridge structures).

Definition

Stress is an individual's physical and mental reaction to environmental demands or pressures.

Description

When stress was first studied, the term was used to denote both the causes and the experienced effects of these pressures. More recently, however, the word stressor has been used for the stimulus that provokes a stress response. One recurrent disagreement among researchers concerns the definition of stress in humans. Is it primarily an external response that can be measured by changes in glandular secretions, skin reactions, and other physical functions, or is it an internal interpretation of, or reaction to, a stressor; or is it both?

Stress was first studied in 1896 by Walter B. Cannon (1871–1945). Cannon used an x-ray instrument called a fluoroscope to study the digestive system of dogs. He noticed that the digestive process stopped when the dogs were under stress. Stress triggers adrenal hormones in the body and the hormones become unbalanced. Based on these findings, Cannon continued his experimentation and came up with the term homeostasis, a state of equilibrium in the body.

Hans Selye, a Canadian scientist (1907–1982), noticed that people who suffered from chronic illness or disease showed some of the same symptoms. Selye related this to stress and he began to test his hypothesis. He exposed rats to different physical stress factors such as heat, sound, poison, and shock. The rats showed enlarged glands, shrunken thymus glands and lymph nodes, and gastric ulcers. Selye then developed the Three Stage Model of Stress Response. This model consisted of alarm, resistance, and exhaustion. Selye also showed that stress is mediated by cortisol, a hormone that is released

TOP TEN STRESSFUL EVENTS
Death of spouse
Divorce
Marital separation
Jail term or death of close family member
Personal injury or illness
Marriage
Loss of job due to termination
Marital reconciliation or retirement
Pregnancy
Change in financial state

from the adrenal cortex. This increases the amount of glucose in the body while under stress.

Stress in humans results from interactions between persons and their environment that are perceived as straining or exceeding their adaptive capacities and threatening their well-being. The element of perception indicates that human stress responses reflect differences in personality, as well as differences in physical strength or general health.

Risk factors for stress-related illnesses are a mix of personal, interpersonal, and social variables. These factors include lack or loss of control over one's physical environment, and lack or loss of social support networks. People who are dependent on others (e.g., children or the elderly) or who are socially disadvantaged (because of race, gender, educational level, or similar factors) are at greater risk of developing stress-related illnesses. Other risk factors include feelings of helplessness, hopelessness, extreme fear or anger, and cynicism or distrust of others.

Causes & Symptoms

Causes

The causes of stress can include any event or occurrence that a person considers a threat to his or her coping strategies or resources. Researchers generally agree that a certain degree of stress is a normal part of a living organism's response to the inevitable changes in its physical or social environment, and that positive as well as negative events can generate stress. Stress-related disease, however, results from excessive and prolonged demands on an organism's coping resources. It is now believed that 80–90% of all disease is stress-related.

Recent research indicates that some vulnerability to stress is genetic. Scientists at the University of Wisconsin and King's College, London, discovered that people who inherited a short, or stress-sensitive, version of the serotonin transporter gene were almost three times as likely to experience depression following a stressful event as people with the long version of the gene. Further research is likely to identify other genes that affect susceptibility to stress.

One cause of stress that has affected large sectors of the general population around the world since 2001 is terrorism. The events of September 11, 2001, the sniper shootings in Virginia and Maryland, the Bali nightclub bombing in 2002, and the suicide bombings in the Middle East in 2003 have all been shown to cause short-term symptoms of stress in people who read about them or watch television news reports as well as those who witnessed the actual events. Stress related to terrorist attacks also appears to affect people in countries far from the location of the attack as well as those in the immediate vicinity. It is too soon to tell how stress related to episodes of terrorism will affect human health over long periods of time, but researchers are already beginning to investigate this question.

Symptoms

The symptoms of stress can be either physical and/or psychological. Stress-related physical illnesses, such as irritable bowel syndrome, heart attacks, and chronic headaches, result from long-term overstimulation of a part of the nervous system that regulates the heart rate, blood pressure, and digestive system. Stress-related emotional illness results from inadequate or inappropriate responses to major changes in one's life situation, such as marriage, completing one's education, the death of a loved one, divorce, becoming a parent, losing a job, or retirement. Psychiatrists sometimes use the term adjustment disorder to describe this type of illness. In the workplace, stress-related illness often takes the form of burnout—a loss of interest in or ability to perform one's job due to long-term high stress levels.

Diagnosis

When the doctor suspects that a patient's illness is connected to stress, he or she will take a careful history that includes stressors in the patient's life (family or employment problems, other illnesses, etc.). Many physicians will evaluate the patient's personality as well, in order to assess his or her coping resources and emotional response patterns. There are a number of personality inventories and psychological tests that doctors can use to help diagnose the amount of stress that the patient experiences and the coping strategies that he or she uses to deal with them. Stress-related illness can be diagnosed by primary care doctors as well as by those who specialize in psychiatry. The doctor will need to distinguish between adjustment disorders and anxiety or mood disorders, and between psychiatric disorders and physical illnesses (e.g. thyroid activity) that have psychological side effects.

Treatment

Relaxation training, yoga, t'ai chi, and dance therapy help patients relieve physical and mental symptoms of stress. Hydrotherapy, massage therapy, and aromatherapy are useful to some anxious patients because they can promote general relaxation of the nervous system. Essential oils of lavender, chamomile, neroli, sweet marjoram, and ylang-ylang are commonly recommended by aromatherapists for stress relief.

Meditation can also be a useful tool for controlling stress. Guided imagery, in which an individual is taught to visualize a pleasing and calming mental image in order to counteract feelings of stress, is also helpful. Many individuals may find activities such as exercise, art, music, and writing useful in reducing stress and promoting relaxation.

Sometimes the best therapy for alleviating stress is a family member or friend who will listen. Talking about stressful situations and events can help an individual work through his or her problems and consequently reduce the level of stress related to them. Having a social support network to turn to in times of trouble is critical to everyone's mental and physical well-being. Pet therapy has also been reported to relieve stress.

Herbs known as adaptogens may also be prescribed by herbalists or holistic healthcare providers to alleviate stress. These herbs are thought to promote adaptability to stress, and include Siberian ginseng (Eleutherococcus senticosus), ginseng (Panax ginseng), wild yam (Dioscorea villosa), borage (Borago officinalis), licorice (Glycyrrhiza glabra), chamomile (Chamaemelum nobile), milk thistle (Silybum marianum), and nettle (Urtica dioica).

Practitioners of Ayurvedic, or traditional Indian, medicine might prescribe root of winter cherry, fruit of emblic myrobalan, or the traditional formulas geriforte or mentat to reduce stress and fix the imbalance in the vata dosha.

It is also said that stress reduces the body's immune response, therefore vitamin supplementation can be helpful in counteracting the depletion. Diet is also important—coffee and other caffeinated beverages in high doses produce jitteriness, restlessness, anxiety, and insomnia. High-protein foods from animal sources elevate brain levels of dopamine and norepinephrine, which are associated with higher levels of anxiety and stress. Whole grains promote production of the brain neuro-transmitter serotonin for a greater sense of well-being.

Allopathic Treatment

Recent advances in the understanding of the many complex connections between the human mind and body have produced a variety of mainstream approaches to stress-related illness. Present treatment regimens may include one or more of the following:

• Medications. These may include drugs to control blood pressure or other physical symptoms of stress as well as drugs that affect the patient's mood (tranquilizers or antidepressants).
• Stress management programs. These may be either individual or group treatments, and usually involve analysis of the stressors in the patient's life. They often focus on job- or workplace-related stress. A number of studies have found that good stress management programs significantly reduce absenteeism from work and visits to the doctor. They also improve immune system function and overall well-being in patients with such chronic disorders as HIV infection and diabetes.
• Behavioral approaches. These strategies include relaxation techniques, breathing exercises, and physical exercise programs including walking.
• Biofeedback. Biofeedback is a technique in which patients are taught to interpret and respond to signals from their own bodies. It can be taught by doctors, dentists, nurses, and physical therapists as well as by psychologists or psychiatrists. Biofeedback is often recommended as a treatment for chronic tension-type headaches.
• Massage. Therapeutic massage relieves stress by relaxing the large groups of muscles in the back, neck, arms, and legs. It is particularly helpful for people who tend to convert stress into muscle tension.
• Cognitive therapy. These approaches teach patients to reframe or mentally reinterpret the stressors in their lives in order to modify the body's physical reactions.

Expected Results

The prognosis for recovery from a stress-related illness is related to a wide variety of factors in a person's life, many of which are genetically determined (race, sex, illnesses that run in families) or beyond the individual's control (economic trends, cultural stereotypes and prejudices). It is possible, however, for humans to learn new responses to stress and change their experiences of it. A person's ability to remain healthy in stressful situations is sometimes referred to as stress hardiness. Stress-hardy people have a cluster of personality traits that strengthen their ability to cope. These traits include believing in the importance of what they are doing; believing that they have some power to influence their situation; and viewing life's changes as positive opportunities rather than as threats.

Prevention

Complete prevention of stress is neither possible nor desirable because stress is an important stimulus of human growth and creativity, as well as an inevitable part of life. In addition, specific strategies for stress prevention vary widely from person to person, depending on the nature and number of the stressors in an individual's life, and the amount of control he or she has over these factors. In general, however, a combination of attitudinal and behavioral changes work well for most patients. The best form of prevention appears to be parental modeling of healthy attitudes and behaviors within the family.

Resources

Books

Clark, R. Barkley. "Psychosocial Aspects of Pediatrics and Psychiatric Disorders." Current Pediatric Diagnosis &Treatment. Edited by William W. Hay, Jr., et al. Stamford, CT: Appleton & Lange, 1997.

Eisendrath, Stuart J. "Psychiatric Disorders." Current Medical Diagnosis & Treatment. Edited by Lawrence M. Tierney, Jr., Stephen J. McPhee, and Maxine A. Papadakis. Stamford, CT: Appleton &Lange, 1997.

Pelletier, Kenneth R., MD. The Best Alternative Medicine, Part I, "Spirituality and Healing." New York: Simon & Schuster, 2002.

"Psychiatry in Medicine." Section 15, Chapter 185 in The Merck Manual of Diagnosis and Therapy, edited by Mark H. Beers, MD, and Robert Berkow, MD. Whitehouse Station, NJ: Merck Research Laboratories, 1999.

Selye, Hans, MD. The Stress of Life. New York, Toronto, and London: McGraw-Hill Book Company, 1956.

Periodicals

Antoni, M. H., D. G. Cruess, N. Klimas, et al. "Stress Management and Immune System Reconstitution in Symptomatic HIV-Infected Gay Men Over Time: Effects on Transitional Naive T Cells (CD4(+)CD45RA(+)CD29(+))." American Journal of Psychiatry 159 (January 2002): 143-145.

Blumenthal, J. A., M. Babyak, J. Wei, et al. "Usefulness of Psychosocial Treatment of Mental Stress-Induced Myocardial Ischemia in Men." American Journal of Cardiology 89 (January 15, 2002): 164-168.

Cardenas, J., K. Williams, J. P. Wilson, et al. "PSTD, Major Depressive Symptoms, and Substance Abuse Following September 11, 2001, in a Midwestern University Population" International Journal of Emergency Mental Health 5 (Winter 2003): 15–28.

Gallo, L. C., and K. A. Matthews. "Understanding the Association Between Socioeconomic Status and Physical Health: Do Negative Emotions Play a Role?" Psychological Bulletin 129 (January 2003): 10–51.

Hawkley, L. C., and J. T. Cacioppo. "Loneliness and Pathways to Disease." Brain, Behavior, and Immunity 17 (February 2003) (Supplement 1): S98–S105.

Latkin, C. A., and A. D. Curry. "Stressful Neighborhoods and Depression: A Prospective Study of the Impact of Neighborhood Disorder." Journal of Health and Social Behavior 44 (March 2003): 34–44.

Ottenstein, R. J. "Coping with Threats of Terrorism: A Protocol for Group Intervention." International Journal of Emergency Mental Health 5 (Winter 2003): 39–42.

Rahe, R. H., C. B. Taylor, R. L. Tolles, et al. "A Novel Stress and Coping Workplace Program Reduces Illness and Healthcare Utilization." Psychosomatic Medicine 64 (March-April 2002): 278-286.

Solomon, G. D. "Chronic Tension-Type Headache: Advice for the Viselike-Headache Patient." Cleveland Clinic Journal of Medicine 69 (February 2002): 173-174.

Surwit, R. S., M. A. van Tilburg, N. Zucker, et al. "Stress Management Improves Long-Term Glycemic Control in Type 2 Diabetes." Diabetes Care 25 (January 2002): 30-34.

West, P., and H. Sweeting. "Fifteen, Female and Stressed: Changing Patterns of Psychological Distress Over Time." Journal of Child Psychology and Psychiatry 44 (March 2003): 399–411.

Organizations

The American Institute of Stress. 124 Park Avenue, Yonkers, NY 10703 (914) 963-1200. Fax: (914) 965-6267. .

National Institute of Mental Health (NIMH). 6001 Execut Boulevard, Room 8184, MSC 9663, Bethesda, MD 20892-9663. (301) 443-4513. .

Stress and Anxiety Research Society (STAR). STAR is an international multidisciplinary organization of researchers that began in the Netherlands in 1980. .

Other

National Center for Post-Traumatic Stress Disorder, Department of Veterans Affairs. Fact Sheet: Survivors of Human-Caused and Natural Disasters. .

National Institute of Mental Health (NIMH) news release, July 17, 2003. "Gene More Than Doubles Risk of Depression Following Life Stresses." .

[Article by: Paula Ford-Martin; Rebecca J. Frey, PhD]

Over the course of evolution, the human mind and body have developed means of handling stressful situations. Over the short term, such stress response pathways are highly adaptive, allowing a person to manage his or her resources in order to navigate the crisis; in some cases, however, these processes go awry and result in pathology. Chronic stress is becoming increasingly problematic in the United States as workers work longer and harder hours. Approximately one-third of all workers report that they are in high-stress jobs, and that not only is stress implicated in 15 percent of all disability claims, the number of stress-related absences is increasing. Such prolonged exposure to stress can also result in consequences in the form of physical illness. Alternatively, a severe acute stressor may result in a stress-response syndrome such as an acute stress disorder or a post-traumatic stress disorder.

In acute stress, the mind and body respond with a fight or flight response that involves activation of the sympathetic nervous system and release of stress hormones such as cortisol. Psychologically, this increases the organism's alertness and response time. Physiologically, these changes provide the organism with the energy needed to meet the emergency. Such intense activation helps the organism in the short term, but prolonged activation of this system creates problems in that it may increase the risk of certain disease states, and, once set into motion, chronic stress responses may be difficult to extinguish. This has led some researchers to investigate potential mediating factors such as personality. For example, a correlation has been established between a personality characterized by hostile competitiveness (type A) and increased risk of myocardial infarction (heart attack).

An acute stressor or psychological trauma, such as a life-threatening circumstance, presents a person with new information that may be difficult to assimilate. In an attempt to adapt, the person will typically alternate between contemplation of the stressor and avoidance of reminders of the event. Such a cycle allows for dose-by-dose psychological processing of the event. Difficulties in adaptation may present as an acute stress disorder that manifests itself as an extreme version of this cycle. People with such a disorder may have intrusive remembrances, nightmares, or even flashbacks of the stress event. These can alternate with emotional numbing, interpersonal alienation, and extreme avoidance of traumatic reminders. A diagnosis of postraumatic stress disorder (PTSD) is made if these symptoms persist longer than one month. Studies suggest that approximately 0.5 percent of men and 1.3 percent of women meet criteria for PTSD over their lifetime. A larger percentage (approximately 15%) of subjects were found to have some symptoms but did not meet criteria for the full disorder.

At present, psychotherapy is the mainstay of treatment for stress response syndromes. A variety of approaches exist, but they share a common goal of assisting the patient with conscious contemplation of the event in such a way that it may be assimilated and anxiety responses extinguished. Care must be taken to create an environment of safety and to avoid retraumatization, which may occur with overly rapid exposure to traumatic memories. Patients experience decreased feelings of guilt and shame as they learn that they responded to the trauma as adequately as possible. Contemplation of the event in therapy may lead to further benefits, including an enhanced understanding of the meaning of the event in the larger context of the individual's life.

Psychopharmacologic treatment may be a useful adjunct for specific symptom clusters such as associated anxiety, depression, and insomnia. The prognosis for treatment is good and is improved if the patient was without preexisting psychiatric comorbidity and if the treatment occurs in close proximity to the event. Brief treatment is frequently helpful in restoring a patient to a baseline level of functioning, but longer-term treatment may be necessary if exposure to the stressor was chronic or occurred in childhood.

Stress response systems have developed in humans as an adaptive mechanism to assist individuals in times of crisis. These systems, however, may also result in physical or psychological pathology. Chronic overactivation of the stress response may predispose an individual to greater risk for physical illnesses such as heart disease. Overly intense exposure to an acute stressor may result in a stress response syndrome with potentially disabling consequences. Treatment is, however, available and may return individuals to their previous level of functioning. A subset of patients even report a sense of enhanced insight into their lives as a result of the trauma.

(SEE ALSO: Mental Health)

Bibliography

Eisendrath, S. J., and Feder, A. (1995). "The Mind and Somatic Illness: Psychological Factors Affecting Physical Illness." In Review of General Psychiatry. ed. H. H. Goldman. Norwalk CT: Appleton & Lang.

Horowitz, M. J. (1997). Stress Response Syndromes: PTSD, Grief and Adjustment Disorders, 3rd edition. Northvale, NJ: Aranson.

Van der Kolk, B. A.; McFarlane, A. C.; and Weisaeth, L. (1996). Traumatic Stress: The Effects of Overwhelming Experience on Mind, Body and Society. New York: Guilford Press.

— JAMES POWERS; STUART J. EISENDRATH

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The force applied to a unit area of a substance measured in newtons per square metre. Compressive stress crushes the rock which may collapse as the air pockets within it are compressed. Tensile stress is a force which tends to pull a rock or soil apart and which may cause fractures and pores to open. A shear stress deforms a rock or soil by one part sliding over another.

For more information on stress, visit Britannica.com.

The internal forces set up at a point in an elastic material by the action of external forces; expressed in units of force per unit area, e.g., pounds per square inch or kilograms per square millimeter.

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1. The magnitude of a distorting force, expressed as force per unit area of the surface on which it is applied. If the stress on an object, such as bone, exceeds the tolerance load, a fracture may occur (see also stress fracture). A compressive stress results from squeezing or pressing objects together; tensile stress results from pulling forces (see tension); and shear stress results from sliding forces (see shear force).

2. Any factor, physical or psychological, that tends to disturb homeostasis and has a detrimental effect on body functions

3. A psychological condition occurring when individuals perceive a substantial imbalance between demands being made on them and their ability to meet those demands, where failure to do so has important consequences. See also distress, eustress, general adaptation syndrome, state anxiety, triad response.

A physical factor, such as injury, or mental state, such as anxiety, that disturbs the body's normal state of functioning. Stress may contribute to the development of some illnesses, including heart disease and cancer.

The term stress also refers to the physical and mental state produced in the body when it is influenced by such factors: “The stress of the new job was too much for Tim, so he requested reassignment to his old position in the company.”

1. forcibly exerted influence; pressure, e.g. compression, tension.
2. the sum of the biological reactions to any adverse stimulus, physical, mental, or emotional, internal or external, that tends to disturb the homeostasis of an organism. Should these reactions be inappropriate, they may lead to disease states. The term is also used to refer to the stimuli that elicit the reactions, e.g. heat, nutritional, lactational, confinement, transportation. See also psychosomatic disease.

• s. induced diarrhea of the horse — see acute undifferentiated and chronic undifferentiated diarrhea of the horse.
• porcine s. syndrome — see porcine stress syndrome.
• s. reaction — see alarm reaction.
• s.-starvation syndrome — said of sheep. See pregnancy toxemia.
• s. testing — a test for evaluating circulatory response to physical stress produced by exercise. See also exercise testing.

IN BRIEF: A physical, chemical, or emotional event that causes bodily or mental tension.

If you had to define stress, it would not be far off if you said it was the process of living. The process of living is the process of having stress imposed on you and reacting to it. — Stanley J. Sarnoff

Quotes:

"The perfect no-stress environment is the grave. When we change our perception we gain control. The stress becomes a challenge, not a threat. When we commit to action, to actually doing something rather than feeling trapped by events, the stress in our life becomes manageable." - Greg Anderson

"You don't get ulcers from what you eat. You get them from what's eating you." - Vicki Baum

"Pressure and stress is the common cold of the psyche." - Andrew Denton

"When you suffer an attack of nerves you're being attacked by the nervous system. What chance has a man got against a system?" - Russell Hoban

"In this world without quiet corners, there can be no easy escapes from history, from hullabaloo, from terrible, unquiet fuss." - Salman Rushdie

"Mental tensions, frustrations, insecurity, aimlessness are among the most damaging stressors, and psychosomatic studies have shown how often they cause migraine headache, peptic ulcers, heart attacks, hypertension, mental disease, suicide, or just hopeless unhappiness." - Hans Selye

See more famous quotes about Stress

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Dansk (Danish)
n. - stress, pres, tryk, betoning, eftertryk, vigtighed, belastning, spænding
v. tr. - betone, fremhæve, lægge vægt på, lægge eftertryk på, stresse

idioms:

• lay stress on    lægge vægt på, lægge tryk på, understrege, betone, fremhæve

Nederlands (Dutch)
spanning, nadruk, klemtoon, beklemtonen, drukken, onder druk zetten, testen (door extra veel te eisen)

Français (French)
n. - tension, stress, insistance, (Génie Civ, Phys) effort, (Ling, Phon) accentuation, accent
v. tr. - insister sur, mettre l'accent sur, (Ling, Mus) accentuer, (Génie Civ, Tech) soumettre (qch) à des efforts, faire travailler (métal)

idioms:

• lay stress on    insister sur, placer l'accent sur

Deutsch (German)
v. - betonen, belasten, überanstrengen
n. - Nachdruck, Betonung, Spannung, Streß, Belastung

idioms:

• lay stress on    Wert legen auf

Ελληνική (Greek)
v. - τονίζω, υπογραμμίζω, δίνω έμφαση σε, καταπονώ, κουράζω, ζορίζω, (καθομ.) προκαλώ άγχος
n. - (γραμμ., μτφ.) τονισμός, τόνος, ένταση, έμφαση, υπερένταση, άγχος, στρες, κόπωση, καταπόνηση

idioms:

• lay stress on    δίνω έμφαση σε, υπογραμμίζω

Italiano (Italian)
accentuare, accento, tensione, risalto, stress

idioms:

• lay stress on    sottolineare

Português (Portuguese)
v. - salientar
n. - acento (m), fadiga (f), pressão (f), importância (f)

idioms:

• lay stress on    acentuar

Русский (Russian)
давление, напряжение, ударение, значение, усилие, стресс, ставить ударение, подчеркивать, подвергать действию внешней силы, создавать или вызывать напряжение, стресс

idioms:

• lay stress on    придавать (чему-л.) особое значение

Español (Spanish)
n. - acento, acentuación, tensión, ansiedad, énfasis, insistencia, estrés
v. tr. - acentuar, enfatizar, recalcar, insistir en

idioms:

• lay stress on    hacer hincapié en, dar importancia a

Svenska (Swedish)
v. - stressa, utsätta för stress
n. - stress, påfrestningar

中文（简体）(Chinese (Simplified))
重压, 压力, 逼迫, 着重, 重读, 强调

idioms:

• lay stress on    把重点放在, 在...上用力

中文（繁體）(Chinese (Traditional))
n. - 重壓, 壓力, 逼迫
v. tr. - 著重, 重讀, 強調

idioms:

• lay stress on    把重點放在, 在...上用力

한국어 (Korean)
n. - 강조, 강세, 변형 작용
v. tr. - 강조하다, ~임을 강조하다, 압력을 가하다

idioms:

• lay stress on    ~을 역설하다

日本語 (Japanese)
n. - 圧迫, 緊張, ストレス, 圧力, 緊迫, 力, 強調, 重視, 強勢
v. - 強調する, 強勢を置く

العربيه (Arabic)
‏(فعل) أكد, شدد على (الاسم) ضغط, وطأة, تأكيد, اجهاد‏

עברית (Hebrew)
n. - ‮לחץ, מתיחות, מצוקה, מתח נפשי, דגש, חשיבות, משקל, נגינה, טעם, הטעמה‬
v. tr. - ‮הדגיש, הטעים‬

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stress ball	stress relief
stress ez	Stress Tab With Zinc