Presented by: Kale Burbine, Matt Coady and Breagh Wallebeck

Introduction Background Information Pathophysiology Signs and Symptoms Stress Effects Diagnosis Stress and Obesity Facts and Statistics Treatment Risk Factors Prevention Future Research Questions and Comments

 What

is Stress?

Stress can be defined as any type of change that causes physical, emotional or psychological strain
The disruption of normal homeostasis

Stressor: Factor or event, real or imagined, that elicits a state of stress Examples:

Loss of a friend, starting a romance, deadlines, overtraining or having a baby, etc.

 Eustress:

A helpful kind of stress. It benefits both physical and mental aspects of life Fight or flight response

 Distress:

Harmful type of stress. Brought on by alterations in routine that the mind and body do not positively adapt to Two types of distress: Acute stress: Temporary stress that arises suddenly and at a high intensity Chronic stress: Prolonged stress that can open up the flood gates to great health risks

For fast-acting relief, try slowing down.

-Lily Tomlin

Hans Hugo Bruno Selye, C.C

January 26, 1907- October 16, 1982 Canadian endocrinologist Scientist at McGill University Theorized the General Adaptation Syndrome (GAS)

Walter Bradford Cannon, M.D

October 19, 1871- October 1, 1945 American physiologist, professor and chairman of the Department of Physiology at Harvard Medical School Coined the term fight or flight response Expanded on Claude Bernards concept of homeostasis

 Three

stages in response to sustained stress:

Alarm: response to immediate danger Resistance: the bodys attempt to reestablish its internal balance (homeostasis) Exhaustion: our bodies suffer permanent damage or mortality

 An

adaptive response to a stressor by way of confrontation or avoidance Responses:

Increased heart rate Muscle tension Shallow and rapid breathing Increased release of adrenaline

Correlates

with the first stage of the GAS

 Excess

hormone production may show accelerated progress toward atherosclerosis, obesity, and type II diabetes

Hyperactivity of the ANS and elevated cortisol will lead to type II diabetes

Systems

that are normally contained by cortisol become hyperactive

Arthritis and Lupus

Elevation

of ANS activity, combined with hyperglycemia and hyperinsulinemia

Hypertension and atherosclerosis

Physical

Muscle tension Stiff neck Cold, sweaty hands Facial tics Fatigue Tension headaches Indigestion High blood pressure Heart palpitations Back pain Jaw tension Nervous stomach Nausea Diarrhea Teeth grinding Change in appetite

Behavioral

Emotional

Change in appetite Sleep disturbance Forgetfulness Anger outbursts Decline in productivity Social withdrawal Indecisiveness Increased use of alcohol/drugs Increased use of caffeine/tobacco

Anxiety Fear Irritability Hopelessness Helplessness Impatience Depression Nervousness Overwhelmed Apathy Loss of concentration

Physiological and psychological effects

 Mental

state or actions brought on by psychological or social factors that may influence immune system functioning (PNI)

Psychoneuroimmunology

Study of influences on the neurological responding involved in the bodys immune response

 Link

between CNS and immune system exists on biological levels Adrenal glands are a well known pathway

Release corticosteroid hormones (stress hormones) into the blood in reaction to stress messages from the brain These hormones respond to emergencies by mobilizing the bodys energy reserves Leads to eventual decrease in antibodies and reduction in lymphocytes (number and strength)

 Direct

connection between HPA axis (hormonal) and immune system During the fight or flight response, the body responds by increasing levels of cortisol to give you more energy Cortisol is an anti-inflammatory hormone that in small quantities, repairs muscles, but in large quantities, depresses the bodys immune system

The immune system becomes compromised as cortisol causes immune system cells, particularly Natural Killer cells, to shut off and stop working

 Changes

in regular behavior patterns that become detrimental to an individuals level of stress, overall health, and immune system

Examples

Smoking Poor eating habits, overeating Little or no physical activity Alcohol consumption Drugs

 Stress

can affect the blood cells that help fight off infection
More likely to get colds and other diseases

Autonomic

nervous system (ANS) can diminish immune system capabilities

Frequent activation of ANS during chronic stress

 Constant

stress can increase blood pressure and can increase the risk for stroke Increases the risk of heart attacks Triggers behaviors that contribute to death and disability; such as smoking, alcoholism, drug abuse, and overeating Can cause chronic fatigue, digestive upsets, headaches, and back pain

Hard to employ behavior change to improve health

 Stress

affects numerous systems within our

body:

Nervous system Musculoskeletal system Respiratory system Cardiovascular system Endocrine system* Gastrointestinal system Reproductive system

There's never enough time to do all the nothing you want. ~Bill Watterson, Calvin and Hobbes

 Fight

or Flight response

Sympathetic nervous system signals adrenal glands

Release

of adrenaline and cortisol into bloodstream Increase in heart rate Increase in blood pressure Change in digestive process Boosts glucose levels in bloodstream

 Muscles

become tense Extended periods of muscle contraction can lead to:

Headaches Migraines Various musculoskeletal conditions

 Breathe

harder Rapid breathing Physical fatigue Limited and obstructed oxygen absorption

 Acute

stress causes an increase in heart rate Blood vessels dilate, increasing amount of blood pumped to the body Repeated stressors can cause inflammation in the coronary arteries Elevated blood pressure

Hypertensive: BP >140/90

Adrenal gland anatomy Liver Cortisol Norepinephrine HPA axis

 Adrenal

glands

Orange-colored glands Endocrine glands Located in the retroperitoneum situated atop the kidneys Responsible for releasing hormones in conjunction with stress through the synthesis of corticosteroids such as cortisol and catecholamines, such as epinephrine

 Adrenal

Medulla (inner part)

20% of the gland Upon stimulation, secretes the hormones epinephrine and norepinephrine into the blood

Adrenal

Cortex (outer part)

Ongoing daily regulation Modification of bodily processes 4 zones: zona glomerulosa, zona fasciculata, zona reticularis, and the interface zone

 When

cortisol and epinephrine are released, the liver produces more glucose, a blood sugar that would give you the necessary energy to fight or flight in an emergency.

 The

normal function of cortisol is reacting towards the stresses of the body by converting proteins into energy

This conversion process releases glycogen and counteracting inflammation in order to combat stress

Short

durations of high levels of cortisol is healthy

Creates bursts of energy when needed Contributes to better memory Increased immunity Maintains homeostasis within the body

 Long

durations of high levels of cortisol can be detrimental to health

Over time, high levels of cortisol can gradually tear down muscle tissue and bone Impair the immune system Contribute to digestive and metabolism issues Lead to weight gain

How

do you maintain healthy levels of cortisol?

Reduce abdominal fat Engage in body relaxation techniques or exercises (jogging, yoga, stretching, etc.)

A catecholamine released from the adrenal medulla

Release is triggered by the release of acetylcholine from the preganglionic sympathetic nerves

Along with epinephrine, prepares the body for a fight-or-flight response

Facilitate immediate physical reactions by triggering increases in heart rate and breathing, constricting blood vessels and tightening muscles

The activation of the sympathetic nervous system leads to the release of norepinephrine from the nerve endings acting on the heart, blood vessels, respiratory centers, and other sites

The ensuing physiological changes constitute for a major part of acute stress response

 Amount

of cortisol circulating is regulated by the interaction between the hypothalamus, pituitary gland, and the adrenal glands
feedback system homeostasis

Negative

Maintains

 Esophagus

Negative effects of tobacco or alcohol. May experience heartburn or acid reflux Butterflies or even nausea or pain. Vomiting may be a side effect Stress can affect digestion and which nutrients your intestines absorb. Diarrhea or constipation may result

Stomach

Bowels

 Affected

by excessive levels of cortisol

Disrupts normal function of reproductive system

Chronic

stress can impair testosterone and sperm production and cause impotence In women, stress can cause absent or irregular menstrual cycles or more painful periods

 Immunodeficiency

disorder Autoimmune disorders

Lupus, Still disease, Asthma, Eczema

 Recall:

Stress is defined as a disruption of normal homeostasis Stress gives rise to a number of responses:

Physical, psychological, behavioral, emotional

There

are currently 3 main methods used clinically for the diagnosis of stress:
Questionnaires Biochemical measures Physiological measures

 Life

Stress Inventory The Perceived Stress Scale Social Readjustment Rating Scale
If

the stress reaches anxiety/depression levels:

Profile Moods Survey Minnesota Multi-Phasic Personality Inventory Becks Depression Inventory Traumatic Stress Symptom Checklist

 Body

responds to stress by increased HPA axis activity Involves release of hormones that can be measured in body fluids Indwelling catheter

24 hours Specimens analyzed, concentration of hormone(s) plotted against time

 Heart

rate
that must be taken into account:

Auscultation, palpation of peripheral pulses Electrocardiogram (ECG) White-Coat effect Circadian variation Body posture Environmental conditions Medications

Factors

 Heart

rate variability

Time interval between heart beats varies

Continuous

ECG Factors that may affect reading:

Body posture, medication, age

Blood

pressure

Result of cardiac output and peripheral vascular resistance Systolic blood pressure changes more rapidly then diastolic blood pressure

 Stress

eaters

High-fat, high-sugar, high-carbohydrate foods

Can

lead to Polycystic Ovarian Syndrome (PCOS)

Increases the risk of developing pre-diabetes

Increased

risk of Metabolic Syndrome

Upset hormone balance (HPA axis)

Cortisol

 Laughing

lowers stress hormones and strengthens the immune system by releasing health-enhancing hormones The top three stressful cities in America are Chicago, Illinois; Los Angeles, California; and New York, New York More than half of all deaths between the ages of one and 65 result from stressful lifestyles A 2009 CNN poll revealed that the number one reason for stress in most countries is money

 An

accumulation of persistent stressful situations, particularly those that a person cannot easily control

Example: High-pressured work plus an unhappy relationship

Persistent

stress following a severe acute response to a traumatic event

Example: An automobile accident

Acute

stress accompanying a serious illness, such as heart disease

 Outlook

and attitude
of the neurotransmitter, epinephrine

Feeling of stress relief Produces a very positive feeling A hard workout produces an intense and more rapid chemical effect

Release

Instantaneous

and long-term mood boost

Don't let your mind bully your body into believing it must carry the burden of its worries. ~Astrid Alauda

 Physical

Cardiovascular function Blood vessel elasticity Reduces blood triglycerides and cholesterol Reduced chance of heart conditions Outlet for negative emotions Endorphins Biochemical changes in body and brain

Mentally

 Exercise

relaxes muscles Utilizes stress hormones Uses fat and cholesterol Provides a feeling of happiness Can reduce frustration Look better Can provide social support Reduces the impact of illness Improves resiliency to stress

 Different

stress relieving benefits come from different types of exercise

Yoga Aerobic exercise Runners High Anaerobic

 Early

nurturing Personality type Genetic factors Immune regulated diseases The length and quality of stressors

 Adults

No participation in critical decisions Unreasonable demands for performance Lack of effective communication and conflictresolution methods Lack of job security Excessive time spent away from home and family Inadequate wages Anyone experiencing financial pain Isolated individuals

 Type

A:
B: C: D:

Self driven, competitive, dominant, impatient Extrovert, inspiring, engaging Cautious, detail-oriented, reserved

Type

Type

Type

Supportive, passive

* Most people are combinations of personality types

Where does that put you on the Stress Index? 1 - 6: There are few hassles in your life. Make sure, though, that you are not trying so hard to avoid problems that you shy away from challenges. 7 - 13: You've got your life in fairly good control. Work on the choices and habits that could still be causing you some unnecessary stress in your life. 14 - 20: You're approaching the danger zone. You may well be suffering stress-related symptoms and your relationships could be strained. Think carefully about choices you've made and take relaxation breaks every day. Above 20: Emergency! You must stop now, re-think how you are living, change your attitudes, and pay careful attention to diet, exercise, and relaxation.

 Every

day perform some form of exercise Eat healthy by including a daily diet in fruits, vegetables and whole grain cereals Reduce alcohol consumption and quit smoking Make time for rest, serenity, and relaxation Develop strong relationships with friends, colleagues and family members. They offer support and relief from the stressful situations of everyday life Slow down and enjoy more of less

 Recognize

how your body feels when stressed Manage time wisely Dont sweat the small stuff Develop coping strategies Accept and adapt to change Dont take things personally Believe in yourself Glass half full mentality

 Address

whether the stressors in life result from depression Explore developmental changes in stress and coping processes over time Examine the degree of health problems

Are associated stressors the prominent factor?

Study

physical habits

Is immune response affected by individual lifestyle habits rather than stressors?

More

reliable way of measuring stress

http://www.highbloodpressureinfo.org/stresseffects-on-blood-pressure.html http://www.stress-management-for-health.com/ http://www.healthcentral.com/ency/408/guides /000031_6_2.html Abnormal Psychology, 2nd Canadian Edition, David H. Barlow, V. Mark Durand, Sherry H. Stewart, 2009. Physiology of Sport and Exercise, 4th Edition, Jack H. Wilmore, David L. Costill, W. Larry Kenney, 2008. Diagnosis of stress, Rudolf E. Noble, 2002