TOPIC: ACUTE STRESS AND CHRONIC STRESS

In humans, psychological states have a role in activating the physiological stress reaction. An
individual’s evaluation of a situation as stressful or not affects whether a situation evokes stress
or not. Whether a situation is experienced as stressful or not is dependent on earlier experiences,
affective states, personality, available resources, and the interpretation of events. Stress occurs
when there is an imbalance in terms of the actual and/or perceived resources not being adequate
to counter actual and/or perceived demands (Butler, 1993; Lazarus & Folkman, 1984).
Research and theory suggests that there is a constant interplay between physiological,
psychological, and environmental factors that influences whether stress is elicited or not, which
(if any) stress symptoms are evoked, and how the individual reacts to stress. It is this complex
interplay of multiple factors, along with the variation between individuals that makes it difficult
to definitively explain the causes and effects of stress processes. All stress is not created
equally. Stress can be mild and temporary, or it can severe and experienced repeatedly. There
are three different levels of stress, each of which often has its own types of symptoms, acute
stress, episodic acute or chronic stress. Here we will only discuss acute and chronic stress:

Acute stress: Sometimes we have been about to fall asleep and we jerk awake suddenly or had
a near-miss collision with a bus. Those movements of sharp, sudden stress are examples of
acute stress. It is the most common form of stress. This form of stress is usually short-term and
specific. The cause of acute stress is often immediately apparent. Acute stress will be triggered
by an imminent emotional or physical threat, such as demands on your schedule or the pressure
that comes from being in an upsetting situation. Because it is short term, acute stress doesn't
have enough time to do the extensive damage associated with long-term stress. In most
situations, small doses of acute stress are normal and beneficial. Luckily, it is easier to
overcome acute stress. The symptoms of acute stress are:
• Brief jump in heart rate
• Increase in blood pressure
• Possibly followed by a tension headache
• Momentarily strong emotions such as anger or fear

Acute stress corresponds to our organism`s reactions when facing a threatening, imminent or
unforeseeable situation (public presentation, accident, new learning experience). When this

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stressful situation ends, stress symptoms generally stop soon after. Hence, it can be useful to
help us cope with a situation.

Treatment of acute stress

Most of the time, the symptoms experienced with acute stress will be brief and easily
manageable. The key to acute stress management is learning how to control emotional
responses. It’s not about trying to stop acute stress, as it is too quick to prevent and some stress
is healthy. Instead, it’s about managing psychological responses to the acute stress. Stress
management techniques might include stepping away for a minute and doing breathing
exercises, or taking an hour a day to practice yoga.

Chronic stress: Eventually, repeated stress becomes the chronic. It becomes the normal state
of being instead of an occasional occurrence. The level of stress makes it feel as if there is
nothing that we can do to make it better and it can feel as if there is no way out of the situation.
It is, however, well understood that experiencing stressors over a prolonged period of time,
results in a long term drain on the body is called chronic stress, eventually it have a negative
impact on health and may cause serious mental and physical diseases (Perski, 2006; Theorell,
2004).

The allostatic response is an important physical reaction that protects the body from external
and internal stress. It usually decreases together with decreasing stress, but if the imbalance
between spending and regaining energy persists over a long period of time, may result allostatic
load (McEwen, 2006; McEwen & Stellar, 1993). More specifically, allostatic load occurs when
too few essential anabolic processes are taking place, which implies a lack of energy
regeneration. Allostatic load is often described as the wear and tear on the body that results
from chronic overactivity of the allostatic system. This kind of prolonged stress is then referred
to as chronic stress, which is associated with severe stress symptoms such as somatic
symptoms, emotional and physical exhaustion, and sleep and cognitive difficulties. This long-
term stress usually comes from life situations like an unhealthy relationship, living in long-
term poverty or any other miserable situation. Chronic stress usually sets in when there is no
way out of a stressful situation, so trying to find out a solution to the problem is stopped and
the emotional turmoil is chosen instead.

People who suffer from chronic stress are most at risk for developing medical conditions related
to the long-term problem and can be at higher risk of attempting suicide. The biggest problem

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with chronic stress is that some people can get so familiar with this lifestyle that they sometimes
don’t realize there is an issue until physical symptoms start to show up their doctor brings up
the idea that chronic stress could be a factor in their conditions
Health and safety risks of chronic stress:
People who struggle with chronic stress can face a lot of health issues. This is partially because
those dealing with chronic stress often don’t take care of themselves and may share behaviors
that are unhealthy, such as overeating or smoking.
• Lung disease
• Cardiovascular disease
• Hypertension
• Drug and alcohol dependence
• Some types of cancer
• Suicide
• Accidents
• Significant weight gain or weight loss
• Stomach aches

Chronic stress and its associated symptoms eventually lead to a depletion of the body’s energy.
The degree to which this occurs has been associated with a stage of exhaustion that carries with
it an increased susceptibility to negative health outcomes, such as a heightened risk for
cardiovascular morbidity, diabetes, immunosuppression, and affective disorders (Sapolsky,
2004). Chronic stress presents itself as an ongoing, open-ended problem located in the structure
of the social environment. While there are many specific examples of chronic stress situations
in the literature, most reflect one or more of a set of basic themes that recur as fundamental
forms of chronic stress.

Forms of Chronic Stress

Chronic stress can occur in a number of ways (Wheaton, 1997) distinguished seven kinds of
problems that suggest chronic stress. Following are the different forms of chronic stress that
reflect one or more set of basic themes: (1) Threats, (2) Demands, (3) Structural constraints,
(4) Complexity, (5) Uncertainty, (6) Conflict, (7) Restriction of choice, (8) Under reward, and
(9) Resource deprivation.

1. Threats

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Chronic stress is often defined by the continuing possibility or expectation of potential harm.
This is the problem in such stressors as regular physical abuse by a spouse, life in a high crime
area, and life in a war zone. In these cases, the episodes of actual danger are not the entire
stressor. The chronic stressor at this issue is in the constant presence of the possibility of
vulnerability to dangerous forces that cannot be controlled or avoided. But these cases are only
the most obvious examples in which continuing threat is the main issue. It is also the issue
when a current identity is in question, for example, when a marriage is valued but also beset
with continuing conflict or when a student begins to perform poorly after developing an
expectation of success. The change in grades for the student may be gradual or sudden, but the
threat to one's identity as a "good student" accumulates only with persistent evidence of
performance problems.

Threat operates as a continuing reality that exists apart from the realization of the threat and is
a fundamental component of what is stressful about the situation. Between episodes of abuse,
in a situation where performance in school may not change for the better or when the inability
to meet obligations in major roles is imminent.

2. Demands
The word "demands," and accompanying terms such as overload, are among the most
commonly used in defining the nature of stress. There is simply too much to do, and the person
feels pulled by multiple, independent, immediate, and uncontrollable demands that cannot be
put aside. Excessive demand is at the heart of many stressful situations, but often in conjunction
with other important features of chronic stress. For example, being a caregiver may have
elements of excessive demand, but these situations usually also include a sense of absence of
alternatives and restricted choice. Stress is usually defined to be bidirectional with respect to
demand characteristics. That is, it is possible for both overdemand and under demand to be
stress problems.

3. Structural constraints
Structural constraint includes the lack of access to opportunity or the necessary means to
achieve ends or the structured reduction in available alternatives or choices. The idea of
structural constraints is essential to understanding that stressors arise from and are embedded
in locations in a social structure (Pearlin, 1989). Structural constraints come in many forms,
from the influence of rules or regulations that impede dealing with a problem straightforwardly
to the fact of severe and non-self-limiting social disadvantage resulting from inequality of

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opportunity or systemic discrimination. Restriction in access to means, as a form of structural
strain (Merton, 1957), is a form of stress. The notion of structural constraints raises the problem
of how to impute stress to social locations.

4. Under reward
The notion of under reward is derived from Equity Theory (Walster, Berscheid, & Walster,
1976), a theory of social exchange that posits stable social exchange under conditions of equity,
defined as an equal ratio of outputs to inputs for the two parties involved in a relationship. This
feature of social relations has various incarnations in sociological theory (Blau, 1964; Homans,
1961). Equity Theory defines a specific condition for under reward that is quite general. In this
formulation, importantly, it is outputs relative to inputs that matter, not absolute levels of
outputs or rewards. The absolute problem of under reward is defined by the twin notions of
restriction of choice and restriction of access to means. A basic prediction of Equity Theory is
that inequity produces distress in both parties. This feature is evocative of the bidirectional
assumption underlying the effects of demands, where either too much or too little is distressing.
But the role of victim in the equity equation is probably more universally stressful than the role
of harm doer, for reasons offered by the theory: The harm doer can rationalize harm by
derogating the victim, without losing any outputs. Inequity is probably a prevalent form of
chronic stress, in that it expresses a structure for "feeling unappreciated." Often, such feelings
have to do with presumption, the thoughtlessness of others, or simply "being taken for granted."
Sometimes, the problem is outright volitional harm doing. It is likely that the level of the stress
in the latter form of inequity is much higher (Walster et al., 1976).

5. Complexity
Complexity can be a positive feature of social life, such as when it expresses the fine points of
an enjoyed or understood activity or when it is the source of continued interest in work tasks
(as in the substantive complexity of work). However, complexity can also represent a form of
excessive demand, with its own unique characteristics. The complexity of demand is distinct
from the level of demand in social roles. When demands are more contingent and yet also
interdependent, the effects of the resulting complexity can amount to a form of chronic stress.
People with complex jobs complain about the strain of facing constantly problematic issues
without a standard or clear resolution. Complexity of routines in social roles can also be a
source of chronic stress. When a single parent has many contingent issues involved in each
day-involving childcare, short-term changes in arrangements, and work demands that lead to

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staying late at work unpredictably-the whole fabric of daily life begins to be excessively
complex. The amount of time devoted to logistics takes up a larger portion of each day.
6. Uncertainty
A closely related problem is uncertainty. Complexity and uncertainty usually feed each other
in the following sense: At a given level of complexity, uncertainty multiplies the effects of
complexity, and at a given level of uncertainty, complexity multiplies the effects of uncertainty.
Uncertainty can also be a positive feature of daily life, but usually within well-known role
situations or in clearly delimited amounts. Prolonged uncertainty about something that requires
resolution, or for which resolution is desired, is itself stressful. This is a common situation in
work roles where turnaround involves long periods of time or when the outcomes of tasks do
not have a clear success-failure component.

7. Conflict
It would be difficult to exclude conflict in a discussion of long-term sources of stress. Conflicts
at work, in marriages, and in families become regular enactments, reflecting basic differences
in viewpoints, values, principles, goals, or desires. Long-term conflicts tend to be those that are
defined by the inability to agree on starting premises, or even on the common goal (Wheaton,
1974). Both the fear of bringing the conflict to the surface and the ritualized enactment of the
conflict become sources of chronic stress.

8. Restriction of Choice
Restriction of choice can be considered to be a kind of structural constraint. Pearlin, 1983
argued for the distinct importance of restriction of choice as manifest by the problem of role
captivity (a situation in which exit from a role is desired but not really an option. When this
occurs, this is likely to be a powerful source of stress, captured by the phrase "feeling trapped."
This may be an important source of chronic stress in many lives, from the situation of
caregivers, to the experience of a long-term debilitating chronic illness, to a marriage one
cannot leave because of commitments to children, to the lack of alternative choices for jobs
with no hope of promotion, to the absence of alternatives when your child is in a bad school.
In all of these situations, it is the restriction of choice that is the source of stress, over and above
the stress emanating from the situation itself.

9. Resource Deprivation
Whether resource deprivation should be considered a form of stress is a controversial issue.
This is a closely related concept to the notion of restriction of choice. Insufficient means or

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resources to achieve desired goals qualify as a restriction of choice or as a kind of structural
constraint. However, what if the resource deprivation has to do with resources that are
important in coping with stress, such as social support? Is a state of low social support also a
kind of stress? In cases where the absence of a coping resource may also define a stressful state,
a choice must be made.
Treatment of chronic stress
Treatment of chronic stress most often involves therapy with a licensed psychologist to help to
learn how to effectively deal with the common types of stress that is faced in life. In many
cases, people have spent so long dealing with a chronic stress that it takes a lot of therapy for
them to see where the stress stems from, which makes the problem much harder to resolve.

In some situations, chronic stress treatment can involve medicinal treatments to combat the
symptoms of being stressed. While this does not get rid of the stress itself, it can help better to
control emotional and physical reactions to the problems that people are facing. Stress is
plaguing the life; managing the stress can become a source of stress in and of itself. This is
especially true when people are confused about why they are stressed and why it happens.
When a clearer understanding of stress is developed, a clearer plan can be created to deal with
it. Chronic and acute stresses are derived from different sources and affect different cognitive
and somatic processes (Lazuras & Folkman 1984; McCarty, Horwatt, &Konarska, 1988). For
example, in regard to the physiological effects of stress, Mahl 1953; (cited in Lazuras &
Folkman 1984) reported that gastric acid secretion occurs only with chronic, but not acute
stressors. A possible explanation for this may be that reactions to threatening stimuli are
heightened when subjects have time to process internal sensations (Pennebaker, 1982).

The distinction between acute and chronic stress is blurred by the fact that these two types of
stress are often related. Acute stressors exert their impact on well-being and adjustment
partially through the ongoing minor, recurrent stressors that are the result of acute stress (e.g.,
Compas, Howell, Phares, Williams, & Ledoux, 1989; Wagner, Compas, & Howell, 1988;
Wheaton, 1994). For example, parental divorce may affect children through the myriad of
changes in ongoing daily routines, roles, and relationships. Acute stress can also affect
adjustment through cognitive processes. The significance of cognitive mechanisms in chronic
stress is found in research by Baum et al. (1993) on the enduring effects of the Three Mile
Island (TMI) nuclear accident. Those residents of the TMI area, who experienced high levels
of intrusive thoughts and memories of the event, had the most long lasting emotional, physical,

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cognitive, and behavioral problems. Enduring intrusive thoughts and memories related to the
accident served as a form of continued cognitive re-exposure to the stressor for a subgroup of
those who lived near TMI, creating chronic stress from a seemingly acute event. Taken
together, these findings suggest that there are two processes, one exogenous and the other
endogenous, through which acute events contribute to chronic stress, exogenous processes are
represented by the ongoing demands and threats that are produced in the environment. For
example, the diagnosis of cancer represents an acute traumatic event for patients and their
families and is associated with significant short-term psychological distress (Andersen,
Andersen & DeProsse, 1989). However, the enduring effects of this event are played out
through the disruptions that are created in the daily routines, family roles, and threats to goals
and values of patients and their families (e.g., Grant & Compas, 1995). Endogenous processes
are reflected in the persistent cognitive and affective reexperiencing of the stressor by patients
and family members (e.g., Compas et al., 1994). Intrusive and uncontrollable thoughts and
memories about the disease and reminders of it maintain appraisals of threat and emotional
arousal (Baum, A., Cohen, L., & Hall, M., 1993). Involuntary negative thoughts are part of the
response system that unwittingly prolongs stress. Both of these processes are the direct
consequence of the effects of acute stress on the individual and the environment. The
association of acute and chronic stress is not perfect, as not all acute events lead to chronic
stress, nor do all individuals exposed to acute traumatic events experience chronic cognitive
and affective abnormalities of these events (Wheaton, 1994, for a discussion of the continuum
of stress processes). Further, not all chronic stressful conditions are the result of acute events
(e.g., poverty, a congenital birth defect; (Compas, 1994).Although chronic stressors are more
likely to have long term effects, those which include acute stress may or may not lead to chronic
stress, depending on the effectiveness of the person’s coping skills.

Coping with Acute and Chronic stress

According to the literature there are three basic models of coping and adaptation:
psychodynamic, coping styles, and coping processes (Aldwin, C. M., Levenson, M. R., &
Spiro, A, 1994). The distinctions between these three areas are often blurred; indeed, all use
similar terminology (e.g., denial, suppression), and there is often a substantial degree of overlap
in the items in coping inventories. However, the three models differ in their assumptions
concerning the source, development, and efficacy of adaptive strategies.

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Psychodynamic Models: Psychodynamic approaches focus primarily on defense mechanisms,
which are unconscious means of regulating negative affect, primarily anxiety. According to
Freud (1966), defense mechanisms are ego processes for regulating anxiety generated by
conflicts between the id and the superego that function primarily by distorting reality, whether
through denial, projection, repression, or sublimation and, as such, are inherently pathological.
Subsequent theorists expanded this list to include defenses such as intellectualization (see Tart,
1987, for a good description of defense mechanisms). Shapiro (1965) argued that the use of
certain defense mechanisms can become habitual and result in what he termed neurotic styles.

Coping Styles: The second major model, coping styles, assumes that people can be
characterized by a consistent pattern of coping based on perceptual styles and/ or personality
characteristics. This pattern has been described generally in terms of a dichotomy, such as
repression/ sensitization, approach/avoidance, or blunting/monitoring, among many others
(Roth & Cohen, 1986). Basically, this model holds that people can be characterized by the
manner in which they process information, either approaching or seeking information or
avoiding or denying it.

Coping Processes: The coping process approach assumes that coping is flexible, planful, and
responsive to both environmental demands and personal preferences (Lazarus & Folkman,
1984). Thus, researchers in this area study the cognition and behaviors of individuals in specific
circumstances. Coping is assumed to derive from how people appraise the stressors they
experience as to whether these entail threat, harm/loss, or challenge. Thus, appraisals and
coping strategies are not necessarily stable characteristics of the person but arise from a
transaction between environmental demands and resources, on the one hand, and the
individual's personal resources, such as coping skills and values, on the other. The focus of
coping efforts may be the environment (problem focused coping) or the emotions (emotion-
focused coping), but the overwhelming majority of people utilize both types of strategies
(Folkman & Lazarus, 1980). The coping process is thought to unfold over time, in part as a
function of changing environmental circumstances. However, people may also change their
tactics based upon the successfulness of their initial coping efforts. Reducing stress makes a
person feel better immediately and can help protect health long-term. In one study examining the
association between feelings like happiness, joy, contentment and enthusiasm, and the development of
coronary artery disease, it was demonstrated that as positive emotions increase, the risk of coronary
artery disease decreases.

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