Stress can be a result of any situation or thought that makes us feel frustrated,angry, fearful, or anxious.

Everyone sees situations differently and has different coping skills. For this reason, no two people will
respond exactly the same way to a given situation. It is not the event, but rather a person’s perception and
experience
of an event, which defines whether or not it is stressful.

Definition:
Stress: “The reaction people may have when presented with demands and pressures that
are not matched to their knowledge and abilities and which challenge their ability
to cope.” (World Health Organisation)

TYPES OF STRESS
 The human body is designed to experience stress and react to it. Stress can be positive, keeping us
alert, motivated, and ready to avoid danger (eustress)
 Stress becomes negative (distress) when a person faces continuous challenges without relief or
relaxation between stressors leaving us overworked, depleted while the stress-related tension builds.
 The body's autonomic nervous system response can become chronically activated during prolonged
periods of stress causing wear and tear on the body – both physical and emotional.
 Distress can disturb the body's homeostasis, leading to physical symptoms such as headaches,
an upset stomach, an elevated blood pressure, chest pain, sexual dysfunction, and problems sleeping.
 Emotional problems can also result from distress like depression, panic attacks or other forms
of anxiety and worry.
 Research suggests that stress is linked to 6 of the leading causes of death: heart disease, cancer, lung
ailments, accidents, cirrhosis of the liver and suicide.
Stress also becomes harmful when people engage in the compulsive use of substances or behaviors to try to
relieve their stress. These substances or behaviors include food, alcohol, tobacco, drugs, gambling, sex,
shopping, and the Internet. Rather than relieving the stress and returning the body to a relaxed state, these
substances and compulsive behaviors tend to keep the body in a stressed state and cause more problems.

Sources of Stress
We can experience stress from four basic sources:
1. The Environment – The environment can bombard you with intense and competing demands to adjust.
Examples of environmental stressors
include weather, noise, crowding, pollution, traffic, unsafe and substandard housing, and crime.
2. Social Stressors – We can experience many stressors at the same time arising from the demands of the
various roles we play in life, (e.g., being a parent, spouse, caregiver, and employee at the same time).
Examples of social stressors include deadlines, financial problems, job interviews, presentations,
disagreements and conflicts, demands for our time and attention, loss of a loved one, divorce, and co-
parenting.
3. Physiological – Situations and circumstances that affect our body can be stressful. Examples of
physiological stressors include rapid growth during adolescence, menopause, illness, aging, giving birth,
accidents, lack of exercise, poor nutrition, and sleep disturbances.
4. Thoughts – Our brain interprets and perceives situations as stressful, difficult, painful, or pleasant. Many
situations in life can be stress provoking, but it is our thoughts that determine whether they are a problem for
us.
Explaining the Stress Response – Fight / Flight Response:
The behavioural blueprint for humankind was laid down hundreds of thousands of years ago when the main
threat to human life was from a variety of animal species. Human beings had to be able to react swiftly when
confronted with a threat to life.
This is known as the Fight / Flight response. The stress response is designed to ensure that the body can take
appropriate survival measures whenever a Fight / Flight situation might occur. The action is swift and
happens entirely at an unconscious level. The response is designed to be short term with adequate
time given for the body to recover.
The “fight or flight response” is our body’s primitive, automatic, inborn response that prepares the body to
react to perceived threat. Originally discovered by Harvard physiologist Walter Cannon, this response is
hard-wired into our brains and represents a genetic wisdom to protect us from danger. If we experience a
threat from an external source or one that is generated by our own internal thoughts, the hypothalamus in the
brain initiates a sequence of nerve cell firing and chemical release which prepares the body to respond.This
response is determined by our own subjective interpretations and perceptions of day to day events /
situations.
Fight-or-flight response: what happens in the body
When you feel threatened, your nervous system responds by releasing a flood of stress hormones, including
adrenaline and cortisol, which rouse the body for emergency action. Your heart pounds faster, muscles
tighten, blood pressure rises, breath quickens, and your senses become sharper.
These physical changes increase your strength and stamina, speed your reaction time, and enhance your
focus—preparing you to either fight or flee from the danger at hand.

Signs and symptoms of stress overload

The most dangerous thing about stress is how easily it can creep up on you. You get used
to it. It starts to feels familiar - even normal. You don’t notice how much it’s affecting you,
even as it takes a heavy toll. That’s why it’s important to be aware of the common warning
signs and symptoms of stress overload.
Cognitive problems
• Memory problems
• Inability to concentrate
• Poor judgment
• Seeing only the negative
• Anxious or racing thoughts
• Constant worrying

EMOTIONAL SYMPTOMSmotional symptoms

• Depression or general unhappiness
• Anxiety and agitation
• Moodiness, irritability, or anger
• Feeling overwhelmed
• Loneliness and isolation
• Other mental or emotional health problems
PHYSICAL SYMPTOMS
• Aches and pains
• Diarrhea or constipation
• Nausea, dizziness
• Chest pain, rapid heart rate
• Loss of sex drive
• Frequent colds or flu

BEHAVIORAL SYMPTOMS
• Eating more or less
• Sleeping too much or too little
• Withdrawing from others
• Procrastinating or neglecting responsibilities
• Using alcohol, cigarettes, or drugs to relax
• Nervous habits (e.g. nail biting, pacing)

Causes of stress
The situations and pressures that cause stress are known as stressors. We usually think
of stressors as being negative, such as an exhausting work schedule or a rocky
relationship. However, anything that puts high demands on you can be stressful. This
includes positive events such as getting married, buying a house, going to college, or
receiving a promotion.
Of course, not all stress is caused by external factors. Stress can also be internal or selfgenerated,
when you worry excessively about something that may or may not happen, or have irrational, pessimistic
thoughts about life.
Finally, what causes stress depends, at least in part, on your perception of it. Something that's stressful to
you may not faze someone else; they may even enjoy it. For example, your morning commute may make
you anxious and tense because you worry that traffic will make you late. Others, however, may find the trip
relaxing because they allow more than enough time and enjoy listening to music while they drive.
Things that influence your stress tolerance level
Your support network - A strong network of supportive friends and family members is an enormous buffer
against stress. When you have people you know you can count on, life’s pressures don’t seem as
overwhelming. On the flip side, the more lonely and isolated you are, the greater your risk of succumbing to
stress.
Your sense of control - If you have confidence in yourself and your ability to influence events and
persevere through challenges, it’s easier to take stress in stride. On the other hand, if you believe that you
have little control over your life—that you’re at the mercy of your environment and circumstances, with
limited ability to make changes—stress is more likely to paralyze you and knock you off course.
Your attitude and outlook - The way you look at life and its inevitable challenges makesa huge difference
in your ability to handle stress. If you’re generally hopeful and optimistic, you’ll be less vulnerable. Stress-
hardy people tend to embrace challenges, have a stronger sense of humor, believe in a higher purpose, and
accept change as an inevitable art of life.
Your ability to deal with your emotions - If you don’t know how to calm and soothe yourself when you’re
feeling sad, angry, or afraid, you’re highly likely to become stressed and agitated. Having the ability to
identify and deal appropriately with your emotions (/emotional-intelligence-toolkit/) can increase your
tolerance to stress and help you bounce back from adversity.
Your knowledge and preparation - The more you know about a stressful situation—including how long it
will last and what to expect—the easier it is to cope. For example, if you go into surgery with a realistic
picture of what to expect post-op, a painful recovery will be less stressful than if you were expecting to
bounce back immediately.
Coping With Stress
What is the best way to cope with stressors?
Next are some suggestions that can help you cope with stress. Each technique that follows has been
categorized for your convenience as being a technique or strategy that can help reduce your level of stress by
attending to either bodily needs, school-related demands, or thinking which ultimately has a lot to do with
how you think, feel, and act toward a stressor in your life.
You are encouraged to begin by making a commitment to implement just a few of these strategies initially,
since making small changes first may be more desirable and realistic than committing to significant changes
all at one time.
Techniques to Help with Physical Well-Being
 Relaxation techniques. Relaxation techniques can help us gain more control over the stress we encounter.
This
is because it is a technique that helps brings about the opposite bodily changes of the stress response or can
reduce muscle tension. Refer to a book or see a counsellor at Counselling Services for specific guidance on
relaxation techniques.
 Eat regular well-balanced meals and get plenty of rest. When your body is run down, things can look
worse than they really are and your ability to cope with them is also reduced. Limit your coffee to 3 cups per
day and remember that chocolate and cola drinks also contain caffeine.
 Exercise. A physical workout is a great tension releaser. Find something that you enjoy and will do on a
regular basis. It can be as simple as walking or demanding as racquetball. Exercise can reduce anxiety and
depression, reduce muscle tension and temporarily distract us from our stressors.

Techniques to Help with Psychological Well-Being

 Identify and deal with the cause. It is important to determine what is causing your distress. Otherwise you
may only superficially deal with your distress so that little relief is experienced. Without this step, stress will
build and continue. You may ask yourself: What has changed? When did I start feeling distress? How are
my beliefs or Thoughts contributing to how I see the stressful situation? Am I expecting too much? Do I not
believe I can handle the situation? By identifying the cause, we can more accurately select ways of coping
such as revising our expectations, improving study techniques, or gaining support from others.
 Be aware of negative self-talk and negative attitudes.

STRESS RELATED DISORDERS IN DSM 5-

 DSM lists Trauma and Stressor-Related Disorders as a function of chronic distress . All these
disorders result from a known cause of either traumatic or stressful situations, or events recognized
explicitly in the diagnostic criteria They are :-
 Disinhibited social engagement disorder
 Reactive attachment disorder
 Adjustment Disorders
 Posttraumatic stress disorder
 Other Specified Trauma and Stressor-Related Disorder
 Unspecified Trauma and Stressor-Related Disorder
 Complex PTSD is likely to be included in the International Classification of Diseases diagnostic
manual, which is currently being revised.
 Reactive attachment disorder and Disinhibited social engagement disorder both result from social
neglect during both result from social neglect during childhood (a lack of appropriate care-giving),
and onset is during childhood.
Trauma and /or Abuse are the only recognized causes of PTSD and Complex PTSD. However, these
disorders require the trauma to be a minor trauma sometimes referred to as ‘Type I trauma’ and more minor
traumatic experiences, sometimes called ’Type II trauma’. However, the role of multiple and more minor
traumatic experiences is now being increasing recognized.