The 4 Sources of Stress

Sources of stressStress, the reaction that mobilizes our resources against a potential danger (real or perceived), can be produced by an almost infinite variety of single triggers.  This variety is produced by the many different situations that can cause stress, in addition to the individual differences among individuals in their perceptions of these triggers.  It is not uncommon to see a threat where someone else may see an opportunity or a challenge, and vice versa.  For ease of understanding, stress triggers may be classified into four major sources, which in turn can be further combined into two categories.  The principal categories are: physical stressors and psychological stressors.

Physical stressors impinge upon the five senses and pertain to the domain of the tangible and concrete. These are stress triggers that we can see, hear, touch, smell or taste.  A car coming straight at us on the sidewalk is a real, tangible and imminent physical threat, which must and does trigger an immediate stress reaction.  We respond to this physical threat by stepping out of the way, instinctively and without giving it much thought.  Included in the physical stressors is pain, which is the body’s reaction to a noxious agent that attacks its structure.  Thus, illness, which frequently produces pain, is considered primarily as a physical stressor, rather than psychological.  However, and it’s a big caveat, it would be a mistake to consider illness a purely physical stressor, as illness (especially if accompanied by pain) has a way of affecting the mind by producing negative thinking, negative self-appraisal, hopelessness, mental fatigue and other effects on the person’s spirit, attitude and worldview.

Psychological stressors are the most complex and perhaps the most frequent type of stressors we encounter in our daily lives.  To understand psychological stressors it is important to remember that they can fall into two distinct categories: real or perceived. Real psychological stressors are produced by the perception of an emotional danger or threat, in other words by a concern over something that is based on reality and does or may objectively occur. An example of this may be an impending relationship breakup.  Perceived psychological stressors are produced by the same mechanism, and are a concern over events or situations that are often based on reality but may be exaggerated or may in fact never occur. An example of the latter may be a worry or concern over an unnamed threat that may keep us from being able to take an elevator, or ride in an aircraft.

To summarize, the four principal sources of stress may be grouped as follows:

  1. Environmental
    • Includes physical stressors that impinge upon the five senses, such as weather, traffic, noise, pollution, disturbing images.
  2. Social
    • Includes psychological stressors triggered when demands are made on our time, attention and skills, such as in job interviews, public speaking, work presentations, interpersonal conflict, competing priorities, financial problems, and loss of relationships and loved ones.
  3. Physiological
    • Includes physical stressors that are produced at various stages in our life, such as during growth spurts in adolescence, menopause, lack of exercise, poor nutrition  insufficient sleep, illness, injuries, and aging.
    • Included in this category is also the physical stress produced by psychological stressors, which produce muscle tension, headaches, stomach upsets, anxiety attacks, and bouts of depression.
  4. Cognitive-emotional
    • The principal source of this type of stress is our own thoughts. Our brain interprets changes in our environment and body and conducts an automatic “threat assessment” to decide whether a danger is present and thus mobilize the body’s defenses.  The good functioning, or poor functioning of our threat assessment mechanism determines whether we become alarmed appropriately or inappropriately, and whether to remain stressed or relax.

In all cases, the stress reaction and the response that follows begins with our ability to correctly assess the situation and to estimate danger. Stress researchers Lazarus and Folkman (1984) were the first to point out that stress begins with our appraisal of a situation. Instinctively, we first ask ourselves how dangerous or difficult a situation is and what resources we have at our disposal to cope with it.  Self-confident individuals are more likely to conclude that, although the situation may be serious, they have what it takes to face it.  Less confident individuals tend to conclude that the same situation requires resources that they either do not have or that they have in insufficient measure.

The stress response of fight, flight or freeze is directly correlated to our ability to interpret the danger correctly, and to select the best course of action that produces the wanted results.  In some case, we will be able to eliminate the stressor (turn the source of noise off), in others we may simply need to distance ourselves from the stressor (flight response), and in some other cases it will be appropriate to do nothing and let the situation resolve itself (the freeze response).  What we choose to do largely depends on our assessment of available resources: making the correct appraisal of what we are capable of can be the difference between the right response and the wrong one.

Stress and Memory: An Update

Salvador Dali Persistence of Memory at Stresshacker.comStress can interfere with the functioning of memory by either augmenting the impact and persistence of the recollection of an event, or by diminishing both. A recent article by Schwabe et al. (2012) summarizes and updates the most recent findings on the effects of stress on memory. Their research concludes that the timing of the exposure to the stressor is crucial in determining whether memory is improved or impaired. Timing may explain why there are stressful situations in which we are unable to retrieve critical information that we have learned prior to the stressor, e.g. an important phone number or address. In contrast, experiencing stress at the same time as we participate in certain embarrassing, shameful, or frightening events can cause a dramatic enhancement of memory formation.

Schwabe and colleagues examine and attempt to integrate two models of how stress may alter memory processes, the “vertical” model (the mechanisms of stress on memory) and the “horizontal” model (the changes in stress effects on memory over time.)

The vertical perspective implicates principally the action of glucocorticoids (GC) and noradrenaline on the basolateral amygdala. In a typical stress reaction, the hypothalamus activates the hypothalamic-pituitary-adrenal (HPA) axis in response to input from several other brain regions and the sympathetic nervous system (SNS). Through the portal blood system, corticotrophin releasing hormone (CRH) and vasopressin flood the pituitary gland, which trigger its secretion of adrenocorticotropic hormone (ACTH). In response to ACTH release from the pituitary, the adrenal glands secrete glucocorticoids (GCs), of which cortisol is the principal component. GCs, which are lipophilic (fat-loving) steroid hormones, enter the brain relatively easily and can exert their excitatory effect in multiple regions throughout the brain. These effects are often mediated through the binding to the two receptors for the hormone: the mineralocorticoid receptor (MR) and the glucocorticoid receptor (GR). These two receptors differ in their affinity for cortisol (with the MR having a much higher affinity) and also in their localization in the brain. In addition, GCs can exert nongenomic effects (occurring rapidly and acutely) by influencing ion channels or neurotransmitter receptors at the membrane level. It is important to note that CRH, vasopressin, and ACTH can, on their own, influence cognition. When released in concurrence with a stressor, they can have an almost instantaneous effect on memory processes.

The horizontal perspective suggests that the memory of an event or cognition is enhanced when new information is acquired during the stressful situation, whereas the memory process is impaired for information that was acquired prior to or after the stressful situation. In these situations, the flood of GCs acutely enhances memory consolidation of emotional arousing material, while significantly impairing memory retrieval. At the moment of greatest stress, the memory of a significantly stressful event is instantaneously etched into the memory banks in vivid and abundant detail. The recollection of a sometimes important and well-known piece of information is inhibited. It is as if the whole of our attention is absorbed, or mobilized, toward the assessment of the threat presented by the stressor and in the formulation of a reaction to it. The excitatory hormones cursing through the blood system rapidly arouse the nervous, cardio-circulatory, respiratory, and endocrine system. There is no time or resource available for other activities that are not related to the defense of the organism against the perceived (or real) threat of the stressor. Included in these “secondary” activities that are postponed as non-critical is memory retrieval of old information.

Other important findings highlighted in this article are the effects of stress on the striatum, a brain structure that was originally associated with motor control but that is now receiving increased attention as one of the loci of mnemonic function. Secondly, memory is affected by stress not only in terms of its quantity, but also its quality. Lastly, the authors cite important research conducted in the last decade which points to the effects of maternal stress during pregnancy or early childhood stress as harbingers of an individual’s impaired performance as an adult in high-stress environments.

The article concludes with several important questions, which provide an indication of the limits of current research in explaining important aspects of memory formation. For example, it remains difficult to understand how the same neurochemicals can exert opposite effects on the same brain structures, or how individuals in similar situations exhibit such differing recollections of the same event, and other similarly unexplored mysteries. These limitations do not detract from the thoroughness and relevance of this article.

Fear and Attraction: Racial Stress

The-Pirates-AttackThe coastal populations of Mediterranean countries lived for decades, stretching into centuries, with the fear of pirates, the strange invaders suddenly appearing from the sea.  Inhabitants of regions bordering with sparsely settled or frontier territories lived in fear of the sudden appearance of “barbarians” or “savages,” variously labeled according to time and locale.  With the increased sameness of living conditions brought on by progress and technological advance, there now remain far fewer parts of the world where the fear of strange invaders is part of daily life.  But is the fear of people that are unlike us still in the background, perhaps below the threshold of full awareness, but active nonetheless in driving our reactions, and sometimes our prejudice and discrimination?

The Strange Attraction of the Strange

barbarians-at-the-gatesWithout attempting a comprehensive definition of racial diversity, at a very minimum, physical differences in appearance often appear to be the first (and sometimes the only) trigger of a psychological defense mechanism.  In most human beings, there appears to be an innate drive to self-preservation that may be activated in the presence of individuals we may not recognize as familiar to us.

Often, there appears to be an instinctive and uncontrollable stress reaction that mobilizes our psychological, and at times also physical defenses against what we perceive as a possible threat from another human being.  This is by no means a new phenomenon.  As the coastal villagers and the frontier dwellers, we know that our own survival depends on being able to accurately assess any potential threat to ourselves and to our families and possessions, and take the most appropriate action (fight, flee or do something else) toward self-protection.

Clearly, not everyone we meet who is not like us is automatically a physical or psychological threat to our well-being.  Indeed, even those who appear to be exactly like us, in race, language, culture and background, may turn out to be a severe threat.  In ensuring survival, it pays to be alert to any potential danger. As President Reagan once put, Trust But Verify is a wise policy to live by, in politics but also in business and in interpersonal relations.

In some ways, we are attracted to the strange and the unfamiliar.  Our attention is automatically directed to it, out of simple curiosity, concern or fear.  When a different physical appearance is thrown in the mix, the perceived threat may be magnified by real or imaginary thoughts of danger and risk.  Paradoxically, there is also a part of us that is attracted to risky or dangerous situations, which does nothing to simplify the cacophony of feelings that are triggered by the sudden appearance in our midst of the strange and the mysterious.

A Universal Phenomenon

racially-diverse-babiesIt appears that no particular group of human beings is immune to this type of consideration when coming in contact with strangers.  There is certainly also an economic factor that plays a role, as when the need to defend one’s income or property, ends up taking precedence over solidarity and cooperation with the stranger.  It has been observed that people down on their luck, destitute, physically ill, or in need of urgent help seem to exhibit a tendency to be far less discriminating or threatened by the stranger than those who, by their own definition, may have a lot more to lose in such encounters.  Thankfully, human solidarity seems to shed at least part of its suspicions and reservations in the face of natural disasters or man-made calamities.  There are indeed moments in time when we realize that we are all humans, that we share a common identity, and that we inhabit this small planet together, if not always at peace with each other.

Awareness Normalizes

Our God-given capacity to muster our defenses against potential threats is a powerful asset, whose importance should not be overlooked even in a world where physical danger has been greatly diminished (though certainly not eliminated) by the safeguards of civilization.  Imagine would it would be like to automatically and unthinkingly assume that everyone we meet is friendly, honest, kind and has our best interest at heart.  Unrealistic, naive?  Yes, and I would also say, definitely dangerous to our personal and collective well-being.

Being aware that we possess the gift of discriminating between the real and the perceived, the dangerous and the annoying, the severe and the trivial can help us realize that it is the way we normally are and to make the best use of it.  Racial discrimination may be caused by an overuse of this important asset.  To automatically assume that anyone not like us (by various definitions) is a dangerous threat is clearly discriminatory, exaggerated and ultimately detrimental to our own well-being.  We are societal beings, by nature, and isolating ourselves from large swatches of humanity may be an attempt at self-defense, but one that clearly exceeds the intent and the practice of reasonable threat assessment. Unreasonable fear and loneliness often travel together.

Stress and the Typical Male

typical-male Although all men are fully capable of experiencing the full range of human emotions and can face a variety of challenges, certain issues can occur more frequently in men than they do in women. Among the challenges that occur more frequently in men, the most common are self-medication through the use of alcohol or other substances, anger management, impulse control, and problems with emotional and sexual intimacy.

For many men, the healthy expression of stressful negative feelings can be a challenge. The typical male relies very heavily on a “logical or rational” approach to most emotional or psychological issues. Often from childhood, men have been accustomed to think that emotional vulnerability equals weakness and that it should be avoided as much as possible. Given this mindset, it is understandable that for many men it is objectively difficult to share with others how they are truly feeling. For some, it may even be difficult to read their own emotions correctly, to know for themselves how they are really feeling about certain issues. Issues arise that may require an adjustment of these beliefs and attitudes, as for example in the inability to connect, to open up in relationships, or in knowing how to be sensitive.

When this complex set of stress-inducing emotions are routinely avoided, repressed or denied, some problematic behaviors can result. Mismanaged emotions and feelings often produce addictions, compulsions, and avoidance. One of the most common ways of expressing hurt or emotional pain is anger; for other men, working longer hours helps them avoid relationship challenges; for others, superficial intimacy takes the place of genuine connection; other men resort to addictive substances and compulsive behaviors to “take the edge off” or avoid the full experience of negative feelings.

There are many counselors who specialize in working with men’s issues. The right counselor can help identify and work through avoidance, repression and denial in a way that appeals to men’s desire to approach issues in a logical, rational and goal-oriented way, while providing guidance toward learning about the values and benefits of emotional intelligence.

The Valor of Stress

James_DixonUnlike for physical injuries, no formal recognition is currently given by the US military for the biopsychosocial injuries sustained in combat, known as posttraumatic stress disorder or PTSD.  It is as if the many behavioral, emotional, and social consequences of traumatic stress are perceived to be of lesser impact, and thus less deserving of acknowledgement.  That they can be serious enough to warrant medical and psychological attention is now fairly well established.

The evidence is certainly not lacking, as serious outcomes of PTSD continue to occur. Most recently, the blog The Soldier’s Load reported  the story of  James “Rooster” Dixon III, an ex-Marine and long-time sufferer from PTSD who was killed by a State Police SWAT team in front of his house in Baxley, Georgia.

James sought treatment from the VA for his Post-Traumatic Stress Disorder (PTSD), but was unable to shake the constant anxiety and depression that are hallmarks of the disorder. On February 19, 2012 James decided to end his struggle by walking into the bullets of law enforcement: as much a casualty of the war as any service member who died in Iraq.

The blog’s editor, as someone with direct experience of war zone and combat stress and its psychological consequences, also offer insights into his own struggles with PTSD.

I became a functional recluse—avoiding social situations and new experiences that might trigger a panic attack. Friends and acquaintances got accustomed to me declining their invitations to socialize. Eventually they stopped asking. I drank heavily and destroyed romantic relationships in a depressing cycle of thrilling novelty, fear of entrapment and cold dismissal. After three years of struggling with the symptoms of my unknown malady, I chose to leave the Marine Corps. On my way out the door, the VA finally diagnosed me with combat-induced PTSD.

A Purple Hart for PTSD?

images Events such as the tragic end of James Dixon highlight the important questions that still surround how PTSD is perceived, labeled, acknowledged and treated—including the idea of awarding a Purple Hart in recognition of this very serious constellation of injuries that are sustained by so many service men and women. According to the Military Order of the Purple Heart, the Purple Heart medal “is awarded to members of the armed forces of the US who are wounded by an instrument of war in the hands of the enemy and posthumously to the next of kin in the name of those who are killed in action or die of wounds received in action. It is specifically a combat decoration.”  Should this wording be applicable to PTSD?

The Soldier’s Load asks,

Why do we fail to classify veterans with PTSD as combat wounded? I suggest that the reason has less to do with logic and more to do with the emotions surrounding a small bronze portrait suspended from a narrow purple ribbon. (…) Until we correctly label combat-induced PTSD as a “wound” suffered from contact with the enemy, we as a society will continue to view its sufferers as a shadow legion of men with strange habits and questionable character. We will not methodically identify the trauma, apply medical treatments, and provide appropriate rehabilitation and therapy during the recovery process. In short, we will draw distinctions between segments of combat veterans based on an arbitrary and antiquated determination that only the visible wounds of war are worth recognition, honor and treatment. Such a view will not be helpful to the thousands of combat veterans waging a daily war within, nor prevent some from ending that struggle before victory is won.

Read the full blog post. Do you support a Purple Hart for PTSD?

Allostatic Load: Stress Upon Stress

Chronic stress is a potentially lethal condition that is characterized by long duration and effect accumulation. Humans respond to stressors such as physical or perceived danger, an infection, or a crowded and noisy environment, by initiating a complex biopsychosocial adaptation and coping response. This response is initiated by the sympathetic nervous system and leads to release of excitatory stress hormones (the catecholamines) and glucocorticoids from the adrenal cortex (the well-known adrenaline rush).

The objective of this rapid physical mobilization of the body’s resources is to engage with the stressor, resolve it and return to a more normal state of alertness. Regaining normal arousal levels through a response and adaptation to the stressor is called allostasis. A highly stressed state is meant to be temporary and to subside naturally when the challenge has passed.

There is never a shortage of situations that trigger the stress reaction, at work or at home. All of us face the not too uncommon challenge of having to cope with more than one stressor at once or a series of stressors that happen within a relative short time. Most individuals can cope with this type of demands and are able to regain allostasis once the stressor or stressors have been taken care of or have taken care of themselves.

When individuals are not able to cope effectively with the stressor and cannot regain allostasis, this creates an accumulation of allostatic load. In this situation, there is an incomplete return to the normal condition and a regaining of physical and emotional stability. In fact, a state of stress at relatively high levels becomes the “new normal.” Over many weeks, months, or even years, this exposure to elevated levels of stress hormones can produce allostatic overload, with predictably serious health consequences.

Type 1 Allostatic Load

If the physical and emotional energy required to meet the demands created by one’s cumulative allostatic load routinely exceeds the energy intake and what can be mobilized from one’s own resources, type 1 allostatic overload occurs.

Allostatic overload type 1 is characterized by a significant increases in the circulation of glucocorticoids in the bloodstream (and other hormones that regulate allostasis), which triggers physiological and behavioral changes. These changes refocus the individual from functioning at normal levels of stress in daily routines into a high-stress high-alert survival mode.

Type 2 Allostatic Load

If energy demands are not exceeded and the individual continues to take in or store as much or even more energy than he/she needs—perhaps as a result of stress-related food consumption, choice of a fat-rich diet, or metabolic imbalances (prediabetic state) that favor fat accumulation—then type 2 allostatic overload occurs.

Allostatic overload type 2 causes lesser but higher than normal levels of glucocorticoids (and other hormones that regulate allostasis), which do not trigger physiological and behavioral responses, in such a way the individual remains stuck in a situation of high allostatic load without resolution.

Allostatic Load and Its Consequences

Elderly people who have had a lifetime of sustained economic hardship can have a more rapid decline of physical and mental functioning.  Hypertension is often an indicator of job stress, particularly in factory workers, in other workers with repetitive jobs and time pressures, and in workers whose jobs were unstable due to financial and market conditions.

In certain societies, conflict and social instability have been found to increase illness and mortality. For example, cardiovascular disease was found to be a major contributor to the almost 40% increase in the death rate among Russian males in the social upheaval which followed the fall of Communism. High blood pressure causes atherosclerosis as well as increased risk for heart attacks.

Abdominal obesity is another stress-linked change, which is often a precursor to more serious illness such as diabetes. The immune system is also a likely target of psychosocial stress, increasing vulnerability to the common cold and other more serious infections.

Just 14 of the Many Facets of Stress

aaTintoretto_SanGiorgioDragoMRI scans have revealed that children of depressed mothers have a larger amygdala, a part of the brain associated with emotional responses, researchers from the University of Montreal explained in the Proceedings of the National Academy of Sciences (PNAS).

A new study published in the American Journal of Industrial Medicine reveals that the World Trade Center attacks affected the health of the New York City Fire Department (FDNY) resulting in more post-9/11 retirements than expected.

Researchers in the Hotchkiss Brain Institute (HBI) at the University of Calgary’s Faculty of Medicine have uncovered a mechanism by which stress increases food drive in rats.

Do you run when you should stay? Are you afraid of all the wrong things? An enzyme deficiency might be to blame, reveals new research in mice by scientists at the University of Southern California.

Constant bitterness can make a person ill, according to Concordia University researchers who have examined the relationship between failure, bitterness and quality of life.

Listening to music or sessions with trained music therapists may benefit cancer patients. Music can reduce anxiety, and may also have positive effects on mood, pain and quality of life, a new Cochrane Systematic Review shows.

Researchers at Harvard-affiliated McLean Hospital have found that those who believe in a benevolent God tend to worry less and be more tolerant of life’s uncertainties than those who believe in an indifferent or punishing God.

Knowing the right way to handle stress in the classroom and on the sports field can make the difference between success and failure for the millions of students going back to school this fall, new University of Chicago research shows.

An 8-week course of stress-reducing Transcendental Meditation resulted in a 50% reduction in PTSD (post-traumatic stress disorder) symptoms among Iraq/Afghanistan veterans, researchers reported in Military Medicine. The pilot study involved five veterans aged 25 to 40 years with PTSD symptoms – they had all served between 10 and 24 months and had been involved in moderate or heavy moderate combat.

When parents fight, infants are likely to lose sleep, researchers report. "We know that marital problems have an impact on child functioning, and we know that sleep is a big problem for parents," said Jenae M. Neiderhiser, professor of psychology, Penn State. New parents often report sleep as being the most problematic of their child’s behavior.

By helping people express their emotions, music therapy, when combined with standard care, appears to be an effective treatment for depression, at least in the short term, said researchers from the University of Jyväskylä in Finland who write about their findings in the August issue of the British Journal of Psychiatry.

Young adults whose mothers experienced psychological trauma during their pregnancies show signs of accelerated aging, a UC Irvine-led study found. The researchers discovered that this prenatal exposure to stress affected the development of chromosome regions that control cell aging processes.

A child who has a psychological adversity or a mental disorder that starts during childhood has a higher chance of developing a long-term (chronic) physical condition later on, researchers from the University of Otago, Dunedin, New Zealand reported in Archives of General Psychiatry. The authors explain that child abuse has been linked to a higher chance of adverse physical health outcomes.

Individuals with anxiety-related symptoms who self-medicate with drugs or alcohol have a higher risk of having a substance abuse problem and social phobia, researchers from the University of Manitoba, Winnipeg, Canada, revealed in Archives of General Psychiatry.

Emotional Safety, Stress and Health

Many individuals who suffer from chronic stress report being “on edge” or “keyed up” most of the time. This near-constant state of arousal is reported at times when the person should be at rest, i.e. during normal sleeping hours, while relaxing with family or friends, or even while eating or taking a shower. Certain features appear to be common to most people who share this emotional state. Let’s look at a few of the most important ones.

Emotional Stress Often Translates Into Physical Symptoms

In most instances, psychological stress caused by real adversities or by the anticipation of adversity causes the body to react in an attempt to fight the stressor, flee from it or shut it off and away from immediate consciousness. In the process of taking these defensive measures, muscles tense, the cardiocirculatory system kicks into high gear, and many non-indispensible systems (such as the digestive and sexual systems) shut down or significantly slow their functioning. Since the stressor is often non-physical in nature, this bodily mobilization of resources never quite finds its target. Over time this may wear down certain organs of the body, which begin to manifest signs of illness. High blood pressure, irritable bowel syndrome, erectile dysfunction, muscle spams or pain, ulcerative colitis are but a few of the more or less serious physical ailments that can be directly associated with chronic anxiety and stress.

Emotional Stress Can Contribute to Mental Disorders

Frequent stress has an augmenting and, some say, even causative effect on poor mental health. In the presence of serious stressors, such as the loss of a home or a job, or a serious physical illness, or the loss of a significant relationship, many people develop symptoms that are typical of certain mental disorders. It is debatable whether the mental disorder comes first and the stress comes next, or vice versa, but regardless of whether the chicken comes before the egg, the results can be quite the same. A serious stressor may provoke depressive symptoms or acute stress disorder. What makes a difference is the individual’s proneness to manifest a psychological disturbance either in an “externalizing” manner, e.g. with visible signs of anxiety, or in an “internalizing” manner, e.g. with the shutdown of activity that is typical of depression.

Taking the other side of the equation, people who already suffer from an anxiety disorder or a depressive disorder may feel that their symptoms are aggravated by another stressor added on top of the ones they have experienced in the past. Anxious individuals will feel less prepared to meet the new psychological challenge, and even the mere anticipation of a new threat may be sufficient to produce a panic attack. Depressed individuals, who also may feel that their personal resources are inadequate to cope with a new challenge, may not show any signs of panic or heightened anxiety and will instead further retreat into the dark recesses of depression.

Emotional Stress Is Fear Under Another Name

Psychological stressors share a common characteristic: they are caused by generally unwanted and often unexpected events or situations. Regardless of their origin, negative stressors produce a reaction of surprise and, in most cases, fear. Since negative consequences usually accompany the arrival of a stressor, and since most people are quite capable of predicting a whole range of possible negative outcomes resulting from a stressful event or situation, fear (often masking as anxiety or even anger) is the naturally occurring and logical emotion. Even in the classic case of a positive stressor such as winning the lottery, fear is not too far behind the initial moment of wild elation. Even the arrival of a large sum of money can produce fears of its loss even before the unexpected windfall lands on the lucky winner’s bank account. Stories of big winnings have often culminated in poor choices, reckless decisions, broken relationships, and ultimate unhappiness.

Regardless of its origin, a significant stressor may produce quite a significant state of perceived danger. Many people feel that they can meet the challenge, but many others may not feel up to the task because of low self-esteem, a personal history of negative outcomes, low resilience, or a pessimistic outlook on life. A feeling of emotional safety is a protective condition that helps us make better decisions, enhances our judgment, and is generally good for our physical health. Conversely, the lack of emotional safety (which may range from a mild state of anxiety to the perception that a catastrophic event is about to occur) may be conducive to poor decision making, errors in judgment, inefficient allocation of personal resources or lack of adequate self-care, and may be linked to a higher probability of physical illness.

How To Tame Fear and Fight Chronic Stress

Emotional safety is one of the ingredients of good mental and physical health that, especially nowadays, appears to be in especially short supply.  How can it be increased? A good place to start is by developing better insight into our situation. Insight is the awareness not only of the content of our worries and stressors (“what” makes us feel stressed), but also of the process (the “how”) by which we attempt to manage or cope with the situation. In many cases, our coping attempts are so automatic and out of awareness that they happen without our direct control. Insight into the process can change this. There is a significant reservoir of power and energy that can be tapped by the simple act of self-observation. It is the ability to say not only, “I can’t believe this is happening to me,” but also and at the same time to be able to say, “and just look at how I am handling this right now.”

Insight into the process of coping leads to one very important moment of choice. Being able to ask the question, “Is this way of (over)reacting the only option I have right now?” constitutes a tremendous step forward from a wholly automated and fear-driven response. While it is possible that in the moment no other reaction may be possible except anxiety or depressive thoughts, the presence of insight into the process can help come up with options and alternative ways of handling the stressor. This sets up the vital, and perhaps best, way to cope with the unexpected: an initial automatic and spontaneous reaction to a stressor (which may be physical and psychological in nature, entirely human and to be expected), followed by a more intentional and not so automatic response that comes from the ability to choose between several available options.

How Good and Bad Stress Are the Same

MountRotui_EN-US1706638791Eustress (or good stress) and bad stress (acute or chronic) cause the exact same reaction in the human body. Even during voluntary “stressful” activities such as sport or exercise or when we receive unexpected good news, the brain stem, the oldest and more primordial part of the human brain, immediately mobilizes the body’s resources. The brain stem does not know, and one might say does not care, what triggers the sudden demand for additional physical activity. All the brain stem knows, prior to any higher brain intervention such as a decision to be afraid of something, or a decision to exercise, is that more blood is needed immediately to fulfill physical demands that may already be occurring (in the case of exercise or a real and impending threat) or that may be presumed to occur (in the case of perceived danger in a situation).

When the motor areas of the brain and the limbic system become activated by a positive but sudden event, most of the reticular activating system of the brain stem is also mobilized. This activation includes greatly increased stimulation of the vasoconstrictor and cardioacceleratory areas of the vasomotor center of the brain stem. Thus, the increase in arterial pressure permits to keep pace with an expected increase in muscle activity. A similar rise in pressure occurs during negatively stressful situations. The need to prepare to meet the danger posed by the stressor mobilizes the reticular activating system and the vasomotor center of the brain stem.

During dangerous situations (real or perceived), arterial pressure rises to as high as twice its normal value within a few seconds. This dramatic increase can immediately supply blood to any or all muscles of the body needed to respond. This translates into an enormously increased ability to fight against or to flee from the cause of danger. It is indeed a significant survival factor that no conscious decision is needed when this split-second mobilization is required.

Type A and Hi-Tech: A Dangerous Mix

Tower of Babel by Bruegel at Stresshacker.comWhat does the relentless push of technology into our lives do to our ability to manage stress and to our health in general? It depends on the personality. For individuals who have a type A personality, multiple e-mail addresses available from any platform, high-speed anywhere Internet access, smart mobile phones, tablets, and e-readers have enabled even greater flexibility and mobility in teleworking and telecommuting. In effect, traditional boundaries between the different roles at work, in the family, at leisure have been blurred or even removed.

In addition to the advancing technology, economic conditions have made short-term employment, work on time-limited projects, and working two or even three part-time jobs simultaneously increasingly more common.

Type A individuals claim that this new rhythm of life has produced beneficial effects in terms of greater task variety and flexibility. Thanks to these ubiquitous and always-on hardware devices and the software tools they provide, there often is no break of continuity between work and non-work states, between being somewhere dedicated to work activities and being somewhere else, where relationships or relaxation are possible. Again, for the type A personality, this is just fine–at least in theory and by their own admission.

Type A Individuals Thrive…At Their Own Peril?

Type A personality is characterized by an extreme sense of time urgency, frequent impatience with one’s self and others, high competitiveness, and more frequent aggression and/or hostility (either in the form of overt outbursts, or constricted and internalized through tight behavioral control). Clinical evidence indicates that there is at least an increased risk of stress in these individuals due to their proneness to work overload, disruption of natural circadian patterns, role conflicts, lack of time for relationships, for sufficient rest and energy replenishment through sleep or relaxation activities.

This particular personality type, given the current availability of communication and connection devices, appears to thrive in this environment that promotes maximum efficiency, high productivity, a faster pace of work output, and competitiveness.

Is this a competitive advantage for individuals who happen to possess these personality traits, or is this a potential problem? Apparently, higher productivity and efficiency are desirable outcomes. From a business efficiency point of view, they most definitely are. This may explain why significant technological resources are being devoted by an increasing number of companies toward making this always-on-the-job state of affairs a reality for their employees. It is seen as a competitive advantage over other companies (which are fewer and fewer) that shut down at a reasonable hour and do not work on weekends.

Most type A individuals proclaim to “love” this uninterrupted access to the marketplace and the instantaneous availability that is demanded of them.

There are however potentially serious health consequences, unless the individual can set and maintain reasonable and appropriate boundaries.

Type A personality have long been known to be at risk in terms of elevated blood pressure, increased heart rate, higher blood lipids, and near-continuous catecholamine (stress hormone) output. Intensive, frequent, and sustained activation of these physiological stress responses can contribute to the atherosclerotic process and to blood clotting. This prolonged state of arousal can cause, with type A behavior, an elevated risk of myocardial infarction. A longitudinal study by Barefoot et al., found that medical students with high scores on the Cook-Medley hostility scale of the Minnesota Multiphasic Personality Inventory (MMPI)–which would indicate type A personalities– had a six fold increase in mortality when followed up 25 years later, mainly due to coronary heart disease.

The negative psychosocial and socioeconomic factors in which type A behavior appears to thrive is associated with increased risk of serious illness and mortality because of the elevated activity of the hypothalamic-pituitary-adrenocortical (HPA) system and the increased secretion of the stress hormone cortisol. A very high workload, such as regularly working more than 10 hours of overtime per week, is also associated with markedly elevated cortisol levels. Prolonged and sustained activity of the HPA system is related to a series of endocrine and metabolic effects, causing, among other things, increased storage of fat in the abdominal region.

It is a mixed blessing, to say the least, for type A personality to see modern technology facilitate and indeed augment their relentless rhythm of activity. Is the risk really worth the reward?

8 Hours of Stress Each Day

Excluding the off-the-charts stress of a job loss, there are certain on-going job conditions that may be present throughout the working day and that almost invariably lead to significant stress.

Job Design

Some jobs are just not well-designed, i.e. they contain requirements and features that are inherently stressful. This may include a heavy workload caused by the organization’s need or desire to have one person do the job of two (or even three) people. Another may be inadequate or frowned-upon breaks that do not let the individual rest the mind and the body for even a few minutes at a time. A third may be too-long working hours that interfere with needed rest and one’s personal life. Yet another is being asked to perform tasks that have little chance of being successful, do not utilize one’s skills adequately, or force individuals to use skills that are not their strong suit. In these situations, and in these economic times, it is not unheard of for someone to work to the point of mental or physical exhaustion and beyond, as “anything else would jeopardize the job.” A fear-induced highly negative perception of the precariousness of the job can be a significant factor that may make overlooking a flawed or poorly designed job a dire necessity.

Management Style

The wrong management style, either authoritarian or overly permissive, can cause a lack of participation in decision-making, poor communication within the organization, absent or ineffective people-friendly policies, inattention to ergonomic or environmental problems, poor handling of grievances or legitimate complaints, or micromanagement. Often, these circumstances can only change if there is a change in management. 

Stressful Interpersonal Relationships

Difficult or strained relationships with bosses, coworkers or subordinates, due to lack of support, camaraderie or helpfulness can foster a sense of isolation or of being under attack. Usually, something can be done to remedy these situations from the personal side, as in, “better relationships start with me.” However, seldom these issues are perceived, and often dysfunctikonal relationships tend to promote further isolation and to create a vicious circle of misery.

Confusion Over Job Roles

These can take the form of having diverging or simply too many responsibilities, or the all too common occurrence of having to please or satisfy two or more constituencies with opposing goals, i.e. please the customer while maximizing revenue. Often these confusions are unavoidable due to the competitive and profit-oriented nature of most businesses. 

Career Concerns

We may harbor sometimes overt but more often secret concerns over various aspects of the position we occupy, such as the security of the job itself, due to job-specific or industry or general economy threats. There may be rapid changes in the job description or its requirements for which we may feel unprepared. There may also be unfulfilled desires of growth opportunities, such as advancement, promotion or change. A fear-induced highly negative perception of the precariousness of the job can be a significant factor, even though it may not be commensurate to the objective reality of the threat, i.e. fear without real risk of job loss.

Structural and Environmental Conditions

The conditions in which we must perform our tasks may range from mildly unpleasant to physically dangerous. There may also be noise, bad breathable air, overcrowding or constrictive body positions, such as prolonged standing or sitting or heavy lifting, or even too much typing. The degree of control that we can have over these stressors is often minimal or none.These often are legitimate and objective constraints that would stress anyone under the same circumstances.

Stress News: The Good, the Bad, the Ugly

Stress and the Unborn

Overexposure to stress hormones in the womb can program the potential for adverse health effects in those children and the next generation, but effects vary depending on whether the mother or father transmits them, a new animal study suggests. The results were presented this past Saturday at The Endocrine Society’s 93rd Annual Meeting in Boston.

Posttraumatic Stress Disorder

Depressed-Soldier-02A new study from the Journal of Traumatic Stress finds that for active-duty male soldiers in the U.S. Army who are happily married, communicating frequently with one’s spouse through letters and emails during deployment may protect against the development of posttraumatic stress disorder (PTSD) symptoms after returning home.

Veterans of the Iraq/Afghanistan wars showed a 50 percent reduction in their symptoms of post-traumatic stress disorder (PTSD) after just eight weeks of practicing the stress-reducing Transcendental Meditation technique, according to a pilot study published in the June 2011 issue of Military Medicine.

Individuals with post-traumatic stress disorder (PTSD) are likely to have a higher chance of developing heart disease and to die prematurely, US researchers reported in the American Journal of Cardiology. They found that those with PTSD were more likely to have coronary artery disease, an accumulation of plaque in the arteries that lead to the heart disease.

Stress and Multiple Sclerosis

Contrary to earlier reports, a new study finds that stress does not appear to increase a person’s risk of developing multiple sclerosis (MS). The research is published in the May 31, 2011, print issue of Neurology®, the medical journal of the American Academy of Neurology.

Stress and Alzheimer’s Disease

Stress promotes neuropathological changes that are also seen in Alzheimer’s disease. Scientists from the Max Planck Institute of Psychiatry in Munich have discovered that the increased release of stress hormones in rats leads to generation of abnormally phosphorylated tau protein in the brain and ultimately, memory loss and dementia.

The Stress of… Stress

ClareIsland_EN-US2748591595There are times in which the stress reaction and the level of anxiety caused by a stressor are so high that the body’s reactions become extreme and add to the burden. Stress becomes stressful in itself and a problem of its own. Although the stress reaction itself is normal and necessary for survival, learning and for personal growth, the body’s reaction to the increased alert level causes a predictable and rather universal set of physical changes. These include:

  • Increased central nervous system activity—a state of full awareness
  • Increased mental activity and brainwave activity—full mental alert
  • Increased secretion of adrenaline (epinephrine), noradrenaline (norepinephrine), and cortisol into the bloodstream—a state of endocrine mobilization
  • Increased heart rate, cardiac output, and blood pressure—the way in which the body prepares to meet the physical demands of the stressor
  • Increased breathing rate, breathing airways dilation—brings more oxygen into the lungs
  • Increased metabolism, oxygen consumption, oxygen to the brain—oxygen is the principal sustainer of life for brain cells and for the whole body
  • Blood is diverted away from the digestive tract and directed into the muscles and limbs—the processing of food become secondary to averting or confronting the danger
  • Increased muscle contraction, which leads to increased strength—for either fight or flight, muscle readiness is automatically brought to the highest levels
  • Increased blood coagulation (blood clotting ability)—helps the body minimize the impact of possible injuries
  • Increased circulation of free fatty acids, a source of cellular energy—contributes to the readiness of the body to greater energy expenditure
  • Increased output of blood cholesterol—makes the blood richer in nutrients to be carried to muscles and other organs
  • Increased blood sugar released by the liver, to nourish the muscles—another important source of energy for best performance and strength
  • Release of endorphins from the pituitary gland—an activating hormone that boosts alertness throughout the body
  • Pupils of the eyes dilate—increases field and acuity of vision
  • Hair stands on its end—a remnant from the time when hair covered the most vulnerable body parts
  • Blood thins—this speeds up blood circulation for faster travel from center to periphery and back
  • Sweat glands increase secretion—a well lubricated body presents a slippery surface in a fight and cools it down below dangerous heat levels
  • Increased secretion from apocrine glands resulting in foul body odor—designed to repulse enemies
  • Capillaries under the surface of the skin constrict with a consequent increases in blood pressure—blood pumping to all parts of the body is enhanced
  • Immune system is suppressed–the immune system may have energy made available for it via reduction of other activities, may change in energetically conservative ways when the protection it confers needs to be balanced with the energetic demands of other activities such as fight or flight, or may be suppressed when other activities are more important than immunity for total well-being
  • Reproductive and sexual systems stop working normally—in times of high stress, sex and reproduction take a back seat to survival and protection
  • Decreased perception of painthe analgesia system, a pain suppressing mechanism that effectively shuts off sensory transmission to the brain, so that we are permitted to go about the business of getting out of the gravest danger without the crippling sensations of pain.

Stressed_WomanNo command is needed to activate these reactions that are programmed in the genetic code. Moreover, they cannot be prevented from occurring, except to a limited extent. At best, one can learn to control what is visible to others and, in some individuals, the heart rate can be somewhat controlled.

This cascade of physical reactions is good in two ways. First, when there is a danger or threat of some sort (e.g., a bus coming straight at us) we are instantaneously aroused into action: we step out of the bus’s path without really planning to do so, automatically. In this way, we have a chance to avoid and/or survive many physical threats to our well being. This ability enabled a  physically weak human race to survive and thrive among larger and stronger animals, earthquakes, fires, and interpersonal conflict during our long history on this planet. Can we imagine surviving very long without the mobilization caused by the stress reaction alarm system?

Second, we are programmed to respond not only to physical threats but also, and more importantly in our society, to non-physical threats that are emotional, social or psychological in nature. This is of great value because most threats nowadays come from circumstances of social living, such as relationships, jobs, economics, politics, environment, and technology.

Unfortunately, the stress reaction can be so overwhelmingly strong that we become stressed by stress itself, incapable of moving beyond its mesmerizing message of danger. Changing back the focus from the stress reaction to the stressor is the key to making an appropriate use of this vitally important warning system. It is also the key to responding vs. simply reacting. Learn this, and stress becomes the alert system most useful in navigating the treacherous straits of modern life.

Discovery: A New Brain Pathway for Stress

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In many individuals, a major stressor activates a critical and previously unknown pathway in the brain that regulates anxiety in response to traumatic events. The amygdala, which is the emotional center of the brain, reacts to the stressor by increasing production of the protein neuropsin. The release of neuropsin activates a series of chemical events  that further stimulate amygdala activity, which in turn activates a gene that determines the stress response at a cellular level. Due to this gene activation, these individuals develop long-term anxiety and a typical anxious response to real or perceived stressors.

A study just published in the journal Nature for the first time clarifies the mechanism whereby, in certain individuals and not in others, the extracellular proteolysis triggered by fear-associated responses facilitates neuronal plasticity at the neuron–matrix interface. This process centers around the activity of the serine protease neuropsin, which is critical for stress-related plasticity in the amygdala. Neuropsin determines the dynamics of the EphB2–NMDA-receptor interaction, the expression of the “anxiety gene” Fkbp5 and the triggering of anxiety-like behavior. When faced with a stressor, individuals who are neuropsin-deficient show a much less frequent expression of the Fkbp5 gene and low anxiety. On the other hand, the behavioral response to stress in individuals who are rich in neuropsin shows a more frequent expression of the Fkbp5 gene and much more significant anxiety-related behavior. The researchers, consisting of a team of neuroscientists at the University of Leicester, UK, in collaboration with researchers from Poland and Japan, conclude that their findings establish a novel neuronal pathway linking stress-induced proteolysis of EphB2 in the amygdala to the development of an anxiety-driven response to stress.

Stress-related disorders affect a large percentage of the population and generate an enormous personal, social and economic impact. It was previously known that certain individuals are more susceptible to detrimental effects of stress than others. Although the majority of us experience traumatic events, only some develop stress-associated psychiatric disorders such as depression, anxiety or posttraumatic stress disorder… We asked: What is the molecular basis of anxiety in response to noxious stimuli? How are stress-related environmental signals translated into proper behavioral responses? To investigate these problems we used a combination of genetic, molecular, electrophysiological and behavioral approaches. This resulted in the discovery of a critical, previously unknown pathway. –Dr. Robert Pawlak, University of Leicester.

The study took four years to complete and it sought to examine the behavioral consequences of a series of cellular events caused by stress in the amygdala. They discovered that when certain proteins produced by the amygdala were blocked, either via medication or by gene therapy, the study subjects did not exhibit the highly anxious traits.

This is a significant discovery for the study and treatment of maladaptive stress responses that result in anxiety. By knowing which chemicals along the neuropsin pathway are present in the human brain at the moment of traumatic events, the researchers believe that it will be possible to design intervention therapies for controlling stress-induced behaviors and for the prevention and treatment of stress-related psychiatric disorders such as depression and posttraumatic stress disorder.

When Stress Matters Most, What Do You Do?

NeuschwansteinStress is the physiopsychological reaction to a challenge or a threat. It is particularly acute when the stressful event triggers the perception that one’s available resources are insufficient or poorly matched to successfully face it. Take for example our job, a purposeful activity that we engage in as a means of livelihood. On the job, our resources (finances, physical and mental abilities, time, image, and self-concept) are allocated and expended to adequately meet its demands, which carries great potential for stress. Being able to pay attention to warning signs of trouble, of which stress is certainly one of the most prominent, may make a difference in our ability to respond quickly and effectively.

Stress on the job is of the same kind as the threat of a saber-toothed tiger—not the same, but of the same kind. Should we ever find ourselves face to face with the feline, our body would instantly spring into full mobilization mode. The heart rate would go up, respiration would increase in depth and frequency, muscles would tense and pupils dilate, the stomach would contract, and adrenaline and other excitatory hormones would flood into the bloodstream. We would be faced with three possible choices: fight, flight or freeze.

When face to face with a job challenge of a serious nature (loss of a major client, a sudden promotion, the loss of the job itself, a major breakthrough), we are alerted to a threat and our body instantly springs into full mobilization mode, with the same biological changes as when in a close encounter with the wild cat. The threat or challenge may be very different, with linoleum under our feet instead of savanna grasses, but the body doesn’t care—a threat is a threat. We are faced with the same three possible choices: fight, flight or freeze.

Even when we know we are not going to suffer physical harm, the body can’t help but to prepare for the worst. Our chances of being killed by wildlife or to compete with the tiger for our lunch are abysmally small. The last saber-toothed tiger became extinct sometime between the Oligocene and the Pleistocene epoch. Yet, we humans continue to be instinctively and instantly mobilized when we perceive a threat of any kind. Which is a good thing.

The usefulness of stress throughout or history is undeniable. Many more of our ancestors would have been killed had they not perceived the appearance of predators as a possible threat. A great many probably did get killed when they chose the option to freeze. Others, owing to inadequate weapons, got killed while exercising their option to fight. And still others were not fast enough to take full advantage of the opportunity to flee. To be sure, one hundred percent of those who saw no threat in the approaching tiger and lingered to consider the size of her teeth, or in other words, those who felt no stress in the situation, were swiftly eliminated from the genetic pool by a process of natural selection.

Fast forward to the present, and General Motor and Chrysler executives must have felt pretty safe from the saber-toothed tigers of competition and market change, because up until the last minute they felt no real stress from their falling sales (except for SUVs) and dwindling customer base (except for SUV buyers). How many people lost their job in the current recession and never saw it coming? Or saw it coming and froze? Or didn’t flee soon enough, or did not fight for change? Stress told Ford executives to come up with a plan, a better plan as it turns out. One wishes that GM and Chrysler executives had felt a little bit more stressed out, a bit more mobilized into action, less complacent and relaxed. Stress is a bright amber light on the dashboard of our life that simply says, something requires our attention—NOW. More often than not, the light is right.