Stress

Silvia Irina Briganti

Matteo Paolucci
What is stress and how can we
define it?

Stress is a condition of alarm characterized by

an excessive and persistent request of
psychological and physical energies that an
individual has to invest to realize his objectives
or to do his duties
 In psychology, stress is considered as an
adaptive reaction, connected to emotions and
responsible of changes in physiological
regulation, conscience and everyday life
behaviour, in front of situations of emergency
or serious danger
 Eustress & Distress

! " Eustress is a “positive” stress, temporary and

necessary to preserve human life;

! " Distress is “negative” stress, prolonged and

harmful for both human body and mind
Physiology vs stress
Two endocrine response systems are reactive to
psychological stress: the hypotalamic-pituitary-
adrenocortical axis (HPA) and the sympathetic-
adrenal-medullary (SAM) system
Hypotalamic-pituitary-
adrenocortical axis
Cortisol, the primary
effective hormone of
HPA, regulates a great
range of physiological
processes, like
inflammatory responses,
metabolism of
macromolecules
(proteins, lipids...) and
gluconeogenesis
Sympathetic-adrenal-medullary
system

Catecholamines, released after SAM

activation, work with autonomic nervous
system to control cardiovascular and immune
systems, liver, lungs and skeletal muscles
 Prolonged activation of HPA and SAM
produced by stress can have serious effects on
health: clinical depression, human
immunodeficiency (HIV), cancer,
hypertension, infectious and coronary arterie
deseases etc
Immune system is
vulnerable more
than the others: it
can be struck
directly, through the
innervation of
lymphatic tissue,
wich carries
immune cells, or
indirectly, through
the release of HPA
and SAM
hormones, wich
alter immune cell
functions
Stressors
 Common factors of stress
•" Physical stressors
Illness, disabilities…

•" Enviromental stressors

Poverty, natural disasters, noise…

•" Life situations

Events, responsabilities, social and financial problems,
relationships…

•" Behaviors
Habits, lifestyle, certain patterns of thinking…
 Levels of stressors

Emotional states
Distress
Physical symptoms

Eustress
Signs & symptoms
Symptoms are various and individuals; is possible to find out 3 levels
of symptoms correlated with the increasing of stress level

Inner emotional Anxiousness, nervousness,

distraction, excessive worry,
state internal pressure

Distracted, self-assorbed,
Outward appearance irritable

Excessive fatigue, depression,

headaches, nausea, vomiting,
Physical effects diarrhea, chest pain, heart
racing, dizziness or flushing,
tremolousness or restleness
Does Stress cause diseases?
Stressful events & diseases
High and persistant stress level

Direct
Effects
Other
Pathways

Hyperactivation of Behaviors
HPA & SAM •" Increased smoking •"Poorer adherence
•" Decreased exercise to medical
•" Descreased sleep regimens
 Review “Psychological stress and diseases”
10/2007

•" Clinical depression

•" Cardiovascular disease (CVD)

•" Human immunodeficiency virus (HIV)/AIDS

•" Cancer
 Review “Psychological stress and diseases”
10/2007

Depression CVD HIV/AIDS Cancer

Role of stress ++ ++ ++ ?

•" Upper respiratory tract infections

•" Asthma

•" Herpes viral infections

•" Autoimmune diseases

•" Wound healing

Stress treatments
 First step: identification of the
source of stress
•" What type of stressors?
•" Illness can lead to stress
•" Emotional stress can lead to illness

!" friends, family, spiritual advisers

!" doctor (interview, lab tests, ECG)

! Is there need of a medical treatment?

 Self-Care at home
! " Remove yourself from the source of your stress
•" Physically
•" Mentally ! time-out

•" Relax
•" Formulate a plane for dealing with the problem
 Medical treatment
! " Stress affects you as an individual: everyone reacts in
different ways
! " The treatment of your stress will vary greatly depending on
the types of symptoms you are experiencing and how severe
they are
•" In case of psycho-somatic disease, is reccomened a counseling by
qualified mental health professionals
•" In case of physical disease, medical intervention can consist in a
pharmacological treatment
•" Direct to the general perception (benzodiazepine, ephedrine)
•" Direct to the specific symptom
 Prevention
stress management
•" Set realistic goals and limit yourself

•" Put things into perspective and try not to get upset about insignificant or
relatively unimportant matters

•" Find activities that you enjoy and set aside time to participate them on a
regular basis

•" Participate in regular physical exercise

•" Mantain a positive outlook

•" Set goals and break them into easily achievable tasks

•" Manage your time

•" Reward yourself for the good things that you do each day
Thanks & Relax!