PSYCHIATRY
STRESS
STRESS
 Is a state in which a strong demand is made on
the nervous system
 Is the state of an elastic body under conditions of
strain
 Is an external stimulus that the brain perceives as
dangerous
 Whether an event is perceived as stressful
depends on the nature of the event and the
person’s resources, psychological defenses and
coping mechanism.
 It is a fact that every species has developed
various means & mechanism to obtain an
adjustment to the life conditions it must meet.
 In this light, man has developed not only
anatomical adjustments to protect himself
structurally or physiologically in respect to his
environment but he has also evolved
psychological devices to assist him in dealing with
his emotional needs & stresses.
 Man has to adapt to his day to day & minute to
minute existence.
 Adaptation is the very essence of life just like how
the body physically & biochemically maintain
equilibrium or homeostasis
 Man does not only strive to maintain his body
physically but he also does so psychologically.
 The personality through unconscious & automatic
psychological processes seeks to maintain
psychological stability.
 The personality by different techniques attempts
to enhance & defend itself to establish acceptable
compromises between conflicting impulses & to
allay inner tensions.
 A civil war exists within the personality that leads
to intrapsychic conflict.
STRESS & DEFENSE MECHANISM
 Reaction to stress involves the ego, which deals
with the reality principle.
 The ego’s struggle against painful or unendurable
ideas or affects is called the defense mechanism.
 All of us continually use defense mechanisms & in
themselves they are not necessarily pathological.
 Defense mechanisms are designed to manage
anxiety, aggressive impulses, hostilities,
resentments & frustrations.
 Defense mechanisms may promote the
individual’s ability to live in peace with himself.
 Defense mechanisms help emotional needs of
affection, personal security, personal significance
& perturbing anxiety.
 Defense mechanism effect an adjustment to inner
situations & experiences that are troublesome.

 A person whose ego is functioning properly is in
adaptive balance with the external & internal
worlds.
 If it were not functioning properly & the
imbalance continues long enough, one could
develop chronic anxiety.
 The ego’s capacity for maintaining a relationship
to the external world is among its principal
functions.
 The character of its relationship to the external
world maybe divided into 3 components: sense of
reality, reality testing & adaptation to reality.
 Other functions of the ego:
o CONTROL & REGULATION OF
INSTINCTUAL DRIVES
 (capacity to delay gratification)
o SYNTHETIC FUNCTION
 integrative capacity (simplify &
generalize)
o PRIMARY AUTONOMOUS
 perception, intuition,
comprehension, thinking,
language, learning, intelligence
o SECONDARY AUTONOMOUS
o OBJECT RELATIONSHIPS
o JUDGMENT
 George Valliant has classified defenses into 4
types:
o NARCISSISTIC DEFENSES
 used by children & psychotics
o RESISTANCE
 used by adolescents, seen in
depression & obsessive-
compulsives
o NEUROTIC DEFENSES
 seen in adults under stress,
obsessive-compulsives,
hysterical persons
o MATURE DEFENSES
 normal adult adaptive
mechanism
 The repertoire of defense mechanisms used by a
person could help in the understanding of the
psychodynamics of that person.
 When is one well adapted?
o One is well adapted if his productivity, his
ability to enjoy life & his mental
equilibrium are undisturbed.
 What is the measure of one’s mental health?
o type of defense unconsciously selected
to meet emotional needs & stresses &
anxiety
o extent of employment of these defenses
o degree to which these distorts one’s
personality, dominates his behavior &
disturbs his adjustment with others
PSYCHIATRY

STRESS
SYMPTOMS OF LIVING WITH HIGH LEVEL OF STRESS o Lowered immunity
 PHYSICAL o Cardiovascular effects
o Extended fatigue o Fatigue, sleep problems, appetite change
o Feeling tired, drained
o Frequent physical complaints BURN-OUT SYNDROME
o Chronic physical ailments linger or recur  Exhaustion
o Sleep & eating disturbances  Irritability
 EMOTIONAL  Fatigue
o Feeling alienated from people  Decreased effectiveness and capability in work
o Desire to be alone/need for constant
company MANAGEMENT OF STRESS
o Boredom  ASSESSING ONE’S OWN STRESS
o Feeling immobilized o Perception of Stress
o Negativism/cynicism o Coping Techniques
o Feeling of always meeting needs of o Social Support Systems
others  DEVELOPING A HEALTHY LIFESTYLE
o Dependence on alcohol &/or drugs o Exercise
o Suspiciousness/paranoia o Nutrition
o Chronic sadness
 COGNITIVE 10 SUGGESTIONS FOR RELIEVING DISTRESS
o Tired of thinking 1. Learn to relax
o Feeling of overload 2. Practice acceptance
o Difficulty in concentration 3. Talk rationally to yourself
o Reluctance to begin projects 4. Get organized
o Problems with prioritizing & decision 5. Exercise
making 6. Reduce time urgency
 BEHAVIORAL 7. Disarm yourself
o Irritability/ displacement of anger 8. Quiet time
o Delay in dealing with difficult interactions 9. Watch your habits
at work, on projects & at home 10. Talk to friends
o Reluctance to take on other people’s
problems WHEN STRESSED:
o Absenteeism,  Establish meaning, understand personal
o Withdrawal significance of the situation
 SPIRITUAL  Confront reality & respond to requirements of
o Declining investment in others external situation
o Doubt of value system/religious beliefs  Sustain relationships
o Questioning major life areas (profession,  Preserve a reasonable emotional balance
employment, etc.)  Preserve satisfactory self-image & maintain sense
o Feeling threatened/victimized by others of competence & mastery
o Self preoccupation
o Disillusionment

ACUTE STRESS REACTIONS

 ACUTE PHYSICAL REACTIONS:
o Increase in heartbeat & respiration
o Elevation in blood sugar level
o Increase in perspiration
o Dilated pupils
o Slowed digestion

CHRONIC STRESS REACTIONS

 PHYSICAL
o Tension in musculoskeletal system
o Digestive difficulties