CONTENT

I. What you need to know.

1. Definition
Stress is no longer a new term for us anymore, no matter who you are,
what you are doing, you gender,… you must have experienced stress
one or two time already. Stress as most of us know is bad and
unpleasant to experience. According to a survey conducted in Nigeria
in 1984 more than 90% of people who joined this survey voted stress
as bad, 5% voted for normal and the rest was good. After that survey,
many question have been raised and the most common that I have
found on the internet is “ What stress exactly is ? How it affects us ?
Why people have different way of thinking when it comes to stress ?
Stress.
Stress is not a useful term for scientists because it is such a highly
subjective phenomenon that it defies definition. And if you can’t define
stress, how can you possibly measure it? The term “stress”, as it is
currently used was coined by Hans Selye in 1936, who defined it as “the
non-specific response of the body to any demand for change”. Selye had
noted in numerous experiments that laboratory animals subjected to acute
but different noxious physical and emotional stimuli (blaring light, deafening
noise, extremes of heat or cold, perpetual frustration) all exhibited the same
pathologic changes of stomach ulcerations, shrinkage of lymphoid tissue
and enlargement of the adrenals. He later demonstrated that persistent
stress could cause these animals to develop various diseases similar to
those seen in humans, such as heart attacks, stroke, kidney disease and
rheumatoid arthritis. At the time, it was believed that most diseases were
caused by specific but different pathogens. Tuberculosis was due to the
tubercle bacillus, anthrax by the anthrax bacillus, syphilis by a spirochete,
etc. What Selye proposed was just the opposite, namely that many different
insults could cause the same disease, not only in animals, but in humans
as well.

Selye’s theories attracted considerable attention and stress soon became a

popular buzzword that completely ignored Selye’s original definition. Some
people used stress to refer to an overbearing or bad boss or some other
unpleasant situation they were subjected to. For many, stress was their
reaction to this in the form of chest pain, heartburn, headache or
palpitations. Others used stress to refer to what they perceived as the end
result of these repeated responses, such as an ulcer or heart attack. Many
scientists complained about this confusion and one physician concluded in
a 1951 issue of the British Medical Journal that, “Stress in addition to being
itself, was also the cause of itself, and the result of itself.”
Unfortunately, Selye was not aware that stress had been used for centuries
in physics to explain elasticity, the property of a material that allows it to
resume its original size and shape after having been compressed or
stretched by an external force. As expressed in Hooke’s Law of 1658, the
magnitude of an external force, or stress, produces a proportional amount
of deformation, or strain, in a malleable metal. This created even more
confusion when his research had to be translated into foreign languages.
There was no suitable word or phrase that could convey what he meant,
since he was really describing strain. In 1946, when he was asked to give
an address at the prestigious Collège de France, the academicians
responsible for maintaining the purity of the French language struggled with
this problem for several days, and subsequently decided that a new word
would have to be created. Apparently, the male chauvinists prevailed, and
le stress was born, quickly followed by el stress, il stress, lo stress, der
stress in other European languages, and similar neologisms in Russian,
Japanese, Chinese and Arabic. Stress is one of the very few words you will
see preserved in English in these and other languages that do not use the
Roman alphabet.

Because it was apparent that most people viewed stress as some

unpleasant threat, Selye subsequently had to create a new word, stressor,
to distinguish stimulus from response. Stress was generally considered as
being synonymous with distress and dictionaries defined it as “physical,
mental, or emotional strain or tension” or “a condition or feeling
experienced when a person perceives that demands exceed the personal
and social resources the individual is able to mobilize.” Thus, stress was
put in a negative light and its positive effects ignored. However, stress can
be helpful and good when it motivates people to accomplish more.

As illustrated to the left, increased stress results in increased productivity –

up to a point, after which things go rapidly downhill. However, that point or
peak differs for each of us, so you need to be sensitive to the early warning
symptoms and signs that suggest a stress overload is starting to push you
over the hump. Such signals also differ for each of us and can be so subtle
that they are often ignored until it is too late. Not infrequently, others are
aware that you may be headed for trouble before you are.

Any definition of stress should therefore also include good stress, or what
Selye called eustress. For example, winning a race or election can be just
as stressful as losing, or more so. A passionate kiss and contemplating
what might follow is stressful, but hardly the same as having a root canal
procedure.

Selye struggled unsuccessfully all his life to find a satisfactory definition of

stress. In attempting to extrapolate his animal studies to humans so that
people would understand what he meant, he redefined stress as “The rate
of wear and tear on the body”. This is actually a pretty good description of
biological aging so it is not surprising that increased stress can accelerate
many aspects of the aging process. In his later years, when asked to define
stress, he told reporters, “Everyone knows what stress is, but nobody really
knows.”

As noted, stress is difficult to define because it is so different for each of us.

A good example is afforded by observing passengers on a steep roller
coaster ride. Some are hunched down in the back seats, eyes shut, jaws
clenched and white knuckled with an iron grip on the retaining bar. They
can’t wait for the ride in the torture chamber to end so they can get back on
solid ground and scamper away. But up front are the wide-eyed thrill
seekers, yelling and relishing each steep plunge who race to get on the
very next ride. And in between you may find a few with an air of
nonchalance that borders on boredom. So, was the roller coaster ride
stressful?

The roller coaster analogy is useful in explaining why the same stressor
can differ so much for each of us. What distinguished the passengers in the
back from those up front was the sense of control they had over the event.
While neither group had any more or less control their perceptions and
expectations were quite different. Many times we create our own stress
because of faulty perceptions you can learn to correct. You can teach
people to move from the back of the roller coaster to the front, and, as
Eleanor Roosevelt noted, nobody can make you feel inferior without your
consent. While everyone can’t agree on a definition of stress, all of our
experimental and clinical research confirms that the sense of having little or
no control is always distressful – and that’s what stress is all about.

 More information at The institude of stress.

In short, Stress is a feeling that people have when they are struggling to
cope with challenges related to finances, work, relationships, environment,
and other situations. Moreover, stress is felt when an individual perceives a
real or imagined challenge or threat to a their well-being. People often use
the word stress interchangeably with anxiety, feeling anxious, fearful,
nervous, overwhelmed, panic, or stressed-out.

Stress is the body’s natural defense against real or imagined danger. It

flushes the body with hormones to prepare systems to evade or confront
danger. This is known as the “fight-or-flight or freeze” response.

The body is an intelligent operating system, but the body can not determine
the difference between life threatening external threat from imagined or
perceived non-life threatening stressors. The body reacts the same either
way. The body produces significantly greater quantities of the chemicals
cortisol, adrenaline, and noradrenaline. The Neurobiology of stress is a
complex operating mechanism.

According to American Psychological Association (APA), there are 3

different types stress — acute stress, episodic acute stress, and chronic
stress. The 3 types of stress each have their own characteristics,
symptoms, duration, and treatment approaches.

Stress management can be complicated because each of the 3 different

types of stress can present as single, repeated, complicated, or chronic.
Therefore, they require different levels of treatment interventions,
management, and psychological treatment modalities due to the nature of
the person’s environment, lifestyle, developmental history, coping
resources, and personality.

ACUTE STRESS
Acute stress is usually brief. It is the most common and frequent
presentation. Acute stress is most often caused by reactive thinking.
Negative thoughts predominate about situations or events that have
recently occurred, or upcoming situations, events, or demands in the near
future.

For example, if you have recently been involved in an argument, you may
have acute stress related to negative thoughts that are repetitive about the
argument. Or you may have acute stress that is about an upcoming work
deadline, again the stress is thought induced. However, most often when
the thinking induced stress is reduced or removed the stress will subside
too. However, if the stress meets DSM-5 criteria, then individual may be
diagnosed with Acute Stress Disorder

Acute stress causes signs and symptoms in the body +

brain + emotions, but does not cause the significant
amount of damage as Episodic Stress and Chronic stress.

Short-term Effects of Acute

Stress
The most common signs + symptoms:


o Transient Emotional distress — some combination of anger or irritability,

anxiety and depression.

o Transient Muscular distress—tension, headache, back pain, neck pain, jaw

pain, and other muscular tensions that lead to pulled muscles and tendons
and ligament problems.

o Transient stomach, gut and bowel problems, heartburn, acid stomach,

flatulence, diarrhea, constipation.

 Transient hyperarousal—elevated blood pressure, rapid heartbeat, rapid

pulse, sweaty palms, heart palpitations, dizziness, migraine headaches,
cold hands or feet, shortness of breath, sleep problems, and chest pain.

Acute stress can present in anyone’s life.

It is highly treatable and manageable.
However, repeated acute stress can become very harmful
for your physical and mental health.

EPISODIC ACUTE STRESS

People who frequently experience acute stress, or whose lives present with
frequent triggers of stress, have episodic acute stress.

The individuals who frequently suffer acute stress often live a life of chaos
and crisis. They are always in a rush or feel pressured. They take on many
responsibilities, and usually can not stay organized with so many time
demands. These individuals are perpetually in the grips of acute stress
overload.
 There are 2 main personality types
that frequently present with Episodic
Acute Stress: 1) “Type A” personality
2) The “Worrier”
“Type A” personality: Type A personality have an excessive competitive
drive, aggressiveness, impatience, abrupt, and a sense of time urgency. In
addition, Type A personality presents as reactive with hostility, and almost
always a deep-seated insecurity about performance. These personality
traits create frequent episodes of acute stress for the Type A individual.
The cardiologists, Friedman and Rosenman found Type A’s to be
significantly likely to develop coronary heart disease.

The “Worrier”: The Worrier presents with almost incessant negative

thoughts causing episodic acute stress on physical and mental health.
“Worry warts” project probable disaster and negatively forecast catastrophe
in almost every situation. They have core beliefs that the world is a
dangerous, unrewarding, punitive place where something awful is always
about to happen. These negative binge thinkers also tend to be over
aroused and tense, but are more anxious and depressed than angry and
hostile. Their thoughts are frequently filled with “What if….” statements that
are with projected negative outcomes. They are often diagnosed DSM-
5 with generalized anxiety disorder.

Episodic Effects of Acute

Stress
The most common signs + symptoms are similar to acute stress, but due to
the extended frequent over arousal or extended hyperarousal there is
ongoing damage and suffering.

 Emotional distress —anger or irritability, anxiety and depression, short-

tempered, impatient, tense.
 Cognitive distress: compromised attention/concentration, compromised
processing speed, compromised new learning and new learning memory
consolidation and retrieval, and mental fatigue.
 Interpersonal relationships deteriorate, The workplace becomes a very
stressful place for them.
 Muscular distress—tension, headache, back pain, jaw pain, pulled
muscles, tendons, and ligament problems.
 Stomach, gut, bowel problems, heartburn, acid stomach, flatulence,
diarrhea, constipation, irritable bowel syndrome (IBS).
 High blood pressure, rapid heartbeat, sweaty palms, heart palpitations,
dizziness, migraine headaches, cold hands or feet, shortness of breath,
insomnia, chest pain, and heart disease.
 Immune System Compromise: frequent colds/flu, allergies, asthma, and
other immune system compromise illnesses.

Episodic acute stress leads to more pronounced health

issues such as, high blood pressure and heart disease,
and irritable bowel syndrome (IBS).

Treatment for Episodic Acute

Stress
Episodic acute stress requires intervention on a many levels. The treatment
requires professional help spanning many months.

Most often the lifestyle and personality characteristics are so ingrained and
habitual that these individuals may see nothing wrong with the way they
conduct their lives. It is common for these individuals to blame their
problems on other people and external events. Frequently, they see their
lifestyle patterns, and their patterns of interacting with others, and their
ways of perceiving the world as an essential or integral component of their
personality and therefore are often resistant to seek professional
psychological help.

These individuals can be very resistant to change their behaviors and

thinking patterns. It is common for these individuals to only seek
psychological treatment when physical pains and discomforts become too
much.

CHRONIC STRESS
Chronic stress is the most harmful type of stress. If chronic stress is left
untreated over a long period of time, it can significantly and often
irreversibly damage your physical health and deteriorate your mental
health.
For example, long term poverty, repeated abuse in any form,
unemployment, dysfunctional family, poor work environment, substance
abuse, or an unhappy marriage can cause significant chronic stress.

Chronic stress can also set in when an individual feels hopeless, does not
see an escape from the cause of stress, and gives up on seeking solutions.

Chronic stress can be caused by a aversive experiences in childhood or

traumatic experiences later in life.

When an individual lives with chronic stress, his/her behavioral actions and
emotional reactions become ingrained. There is change in the hardwiring
of the neurobiology of the brain and body. There by making them
constantly prone to the hazardous stress effects on the body + mind+
cognitive regardless of the scenarios.

People with chronic stress have the

list of signs and symptoms previously
mentioned, but the signs and
symptoms are chronic and can result
in a physical and mental breakdown
that can lead to suicide, violent
actions, homicide, psychosis, heart
attacks, and strokes.
Chronic stress is grinding stress. It wears people away day after day, year
after year. Chronic stress destroys lives, bodies, and minds. It wreaks
havoc through long-term attrition. It is the stress of poverty, dysfunctional
families, violence, abuse, trauma, despised job, ethnic rivalry, war.

Treatment for Chronic Stress

When a person never sees a way out of a miserable situation, feels anxiety
of unrelenting demands and pressures for seemingly interminable periods
of time. With no hope, the individual gives up searching for solutions.
Some chronic stressors or triggers stem from traumatic early childhood
experiences that become internalized and remain forever painful and
present. Early childhood experiences profoundly affect personality; often
resulting in core belief systems that are created by causes of unending
stress for the individual (e.g., the world is a threatening place, you must be
perfect at all times). When personality or deep-seated convictions and
beliefs must be reformulated, recovery requires active self-examination with
professional psychological help. Good news is psychological treatment is
very effective.

The worst variable of chronic stress is that some people habituate to

it. They almost forget it is there. In some ways, one could say it is an
adaptation in the form of a ultimate psychological defense mechanism.
People are immediately aware of acute stress because it is new. However,
individuals with chronic stress frequently ignore all of the signs and
symptoms because it is old, familiar, and also because often they feel
helpless and hopeless.

Chronic stress kills through suicide, violence, homicide, heart attack, stroke
and, perhaps, even cancer. People wear down to a final, fatal breakdown.
Their physical and mental resources are depleted through long-term
attrition. The signs and symptoms of chronic stress are difficult to
treat, but not impossible to treat.

People with Chronic Stress require extended medical and

psychological treatment that includes behavioral and
stress management.
How we react to a difficult situation will affect how stress affects our life and
our physical and mental health. A person who feels they do not have
enough resources to cope will be more likely to have a stronger reaction
that triggers significant physical and mental health problems. It is
paramount to remember that the mind and body are connected — meaning
that psychological factors affect how a person feels physically and the
longevity of the body.

A persistently negative response to challenges can have a detrimental

effect on mind + body + emotions. However, being aware of how you
react to stressors and seeking professional help can help reduce the
negative feelings and effects of stress, and to manage it more effectively.

Get help. If you continue to feel stress, anxious, overwhelmed, panic,

stressed-out, then consult with a licensed clinical psychologist who can
help you learn how to manage stress effectively. He or she can help you
identify situations, thoughts, and behaviors that contribute to your stress
and anxiety. Treatment will involve developing an action plan to get you
healthy. Your health depends on your environment, body, mind, thoughts,
and emotions.

Is all stress bad?

Stress isn’t necessarily a bad thing. It’s what helped our hunter-gatherer
ancestors survive, and it’s just as important in today’s world. It can be
healthy when it helps you avoid an accident, meet a tight deadline, or keep
your wits about you amid chaos.

We all feel stressed at times, but what one person finds stressful may be
very different from what another finds stressful. An example of this would
be public speaking. Some love the thrill of it and others become paralyzed
at the very thought.

Stress isn’t always a bad thing, either. Your wedding day, for example, may
be considered a good form of stress.

But stress should be temporary. Once you’ve passed the fight-or-flight

moment, your heart rate and breathing should slow down and your muscles
should relax. In a short time, your body should return to its natural state
without any lasting negative effects.

On the other hand, severe, frequent, or prolonged stress can be mentally

and physically harmful.

And it’s fairly common. When asked, 80 percent of Americans reported

they’d had at least one symptom of stress in the past month. Twenty
percent reported being under extreme stress.

Life being what it is, it’s not possible to eliminate stress completely. But we
can learn to avoid it when possible and manage it when it’s unavoidable.

According to McGonigal, he explains in “THE UPSIDE OF STRESS” stress is a natural

response to meaning in life.
In the Introduction of The Upside of Stress, Kelly McGonigal establishes an important
concept: stress isn't always bad.

“Stress is what arises when something you care about is at stake, " she explains. "This
definition is big enough to hold both the frustration over traffic and the grief over a loss. It
includes your thoughts, emotions, and physical reactions when you’re feeling stressed, as
well as how you choose to cope with situations you’d describe as stressful." Moreover,
McGonigal says this "...also highlights an important truth about stress: Stress and meaning
are inextricably linked. You don’t stress out about things you don’t care about, and you can’t
create a meaningful life without experiencing some stress.” This definition sets a new
standard for how we define stress. In essence, stress is actually a good thing to experience - it
implies something has meaning to you

We all need to rethink of stress. In that book, the author explains we have a predetermined set
of core beliefs regarding stress. "The beliefs that become mindsets transcend preferences,
learned facts, or intellectual opinions. They are core beliefs that reflect your philosophy of
life." Not only do these beliefs reflect on your life - they reflect on how you perceive stress.
"It turns out that how you think about stress is also one of those core beliefs that can affect
your health, happiness, and success, " says McGonigal. "Your stress mindset shapes
everything from the emotions you feel during a stressful situation to the way you cope with
stressful events. That, in turn, can determine whether you thrive under stress or end up burned
out and depressed."

Different type of mindset can lead to different type of its effect.

"Stress mindsets are powerful because they affect not just how you think but also how you
act, " writes McGonigal." When you view stress as harmful, it is something to be avoided [...]
In contrast, people who believe that stress can be helpful are more likely to say that they cope
with stress proactively. For example, they are more likely to: Accept the fact that the stressful
event has occurred and is real. Plan a strategy for dealing with the source of stress. Seek
information, help, or advice. Take steps to overcome, remove, or change the source of stress.
Try to make the best of the situation by viewing it in a more positive way or by using it as an
opportunity to grow" (excerpt from Chapter 1 of The upside of stress).

MINDSET 1: STRESS IS HARMFUL MINDSET 2: STRESS IS ENHANCING

Experiencing stress depletes my health Experiencing stress enhances my

and vitality. Experiencing stress
debilitates my performance and
productivity. Experiencing stress
inhibits my learning and growth. The
effects of stress are negative and should
be avoided.
performance and productivity. Experiencing
stress improves my health and vitality.
Experiencing stress facilitates my learning
and growth. The effects of stress are positive
and should be utilized.
 Many people think that stress is harmful so they feel depressed and try
everything to hide away from it. Stress has been the causes of death ,
illness and heart attack for more than 94% adults believe this is true.
 On a scale of 1 to 10, the mean rating for stress this year fell to 5.2, the lowest level
in 5 years (5.4 for 2009 and 2010; 5.9 for 2008; and 6.2 for 2007).
 The gap between what Americans see as a healthy level of stress and their
perception of their own stress level continues to exceed one point, reaching a 1.6-
point differential this year (compared to 1.7 for 2008 – 2010 and 1.8 for 2007) on a
scale of 1 to 10.
 More adults report that their stress is increasing than decreasing. 39 percent said
their stress had increased over the past year and even more said that their stress
had increased over the past five years (44 percent). Only 27 percent of adults report
that their stress has decreased in the past five years and fewer than a quarter of
adults report that their stress has decreased in the past year (17 percent).
 While adults continue to fall short of their ideal when it comes to how well they are
achieving key goals related to specific aspects of well-being, there does appear to be
some improvement related to stress management. The gap between the importance
that respondents placed on stress management and their success at managing
stress shrank from 32 percent in 2010 to 26 percent in 2011.
While people’s perceptions of their own personal stress may be improving, the
impact of stress on their physical health and their inability to prevent stress is cause
for continued concern. At the same time, while there is an awareness that stress can
have a health impact, there is a disconnect when it comes to the awareness of the
impact stress may have on an individual’s personal health.
 More than half of Americans reported personal health problems (53 percent) as a
source of stress, roughly the same level (52 percent) as last year but up from 2009
(47 percent).
 More than half (56 percent) of adults say they are doing an excellent or very good
job of knowing when they are feeling stressed, but only about half as many (26
percent) report doing an excellent or very good job at preventing themselves from
becoming stressed.
 When stress occurs, only 29 percent say they are doing an excellent or very good
job at managing or reducing it.
 The majority of adults (83 percent) report that they think stress can have a strong or
very strong impact on a person’s health.
 More than 9 in 10 (94 percent) adults believe that stress can contribute to the
development of major illnesses, such as heart disease, depression and obesity, and
that some types of stress can trigger heart attacks, arrhythmias and even sudden
death, particularly in people who already have cardiovascular disease (92 percent).
 Although the majority of adults understand that stress has a strong impact on a
person’s health, a sizeable minority still think that stress has only a slight or no
impact on their own physical health (31 percent) and mental health (36 percent).
However, some people think that stress is good.
Stress is something that every college student knows way too well. However, the
positive effects of stressare often overlooked. Vilma Ruddock, author of “What Is
Positive Stress?” says, “Positive stress or eustress (also called good stress) is
when you perceive a stressful situation as an opportunity that will lead to a good
outcome.” Stress can lead you to accomplish your goals and allow you to be
successful.
Lisa Witzberger, West Liberty University’s counselor, said, “A certain level
of stress can be helpful and at times stress acts as a motivator to accomplish
goals.” Stress can lead to motivation, causing us to complete a difficult task or event
that we must deal with.

John Whyte, Former Chief Medical Expert and VP, Health and Medical Education at
Discovery Channel, wrote, “Occasional stress can help keep you focused and
improve your recall, which can be a plus when cramming for that test or preparing for
an important presentation at work.”

Stress can be positive in the way that it can motivate you to not only do better on
tests, work and events, but it can also push you to your fullest potential.

Another way stress can be beneficial is that it helps people learn the best way to
overcome and manage stressful situations. Tammy McClain, Interim Dean of
the College of Liberal Arts at West Liberty, said, “Exercising regularly, having time
to relax and getting enough sleep are effective ways in managing stress.”

Everyone responds to stress differently and has to figure out their way to
manage stress.

WLU student Meredith Garner said, “Exercise is my gateway to happiness and my

way to manage my stress.” Stress is something you have to learn to cope with and
figure out your method to deal with it.

Positive stress also has a surprising health benefit. At Stanford University of

Medicine, they have conducted a study on how stress can boost your immune
system.

Christian Nordqvist, author of “What is Stress? How To Deal With Stress,” wrote,
“Some situations which are not negative ones may still be perceived as stressful.
This is because we think we are not completely prepared to cope with them
effectively.”

Even though the situation is not negative, it may cause us to

become stressed because we don’t know how to handle the situation presented.
Nordqvist also stated, “Your interpretation of events and challenges in life may
decide whether they are invigorating or harmful for you.” Not every event can have a
negative effect on you, and it depends on your perception of the event to determine
how it will affect you.

Stress is something we all must deal with at some point in our lives. You just have to
find the way that works best for you to deal with it.

Once you learn how to manage stress, it can have benefits.

II. Survey
We have asked students in Lao Cao about how they think about stress
and question related to it.