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Medicine LibreTexts

6.1: Stress

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Stress

In today’s fast-paced world, many people report feeling stressed, but few truly understand what stress means. It is often associated with negative emotions and events, leading to a common misconception that stress is solely about tension and nervousness. However, stress affects us on physical, mental, and emotional levels, and it can be both beneficial and harmful depending on its duration and our perception of it.

For example, the stress students feel before an important exam or athletes experience before a major competition can improve focus and performance. In contrast, prolonged or overwhelming stress can have detrimental effects. This page defines stress and explains how the body reacts to it, laying the foundation for later discussions on its impact on health, common stressors, and effective coping strategies.

Defining Stress

Stress is the body’s physical, mental, and emotional response to a stimulus, known as a stressor. It is part of a natural coping mechanism that prepares us for challenging situations. The key to whether stress is positive or negative lies in how it is experienced and managed. Small, short-term stress can enhance motivation and concentration, while chronic or overwhelming stress can lead to serious health problems.

In summary, stress is more than just a reaction to problems or traumatic events. It is an automatic, adaptive response that is a normal part of life. Whether stress is empowering or harmful depends on its duration, intensity, and our ability to manage it.

General Adaptation Syndrome

Hans Selye (1907-1982) pioneered the modern era of research into stress. He proposed a three-stage pattern of response to stress that he called the General Adaptation Syndrome (GAS). The model represents that when the organism first encounters stress, in the form of novelty or threat, it responds with an alarm reaction. This is followed by a recovery or resistance stage during which the organism repairs itself and stores energy. If the stress-causing events continue, exhaustion sets in. This third stage is what has become known as “burn-out”. Classic symptoms of burn-out include loss of drive, emotional flatness, and (in humans) dulling of responsiveness to the needs of others.

Three Stages of GAS

  1. Alarm Reaction Stage: The body’s initial response to a stressor triggers the “fight or flight” reaction. This survival mechanism, regulated by the sympathetic nervous system, prepares the body to either confront or escape danger. Key physiological changes include:

    • The adrenal glands release epinephrine (adrenaline) and norepinephrine (noradrenaline), which increase heart rate, blood pressure, and energy availability.

    • Blood is redirected to the brain, heart, and muscles, enhancing physical readiness.

    • The hormone cortisol is released to maintain the body's energy supply. 

  2. Resistance Stage: If the stressor persists, the body enters the resistance stage. The parasympathetic nervous system attempts to restore balance (homeostasis), though stress hormone levels remain elevated. During this phase:

    • Blood pressure and glucose levels stay high.

    • The body continues to focus on coping with the stressor.

    • Signs of prolonged resistance include irritability, frustration, and difficulty concentrating.

  3. Exhaustion stage:  After an extended period of stress, the body enters this final stage of GAS. At this stage, the body has depleted its physical, emotional, and mental resources and is unable to maintain normal function. Once the body is no longer equipped to fight stress and may experience these symptoms:

    • Fatigue

    • Depression

    • Anxiety

    • Feeling unable to cope

Health Assessment: Perceived Stress

The Perceived Stress Scale (PSS) is a widely used psychological tool designed to assess the degree to which situations in an individual’s life are perceived as stressful. This tool can help you identify your current stress levels and reflect on strategies to manage stress effectively.

Instructions

  1. Access the Scale:

  2. Complete the Questionnaire:

    • Answer all 10 questions based on how you have felt during the last month.
  3. Scoring and Interpretation:

    • Reverse score items 4, 5, 7, and 8 (e.g., if you answered 0, it becomes 4; if you answered 1, it becomes 3, etc.).
    • Add the scores for all items to calculate your total score.
    • Compare your total score to the interpretation guide below:
      • 0–13: Low stress
      • 14–26: Moderate stress
      • 27–40: High stress
    • Reflect on your score and consider what it indicates about your perceived stress levels.
  4. Reflect on Your Results:

    • Summarize Your Results: Report your total score and its corresponding stress level (low, moderate, or high).
    • Describe Your Feelings: Reflect on your emotional response to the results. Were you surprised or did the score align with your expectations? Why?
  5. Identify Next Steps:

    • If your score indicates moderate or high stress, explore stress management strategies, such as mindfulness, physical activity, or seeking professional support.
    • If your score indicates low stress, consider maintaining and enhancing your current coping mechanisms.
  6. Set a SMART Goal for Stress Management:

    • Create a specific, measurable, achievable, relevant, and time-bound (SMART) goal to improve or maintain your stress management skills. For example: "I will practice 10 minutes of guided meditation three times a week for the next month to reduce stress and improve mindfulness."

Additional Resources

  • American Institute of Stress: Visit stress.org for resources and tools.
  • Mindfulness-Based Stress Reduction (MBSR): Explore programs or apps for mindfulness practices.
  • Crisis Support: Text HOME to 741741 to connect with a trained crisis counselor.

This assessment is designed to help you understand your stress levels and develop effective strategies for managing stress in your daily life.

Eustress vs Distress

Negative stress, or distress, is often part of activities that we perceive we cannot escape. Our bodies and minds seem to have evolved to cope well with sudden and brief stressors, such as escaping an attack by a predator. We do not seem to be designed to handle chronic stress even if it is mild. Our society has created many conditions that produce chronic stress and are associated with stress-related illnesses. We have time pressures, work pressures, relationship pressures, crowding, noise, crime, achievement pressures, and even education-related pressures in this course.

However, stress is not always bad. Sometimes a challenge is a good thing. Indeed, one could argue that nothing useful in life can be accomplished without some degree of stress. “Good stress,” Selye pointed out, is “the spice of life.” To combat the notion that all stress was bad, Selye developed the idea of eustress, which is a person’s ideal stress level. Selye proposed that different people needed different levels of challenge or stimulation (stress) in their lives. Some people (“turtles”) need low levels of stress. Others (“racehorses”) thrive on challenges. Challenges are not harmful in themselves. A person could be a busy executive or engage in strenuous exercise without experiencing negative stress-related symptoms, as long as the person enjoys the challenge.

 


6.1: Stress is shared under a CC BY license and was authored, remixed, and/or curated by LibreTexts.

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