People have an intuitive understanding of the concept of stress but may not be aware of all of its facets. Stress is most commonly thought of as psychological tension (“I feel stressed”); this description is partly accurate. Stress is also a physical response to a threatening or challenging situation (a stressor) and involves activation of most body systems. This physical response, called the stress response or the fight-or-flight response, is quite dramatic and includes elevated heart rate, elevated blood pressure, release of stress hormones including adrenaline, mobilization of energy stores in the body (i.e., glucose in the liver), a slowing of digestion, enhanced blood flow to large muscles, pupil dilation, and many other physical changes. In short, stress is experienced both physically and psychologically; it is an arousal of both body and mind.
The study of stress is popular largely because stress is costly to individuals. It can cause damage to the body that is severe enough to contribute to both physical and psychological disease states. Both Sapolsky (2004) and McEwen and Lasley (2002) wrote highly informative and readable books about the relationship between stress and disease. As they (and others) describe, it is clear that stress contributes to heart disease. When under stress, the stress hormones cortisol and epinephrine (adrenaline) mobilize cholesterol and fats for energy. The cholesterol and fats that are not used during the stress response may continue to circulate through the bloodstream, adhering to the inside of blood vessels. This adhesion, called atherosclerosis, reduces the circumference of the blood vessels, leading to an increase in blood pressure which can damage the entire circulatory system including the heart. This is only one of many ways that stress can contribute to heart disease.
Stress often suppresses the immune system, increasing susceptibility to many types of infections (possibly multiple infections). As Sapolsky (2004) describes, the evidence is clearest regarding the common cold: immune suppression related to stress increases common cold risk. Additionally, stress is probably related to the worsening of AIDS. More research is needed to determine the precise relationships between stress, immune suppression, and susceptibility to infections of various kinds.
Stress contributes to psychiatric disease. A clear connection has been found between stress and clinical depression, which is more common among people who have experienced significant stress. Research on the relationship between stress and psychiatric diseases including depression is currently active and promising. Additionally, stress has been associated with symptoms that are not considered disorders, for example fatigue states (because the stress response is highly energy consuming) and irritability and interpersonal problems, both of which may be related to fatigue. Even if stress does not cause a disease, it can affect an individual's well-being. In sum, stress is related to many types of diseases, both physical and psychiatric, and general dysfunction.
A variety of stress management techniques are available to mitigate the damaging effects of stress, or even to prevent negative effects. As Monat, Lazarus, and Reevy (2007) describe, stress management techniques can be divided into three basic categories: (1) a change in one's environment or lifestyle, for example, maintaining proper nutrition, quitting smoking, or avoiding stressors; (2) a change in one's personality or perception, for example, choosing to see the silver lining in the cloud, using one's sense of humor, or taking an anger management course; and (3) a modification of the physiological effects of stress, for example, meditation, deep breathing, or massage. A number of excellent books provide how-to descriptions of many potentially helpful stress management techniques, including Davis, Eshelman, and McKay's (2008) The Relaxation and Stress Reduction Workbook, which has sold over 700,000 copies.
As a number of stress experts, including Lazarus (1999), have noted, stress and emotion are interconnected: when one experiences an emotion, especially one of the negative emotions, a stress response ensues. (In general, strong emotions produce strong stress responses and mild emotions produce less intense stress responses.) This is true regardless of the specific negative emotion—fear, anger, and sadness are all associated with increased heart rate, increased blood pressure, release of stress hormones, and so on. Lazarus therefore recommended that stress researchers and emotion researchers collaborate to better understand these psychological phenomena.
See also autogenic training, deep breathing, meditation, mindfulness, progressive muscle relaxation, stress hormones, yoga.
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