Chapter 6 The Effects of Stress on the Body and Mind Akira Kaede/Getty Images McGraw-Hill/Irwin Copyright © 2012 by The McGraw-Hill Companies, Inc. All rights reserved. From Stress to Disease: The Medical Model Separates mind and body Used to explain disease and treatment Koch’s Postulates: Every disease has a single etiologic agent, a microorganism No recognition of interaction of mind and body GAS model clearly includes interaction of mind and body Akira Kaede/Getty Images 6-2 Psychosomatic Disease Models Akira Kaede/Getty Images Term coined by Philip Deutsch to illustrate the interaction between the mind and body in the disease process All illnesses involve mental processes – No separation Common misunderstanding: belief that psychosomatic diseases are all in one’s head (those are referred to as somatoform disorders) Selye’s GAS model was a clear break from a medical model approach to disease development Led to a variety of models on exhaustion and disease development (Schwartz, Everly & 6-3 Benson, Alexander etc…) Everly & Benson’s Disorders of Arousal Model (Fig. 6-1 in Text) Potential stressors trigger limbic system arousal (can become Limbic Hypersensitivity Phenomenon, or LHP) Limbic arousal triggers neurological, neuronendocrine, and endocrine stress axes Overstimulation of those axes triggers stress arousal (can become arousal disorder) 6-4 Akira Kaede/Getty Images Two Categories of Psychosomatic Disease Psychogenic disease No disease-causing pathogen Occurs when chronic stress response alters structure and function of body Examples: colitis, atherosclerosis, backache, peptic ulcers 6-5 Akira Kaede/Getty Images Two Forms of Psychosomatic Disease (continued) Somatogenic disease A causative organism exists The long-term effects of the stress response weaken the body’s defenses Example: Mononucleosis, influenza 6-6 Akira Kaede/Getty Images Acute Stress Alarm-phase stress State of complete mental and physical readiness Prepared to fight or flee Result is fatigue 6-7 Akira Kaede/Getty Images Acute Stress Effects on Physical Illness The body suffers no harm when the lifestyle is balanced Proper nutrition and exercise Adequate rest The greater the frequency of high level stress, the greater the need for rest 6-8 Akira Kaede/Getty Images Acute Stress Effects on Psychological Illness Anxiety disorders Panic attacks Acute stress disorder Post-traumatic stress disorder (PTSD) 6-9 Akira Kaede/Getty Images Chronic Stress Long-term resistance-phase stress response General wear and tear on body Body parts and systems forced to work for long periods without adequate rest Result is malfunction and breakdown 6-10 Akira Kaede/Getty Images Effects of Chronic, LowLevel Stress on Physical Illness The effects are most clear in psychogenic diseases Five body systems are most susceptible Endocrine Muscular Cardiovascular Immune Digestive Akira Kaede/Getty Images 6-11 Chronic Stress and the Endocrine System The endocrine system perpetuates low-level stress response Responsible for a wide range of other functions Chronic stress can interfere with and shut down the endocrine system – i.e. adrenaline, noradrenaline, cortisol. 6-12 Akira Kaede/Getty Images Chronic Stress and the Endocrine System (continued) Epinephrine production causes blood vessels to constrict Forces heart to pump under greater pressure Chronic increase in blood pressure results in hypertension Hypertension is primary risk factor for stroke and heart attack 6-13 Akira Kaede/Getty Images Chronic Stress and the Endocrine System (continued) Norepinephrine production disturbs platelets and red blood cells Causes damage to endothelium Precursor to atherosclerosis Converts testosterone into estradiol Estradiol not completely understood Akira Kaede/Getty Images Often elevated in men who have 6-14 heart attacks Chronic Stress and the Endocrine System (continued) Cortisol production inhibits breakdown of epinephrine and norepinephrine Interferes with the body’s ability to relax Increases blood cholesterol and fat levels These are recognized risk factors for heart disease 6-15 Akira Kaede/Getty Images Chronic Stress and the Endocrine System (continued) Sexual disorders Men under chronic stress Show reduced levels of testosterone Demonstrate reduced sexual desire Return to normal when stress is removed Women under chronic stress Exhibit increased premenstrual syndrome (PMS) symptoms Research about causes and treatment lack consistency Akira Kaede/Getty Images 6-16 Chronic Stress and the Muscular System Stress affects all three types of muscle tissue Skeletal muscles Smooth (internal organ) muscles Cardiac (heart) muscle 6-17 Akira Kaede/Getty Images Chronic Stress and the Muscular System (continued) Stress causes a chronic state of muscle contraction called bracing Skeletal muscles bracing results Headache Backache and muscle pain Temporomandibular-joint (TMJ) syndrome 6-18 Akira Kaede/Getty Images Chronic Stress and the Muscular System (continued) Smooth muscles bracing results A chronic state of internal tension Stomach ache and diarrhea Hypertension Cardiac muscle bracing results Angina-like symptoms (chest pains) 6-19 Akira Kaede/Getty Images Chronic Stress and the Cardiovascular System (continued) The cardiovascular system is a closed system with three components Heart Blood vessels Blood Main purpose is to provide food and oxygen to cells and to remove waste 6-20 Akira Kaede/Getty Images Chronic Stress and the Cardiovascular System Stress (continued) Accelerates the heart rate Makes the heart pump faster and under greater pressure than necessary Increases cholesterol and fats in blood Causes atherosclerosis in blood vessels 6-21 Akira Kaede/Getty Images Chronic Stress and the Immune System Psychoneuroimmunology The immune system performs five primary functions Identifies foreign substances such as germs Attacks these invaders Prevents reinfection from these invaders Destroys mutant cells Resists recurrent chronic infections 6-22 Akira Kaede/Getty Images Chronic Stress and the Immune System (continued) Chronic stress can alter the immune system Depletes nutritional factors associated with immunity Causes an imbalance in the system Weakens T cells Exerts a general immunosuppressive effect 6-23 Akira Kaede/Getty Images Chronic Stress and the Digestive System Stress upsets the digestive process Smooth muscle tension Excessive stomach acids Spasms of esophagus and colon Ulcers Incomplete digestion Akira Kaede/Getty Images 6-24 Effects of Chronic Stress on Psychological Illness Stress is related to many psychological factors Burnout Anxiety disorders Stress-related specific phobia Stress-related generalized anxiety disorder Mood disorders Stress-related major depressive disorder, dysthymic disorder, and bipolar disorders (and seasonal pattern specifier condition) Suicide: a permanent solution to a temporary problem People who take their own lives don’t see options (unpredictable and uncontrollable). Suicide rates for adolescents and college-age people are rising Three stress-related suicide risk factors Depression Major loss Stressful life events 6-25 Akira Kaede/Getty Images