Chapter 6

1. Chapter 6 The Effects of Stress on the Body and Mind

2. Overview • This chapter • Explains the role of two types of psychosomatic illnesses on disease • Examines the relationship of acute stress responses to the development of physical and mental illnesses • Explores the impact of chronic stress on the development of physical and mental illnesses

3. Outline • From stress to disease: The medical model and psychosomatic models • The effects of acute, high-level stress on physical and psychological disease • The effects of chronic, low-level stress on physical and psychological disease, including suicide

4. 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

5. Psychosomatic Disease Models • Term coined by Philip Deutsch to illustrate the interaction between the mind and body in the disease process • All illnesses involve mental processes • Common misunderstanding: belief that psychosomatic diseases are all in one’s head

6. Psychosomatic Models • Selye’s GAS model was a clear break from a medical model approach to disease development • Everly & Lating identified six major psychophysiologic disease models that expand on Seyle’s research • Lachman’s Model • Sternbach’s Model • Kraus & Raab’s Hypokinetic Disease Model • Schwartz’ Dysregulation Model • Alexander’s Conflict Theory Model • Everly & Benson’s Disorders of Arousal Model

7. 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)

8. 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

9. 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

10. Acute Stress • Alarm-phase stress • State of complete mental and physical readiness • Prepared to fight or flee • Result is fatigue

11. 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

12. Acute Stress Effects on Psychological Illness • Anxiety disorders • Panic attacks • Acute stress disorder • Post-traumatic stress disorder (PTSD)

13. 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

14. Effects of Chronic, Low-Level Stress on Physical Illness • The effects are most clear in psychogenic diseases • Five body systems are most susceptible • Endocrine • Muscular • Cardiovascular • Immune • Digestive

15. 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

16. Chronic Stress and the Endocrine System (continued) • The role of three hormones • Epinephrine • Norepinephrine • Cortisol

17. 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

18. 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 • Often elevated in men who have heart attacks

19. 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

20. 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

21. Chronic Stress and the Muscular System • Stress affects all three types of muscle tissue • Skeletal muscles • Smooth (internal organ) muscles • Cardiac (heart) muscle

22. 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

23. 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)

24. 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

25. Chronic Stress and the Cardiovascular System (continued) • Stress • 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

26. Chronic Stress and the Immune System • 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

27. 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

28. 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

29. 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)

30. Stress and Suicide • Suicide: a permanent solution to a temporary problem • People who take their own lives don’t see options • Suicide rates for adolescents and college-age people are rising • Three stress-related suicide risk factors • Depression • Major loss • Stressful life events

31. Chapter 6: The Effects of Stress on the Body and Mind • Summary