Stress and mental health is there any relation ?

How does stress affect mental health ?

• Stress is very important word of our daily life. In a simple word, it is our response to real or imagined challenges or threats.
• A stressor is an environmental stimulus, that affects an organism, producing physical and psychological effects such as tension and anxiety.
• This challenge involves a transaction between the person and the situation.
• Stress is also a subjective experience that may or may not correspond to physiological responses.
• Stress influences human biology, physiology, behavior, emotion and cognitive process

• Term  “Stress”  was coined by Hans Selye    (A Canadian medical researcher), who gave the famous concept of The general adaptation syndrome.

The general adaptation syndrome.

According to Selye, people’s responses to a stressor are similar, regardless of the type of stressor.

There are three stages in stress-

1-Alarm (an initial short stage)

2-Resistance (a longer period)

3-Exhaustion (the final stage)

   Stress and mental health is there any relation ?

1-Alarm

• Alarm begins when the stressor first appears.
• People experience physiological arousal.
• The sympathetic nervous system activates.

2-Resistance

• Resistance occurs after a relatively long exposure to a stressor.
• The person seems to have adapted to the stressor.
• The person may appear normal, but physiological responses are not.

3-Exhaustion

• Exhaustion occurs when adaptability is depleted.
• If stress is not reduced, physical, mental, and emotional exhaustion occurs.

Exhaustion may result in serious illness or death.

What is mental stress ?

STRESS TYPES:

There are many ways to classify stress. They can be:

1-Life events : They are identifiable, discrete changes in life pattern that disrupt the usual behavior and threaten the process well-being. For example Bereavement, the reaction to loss of loved one, is the prototype  stressful life event.

 2-Chronic stress: It includes long term condition that challenges the person, including financial deprivation, ongoing interpersonal difficulties and persistent treat to security.

e.g. living in a dangerous neighborhood.

3-Developmental stressor: Those associated with transitional phases of psychosocial development (adolescence, childbirth).

4-Daily hassles: They are ordinary but stressful occurrences that are universal in modern life.

e.g. managing household finances, unpleasant interaction with neighbourers.

5-Accidental stressor: Associated with unexpected non-developmental life events.

e.g. death Stress and mental health is there any relation ?

 Interesting types:

Enstress : They are pleasant, describable events.

Distress: They are unpleasant, undesirable events.

Other various classifications can be…

1. Personal and impersonal life events.
2. Major and minor life events.

Negative effects of stress

Stress can also be produced from frustration, conflict or pressure.

Others:

A concept of people poisoning has been given to people producing stress in other (stress generators or stress carriers).

Stress and mental health is there any relation ?

• Mental disorders have been ascribed to an imbalance in bodily humors, to the influence of external spiritual or other supernatural forces, and to moral or somatic deficiency.
• In the early to mid-1800s, a school of thought emerged, led by Philippe Pinel in Paris and Amariah Brigham in America, that the expression of mental illness was affected by life circumstances and, more broadly, by societal factors.
• These various influences converge in the very popular  biopsychosocial model proposed by Meyer.
• Multideterminate model of mental illness dominates modern psychiatric thinking.

Disorder  described as a direct consequence of stress.

• Reaction to severe stress and adjustment disorder acute stress reaction, post traumatic stress disorder, adjustment disorder comes under this category.

These characterize stress as an acute sever stress (a serious threat to security, physical integrity of the individual or the loved one or an unusually sudden and threatening change in the social position or network of the individual) or a continued trauma.

Causes of mental stress

The temporal association of the disorders with stress are:

• Acute stress reaction onset should be within minutes, for PTSD (Post traumatic distress disorder) it is less than 6 months and for adjustment disorder onset should be within one month.
• Conversion disorder/ dissociation disorder- the criteria to meet a diagnosis is evidence for psychological causation in the form of clear association in time with stressful events and probes or disturbed relationship.
• Symptoms are judged to be initiated or exacerbated by preceding conflicts or other stress. 

• Posttraumatic Stress disorder (PTSD) has its onset after particularly traumatic (often life-threatening) events, such as violent assault or serious accidents, and is denoted by the presence of prominent dissociative symptoms (e.g., derealization, numbing).
• When acute stress disorder occurs after trauma, it identifies individuals, who are at several fold increased risk for the subsequent development of PTSD (and major depression).

Lasting personality change after catastrophic experience :

• Here stress has been characterized to be so extreme . It is usually is a prolonged exposure in life threatening circumstances.
• Similar personality changes occur in  psychiatric illness that this develops following clinical recovery from a mental disorder that must have been experienced as emotionally extremely stressful and shattering to the patients self image.

• Adverse life events and stressful social and familial background play an important role in determining the course of illness in general and episodes of relapse in particular.

Schizophrenia:

• Role of stress is uncertain in schizophrenia. The stress vulnerability model which states schizophrenias a biologic illness is postulated to be stress related and the onset and relapse is related to both.

• Expressed emotion a form of every day stress has been studied by various researchers and found to be related to causative for schizophrenic relapses.
• Studies of expressed emotion demonstrated that individuals with schizophrenia residing in homes with high expressed emotion tend to relapse at twice the rate of those who live in families with low expressed emotion.
• Chronic interpersonal stress, usually studied in the context of the family, has been shown to be an important risk factor for relapse in schizophrenia.
• Other stressors like poverty, homelessness, and criminal victimization also powerfully affect the clinical course of their illness.
• Schizophrenia renders the individual more susceptible and sensitive to the negative effects of even minor stressors. Stress and mental health is there any relation ?

Affective Disorders (Mood disorders)

Other than genetic and biologic factors which are known to play a major role in etiology of mood disorder, psychosocial factors do influence onset timing type and outcome of affective episodes. 

• But the nature of association and mechanism of action is still unclear  One proposed mechanism is social rhythm dysfunction.
• Stressor as a precipitant of bipolar relapse is applicable only for earlier episodes is a consistent research findings

Time frame for life events preceding the onset of an episode for unipolar depression proposed is 4 weeks, though chronic difficulties up to 6 months have been shown to exert effects.

The time frame for life event stress precipitating a bipolar relapse has been proposed to be 3 weeks.

Recent life events in patients completed suicide in bipolar/unipolar illness is found to  higher within the last 3 months.

• New studies raise the possibility that childhood trauma leaves a neuro-hormonal scar that leads to stress and may be a vulnerability factor for mood  disorders.

How does stress affect mental health ?

Anxiety Disorders

• Early life stressors,  sexual or physical abuse, may be risk factors.for the later development of panic disorder, particularly in women.
• Panic disorders frequently has its onset in the context of stressful life events.  In terms of early life stressors, there is growing evidence that certain adverse life events such as sexual and physical abuse, may be risk factor for later development or panic disorder particularly women.

What are symptoms of mental  stress ?

Stress, Depression, and Rheumatoid Arthritis

Stress and depression can lead to HPA (Hypothalamic pituitary activation,a type of neural system which controls entire body functioning) axis activation and increases of cytokines (a type of inflammatory biomarker in body).

• Moreover, the presence of depression in rheumatoid arthritis patients undergoing stress is associated with exaggerated increases of IL-6, a biomarker predictive of disease progression.
• Psychological intervention that decreases emotional distress produced, and improvements in disease activity in rheumatoid arthritis patients.
• Onset of major depression was best explained by a model that, genes are also responsible for connection of depression with effects of stressful life events. Stress and mental health is there any relation ?

Substance use

• In marijuana users, drug is used in response to a failure to cope with stress (interpersonal, economic, scholastic) but the presence of these stressors are not necessary to maintain the addiction.
• Role of stress in relapse in general is noted as one of the many factors contributing to relapse but definite role is confusing. 
• Possibly stress elevates relative risk by decreasing the persons ability to cope with temptation.
• Stressful life events have been associated with increased alcohol use  but this associations is also influenced by other variables and the interaction is complex. Stress and mental health is there any relation ?

Others:

Acute or short term disturbances is usually associated with variety of situational stress in sexual disorders. 

Psychological distress appear to be quite common with sleep disorder. 

In chronic insomnia in an adult  stress appear to be primary and in other sleep disorder it is secondary in origin.

Stress and mental health is there any relation ?

Cardiovascular Disease (Heart disease)

Psychological and physical stressors leads to release of pro-inflammatory cytokines and expression of adhesion molecules that bind and  immune cells to the vascular endothelium in blood.

Depression is associated with activation of the endothelium.

In patients who have recently experienced acute coronary events (like heart attack), levels of the endothelium activation marker, soluble intercellular adhesion molecule 1 (sICAM) are significantly higher among depressed patients than among non depressed patients.

Infectious Disease:

Studies show that individuals reporting more psychological stress have both a higher incidence and  greater severity of certain infectious illnesses, such as Epstein-Barr virus infections and the common cold.

HIV (AIDS)

Depression, bereavement, and maladaptive coping responses to stress (including the stress of HIV infection itself) have all been shown to predict the rate of immune system decay in HIV patients.

Cancer:

• Research  showing psychological parameters to cancer onset and progression are inconsistent in humans and the role of the immune system in mediating any psychological effects on disease course is not established.
• Though, psychological interventions can lead to decreased distress, increases in active coping.
• Higher rate of survival seen in malignant melanoma(a type of skin cancer) patients, and women with advanced breast cancer who have received such interventions.
• These findings indicate that role of stress in cancers patients should not overlooked. Stress and mental health is there any relation ?

Conclusion:

If you continue to experience stress, don’t be scared to seek expert help. It does not indicate you are a failure. It is essential to take help as as soon as possible so you can start to think better.