STRESS AND HEALTH

STRESS
Stress is defined as the emotional, physical, and cognitive response to
situations that are perceived as demanding, threatening, or
overwhelming to an individual’s well-being. It occurs when
environmental demands exceed a person's perceived ability to cope.
This state involves both mental tension and automatic physiological
reactions, such as the fight-or-flight response, which can be triggered
by both negative (distress) and, occasionally, positive (eustress)
challenges.
Causes of Stress The most frequent reasons for “stressing out” fall
into three main categories:
1. The unsettling effects of change
2. The feeling that an outside force is challenging or threatening you
3. The feeling that you have lost personal control.

Types of stress

There are three main kinds of stress: acute, episodic acute and
chronic.

 Acute stress: Acute stress is short-term stress that comes and

goes quickly. It can be positive or negative. It’s the feeling you
get when you’re riding on a rollercoaster or having a fight with
your boyfriend. Everyone experiences acute stress from time to
time.
 Episodic acute stress: Episodic acute stress is when you
experience acute stress on a regular basis. With this kind of
stress, you don’t ever get the time you need to return to a calm,
relaxed state. Episodic stress frequently affects people working
in certain professions, like healthcare providers.
 Chronic stress: Chronic stress is long-term stress that goes on
for weeks or months. You may experience chronic stress due to
 marriage troubles, issues at work or financial problems. It’s
important to find ways to manage chronic stress because it can
lead to health issues.

Distress: the negative stress response, often involving negative affect

and physiological reactivity: a type of stress that results from being
overwhelmed by demands, losses, or perceived threats. Distress
triggers physiological changes that can pose serious health risks,
especially if combined with maladaptive ways of coping.
Eustress: the positive stress response, involving optimal levels of
stimulation: a type of stress that results from challenging but
attainable and enjoyable or worthwhile tasks (e.g., participating in an
athletic event, giving a speech). It has a beneficial effect by
generating a sense of fulfillment or achievement and facilitating
growth, development, mastery, and high levels of performance.

Appraisal of stressors is a psychological process through which

individuals evaluate situations or events to determine their
significance for well-being. According to Lazarus and Folkman, this
process involves two key stages: primary appraisal and secondary
appraisal.

In primary appraisal, a person assesses whether an event is irrelevant,

benign-positive, or stressful. If it is stressful, it may be perceived as a
threat, challenge, or harm/loss.

Secondary appraisal involves evaluating one’s available coping

resources and options to manage the stressor, such as skills, social
support, or past experience. The way a stressor is appraised strongly
influences emotional reactions, physiological responses, and coping
behavior. Two people may experience the same event differently
depending on their appraisal, making stress a subjective experience
rather than an objective one.

Stress symptoms may be affecting your health, even though you

might not know it. You may blame sickness for that annoying
headache, your sleeping troubles, feeling unwell or your lack of focus
at work. But stress may really be the cause.
Common effects of stress
Stress symptoms can affect your body, your thoughts and feelings,
and your behavior. Knowing common stress symptoms can help you
manage them. Stress that's not dealt with can lead to many health
problems, such as high blood pressure, heart disease, stroke, obesity
and diabetes.

Common effects of stress

On your body On your mood On your behavior

Headache Anxiety Overeating or

undereating

Muscle tension Restlessness Angry outbursts

or pain

Chest pain Lack of motivation Drug or alcohol

or focus misuse

Fatigue Memory problems Tobacco use

Act to manage stress

 Get regular physical activity on most days of the week.

 Practice relaxation techniques. Try deep breathing, meditation,
yoga, tai chi or massage.
 Keep a sense of humor.
 Spend time with family and friends.
 Set aside time for hobbies. Read a book, listen to music or go for a
walk. Schedule time for your passions.
 Write in a journal.

Daily stress refers to the routine pressures and minor hassles

encountered in everyday life, such as work demands, time constraints,
financial concerns, and interpersonal conflicts. Although these
stressors may seem insignificant individually, their cumulative effect
can significantly impact physical and mental health. Daily stress often
requires continuous adjustment and coping, which can lead to fatigue,
irritability, and reduced concentration if not managed effectively. The
way individuals perceive and respond to daily stress varies based on
personality, coping skills, and social support. Developing healthy
habits, time management skills, and relaxation techniques can help
reduce the negative effects of daily stress and promote emotional
well-being and resilience.

Contribution of Stress to Illness

Stress is a major psychological factor that contributes to the onset,

progression, and severity of physical illnesses. When individuals
experience stress, the body activates physiological systems designed
to help cope with perceived threats. The autonomic nervous system
and the endocrine system play a central role in this process. Stress
activates the sympathetic nervous system and the hypothalamic–
pituitary–adrenal (HPA) axis, leading to the release of stress
hormones such as adrenaline and cortisol. These changes prepare the
body for immediate action, but prolonged activation can damage
bodily systems .

Chronic stress is strongly associated with cardiovascular illness.

Persistent increases in heart rate and blood pressure place continuous
strain on the cardiovascular system. Over time, this can lead to
hypertension, atherosclerosis, coronary heart disease, and an increased
risk of heart attacks and strokes. Stress also affects blood clotting
mechanisms and lipid levels, which further increases cardiovascular
risk.

Stress has a significant impact on immune functioning. Long-term

stress suppresses immune responses by reducing the activity of
immune cells, making individuals more susceptible to infections such
as colds and flu. Stress can also slow wound healing and reduce the
effectiveness of vaccines. In some cases, stress may worsen
autoimmune disorders by disrupting immune balance. These
interactions between psychological stress and immune functioning are
explained by the field of psychoneuroimmunology .

The digestive system is particularly sensitive to stress. Stress can alter

gastrointestinal functioning by increasing stomach acid secretion,
slowing digestion, and affecting gut motility. As a result, stress can
contribute to disorders such as irritable bowel syndrome, gastritis,
acid reflux, and ulcers. Stress is also linked to changes in appetite,
leading to overeating or undereating, which can negatively affect
nutritional health.

Stress also contributes indirectly to illness through health-risk

behaviors. Individuals under stress are more likely to engage in
behaviors such as smoking, excessive alcohol consumption, substance
use, physical inactivity, and poor sleep patterns. These behaviors
increase the risk of chronic illnesses including diabetes, obesity, liver
disease, and mental health disorders.

An important concept explaining the long-term effects of stress on

health is allostatic load. Allostatic load refers to the cumulative
physiological wear and tear on the body resulting from repeated or
chronic stress. When stress is frequent and recovery is insufficient,
the body’s adaptive systems become overused, leading to long-term
damage. High allostatic load is associated with conditions such as
cardiovascular disease, depression, weakened immunity, and
metabolic disorders.
Daily Stress
Daily stress refers to the routine pressures, minor frustrations, and
everyday hassles that individuals encounter in daily life. These
include academic demands, work pressure, time constraints, financial
worries, household responsibilities, interpersonal conflicts, and
environmental stressors such as noise and traffic. Although these
stressors may appear small individually, their frequent and ongoing
nature makes them particularly harmful to physical and mental health

Research in health psychology suggests that daily stressors can have a

greater cumulative impact on well-being than major life events.
Unlike major stressors, daily stress occurs repeatedly and requires
constant coping. Continuous exposure to daily hassles can lead to
fatigue, irritability, headaches, sleep disturbances, reduced
concentration, and emotional exhaustion. Over time, unmanaged daily
stress may contribute to anxiety disorders, depression, and stress-
related physical illnesses.

Daily stress influences health by maintaining prolonged physiological

arousal. Even low-level stressors can repeatedly activate the stress
response, preventing the body from returning to a relaxed state. This
repeated activation increases allostatic load and places strain on
multiple bodily systems, including the cardiovascular, immune, and
endocrine systems.

Individual differences play an important role in daily stress

experiences. Factors such as personality traits, coping styles, social
support, and perceived control influence how daily stress is appraised
and managed. Individuals with poor coping skills or limited social
support are more vulnerable to the negative health effects of daily
stress.

Effective management of daily stress is essential for maintaining

overall health and well-being. Strategies such as time management,
relaxation techniques, regular physical activity, adequate sleep, social
support, and mindfulness practices can help reduce the impact of daily
stress. Developing healthy coping mechanisms allows individuals to
manage daily challenges more effectively and prevents the
accumulation of stress-related health problems.

Chronic stress

Chronic stress occurs when the body’s stress response remains active
for a long period, even in the absence of immediate danger. Unlike
acute stress, which is temporary, chronic stress persists and leads to
mental, emotional, and physical exhaustion, disrupting daily life and
well-being

Causes of chronic stress include financial problems, relationship

difficulties, workplace pressure, retirement issues, chronic illness, and
heavy family responsibilities. These stressors are long-lasting and
repeatedly affect the mind.

• Financial problems: Ongoing worries about debts, bills, and

expenses create constant pressure and feelings of loss of control.

• Relationship difficulties: Conflicts, lack of support, and emotional

instability in relationships lead to long-term emotional stress.

• Workplace stress: Heavy workload, long hours, job insecurity, and

toxic work environments contribute significantly to chronic stress.

• Health-related challenges: Chronic illness, medical expenses, and

uncertainty about health outcomes cause continuous physical and
mental strain.

• Family responsibilities: Caring for children, managing household

duties, or supporting elderly parents can be overwhelming and
exhausting.
• Retirement and aging: Loss of routine, financial concerns, social
isolation, and health issues during retirement increase stress levels.

Signs and symptoms appear across multiple areas:

• Psychological: anxiety, depression, poor concentration, memory

problems

• Emotional: irritability, low motivation, emotional exhaustion,

negative outlook

• Physical: headaches, muscle tension, digestive issues, high blood

pressure, weak immunity

• Behavioural: social withdrawal, substance use, overeating or loss of

appetite, restlessness

• Sleep problems: insomnia and poor-quality sleep

• Hormonal and neurological effects: fatigue, mood swings, dizziness,

migraines

Impact on health includes increased risk of heart disease, weakened

immunity, anxiety, depression, strained relationships, unhealthy
habits, and reduced quality of life.

Coping and management strategies involve mindfulness, realistic

goal-setting, self-compassion, strong social support, regular exercise,
healthy diet, and good sleep habits.

Treatments for chronic stress include:

• Psychological therapies: Cognitive Behavioural Therapy (CBT),

Dialectical Behaviour Therapy (DBT)
• Relaxation techniques: meditation, yoga, breathing exercises, Tai
Chi

• Medication: antidepressants or anti-anxiety drugs when required

• Alternative therapies: acupuncture, aromatherapy, mindfulness

practices

Early recognition, healthy coping strategies, and professional support

are essential to effectively manage chronic stress and restore balance
in life

PTSD

Definition

Post-Traumatic Stress Disorder (PTSD) is a mental disorder that

develops after experiencing or witnessing a traumatic event involving
threat to life, injury, or safety. It causes persistent distress and
impairment in daily functioning. According to DSM, symptoms must
last more than one month.

Onset and Duration

Symptoms may appear immediately, within months, or even years

after trauma. If symptoms last less than one month, it is diagnosed as
Acute Stress Disorder.

Core Symptom Clusters

PTSD symptoms are grouped into four main categories:

• Re-experiencing – intrusive memories, nightmares, flashbacks, and

intense emotional or physical reactions to reminders.
• Avoidance – avoiding thoughts, feelings, people, places, or
situations related to the trauma.

• Negative changes in thinking and mood – guilt, shame, fear,

emotional numbness, detachment, memory problems, and loss of
interest.

• Hyperarousal – irritability, sleep problems, poor concentration,

hypervigilance, exaggerated startle response, and risky behaviour.

Symptoms in Children

Children may reenact the trauma during play, have frightening

dreams, behavioural changes, and may blame themselves.

Causes

PTSD results from a combination of severe or repeated trauma,

genetic vulnerability, personality traits, and changes in brain stress
regulation.

Risk Factors

• Previous trauma or childhood abuse

• Female gender

• Physical injury during trauma

• High-risk occupations (military, first responders)

• Lack of social support

• Mental health problems and substance misuse

Types of PTSD
• Acute PTSD:

Symptoms appear soon after a traumatic event and last for less than 3
months. Individuals experience intense fear, anxiety, flashbacks, and
avoidance, but symptoms may reduce with timely support.

• Chronic PTSD:

Symptoms last for 3 months or longer and can persist for years if
untreated. It includes ongoing flashbacks, emotional numbness, sleep
disturbances, and difficulty functioning in daily life.

• Delayed-onset PTSD:

Symptoms do not appear immediately after trauma but develop

months or even years later. Stressors or reminders may trigger the
delayed response.

• Complex PTSD (C-PTSD):

Results from prolonged or repeated trauma, such as abuse or

captivity. Along with core PTSD symptoms, individuals experience
emotional dysregulation, low self-esteem, and relationship difficulties

Effects and Complications

PTSD may lead to depression, anxiety, substance abuse, relationship

and work problems, physical illness, and suicidal thoughts.

Diagnosis

Diagnosed through clinical interviews; no blood tests or scans.

Symptoms must impair functioning for over one month

Treatment

• Psychological therapies: Trauma-focused CBT, EMDR, Prolonged

Exposure Therapy
• Medications: SSRIs and SNRIs

Self-Care and Prevention

Early support, social connection, healthy lifestyle, stress management,

avoiding alcohol and drugs, and timely professional help reduce risk
and improve recovery.

WHO includes PTSD as a priority condition under the mhGAP

Programme and provides guidelines for treatment, especially in
humanitarian and low-resource settings.

MANAGMENT OF STRESS: COPING STYLE; COPING

WITH STESS AND RESILIENCE; TECHNIQUES IN STRESS
MANAGEMENT

Coping style

The characteristic thoughts and behaviours individual use to manage

stress.

Types of Coping Styles:

a) Problem-Focused Coping:

involves attempts to do something constructive about the stress-

ful conditions that are harming, threatening, or challenging an
individual.

Used when the stressor is controllable

b) Emotion-Focused Coping:

Strategies aimed at reducing the negative emotional responses

associated with stress, such as meditation, humor, or positive
reframing.
 Used when the stressor is not controllable

c) Avoidant Coping:

Attempting to escape or ignore the stressor through distractions,

detachment, or substance use.

Coping with stress and resilience

Coping with stress involves actively managing pressures

through techniques like mindfulness, exercise, and social
support, while resilience is the ability to bounce back from
stress, adversity, trauma, or difficult life situations.

Characteristics of Resilient Individuals

1. Optimistic attitude
2. Emotional control
3. Problem-solving skills
4. Strong social relationships
5. Self-confidence
6. Flexibility in thinking

Relationship Between Coping and Resilience

 Effective coping strategies increase resilience.

 Resilient individuals use adaptive coping methods.
 Poor coping reduces the ability to recover from stress.
 Resilience acts as a buffer against stress.

Techniques in stress management

What is stress management?

Stress management involves using various techniques and

coping strategies to manage your overall stress levels, improve
 how you react to stressful things in your life, and build
resilience.

Practice the 4 As of stress management

There are many healthy ways to reduce stress or cope with its effects,
but they all require change. You can either change the situation or
change your reaction. When deciding which option to choose, it’s
helpful to think of the four As: avoid, alter, accept, or adapt.

1. Avoid unnecessary stress

Not all stress can be avoided, and it’s not healthy to avoid a situation
that needs to be addressed.

 Learn how to say “no.”

 Avoid people who stress you out
 Pare down your to-do list

2. Alter the situation

If you can’t avoid a stressful situation, try to alter it. Often, this
involves changing the way you communicate and operate in your
daily life.

 Express your feelings instead of bottling them up

 Be willing to compromise

 Be more assertive

3. Adapt to the stressor

If you can’t change the stressor, change yourself. You can adapt to
stressful situations and regain your sense of control by changing your
expectations and attitude.
  Reframe problems

 Adjust your standards.

 Practice gratitude

4. Accept the things you can’t change

Some sources of stress are unavoidable. You can’t prevent or change

stressors such as the death of a loved one, a serious illness, or a
national recession. In such cases, the best way to cope with stress is to
accept things as they are. Acceptance may be difficult, but in the long
run, it’s easier than railing against a situation you can’t change.

 Don’t try to control the uncontrollable

 Learn to forgive

 Share your feelings

To know more about 4 A’s:

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Mindfulness as a Relaxation Technique

Introduction

Jon Kabat-Zinn “Mindfulness is paying attention in a particular way:

on purpose, in the present moment, and non-judgmentally.”

Mindfulness is a widely used relaxation technique in health psychology that focuses on

present-moment awareness without judgment. It helps individuals manage stress by reducing
automatic emotional reactions and promoting acceptance. Mindfulness is strongly supported
by the biopsychosocial model of health.
Meaning

Mindfulness refers to consciously paying attention to thoughts, emotions, bodily sensations,

and surroundings in the present moment. Instead of avoiding or suppressing experiences,
individuals observe them with openness and acceptance. This awareness reduces stress and
emotional reactivity.

Methods of Mindfulness

1. Mindful Breathing
This involves focusing attention on the natural flow of breathing. When the mind
wanders, attention is gently brought back to the breath. This practice calms the
nervous system and reduces physiological arousal.
2. Body Scan
In the body scan technique, attention is moved slowly through different parts of the
body. Individuals notice sensations without trying to change them. This increases
body awareness and promotes physical relaxation.
3. Mindfulness-Based Stress Reduction (MBSR)
MBSR is a structured program combining meditation, breathing, and awareness
exercises. It is used to reduce stress, pain, and emotional distress. Regular practice
improves coping and emotional balance.

Mechanism of Action

1. Reduction of Rumination
Mindfulness reduces repetitive negative thinking by bringing attention to the present
moment. This prevents excessive worry about the past or future. Reduced rumination
lowers stress and anxiety.
2. Emotional Regulation
By observing emotions without judgment, individuals respond rather than react
impulsively. This leads to better control over emotional responses. Emotional stability
reduces psychological distress.
 3. Physiological Relaxation
Mindfulness lowers heart rate, blood pressure, and cortisol levels. It activates the
parasympathetic nervous system. This reduces the harmful effects of chronic stress on
the body.

Health Benefits

1. Reduction in Stress and Anxiety

Mindfulness helps individuals manage daily stressors effectively. It reduces anxiety
symptoms by calming the mind. This improves overall psychological well-being.
2. Improved Physical Health
Regular mindfulness practice improves immune functioning and cardiovascular
health. It reduces stress-related illnesses. This supports long-term physical well-being.
3. Enhanced Quality of Life
Mindfulness improves self-awareness and emotional balance. Individuals experience
greater life satisfaction. This leads to better mental health outcomes.

Applications

1. Stress Management
Mindfulness is widely used to manage academic, occupational, and daily life stress. It
helps individuals cope effectively with pressure. This prevents stress-related
disorders.
2. Chronic Illness Management
Mindfulness helps patients cope with pain and illness-related stress. It improves
acceptance and emotional adjustment. This enhances treatment outcomes.
3. Mental Health Promotion
Mindfulness is used in anxiety and depression prevention programs. It improves
emotional resilience. This supports mental health maintenance.

Conclusion
Mindfulness is an effective relaxation technique that promotes emotional regulation and
physical health. Through awareness and acceptance, it reduces stress and improves overall
well-being.

Expressive Writing as a Relaxation Technique

Introduction

Expressive writing is a psychological technique that involves writing about emotional and
stressful experiences. It is based on the idea that emotional suppression increases stress and
health problems. Expressive writing promotes emotional release and psychological healing.

Meaning; James W. Pennebaker

“Expressive writing involves writing about one’s deepest thoughts and feelings regarding
stressful or traumatic experiences.”

Expressive writing refers to freely writing about personal thoughts and feelings related to
stressful events. The focus is on emotional expression rather than language accuracy. This
process helps individuals process difficult experiences.

Methods of Expressive Writing

1. Timed Writing Sessions

Individuals write continuously for 15–20 minutes. The time limit encourages free
emotional expression. This reduces emotional inhibition.
2. Repeated Writing Sessions
Writing is done over several days. Repetition helps deeper emotional processing. This
enhances long-term benefits.
3. Private and Unstructured Writing
Writing is personal and not evaluated. This allows honest expression of emotions. It
increases emotional relief.
Mechanism of Action

1. Emotional Disclosure
Writing helps release suppressed emotions. Emotional expression reduces
psychological tension. This lowers stress levels.
2. Cognitive Processing
Expressive writing helps organize thoughts and experiences. Individuals gain new
perspectives. This improves emotional understanding.
3. Reduction of Physiological Stress
Emotional release lowers stress hormones. This reduces physical strain on the body.
Health improves over time.

Health Benefits

1. Improved Psychological Well-Being

Expressive writing reduces anxiety and depression. Emotional clarity improves
mental health. Individuals feel emotionally lighter.
2. Better Immune Functioning
Reduced stress improves immune responses. This decreases illness vulnerability.
Physical health improves.
3. Reduced Health Complaints
Individuals report fewer physical symptoms. Medical visits decrease. This reflects
improved health adjustment.

Applications

1. Trauma and Grief Coping

Expressive writing helps process traumatic experiences. Emotional expression
supports healing. It reduces long-term distress.
 2. Chronic Illness Adjustment
Patients express illness-related emotions. This improves acceptance and coping.
Psychological well-being improves.
3. Academic Stress Management
Writing helps students release exam-related stress. Emotional regulation improves.
Academic performance benefits.

Conclusion

Expressive writing is a simple yet effective relaxation technique that promotes emotional
expression and health. By reducing emotional suppression, it enhances psychological and
physical well-being.

Self-Affirmation as a Relaxation Technique

Introduction

Self-affirmation is a cognitive relaxation technique that helps individuals cope with stress by
reinforcing self-worth. Stress often threatens self-esteem and identity. Self-affirmation helps
maintain self-integrity and emotional balance.

Meaning: Claude M. Steele

“Self-affirmation refers to the process by which individuals maintain their sense of self-
integrity by reflecting on important values and strengths.”

Self-affirmation involves reflecting on personal values, strengths, and achievements. It

reminds individuals of their worth beyond current stressors. This reduces emotional threat
and anxiety.

Methods of Self-Affirmation
 1. Value Affirmation Writing
Individuals write about important personal values. This strengthens self-concept. It
reduces stress reactions.
2. Positive Self-Statements
Repeating affirming statements reinforces self-worth. This counters negative self-talk.
Emotional confidence increases.
3. Recalling Past Achievements
Reflecting on successes boosts self-esteem. It reminds individuals of their capabilities.
Stress becomes more manageable.

Mechanism of Action

1. Protection of Self-Integrity
Self-affirmation maintains a positive self-image. This reduces the emotional impact of
stress. Individuals feel psychologically secure.
2. Reduction of Defensiveness
Affirmation reduces threat perception. Individuals become more open and calm.
Stress responses decrease.
3. Physiological Stress Buffering
Stress hormone levels reduce after affirmation. Emotional calmness increases.
Physical relaxation occurs.

Health Benefits

1. Reduced Stress and Anxiety

Self-affirmation lowers emotional distress. It improves coping ability. Psychological
well-being improves.
2. Improved Coping with Illness
Patients feel emotionally stronger. Illness-related stress reduces. Treatment adherence
improves.
 3. Enhanced Psychological Resilience
Affirmation builds confidence. Individuals handle challenges better. Long-term
mental health improves.

Applications

1. Health Behaviour Change

Self-affirmation increases acceptance of health advice. Individuals are less defensive.
Positive behaviour change occurs.
2. Academic and Performance Stress
Affirmation improves confidence before exams or tasks. Anxiety reduces.
Performance improves.
3. Stress Management Programs
Self-affirmation is used in counseling and interventions. It strengthens emotional
coping. Stress outcomes improve.

Conclusion

Self-affirmation is an effective relaxation technique that protects self-worth and promotes

resilience. By reinforcing core values, it helps individuals manage stress and maintain
psychological health.

Dithesis-Stress Model
This model suggests that the psychological disorder aroused from interaction of an
underlying vulnerability and a triggering stressor. According to this model the emergence of a
psychological disorder requires:
1. Existence of a diathesis
2. Challenging life stressor that trigger the disorder.
Predisposition(innate) or underlying vulnerability (genetic vulnerability)-development of
stress
Positive to negative situation: condition becomes adverse.
Dotted lines indicate the graph of a vulnerable individual.
Protective factors: Behaviors that shield you from psychological stress or reduce its impact.
Eg; coping skills, relaxation exercise, breathing exercise, lifestyle,acupuncture, therapy,
mental health resources etc.