Stress is a natural human response to challenges or threats and is commonly experienced by everyone to varying

degrees. It can be defined as a state of worry or mental tension triggered by difficult situations, prompting us to
take action or adapt. One well-known definition describes stress as the “rate of wear and tear caused by life,”
reflecting how ongoing pressures impact our mental and physical health. Stress occurs when there is a perceived
imbalance between the demands placed on an individual and the resources available to cope—whether those
demands are external (like work or relationships) or internal (such as self-expectations). This leads to both
psychological and physiological reactions, which can either motivate adaptive behavior or, if prolonged or intense,
harm overall well-being. Crucially, how a person responds to stress—their coping style—plays a major role in
determining its impact on their health.
Stress can be both positive and negative, depending on how it affects an individual. Positive stress, known as eustress,
is a healthy form of stress that can motivate, enhance focus, and improve performance—such as feeling energized before
a presentation or exam. It helps individuals rise to challenges and build resilience. In contrast, negative stress, or distress,
occurs when stress becomes overwhelming, leading to feelings of anxiety, worry, or helplessness. This type of stress can
impair functioning, lower productivity, and negatively impact both mental and physical health if not managed properly.

Stress affects both the mind and body, influencing how we think, feel, and function. In small amounts, stress can be
helpful, motivating us to complete tasks, stay alert, and handle everyday challenges. However, when stress becomes
chronic or excessive, it can lead to physical problems like headaches, fatigue, and high blood pressure, as well as
mental health issues such as anxiety, irritability, or depression. Learning to cope with stress effectively is essential for
maintaining both mental and physical well-being, helping us feel more in control and less overwhelmed in difficult
situations.

The word 'stress' is used in physics to refer to the interaction between a force and the resistance to counter that force, and
it was Hans Selye who first incorporated this term into the medical lexicon to describe the “nonspecific response of the
body to any demand”. Stress involves a process of events that essentially has three basic, interrelated and sequential
stages: Onset, Reaction, and Outcome. E = events (or stressors, which can be either external or internal). Perception=
(your views, beliefs, interpretations, etc.);and R= response or actions (which in turn contributes to the quality and quantity
of related reactions and outcomes) These reactions and outcomes occur in four basic areas: behavioral ,mental,
physical and social. Stress is truly subjective given the central role perception plays between the E, which is essentially
the stimulus, and R , which is essentially the response. As a result of the above mentioned transaction view of stress, it
is our thoughts and expectations, i.e., how we interpret and label our experiences, that can serve either to relax or cause us
stress. Depending on the relationship between the demands placed on you and all the resources available to you (i.e.,
internal and external) at anytime determine to what degree, you will experience stress. When your life demands (i.e., both
internal and external) are in relative balance with your resources (i.e., even load), you have "ideal“ living experiences
with, at best, negligible or "tolerable" amounts of stress.

Hans Selye (1980) defined stress as the non-specific response of the body to any demand, highlighting that stress can
be triggered by a wide range of events based on individual differences. Stressors can be threatening or non-threatening,
real or imagined, and may be physical (e.g., pain, noise), social (e.g., crowds, meeting new people), or psychological
(e.g., anxiety about future events). Even positive life changes, like marriage, can act as stressors. Selye’s view shows that
stress is not limited to danger—it can arise from any significant change or challenge. Stressors also may be hidden, i.e.,
we are "unaware" of their influence (e.g., when you feel some unexplained anger, envy, or resentment toward someone
else) versus stressors being obvious, i.e., when you are somewhat aware of their presence.
PHYSIOLOGICAL STRESS RESPONSE: Sympathetic activation is the body's immediate response to stress. When
the cerebral cortex perceives an event as harmful or threatening, it sends signals to the hypothalamus, which initiates
the fight-or-flight response, a concept introduced by Walter Cannon. This response activates the medulla of the
adrenal glands, prompting the release of catecholamines, such as epinephrine (adrenaline) and norepinephrine. These
hormones prepare the body for rapid action by increasing heart rate, blood pressure, and energy availability to handle the
perceived threat. During the stress response, the adrenal glands secrete catecholamines, mainly epinephrine
(adrenaline) and norepinephrine, which prepare the body for immediate action. These hormones cause the heart rate to
increase and heart capillaries to dilate, allowing more blood flow. Blood pressure rises, and blood is redirected to the
muscles to enhance physical readiness. At the same time, the breathing rate increases to supply more oxygen, digestion
slows down to conserve energy, and the pupils dilate to improve vision and alertness—all essential changes for
confronting or escaping a perceived threat.

The HPA axis is a major system activated during stress, working alongside the sympathetic nervous system. Building on
Hans Selye’s research, it explains how the brain and endocrine system coordinate the body’s stress response. When
stress is perceived, the hypothalamus releases corticotrophin-releasing hormone (CRH), which stimulates the
pituitary gland to secrete adrenocorticotropic hormone (ACTH). ACTH then prompts the adrenal cortex to release
cortisol, a key stress hormone. Cortisol helps the body cope by mobilizing proteins and fats, increasing access to
energy stores, raising blood glucose levels, and suppressing inflammation, preparing the body to manage prolonged
stress.

PHYSIOLOGY OF STRESS: The hypothalamic-pituitary-adrenal (HPA) axis is a critical system in the body that plays
a major role in how we respond to stress and regulate various bodily functions through hormones. It involves three main
components: the hypothalamus, the pituitary gland, and the adrenal glands. Hypothalamus: This small structure in the
brain helps regulate hormones and control several vital functions, such as sleep, body temperature, and appetite. It releases
corticotropin-releasing hormone (CRH) in response to stress. Pituitary Gland: Located at the base of the brain, it
produces and releases hormones, including adrenocorticotropic hormone (ACTH), which signals the adrenal glands to
release cortisol. It is also responsible for regulating growth and maturation. Adrenal Glands: Found above the kidneys,
these glands produce several hormones, including cortisol, adrenaline, and noradrenaline, which play a key role in the
body's stress response. When the body faces a stressor, the hypothalamus signals the release of CRH, which then activates
the pituitary gland to release ACTH. This hormone travels through the bloodstream to the adrenal glands, which respond
by producing cortisol, often referred to as the "stress hormone." Cortisol helps the body cope with stress by increasing
heart rate, blood pressure, and glucose levels, preparing the body for a fight-or-flight response. The balance of cortisol is
essential for maintaining health, as both too much or too little can lead to health problems, including immune system
suppression, digestive issues, and mood disturbances. This complex interaction between the nervous and endocrine
systems ensures that the body can adapt to stress and maintain homeostasis.

Physiology of Stress Response

When the body is confronted with a stressor, whether actual event or imagined, a reaction is evoked to help the body cope.
General Adaptation Syndrome (GAS) is a profile of how organisms adapt to stress created by Hans Selye. General
adaptation syndrome (GAS) is a theory that describes the physiological changes the body experiences when under stress.
The syndrome includes three stages: The alarm stage- It contains two substages: shock phase and countershock phase
In the shock phase, body temperature and blood pressure both decrease. Loss of fluid from body tissues also occurs.
In the countershock phase, the body’s fight-or-flight response is triggered. This is the stage in which we are able to deal
with challenging (adverse) events. The body is prepared to either confront or flee the imagined threat. This stage causes
the production of stress hormones such as cortisol, noradrenaline, and adrenaline from the adrenal glands, as well as an
increase in heart rate, blood sugar level, and blood pressure. If the body’s compensatory systems have been successful in
counteracting the stressor’s effect, the recovery stage begins. The fatigue stage occurs when the body’s resources have
been depleted and it is unable to continue regular function. If the tiredness stage lasts for a long time, it can have long-
term consequences, putting the person at risk of developing more significant health problems. It has the potential to cause
depression, hypertension, and coronary artery disease.
 The resistance stage: Following the alarm stage, the body begins to repair itself. If the stressful situation is resolved, the
body continues to repair itself until it returns to its pre-stress state. If the stressful situation is not resolved, the body
remains on high alert, eventually adapting to the higher stress level. Stress hormones and blood pressure remain elevated.
This can lead to hypertension and heart problems as well as irritability, frustration, and poor concentration. 3. The
exhaustion stage: This stage occurs during prolonged or chronic stress when the body’s adaptation to higher stress levels
starts to break down. The body no longer has the strength or resources to fight the stress. Signs of the exhaustion stage
include, but are not limited to, the following: Trouble sleeping, Severe loss of concentration, Fatigue, Depressed mood,
Trembling, Anxiety attacks, Crying spells, Stress-related illnesses, For short-term or mild stressors, the alarm stage is not
harmful. It is a natural mechanism that is designed to protect the body from danger. However, when prolonged or chronic
stress is experienced, the body may not be able to repair itself in a timely manner, which can lead to the exhaustion stage.
Understanding the stages of GAS can help with the identification of personal stress signals, which can help with the
reduction of stress levels.

DRAWBACKS WITH SELYE’S MODEL: Very limited role attributed to psychological factors – considered more
crucial now. Not all stressors produce the same response. The exhaustion of physiological resources or chronic activation
is more implicated in stress; however, research now suggests that continued activation (resistance) leads to accumulating
damage to physiological systems. Selye assessed stress as an outcome of General Adaptation Syndrome, but people
experience harmful effects of stress during a stressful event and even in anticipation of its occurrence.

TRANSACTIONAL MODEL OF STRES SLazarus & Folkman (1984): Stress involved a transaction b/w the individual
& the external world. Individuals are appraisers (appraise the outside world) and not just passive responders (don’t
passively respond to it) – cognitive component. Stress response was elicited if the individual appraised a potentially
stressful event as actually being stressful. Appraisals – Primary (event) & Secondary (self/evaluating coping strategies)

Primary Appraisal – first step in appraising a stressor & involves estimating the severity of the stressor and classifying it
as: Threat – something that could be harmful in the future. Challenge – something to be met & defeated. Harm/Loss –
harm or loss that has already occurred. Perceiving the stressor as a challenge instead of a threat leads to more successful
coping – confident expectations of ability to cope, more favorable emotional reactions to an event. Perceiving the stressor
as an embarrassment, or imagining future failure or rejection, is more likely to lead to increased stress reactions, negative
emotions, & inability to cope well. Blood pressure is higher when threat is high & challenge is low. Blood pressure is
lower when challenge is high

Secondary Appraisal: While the primary appraisals of the stressful situations are occurring, secondary appraisal is
initiated. An individual who has identified a threat or harmful effect must estimate the resources they have available for
coping with the stressor. Resources include – social support, money, time, energy, ability and other potential resources. If
resources are perceived as adequate/abundant  the degree of stress will be minimal. If resources are perceived as
missing/lacking the degree of stress will be higher

COPING WITH STRESS:

The term coping is usually applied to strategies that individuals use to manage the distressing problems and emotions in
their lives. Personal Resources that Influence Coping- Social Support – refers to a variety of material and emotional
supports a person receives from others. People with a high level of social support ordinarily have a broad social network
and many social contacts; socially isolated people have neither. Personal Control – refers to the confidence that people
have some control over the events that shape their lives. Optimism – Optimists are people who expect good things to
happen to them, whereas pessimists are people who generally expect bad things

Types of Coping- Problem-focused coping is aimed at changing the source of the stress, whereas emotion-focused coping
is oriented toward managing the emotions that accompany the perception of stress
Personality
Personality can be defined as the ‘dynamic organization within the individual of those psychophysical systems that
determine his characteristic behaviour and thought’Personality a protective or risk factor? The model adopted most widely
in health psychology is a five-factor model, often referred to as the ‘Big Five’ theory, which conceptualizes and assesses
personality using the following dimensions/factors: Openness – i.e., imaginative, curious, open to new experiences,
Conscientiousness – i.e., responsible and striving, Extraversion – i.e., positive, assertive, active, sociable, Agreeableness –
i.e., cooperative, trusting, compliant, Neuroticism – i.e., tense, anxious, pessimistic

Type A- Friedman & Rosenman – Cardiologists (CHD)

Consists of 4 characteristics: Competitive, Ambitious, Hate to waste time, Easily annoyed (hostility), Often successful
but frequently dissatisfied, Find it difficult to relax and do nothing

Type B
Low levels of: Competitive spirit, Achievement orientation, Time urgency, Anger or hostility, Easy going & philosophical
about life, Speech is slower, softer, & reflects a more relaxed ‘give and take’, (Mental illness & substance abuse)

Type C- Researchers – Temoshok & Dreher (1992)

Identified a third personality type as being associated with a higher incidence of cancer
Type C people: Tend to be very pleasant, Try to keep the peace, Find it difficult to express emotions (esp. negative ones),
Tend to internalize anger, Often lonely, The internalized negative emotions of the Type C personality may increase the
levels of harmful stress hormones, weaken immune system, & slow recovery

There are several effective behavioral interventions for managing stress, including relaxation training, cognitive
behaviour therapy, emotional disclosure, and mindfulness. Relaxation training involves techniques such as deep
breathing exercises, progressive muscle relaxation, and guided imagery to help calm the body and mind. These methods
reduce muscle tension, lower heart rate, and promote a sense of peace. Cognitive Behaviour Therapy (CBT) is a
structured approach that focuses on identifying and changing negative thought patterns and behaviors that contribute to
stress. By learning problem-solving skills and developing healthier thinking habits, individuals can improve their
emotional responses to stressful situations. Emotional disclosure is another useful strategy, which involves expressing
emotions related to stressful or traumatic experiences. This can be done through journaling or talking with a therapist and
has been shown to improve both mental and physical well-being. Finally, mindfulness teaches individuals to focus on the
present moment in a non-judgmental way. Mindfulness practices, such as meditation and body scans, help people become
more aware of their thoughts and feelings, reducing reactivity and promoting a calm, balanced state. When practiced
regularly, these interventions can significantly improve stress management and overall resilience.