Stress

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  • Stress
    • 'Stress is a pattern of psychological and physiological responses to a stressor. It is when a person has to cope with something (usually an unpleasant stimulus) and feels unable to do so'
    • There are two main ways that the body responds to stress;
      • The sympathomedullary pathway
        • This is the body's immediate response to a stressor
          • The hypothalamus activates the sympathetic branch of the autonomic nervous system which immediately begins to prepare the body for fight or flight
            • This stimulates the medulla (the inner part) of the adrenal gland to release the stress hormones adrenaline and noradrenaline
              • These hormones increase arousal, heart rate, and blood pressure, the blood is directed to the muscles, blood sugar level increases, bone marrow produces more white blood corpuscles to fight infection etc.
      • The pituitary-adrenal system
        • The hypothalamus releases corticotrophic-releasing hormone which stimulates the pituitary gland to release the hormone ACTH (adreno-corticotrophic hormone) into the bloodstream
          • It reaches the cortex (the outer part) of the adrenal gland causing it to release cortisol into the bloodstream which stimulates the liver to release glucose into the bloodstream to provide energy
      • If the stressor is only short term and goes away, the parasympathetic branch of the ANS is activated. This reduces arousal, reversing the changes brought about by the sympathetic system and stress hormones and the body returns to normal
        • However, if the stressor persists and arousal remains high for some time, eventually we may become ill e.g. prolonged high levels of cortisol may weaken the immune system and prolonged high levels of adrenaline increase levels of cholesterol
    • Stress management
      • Biological Methods
        • Drug therapy
          • The most frequently prescribed anxiolytic drugs are the benzodiazepines e.g. Librium, valium
            • These work by enhancing the activity of gamma-amino-butyric-acid (GABA), a neurotransmitter substance in the brain. GABA has the effect of blocking nerve impulses, so drugs that increase it's action reduce arousal and increase relaxation
              • The drugs also reduce the action of serotonin, a neurotransmitter substance that leads to anxiety if there is too much of it
                • Beta blockers are sometimes used when prolonged stress has led to hypertension (prolonged high blood pressure). They act of nerves that serve the heart so that the rate and power of the heartbeat is reduced and so is blood pressure
          • Strengths
            • They can be very useful in reducing symptoms of stress and so making the person feel better, enabling them to deal more effectively with the stressors
            • They are quick and easy to use
          • Weaknesses
            • They may have side effects. Those of benzodiazepines include; drowsiness, impaired concentration and memory and depression
            • If some drugs are taken for a long period of time, people can become physically and/or psychologically dependent and have difficulty in coming off them
            • When medication stops, anxiety may return
            • The drugs do not address any underlying problems that there may be e.g. with work or relationships
      • Psychological Methods
        • Stress-Inoculation Therapy (SIT) - Meichenbaum
          • Stress-inoculation therapy has three stages;
            • 1. Conceptualisation
              • The client and therapist begin to develop a relationship. The client is encouraged to re-live stressful situations and ask themselves 'What was stressful about it', 'How did I try to cope', 'Why wasn't it successful'
                • This allows the client to develop a more realistic understanding of what makes them stressed
            • 2. Skills Training and Practice
              • The client is taught skills and strategies for coping with their stressful situations e.g. time management, relaxation training, study skills, social skills training.
                • These skills are practiced in the therapeutic setting e.g.role-playing with therapist
            • 3. Application and Follow Through
              • In the final phase, the skills learned in phase 2 are carried out in real-life settings, starting with low stress situations and gradually increasing to higher stress situations
                • The client keeps in contact with the therapist and follow up sessions and more training are provided if necessary, to spot warning signs of relapse and deal with them
          • Strenghts
            • Targeting symptoms. Meichenbaum's approach looks at both sources of stress and coping strategies. By reviewing the coping methods they have used in the past, clients can gain a clearer understanding of their strengths and weaknesses
              • By acquiring new skills and techniques, they can improve their coping strategies and clients gain more confidence in their ability to handle previously stressful situations
            • Effectiveness. The combination of cognitive therapy and behavioral therapy makes SIT an effective method of stress management
          • Weaknesses
            • There have been few controlled studies of it's effectiveness
            • It takes time, effort and money. Clients have to go through a rigorous programe over a long period. This requires high levels of motivation and commitment so it is not a quick and easy fix
            • The way we cope with stressors can be part of our personality and have been part of our behavior for a long time. Changing well established habits will always be difficult

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