Q: What are the origins of the stress response?

A: Stress is an extremely important protective mechanism for human beings, and in fact for all animals, because if you're being chased by a lion it's important to get away. In order to get away you need to give as much oxygen and as much sugar to your muscles to make them work as fast as they can, so your blood flow needs to go faster. When you're being frightened, your brain detects the danger, it sends signals down your spinal cord to your adrenal medulla to release adrenaline. The adrenaline increases the amount of sugar in your blood and increases your heart rate, and this helps your efficiency of getting away from the lion. Your brain also sends signals down to the pituitary gland, which releases another hormone which acts on the outside of the adrenal, the adrenal cortex, and that releases cortisol. Cortisol is also very important in keeping your blood sugar up, keeping your blood pressure up, and helping allow the body to have maximal exertion to get away from danger. Q: What happens to the body as a result of the stress response in the brain? A: One of the fascinating things that happens is [that] the body is being prepared only to use its really essential functions, so the muscles work well, the liver releases more sugar, for energy, but things are actually being turned off as well. Although the heart rate is going up and more blood is going round the body, parts of the body which aren't needed urgently are being turned off. The blood supply to the gut and areas like this is actually decreased, so your digestion diminishesyou don't need digestion when you're running away from a lion obviously your sexual function is turned off, and a lot of the non-essential activities of the body just decrease so that you preserve the really essential ones to get away from the dangerous situation. In a modern situation we don't have these same sorts of dangerous problems, but what we have are other very stressful situations. And the interesting thing, of course, is that your blood sugar goes up, your heart rate goes up and your blood pressure goes up, but you're not utilizing all of this, you're not running away, you're not having energy, so all of these hormonal responses are happening, but they're actually not being used. Q: When does the stress response become dangerous? A: The important thing about the stress response is it's adapted for short-term responses. It becomes dangerous when you get multiple stress responses, one after the other, or experience chronic stress that goes on for weeks or years. When that happens your levels of cortisol can be raised for very prolonged periods of time, and it can have lots of nasty effects on the body. It can damp down your immune system, for instance, so that you can't respond to diseases as well as you should. It can also have effects on the brain, actually decreasing the number of brain cells in certain parts of the brain and decreasing your memory. It also can affect your blood pressure, and it can affect the fats in the blood and make it more likely for you to have heart attacks and strokes. So when you have chronic stress, that's when stress becomes dangerous.

Q: Can caring for people with chronic illnesses actually lead to illnesses in caregivers? A: There's been quite a lot of interest recently about what chronic stress can do to cause disease. We did a study on caregivers of patients with Alzheimer's diseaseWe've looked at their hormones and we find that their cortisol is indeed raised, so they have a hormonal stress response which is prolonged for a very long period of time. We've also looked at their immune function by giving them influenza vaccination, which is routinely given to elderly people, and we've found that their antibody response to the influenza vaccination is much poorer than equivalent people of the same age who aren't caring for a loved one with Alzheimer's or some other disease. So it's clear that chronic stress does damp down the immune system. And other people have also shown that chronic stress can decrease your ability to heal wounds, so that if you've got small wounds they just don't heal as well. The body just doesn't function quite as well when you have large, high levels of cortisol circulating through it for long periods of time. Q: Has stress been linked to depression and other mental illnesses? A: It's quite clear that chronic stress is related with depression. Depression is a very major common disease in our society, and it is undoubtedly related to the chronic stress that we have in our society. The ability of stress to cause depression as well as other problems like heart disease and high blood pressure are connected in an interesting way. [Patients who are depressed after a] heart attack are much more likely to die within the next few years than people who've had heart attacks and who aren't depressed. So again this depression, which is related to chronic stress, actually has a major effect on life expectancy. Q: Might there someday be a pill to reduce the effects of stress? A: We are involved in an intensive program to develop an anti-stress pill, and the only way we can do this really is to try and block the beginning of the pathway in the brain that causes the response to stress. And this happens at the hypothalamus, which makes a hormone called CRH. We're making a pill that blocks the effect of CRH, and therefore blocks all of the effects of stress on the body, including the effects of stress in causing an increase in cortisol. We're not designing a drug to give to everybody who's stressed. But this can be very important and hopefully should actually be an extremely useful treatment for depression that's associated with severe stress. APA offers the following tips to address chronic stress: Set limits. List all of the projects and commitments that are making you feel overwhelmed. Identify those tasks you feel you absolutely must do in order to survive, and cut back on anything non-essential. For projects that are work-related, discuss a list of your responsibilities

with your supervisor and get his or her input on priorities and how best to tackle the projects at hand. For commitments that are social or non-work related, such as community or volunteer activities, consider contacting the people youve made these commitments to and letting them know that you cannot meet those obligations at this time. You also may ask for assistance in getting these tasks accomplished. Refrain from accepting any more commitments until you feel your stress is under control. Setting limits on non-essential obligations is important to mitigating chronic stress. Tap into your support system. Reach out to a friend and/or relative with whom youve enjoyed a close relationship over the years. Let them know you are having a tough time and welcome their support and guidance; a shared burden is always lighter. Your friend or relative may have tackled similar challenges and have useful ideas and perspectives. There is no need to face challenging life circumstances alone. In fact, support from family or friends may help you start and sustain taking better care of yourself. Make one health-related commitment. Do what is possible to bolster your health so that you can have the energy and strength to tackle the challenges you are facing. One small step, like cutting back on your caffeine consumption, can have a positive effect. Studies show that without caffeine, people reported feeling more relaxed, less jittery or nervous, slept better, had more energy and experienced less heartburn and fewer muscle aches. Similarly, a brisk walk or other aerobic activity can increase your energy and concentration levels and lessen feelings of anxiety. Physical activity increases your bodys production of good-feeling endorphins, a type of neurotransmitter in the brain, and decreases the production of stress hormones. Taking positive steps for your health will help you manage your stress. Enhance your sleep quality. People who are chronically stressed often suffer from lack of adequate sleep and, in some cases, stress-induced insomnia. According to APAs 2009 Stress in America survey, 47 percent of all adults say they lie awake at night because of stress. It is important to take steps to increase the quality of your sleep. Experts recommend going to bed at a regular time each night, striving for at least 7-8 hours of sleep, and if possible, eliminating distractions, such as television and computers from your bedroom. Begin winding down an hour or two before you go to sleep and engage in calming activities such as listening to relaxing music, reading an enjoyable book, taking a soothing bath or practicing relaxation techniques like meditation. Avoid eating a heavy meal or engaging in intense exercise immediately before bedtime. If you tend to lie in bed and worry, write down your concerns well in advance of bedtime and then work on quieting your thoughts before lights-out. You can figure out how to address stressful issues in the morning, after a good nights sleep. Strive for a positive outlook. Looking at situations more positively, seeing problems as opportunities and refuting negative thoughts are all important aspects of staying positive and trying to minimize your stress. In some people, stress can be caused by their attempts to handle things perfectly. Setting more realistic expectations and positively reframing the way you look at stressful situations can make life more manageable. Also, difficult circumstances have a

way of working out; it is important to keep challenges in perspective and do what you can reasonably do to move forward. Seek additional help. If you continue to feel overwhelmed, are feeling hopeless or are having trouble getting through your daily routine, seek consultation with a licensed mental health professional such as a psychologist. Psychologists are trained to help you develop strategies to manage stress effectively and make behavioral changes to help improve your overall health.

Chronic stress symptoms are mostly those of the diseases that result
Severe long-term pain is one of the common chronic stress symptoms along with a variety of stress related diseases. People respond to chronic stress is their own way, usually in a 'preferred system' so your symptoms may be very different from another person's. If you do not manage the stress you suffer then other worse symptoms of chronic stress may appear - this stage is disease related and should not be ignored. Long-term stress can bring about;

muscular tension leading to pulled muscles and accidents severe persistent headaches and migraines hypertension - high blood pressure, angina and even heart attack stomach ulcers and IBS worsened asthma and bronchitis depression increased frequency of getting colds/flu/ viruses cancer cessation of ovulation and menstruation in women or even a combination or series of these

Stress related diseases originate from chronic stress - long periods of severe stress in response to prolonged pressure, or a series of high pressure events that continually trigger your stress response. Your stress response affects most if not all the body and thus stress induced illnesses can affect most parts of the body. People respond to chronic stress differently depending where they 'feel' the stress and so exhibit different symptoms and diseases.

Stress related diseases result from long term chronic stress

Unmanaged, stress continues to cause a range of effects on the body and other stress illnesses may occur over time as the stress worsens.

Stress induced illnesses

Through constant stimulation your adrenal glands can become exhausted, as will you; forever tired, run-down and burnt out with chronic fatigue. Stress can cause mental problems including depression. Peptic ulcers are common in those that exhibit their stress in their stomach and can cause acute pain and severe consequences if they rupture. Chronic pain is common in those with muscle tension, as too are debilitating headaches and migraines. Other may suffer eating disorders like bulimia and/ or anorexia nervosa as they stress about internal thoughts and beliefs of themselves. Alcoholism or drug dependency can develop following longterm miss-use as a way of managing stress that gets out of control can be a longterm difficult to manage 'disease'. Many people suffer poor immune function, low white blood cell counts and repeated bouts of colds or flu as a result of severe stress. For those that develop hypertension in response to stress, there is a series of problems from high blood pressure, constricted blood vessels causing anginal pains in the chest to increased risk of stroke and heart attack. All of these can severely limit your ability to enjoy life and stress is recognized as the most common cause. Other disease problems include cancer and auto-immune diseases, which are often now thought to be part stress induced. Eczema and asthma can also be part caused/ triggered by chronic stress as well as being more common in those with super clean homes. Our modern lifestyle has a lot to answer for!