Module 33 Stress and Illness

Stress and Illness Stress: Some Basic Concepts 33-1: WHAT EVENTS PROVOKE STRESS RESPONSES, AND HOW DO WE RESPOND AND ADAPT TO STRESS? Stress is process by which we perceive and respond to certain events, called stressors, that we appraise as threatening or challenging Stress arises less from the events themselves than from how we appraise them Stressors appraised as threats can lead to strong negative reactions Experiencing some stress early in life builds resilience Extreme or prolonged stress can cause harm

Stress: Some Basic Concepts Stressors—Things That Push Our Buttons Stressors fall into three main types: Catastrophes: Unpleasant, large-scale events Significant damage to emotional and physical health Significant Life Changes: Personal life transitions Many significant changes happen during young adulthood A cluster of crises raises risk of disease and death Daily Hassles and Social Stress: Day-to-day challenges Some people more affected by everyday hassles than others, with stress taking a greater toll on their well-being Some also have various forms of prejudice compounding those daily challenges

Stress: Some Basic Concepts The Stress Response System Walter Cannon (1929) viewed the stress response as a unified mind-body fight-or-flight system. Hans Selye (1936, 1976) extended Cannon’s findings, proposing a general three-phase general adaptation syndrome (GAS): Phase 1: Alarm—sympathetic nervous system activated Phase 2: Resistance—the body copes with stressor Phase 3: Exhaustion—body’s reserves get depleted Seyle’s basic point: Although the human body copes well with temporary stress, prolonged stress can damage it.

Stress: Some Basic Concepts The Stress Response System Selye’s General adaptation syndrome

Stress and Vulnerability to Disease 33-2: HOW DOES STRESS MAKE US MORE VULNERABLE TO DISEASE? Psychoneuro-immunology: Studies our mind-body interactions Thoughts and emotions (psycho) affect your brain (neuro) which controls the stress hormones that influence your disease-fighting immune system. This field is the study of (ology) those interactions.

Stress and Vulnerability to Disease Four types of cells are active in the search-and-destroy mission of the immune system: B lymphocytes—mature in the bone marrow and release antibodies that fight bacterial infections T lymphocytes—mature in the thymus and other lymphatic tissue and attack cancer cells, viruses, and foreign substances Macrophages—identify, pursue, and ingest harmful invaders and worn-out cells Natural killer cells (NK cells)—pursue diseased cells (such as those infected by viruses or cancer )

Stress and Vulnerability to Disease Immune system activity is affected by Age Nutrition Genetics Body temperature Stress When the immune system does not function properly, it can err in one of two directions: Responds too strongly Doesn’t respond strongly enough

Stress and Vulnerability to Disease Overreaction May Result in Self-attacking diseases Some forms of arthritis Allergic reaction Underreaction May Result in Bacterial infection flare-up Dormant virus eruption Cancer cells multiplying

Stress and Vulnerability to Disease Stress hormones suppress immune system. Research has shown this in Animal studies: Stress of social disruption in monkeys caused weakened immune systems Human studies: Stress caused slower surgical wound healing, greater vulnerability to colds, and decreased effectiveness of flu vaccines The point to remember: Stress does not make people sick but it reduces immune system’s ability to function optimally

Stress and Vulnerability to Disease Stress and AIDS We know that stress suppresses immune system functioning, so what does this mean for people with AIDS (acquired immune deficiency syndrome)? As its name tells us, AIDS is an immune disorder, caused by the human immunodeficiency virus (HIV). Stress cannot give people AIDS, but may speed transition from HIV infection to AIDS and the decline in those with AIDS. Worldwide efforts to reduce stress have had some modest positive consequences for HIV-positive people.

Stress and Vulnerability to Disease Stress and Heart Disease 33-3: WHY ARE SOME OF US MORE PRONE THAN OTHERS TO CORONARY HEART DISEASE? Coronary heart disease: The clogging of the vessels that nourish the heart muscle; the leading cause of death in many developed countries. About U.S. 610,000 coronary heart disease-related deaths yearly (CDC, 2015). Stress and personality play a role in heart disease. The more psychological trauma people experience, the more their bodies generate inflammation, which is associated with heart and other health problems. Let’s take a closer look at personality factors.

Stress and Vulnerability to Disease Stress and Heart Disease Type A Personality Classic study by Meyer Friedman and colleagues (Friedman & Ulmer, 1984) Tested the idea that stress increases heart disease risk by measuring blood cholesterol level and clotting speed Stress predicted heart attack risk for tax accountants Type A men more likely to have heart attack Not one of the “pure” Type B suffered a heart attack Blood pressure also rises as students approach stressful exams (Conley & Lehman, 2012)

Stress and Vulnerability to Disease Stress and Heart Disease Type A Friedman and Rosenman’s term for competitive, hard-driving, impatient, verbally aggressive, and anger-prone people Type B Friedman and Rosenman’s term for easy going, relaxed people Type D More recent term, used for people who suppress negative emotion to avoid social disapproval (Grande et al., 2012)

Stress and Vulnerability to Disease Stress and Heart Disease Effects of Pessimism and Depression Pessimists more than twice as likely as optimists to develop heart disease Depression increases risk of death, especially by cardiovascular disease Stress and Inflammation Chronic stress triggers persistent inflammation which increases risk of heart disease and depression Much greater risk of heart attacks among middle-aged American women facing significant work stress Also greater for Danish nurses reporting work pressure And middle-aged American workers facing involuntary job loss has more than doubled risk of a heart attack Stress→inflammation→heart disease and depression; Gregory Miller and Ekin Blackwell (2006) report that chronic stress leads to persistent inflammation, which heightens the risk of both depression and clogged arteries.

Stress and Vulnerability to Disease Stress and Heart Disease Pessimism and Heart Disease A Harvard School of Public Health team found pessimistic men at doubled risk of developing heart disease over a 10-year period. (Data from Kubzansky et al., 2001.)

Stress and Vulnerability to Disease Stress and Heart Disease Stress can have a variety of health-related consequences This is especially so when stress is experienced by angry, depressed, or anxious people. Job and income loss caused by economic recessions creates stress for many people, such as this jobless Japanese man living in a Tokyo “capsule hotel.”

Stress and Vulnerability to Disease Stress and Heart Disease Anger Management 33-4: HOW DO STRATEGIES FOR HANDLING ANGER COMPARE IN THEIR EFFECTIVENESS? Catharsis: In psychology, the idea that “releasing” aggressive energy (through action or fantasy) relieves aggressive urges. Experts offer three suggestions to manage anger: Wait: Emotional arousal will decrease if you wait just long enough. Find a healthy distraction or support: Exercise, play an instrument, talk to a friend. Distance yourself: Try to move away from the situation mentally. When someone’s behavior is really hurtful, follow the age-old advice to forgive—it releases anger and calms the body.