1. Lesson 18

2. Learning Objectives  To understand biological methods of stress management. Success Criteria 1. Produce evaluation notes about the use of drugs to treat stress on page 20 of your booklet. 2. Complete a practice question about biological methods of stress management and hand it in at the end of the lesson.  Challenge Criteria  Create a drug flashcard to help you remember the action of drugs

3.  You each have a note stuck to your back. You will play the yes/no game…  You will ask a series of questions to your study buddy to try to guess the stress-related key word/psychologist’s name/concept etc.  Your study buddy can only say “yes” or “no”!

4.  Two sets of drugs are commonly used to treat stress are:  Benzodiazepines (BZs)  Beta-blockers (BBs)

5.  BZs (Librium and Valium) are the most common drugs to treat stress and anxiety  BZs slow down the activity of the CNS

6.  These are the most common drugs to treat stress and anxiety; they slow down the activity of the CNS.  Nerve cells communicate by sending chemicals (neurotransmitters) to the next nerve cell.

7.  One of the neurotransmitters is called GABA.  40% of neurons in the brain respond to GABA.  GABA gives relief from anxiety by altering other neurotransmitters; it reduces serotonin (which reduces arousal and anxiety).  Drugs interfere with this process; benzodiazepines increase the activity of GABA in order to decrease serotonin activity, which in turn reduces arousal.

10.  Beta-Blockers (BBs) reduce the activity of adrenaline and noradrenaline which are part of the sympathomedullary response to stress.  These do not enter the brain, instead BBs bind to the receptors in the heart and other parts of the body that are stimulated during arousal  This reduces the activity of the autonomic nervous system associated with arousal, i.e. reducing heart-rate, blood pressure and cortisol levels.  There is therefore less stress on the heart and the person feels calmer and less anxious.  These are sometimes used by snooker + darts players and musicians to reduce the negative effects on their performance.

11. Stress Raised blood pressure Increased heart rate Elevated levels of cortisol Arousal of the sympathetic nervous system Cardiovascular disorders and reduced immune system

12.  Complete the table on page 20 of your booklet showing the strengths and weaknesses of drug treatments.

13. Strengths of Biological TreatmentsWeaknesses of Biological Treatments Effective at combating the effects of stress. To assess the effectiveness of drugs you give one group of anxious patients a drug and the other group a placebo. The patients do not know which drug they are taking. This helps to determine whether the effects of the drug are pharmacological or psychological. Kahn et al (1986) followed 250 patients for eight weeks. BZs were far superior to the placebo. Hildalgo et al (2001) carried out a meta-analysis on social anxiety treatments and found that BZs were superior to other anti-anxiety drugs, e.g. antidepressants. Beta-blockers are more effective in reducing anxiety in a variety of stressful situations, e.g. among musicians and is sports where accuracy is more important than stamina (e.g. golf or snooker). Drugs are easy to use and require little effort – you just have to remember to take the pill. This is easier than the effort required for psychological treatments. BZs were introduced over 40 years ago and replaced barbiturates which tended to be addictive (withdrawal symptoms occurred). Recently addiction to BZs has been noticed, especially low-dose dependence (i.e. withdrawal symptoms occur with low doses). It is therefore recommended that BZs are only taken for four weeks (Ashton, 1997). Side effects of BZs include ‘paradoxical’ symptoms (i.e. the opposite of what you would expect occurs) such as increased aggressiveness and cognitive side effects (impaired memory and not being able to store things in LTM). Although most people do not experience side effects, there has been a link with developmental diabetes. Sometimes the effect of drugs only lasts as long as the drugs are taken, as soon as they stop, the effectiveness disappears. It may be that the problem has passed, but in the case of chronic stress, it may be that it covers up for the problem temporarily and the addiction poses an additional problem – therefore psychological treatments may be better as they deal with the symptoms.

14.  Discuss one or more biological methods of stress management. [10 marks]