Module IV - Health

Enhancing Behavior
PSYC 713
HEALTH PSYCHOLOGY
 Introduction to Stress
• The word ‘stress’ is derived from the Latin word ‘stringer’ which means ‘to draw tight’. Stress is
a general term applied to the pressures feel in life. The presence of stress at work is almost
inevitable in many jobs.
• However individual differences account for a wide range of reactions to stress- a task viewed as
challenging by one person may produce high levels of anxiety in another.
• People who are stressed may become nervous & chronically worried. They are easily provoked to
anger and are unable to relax. They may be uncooperative or use alcohol or other drugs
excessively.
• Stress is a negative emotional experience accompanied by predictable biochemical, physiological,
cognitive and behavioural changes that are directed either toward altering the stressful event or
accommodating its effects. (Baum 1990)
• R.S. Schuler has defined stress as “A dynamic condition in which an individual is
confronted with an opportunity, a demand, or a resource related to what the individual
desires and for which the outcome is perceived to be both uncertain and important.
• Cox states that “it is useful to think of stress as embedded in an ongoing process
which involves individuals interacting with their environment, making appraisals of
those interactions and attempting to cope with the problem that arises”.
• Edward suggests stress is the result of a “lack of fit between a person (in terms of
personality, aptitudes and abilities) and the environment and a consequent inability to
cope effectively with the various demands that it makes of him/her”.
 Types of Stressors
• Stressors come in a variety of different forms: tests, finances, job interviews, health problems, achieved
goals, praise, family conflicts, romantic relationships, competitions, homework assignments.
 Physical stressors
1. Environmental:
• Heat, cold, wetness
• Vibration, noise, blast
• Hyposia (insufficient oxygen), fumes, poisons, chemicals
• Skin irritants
• Physical work
• Bright light, darkness
2. Physiological:
• Illness/ injury
• Muscular fatigue
• Malnutrition, poor hygiene
• Mental stressors:
3. Cognitive
• Too much /too little information
• Sensory overload verses deprivation
• Ambiguity, uncertainty, isolation
• Time pressure verses waiting
• Unpredictability
Emotional Stressors
• Fear And anxiety producing stress
• Grief producing loses
• Interpersonal feelings
• Boredom producing inactivity
• Conflicting motives
 TYPES OF STRESS
• Eustress: This type of stress makes us feel good & is known as ‘good stress’ or
positive stress. Eustress is also known as ‘curative stress’ because it gives a person
the ability to generate best performance or maximum output.
• Distress: This is a negative stress. It is a stress disorder that is caused by adverse
events and often influences a person’s ability to cope.
• Physical stress: trauma (injury, infection, surgery), intense physical labor/over-
exertion, environmental pollution (pesticides, herbicides, toxins, heavy metals,
inadequate light, radiation, noise, electromagnetic fields), illness (viral, bacterial,
or fungal agents), fatigue,
• Psychological stress: emotional stress (resentments, fears, frustration,
sadness, anger, grief/bereavement), cognitive stress (information overload,
accelerated sense of time, worry, guilt, shame, jealousy, resistance,
attachments, self-criticism and so on.
• Psychosocial stress: relationship/marriage difficulties, lack of social
support, lack of resources for adequate survival, loss of
employment/investments/savings.
• Psycho-spiritual stress: A crisis of values, meaning, and purpose of life.
• Acute Stress: Acute stress is the most common form of stress. It comes
from demands and pressures of the recent past and anticipated demands
and pressures of the near future.
• Chronic stress: This is the grinding stress that wears people away day
after day, year after year. Chronic stress destroys bodies, minds and lives.
Stages of Stress
 Alarm Phase
• The Alarm Phase refers to our immediate stress response when we perceive a situation that is a potential
threat to us. You’ve probably already heard of this phase as the “fight-or-flight response.”
• In this phase our brain responds to the “alarm” with hundreds of responses. One of these is to release
stress hormones such as adrenalin and cortisol into our bloodstream to give it a boost in order to do
whatever must be done to survive, such as escape from a predator.
• These hormones cause the body to become highly stimulated. The heart beats harder, the lungs breathe
faster, your muscles may tense – you’re ready to fight or to run. The vision gets sharper as it focuses on
the potential threat. The liver releases extra glucose for energy, and blood pressure goes up. The digestive,
immune and reproductive systems go on hold temporarily so all that energy can be directed toward
responding to the threat.
• This is all because our nervous system was designed to help increase the chances of surviving a physical
threat to safety.
 Resistance Phase
• If the situation that alarmed us does not disappear, our body goes into Phase 2: Resistance. During Phase 2, the
body shifts the mix of stress hormones over from being mostly the quick acting adrenalin over to the longer lasting
cortisol. It also releases other hormones, particularly corticosteroids. Because of this, blood sugar and blood
pressure levels rise. This is done to help us maintain energy levels (as if we’re still fighting off that dragon) and to
help us adapt physically to the ongoing tension.
• Phase 2 is the period of time when we recognise and begin to interpret the stressful situation. We try to adapt to it
or cope with it.
• Our response is largely dictated by our core beliefs, attitudes and values. As you can imagine, these directly affect
the choices we make. If we consider the situation a threat, demand, or a disaster, we may compromise our own
ability to cope.
• If a person remains in Phase 2 for a prolonged period of time, or continually bounces from Phase 1 to Phase 2, they
will begin to suffer irritability and fatigue. It is too difficult for the body to sustain a highly stimulated state over
time.
 Exhaustion Phase
• If we stay in Phase 2 for a long time, the glands that produce the stress hormones become exhausted, as do the organs that
have either been stimulated or shut down by the hormones. This is Phase 3 of stress – the phase of Exhaustion.
• In this third stage of stress, we feel depleted. The chronic production of stress hormones has worn out our physiological
functioning, causing deep physical exhaustion, and fatigue even when not doing very much. There can also be mental and
emotional effects such as depression. The body has depleted its energy, as well as its ability to combat disease. The body is
both mentally and physically on the verge of collapse.
• Long term chronic stress weakens our body, due to the stress hormones that circulate constantly through it. Our
physiological systems aren’t made to work on overdrive for long periods. They’ll eventually start to lose efficiency, break-
down, or even collapse and stop working. Chronic stress can cause serious illnesses, as well as burnout:
• Chronic fatigue
• Adrenal exhaustion
• Depression
• Behavioural problems
• Relationship issues
Physiology of Stress
 SYMPATHETIC Activation
• When events are perceived as harmful or threatening, they are identified as such by the
cerebral cortex, which, in turn, sets off a chain of reactions mediated by these appraisals.
Information from the cortex is transmitted to the hypothalamus, which initiates one of
the earliest responses to stress—namely, sympathetic nervous system arousal.
• Sympathetic arousal stimulates the medulla of the adrenal glands, which, in turn, secrete
the catecholamines epinephrine (EP) and norepinephrine (NE). These effects result in the
cranked-up feeling we usually experience in response to stress: increased blood pressure,
increased heart rate, increased sweating, and constriction of peripheral blood vessels,
among other changes. The catecholamines modulate the immune system as well.
 SYMPATHETIC Activation
• Parasympathetic functioning may also become dysregulated in response to stress. For
example, stress can affect heart rate variability. Parasympathetic modulation is an important
restorative aspect of sleep, and so, changes in heart rate variability may both represent a
pathway to disturbed sleep and help to explain the relation of stress to illness and increased
risk for mortality (Hall et al., 2004).
• The hypothalamic-pituitary adrenal (HPA) axis is also activated in response to stress. The
hypothalamus releases corticotrophin releasing hormone (CRH), which stimulates the pituitary
gland to secrete adrenocorticotropic hormone (ACTH), which, in turn, stimulates the adrenal
cortex to release glucocorticoids. Of these, cortisol is especially significant. It acts to conserve
stores of carbohydrates and helps reduce inflammation in the case of an injury. It also helps
the body return to its steady state following stress.
Hypothalamic Pituitary Adrenal (HPA) Axis
• The hypothalamic-pituitary adrenal (HPA) axis is also activated in
response to stress. The hypothalamus releases corticotrophin releasing
hormone (CRH), which stimulates the pituitary gland to secrete
adrenocorticotropic hormone (ACTH), which, in turn, stimulates the
adrenal cortex to release glucocorticoids. Of these, cortisol is especially
significant. It acts to conserve stores of carbohydrates and helps reduce
inflammation in the case of an injury. It also helps the body return to its
steady state following stress.
Hypothalamic Pituitary Adrenal (HPA) Axis
• Repeated activation of the HPA axis in response to chronic or recurring stress can
ultimately compromise its functioning. Daily cortisol patterns may be altered. Normally,
cortisol levels are high upon waking in the morning, but decrease during the day (although
peaking following lunch) until they flatten out at low levels in the afternoon. People under
chronic stress, however, can show any of several deviant patterns: elevated cortisol levels
long into the afternoon or evening, a general fl attening of the diurnal rhythm, an
exaggerated cortisol response to a challenge, a protracted cortisol response following a
stressor, or, alternatively, no response at all (McEwen, 1998).
• Any of these patterns is suggestive of compromised ability of the HPA axis to respond to
and recover from stress (McEwen, 1998; Pruessner, Hellhammer, Pruessner, & Lupien,
2003)
 Symptoms of Stress
Emotional symptoms of stress include:
• Becoming easily agitated, frustrated, and moody
• Feeling overwhelmed, as if you are losing control or need to take control
• Having a hard time relaxing and quieting your mind
• Feeling bad about yourself (low self-esteem), and feeling lonely, worthless, and depressed
• Avoiding others
• Physical symptoms of stress include:
• Low energy
• Headaches
• Upset stomach, including diarrhea, constipation, and nausea
• Aches, pains, and tense muscles
• Chest pain and rapid heartbeat
• Insomnia
• Frequent colds and infections
• Loss of sexual desire and/or ability
• Nervousness and shaking, ringing in the ears, and cold or sweaty hands and feet
• Dry mouth and a hard time swallowing
• Clenched jaw and grinding teeth
Cognitive symptoms of stress include:
• Constant worrying
• Racing thoughts
• Forgetfulness and disorganization
• Inability to focus
• Poor judgment
• Being pessimistic or seeing only the negative side

Behavioral symptoms of stress include:

• Changes in appetite -- either not eating or eating too much
• Procrastinating and avoiding responsibilities
• More use of alcohol, drugs, or cigarettes
• Having more nervous behaviors, such as nail biting, fidgeting, and pacing
Katharine Ann James, 1,2,*
Juliet Ilena Stromin, 1 Nina Steenkamp, 1 and Marc Irwin Combrinck 2

Relationship between Psychological and

Physiological Health
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10025564/
“Understanding the relationships between physiological and psychosocial stress, cortisol and
cognition” (2023)
 Importance of stress management

• A certain level of stress is always present in any workplace. As soon as the level of stress escalates to a
point that it becomes dangerous for the well-being of the organization as well as employees, stress
management becomes important. It has the following benefits:
• Enables you to motivate employees better. Stressful situation can have a devastating effect on the
morale of employees, causing increased absenteeism and employee turnover. However, good stress
management skills help the morale of employees to stay intact so that they are more motivated and
better focused on their jobs and performance.
• Reduced chances of workplace conflicts. Among many other factors contributing to workplace
conflicts such as differences in opinions, backgrounds and personalities, the increased level of stress
also plays a major role. It shatters the workplace relationships, undermining the overall culture.
However, effective stress management skills prevent such distractions and builds teamwork, making
everyone’s lives easier and fun.
• Improves productivity even in stressful situations. Since the employee
morale and workplace relationships remain intact, stress management
skills are considered to be one of the major contributors to the improved
productivity. With ideal stress management skills, there will be lesser
chances of customer complaints or poor decision-making even in the most
stressful circumstances.
 Improvement in stress management
• Identify the sources of stress and prioritize. There can be personal as well as workplace pressures causing
stress. The first step towards improvement of stress management skills is to be able to identify the source
causing it. Once identified, make a priority list and tackle the stressors one at a time. Being more organized
sometimes helps in relieving part of the stress.
• Motivate yourself to find solutions. There are many ways you can boost up your morale for managing
stress. For example, make a list of similar situations you have managed to handle in the past and recall how
you did it, or promise yourself a reward after you have successfully managed to cope with the stressful
situation. However, if the stressors are things that are completely out of your control, you must be able to
remind yourself and be okay with the fact that there is nothing you can do.
• Manage stress through exercise. Take care of your physical health by eating healthy, avoiding excessive
sugar and, most of all, exercising regularly. Learn yoga as well as other exercises for muscle relaxation. This
will help you manage your physical responses to a stressful situation.
 Benefits of stress management
• Try to build stress-reducing activities into your life, such as exercise, relaxation and
hobbies.
• Eat well and ensure you have sufficient rest and sleep to prepare yourself for the
inevitable stresses of life.
• Avoid making self-critical comments.
• Become aware of your own strengths, weaknesses and needs.
• Make it a priority to get plenty of support rather than trying to cope alone.
• Write down your thoughts so they begin to make sense. Decide on priorities and look for
solutions.
• Think creatively — what might another person do in your situation?
• Delegate, share responsibility, and renegotiate deadlines. Often those
around you won’t realize how overloaded you’re feeling.
• Prepare for events as much as possible in advance, but don’t try to be
perfect, or expect other people and events to be perfect.
• Always seek expert advice when you experience severe physical and
emotional symptoms.
 Healthy and Unhealthy strategies

• Healthy strategies:
1. Identify the sources of stress in your life- Stress management starts with
identifying the sources of stress in your life. This isn’t as easy as it
sounds. Your true sources of stress aren’t always obvious, and it’s all too
easy to overlook your own stress-inducing thoughts, feelings, and
behaviors. Sure, you may know that you’re constantly worried about work
deadlines. But maybe it’s your procrastination, rather than the actual job
demands, that leads to deadline stress.
2. Start a Stress Journal- A stress journal can help you identify the regular
stressors in your life and the way you deal with them. Each time you feel
stressed, keep track of it in your journal. As you keep a daily log, you will
begin to see patterns and common themes. Write down:
• What caused your stress (make a guess if you’re unsure)
• How you felt, both physically and emotionally
• How you acted in response
• What you did to make yourself feel better
3. Look at how you currently cope with stress- Think about the ways you
currently manage and cope with stress in your life. Your stress journal can
help you identify them. Are your coping strategies healthy or unhealthy,
helpful or unproductive? Unfortunately, many people cope with stress in
ways that compound the problem.
• Unhealthy strategies

1.Smoking
2.Drinking too much
3. Overeating or under eating
4.Zoning out for hours in front of the TV screen
5. Withdrawing from friends, family, and activities
6. Taking out your stress on others (lashing out, angry outbursts, physical violence)
7. Procrastinating
8. Filling up every minute of the day to avoid facing problems
9. Sleeping too much
 Peer group and social support

We all have a good basic idea of what it means to have social support in
one’s life, but when discussing research, it helps to be precise. Social
support, when studied by psychologists, is often defined as “acts that
communicate caring; that validate the other’s words, feelings or actions;
or that facilitate adaptive coping with problems through the provision of
information, assistance, or tangible resources”. There are a few different
types of social support, all of which are beneficial.
• Types of Social Support
1. Emotional Social Support includes affirmations of one’s worth, concern about
one’s feelings, and the sharing of positive regard. This falls along the lines of
listening to and validating feelings, letting others know they are valued, and
offering a shoulder to cry on.
2. Informational Social Support involves the sharing of advice or information
that can help someone who is experiencing a stressor or challenge they don’t
know how to handle. This includes offering advice that people may find useful,
pointing people to experts who may offer advice, and sharing experiences.
3. Tangible Social Support includes sharing resources, either material or financial. Obviously, this
can include providing loans of monetary gifts, but it can also involve offers to share childcare
duties, helping a friend move, or even bringing a casserole to a grieving family.
4. Belonging Social Support involves providing social leisure and belonging. This means
including friends in the group, and spending time with friends who need support and may feel
alone.
5. Venting reduces bad emotions: Many people are too insecure to talk about their problems with
their friends or relatives. Studies found that the more you expose yourself to others and talk
about every detail of your problems the better you will feel. In fact suppressed emotions are
among the popular causes for bad moods and depression. In other words, unless you talk about
your problems and share them with close people you will hardly feel better
6. Planned distraction can lead to finding solutions: your subconscious mind keeps
thinking about your problems even when you don't. Studies have found that you can
find good solutions to tough problems if you stopped thinking about them for a
while. Social support can help you stop thinking about your problems for a while
and as a result you might suddenly find a solution popping up in your mind.
7. Less Stress and reduced depression symptoms: Studies found that people who got
good social support managed to get over depression faster and experienced less
severe symptoms. Stress was also found to be reduced a great deal if good social
support was provided.
8.Less Stress and reduced depression symptoms: Studies found that people who got good social support manged to get
over depression faster and experienced less severe symptoms. Stress was also found to be reduced a great deal if good
social support was provided. One study has found that married men live longer than single ones, researchers then
concluded that the emotional support married men get from their wives helps them have a better health.

9. Intellectual friends and permanent solutions: When we feel bad or down we see the world differently and
our perception of everything changes that's why we might need to let someone other than us suggest solutions to our
problems. Because our bad moods can cloud our thinking process a good friend who feels better can sometimes help us
find the right answer. If you were lucky to have an intelligent friend then he might propose a good solution that can help
you solve your problems.
• Healthy coping strategies include exercise, relaxation techniques, social support, and Cognitive-Behavioral
Therapies (CBT). Exercise has been shown to have numerous health benefits, including stress reduction,
improved mood, and enhanced cognitive function (Sui et al., 2019).
• Relaxation techniques such as deep breathing, meditation, and yoga have also been shown to reduce stress and
improve mental health outcomes (Pascoe et al., 2017).
• Social support, such as emotional and practical support from family and friends, can help individuals cope with
stress (Cohen & Wills, 1985).
• CBT helps individuals recognize and change negative thought patterns and behaviors, improving mental health
outcomes (Hofmann et al., 2012).
• Additional strategies that can improve mental and physical health are getting enough sleep, eating healthily, and
avoiding alcohol (or consuming it in moderation). They do not impact stress directly, but they provide the
scaffolding so individuals are better positioned to cope with stressful experiences effectively.
• Besides these healthy coping strategies, there are several psychological techniques
or mechanisms that individuals can use to manage stress.
• One mechanism is problem-focused coping, which involves addressing the stressor
directly through problem-solving strategies (Lazarus & Folkman, 1984).
• Emotion-focused coping involves managing the emotional response to stress
through strategies such as positive reappraisal or acceptance (Lazarus & Folkman,
1984).
• Meaning-focused coping involves finding meaning or purpose in the stressor or the
experience of coping with it (Park, 2010).
HAPPY LEARNING