negative stress definition essay

• Types Of Stressors (Eustress Vs. Distress)

Types of Stressors (Eustress vs. Distress)

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Eustress vs. Distress

Examples of eustress and distress, work and internal sources of distress, what is positive stress, what is negative stress, what is a stressor how does it impact mental health, coping mechanisms for distress, seeking help for distress.

Stress is an intrinsic and universal aspect of human life, manifesting as the body and mind's natural response to any demand or challenge that disrupts our equilibrium. It's a physiological and psychological reaction that occurs when an individual perceives a situation as threatening or demanding, triggering a wide array of internal processes designed to help the person adapt or cope with the situation. This response includes the release of hormones, such as adrenaline and cortisol, that prepare the body for what is commonly known as the "fight or flight" reaction.

Stress is not inherently negative; it serves an essential function in our survival by enabling us to respond quickly to threats and challenges. However, the nature and impact of stress can vary significantly, depending on its duration, intensity, and the individual's perception and coping abilities.

Understanding stress as a nuanced and multifaceted phenomenon is crucial in discerning its potential effects on our health and well-being, paving the way for effective management strategies that harness the benefits of positive stress while mitigating the adverse effects of negative stress.

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Stress is not always a bad thing . Stress is simply the body's response to changes that create taxing demands. The previously mentioned Dr. Lazarus (building on Dr. Selye's work ) suggested that there is a difference between eustress , which is a term for positive stress , and distress , which refers to negative stress .

In daily life, we often use the term "stress" to describe negative experiences or situations. This leads many people to believe that all stress is bad for you, which is not true.

Eustress , or positive stress response, has the following characteristics:

• Motivates and focuses energy
• Is short-term
• Is perceived as within our coping abilities
• Feels exciting
• Improves performance

As Dr. Brindusa Vanta, MD, says, "Eustress, also known as positive stress, acts as a powerful motivator, driving you to take on challenges. By embracing these stressors, you experience personal growth and resilience and a sense of accomplishment and fulfillment."

In contrast, d istress , or negative stress, has the following characteristics:

• Causes anxiety or concern
• Can be short- or long-term
• Is perceived as outside of our coping abilities
• Feels unpleasant
• Decreases performance
• Can lead to mental and physical problems

It is somewhat hard to categorize stressors into objective lists of those that cause eustress and those that cause distress because different people will have different reactions to particular stressful events and situations. However, by generalizing , we can compile a list of stressors that are typically experienced as negative or positive by most people most of the time. Worried about your mental health? Start with our anxiety test .

Examples of negative personal stressors include:

• The death of a spouse
• Filing for divorce
• Losing contact with loved ones
• The death of a family member
• Hospitalization (of yourself or a family member)
• Injury or illness (of yourself or a family member)
• Being abused or neglected
• Separation from a spouse or committed relationship partner
• Conflict in interpersonal relationships
• Bankruptcy/money problems
• Unemployment
• Sleep problems
• Children's problems at school
• Legal problems

Examples of positive personal stressors include:

• Receiving a promotion or raise at work
• Starting a new job
• Buying a home
• Having a child
• Taking a vacation
• Holiday seasons
• Taking educational classes or learning a new hobby

Work and employment concerns such as those listed below are also frequent causes of distress :

• Excessive job demands
• Job insecurity
• Conflicts with teammates and supervisors
• Inadequate authority necessary to carry out tasks
• Lack of training necessary to do the job
• Making presentations in front of colleagues or clients
• Unproductive and time-consuming meetings
• Commuting and travel schedules

Stressors are not always limited to situations where some external situation is creating a problem . Internal events , such as feelings, thoughts, and habitual behaviors, can also cause negative stress .

Common internally caused sources of distress include:

• Fears (e.g., fears of flying, heights, public speaking, chatting with strangers at a party)
• Repetitive thought patterns
• Worrying about future events (e.g., waiting for medical test results or job restructuring)
• Unrealistic, perfectionist expectations

Habitual behavior patterns that can lead to distress include:

• Overscheduling
• Failing to be assertive
• Procrastinating and/or failing to plan ahead

If you suffer from distress associated with depression or anxiety, you may be looking to different therapies for relief. Ketamine-assisted therapy is a treatment approach that involves the use of the medication ketamine in low doses to help individuals who are struggling with mental health problems, such as depression, anxiety, or post-traumatic stress disorder (PTSD). Ketamine therapy is not indicated for stress but for commonly associated conditions such as depression and anxiety. While more research is needed to fully understand the mechanisms behind how ketamine works to alleviate depression or anxiety, it has shown promise as a treatment option when other therapies do not provide enough symptom relief. Find a  ketamine treatment clinic near you to learn more about the benefits of ketamine therapy .

Positive stress, also known as eustress, is a type of stress that can have a beneficial effect on the body and mind. Unlike other negative types of stress, which can cause anxiety and harm to the body, positive stress comes from facing challenges. It can have positive effects that help motivate and energize a person. Examples of positive stress include starting a new job or project, working toward a goal, or even exercising. When we face these challenges, our bodies release hormones that help us learn, stay motivated, and become excited about the outcome. Eustress can provide many benefits, including increased productivity, better job performance, and improved overall health.

Negative stress, also known as distress, is a feeling of being overwhelmed, anxious, or worried due to challenging situations. It can arise when we feel like we don't have control over the things happening in our lives or when we feel overwhelmed or are facing too much pressure from work, relationships, or other stressors. Negative stress may lead to physical symptoms like headaches, muscle tension, and heart palpitations, as well as mental health problems like anxiety and depression. It's important to identify the sources of these negative feelings and stress and find ways to cope, such as exercising, talking to friends or an online therapist, and practicing relaxation techniques.

A stressor is any event or situation that causes stress. It could be a physical or psychological demand that creates a response in the body, leading to stress. Stressors can be anything from a busy workday to a traumatic event or an ongoing difficult situation in life. People can experience stressors in many different aspects of their lives, and the adverse effects of stressors on individuals can vary based on variables such as their coping mechanisms and resources. Understanding stressors and how we respond to them is important for our overall mental health and well-being. By recognizing stressors, we can find ways to manage them and reduce their negative effects on our body and mind.

Effectively managing distress requires a multifaceted approach that incorporates both self-help strategies and, when necessary, professional support. Understanding and employing various coping mechanisms can significantly improve your ability to navigate stressful situations, reduce the impact of distress, and enhance overall well-being. Here is a brief overview of effective coping strategies.

• Mindfulness and relaxation techniques: Practices such as meditation, deep breathing exercises, and progressive muscle relaxation can help calm the mind and body, reducing immediate feelings of stress and anxiety.
• Physical activity: Regular exercise is a powerful stress reliever. It can enhance your mood, improve sleep, and increase your energy and strength, making you more resilient to stress.
• Healthy lifestyle choices: Maintaining a balanced diet, ensuring adequate sleep, and avoiding excessive alcohol, caffeine, and sugar can help reduce the physical symptoms of distress.
• Time management : Prioritizing tasks, setting realistic goals, and breaking projects into smaller steps can help manage work-related stress and prevent feeling overwhelmed.
• Social support: Connecting with friends, family, or colleagues can provide a sense of belonging, increase your sense of self-worth, and offer an outlet for sharing feelings.
• Hobbies and interests: Engaging in activities you enjoy can be a great way to distract yourself from stressors and channel your energy into positive outlets.

As Dr. Brindusa Vanta, MD, says, "Looking to add meditation to your routine but struggle to find time? Try a smartwatch. It reminds you to set aside 3 minutes daily for meditation sessions. It also tracks exercise, sleep, and diet—all key components of stress management.'

When these self-help strategies are not enough, it may be time to seek professional support. Resources for professional support include:

• Mental health professionals. Psychologists, psychiatrists, and licensed counselors can offer diagnosis and treatment for mental health issues related to distress.
• Primary care providers. Your doctor can assess your symptoms, provide initial treatment, and refer you to a specialist if necessary.
• Employee assistance programs (EAPs). Many organizations offer EAPs that provide confidential access to professional counseling and support services.
• Online therapy platforms. Digital services offer convenient access to licensed therapists through video calls, messaging, or phone, making it easier for people to find help.
• Hotlines and crisis centers. For immediate support, there are various hotlines and crisis centers available that offer confidential advice and assistance from trained volunteers and professionals.

By employing these coping mechanisms and knowing when and where to find professional support, individuals can better manage distress and work toward a more balanced state of well-being.

If you're experiencing distress, recognizing when to seek professional help is crucial for your mental and emotional well-being. While it's normal to feel stressed or anxious at times, certain indicators suggest that professional intervention may be beneficial. These include:

• Persistent feelings of overwhelm that don't improve with self-care
• Difficulty performing daily tasks and responsibilities
• Changes in sleeping or eating patterns
• Withdrawing from social activities and relationships
• Experiencing intense, uncontrollable emotions
• Thoughts of self-harm or harm to others

When these or similar signs persist, it's important to consider seeking professional help. Mental health professionals can offer support and strategies to manage and alleviate distress. 

Additional Stress Articles

• Different Types of Stress 
• Long Term Consequences of Stress
• Effects of Stress on Social Help
• Introduction of Stress
• Methods of Stress Reduction
• Prevention of Management and Stress
• Top 7 Sources of Stress
• Stress Inoculation Therapy 
• Stress Management Techniques

Additional Resources

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• Assertiveness and Interpersonal Boundaries in Stress Reduction
• Cognitive Restructuring
• Developing a Personalized Stress Prevention Plan
• Distraction and Humor in Stress Reduction
• Do Not Wish Your Life Away
• Dysfunctional Beliefs Affecting Stress
• Environmental, Social and Spiritual Strategies for Stress Relief
• Factors Determining Whether Stressors are Experienced as Negative or Positive
• Factors Influencing the Stress Response
• Hypnosis and Autogenic Training for Stress Reduction
• Kinetic (Movement) Strategies for Stress Relief
• Psychological Effects of Stress
• Religious/Spiritual Practice for Stress Reduction
• Selecting Methods and Making a Commitment in Stress Prevention
• Self-Efficacy and the Perception of Control in Stress Reduction
• Social Impact of Stress
• Socialization and Altruistic Acts as Stress Relief
• Step Outside Your Comfort Zone
• Stress and Young Children
• Stress Inoculation Therapy
• Stress Prevention
• Stress Reduction
• Stress Regulation and Withdrawal: Addictions’ Effect on the Hypothalamus
• Students and College, A Stressful Time of Life: Parents and Students Beware
• Symptoms – Acute Stress Disorder
• The Biology of Stress
• The Fours Stages of A Stress Reaction
• The Long-Term Consequences of Negative Stress
• The Vitality of Natural Environments for Stress Reduction
• The Zeigarnik Effect and Completing Everything
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Stress Management: How to Tell the Difference Between Good and Bad Stress

Posted January 18, 2021

Stress is a natural part of our modern lives. Bills come every month, kids’ activities are year-round and work never seems to slow down. A little bit of stress is inevitable, but oftentimes that’s a good thing.

Stress helps you meet your daily challenges and motivates you to reach your goals, ultimately making you a smarter, happier and healthier person. That’s right. Good stress is vital for a healthy life.

Good vs. Bad Stress

You may think any type of stress is bad, but that isn’t the case. Good stress, or eustress, is the type of stress you feel when you’re excited. Your pulse quickens and your hormones surge, but there is no threat or fear.

You might feel this type of stress when you ride a roller coaster, compete in a game, or go on a first date. Good stress is short-term and it inspires and motivates you, focuses your energy and enhances performance.

Bad stress, however, is the kind that wears you out, leaves you jittery and is harmful to your health. Bad stress, or distress, can lead to anxiety, confusion, poor concentration and decreased performance.

Bad stress can be short-term (acute) or long-term (chronic). Acute stress doesn’t take a heavy toll on your body if you can find ways to relax quickly. However, chronic stress, when you repeatedly face stressors, can take a heavy toll on your body and can cause negative health effects. Chronic stress can cause headaches, insomnia, weight gain, anxiety, pain and high blood pressure.

Common chronic stressors include:

• Relationships
• Unmanaged health or mental health problems
• Racial inequities
• Perceived loss

Both good and bad stress result in your body releasing hormones, such as adrenaline and cortisol, that trigger common signs of stress: butterflies in the stomach, racing heart and sweaty palms. Ultimately, what distinguishes good stress from bad is how you react or feel about the experience.

How to Reduce Bad Stress

Stress becomes a problem when it starts to take over your life. The key to stress management is identifying the bad stressors in your life and developing healthy ways to deal with them. Summa Health offers 7 healthy ways to manage your bad stress.

• Eliminate stress where you can. Learning how to say “no” more often, paring down your to-do list and avoiding people who stress you out is a great place to start. Once you learn to manage your time more effectively, your stress level will go down.
• Accept there are events you can’t control. There are things in life beyond your control, such as someone else’s behavior. Instead of stressing about what you can’t control, focus on what you can control and how you react to the problem. That way, you are expending your energy where it can be more effective.
• Think positive thoughts. Negative thoughts can lead to negative behavior, while a positive attitude can help offset difficult situations. Make an effort to think positively by looking for the upside in every situation, whether you learn from your mistakes or use major challenges as a time for personal growth. In addition, thinking about all the things you appreciate in your life, including your own positive qualities, can change your perspective.
• Get support. Confide in family and friends, or turn to someone professional. Expressing how you feel can be cathartic. Also, it’s important to express your feelings, instead of bottling them up because that can add to your stress.
• Add relaxation techniques to your everyday routine. Relaxation promotes overall health and gives you a chance to step away and clear your head. It doesn’t have to be a big time commitment; it can be accomplished with deep breathing exercises, meditation or even yoga.
• Stay healthy and fit. A well-balanced diet and staying active ensures your body is better prepared to fight stress. Exercise relaxes your body and mind, while improving your mood. In fact, physical exercise has been proven to play a key role in preventing and reducing the effects of stress.
• Get a good night’s rest. Getting enough rest is important because it gives your body time to recover from stressful events and sets you up to fight new challenges the next day.

The key is identifying good stress from bad stress. As long as it’s not chronic, stress can be a positive addition to your life. Make an effort to reduce your chronic stress as much as possible, and add positive activities to promote good stress. It creates a healthy balance and a better quality of life.

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• Stress management
• Chronic stress puts your health at risk

Chronic stress can wreak havoc on your mind and body. Take steps to control your stress.

Your body is made to react to stress in ways meant to protect you against threats from predators and other aggressors. Such threats are rare today. But that doesn't mean that life is free of stress.

Instead, you likely face many demands each day. For example, you may take on a huge workload, pay bills or take care of your family. Your body treats these everyday tasks as threats. Because of this, you may feel as if you're always under attack. But you can fight back. You don't have to let stress control your life.

Understanding the natural stress response

When you face a perceived threat, a tiny region at the brain's base, called the hypothalamus, sets off an alarm system in the body. An example of a perceived threat is a large dog barking at you during your morning walk. Through nerve and hormonal signals, this system prompts the adrenal glands, found atop the kidneys, to release a surge of hormones, such as adrenaline and cortisol.

Adrenaline makes the heart beat faster, causes blood pressure to go up and gives you more energy. Cortisol, the primary stress hormone, increases sugar, also called glucose, in the bloodstream, enhances the brain's use of glucose and increases the availability of substances in the body that repair tissues.

Cortisol also slows functions that would be nonessential or harmful in a fight-or-flight situation. It changes immune system responses and suppresses the digestive system, the reproductive system and growth processes. This complex natural alarm system also communicates with the brain regions that control mood, motivation and fear.

When the natural stress response goes wild

The body's stress response system is usually self-limiting. Once a perceived threat has passed, hormones return to typical levels. As adrenaline and cortisol levels drop, your heart rate and blood pressure return to typical levels. Other systems go back to their regular activities.

But when stressors are always present and you always feel under attack, that fight-or-flight reaction stays turned on.

The long-term activation of the stress response system and too much exposure to cortisol and other stress hormones can disrupt almost all the body's processes. This puts you at higher risk of many health problems, including:

• Depression.
• Digestive problems.
• Muscle tension and pain.
• Heart disease, heart attack, high blood pressure and stroke.
• Sleep problems.
• Weight gain.
• Problems with memory and focus.

That's why it's so important to learn healthy ways to cope with your life stressors.

Why you react to life stressors the way you do

Your reaction to a potentially stressful event is different from everyone else's. How you react to your life stressors is affected by such factors as:

• Genetics. The genes that control the stress response keep most people at a fairly steady emotional level, only sometimes priming the body for fight or flight. More active or less active stress responses may stem from slight differences in these genes.
• Life experiences. Strong stress reactions sometimes can be traced to traumatic events. People who were neglected or abused as children tend to be especially at risk of experiencing high stress. The same is true of airplane crash survivors, people in the military, police officers and firefighters, and people who have experienced violent crime.

You may have some friends who seem relaxed about almost everything. And you may have other friends who react strongly to the slightest stress. Most people react to life stressors somewhere between those extremes.

Learning to react to stress in a healthy way

Stressful events are facts of life. And you may not be able to change your current situation. But you can take steps to manage the impact these events have on you.

You can learn to identify what causes you stress. And you can learn how to take care of yourself physically and emotionally in the face of stressful situations.

Try these stress management tips:

• Eat a healthy diet and get regular exercise. Get plenty of sleep too.
• Do relaxation exercises such as yoga, deep breathing, massage or meditation.
• Keep a journal. Write about your thoughts or what you're grateful for in your life.
• Take time for hobbies, such as reading or listening to music. Or watch your favorite show or movie.
• Foster healthy friendships and talk with friends and family.
• Have a sense of humor. Find ways to include humor and laughter in your life, such as watching funny movies or looking at joke websites.
• Volunteer in your community.
• Organize and focus on what you need to get done at home and work and remove tasks that aren't needed.
• Seek professional counseling. A counselor can help you learn specific coping skills to manage stress.

Stay away from unhealthy ways of managing your stress, such as using alcohol, tobacco, drugs or excess food. If you're worried that your use of these products has gone up or changed due to stress, talk to your health care provider.

There are many rewards for learning to manage stress. For example, you can have peace of mind, fewer stressors and less anxiety, a better quality of life, improvement in conditions such as high blood pressure, better self-control and focus, and better relationships. And it might even lead to a longer, healthier life.

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• How stress affects your health. American Psychological Association. https://www.apa.org/topics/stress/health. Accessed March 19, 2021.
• Stress effects on the body. American Psychological Association. https://www.apa.org/topics/stress/body. Accessed March 19, 2021.
• Lower stress: How does stress affect the body? American Heart Association. https://www.heart.org/en/healthy-living/healthy-lifestyle/stress-management/lower-stress-how-does-stress-affect-the-body. Accessed March 18, 2021.
• Stress and your health. U.S. Department of Health & Human Services. https://www.womenshealth.gov/mental-health/good-mental-health/stress-and-your-health. Accessed March 18, 2021.
• AskMayoExpert. Stress management and resiliency (adult). Mayo Clinic. 2019.
• Seaward BL. Essentials of Managing Stress. 5th ed. Jones & Bartlett Learning; 2021.
• Seaward BL. Managing Stress: Skills for Self-Care, Personal Resiliency and Work-Life Balance in a Rapidly Changing World. 10th ed. Jones & Bartlett Learning; 2022.
• Olpin M, et al. Stress Management for Life. 5th ed. Cengage Learning; 2020.
• Hall-Flavin DK (expert opinion). Mayo Clinic. March 23, 2021.

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Reviewed by Psychology Today Staff

Stress generally refers to two things: the psychological perception of pressure, on the one hand, and the body's response to it, on the other, which involves multiple systems, from metabolism to muscles to memory .

Some stress is necessary for all living systems; it is the means by which they encounter and respond to the challenges and uncertainties of existence. The perception of danger sets off an automatic response system, known as the fight-or-flight response, that, activated through hormonal signals, prepares an animal to meet a threat or to flee from it.

• What Causes Stress?
• How to Manage Stress
• How Stress Affects Health

A stressful event—whether it’s the sudden appearance of a snake on the path or the fear of losing your job when the boss yells—triggers a cascade of hormones , including adrenaline and cortisol, that surge through the body.

These hormones increase heartbeat and the circulation of blood to support quick action, mobilize fat and sugar for immediate energy, focus attention to track the danger, prepare muscles for movement, and more.

But this lifesaving response was meant to solve short-term, life-threatening problems, not extended difficulties such as daily traffic jams or marital problems—a few of the many challenges that can hijack the stress response today.

Many people today feel they perpetually struggle with stress and anxiety . Society’s obsession with productivity , the steady stream of digital information we consume, increasingly sedentary lifestyles, and feelings of overwhelm may contribute to the stress that so many are feeling.

Chronic stress can often be difficult to spot , as it can emerge in the absence of a severe or acute incident. Different factors, such as a disrupted sleep schedule, feeling perpetually undervalued at work, and not having close relationships with friends or family members can all independently contribute to chronic stress. 

The signs of stress include insomnia , stomachaches, headaches, muscle tension, a racing heartbeat, and trouble concentrating, among others. Signs of burnout , a concept distinct from stress, include three key markers: emotional exhaustion, cynicism and depersonalization, and reduced personal efficacy.

There are both physical and psychological approaches to blunt stress. Physical steps include meditation , yoga, and exercise. Psychological strategies include leaning on loved ones or in more severe cases seeing a mental health professional.

Since the stress response begins in the brain with the perception of danger or the unknown, researchers now believe that the most basic, and likely most effective, way to diffuse stress is to change the perception of certain situations so that they are not seen as stressful in the first place.

Studies show that helping people see certain experiences—such as final exams—as demanding rather than dire protects them from the corrosive effects of stress while still delivering its positive effects, such as focused attention and speedier information processing. Changing the stress mindset not only minimizes the harms of stress, studies show, but it also enhances performance and productivity.

Plan and organize your time, reflect on your values and strengths, and practice relaxation techniques such as deep breathing. Additionally, reframe negative thoughts about a situation to neutral or positive thoughts so that you can see the full picture. Research shows that these strategies and others can successfully curb stress.

There are both healthy and unhealthy responses to stress. Unhealthy responses can include turning to alcohol , drugs, or gambling. Healthy coping strategies include meditation, exercise, journaling, practicing gratitude , and trying to let go of what is beyond our control.

Instead of fixating on an overwhelming worry or responsibility, be specific about the tasks that need to be completed. Break each one down into small, manageable parts, and then focus on one at a time rather than trying to multitask. These actions and others can help bring work stress under control.

Recognize the symptoms of stress—such as difficulty concentrating, irritability or sadness, and sleep problems—to know when and how to respond. Control what you can, and then try to release the concerns that you cannot control. Additionally, limit news consumption, reach out to loved ones, and practice self-care.

Short bursts of stress aren’t inherently harmful, although it can take time for the body to calm down. Yet prolonged or repeated arousal of the stress response can have harmful physical and psychological consequences. Those repercussions include ailments from heart disease and diabetes to anxiety and depression .

Stress can lead to changes in many different parts of the body. Stress can lead to a faster heartbeat, muscle tension, and gastrointestinal issues. It can lead to heavier and faster breathing, which can strain the lungs, and blunt the immune system’s ability to respond to threats.

Ongoing stress assaults the immune system, making us more vulnerable to disease. Although stress hormones ready the body for emergencies, they also depress the immune system by decreasing inflammation and decreasing white blood cell production. Stress may therefore contribute to illnesses such as heart disease, cancer, and others.

Stress hormones, such as cortisol, are naturally produced every day so that people can take on the challenges ahead. But marinating in high levels of stress hormones over time can prompt the brain to function differently, leading to memory impairment, cognitive problems, anxiety, or depression.

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Stress and Its Effects on Health Essay

Introduction, physical effects, psychological effects, behavioral effects.

Stress is the emotional strain or tension experienced by an individual due to a reaction toward various demanding and influential situations. The challenging or compelling situations are termed stressors. Stressors can be internal or external and include life changes such as losing a significant figure, low socioeconomic status, relationship problems, occupational challenges, and familial or environmental factors. An individual’s response to stressors influences the outcome of their life. Health is a state of complete social, emotional, and physical well-being and not merely the absence of disease. Stress is a common risk factor for negative health status secondary to negative adaptation and coping with the stressors. Stressors can create a strain on one’s physical, psychological and behavioral well-being, leading to lasting effects that are detrimental to one’s health.

Stress is associated with various physical health impacts on an individual. In an online cross-sectional survey by Keech et al. (2020) to determine the association between stress and the physical and psychological health of police officers, the findings illustrate that stress negatively impacts physical and psychological well-being. One hundred and thirty-four police officers were involved in the study (Keech et al., 2020). The findings demonstrate that stress resulted in various short and long-term physical effects that included increased heart rates, sweating, high blood pressure, and long-term development of the cardiac condition. In addition, stress resulted in the development of gastrointestinal disorders such as peptic ulcer and irritable bowel syndrome. Keech et al. (2020) note that stress’s associated physical health effects are explained by various mechanisms that include overstimulation of the sympathetic nervous system and the hypothalamic-pituitary-adrenocortical axis.

Overstimulation of the sympathetic nervous system results in increased sympathetic actions on the peripheral body organs leading to increased sweat production, heart rate, respiration rate, and urinary and bowel elimination. The study notes that chronic stress without positive adaptation measures results in the progressive development of hypertension, peptic ulcers, and irritable bowel syndrome as long-term effects (Keech et al., 2020). Within the gastrointestinal tract, chronic stress activity on the sympathetic nervous system results in increased parietal cell action. Overactivity of the parietal cells results in excessive gastric acid production, gradually eroding the mucosa, and ulceration occurs.

The effects of stress on the cardiovascular system are explained in a review by Kivimäki & Steptoe (2017) to determine the impact of stress on the development and progression of cardiovascular diseases. In the review, stress is identified to cause cardiovascular conditions secondary to the effects of sustained sympathetic action on heart contractility and peripheral vascular resistance (Kivimäki & Steptoe, 2017). The sympathetic nervous system contributes to normal heart and blood vessel contractility. However, when the system is overstimulated, a surge in contractility above the normal limits ensues, leading to the progressive development of heart conditions.

Psychological well-being incorporates a positive mental health status evidenced by an individual’s satisfaction with life, happiness, rational thinking and decision-making, and positive mood patterns. Stress has been associated with alterations in an individual’s psychological wellness. An explanation for alteration in an individual’s psychological well-being secondary to stress is negative adaptation. Keech et al. (2020) note that an individual’s response to a stressor determines whether stress results in positive or negative effects. In the online cross-sectional survey by Keech et al. (2020), the findings illustrate that pressure resulted in the development of anxiety, depression, and bipolar disorders as long-term effects among the participants. Exposure to stressful situations resulted in progressively developing anxiety among the individual secondary to persistent worry over the issue. The anxiety results in other physical manifestations, including increased heart rate, palpitations, sweating, and altered mobility. Depression and bipolar conditions were also associated with chronic stress secondary to the impacts of stress on neurotransmitter function and nerves.

Similar findings are noted in a cross-sectional study by Zhang et al. (2020) to compare the prevalence and severity of stress-associated mental health symptoms, including anxiety, depression, and insomnia among healthcare workers during the COVID pandemic. Five hundred and twenty-four healthcare workers were involved in the study. The study findings illustrate that 31.3% of the participants developed depression secondary to the stressful working environment, 41.2% reported anxiety, and 39.3% reported sleep disturbances (Zhang et al., 2020). The scientific explanation for the relationship between stress and depression was attributed to the effects of stressful periods on neurotransmitter homeostasis. Chronic stress results in the altered regulation of neurotransmitters in the central nervous system. Alterations in serotonin, norepinephrine, and dopamine resulted in the progressive development of depression and anxiety. Sleep disturbances reported by the participants are attributed to alterations in cortisol hormone homeostasis secondary to overstimulation of the hypothalamic-pituitary-adrenocortical axis.

Stressful situations can also lead to alterations in the behavioral patterns of an individual. The most common behavioral effects secondary to stress include the development of eating disorders, altered sleeping patterns, impaired concentration, and drug abuse especially alcohol. Alterations in sleep and eating patterns are linked to stress’s effects on the hypothalamic-pituitary-adrenocortical axis (HPA). Exposure to stressful events leads to increased activation of the HPA axis with a net effect of increased catecholamine production (adrenaline and noradrenaline) (Moustafa et al., 2018). Increased adrenaline and noradrenaline production results in dysregulation in the eating and sleeping patterns. Sustained high levels of cortisol results in difficulty falling asleep and increased metabolic processes. The biological clock regulates the typical sleeping pattern that relies on producing the sleep hormone melatonin. Melatonin production by the pineal gland is regulated indirectly by the concentration of serum cortisol levels and directly by light perception. Imbalances in the serum concentration cycle secondary to stress results in imbalanced melatonin production and concentration with a net effect of sleeping difficulties.

The emotional strain caused by stress increases the risk of alcohol and other illicit drug use and dependence. Moustafa et al. (2018) conducted an integrative literature review to determine the relationship between childhood trauma, early-life stress, alcohol and drug use, addiction, and abuse. The review findings illustrate that stress increases the risk of alcohol and drug use, addiction, and abuse among the victims. An explanation for the increased risk is the individuals’ lack of identification and implementation of effective coping strategies (Moustafa et al., 2018). Lack of effective coping strategies results in maladaptive measures such as illicit drug use and alcohol consumption. Extensive use of the maladaptive measures results in progressive addiction and drug abuse among individuals with an increased predisposition to other health effects. Alcohol consumption and other illicit drug use over time increase the risk of developing cardiac, respiratory, and liver conditions.

Stress is the emotional strain or tension experienced by an individual due to a reaction toward various demanding and influential situations. Individual response to stressors influences their health. Maladaptive response to stress results in various physical, psychological, and behavioral negative effects. Negative effects of stress on physical health include increased heart rates, sweating, high blood pressure, and long-term development of the cardiac condition. Psychological effects include the development of anxiety, depression, and bipolar disorders. The behavioral effects of stress on an individual include the development of eating disorders, altered sleeping patterns, impaired concentration, and abuse of alcohol and other drugs. Based on the research findings, it is essential for healthcare providers to identify strategic measures and health initiatives to educate and sensitize the community members on effective stress management approaches in all settings to aid in combating the health effects.

Keech, J. J., Cole, K. L., Hagger, M. S., & Hamilton, K. (2020). The association between stress mindset and physical and psychological well being: Testing a stress beliefs model in police officers . Psychology & Health , 35 (11), 1306-1325. Web.

Kivimäki, M., & Steptoe, A. (2017). Effects of stress on the development and progression of cardiovascular disease . Nature Reviews Cardiology , 15 (4), 215–229. Web.

Moustafa, A. A., Parkes, D., Fitzgerald, L., Underhill, D., Garami, J., Levy-Gigi, E., Stramecki, F., Valikhani, A., Frydecka, D., & Misiak, B. (2018). The relationship between childhood trauma, early-life stress, and alcohol and drug use, abuse, and addiction: An integrative review . Current Psychology , 40 (2), 579–584. Web.

Zhang, X., Zhao, K., Zhang, G., Feng, R., Chen, J., Xu, D., Liu, X., Ngoubene-Italy, A. J., Huang, H., Liu, Y., Chen, L., & Wang, W. (2020). Occupational Stress and Mental Health: A comparison between frontline medical staff and non-frontline medical staff during the 2019 novel Coronavirus Disease outbreak . Frontiers in Psychiatry , 11 . Web.

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Symptoms of Chronic Stress and Treatments

• Biology of Stress
• Complications

Chronic stress is feeling pressured and overwhelmed over a long period. While occasional stress can provide you with the energy and focus needed to achieve more, ongoing stress can be detrimental to your health. This is because being stressed triggers the release of hormones called cortisol and adrenaline (epinephrine) that alter the way your brain and body function.

Among other things, chronic stress has damaging effects on your blood vessels, increasing the risk of high blood pressure and heart disease It can also affect moods and sexual function while increasing the risk of stomach ulcers and upper respiratory infections.

This article describes the symptoms, causes, and complications of chronic stress. It also looks at how chronic stress is diagnosed and treated and what can be done to prevent it.

Luis Alvarez / Getty Images

The Biology of Stress

Stress is the body's natural response to physical and psychological challenges or threats. It is part of a survival mechanism known as the "fight or flight" response in which hormones are released to provide the body with the energy and resources needed to either face the threat or flee it.

The release of these "stress hormones"—called cortisol and adrenaline —triggers physiological changes to address the real or perceived threat.

When the flight-or-fight response is triggered: .

• The heart beats faster to increase blood flow.
• Breathing quickens and deepens to increase blood oxygen levels.
• Blood vessels constrict (narrow) to reroute blood flow to the muscles.
• Glucose (blood sugar) is released from the liver to fuel muscles.
• Pupils dilate (widen) so that you can see better in the dark.
• Digestion slows to redirect energy resources to the muscles.
• Your body breaks into a sweat to keep it from overheating.

When the threat is over, the body will return to its natural balanced state. Stress under these circumstances is known as acute stress .

What Is Chronic Stress?

While stress is generally acute, rising and falling in response to stressors, there are times when the body will react as if the threat is ever-present. This is chronic stress.

With chronic stress, the persistent elevation of stress hormones throws the body off its natural balanced state. Over time, this can affect the body in adverse ways:

• The persistent constriction of blood vessels can cause them to narrow and harden. The increased blood pressure can start to affect the kidneys and liver as well.
• Persistently high glucose levels reduce the body's sensitivity to insulin (the hormone that regulates glucose), making blood sugar harder to control.
• Because you burn more energy with stress, your appetite for food (including sweet, fatty, and salty foods) increases, leading to weight gain.
• Changes in the gastrointestinal system can lead to digestive problems and injury.
• The inflammatory effects of stress hormones can start to affect the brain, moods, and thinking.
• The persistent activation of the immune response can cause it to weaken over time, leading to immune "fatigue." This lowers the body's ability to fight infection, particularly viral infections.

How Common Is Chronic Stress?

According to the American Institute of Stress, 55% of people in the United States experience daily stress. Chronic stress is especially common in workplaces, with 94% of employees reporting work-related stress. Of these, 63% report wanting to quit their jobs because of stress.

Types of Chronic Stress

By definition, stress is chronic when it persists for weeks or months. The stress may be psycholological (related to the mind), physiological (related to the body), or both. Oftentimes, physiological stress (such as managing a severe illness) can lead to psychological stress.

Examples of psychological and physiological stressors associated with chronic stress include:

Being overworked

• Financial hardship

Living in a noisy or chaotic environment

Relationship problems

Death of a loved one

Major changes in life (including a new job, home, or baby)

Marriage or divorce

Lack of work/life balance

Anxiety or anxiety disorders

A major illness, like cancer

A chronic illness, including chronic pain

Malnutrition

General poor health status

Substance use, including alcohol abuse

Heavy manual labor

Working in pollution, including industrial pollutants

Frequent long-distant air travel

Causes of Chronic Stress

Chronic stress does not affect all people equally. Certain social and psychological factors can predispose you to chronic stress, including:

• Racism and discrimination
• Living with a chronic illness
• Lack of access to healthcare
• Childhood abuse or trauma
• Being a caregiver
• Living with depression
• Living in a stressful or unsafe environment
• Socially isolation
• Alcohol or substance abuse

Symptoms of Chronic Stress

Over the short term, chronic stress can induce many of the same symptoms of acute stress, albeit for longer periods. These include:

• Increased heart rate
• Muscle tension
• Agitation or edginess
• Stomach upset or queasiness

But what makes chronic stress distinct is that its symptoms are the result of prolonged exposure to cortisol and adrenaline. Over time, this can cause damage to organ systems, both directly and indirectly, leading to a cascade of possible symptoms, such as:

• Tension headaches
• Chest pains
• Heart palpitations
• Ringing in the ears
• Muscle spasms
• Abdominal cramps
• Back or shoulder pain
• Nausea or vomiting
• Constipation
• Shortness of breath
• Prickly fingers and toes
• Stress eating and weight gain
• Sleep problems
• Forgetfulness
• Loss of concentration
• Loss of sex drive

Complications of Chronic Stress

Left unchecked, chronic stress can start to impact multiple organ systems, including the brain, cardiovascular system, reproductive tract, and digestive tract.

Possible complications of chronic stress include:

• Irregular periods
• Erectile dysfunction
• Hypertension (high blood pressure)
• Atherosclerosis   (hardening of arteries)
• Coronary artery disease  
• Increased risk of heart attack or stroke
• Increased risk of upper respiratory infection
• Type 2 diabetes
• Metabolic syndrome
• Stomach ulcers

How Stress Causes Ulcers

The relationship between stress and stomach ulcers is strong. Chronic stress increases the secretion of stomach acids, in part because the normal balance of the digestive tract has been disrupted. High stomach acids, in turn, contribute to the formation of stomach ulcers.

The risk is further increased if you take nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin, Advil (ibuprofen), or Aleve (naproxen), perhaps to manage stress-related headaches or symptoms like muscle pain. These drugs can promote ulcers and bleeding.

Diagnosing Chronic Stress

Chronic stress is not diagnosed in the same way as high blood pressure or anxiety. It is a characteristic used to describe a primary or contributing factor of a stress-related condition, like high blood pressure.

As such, chronic stress may be described if an evaluation by a healthcare provider reveals physical symptoms like high blood pressure, muscle pain, heart palpitations, and tension headaches accompanied by:

• A lack of mental and physical energy
• Impaired concentration and memory
• Rapid, exaggerated changes in mood

The healthcare provider may order tests to exclude other possible causes of your symptoms such as Cushing's syndrome , a rare disorder caused by the chronic elevation of cortisol.

How Is Chronic Stress Treated?

The approach to stress management is often multifaceted, including lifestyle changes, social support efforts, mindfulness, and seeking professional help.

Some lifestyle changes you can make to help combat stress include:

• Eating a variety of nutritious foods regularly
• Being physically active
• Getting enough good quality sleep

Social Support

Social support efforts that can help combat stress include:

• Spending time with friends and family
• Engaging in physical affection with loved ones or pets
• Joining a support group online or in-person
• Getting involved in the community by taking classes, volunteering, or joining clubs

Though it's easier said than done, relaxing can reduce stress. Some relaxation techniques include:

• Mind-body approaches such as mindfulness, deep breathing , guided imagery, muscle relaxation , meditation , or yoga
• Being creative or engaging in activities you enjoy, such as music, dance, reading, writing, crafting, or gardening
• Letting out your emotions by laughing or crying

Other Practical Ways to Reduce Stress

Getting practical about how your lifestyle influences your stress levels can help. Ways to do this include:

• Identify your stressors
• Look for solutions
• Make a plan in advance for how to manage stress when it arises

Professional Help

Chronic stress can't always be effectively managed on your own. A mental health professional can help you with strategies through:

• Cognitive behavioral therapy (CBT)
• Psychodynamic psychotherapy
• Mindfulness-based stress reduction

Depending on symptoms, antidepressant or anti-anxiety medication may also be prescribed. Discuss medication options with your healthcare provider if you think they could benefit your stress management plan.

Stress can be acute, chronic, or episodic. In the short term, stress is beneficial, allowing us to react to threatening situations and build resiliency. Chronic stress, however, is not helpful and can cause health concerns such as mental health conditions, gastrointestinal discomfort, and sleep difficulties. It is also associated with several health conditions, including heart disease and diabetes.

Approaches to chronic stress management include lifestyle practices, relaxation techniques, and social support. Some people may also find it helpful to see a healthcare provider or mental health professional.

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Harvard Health. Six relaxation techniques to reduce stress .

By Heather Jones Jones is a freelance writer with a strong focus on health, parenting, disability, and feminism.

Psychology Discussion

Essay on stress: it’s meaning, effects and coping with stress.

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Essay on Stress: It’s Meaning, Effects and Coping with Stress!

Stress is a very common problem being faced today. Every individual will experience stress in one or the other time.

The term stress has many definitions, Lazarus and Folkman (1984) have defined stress as “an internal state which can be caused by physical demands of body or by environmental and social situations, which are evaluated as potentially harmful, uncontrollable, or exceeding our resources for coping”.

According to David Fontana “stress is a demand made upon the adaptive capacities of the mind and body”.

These definitions indicate that stress represents those conditions under which individuals have demand made upon them, that they cannot physically or psychologically meet, leading to breakdown at one or other of these levels.

Stress is usually thought of in negative terms. But ii can manifest itself in both positive and negative way. It is said to be positive when the situation offers an opportunity for one, to gain something.

Eustress (the Greek word ‘eu’ means good) is the term used to describe positive stress. It is often viewed as motivator, since in its absence the individual lacks the spirit necessary for peak performance. Distress is the term used to indicate negative stress.

Almost any change in the environment- even a pleasant change such as a joyful trip- demands some coping, and a little stress is useful in helping us to adapt. But beyond some point, stress becomes a ‘distress’.

What acts to produce distress varies from person to person, but some events seem to be stressors for every person.

Examples of stressors are:

1. Injury or infections of the body, dangers in environment, major changes or transitions in life which force us to cope in new ways.

2. Physical stressors like noise, pollutions, climatic changes, etc.

3. Hustles of everyday life centering on work, family, social activities, health and finances.

4. Frustrations and conflicts.

The physical, environmental and social causes of the stress state are termed stressors. Once induced by stressors the internal stress state can then lead to various responses. On the other hand, psychological responses such as anxiety, hopelessness, depression, irritability, and a general feeling of not being able to cope with the world, can result from the stress state.

Stress cycles:

Stress has a number of immediate effects. If the stressors are maintained, long-term behavioural, physiological, emotional and cognitive effects occur. If these effects hinder adaptation to the environment or create discomfort and distress, they themselves become stressors and, tend to perpetuate a ‘cycle’ of distress.

Example, a patient spends more money on treatment, may experience continued stress even after the cure of the disease, because repayment of debt cause stress for long time in him or a patient whose leg is amputated after accident may continue to worry about it.

On the other hand, many people have developed ways of coping with stressors, so that they are able to respond adaptively. This is the ‘wellness cycle’. Teaching people adaptive ways of handling stress, so as to promote the wellness cycle is an important part of the newly emerging field of behavioural medicine.

Effects of stress:

Stress is not always harmful. In fact, it is recognised that low levels of stress can even helps for better performance. For example, a student can prepare well for forthcoming examination only if he has some stress. However, excess level of stress is undoubtedly harmful.

The effects of stress are divided into three categories:

a. Physiological effects:

Commonly appearing stress related bodily disorders are-peptic ulcers, hypertension, chronic fatigue, hormonal changes, increased heart rate, difficulty in breathing, numbness of limbs, heart disease and reduction in immunity, etc.

b. Psychological effects:

Anxiety, depression, hopelessness, helplessness, anger, nervousness, irritability, tension and boredom may be experienced.

c. Behavioural changes:

Decreasing efficiency, making mistakes, inability to take decisions, under eating or overeating, sleeplessness, increased smoking, develop addiction to alcohol and drugs, forgetfulness, hypersensitivity or passiveness, accident proneness and interpersonal difficulties are seen.

Stress is linked to disorders such as cancer and heart disorders. There are several mediating variables that determine whether stress becomes dangerous or not. For example, good coping mechanisms which can help to reduce stress, having good social support, often help in reducing stress.

Perception of stress or how a person views stress is also very important. For example, a person may not perceive a situation as stressful whereas the same situation may be perceived as highly stressful by some other person.

People with personality type ‘A’ are more prone to be affected by stress related disorders like cardiovascular diseases. Personality character like hardiness or emotional stability helps to withstand effects of stress.

Hans Selye, a renowned biological scientist defines stress as the nonspecific response of the body to any demand upon it. He termed the body’s response to stressors the “General Adaptation Syndrome” (GAS).

The GAS consists of 3 stages:

1. Alarm reaction:

It is an emergency response of the body. In this stage prompt responses of the body, many of them mediated by the sympathetic nervous system, prepare us to cope with the stressor here and now.

2. Stage of resistance:

If the stressor continues to be present, the stage of resistance begins, wherein the body resists the effects of the continuous stressor. During this stage certain hormonal responses of the body are an important line of defence in resisting the effects of stressors (For example, release of ACTH).

3. Stage of exhaustion:

In this stage, the body’s capacity to respond to both continuous and new stressors has been seriously compromised. The person will no longer be able to face stressor and he will finally succumb to it. The person may develop psychosomatic illness.

The stress leads to many psychosomatic diseases. Treatment for such diseases involves medical help for the physical problems and, at the same time, attention to the psychological factors producing the stress.

Coping with Stress :

There are different ways of coping with stress such as: confronting (facing), distancing (remoteness), self-control, seeking social support, accepting responsibility, escape or avoid (from the stressor), plan a problem solving strategy and positive reappraisal.

Usually two broad type of coping types are seen- Instrumental coping and Emotional coping.

In instrumental coping, a person focuses on the problem and tries to solve it. In emotional coping, the focus is more on the feelings generated by the problem.

Today, self- help remedies, Do to yourself approaches, weight loss clinics and diets, health foods and physical exercise are being given much attention in mass media. People are actually taking more responsibility to maintain good health.

However, some specific techniques to eliminate or to manage more effectively the inevitable, prolonged stress are as follows:

Good physical exercise like walking, jogging, swimming, riding bicycle, playing soft ball, tennis are necessary to cope with stress.

Relaxation:

Whether a person simply takes it easy once in a while or uses specific relaxation techniques such as bio-feedback, or meditation, the intent is to eliminate the immediately stressful situation or manage a prolonged stressful situation more effectively.

Taking it easy may mean curling up with a good book on an easy chair or watching some light programme on television or listening to a light music. Meditation is scientifically proved to be very useful, both physically and mentally to cope with stress.

Behavioural self-control:

By deliberately managing the antecedents and the consequence of their own behaviour, people can achieve self-control. Besides managing their own behaviour to reduce stress, people can also become more aware of their limits and of ‘red flags’ that signal trouble ahead. They can avoid people or situations that they know will put them under stress.

Maladaptive strategies, rigid strategies or relying on one type of coping method lead to increase in the stress. Social support helps reduce the effect of stress. People may provide help, advice, material support or moral support that helps to reduce stress.

In addition to the above, psychotherapy (Beck’s cognitive therapy, Ellis’s rational emotive therapy and Meichenbaum’s stress- inoculation training), skill training, environmental changes, Bio-feedback (control of physical signs such as Blood pressure, headache, etc), family therapy, group therapy, hypnosis, yoga, are found to be very useful. Finally, uses of drugs are some of the other strategies adopted in coping with stress.

Related Articles:

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• Stress: Meaning, Causes and Suggestions to Manage It
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Writing Anxiety

What this handout is about.

This handout discusses the situational nature of writer’s block and other writing anxiety and suggests things you can try to feel more confident and optimistic about yourself as a writer.

What are writing anxiety and writer’s block?

“Writing anxiety” and “writer’s block” are informal terms for a wide variety of apprehensive and pessimistic feelings about writing. These feelings may not be pervasive in a person’s writing life. For example, you might feel perfectly fine writing a biology lab report but apprehensive about writing a paper on a novel. You may confidently tackle a paper about the sociology of gender but delete and start over twenty times when composing an email to a cute classmate to suggest a coffee date. In other words, writing anxiety and writers’ block are situational (Hjortshoj 7). These terms do NOT describe psychological attributes. People aren’t born anxious writers; rather, they become anxious or blocked through negative or difficult experiences with writing.

When do these negative feelings arise?

Although there is a great deal of variation among individuals, there are also some common experiences that writers in general find stressful.

For example, you may struggle when you are:

• adjusting to a new form of writing—for example, first year college writing, papers in a new field of study, or longer forms than you are used to (a long research paper, a senior thesis, a master’s thesis, a dissertation) (Hjortshoj 56-76).
• writing for a reader or readers who have been overly critical or demanding in the past.
• remembering negative criticism received in the past—even if the reader who criticized your work won’t be reading your writing this time.
• working with limited time or with a lot of unstructured time.
• responding to an assignment that seems unrelated to academic or life goals.
• dealing with troubling events outside of school.

What are some strategies for handling these feelings?

Get support.

Choose a writing buddy, someone you trust to encourage you in your writing life. Your writing buddy might be a friend or family member, a classmate, a teacher, a colleague, or a Writing Center tutor. Talk to your writing buddy about your ideas, your writing process, your worries, and your successes. Share pieces of your writing. Make checking in with your writing buddy a regular part of your schedule. When you share pieces of writing with your buddy, use our handout on asking for feedback .

In his book Understanding Writing Blocks, Keith Hjortshoj describes how isolation can harm writers, particularly students who are working on long projects not connected with coursework (134-135). He suggests that in addition to connecting with supportive individuals, such students can benefit from forming or joining a writing group, which functions in much the same way as a writing buddy. A group can provide readers, deadlines, support, praise, and constructive criticism. For help starting one, see our handout about writing groups .

Identify your strengths

Often, writers who are experiencing block or anxiety have a worse opinion of their own writing than anyone else! Make a list of the things you do well. You might ask a friend or colleague to help you generate such a list. Here are some possibilities to get you started:

• I explain things well to people.
• I get people’s interest.
• I have strong opinions.
• I listen well.
• I am critical of what I read.
• I see connections.

Choose at least one strength as your starting point. Instead of saying “I can’t write,” say “I am a writer who can …”

Recognize that writing is a complex process

Writing is an attempt to fix meaning on the page, but you know, and your readers know, that there is always more to be said on a topic. The best writers can do is to contribute what they know and feel about a topic at a particular point in time.

Writers often seek “flow,” which usually entails some sort of breakthrough followed by a beautifully coherent outpouring of knowledge. Flow is both a possibility—most people experience it at some point in their writing lives—and a myth. Inevitably, if you write over a long period of time and for many different situations, you will encounter obstacles. As Hjortshoj explains, obstacles are particularly common during times of transition—transitions to new writing roles or to new kinds of writing.

Think of yourself as an apprentice.

If block or apprehension is new for you, take time to understand the situations you are writing in. In particular, try to figure out what has changed in your writing life. Here are some possibilities:

• You are writing in a new format.
• You are writing longer papers than before.
• You are writing for new audiences.
• You are writing about new subject matter.
• You are turning in writing from different stages of the writing process—for example, planning stages or early drafts.

It makes sense to have trouble when dealing with a situation for the first time. It’s also likely that when you confront these new situations, you will learn and grow. Writing in new situations can be rewarding. Not every format or audience will be right for you, but you won’t know which ones might be right until you try them. Think of new writing situations as apprenticeships. When you’re doing a new kind of writing, learn as much as you can about it, gain as many skills in that area as you can, and when you finish the apprenticeship, decide which of the skills you learned will serve you well later on. You might be surprised.

Below are some suggestions for how to learn about new kinds of writing:

• Ask a lot of questions of people who are more experienced with this kind of writing. Here are some of the questions you might ask: What’s the purpose of this kind of writing? Who’s the audience? What are the most important elements to include? What’s not as important? How do you get started? How do you know when what you’ve written is good enough? How did you learn to write this way?
• Ask a lot of questions of the person who assigned you a piece of writing. If you have a paper, the best place to start is with the written assignment itself. For help with this, see our handout on understanding assignments .
• Look for examples of this kind of writing. (You can ask your instructor for a recommended example). Look, especially, for variation. There are often many different ways to write within a particular form. Look for ways that feel familiar to you, approaches that you like. You might want to look for published models or, if this seems too intimidating, look at your classmates’ writing. In either case, ask yourself questions about what these writers are doing, and take notes. How does the writer begin and end? In what order does the writer tell things? How and when does the writer convey her or his main point? How does the writer bring in other people’s ideas? What is the writer’s purpose? How is that purpose achieved?
• Read our handouts about how to write in specific fields or how to handle specific writing assignments.
• Listen critically to your readers. Before you dismiss or wholeheartedly accept what they say, try to understand them. If a reader has given you written comments, ask yourself questions to figure out the reader’s experience of your paper: What is this reader looking for? What am I doing that satisfies this reader? In what ways is this reader still unsatisfied? If you can’t answer these questions from the reader’s comments, then talk to the reader, or ask someone else to help you interpret the comments.
• Most importantly, don’t try to do everything at once. Start with reasonable expectations. You can’t write like an expert your first time out. Nobody does! Use the criticism you get.

Once you understand what readers want, you are in a better position to decide what to do with their criticisms. There are two extreme possibilities—dismissing the criticisms and accepting them all—but there is also a lot of middle ground. Figure out which criticisms are consistent with your own purposes, and do the hard work of engaging with them. Again, don’t expect an overnight turn-around; recognize that changing writing habits is a process and that papers are steps in the process.

Chances are that at some point in your writing life you will encounter readers who seem to dislike, disagree with, or miss the point of your work. Figuring out what to do with criticism from such readers is an important part of a writer’s growth.

Try new tactics when you get stuck

Often, writing blocks occur at particular stages of the writing process. The writing process is cyclical and variable. For different writers, the process may include reading, brainstorming, drafting, getting feedback, revising, and editing. These stages do not always happen in this order, and once a writer has been through a particular stage, chances are she or he hasn’t seen the last of that stage. For example, brainstorming may occur all along the way.

Figure out what your writing process looks like and whether there’s a particular stage where you tend to get stuck. Perhaps you love researching and taking notes on what you read, and you have a hard time moving from that work to getting started on your own first draft. Or once you have a draft, it seems set in stone and even though readers are asking you questions and making suggestions, you don’t know how to go back in and change it. Or just the opposite may be true; you revise and revise and don’t want to let the paper go.

Wherever you have trouble, take a longer look at what you do and what you might try. Sometimes what you do is working for you; it’s just a slow and difficult process. Other times, what you do may not be working; these are the times when you can look around for other approaches to try:

• Talk to your writing buddy and to other colleagues about what they do at the particular stage that gets you stuck.
• Read about possible new approaches in our handouts on brainstorming and revising .
• Try thinking of yourself as an apprentice to a stage of the writing process and give different strategies a shot.
• Cut your paper into pieces and tape them to the wall, use eight different colors of highlighters, draw a picture of your paper, read your paper out loud in the voice of your favorite movie star….

Okay, we’re kind of kidding with some of those last few suggestions, but there is no limit to what you can try (for some fun writing strategies, check out our online animated demos ). When it comes to conquering a block, give yourself permission to fall flat on your face. Trying and failing will you help you arrive at the thing that works for you.

Celebrate your successes

Start storing up positive experiences with writing. Whatever obstacles you’ve faced, celebrate the occasions when you overcome them. This could be something as simple as getting started, sharing your work with someone besides a teacher, revising a paper for the first time, trying out a new brainstorming strategy, or turning in a paper that has been particularly challenging for you. You define what a success is for you. Keep a log or journal of your writing successes and breakthroughs, how you did it, how you felt. This log can serve as a boost later in your writing life when you face new challenges.

Wait a minute, didn’t we already say that? Yes. It’s worth repeating. Most people find relief for various kinds of anxieties by getting support from others. Sometimes the best person to help you through a spell of worry is someone who’s done that for you before—a family member, a friend, a mentor. Maybe you don’t even need to talk with this person about writing; maybe you just need to be reminded to believe in yourself, that you can do it.

If you don’t know anyone on campus yet whom you have this kind of relationship with, reach out to someone who seems like they could be a good listener and supportive. There are a number of professional resources for you on campus, people you can talk through your ideas or your worries with. A great place to start is the UNC Writing Center. If you know you have a problem with writing anxiety, make an appointment well before the paper is due. You can come to the Writing Center with a draft or even before you’ve started writing. You can also approach your instructor with questions about your writing assignment. If you’re an undergraduate, your academic advisor and your residence hall advisor are other possible resources. Counselors at Counseling and Wellness Services are also available to talk with you about anxieties and concerns that extend beyond writing.

Apprehension about writing is a common condition on college campuses. Because writing is the most common means of sharing our knowledge, we put a lot of pressure on ourselves when we write. This handout has given some suggestions for how to relieve that pressure. Talk with others; realize we’re all learning; take an occasional risk; turn to the people who believe in you. Counter negative experiences by actively creating positive ones.

Even after you have tried all of these strategies and read every Writing Center handout, invariably you will still have negative experiences in your writing life. When you get a paper back with a bad grade on it or when you get a rejection letter from a journal, fend off the negative aspects of that experience. Try not to let them sink in; try not to let your disappointment fester. Instead, jump right back in to some area of the writing process: choose one suggestion the evaluator has made and work on it, or read and discuss the paper with a friend or colleague, or do some writing or revising—on this or any paper—as quickly as possible.

Failures of various kinds are an inevitable part of the writing process. Without them, it would be difficult if not impossible to grow as a writer. Learning often occurs in the wake of a startling event, something that stirs you up, something that makes you wonder. Use your failures to keep moving.

Works consulted

We consulted these works while writing this handout. This is not a comprehensive list of resources on the handout’s topic, and we encourage you to do your own research to find additional publications. Please do not use this list as a model for the format of your own reference list, as it may not match the citation style you are using. For guidance on formatting citations, please see the UNC Libraries citation tutorial . We revise these tips periodically and welcome feedback.

Hjortshoj, Keith. 2001. Understanding Writing Blocks . New York: Oxford University Press.

This is a particularly excellent resource for advanced undergraduates and graduate students. Hjortshoj writes about his experiences working with university students experiencing block. He explains the transitional nature of most writing blocks and the importance of finding support from others when working on long projects.

Rose, Mike. 1985. When a Writer Can’t Write: Studies in Writer’s Block and Other Composing-Process Problems . New York: Guilford.

This collection of empirical studies is written primarily for writing teachers, researchers, and tutors. Studies focus on writers of various ages, including young children, high school students, and college students.

You may reproduce it for non-commercial use if you use the entire handout and attribute the source: The Writing Center, University of North Carolina at Chapel Hill

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The impact of stress on body function: A review

Habib yaribeygi.

1 Neurosciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran

Yunes Panahi

2 Clinical Pharmacy Department, Faculty of Pharmacy, Baqiyatallah University of Medical Sciences, Tehran, Iran

Hedayat Sahraei

Thomas p. johnston.

3 Division of Pharmaceutical Sciences, School of Pharmacy, University of Missouri-Kansas City, Kansas City, Missouri, USA

Amirhossein Sahebkar

4 Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

Any intrinsic or extrinsic stimulus that evokes a biological response is known as stress. The compensatory responses to these stresses are known as stress responses. Based on the type, timing and severity of the applied stimulus, stress can exert various actions on the body ranging from alterations in homeostasis to life-threatening effects and death. In many cases, the pathophysiological complications of disease arise from stress and the subjects exposed to stress, e.g. those that work or live in stressful environments, have a higher likelihood of many disorders. Stress can be either a triggering or aggravating factor for many diseases and pathological conditions. In this study, we have reviewed some of the major effects of stress on the primary physiological systems of humans.

Abbreviations

ACTH: Adrenocorticotropic hormone

CNS: Central nervous system

CRH: Corticotropin releasing hormone

GI: Gastrointestinal

LTP: Long-term potentiation

NMDA : N-methyl-D-aspartate

VTA: Ventral tegmental area

Stress and the Brain Function Complications

For a long time, researchers suggested that hormones have receptors just in the peripheral tissues and do not gain access to the central nervous system (CNS) (Lupien and Lepage, 2001[ 63 ]). However, observations have demonstrated the effect of anti-inflammatory drugs (which are considered synthetic hormones) on behavioral and cognitive disorders and the phenomenon called “Steroid psychosis” (Clark et al., 1952[ 16 ]). In the early sixties, neuropeptides were recognized as compounds devoid of effects on the peripheral endocrine system. However, it was determined that hormones are able to elicit biological effects on different parts of the CNS and play an important role in behavior and cognition (De Kloet, 2000[ 22 ]). In 1968, McEven suggested for the first time that the brain of rodents is capable of responding to glucocorticoid (as one of the operators in the stress cascade). This hypothesis that stress can cause functional changes in the CNS was then accepted (McEwen et al., 1968[ 74 ]). From that time on, two types of corticotropic receptors (glucocorticosteroids and mineralocorticoids) were recognized (de Kloet et al., 1999[ 23 ]). It was determined that the affinity of glucocorticosteroid receptors to cortisol and corticosterone was about one tenth of that of mineralocorticoids (de Kloet et al., 1999[ 23 ]). The hippocampus area has both types of receptors, while other points of the brain have only glucocorticosteroid receptors (de Kloet et al., 1999[ 23 ]).

The effects of stress on the nervous system have been investigated for 50 years (Thierry et al., 1968[ 115 ]). Some studies have shown that stress has many effects on the human nervous system and can cause structural changes in different parts of the brain (Lupien et al., 2009[ 65 ]). Chronic stress can lead to atrophy of the brain mass and decrease its weight (Sarahian et al., 2014[ 100 ]). These structural changes bring about differences in the response to stress, cognition and memory (Lupien et al., 2009[ 65 ]). Of course, the amount and intensity of the changes are different according to the stress level and the duration of stress (Lupien et al., 2009[ 65 ]). However, it is now obvious that stress can cause structural changes in the brain with long-term effects on the nervous system (Reznikov et al., 2007[ 89 ]). Thus, it is highly essential to investigate the effects of stress on different aspects of the nervous system (Table 1 (Tab. 1) ; References in Table 1: Lupien et al., 2001[ 63 ]; Woolley et al., 1990[ 122 ]; Sapolsky et al., 1990[ 99 ]; Gould et al., 1998[ 35 ]; Bremner, 1999[ 10 ]; Seeman et al., 1997[ 108 ]; Luine et al., 1994[ 62 ]; Li et al., 2008[ 60 ]; Scholey et al., 2014[ 101 ]; Borcel et al., 2008[ 9 ]; Lupien et al., 2002[ 66 ]).

Stress and Memory

Memory is one of the important functional aspects of the CNS and it is categorized as sensory, short term, and long-term. Short term memory is dependent on the function of the frontal and parietal lobes, while long-term memory depends on the function of large areas of the brain (Wood et al., 2000[ 121 ]). However, total function of memory and the conversion of short term memory to long-term memory are dependent on the hippocampus; an area of the brain that has the highest density of glucocorticosteroid receptors and also represents the highest level of response to stress (Scoville and Milner, 1957[ 107 ]; Asalgoo et al., 2015[ 1 ]). Therefore, during the past several decades, the relationship between the hippocampus and stress have been hotly debated (Asalgoo et al., 2015[ 1 ]; Lupien and Lepage, 2001[ 63 ]). In 1968, it was proven that there were cortisol receptors in the hippocampus of rats (McEwen et al., 1968[ 74 ]). Later, in 1982, by using specific agonists of glucocorticosteroid and mineralocorticoid receptors, the existence of these two receptors in the brain and hippocampus area of rats was proven (Veldhuis et al., 1982[ 119 ]). It should also be noted that the amygdala is very important to assessing the emotional experiences of memory (Roozendaal et al., 2009[ 91 ]).

The results of past studies have demonstrated the effect of stress on the process of memory (Ghodrat et al., 2014[ 32 ]). Various studies have shown that stress can cause functional and structural changes in the hippocampus section of the brain (McEwen, 1999[ 72 ]). These structural changes include atrophy and neurogenesis disorders (Lupien and Lepage, 2001[ 63 ]). Also, chronic stress and, consequently, an increase in plasma cortisol, leads to a reduction in the number of dendritic branches (Woolley et al., 1990[ 122 ]) and the number of neurons (Sapolsky et al., 1990[ 99 ]), as well as structural changes in synaptic terminals (Sapolsky et al., 1990[ 99 ]) and decreased neurogenesis in the hippocampus tissue (Gould et al., 1998[ 35 ]). Glucocorticosteroids can induce these changes by either effecting the cellular metabolism of neurons (Lawrence and Sapolsky, 1994[ 58 ]), or increasing the sensitivity of hippocampus cells to stimulatory amino acids (Sapolsky and Pulsinelli, 1985[ 98 ]) and/or increasing the level of extracellular glutamate (Sapolsky and Pulsinelli, 1985[ 98 ]).

High concentrations of stress hormones can cause declarative memory disorders (Lupien and Lepage, 2001[ 63 ]). Animal studies have shown that stress can cause a reversible reduction in spatial memory as a result of atrophy of the hippocampus (Luine et al., 1994[ 62 ]). In fact, high plasma concentrations of glucocorticosteroids for extended periods of time can cause atrophy of the hippocampus leading to memory disorders (Issa et al., 1990[ 45 ]). Additionally, people with either Cushing's syndrome (with an increased secretion of glucocorticosteroids), or people who receive high dosages of exogenous synthetic anti-inflammatory drugs, are observed to have atrophy of the hippocampus and associated memory disorders (Ling et al., 1981[ 61 ]). MRI images taken from the brains of people with post-traumatic stress disorder (PTSD) have demonstrated a reduction in the volume of the hippocampus along with neurophysiologic effects such as a weak verbal memory (Bremner, 1999[ 10 ]). Several human studies have suggested that even common therapeutic doses of glucocorticosteroids and dexamethasone can cause problems with explicit memory (Keenan et al., 1995[ 49 ]; Kirschbaum et al., 1996[ 53 ]). Thus, there is an inverse relationship between the level of cortisol and memory (Ling et al., 1981[ 61 ]), such that increasing levels of plasma cortisol following prolonged stress leads to a reduction in memory (Kirschbaum et al., 1996[ 53 ]), which improves when the level of plasma cortisol decreases (Seeman et al., 1997[ 108 ]).

Stress also has negative effects on learning. Results from hippocampus-dependent loading data demonstrate that subjects are not as familiar with a new environment after having been exposed to a new environment (Bremner, 1999[ 10 ]). Moreover, adrenal steroids lead to alteration in long-term potentiation (LTP), which is an important process in memory formation (Bliss and Lømo, 1973[ 7 ]).

Two factors are involved in the memory process during stress. The first is noradrenaline, which creates emotional aspects of memories in the basolateral amygdala area (Joëls et al., 2011[ 47 ]). Secondly, this process is facilitated by corticosteroids. However, if the release of corticosteroids occurs a few hours earlier, it causes inhibition of the amygdala and corresponding behaviors (Joëls et al., 2011[ 47 ]). Thus, there is a mutual balance between these two hormones for creating a response in the memory process (Joëls et al., 2011[ 47 ]).

Stress does not always affect memory. Sometimes, under special conditions, stress can actually improve memory (McEwen and Lupien, 2002[ 71 ]). These conditions include non-familiarity, non-predictability, and life-threatening aspects of imposed stimulation. Under these specific conditions, stress can temporarily improve the function of the brain and, therefore, memory. In fact, it has been suggested that stress can sharpen memory in some situations (Schwabe et al., 2010[ 105 ]). For example, it has been shown that having to take a written examination can improve memory for a short period of time in examination participants. Interestingly, this condition is associated with a decrease in the level of cortisol in the saliva (Vedhara et al., 2000[ 118 ]). Other studies have shown that impending stress before learning occurs can also lead to either an increase in the power of memory (Domes et al., 2002[ 27 ]; Schwabe et al., 2008[ 102 ]), or decrease in the capacity for memory (Diamond et al., 2006[ 26 ]; Kirschbaum et al., 1996[ 53 ]). This paradox results from the type of imposed stress and either the degree of emotional connection to the stressful event (Payne et al., 2007[ 83 ]; Diamond et al., 2007[ 25 ]), or the period of time between the imposing stress and the process of learning (Diamond et al., 2007[ 25 ]).

The process of strengthening memory is usually reinforced after stress (Schwabe et al., 2012[ 103 ]). Various studies on animal and human models have shown that administration of either glucocorticosteroids, or stress shortly after learning has occurred facilitates memory (Schwabe et al., 2012[ 103 ]). Also, it has been shown that glucocorticosteroids (not mineralocorticoids) are necessary to improve learning and memory (Lupien et al., 2002[ 66 ]). However, the retrieval of events in memory after exposure to stress will be decreased (Schwabe et al., 2012[ 103 ]), which may result from the competition of updated data for storage in memory in a stressful state (de Kloet et al., 1999[ 23 ]). Some investigations have shown that either exposure to stress, or injection of glucocorticosteroids before a test to assess retention, decreases the power of memory in humans and rodents (Schwabe and Wolf, 2009[ 104 ]).

In summary, it has been concluded that the effect of stress on memory is highly dependent on the time of exposure to the stressful stimulus and, in terms of the timing of the imposed stress, memory can be either better or worse (Schwabe et al., 2012[ 103 ]). Moreover, recent studies have shown that using a specific-timed schedule of exposure to stress not only affects hippocampus-dependent memory, but also striatum-dependent memory, which highlights the role of timing of the imposed stressful stimulus (Schwabe et al., 2010[ 105 ]).

Stress, Cognition and Learning

Cognition is another important feature of brain function. Cognition means reception and perception of perceived stimuli and its interpretation, which includes learning, decision making, attention, and judgment (Sandi, 2013[ 95 ]). Stress has many effects on cognition that depend on its intensity, duration, origin, and magnitude (Sandi, 2013[ 95 ]). Similar to memory, cognition is mainly formed in the hippocampus, amygdala, and temporal lobe (McEwen and Sapolsky, 1995[ 73 ]). The net effect of stress on cognition is a reduction in cognition and thus, it is said that any behavioral steps undertaken to reduce stress leads to increase in cognition (Scholey et al., 2014[ 101 ]). In fact, stress activates some physiological systems, such as the autonomic nervous system, central neurotransmitter and neuropeptide system, and the hypothalamus-pituitary-adrenal axis, which have direct effects on neural circuits in the brain involved with data processing (Sandi, 2013[ 95 ]). Activation of stress results in the production and release of glucocorticosteroids. Because of the lipophilic properties of glucocorticosteroids, they can diffuse through the blood-brain barrier and exert long-term effects on processing and cognition (Sandi, 2013[ 95 ]).

It appears that being exposed to stress can cause pathophysiologic changes in the brain, and these changes can be manifested as behavioral, cognitive, and mood disorders (Li et al., 2008[ 60 ]). In fact, studies have shown that chronic stress can cause complications such as increased IL-6 and plasma cortisol, but decreased amounts of cAMP responsive element binding protein and brain-derived neurotrophic factor (BDNF), which is very similar to what is observed in people with depression and mood disorders that exhibit a wide range of cognitive problems (Song et al., 2006[ 114 ]). Additionally, the increased concentrations of inflammatory factors, like interleukins and TNF-α (which play an important role in creating cognitive disorders), proves a physiologic relationship between stress and mood-based cognitive disorders (Solerte et al., 2000[ 113 ]; Marsland et al., 2006[ 68 ]; Li et al., 2008[ 60 ]). Studies on animals suggest that cognitive disorders resulting from stress are created due to neuroendocrine and neuroamine factors and neurodegenerative processes (Li et al., 2008[ 60 ]). However, it should be noted that depression may not always be due to the over activation of the physiological-based stress response (Osanloo et al., 2016[ 81 ]).

Cognitive disorders following exposure to stress have been reported in past studies (Lupien and McEwen, 1997[ 64 ]). Stress has effects on cognition both acutely (through catecholamines) and chronically (through glucocorticosteroids) (McEwen and Sapolsky, 1995[ 73 ]). Acute effects are mainly caused by beta-adrenergic effects, while chronic effects are induced in a long-term manner by changes in gene expression mediated by steroids (McEwen and Sapolsky, 1995[ 73 ]). In general, many mechanisms modulate the effects of stress on cognition (McEwen and Sapolsky, 1995[ 73 ]; Mendl, 1999[ 75 ]). For instance, adrenal steroids affect the function of the hippocampus during cognition and memory retrieval in a biphasic manner (McEwen and Sapolsky, 1995[ 73 ]). In chronic stress, these steroids can destroy neurons with other stimulatory neurotransmitters (Sandi, 2013[ 95 ]). Exposure to stress can also cause disorders in hippocampus-related cognition; specifically, spatial memory (Borcel et al., 2008[ 9 ]; Sandi et al., 2003[ 96 ]). Additionally, stress can halt or decrease the genesis of neurons in the dentate gyrus area of the hippocampus (this area is one of the limited brain areas in which neurogenesis occurs in adults) (Gould and Tanapat, 1999[ 34 ]; Köhler et al., 2010[ 54 ]). Although age is a factor known to affect cognition, studies on animals have demonstrated that young rats exposed to high doses of adrenal steroids show the same level of decline in their cognition as older adult animals with normal plasma concentrations of glucocorticoids (Landfield et al., 1978[ 57 ]). Also, a decrease in the secretion of glucocorticosteroids causes preservation of spatial memory in adults and has also been shown to have neuroprotective effects (Montaron et al., 2006[ 78 ]). Other studies have shown that stress (or the injection of adrenal steroids) results in varied effects on cognition. For instance, injection of hydrocortisone at the time of its maximum plasma concentration (in the afternoon) leads to a decrease in reaction time and improves cognition and memory (Lupien et al., 2002[ 66 ]).

In summary, the adverse effects of stress on cognition are diverse and depend on the type, timing, intensity, and duration (Sandi, 2013[ 95 ]). Generally, it is believed that mild stress facilitates an improvement in cognitive function, especially in the case of virtual or verbal memory. However, if the intensity of stress passes beyond a predetermined threshold (which is different in each individual), it causes cognitive disorders, especially in memory and judgment. The disruption to memory and judgment is due to the effects of stress on the hippocampus and prefrontal cortex (Sandi, 2013[ 95 ]). Of course, it must be realized that factors like age and gender may also play a role in some cognitive disorders (Sandi, 2013[ 95 ]). Importantly, it should be emphasized that different people may exhibit varied responses in cognition when exposed to the very same stressful stimulus (Hatef et al., 2015[ 39 ]).

Stress and Immune System Functions

The relationship between stress and the immune system has been considered for decades (Khansari et al., 1990[ 50 ]; Dantzer and Kelley, 1989[ 21 ]). The prevailing attitude between the association of stress and immune system response has been that people under stress are more likely to have an impaired immune system and, as a result, suffer from more frequent illness (Khansari et al., 1990[ 50 ]). Also, old anecdotes describing resistance of some people to severe disease using the power of the mind and their thought processes, has promoted this attitude (Khansari et al., 1990[ 50 ]). In about 200 AC, Aelius Galenus (Galen of Pergamon) declared that melancholic women (who have high levels of stress and, thus, impaired immune function) are more likely to have cancer than women who were more positive and exposed to less stress (Reiche et al., 2004[ 88 ]). This may be the first recorded case about the relationship between the immune system and stress. In an old study in the early 1920's, researchers found that the activity of phagocytes in tuberculosis decreased when emotional stress was induced. In fact, it was also suggested that living with stress increases the risk of tuberculosis by suppressing the immune system (Ishigami, 1919[ 44 ]). Following this study, other researchers suggested that the probability of disease appearance increases following a sudden, major, and extremely stressful life style change (Holmes and Rahe, 1967[ 41 ]; Calabrese et al., 1987[ 12 ]).

Over the past several decades, there have been many studies investigating the role of stress on immune system function (Dantzer and Kelley, 1989[ 21 ]; Segerstrom and Miller, 2004[ 109 ]). These studies have shown that stress mediators can pass through the blood-brain barrier and exert their effects on the immune system (Khansari et al., 1990[ 50 ]). Thus, the effect of stress on the immune system is now an accepted relationship or association.

Stress can affect the function of the immune system by modulating processes in the CNS and neuroendocrine system (Khansari et al., 1990[ 50 ]; Kiecolt-Glaser and Glaser, 1991[ 51 ]). Following stress, some neuroendocrine and neural responses result in the release of corticotropin-releasing hormone (CRH), adrenocorticotropic hormone (ACTH), and other stress mediators (Carrasco and Van de Kar, 2003[ 13 ]). However, evidence suggests that the lymphatic system, which is a part of the immune system, also plays a role in releasing these mediators (Khansari et al., 1990[ 50 ]). For instance, thymus peptides, such as thymopentine, thymopoietin, and thymosin fraction-5, cause an increase in ACTH production (Goya et al., 1993[ 36 ]). Additionally, the existence of CRH in thymus has been proven (Redei, 1992[ 87 ]). It has also been proven that interleukin-1 released from phagocytes has a role in ACTH secretion (Berkenbosch et al., 1987[ 4 ]). On the other hand, natural or synthetic glucocorticosteroids (which are the final stress operators) are known as anti-inflammatory drugs and immune suppressants and their role in the inhibition of lymphocytes and macrophages has been demonstrated as well (Elenkov et al., 1999[ 28 ]; Reiche et al., 2004[ 88 ]). Moreover, their role in inhibiting the production of cytokines and other immune mediators and decreasing their effect on target cells during exposure to stress has also been determined (Reiche et al., 2004[ 88 ]).

In addition to adrenal steroids, other hormones are affected during stress. For example, the secretion of growth hormone will be halted during severe stress. A study showed that long-term administration of CRH into the brain ventricles leads to a cessation in the release of growth hormone (Rivier and Vale, 1985[ 90 ]). Stress also causes the release of opioid peptides to be changed during the time period over which the person is exposed to stress (McCarthy et al., 2001[ 70 ]). In fact, stress modifies the secretion of hormones that play a critical role in the function of the immune system (Khansari et al., 1990[ 50 ]). To date, it has been shown that various receptors for a variety of hormones involved in immune system function are adversely affected by stress. For example, ACTH, vasoactive intestinal peptide (VIP), substance P, growth hormone, prolactin, and steroids all have receptors in various tissues of the immune system and can modulate its function (De la Fuente et al., 1996[ 24 ]; Gala, 1991[ 30 ]; Mantyh, 1991[ 67 ]). In addition, active immune cells are also able to secrete several hormones; thus, some researchers believe that these hormones, as mediators of immune system, play a significant role in balancing its function (Blalock et al., 1985[ 6 ]).

Severe stress can lead to malignancy by suppressing the immune system (Reiche et al., 2004[ 88 ]). In fact, stress can decrease the activity of cytotoxic T lymphocytes and natural killer cells and lead to growth of malignant cells, genetic instability, and tumor expansion (Reiche et al., 2004[ 88 ]). Studies have shown that the plasma concentration of norepinephrine, which increases after the induction stress, has an inverse relationship with the immune function of phagocytes and lymphocytes (Reiche et al., 2004[ 88 ]). Lastly, catecholamines and opioids that are released following stress have immune-suppressing properties (Reiche et al., 2004[ 88 ]).

Stress and the Function of the Cardiovascular System

The existence of a positive association between stress and cardiovascular disease has been verified (Rozanski et al., 1999[ 93 ]). Stress, whether acute or chronic, has a deleterious effect on the function of the cardiovascular system (Rozanski et al., 1999[ 93 ]; Kario et al., 2003[ 48 ]; Herd, 1991[ 40 ]). The effects of stress on the cardiovascular system are not only stimulatory, but also inhibitory in nature (Engler and Engler, 1995[ 29 ]). It can be postulated that stress causes autonomic nervous system activation and indirectly affects the function of the cardiovascular system (Lazarus et al., 1963[ 59 ]; Vrijkotte et al., 2000[ 120 ]). If these effects occur upon activation of the sympathetic nervous system, then it mainly results in an increase in heart rate, strength of contraction, vasodilation in the arteries of skeletal muscles, a narrowing of the veins, contraction of the arteries in the spleen and kidneys, and decreased sodium excretion by the kidneys (Herd, 1991[ 40 ]). Sometimes, stress activates the parasympathetic nervous system (Pagani et al., 1991[ 82 ]). Specifically, if it leads to stimulation of the limbic system, it results in a decrease, or even a total stopping of the heart-beat, decreased contractility, reduction in the guidance of impulses by the heart stimulus-transmission network, peripheral vasodilatation, and a decline in blood pressure (Cohen et al., 2000[ 17 ]). Finally, stress can modulate vascular endothelial cell function and increase the risk of thrombosis and ischemia, as well as increase platelet aggregation (Rozanski et al., 1999[ 93 ]).

The initial effect of stress on heart function is usually on the heart rate (Vrijkotte et al., 2000[ 120 ]). Depending upon the direction of the shift in the sympatho-vagal response, the heart beat will either increase or decrease (Hall et al., 2004[ 38 ]). The next significant effect of stress on cardiovascular function is blood pressure (Laitinen et al., 1999[ 56 ]). Stress can stimulate the autonomic sympathetic nervous system to increase vasoconstriction, which can mediate an increase in blood pressure, an increase in blood lipids, disorders in blood clotting, vascular changes, atherogenesis; all, of which, can cause cardiac arrhythmias and subsequent myocardial infarction (Rozanski et al., 1999[ 93 ]; Vrijkotte et al., 2000[ 120 ]; Sgoifo et al., 1998[ 111 ]). These effects from stress are observed clinically with atherosclerosis and leads to an increase in coronary vasoconstriction (Rozanski et al., 1999[ 93 ]). Of course, there are individual differences in terms of the level of autonomic-based responses due to stress, which depends on the personal characteristics of a given individual (Rozanski et al., 1999[ 93 ]). Thus, training programs for stress management are aimed at reducing the consequences of stress and death resulting from heart disease (Engler and Engler, 1995[ 29 ]). In addition, there are gender-dependent differences in the cardiovascular response to stress and, accordingly, it has been estimated that women begin to exhibit heart disease ten years later that men, which has been attributed to the protective effects of the estrogen hormone (Rozanski et al., 1999[ 93 ]).

Studies have shown that psychological stress can cause alpha-adrenergic stimulation and, consequently, increase heart rate and oxygen demand (Rozanski et al., 1998[ 92 ], 1999[ 93 ]; Jiang et al., 1996[ 46 ]). As a result, coronary vasoconstriction is enhanced, which may increase the risk of myocardial infarction (Yeung et al., 1991[ 124 ]; Boltwood et al., 1993[ 8 ]; Dakak et al., 1995[ 20 ]). Several studies have demonstrated that psychological stress decreases the microcirculation in the coronary arteries by an endothelium-dependent mechanism and increases the risk of myocardial infarction (Dakak et al., 1995[ 20 ]). On the other hand, mental stress indirectly leads to potential engagement in risky behaviors for the heart, such as smoking, and directly leads to stimulation of the neuroendocrine system as part of the autonomic nervous system (Hornstein, 2004[ 43 ]). It has been suggested that severe mental stress can result in sudden death (Pignalberi et al., 2002[ 84 ]). Generally, stress-mediated risky behaviors that impact cardiovascular health can be summarized into five categories: an increase in the stimulation of the sympathetic nervous system, initiation and progression of myocardial ischemia, development of cardiac arrhythmias, stimulation of platelet aggregation, and endothelial dysfunction (Wu, 2001[ 123 ]).

Stress and Gastrointestinal Complications

The effects of stress on nutrition and the gastrointestinal (GI) system can be summarized with two aspects of GI function.

First, stress can affect appetite (Bagheri Nikoo et al., 2014[ 2 ]; Halataei et al., 2011[ 37 ]; Ranjbaran et al., 2013[ 86 ]). This effect is related to involvement of either the ventral tegmental area (VTA), or the amygdala via N-methyl-D-aspartate (NMDA) glutamate receptors (Nasihatkon et al., 2014[ 80 ]; Sadeghi et al., 2015[ 94 ]). However, it should also be noted that nutrition patterns have effects on the response to stress (Ghanbari et al., 2015[ 31 ]), and this suggests a bilateral interaction between nutrition and stress.

Second, stress adversely affects the normal function of GI tract. There are many studies concerning the effect of stress on the function of the GI system (Söderholm and Perdue, 2001[ 112 ]; Collins, 2001[ 18 ]). For instance, studies have shown that stress affects the absorption process, intestinal permeability, mucus and stomach acid secretion, function of ion channels, and GI inflammation (Collins, 2001[ 18 ]; Nabavizadeh et al., 2011[ 79 ]). Stress also increases the response of the GI system to inflammation and may reactivate previous inflammation and accelerate the inflammation process by secretion of mediators such as substance P (Collins, 2001[ 18 ]). As a result, there is an increase in the permeability of cells and recruitment of T lymphocytes. Lymphocyte aggregation leads to the production of inflammatory markers, activates key pathways in the hypothalamus, and results in negative feedback due to CRH secretion, which ultimately results in the appearance of GI inflammatory diseases (Collins, 2001[ 18 ]). This process can reactivate previous silent colitis (Million et al., 1999[ 76 ]; Qiu et al., 1999[ 85 ]). Mast cells play a crucial role in stress-induced effects on the GI system, because they cause neurotransmitters and other chemical factors to be released that affect the function of the GI system (Konturek et al., 2011[ 55 ]).

Stress can also alter the functional physiology of the intestine (Kiliaan et al., 1998[ 52 ]). Many inflammatory diseases, such as Crohn's disease and other ulcerative-based diseases of the GI tract, are associated with stress (Hommes et al., 2002[ 42 ]). It has been suggested that even childhood stress can lead to these diseases in adulthood (Schwartz and Schwartz, 1983[ 106 ]). Irritable bowel syndrome, which is a disease with an inflammatory origin, is highly related to stress (Gonsalkorale et al., 2003[ 33 ]). Studies on various animals suggest the existence of inflammatory GI diseases following induction of severe stress (Qiu et al., 1999[ 85 ]; Collins et al., 1996[ 19 ]). Additionally, pharmacological interventions, in an attempt to decrease the response of CRH to stress, have been shown to result in an increase in GI diseases in rats (Million et al., 1999[ 76 ]).

Altering the permeability of the mucosal membrane by perturbing the functions of mucosal mast cells may be another way that stress causes its effects on the GI system, since this is a normal process by which harmful and toxic substances are removed from the intestinal lumen (Söderholm and Perdue, 2001[ 112 ]). Also, stress can both decrease the removal of water from the lumen, as well as induce sodium and chloride secretion into the lumen. This most likely occurs by increasing the activity of the parasympathetic nervous system (Barclay and Turnberg, 1987[ 3 ]). Moreover, physical stress, such as trauma or surgery, can increase luminal permeability (Söderholm and Perdue, 2001[ 112 ]) (Table 2 (Tab. 2) ; References in Table 2: Halataei et al., 2011[ 37 ]; Ranjbaran et al., 2013[ 86 ]; Mönnikes et al., 2001[ 77 ]; Collins, 2001[ 18 ]; Nabavizadeh et al., 2011[ 79 ]; Barclay and Turnberg, 1987[ 3 ]; Million et al., 1999[ 76 ]; Gonsalkorale et al., 2003[ 33 ]).

Stress also affects movement of the GI tract. In this way, it prevents stomach emptying and accelerates colonic motility (Mönnikes et al., 2001[ 77 ]). In the case of irritable bowel syndrome, stress increases the movement (contractility and motility) of the large intestine (Mönnikes et al., 2001[ 77 ]). Previous studies have revealed that CRH increases movement in the terminal sections of the GI tract and decreases the movements in the proximal sections of the GI tract (Mönnikes et al., 2001[ 77 ]). A delay in stomach emptying is likely accomplished through CRH-2 receptors, while type 1 receptors affect the colon (Mönnikes et al., 2001[ 77 ]). The effects produced by CRH are so prominent that CRH is now considered an ideal candidate for the treatment of irritable bowel syndrome (Martinez and Taché, 2006[ 69 ]). When serotonin is released in response to stress (Chaouloff, 2000[ 14 ]), it leads to an increase in the motility of the colon by stimulating 5HT-3 receptors (Mönnikes et al., 2001[ 77 ]). Moreover, it has also been suggested that stress, especially mental and emotional types of stress, increase visceral sensitivity and activate mucosal mast cells (Mönnikes et al., 2001[ 77 ]). Stimulation of the CNS by stress has a direct effect on GI-specific nervous system ( i.e. , the myenteric system or plexus) and causes the above mentioned changes in the movements of the GI tract (Bhatia and Tandon, 2005[ 5 ]). In fact, stress has a direct effect on the brain-bowel axis (Konturek et al., 2011[ 55 ]). Various clinical studies have suggested a direct effect of stress on irritable bowel syndrome, intestinal inflammation, and peptic ulcers (Konturek et al., 2011[ 55 ]).

In conclusion, the effects of stress on the GI system can be classified into six different actions: GI tract movement disorders, increased visceral irritability, altered rate and extent of various GI secretions, modified permeability of the intestinal barrier, negative effects on blood flow to the GI tract, and increased intestinal bacteria counts (Konturek et al., 2011[ 55 ]).

Stress and the Endocrine System

There is a broad and mutual relationship between stress and the endocrine system. On one hand, stress has many subtle and complex effects on the activity of the endocrine system (Sapolsky, 2002[ 97 ]; Charmandari et al., 2005[ 15 ]), while on the other hand, the endocrine system has many effects on the response to stress (Ulrich-Lai and Herman, 2009[ 117 ]; Selye, 1956[ 110 ]). Stress can either activate, or change the activity of, many endocrine processes associated with the hypothalamus, pituitary and adrenal glands, the adrenergic system, gonads, thyroid, and the pancreas (Tilbrook et al., 2000[ 116 ]; Brown-Grant et al., 1954[ 11 ]; Thierry et al., 1968[ 115 ]; Lupien and McEwen, 1997[ 64 ]). In fact, it has been suggested that it is impossible to separate the response to stress from the functions of the endocrine system. This premise has been advanced due to the fact that even a minimal amount of stress can activate the hypothalamic-pituitary-adrenal axis, which itself is intricately involved with the activation of several different hormone secreting systems (Sapolsky, 2002[ 97 ]). In different locations throughout this article, we have already discussed the effects of stress on hormones and various endocrine factors and, thus, they will not be further addressed.

Altogether, stress may induce both beneficial and harmful effects. The beneficial effects of stress involve preserving homeostasis of cells/species, which leads to continued survival. However, in many cases, the harmful effects of stress may receive more attention or recognition by an individual due to their role in various pathological conditions and diseases. As has been discussed in this review, various factors, for example, hormones, neuroendocrine mediators, peptides, and neurotransmitters are involved in the body's response to stress. Many disorders originate from stress, especially if the stress is severe and prolonged. The medical community needs to have a greater appreciation for the significant role that stress may play in various diseases and then treat the patient accordingly using both pharmacological (medications and/or nutraceuticals) and non-pharmacological (change in lifestyle, daily exercise, healthy nutrition, and stress reduction programs) therapeutic interventions. Important for the physician providing treatment for stress is the fact that all individuals vary in their response to stress, so a particular treatment strategy or intervention appropriate for one patient may not be suitable or optimal for a different patient.

Yunes Panahi and Amirhossein Sahebkar (Department of Medical Biotechnology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran, P.O. Box: 91779-48564, Iran; Tel: 985118002288, Fax: 985118002287, E-mail: [email protected], [email protected]) contributed equally as corresponding authors.

Conflict of interest

The authors declare that have no conflict of interest in this study.

Acknowledgement

The authors would like to thank the "Neurosciences Research Center of Baqiyatallah University of Medical Sciences" and the “Clinical Research Development Center of Baqiyatallah (a.s.) Hospital” for providing technical supports.

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Eustress is the Good Type of Stress You Didn't Know You Needed

Elizabeth Scott, PhD is an author, workshop leader, educator, and award-winning blogger on stress management, positive psychology, relationships, and emotional wellbeing.

Identify and Respond to Eustress

Potential pitfalls, frequently asked questions.

Not all stress is the same. Some of the stress that you face in life can be more detrimental to your well-being, and some types of stress can actually be healthy. One type of beneficial stress is known as eustress.

Eustress refers to stress that leads to a positive response. It is the opposite of distress and can refer to any type of beneficial stress, whether physical or psychological. It tends to be short-term and often feels exciting. People perceive this type of stress as manageable and even motivating.

Physically, eustress can often resemble distress in many ways. You might feel nervous; your heart might pound; your thoughts might race. The difference is how these physical sensations are perceived.

With distress, they may feel uncomfortable and overwhelmed. With eustress, you might feel excitement or a sense of anticipation.

Eustress can be beneficial and is actually necessary for overall well-being. This type of "positive" stress can contribute to feelings of optimism and excitement about life.

Examples of Eustress

Eustress is associated with positive outcomes. To understand this type of beneficial stress, it can be helpful to consider a few different examples of when it may occur. Unlike distress, eustress is typically associated with feelings of excitement and challenge rather than anxiety or fear.

• Life changes : Major life transitions can create eustress. Examples of changes that can create this type of beneficial stress include starting a new job, being involved in a relationship, and parenting children.
• Smaller challenges : The excitement of a roller-coaster ride, a scary movie, or a fun challenge are all examples of eustress. Even a particularly tough workout can be an example of this type of stress.
• New experiences : Traveling can also create eustress. It can involve significant discomfort and unfamiliarity, but it also provides many discoveries. The anticipation of a first date, the first day at a new job, or other exciting firsts also fall under the umbrella of eustress.

In some instances, distress can transform into eustress. For example, a job loss or breakup might initially be upsetting, but it may be perceived as an opportunity for change and growth over time.

Impact of Eustress

Eustress is a type of stress that is actually important for us to have in our lives. Eustress can have a variety of positive effects. For instance, it may:

• Help you concentrate and focus
• Encourage you to take on new challenges
• Motivate you to pursue your goals ,
• Help you feel more resilient in the face of challenges
• Give meaning and purpose to your life
• Help you to feel healthier and happier

A certain amount of stress can be beneficial when it comes to motivation and performance. In fact, the Yerkes-Dodson law suggests that optimal arousal levels (i.e., stress) contribute to improved performance, but only up to a certain point. And different tasks may benefit from different levels of stress and arousal.

Eustress is often thought of as a beneficial type of stress because it can positively impact your life. However, it's important to remember that eustress is still a type of stress. Because of this, eustress can become distress, or even chronic stress, if it becomes too intense or lasts for too long.

To manage your stress levels, it is important to recognize the differences between eustress and other types of stress. This isn't always straightforward because they sometimes resemble each other.

Understanding eustress can help you more easily manage other types of stress as well. For example, research shows that when an event is perceived as a "threat," people respond to it differently than if it's seen as a "challenge."

Threats tend to elicit a greater stress response and create greater levels of anxiety, while challenges can be exciting and even enjoyable to overcome. Threats are scary, while challenges are opportunities to prove yourself and learn how much you can accomplish when you really try.

This understanding can help you evaluate many of the stressors in your life as challenges rather than threats. There are a number of strategies that can help you shift into seeing events as challenges rather than threats:

• Use positive self-talk : This can be done by changing how you talk to yourself about these challenges. Make an effort to tell yourself that these are challenges you can cope with.
• Focus on what you can control : It can also be helpful to focus on the resources that you have to handle these challenges. Focusing on what you can control rather than what might go wrong can help you feel more positive about the challenges you face.
• Adjust your mindset : When you work on shifting your mindset and approach stress as a challenge whenever possible, you can manage these challenges with greater resilience.

Eustress doesn't generally carry the same type of damage as chronic stress. Chronic stress is persistent, long-lasting stress that is psychologically or emotionally draining. It is also the most harmful to your health and well-being.

However, too much eustress can still tax your system. You can feel overloaded and stressed by too much eustress if you're not allowing yourself to return to a relaxed state and have a healthy balance of restorative downtime.

Balance is essential. A certain amount of eustress can help you feel happier and boost your well-being, but too much might mean you are neglecting other important areas of your life, including self-care and relaxation.

Changing your perspective can certainly help with stress management, but it's not the only strategy that should be used. If you have too many challenges in your life, even eustress can become chronic stress and lead to burnout or worse. Some ways to deal with this include:

• Being mindful of where your limitations are and work to maintain balance in your life.
• Cutting out any unnecessary obligations (particularly ones that you don't enjoy).
• Adopting some resilience-promoting habits that can help you to be less reactive to stress overall.
• Becoming comfortable with saying no to new activities if they won't truly serve you.

This takes practice, but it can make all the difference in your stress levels.

Eustress is perceived as positive and beneficial, while distress is associated with negative outcomes. Eustress may help improve their focus and motivate people to take on new challenges, while distress can lead to anxiety, fear, and other negative emotions.

The word "eustress" is derived from the Greek prefix "eu-," which means "good," and the word "stress." Together, eustress refers to a type of stress that is beneficial or helpful.

Eustress can turn to distress if it is intense or persists too long. For example, riding a roller coaster is often considered an enjoyable eustress-inducing activity. If you are not prepared for the experience or fear heights, this experience can quickly turn into distress. Additionally, eustress can become problematic if it leads to risky behaviors, such as doing something without following safety procedures.

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APA. How stress affects your health .

By Elizabeth Scott, PhD Elizabeth Scott, PhD is an author, workshop leader, educator, and award-winning blogger on stress management, positive psychology, relationships, and emotional wellbeing.