Stress and Unhealthy Behaviors Can Put Us at Serious Risk

Stress and Illness

-Stress and unhealthy behaviors can put us at serious risk.

-10 leading causes of death in US: cigarette smoking, alcohol abuse, unprotected sex, ignoring doctors’ orders, insufficient exercise, illicit drugs, and poor nutrition.

-Modify these behavioral sources of illness and we might lessen suffering, increase life expectancy, and enhance quality of life.

-Health psychology provides psychology’s contribution on behavioral medicine.

1. Module 39: Stress and Illness

·Karl: sees snake while away from campsite; flight or fight? Karl runs to campsite, with his adrenaline flowing, and heart pounding.

·Karen: late to work because of construction, notices her tense muscles, clenched teeth, and churning stomach.

·Karl vs. Karen: Karl’s response = good/healthy; Karen’s response = bad can lead to unhealthy behavior such as more sleep, smoking, alcohol etc.

1. Stress and Stressors

·Karen was under lots of stress, Karl experienced acute stress. Karen’s missing train was a stressor. Karl’s physical + emotional responses were a stress reaction.

·Stress: the process by which we appraise and cope with environmental threats and challenges (not just a stimulus or response).

·Stress arises less from events than from how we appraise them:

·Stressors can have positive effects, arousing and motivating us to conquer problems; but stressors can also threaten our resources, jobs, security, loved ones health/ well being, our beliefs, or self image.

1. The Stress Response System

·Walter Cannon confirmed that the stress response is part of a unified mind-body system; he observed that extreme cold, lack of oxygen, and emotion-arousing incidents all trigger an outpouring of epinephrine (adrenaline) and norepinephrine (noradrenaline).

·These stress hormones enter the bloodstream from sympathetic nerve endings in the inner part of the adrenal glands.

·When altered by any of a number of brain pathways, the sympathetic nervous system increases heart rate and respiration, diverts blood from digestion to the skeletal muscles, dulls pain, and releases sugar and fat from the body’s stores to prepare the body for fight or flight.

·On orders from the cerebral cortex (via the hypothalamus and pituitary gland), the outer (cortical) part of the adrenal gland secretes the stress hormone cortisol.

·There are other alternatives to fight or flight; one is a common response to the stress of a loved ones death: Withdraw, pull back. Conserve energy.

·Another common among women is to seek and give support: “Tend and befriend”

·Canadian scientists Hans Selye’s research on stress extended Cannon’s findings and helped make stress a major concept in both psychology and medicine.

·Selye injected rats with ovarian hormone extract and detected three effects: enlargement of the adrenal cortex, shrinkage of the thymus gland (which contains disease-fighting white blood cells), and bleeding ulcers.

·Selye discovered that the body’s adaptive response to stress was so general that he called it the general adaptation syndrome (GAS).

·Selye saw GAS as having three phases:

1. you experience an alarm reaction due to the sudden activation of your sympathetic nervous system. Your heart rate zooms. Blood is diverted to your skeletal muscles. You feel the faintness of shock.
2. resistance: Your temperature, blood pressure, and respiration remain high, and there is sudden outpouring of hormones.
3. exhaustion:You are most vulnerable to illness or even collapse or death.

·Selye’s basic point: although the human body comes designed to cope with temporary stress, prolonged stress can produce physical deterioration.

1. Stressful Life Events
2. Catastrophes: unpredictable, large-scale events such as war and natural disasters that nearly everyone appraises as threatening

-After 9/11 it was reported that 2/3 of Americans had trouble sleeping.

1. Significant Life Changes: a significant personal life change i.e. leaving home, the death of a loved one, the loss of a job, a marriage, or divorce.

-Studies by the US National Academy of Sciences revealed that people recently widowed, fired, or divorced are more vulnerable to disease.

-Death rates doubled with the death of parents.

1. Daily Hassles

-Everyday annoyances such as rush hour traffic, aggravating housemates, long lines at the bank or store, too many things to do, and misplacing things-may be the most significant sources of stress.

-Over time little stressors add up and effect our health and well being.

-Hypertension (high-blood pressure) rates are high among residents of urban ghettos, where the stresses that accompany poverty, unemployment, solo parenting, and overcrowding are part of daily life.

1. Perceived Control

·Catastrophes, important life changes, and daily hassles and conflicts are especially stressful when we appraise them as both negative and uncontrolled.

·In humans, bacterial infection often combines with uncontrollable stress to produce the most severe ulcers. To cure the ulcer, kill the bug with antibiotics and control the acid secretions with reduced stress.

·Perceiving a loss of control, we become vulnerable to ill health.

·Elderly nursing home patients who have little perceived control over their activities tend to decline faster and die sooner than do those given more control over their activities.

1. Poverty and Inequality

-Control may help explain a well-established link between economic status and longevity. In one study of 843 grave markers in an old grave yard, those with the costliest, highest pillars tended to live the longest.

-In the US/Canada poorer people are more at risk for premature death.

-People also tend to die younger in areas where there is greater income inequality. As income inequality has grown in Eastern Europe and Russia, life expectancy has decreased

1. Optimism-Pessimism

-Optimism is a factor that also influences our vulnerability to stress. Psychologists report that optimists not only perceive more control, but cope better with stressful events and enjoy better health.

-Optimists also respond to stress with smaller increases in blood pressure, and they recover more quickly from heart bypass surgery.

1. Stress and the Heart

·Stress can put us at risk for one of today’s four leading causes of serious illness and death: heart disease, cancer, stroke, and chronic lung disease.

·Coronary heart disease: the closing of vessels that nourish the heart muscle.

·Coronary heart disease became North America’s leading cause of death.

·In addition to family history of the disease, many behavioral factors (i.e. smoking, obesity, a high-fat diet, physical inactivity, elevated blood pressure, and an elevated cholesterol level) increase the risk of heart disease.

·Type A: most reactive, competitive, hard-driving, impatient, time-conscious, super motivated, verbally aggressive, and easily angered (in experiment).

·Type B: easy going (in experiment).

·By the end of the experiment, 257 of the men had suffered heart attacks; 69% were Type A. Not one of the pure Type B’s had one.

·Type A people may be more prone to heart disease for at least two reasons: (1) such individuals smoke more, sleep less, and drink more caffeinated drinks. (2) their temperament may contribute directly to heart disease.

·When harassed, given a challenge, or threatened with a loss of control, Type A individuals are more physiologically reactive. Their hormonal secretions, pulse rate, and blood pressure soar, while Type Bs stay calm.

1. Stress and Susceptibility to Disease

·The term psychomatic described psychologically caused physical symptoms. The genuine physiological effect of psychological states is referred to as psychophysiological illnesses.

1. Stress and the Immune System

·Your immune system is a complex surveillance system that defends your body by isolating and destroying bacteria, viruses, and other foreign substances.

·This system includes two types of white blood cells, called lymphocytes.

·B lymphocytes form inbone marrow/release antibodies/fight bacterial infections.

·T lymphocytes form in thymus and other lymphatic tissue and attack cancer cells, viruses, and foreign substances, even “good” ones (i.e. transplant organs).

·Another agent of the immune system is the macrophage (big eater), which identifies, pursues, and ingests harmful invaders.

·Age, nutrition genetics, body temperature, and stress all influence the immune system’s activity.

·Your immune system can err in two directions. Responding too strongly, it may attack the body’s own tissues, causing arthritis or an allergic reaction. Or it may under react, allowing a dormant herpes virus to erupt or cancer cells to multiply.

·Women are immunologically stronger than men/less susceptible to infections.

·The brain regulates the secretion of stress hormones, which suppress the disease-fighting lymphocytes. So when animals are physically restrained, their immune system becomes less active.

1. Stress and AIDS

·AIDS has become the world’s leading cause of death and the number one killer in Africa. AIDS is an immune disorder (acquired immune deficiency syndrome) caused by the human immunodeficiency virus (HIV), which is spread by the exchange of bodily fluids (i.e. semen and blood).

·If a disease spread by human contact kills quickly, it won’t kill many. If its kills slowly like HIV, it can be lethal to more people (people carrying disease don’t know and can spread it around to more people.)

·HIV-infected men faced with stressful life circumstances, such as the loss of a partner, exhibit greater immune suppression and faster disease progression.

·Efforts to reduce stress would help control the disease.

1. Stress and Cancer

·Stress and negative emotions have also been linked to cancer’s rate of progression. Cancer experiments have implanted tumor cells into rodents or given them cancer-producing substances. Those rodents also exposed to uncontrollable stress were more prone to cancer. With their immune systems weakened by stress, their tumors developed sooner and grew larger.

·Some investigators reported that people are at increased risk for cancer within a year after experiencing depression, helplessness, or bereavement.

·One dander in hyping reports on attitudes and cancer is leading some patients to blame themselves for their illness. A corollary danger is a “wellness macho” among the healthy, who credit their health to their healthy character and lay a guilt trip on the ill.

·We must remember that stress doesn’t create cancer cells, it affects their growth by weakening the body’s natural defenses against a few malignant cells.

1. Conditioning the Immune System

·If conditioning affects the body’s overt physiological responses, it affects the immune system as well. Ader came upon this discovery while researching taste aversion in rats.

·He paired the rats’ drinking of saccharin-sweetened water with injections of a drug that happened to suppress immune functioning.

·After repeated pairings, sweetened water alone triggered immune suppression, as if the drug had been given. Such conditioned immune suppression can triple an animal’s likelihood of growing a tumor when fed a carcinogen.

Promoting Health

1. Coping With Stress

·Stressors—unavoidable; reoccurring stress correlates with heart disease, lowered immunity/ other body ailments.

·If one can’t eliminate stress, one should manage it by aerobic exercise, biofeedback, relaxation, and/or social support.

1. Aerobic Exercise

·Aerobic Exercise: sustained exercise that increases the heart and lung fitness. Such exercise strengthens the body.

1. Exercise and Mood

-Studies suggest that aerobic exercise can reduce stress, depression, and anxiety. Studies indicate 3 in 10 Americans and 4 in 10 Canadians who exercise regularly cope with stressful events better, exhibit more self-confidence, feel more vigor, and feel depressed and fatigued less often.

-Over 150 studies confirm that exercise reduces depression and anxiety and is a useful adjunct to antidepressant drugs and psychotherapy.

-Exercise is effective as drugs, and better prevents symptom reoccurrence.

-Exercise…

(1) strengthens heart, increases blood flow, keeps blood vessels open, and lowers blood pressure and the blood pressure reaction to stress.

(2) orders up chemicals from body’s internal pharmacy by increasing production of mood-boosting neurotransmitters such as norepinephrine, serotonin, and the endorphins.

(3) modestly enhances cognitive abilities, such as memory.

(4) promotes the growth of new brain cells in mice exercising daily on running wheel regimen.

-Emotional benefits are a side effect of increased body arousal and warmth, or of muscle relaxation and better sleep that occurs after.

1. Exercise and Health

-Research reveals that exercise boosts our mood, and benefits our physical health; people who exercise suffer half as many heart attacks.

-By one estimate, moderate exercise adds two years on one’s life.

1. Biofeedback and Relaxation

·Biofeedback: a system of recording, amplifying, and feeding back information about subtle physiological responses.

·Biofeedback instruments have been likened to a mirror and reflect the results of a person’s own efforts, they allow the person to learn techniques for controlling a particular physiological response.

·Many people who set aside a quiet time or two each day report enjoying tranquility. Meditative relaxation counteracts effects of stress (worsens pain, infertility, and insomnia)

·Laughter seems to work in ways similar to exercise (i.e. arouses us, massages muscles, then leaves us feeling relaxed).

·Inner jogging of laughter exercises the muscles of the abdomen, diaphragm, shoulders, and face.

·Recent studies show merry humor defuses stress and strengthen immune activity.

1. Social Support

·Social support—feeling liked, affirmed and encouraged by intimate friends and family promotes happiness and health (i.e. Linda—secluded widow & Emily—happy old lady who lived longer).

·Relationships can be stressful, especially in living conditions that are crowded and lack privacy. Even well meaning family intrusions can be stressful.

·However, close relationships often contribute to health and happiness.

·For most people, family relationships provides most heartaches and comfort/joy.

·Compared with those having few social ties, people are less likely to die prematurely if supported by close relationships with friends, family, fellow workers, members of a faith community, or other support groups.

·Close relations provide the opportunity to confide painful feelings.

·Sustained emotional reactions to stressful events can be debilitating.

·The toxic impact of stressful events can be buffed by a relaxed, health life-style and by the comfort and aid provided by supportive friends and family.

1. Spirituality and Faith Communities

·Historically, religion and medicine have joined hands in caring for the sick.

·Now rather than seeking a spiritual healer when burning with bacterial fever, they turned to antibiotics.

·Keep in mind Women more religiously active than men—women tend to outlive men.

·Religiously active people have healthier life-styles—smoke and drink less.

·Religion encourages another predictor of health and longevity (marriage).

1. Modifying Illness-Related Behaviors

·Fewer than 20% of people going to the doctor with typical complaints (i.e. fatigue, headache, chest or abdominal pain, dizziness, constipation and insomnia) actually have a clear organic problem.

1. Smoking

·Each year through out the world, tobacco kills 4 million of its 1.2 billion customers; According to the World Health Organization (WHO), the death rate will soon grow to 10 million people annually.

·Eliminating smoking would increase life expectancy more than any other preventive measure.

·Nonsmokers live healthier and happier; smoking correlates with higher rates of depression, chronic disabilities, and divorce.

1. When and Why Do People Start Smoking?

-Smoking usually starts during early adolescence and is common among those who get low grades, drop out of school, feel less competent and in control of their future, and whose friends/family smokes.

-If you’re in college or university and cigarette manufacturers haven’t attracted your business, they almost never will.

-Social-cognitive theory (explains how we learn behaviors through models we imitates and social rewards we get) explains an adolescent’s vulnerability to the allure of smoking.

-After smoking’s toxicity became known, smoking in movies declined to once every 12 minutes during the 1970s and 1980s, but returned to once every 4 minutes during the 1990s.

1. Why Don’t People Stop Smoking?

-3 in 4 people try to quit smoking but once one is addicted to nicotine we find it hard to quit.Tobacco products—addictive as heroine and cocaine.

-Ppl initially sensitive to nicotine (feel sick/dizzy—first time smoking) develop a tolerance quickly and become most strongly addicted.

-Quitting causes withdrawal symptoms (i.e. craving, insomnia, anxiety, and irritability). Smoking reinforces smoking by terminating the aversive craving and offering a pleasurable lift.

-Nicotine triggers the release of epinephrine and norepinephrine which diminishes appetite and boosts alertness and mental efficiency.

-Nicotine also stimulates the CNS to release endorphins that calm anxiety and reduce sensitivity to pain.

-i.e. nicotine (like cocaine) increases dopamine; Cocaine does so by blocking dopamine’s reuptake, nicotine by stimulating its release.

-These rewards keep people smoking even when they wish to stop.

1. How Effective Are Programs to Stop Smoking?

-Efforts to help people stop smoking include public health warnings, counseling, drug treatments, hypnosis, aversive conditioning (i.e. having people sicken themselves by rapidly smoking cigarette after cigarette).

-These treatments usually work in the short run but only 1 in 5 smoke again