Health Problems Most Impacted By Stress

1. Health Problems Most Impacted By Stress By: Kimberly Stewart

2. Stress • Definition • Stressors: Internal and External Simply described as the body’s reaction to any and all demands that may be placed upon it.

3. Acute Stress Short-term Fight or Flight Response Not life threatening Chronic Stress Constant One must try to suppress the Fight or Flight response Can be life threatening Types of stress

4. Stress as an ongoing problem • 1983, Time Magazine published a cover story labeling stress as the “Epidemic of the Eighties”. • Stress has become even more extensive today. • Stress can lead to long-term health problems and even lead to death.

5. Stress and the link to health THE LINK • WHO defines health as the presence of well-being, physical, mental and social, not as the absence of disease. • Recent research has found that stress contributes to 80% of all major illness and disease. • Stress can cause many health problems and can affect all systems of the body.

6. Pathophysiology of stress • CNS • Fight or Flight response • The “Information Superhighway” • Limbic-hypothalamic-pituitary-adrenal systems (LHPA) • The information is then relayed into instructions in the form of chemical messengers: neurotransmitters known as catecholamines that trigger the physiological response such as the Acute Phase Response.

7. Pathophysiology of stress • The LHPA axis represents how stressors interact with various centers in the brain and initiate the production of various hormones • Corticotrophin-releasing hormone • Adrenocorticotrophin hormone • Glucocorticoid Hormones: the primary stress hormone- Cortisol • LHPA axis dysfunctions can lead to serious problems

8. Stress and your health • LHPA dysfunctions can range from moderate to serious medical conditions. • The health problems most impacted and researched due to stress: • Immunosuppression • Coronary Artery Disease (CAD) • Hypertension • Diabetes • Metabolic Syndrome

9. The immune systems response • Stress in excess will bring about GC mediated immunosuppression mediated by proinflammatory cytokines: • interleukin-1 • interleukin-6 • Tumor necrosis factor alpha • Decrease number of B-cells, T-cells and NK cells • The suppressed immune system will enhance the body’s susceptibility to many diseases.

10. Stress and Metabolic syndrome • Today’s Life style changes • Leading to more prevalence of atherosclerotic vascular disease and Metabolic Syndrome • What is Metabolic Syndrome: • Obesity, hyperinsulinemia, dislipidemia, impaired glucose tolerance, and HTN.

11. Stress and Diabetes • How stress affects diabetes • The momentary and sustained regulation of blood pressure and blood glucose is regulated by the SNS • Mental stress increases the release of catecholamines from the SNS and overtime excessive release may lead to HTN and hyperglycemia.

12. Stress and CAD • Associated with a proinflammatory state, obesity, insulin-resistance, & diabetes will increase the risk of developing CAD. • 40-50% of patients DX with CAD have no other risk factors associated with CAD other than stress • Traditional risk factors for CAD only account for two thirds of the cases which raises concern for the remaining one third – Psychosocial factors?

13. Susceptibility to Stress • While some handle stress well, others are greatly impacted by it’s negative affects on their mental, physical and emotional health. • Many factors influence one’s susceptibility: • Personality traits, Genetics, Immune regulated diseases • 2001 study reviewed by Nidus

14. Stress Management • Not avoided but Managed • Healthy Lifestyle, cognitive behavior techniques, yoga, deep breathing, and relaxation • 2003 study Freeze Frame technique • Study results showed a decrease in the number of employees reporting any stress symptoms dropped by 56%.

15. Physiology of Mind-Body medicine • Concept of Mind-Body medicine • Based on more than 2,000 scientific research studies in the past 25 yrs. • Paradigm of psychoendoneruroimmunology • New model of health care: biopsychosocial model

16. Conclusion • Even with today’s biomedical advances, our victory over disease and illness is not all from the direct result of these advances. • Research demonstrates that social and psychological variables are linked to overall health. • Chances of improving health care is with a new approach of patient centered care. • Evidence proves that the stress response does play a role in our overall health and that prevention may be the best cure.

17. Test to gauge how stressed you were with masters projects.

18. References Balch, Phyllis A., Balch, J., The Prescription for Nutritional Healing, 3rd Edition. www.choose-health.com/stress.html, 2005. Baker, P. The inflammatory response is an integral part of the stress response: Implications for atherosclerosis, insulin resistance, type II diabetes and metabolic syndrome X. Brain, Behavior, and Immunity 2003; 17: 350- 364. Barnett, P., Jennings, J., Manuck, S., Spence, J. Psychological stress and the progression of carotid artery disease. Journal of Hypertension1997; 15 (1): 49-55. Blumenthal, J., Kaplan, J., Rozanski, A. Impact of Psychological Factors on the Pathogenesis of Cardiovascular Disease and Implications for Therapy. Clinical Cardiology; New Frontier1999; 99: 2192-2217. ChildreD., Cryer B., McCraty R. Pull the Plug on Stress. Harvard Business Review 2003: 102-107. Con, AH., Lenz JW., Linden, W., Individualized stress management for primary hypertension: a randomized trial. Arch Intern Med 2001; 161(8): 1071- 80. Hjemdahl, P. Stress and the Metabolic Syndrome: An interesting but Enigmatic Association. American Heart Association 2002: 106: 2634-2636. Jacobs, Gregg. The Physiology of Mind-Body Interactions: The Stress Response and The Relaxation Response. J. of Alternative and Complementary Med 2001; 7: S83-S92.

19. References Con’t Lozovaya N., Miller A. Chemical Neuroimmunology: Health in A Nutshell Bidirectional Communication between Immune and Stress (Limbic- Hypothalmic-Pituitary-Adrenal) Systems. ChemBioChem 2003; 4: 466- 484. Ray, Oakley. How the Mind Hurts and Heals the Body. American Psychologist 2004a; 59 (1): 29-40. Ray, Oakley. The Revolutionary Health Science of Psychoendoneuroimmunology: A New Paradigm for Understanding Health and Treating Illness. Ann. N.Y. Acad. Sci. 2004b; 1032: 35-51. Scollan-Koliopoulos, Melissa. Managing Stress Response to Control Hypertension in Type 2 Diabetes. The Nurse Practitioner 2005; 30 (2): 46-49. Steptoe, A., Strike, P. Psychosocial Factors in the Development of Coronary Artery Disease. Progress in Cardiovascular Diseases 2004; 26 (4): 337-347.

20. Bibliography 1. www.indiana.edu/~health/stress.html (accessed October 1, 2005) 2. www.stress.org/problem.htm (accessed October 1, 2005) 3. www.lifepositive.com/mind/psychology/stress/stress-and-health.asp (accessed October 1, 2005) 4. American Diabetes Association, 2005 www.healthdiscovery.com/centers/diabetes/ada/yourbody/stress_print.html (accessed November 26, 2005) 5. Nidus Information Services, 2001 www.reutershealth.com/wellconnected/doc31.html (accessed November 26,2005)