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Stress

Stress. Photo: http://www.lam.mus.ca.us/cats/encyclo/smilodon/. Stress: The Importance of Allostasis . The term came into being in the 1980’s as a newer more appreciative way to view the body’s rapid and efficient methods of dealing with stress.

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Stress

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  1. Stress Photo: http://www.lam.mus.ca.us/cats/encyclo/smilodon/

  2. Stress: The Importance of Allostasis • The term came into being in the 1980’s as a newer more appreciative way to view the body’s rapid and efficient methods of dealing with stress. • Allostasis refers to the body’s ability to maintain stability amidst change. M Lu, N Halfon

  3. Allostasis: Maintain Stability through Change McEwen BS. Protective and damaging effects of stress mediators. N Eng J Med. 1998;338:171-9.

  4. Allostasis: Wear and Tear • There are, however, situations that ignite stress response in which neither fight nor flight is an option….the response cannot help us toward resolution. Then, deprived of its natural result, the system designed to protect us begins to cause wear and tear  illness and vulnerability.

  5. ALLOSTASIS TO ALLOSTATIC LOAD Four Scenarios McEwen B. New England J. Med. 1998

  6. Stress and Biology: Allostatic loading • Unremitting chronic stress, or severe trauma, particularly at windows of vulnerability and opportunity in human development. • Inability to adjust. • Not hearing the “all-clear” signal • Feedback loops impaired. Practical leadership action: 1. Foster conditions to prevent stress and severe trauma. 2. Strengthen capacity to deal with stress. 3. Promote healing from stress and trauma.

  7. What we often mean by “stress” is being “stressed out”! Feeling overwhelmed, out of control, exhausted, anxious, frustrated, angry What happens to us? Sleep deprivation Eating too much of wrong things, alcohol excess, smoking, etc. Neglecting regular, moderate exercise All of these contribute to allostatic load Psychosocial stress is a major factor

  8. Levels of stressful experiences: Their causes, consequences and why we experience them! • Positive Stress • - A personal challenge that has a satisfying outcome • Result: Sense of mastery and control • -HEALTHY BRAIN ARCHITECTURE • -good self esteem, judgment and impulse control • Tolerable Stress • Adverse life events buffered by supportive relationships • Result: Coping and recovery • HEALTHY BRAIN ARCHITECTURE • -good self esteem, judgment and impulse control • Toxic Stress • Unbuffered adverse events of greater duration and magnitude • Result: Poor coping and compromised recovery • Result: Increased life-long risk for physical and mental disorders • COMPROMISED BRAIN ARCHITECTURE • Dysregulated physiological systems

  9. HPA Axis Hypothalamic-pituitary-adrenal axis • Initiated in the hypothalamus gland, it is the cornerstone of allostasis. Impaired HPA axis function from toxic stress leads to chronic high levels of cortisol. Prolonged high levels of cortisol suppress immune function, increase inflammation, and may lead to LBW,preterm birth, diabetes, c-v disease, etc. Toxic stress may thus result in a hyper-reactive, dysregulated HPA axis. • Two possible mechanisms: Cumulative “wear and tear” (weathering) throughout the life cycle and fetal or childhood programming.

  10. Social environment and health Central Role of the Brain MacArthur Foundation Research Network on Socioeconomic Status and Health Behavioral responses (“lifestyle”) as well as stressful experiences McEwen B. New England J. Med. 1998

  11. Prenatal Programming of the Hypothalamic-Pituitary-Adrenal Axis Welberg LAM, Seckl JR. Prenatal stress, glucocorticoids and the programming of the brain. J Neuroendocrinol 2001;13:113-28.

  12. Stress, allostasis and allostatic load STRESS Many targets for cortisol AVP CRH Cortisol ACTH Acute - enhances immune, Memory, energy replenishment, Cardiovascular function Chronic - suppresses immune, Memory, promotes bone Mineral loss, muscle wasting; Metabolic syndrome

  13. Mediators of stress and adaptation NETWORK OF ALLOSTASIS CNS function Metabolism Immune function Cardiovascular function Dysregulation by Biphasic and non-linear -unhealthy lifestyle, poor sleep, toxic chemicals -feed into network of allostasis (eg elevated inflammation, cortisol)

  14. Positive Stress Increased cardiac output Increased available glucose Enhanced immune functions Growth of neurons in hippocampus & prefrontal cortex Toxic Stress Hypertension & cardiovascular diseases Glucose intolerance & insulin resistance Infection & inflammation Atrophy & death of neurons in hippocampus & prefrontal cortex Positive Stress vs. Toxic Stress

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