Science of Stress and Stress

Management
Satish Kalra
Introduction
 Stress
• Stress is the state of threatened homeostasis that emerges on
exposure to adverse forces.
• Acute stress: It emerges from pressures of the near future or of
recent past. It is a short term stress and does not have enough time
to damage the body. Acute stresses like exercise are in fact enjoying
and exciting and hence, good in life.
• Chronic stress: It emerges from persisting pressures. Consequences
of chronic stress are serious.
• Stress emerges from over activity of sympathetic nervous system, a
branch of autonomic nervous system.
• Broadly chronic stress leads to increase of heart rate and blood
pressure and, diaphragm and anus lock. Hands and feet get cold
because the blood is directed towards the larger muscles to prepare
for fight or flight.
 Stress sources
Environment: Weather, noise, crowding, interpersonal
demands, time pressures, performance standards,
unpredictable traffic loads, threats to security and self-
esteem
Physiological: Rapid growth of adolescence, menopause in
women, ageing, illness, accidents, lack of exercise, poor
nutrition, shift work and sleep disturbances
Thought: Brain interprets and translates complex events in
environment and body physiology to determine when to
push panic button. How one interprets, perceives and
labels the present experience and how one predicts the
future determines whether to relax or stress.
 Elderly persons are more prone to stress because of
progressive decline in nervous system

With age
• There is gradual loss of nerve cells called neurons and
their offshoots called axons and dendrites; it is through
these offshoots that the central nervous system
communicates with every cell and organ of the body.
• There is 40% loss of sensory receptors from age 60 to
90; present in sense organs, sensory receptors are
responsible for detecting stimuli like temperature,
light, sound, chemicals in food and air, pressure, pain,
blood pH, bladder distension etc.
• Rate of blood flow to visceral organs decrease due to a
decline in cardiovascular and skeleto-muscular changes
 Nervous System
The nervous system is the master controller of the human
body and helps coordinate body activities and ensures
homeostasis; it communicates though brain cells and their
offshoots.
Its general functions are as under:
• Detects changes through sensory receptors: Stimuli are
transformed into electric signals, the language of nervous
system.
• Transmits electrical signals to the central nervous system
• Transmits the information to specific areas of the brain
• Sends commands to the target tissues like muscles and
glands to produce the response
 Place of Autonomic Nervous System
in the Nervous System
Central Nervous System (CNS) consists of the brain and the spinal cord.
Peripheral Nervous System (PNS) consists of nerves that link the body with
CNS; 12 pairs of nerves emerge from brain and 31 pairs from spinal cord.
PNS has two subdivisions
– Sensory nerves are the input nerves and send nerve impulse from the body to
CNS
– Motor nerves are the output nerves.
Motor nerves consists of two systems
– Somatic nervous system regulates voluntary muscles
– Autonomic nervous system regulates involuntary muscles
Autonomic Nervous System (ANS): It is also called the visceral nervous
system because it controls smooth muscle, cardiac muscle, and glands,
that make up the viscera of the body; it has three branches:
– Sympathetic nervous system (SNS)
– Parasympathetic nervous system (PNS)
– Enteric nervous system (ENS)
 Characteristics of ANS
It is a two-neuron chain; preganglionic neurons originate in CNS and
postganglionic neurons originate in the ganglion; ganglia are located
within a few cm of CNS, along the vertebral column
Sympathetic Nervous System (flight– or– fight system)
• Activated in emergencies, and enables the body to flee quickly or
"take a stand“
• Stimulates activities of the organs except digestive organs
Parasympathetic Nervous System (Rest and Digest)
• Functions in opposition to SNS
• Functions mediated by PNS do not require immediate reaction
• Inhibits activities of the organs except digestive organs
Enteric nervous system or ENS
• Governs the function of the gastrointestinal tract
Anatomical Location of PNS and SNS
SNS and PNS do opposite things in the
body
 Enteric nervous system (ENS)
• Also termed as the intrinsic nervous system, ENS Iis
embedded in the lining of the gastrointestinal system,
beginning in the esophagus and extending down to the
anus.
• Consists of about 500 million neurons, equivalent to
1/200th of the number of neurons in the brain and five
times the number neurons in the spinal cord.
• Has been described as a "second brain" since it can operate
autonomously even though it normally communicates with
the CNS through ANS.
• Through intestinal muscles, the motor neurons
control peristalsis and churning of intestinal contents.
• Other neurons control the secretion of enzymes.
 Stress leads to elevated
sympathetic nerve activity
 Stress perception
Physiological symptoms: Raised pulse rate, raised blood pressure,
raised blood cholesterol, ulcers, back pain, headaches, stomach
upsets, cold fingers and wet hands
Behavioral symptoms: Lateness, absence, fatigue, loss of sleep,
impotence, substance abuse, reduced interest in completing tasks,
uncompleted tasks, untidy work area, avoidance, reduced interest
in helping others and reduced interpersonal contact
Symptoms in mental functioning: Lack of concentration, indecision,
poor priorities, procrastination, worrying, lack of creativity and
flexibility
Emotional symptoms: Irritability, low self-esteem, cynicism,
dissatisfaction with work and/or life, depressive mood and
enhanced emotional reactivity
 Physiology of Sympathetic Over-
activity
• We always have a certain amount of stress hormones in our body
dictating activity and energy.
• When the level of stress hormones crosses threshold level, we react
through reptile brain
• The cerebral cortex, the site of the logical thinking process,
witnesses ‘psychological fog’ or loss of ability to think clearly and
show reasonable behavior.
• When the situation is no longer threatening, the brain stops
triggering stress hormones. The hormones and chemicals are
metabolized and within three minutes the body stops sending
emergency signals to the reptile brain and we returns to normal.
• However, if the hormonal and other changes triggered during fight
and flight response persists, it leads to chronic stress.
 Mechanism of Flight-fight Response
• Flight-fight response is series
of changes that prepares the
body to deal with the threat.
• When in a threatening
situation, Hippocampus or the
reptile brain quickly decides
whether we prepare the body
to fight or leave the situation.
• Limbic brain manages the
emotions we perceive as likes
or dislikes.
• These two parts of the brain
coordinate and send signals to
our hormone system.
 Potential consequences of elevated central sympathetic
nerve activity on heart and vascular system

Vascular Effects Heart

Endothelial cell damage Heart muscles hypertrophy

Increased blood pressure Left ventricular hypertrophy

variability
Increased vascular resistance Increased arrhythmia

Hypertension Tachycardia

Atherosclerosis
 Potential consequences of elevated central sympathetic
nerve activity on metabolism and renal system

Metabolism Renal effects

Insulin resistance Vasoconstriction

Increased plasma Sodium and fluid

insulin concentration retention
Dislipidemia or Glomerulosclerosis or
elevated cholesterol hardening of capillaries
and lipid levels in blood in kidney units
Activation of parasympathetic
system is the key to Stress
management
Parasympathetic nerves and their role
• Cranial nerves: They are responsible for functions related
to the eye, ear and naso-pharynx etc like secretion of
salivary, lacrimal and mucus glands and taste receptors etc.
• Vagus nerve: It are destined for thoracic viscera
(esophagus, trachea, heart, lungs) and abdominal viscera
(stomach, pancreas, liver, kidneys, small intestine, and
about half of the large intestine)
• Pelvic nerves
• A useful mnemonic to summarize the functions of the
parasympathetic nervous system is SSLUDD (sexual
arousal, salivation, lacrimation, urination, digestion and def
ecation).
 Emotional support
• Communication is much more than the words we say since
words determine merely 7 - 12 % of the impact and
meaning of our message.
• Over 80% of message comes from our body language like
posture, gestures, eye-contact and the tone of voice
embedding the message; we hear best through our eyes.
• Open arms, open legs, a friendly smile, nodding the head, a
touch on the shoulder, that's the way to show
understanding.
• Mirror the person's emotions and the person under stress
calms down, the psychological fog disappears.
• Communication on the logical level is only the next phase.
 Logical support
• Support in this phase is aimed at helping the
stressed person to find logical solutions.
• Often people find their own solutions.
• Help in formulating the coping action is often
appreciated. Ask: “What are you going to do
about it?” and summarize the planned
action(s), that is the best help you can give.
 Prevention and Coping
Prevention is designed to keep the stress out
• Annual medical checks.
• Open, supportive attitude and behavior
Coping
• Recognize stress symptoms
• Time management and prioritizing, at the beginning of
each day
• One thing at a time, and deal with everything only once
• Less calories, less fat, less sugar food
• Exercise
• Relaxation: breathing, time off and relaxation techniques
• Support systems: family, friends and/or workgroups.
Parasympathetic activation
through Yoga
Stress management by honoring
Circadian Rhythm
 Introduction
• Internal biological clock anticipates day/night cycles
and helps us to optimize our physiology and behavior
• Internal biological clock is known as “circadian”; term is
derived from the Latin words circa meaning “around”
and dies meaning “day”.
Building blocks of a circadian system
• A self-sustained 24-hour rhythm generator or oscillator
• Setting mechanisms that link the internal oscillator to
external stimuli like light
• Output mechanisms to allow the timely scheduling of
physiological processes
 Entrainment and synchronization of
biological clocks
• The central pacemaker is located in the hypothalamus and
functions as the master circadian clock.
• Retina receives photic input and relays this information to the
hypothalamus, which synchronizes its own cellular clocks.
• The central clock regulates circadian rhythms across the entire body
via humoral factors and ANS.
• Circadian system resembles a clock shop rather than a single
clock: Peripheral clocks in different tissues control relevant
physiological outputs, such as glucose production, fat storage and
release of hormones.
• Synchronization of biological clocks: Peripheral clocks can be
synchronized both by the SCN and by environmental cues, including
feeding, physical activity and temperature.
 Circadian clock and human physiology

Circadian clock helps to regulate sleep patterns, feeding behavior, hormone release,
blood pressure and body temperature. It also regulates large proportion of our genes.
 Don’t allow lifestyle to stress the
circadian clock
• Circadian clocks help to regulate sleep patterns, feeding
behavior, hormone release, blood pressure and body
temperature.
• Circadian dysfunction has been linked to sleep disorders, as
well as depression, bipolar disorder, cognitive function,
memory formation and some neurological diseases.
• Chronic misalignment between our lifestyle and the rhythm
dictated by our endogenous circadian clock may be
associated with increased risk for various diseases including
cancer, neurodegenerative diseases, metabolic disorders
and inflammation.
• So don’t allow lifestyle to stress your circadian clock.