Stress

Introduction

We all face different challenges and obstacles and sometimes the pressure is hard to handle. When we feel overwhelmed, under the gun, or unsure of how to meet the demands placed on us, we experience stress.

In small doses, stress can be a good thing. It can give you the push you need, motivating you to do your best. But when the going gets too tough and life’s demands exceed your ability to cope, stress becomes a threat to both your physical and emotional well-being. According to old concept To be alive is to be under stress.

Definition: According to Hans Selye, Stress is nonspecific response of the body to any demand made upon it, whether it is caused by the results of pleasant and unpleasant situation.

Stress is any physiological and psychological tension that threats a person’s total equilibrium. In medical terms, stress is the disruption of homeostasis through physical and psychological stimuli.

It is now accepted fact in the medical community that stress is one of the major causes of all illness. Stress can cause migraines, stroke, eczema, a weak immune system and many other diseases.

Classification of Stress

1.       Good stress

·         It motivates, focuses energy

·         It is short-term

·         It is perceived as within our coping abilities

·         It feels exciting

·         It improves performance

Examples of good stress

·         Meeting a challenge

·         Coming in first or wining

·         Getting a promotion

·         Marriage

·         The holidays

·         Buying a new home

·         Receiving a promotion or raise at work

·         Starting a new job

2.       Distress

It is the most commonly referred to type of stress, having negative implications. The word distress has various meanings

·         Distress is a kind of suffering

·         In medicine, distress is stress caused by adverse events.

It has following characteristics

·         It causes anxiety or concern

·         It can be short-or-long-term

·         It is perceived as outside of our coping abilities

·         It feels unpleasant

·         It decreases performance

·         It can lead to mental and physical problems

Examples of Distress

·         The death of a spouse

·         Divorce

·         Losing contact with loved ones

·         The death of a family member

·         Hospitalization (oneself or a family member)

·         Injury or illness (oneself or a family member)

·         Being abused or neglected

·         Separation from a spouse

·         Conflict in interpersonal relationships

·         Money problems

·         Unemployment

·         Sleep problems

·         Children’s problems at school

·         Legal problems

Different Types of Stress

1. Acute stress: Acute stress is the most common and most recognizable from of stress, the kind of sudden jolt in which a person knows exactly why he/she is stressed. Along with obvious dangers and threats, common causes of acute stress include noise, isolation, crowding and hunger. Normally, the body rests when these types of stressful events cease and life gets back to normal. Because the effects are short-term, acute stress usually doesn’t cause severe or permanent damage to the body.

2. Episodic acute stress: Some people endure acute stress frequently; their lives are chaotic; out of control, and they always seem to be facing multiple stressful situations. They’re always in a rush, always late, always taking on too many projects, handling too many demands. Unfortunately, people with episodic acute stress may find it so habitual that they resist changing their lifestyles until they suffer severe physical symptoms.

3. Chronic stress: Chronic stress is stress that wears you down day after day and year after year, with no visible escape. It grinds away at both mental and physical health, leading to breakdown and even death.

Common causes of chronic stress include:

·         Poverty and financial worries

·         Long-term unemployment

·         Dysfunctional family relationships

·         Caring for a chronically ill family member

·         Felling trapped in unhealthy relationships or career choices

·         Living in an area besieged by war or violence

·         Bullying or harassment

4. Traumatic stress: Severe stress reactions can result from a catastrophic event or intense experience such as a natural disaster, sexual assault, life-threatening accident, or participation in combat.

After the initial shock and emotional fallout, many trauma victims gradually begin to recover. But for some people, the psychological and physical symptoms triggered by the trauma don’t go away, the body doesn’t regain its equilibrium, and life doesn’t return to normal. This is a condition known as post-traumatic stress disorder. Common symptoms include flashbacks or nightmares about the trauma, avoidance of places and things associated with the trauma, hyper vigilance for signs of danger, chronic irritability and tension, and depression. PTSD is a serious disorder that requires professional intervention.  

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7 Health Challenges of Aging 3rd

Cancer
Risk for developing most types of cancer increases with age.

"As women age, the rate of cervical cancer decreases, and endometrial cancer increases," says Brangman. "Sometimes women slack off gynecological exams after their childbearing years, but I still think it's important for women to get regular exams."

The risk of prostate cancer increases with age, and black men have a higher rate than white men. Screening should start in your 40s, and at the very least should involve a digital rectal examination.
Lung cancer accounts for more deaths than breast cancer, prostate cancer, and colon cancer combined. Brangman's advice: "Stop smoking."

Cardiovascular Disease (CVD)
Younger baby boomers take heed: cardiovascular disease (CVD) affects more than one-third of men and women in the 45- to 54-year age group, and the incidence increases with age. Cardiovascular diseases, which are diseases of the heart or blood vessels, are the leading cause of death in the U.S. They include arteriosclerosis, coronary heart disease, arrhythmia, heart failure, hypertension, orthostatic hypotension, stroke, and congenital heart disease.

A healthy lifestyle can reduce the risk of heart disease by as much as 80%, according to data from the Nurses' Health Study, an extensive research effort that followed more than 120,000 women aged 30 to 55 starting in 1976. Looking at data over 14 years, the researchers showed that women who were not overweight, did not smoke, consumed about one alcoholic drink per day, exercised vigorously for 30 minutes or more per day, and ate a low-fat, high-fiber diet had the lowest risk for heart disease.

"If you have high blood pressure, get it under control," says Brangman. "It reduces the rate of stroke and heart attacks. People say the medicines have bad side effects, but there are enough medications to choose from that you and your physician should be able to find one that's right for you."

And limit salt intake to control high blood pressure. "Prepared foods are loaded with salt," says Brangman. "The minute food comes out of a can or frozen food package or from a fast-food environment, you lose control of the ingredients. This is another reason to eat foods as close to naturally prepared as possible."

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7 Health Challenges of Aging 2nd

Experts explain how to prepare for the health issues people face as they age.


Arthritis affects nearly half the elderly population and is a leading cause of disability. "Old injuries from playing weekend warrior or high school football, and years of wearing high-heeled shoes catch up with us," says Brangman. "And arthritis in the knees is the price we pay for walking upright on two legs." The keys to prevention: avoid overuse, do steady, regular exercise rather than in weekend spurts, and stop if you feel pain. "The adage, 'no pain, no gain,' is not true."

And managing your weight is just as essential for joint health as cardiovascular health. The Framingham osteoarthritis study showed that a weight loss of just 11 pounds could reduce the risk of developing osteoarthritis in the knees by 50%.

Osteoporosis and Falls
Osteoporosis and low bone mass affect almost 44 million adults age 50 and older, most of them women. According to the National Osteoporosis Association, osteoporosis is not part of normal aging. Healthy behaviors and treatment, when appropriate, can prevent or minimize the condition.

In a given year, more than one-third of adults age 65 and older experience a fall. Twenty percent to 30% of those who fall suffer injuries that decrease mobility and independence; falls are the leading cause of death from injury in this age group.


"Stop smoking, watch your alcohol intake, get plenty of calcium, and limit foods with high acidic content," says Brangman. "Avoid sodas. They encourage loss of calcium. Our bodies always maintain calcium, and when there's not enough coming in from our diet, it comes out from our bones. One reason women are especially at risk for osteoporosis is that if they've had children; it takes a whole lot of calcium to develop a baby, and that calcium is taken from the mother's bones if she's not getting enough in her diet." Adults in middle age need 1,000 to 1,200 milligrams of calcium daily.

Vitamin D, "the sunshine vitamin," is also important. Using sunscreens to protect against skin cancer is wise, but sunscreens block ultraviolet rays the body needs to make vitamin D. Furthermore, with age our bodies become less efficient at making vitamin D from sunlight, Brangman tells WebMD. "There is a move to get the FDA to increase the minimum requirement for vitamin D to at least 800 and maybe 1,000 units. Most multiple vitamins contain 400 units. Make sure you're getting enough from low-fat dairy products, or take a supplement."

Weight-bearing exercise also helps to keep bones healthy. "If you're not exercising, starting at any age is beneficial," says Brangman. "It's never too late, but the sooner the better."

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7 Health Challenges of Aging

Experts explain how to prepare for the health issues people face as they age.
By Leanna Skarnulis


"If I'd known I was going to live this long, I'd have taken better care of myself." So said Eubie Blake, the great ragtime composer and pianist who was still performing at the age of 99, the year before his death. Let's face it: old age is what lies ahead. If you're 40 or 50 or even 60, you might not give much thought to the health challenges of aging. But just as planning for future financial needs is important, so is planning for optimum health.

What should you prepare for, and how? WebMD talked to experts about the major health issues. While some diseases, such as Alzheimer's and certain cancers, continue to confound researchers, a great number can be prevented, forestalled, or minimized with a healthy lifestyle and regular health screenings.

Sharon Brangman, MD, AGSF, spokeswoman for the American Geriatrics Society, tells WebMD, "The more you do in middle age to prepare yourself for successful aging, the better."

Obesity and Metabolic Syndrome
About three-fourths of adults aged 60 and older are overweight or obese. Obesity is related to type 2 diabetes, cardiovascular disease, breast and coloncancer, gall bladder disease, and high blood pressure.


More than 40% of adults 60 and older have a combination of risk factors known as metabolic syndrome, which puts people at increased risk for developing diabetes, cardiovascular disease, and certain cancers. It is characterized by:

Waist measurement greater than 40 inches in men, 35 inches in women (apple-shaped body)
Triglyceride level of 150 mg/dL or higher
HDL "good" cholesterol level less than 40mg/dL in men, 50 mg/dL in women
Blood pressure of 130/85 or higher
Fasting glucose level of 110 mg/dL or higher
"Women in perimenopause and menopause tend to accumulate fat around the waist and hips, and men get the gut," says Brangman. "The best way to fight it is with increasing exercise, reducing alcohol intake -- because a lot of alcohol calories go right to the gut -- and reducing calorie intake. Also, increase your healthy fat intake -- omega-3 fatty acids and unsaturated fats. And eliminate trans fats completely because there's no safe amount of those."

She also advises avoiding foods sweetened with high-fructose corn syrup. The common sweetener is found in everything from sodas to breakfast cereal to low-fat yogurt. "In middle age, we should eat foods as close to naturally prepared as possible."

source: http://www.webmd.com

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Physiological changes during older adulthood 3rd

8. Changes in Immune System: Age-related changes in the immune system increase vulnerability to inflections, tumors and immune disease. Factors that affect immune system function include hormonal changes, age, nutrition and psychological factors.

  a. As we grow older, our bodies are less able to produce antibodies which are important in fighting infections. As a result older adults are at greater risk for infections.
  b. The thymus gland produces hormones that are important for the development of white blood cells. The shrinking of the thymus gland begins after adolescence and the level of thymus hormones cannot be detected in the blood.
  c. As we age, the immune system also responds less vigorously to skin tests in which a foreign substance is injected below the skin surface, indicating a diminished response to antigens.

Summary of age-related changes in the immune system are:
• Decrease production of thyme hormones
• Decrease levels of antibody response
• Response to antigens diminishes

9. Changes in Musculoskeletal System
 Age-related changes in the musculoskeletal system
• Height decreases an average of 2 inches.
• Weight increase until about age 60 and then declines.
• Body fat mass can double, lean muscle mass is lost.
• Decline in bone density.
• Skin becomes thinner and dryer.
• Hair becomes gray.

10. Changes in Reproductive System
Age-related changes in the female reproductive system:
• Ovulation ceases and estrogen levels drop by 95%.
• Vaginal walls become thinner and lose elasticity.
• Most women experience a decrease in the production of vaginal lubrication.
Age-related changes in the male reproductive system
• In some men, testosterone levels drop by up to 35%.
• The size of the testes decreases.
• There is a decline in the rate of sperm production although the extent varies among individuals.
• Erectile dysfunction, in which an erection cannot be achieved, is experienced by 15% of men by the age of 65 and increases to 50% by age 80.

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Physiological changes during older adulthood 2nd

4. Changes in gastrointestinal system: The gastrointestinal system consists of the esophagus, the stomach, the small intestine, the large intestine or colon, the liver, gallbladder and the pancreas. Generally the physiological changes of an aging digestive system are minor.

Major gastrointestinal changes with aging 
  a. Increased prevalence of atrophic gastritis and achlorhydria.
  b. The liver is less efficient in metabolizing drugs and repairing damaged liver cells.
  c. Diverticulitis in the colon may cause pain.
  d. Reduced peristalsis of the colon can increase risk for constipation.

5. Changes in Urinary System: The urinary system includes the kidneys, ureters, urethra and bladder. It undergoes substantial changes in function as we grow older. In both men and women, urinary changes are often associated with changes in the reproductive system.



Urinary system changes with aging 
  a. Kidney mass decrease by 25-30 percent and the number of glomeruli decrease by 30 to 40 percent. These changes reduce the ability to filter and concentrate urine and to clear drugs.
  b. With aging, there is a reduced hormonal response and an impaired ability to conserve salt which may increase risk for dehydration.
  c. Bladder capacity decreases and there is an increase in residual urine and frequency. These changes increase the changes of urinary infections, incontinence and urinary obstruction.

6. Changes in Endocrine System: The endocrine system is a complex network of glandular tissues that secrete hormones directly into the blood which are used by target organs. The endocrine system controls a variety of important functions such as energy metabolism, reproduction and stress response.

Age-related changes in the endocrine system
  
  a. Insulin resistance may prevent efficient conversion of glucose into energy.
  b. A decrease in aldosterone and cortisol may affect immune and cardiovascular function.

7. Changes in Nervous System

  a. Older nerve cells may have fewer dendrites and some may become demyelinated which can slow the speed of message transmission. Most of these changes do not appear to affect ordinary activities of living.
  b. Decreased blood supply to the brain and loss of cells cause memory loss and confusion which may alter the personality of an older.
  c. The sense organs are functioning less than younger e.g. Hearing slowly declines, visual acuity also declines.
  d. The sense of taste and smell diminishes resulting in decreased appetite.
  e. Ability to respond to stimuli decreases which causes loss of sensation and perception.
  f. As people grow older, the rate at which they process information declines. Information processing has three phases

• Encoding: Getting information into the system. Encoding is particularly vulnerable to age. As we age it takes more time to encode information than when they were younger. This slower rate of encoding may be due to changes in our vision, hearing and other senses that reduce the efficiency of memory. The slower rate of encoding is most likely the reason for age-related declines in short-term memory.
• Storage: retaining information
• Retrieval: recalling information 

Two types of memory tasks are recall and recognition. Regardless of age, recognition is better than recall. recognition does not declines as we age, but recall does. Long-term memory may decline as we age depending on the extent to difficulty with encoding information. Very long-term memory which spans months or years is relatively stable until well after age 70.

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Physiological changes during older adulthood

Physiological changes during older adulthood

• A number of physiological changes occur as we  grow older.
• Most of the normal changes of aging have no impact on normal functioning,although they become apparent when the body is placed under stress (e.g.,acute illness,physical exertion).For example ,the heart rate of older adults is lower than that of younger adults.
• It is important to be able to recognize the changes of normal aging versus the effects of disease.Untreated disease can result in''excess disability'' and reduce the quality of life of individuals.
• Poor health in later life is not inevitable. Much of the illness and disability associated with aging is related to modifiable lifestyle factors that are present in middle  age.

Following are the changes in various systems of an older 

1.changes in the integumenty system
  a. The skin becomes thinner drier and wrinkles appear on the face and neck.
  b. The skin can be easily injured or bruised.
  c. The subcutaneous layer of fat is lost causing sagging of the skin and less tolerance to cold.
  d. There may appear lesion or spots over the skin.
  e. Perspiration may decrease due to diminished blood supply to the skin.

2. Changes in cardiovascular system: In healthy people, the changes that normally occur in the cardiovascular system with aging do not significantly limit the normal work capacity of the heart. Most of the changes that cause clinically significant declines in cardiovascular function are the results of disease.

Major cardiovascular changes with aging are:

  a. The maximum heart rate decreases and it takes longer for heart rate and blood pressure to return to normal resting levels after exertion.
  b. The aorta and other arteries become thicker which may bring a moderate increase in systolic blood pressure with aging. In some individuals, this may result in hypertension.
  c. The valves between the chambers of the heart thicken and become stiffer. As a result heart murmurs are fairly common among older adults.
  d. The pacemaker of the heart loses cells and develops fibrous tissue and fat deposits. These changes may cause a slightly shower heart rate and even heart block. Abnormal heart rhythms and extra heart beats become more common.

3. Changes in respiratory System: The respiratory system reflects changes that occur in many other body systems, including the cardiovascular, nervous and musculature system. Most of the normal respiratory changes with age are of little functional significance in healthy older adults. However, they do reduce reserve capacity and increase vulnerability to respiratory disease.

Major age-related changes in the respiratory system

  a. The lunges become stiffer, muscle strength and endurance diminish, and the chest wall becomes more rigid.
  b.  Total lung capacity remains constant but vital capacity decreases and residual volume increase.
  c. The alveolar surface area decreases by up to 20 percent. Alveolar tend to collapse sooner on expiration.
  d. There is an increase in mucus production and a decrease in the activity and number of cilia.
  e. The body becomes less efficient in monitoring and controlling breathing.

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