Unit 7: Mental and Physical Health

Stress and Health

Stress refers to the process of perceiving and responding to events, called stressors, that we appraise as threatening or challenging. Stress activates both physiological and psychological responses, such as increased heart rate, muscle tension, and heightened alertness, which can affect both mental and physical health.

a. Reasons of Stress

• Daily Hassles: Minor, everyday stressors such as traffic, misplacing items, or interpersonal conflicts. Though small, their cumulative effect can cause chronic stress if unmanaged. Managing these hassles is key for maintaining well-being.
• Major Life Events: Major occurrences such as marriage, divorce, moving, or starting a new job. These require significant adjustment and can be either positive or negative. Commonly measured using the Holmes-Rahe Stress Scale.
• Catastrophes: Large-scale, unpredictable disasters (e.g., earthquakes, wars, pandemics). They can cause intense stress and long-term effects such as post-traumatic stress disorder (PTSD). Coping requires resilience and community support.

b. Cognitive Appraisal Theory (Richard Lazarus)

This theory explains how individuals evaluate and respond to stressors based on their personal perceptions. Stress arises not just from external events but from how we interpret them.

• Primary Appraisal: Determining whether an event is irrelevant, positive, or a stressor. Shapes initial emotional responses (fear, excitement, etc.).
• Secondary Appraisal: Evaluating one’s resources and ability to cope. A positive appraisal reduces stress; a lack of perceived resources increases it.

c. Stress Response and the Body

The body reacts to stress through the General Adaptation Syndrome (GAS), a three-stage model by Hans Selye.

• Alarm Reaction: The “fight-or-flight” response. The sympathetic nervous system activates, releasing adrenaline and cortisol. Body prepares for immediate action.
• Resistance: The body maintains a heightened state of alertness, using energy reserves and coping mechanisms to manage stress. Prolonged resistance strains the body.
• Exhaustion: Prolonged exposure depletes resources, increasing vulnerability to illness, fatigue, and mental health issues. Chronic stress at this stage can cause severe damage.

Chronic stress is especially harmful, weakening the immune system and contributing to conditions like high blood pressure, heart disease, and depression.

d. Coping Mechanisms

Coping mechanisms are strategies for managing stress and challenging situations. They can be:

• Problem-Focused Coping: Directly tackling the problem (e.g., making a plan, seeking information). Effective when the stressor is controllable.
• Emotion-Focused Coping: Managing emotional responses (e.g., relaxation techniques, journaling, seeking emotional support). Useful when the stressor is uncontrollable.
• Maladaptive Coping: Avoidance, denial, or substance use. These reduce stress temporarily but harm long-term mental and physical health.

The Diathesis-Stress Model

The Diathesis-Stress Model explains how mental disorders result from the interaction between genetic/biological predispositions (diathesis) and environmental stressors. Neither factor alone is always sufficient; both contribute to the development of psychological disorders.

Key Components

Diathesis (Vulnerability): A predisposition toward developing a disorder.

• Can be biological (genetics, brain chemistry, neurotransmitter imbalance)
• Can be psychological (personality traits, cognitive style)

Stress (Environmental Triggers): External pressures that can activate the diathesis.

• Examples: trauma, abuse, chronic stress, major life changes, poverty

Interaction:
A disorder develops when the level of stress exceeds the individual’s ability to cope, given their vulnerability.

Example

Two people experience the same stressful event, such as the loss of a loved one:

• Person A has a genetic predisposition for depression. Under stress, symptoms of Major Depressive Disorder appear.
• Person B does not have the same vulnerability and therefore grieves but does not develop clinical depression.

Applications

• Helps explain why some individuals develop disorders while others do not, even under similar stress.
• Used in understanding schizophrenia, depression, anxiety disorders, and PTSD.
• Supports treatment approaches that address both biological vulnerability (e.g., medication) and stress management (e.g., CBT, resilience training).

Psychological Disorders

Psychological disorders are conditions involving patterns of thoughts, feelings, or behaviors that cause distress or impair daily functioning. They are influenced by biological, psychological, and social factors.

Anxiety Disorders

Generalized Anxiety Disorder (GAD): Persistent, uncontrollable worry.
Symptoms: Fatigue, restlessness, irritability, difficulty concentrating, sleep problems.
Treatments: Cognitive-Behavioral Therapy (CBT), SSRIs, relaxation training.

Panic Disorder: Sudden panic attacks with physical symptoms.
Symptoms: Racing heart, sweating, chest pain, fear of dying.
Treatments: CBT with exposure, SSRIs, relaxation techniques.

Phobias: Irrational fears of objects/situations (e.g., heights, spiders, flying).
Symptoms: Avoidance, rapid heartbeat, sweating, panic.
Treatments: Systematic desensitization, exposure therapy.

Obsessive-Compulsive Disorder (OCD): Repetitive thoughts (obsessions) and actions (compulsions).
Symptoms: Compulsive cleaning/checking, intrusive thoughts, fear of contamination.
Treatments: CBT (exposure and response prevention), SSRIs, sometimes deep brain stimulation.

Post-Traumatic Stress Disorder (PTSD): Develops after trauma.
Symptoms: Flashbacks, nightmares, hypervigilance, avoidance of reminders.
Treatments: Trauma-focused CBT, EMDR, SSRIs, support groups.

Mood Disorders

Major Depressive Disorder: Persistent sadness and loss of interest (≥2 weeks).
Symptoms: Low mood, fatigue, appetite/sleep changes, suicidal thoughts.
Treatments: CBT, SSRIs/SNRIs, ECT for severe cases.

Bipolar Disorder: Shifts between mania and depression.
Symptoms: Manic episodes (elevated mood, impulsivity) alternating with depressive episodes.
Treatments: Mood stabilizers (lithium), atypical antipsychotics, therapy.

Psychotic Disorders

Schizophrenia: Characterized by disruptions in thought and perception.
Symptoms:
Positive: Hallucinations, delusions, disorganized speech/behavior.
Negative: Flat affect, withdrawal, reduced motivation.
Treatments: Antipsychotics, CBT for hallucinations/delusions, family therapy, social skills training.

Eating Disorders

Anorexia Nervosa: Extreme restriction of food intake, intense fear of weight gain.
Symptoms: Malnutrition, distorted body image, excessive exercise.
Treatments: Nutritional therapy, CBT, family-based therapy.

Bulimia Nervosa: Binge eating followed by purging.
Symptoms: Vomiting, excessive exercise, fasting, feelings of guilt/shame.
Treatments: CBT, SSRIs, nutrition counseling.

Binge-Eating Disorder: Recurrent overeating without purging.
Symptoms: Loss of control, rapid eating, distress, weight gain.
Treatments: CBT, interpersonal therapy, weight management programs.

Somatic Symptom Disorders

Somatic Symptom Disorder: Physical symptoms without clear medical cause.
Symptoms: Pain, fatigue, GI problems, excessive health worries.
Treatments: CBT, stress management, psychotherapy to address underlying anxiety.

Personality Disorders

Borderline Personality Disorder: Instability in mood and relationships.
Symptoms: Fear of abandonment, impulsivity, self-harm, mood swings.
Treatments: Dialectical Behavior Therapy (DBT), SSRIs, group therapy.

Antisocial Personality Disorder: Disregard for others, lack of empathy.
Symptoms: Deceitfulness, aggression, irresponsibility, unlawful behavior.
Treatments: Difficult to treat; CBT and structured behavior programs, sometimes SSRIs for aggression.

3. Treatment of Psychological Disorders

Cognitive-Behavioral Therapy (CBT): Identifies and changes negative thought patterns.

Psychoanalysis (Freud): Explores unconscious conflicts using free association and dream analysis.

Humanistic Therapy (Carl Rogers): Emphasizes empathy, unconditional positive regard, and personal growth.

Biological Treatments: Includes SSRIs/SNRIs for depression, benzodiazepines for anxiety, antipsychotics for schizophrenia, mood stabilizers for bipolar disorder.

Electroconvulsive Therapy (ECT): Used in severe, treatment-resistant depression.