I continue to be extremely busy on placement within the community, working alongside the Home-Based Treatment Team (formerly called the Crisis Team). This week I also spent two days with the Rapid Assessment Team at two separate local hospitals. The teams deal with mentally ill people who present at Accident and Emergency, and also assess patients who are in hospital already (usually with physical problems), but are also presenting with signs of possible mental illness. Many of the A & E attendees are referred to the Home-Based Treatment Team where I am presently working, and the people are then supported in the community through daily home visits.
Aside from this, I am still busy revising for my forthcoming exam which takes place towards the end of September. At the moment I am revising stress, and in order to help me clarify my learning (like last week with the diabetes topic), I thought that I would try to rewrite some of the main facts that I have learnt.
Long-term Stress and the Effects upon the Body
Short-term positive stress, sometimes known as eustress, can be beneficial, and can help us to achieve things, such as passing an exam! Long term stress, in contrast, is negative and distressing to the individual’s body and their mind.
Short-term stress can produce temporary beneficial changes, such as raised blood pressure and raised blood glucose, and the body’s homeostasis is quickly regained. Long term stress also produces the same increases, as well as a weakened immune system. The body’s homeostatic levels however, are eventually re-set at a much higher level, and the resulting consequences can sometimes be serious illness, such as myocardial infarction and cancers.
When faced with stressful circumstances, the brain’s hypothalamus causes the body to go into fight or flight mode. This stimulates the sympathetic branch of the autonomic nervous system, which then stimulates the adrenal medulla to release adrenaline. The adrenaline causes the heart rate to increase and the blood pressure goes up. If the stress is short-lived, as in healthy individuals, the parasympathetic branch of the autonomic nervous system will eventually take over, and a state of relaxation and calm will once again return. In long-term stress however, the heightened, and potentially damaging, effects of the sympathetic branch are maintained by the release of several hormones.
Stimulated by the hypothalamus, Corticotrophin Releasing Hormone (CRH) stimulates the production of cortisol, which leads to loss of appetite and loss of libido. It also causes a reduction in the immune system, the slow healing of wounds, muscle wastage, loss of bone mass and the breakdown of glycogen to glucose, thus increasing blood glucose levels. The CRH also stimulates the release of AdrenoCorticoTrophic Hormone (ACTH). ACTH stimulates the adrenal medulla to produce aldosterone and cortisol. The aldosterone stimulates the kidneys to retain sodium, which then attracts water, and so the blood volume and blood pressure therefore increase. High blood pressure (hypertension) is associated with problems such as stroke, heart disease and diabetes. Growth Hormone is also released, and this breaks down fat and converts glycogen to glucose. Thyroid Hormone is additionally released, and this stimulates Thyroid Stimulating Hormone (TSH). TSH increases the speed of all bodily reactions, including the metabolic rate, thus increasing the chances of weight loss.
Stressed individuals frequently experience poor sleep, and this inability to rest and recuperate, sadly and ironically, enhances the stresses. Negative coping strategies such as alcohol and drug misuse can make the problem worse, as can poor diet and lack of exercise. Sleep, when achieved, stimulates the parasympathetic branch of the autonomic nervous system, which in turn reduces the adrenaline. Sleep is therefore a great healer in recovering from stress.
Lack of sleep and stress can be antecedents to anxiety and depression. Concentration is diminished or lost, and the small things in life can soon start to feel like huge mountains. Other complications of stress can be migraine, Irritable Bowel Syndrome, ulcers and gastritis.
Needless to say, stress is not good for our working lives either. The Health and Safety Executive (2012) stated that 10.4 million working days were lost through stress, while the Labour Force Survey (2012) found that females generally experienced higher working stress, and that the age group of 35–44 had the highest amounts of individuals affected. This could perhaps be on account of the females’ additional responsibilities such as children, household chores, and possibly caring for elderly parents.
Stress is clearly a potentially negative force, and one that can damage both our bodies and our minds.