Stress-Related Disorders
As it turns out 60-90% of visits to health care providers are stress-related. Recent studies of human well-being have shown that the US population is “mildly happy” only 54% of the time. Psychosocial stress takes a significant toll on human happiness and well-being.
In a "holistic" approach, mental and physical health requires the proper balance of multiple factors with the dual goals of prevention of emotional and cognitive disorders (e.g., panic and anxiety attacks or inability to concentrate) and the promotion of individual well-being.
Personality places a significant role in mental and physical health. That's because the Big Five (5) personality dimensions play a role in psychosocial stress and mental and physical health and can be managed with various forms of psychotherapies, medications, and other forms of treatment.
(1) Neuroticism: Preponderance of negative affect such as anxiety and depression.
(2) Extraversion: Preponderance of positive affect and the propensity to be outgoing with others as opposed to introverted.
(3) Openness: Extent of openness to novel experiences (people, places, events, and things) as opposed to being closed-minded to new experiences.
(4) Agreeableness: Ability to get along with others as opposed to being antagonistic.
(5) Conscientiousness: Ability to do the right thing as opposed to a lack of direction in one's life.
Other factors that impact on mental and physical health include age as early life experiences set the level of responsiveness of the autonomic nervous system and hypothalamic-pituitary-adrenal axis (both are implicated in the human response to psychosocial stress); belief systems (e.g., having a positive attitude); alcohol, diet and nutrition, use and abuse of licit and illicit drugs, and smoking; education (for its protective effects on health); emotional style; exercise; humor; relaxation (including touch, which facilitates immune system enhancement), sexual activity, and quality of sleep (50% of Americans suffer from insomnia); and social support (one's social network of family and friends, as well as colleagues at work).
Psychological factors, including psychosocial stress, have a significant effect on central nervous system functioning as well as heathy functioning of the cardiovascular, endocrine, immune, and metabolic systems.
What is "psychosocial stress"?
Psychosocial stress is a change in one's social environment (home, work) that requires psychological action (thought, emotion, movement). Psychosocial stress is affected by the following factors:
(1) Frequency and multiplicity of sources of stress → Examples of the results of multiple stressors: Cardiovascular disease, hypertension, and diabetes. Treatment: Stress reduction and education.
(2) Inability to adapt to stress → Treatment: Positive psychology: Relieve the states that make life miserable through facilitation of the positive emotions, strengths, and virtues.
(3) Belief systems influence one's expectations that affect health. These include placebo, nocebo, and iatrogenic effects. For instance, often fake substitutes of a medication are as effective as the real medication (placebo effect) or the so-called "white coat syndrome" that affects blood pressure readings in the physician's office. Treatment: Health education, stress reduction, and cognitive-behavioral therapy.
(4) Inability to shut down the stress response → Examples: Elevated serum cortisol and decreased bone density in women. Treatment: Various forms of the psychotherapies, stress reduction and education.
(5) Inadequate stress response → Example: Autoimmune diseases. Treatment: Health maintenance and prevention, and healthy lifestyle choices.
What are the health conditions that appear to result from stress?
(1) Stress causes the deposition of abdominal fat leading to cardiovascular disease and diabetes, which is also affected by chronic hostility towards others. Two-thirds of the US population are overweight; one-third are obese (often leading to a condition called, "diabesity").
(2) Lack of control at work leads to hypertension and cardiovascular disease and these two conditions are also related to living and financial conditions.
(3) Stress-related disorders: Anxiety and depression; autoimmune and allergic disorders; fibromyalgia (chronic fatigue syndrome); headaches; hypochondriasis/malingering; neck, muscle, and back pain; interstitial cystitis and endometriosis; neuralgia; post-traumatic stress syndrome; and rheumatoid arthritis.
(4) Depression and chronic pain are closely associated. For instance, depression is commonly associated with lower back pain (50% of Americans regularly complain of back pain).
(5) Preparation for surgery and infertility are psychosocial stress-related.
(6) Psychosocial stress is significantly implicated in most common autoimmune disorders: autoimmune hepatitis and cirrhosis, glomerulonephritis, Graves’ disease (thyroid), Hashimoto’s thyroiditis, hemolytic amnemia, insulin-dependent diabetes, multiple sclerosis, rheumatoid arthritis, scleroderma, Sjogren’s syndrome, and uveitis.
(7) Psychosocial stress is implicated in some early childhood disorders including asthma, attentional and hyperactivity disorders, influenza, and food allergies.
(8) Irritable bowel syndrome (IBD) may have an autoimmune component and dysthymia (mild depression) and depression are common. Premenstrual syndrome (PMS) may also have a psychosocial stress-related component.
(9) Major psychiatric disorders including bipolar mood disorders (mania and depression), obsessive-compulsive disorders (OCD), psychosis, and Tourette’s disorder may have significant autoimmune-related and stress-related components.
(10) Children and in-laws, separation and divorce, living and financial conditions, marriage, pregnancy, sexual problems, and work issues and career changes are all psychosocial stress-related.
(11) Family constellation such as excessively enmeshed or distant families as well as dysfunctional family relationships are psychosocial stress-related.
