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General Adaptation Syndrome (GAS) - Theory of Stress Date of last revision September 8, 2011 Between stimulus and response

there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom. - Viktor Frankl Introduction Hans Selye (1907- 1982) was a Hungarian endocrinologist, first to give a scientific explanation for biological stress. Hans Selye explained his stress model based on physiology and psychobiology as General Adaptation Syndrome (GAS). His model states that an event that threatens an organisms well -being (a stressor) leads to a three-stage bodily response: o Stage 1: Alarm o Stage 2: Resistance o Stage 3: Exhaustion He explained about hypothalamic-pituitary-adrenal axis (HPA axis) system which prepares the body to cope with stress. Selye also explained about a local adaptation syndrome which refers to the inflammatory response and repair processes occur at the local site of tissue injury as in small, topical injuries, such as contact dermatitis which may lead to GAS if the local injury is severe enough.

Stages Stage 1: Alarm o Upon encountering a stressor, body reacts with fight-or-flight response and sympathetic nervous system is activated. o Hormones such as cortisol and adrenalin released into the bloodstream to meet the threat or danger. o The bodys resources now mobilized. Stage 2: Resistance o Parasympathetic nervous system returns many physiological functions to normal levels while body focuses resources against the stressor. o Blood glucose levels remain high, cortisol and adrenalin continue to circulate at elevated levels, but outward appearance of organism seems normal. o Increase HR, BP, breathing o Body remains on red alert. Stage 3: Exhaustion o If stressor continues beyond bodys capacity, organism exhausts resources and becomes susceptible to disease and death.

Terminology Stress: is a condition in which the human system responds to changes in its normal balanced state. Stressor: is any thing that is perceived as challenging, threatening or demanding. Eustress or positive stress: Manageable stress which can lead to growth and enhanced competence. Distress or Negative stress: Uncontrollable, prolonged, or overwhelming stress is destructive. Adaptation: is the change that takes place as a result of the response to a stressor. Coping: a balancing act between biological, psychological, and social process.

o Adaptive Coping Contribute to resolution of the stress response o Maladaptive Coping Strategies that cause further problems o Active Coping Actively seeking resolution to the stress Homeostasis: refers to a steady state within the body and various physiologic mechanisms within the body respond to internal changes to maintain a relative constancy in the internal environment. Resilience: Resistant quality that permits a person to recovery quickly and thrive in spite of adversity

Conclusion Hans Selye's theory profoundly influenced the scientific study of stress. Stress is a state produced by a change in the environment and the nature of the stressor is variable. The individual appraises and copes with the stress, to reach the goal of adaptation. The process is called coping with the stress, and it is achieved through a compensatory process with physiologic and psychological components.

References 1. 2. 3. Selye H. The Stress of Life (rev. edn.). New York: McGraw-Hill, 1976. Selye H. Stress in health and disease. Reading, MA: Butterworth, 1976. Smeltzer SC, & Bare BG. [Edrs] . Brunner and Suddarth's Textbook of Medical-Surgical Nursing. 10th edition. Philadelphia: Lippincott Williams & Wilkins, 2004.

Stress can be defined as the way you feel when youre under abnormal pressure. All sorts of situations can cause stress. The most common involve work, money matters and relationships with partners, children or other family members. Stress may be caused either by major upheavals and life events such as divorce, unemployment, moving house and bereavement, or by a series of minor irritations such as feeling undervalued at work or dealing with difficult children. Sometimes there are no obvious causes. Stressful events that are outside the range of normal human experience, for example being abused or tortured, may lead to post-traumatic stress disorder (PTSD). Some stress can be positive. Research shows that a moderate level of stress makes us perform better. It also makes us more alert and can help us perform better in situations such as job interviews or public speaking. Stressful situations can also be exhilarating and some people actually thrive on the excitement that comes with dangerous sports or other high-risk activities. But stress is only healthy if it is short-lived. Excessive or prolonged stress can lead to illness and physical and emotional exhaustion. Taken to extremes, stress can be a killer. What are the symptoms of stress? Physical changes When you are stressed, your body produces more of the so-called fight or flight chemicals which prepare your body for an emergency. Adrenaline and noradrenaline raise your blood pressure, increase your heart rate and increase the rate at which you perspire. They can also reduce blood flow to your skin and reduce your stomach activity. Cortisol releases fat and sugar into your system (but also reduces the efficiency of your immune system). All these changes are our bodys way of making it easier for you to fight or run away. Unfortunately these changes are less helpful if you are stuck in a busy office or on an overcrowded train. You cant fight and you cant run away. Because of this, you cant use up the chemicals your own body has produced to protect you. Over time these chemicals and the changes they produce can seriously damage your health. For example, you may start to experience headaches, nausea and indigestion. You may breathe more quickly, perspire more, have palpitations or suffer from various aches and pains. Longer term you may be putting yourself at risk from heart attacks and strokes. Emotional changes When you are stressed you may experience many different feelings, includinganxiety, fear, anger, frustration

and depression. These feelings can feed on each other and can themselves produce physical symptoms, making you feel even worse. Extreme anxiety can cause giddiness, heart palpitations, headaches or stomach disorders. Many of these symptoms may make you feel so unwell that you then worry that you have some serious physical conditions such as heart disease or cancer making you even more stressed. Behavioural changes When you are stressed you may behave differently. For example, you may become withdrawn, indecisive or inflexible. You may not be able to sleepproperly. You may be irritable or tearful all the time. There may be a change in your sexual habits. Even if you were previously mild-mannered, you may suddenly become verbally or physically aggressive. Who is affected by stress? All of us can probably recognise at least some of the feelings described above, and may have felt stressed or anxious at some time or other. Research has shown that around 12 million adults in the UK see their GP with mental health problems each year. Most of these suffer from anxiety and depression and much of this is stress-related. 13.3 million working days are lost per year due to stress, depression and anxiety. Some people seem to be more affected by stress than others. For some people, just getting out of the door on time each morning can be a very stressful experience. Others are more relaxed and easy going and seem to cope better with pressure. If you think you are prone to stress there are various things you can do to help yourself. http://www.mentalhealth.org.uk/help-information/mental-health-a-z/S/stress/ Lazarus (1966) offers this definition of stress: "stress occurs when an individual perceives that the demands of an external situation are beyond his or her perceived ability to cope with them". This definition is arguably now oldfashioned, but we have included it here as we want to draw two things to your attention, and think this quote can be useful in illustrating them. http://www.hypnos.info/book2/page9.html Stress is not a useful term for scientists because it is such a highly subjective phenomenon that it defies definition. And if you cant define stress, how can you possibly measure it? The term stress, as it is currently used was coined by Hans Selye in 1936, who defined it as the non-specific response of the body to any demand for change. Selye had noted in numerous experiments that laboratory animals subjected to acute but different noxious physical and emotional stimuli (blaring light, deafening noise, extremes of heat or cold, perpetual frustration) all exhibited the same pathologic changes of stomach ulcerations, shrinkage of lymphoid tissue and enlargement of the adrenals. He later demonstrated that persistent stress could cause these animals to develop various diseases similar to those seen in humans, such as heart attacks, stroke, kidney disease and rheumatoid arthritis. At the time, it was believed that most diseases were caused by specific but different pathogens. Tuberculosis was due to the tubercle bacillus, anthrax by the anthrax bacillus, syphilis by a spirochete, etc. What Selye proposed was just the opposite, namely that many different insults could cause the same disease, not only in animals, but in humans as well. Selyes theories attracted considerable attention and stress soon became a popular buzzword that completely ignored Selyes original definition. Some people used stress to refer to an overbearing or bad boss or some other unpleasant situation they were subjected to. For many, stress was their reaction to this in the form of chest pain, heartburn, headache or palpitations. Others used stress to refer to what they perceived as the end result of these repeated responses, such as an ulcer or heart attack. Many scientists complained about this confusion and one physician concluded in a 1951 issue of the British Medical Journal that, Stress in addition to being itself, was also the cause of itself, and the result of itself. http://www.stress.org/what-is-stress/

What Is a Crisis? By Kendra Cherry Question: What Is a Crisis? Answer: In mental health terms, a crisis refers not necessarily to a traumatic situation or event, but to a persons reaction to an event. One person might be deeply affected by an event, while another individual suffers little or no ill effects. The Chinese word for crisis presents a good depiction of the components of a crisis. The word crisis in Chinese is formed with the characters for danger and opportunity. A crisis presents an obstacle, trauma, or threat, but it also presents an opportunity for either growth or decline. We often think of a crisis as a sudden unexpected disaster, such as a car accident, natural disaster, or other cataclysmic event. However, crises can range substantially in type and severity. Sometimes a crisis is a predictable part of the life cycle, such as the crises described in Eriksons Stages of Psychosocial Development. Situational crises are sudden and unexpected, such as accidents and natural disasters. Existential crises are inner conflicts related to things such as life purpose, direction, and spirituality. The purpose of crisis counseling is to deal with the current status of the individual dealing with a crisis. Chronic exposure to stress or trauma can lead to mental illness, so it is important that crisis counselors have the skills and knowledge to help clients cope with current stressors and trauma. Crisis counseling is not intended to provide psychotherapy, but instead to offer short-term intervention to help clients receive assistance, support, resources, and stabilization. Different Definitions of Crisis People are in a state of crisis when they face an obstacle to important life goalsand obstacle that is, for a time, insurmountable by the use of customary methods of problem solving. --Caplan, 1961 an upset in equilibrium at the failure of ones traditional pr oblem-solving approach which results in disorganization, hopelessness, sadness, confusion, and panic. --Lillibridge and Klukken, 1978 crisis is a perception or experience of an event or situation as an intolerable difficulty that exceeds the persons current resources and coping mechanisms. --James and Gilliland, 2001 References: Caplan, G. (1961) Prevention of Mental Disorders in Children. New York: Basic Books. Lillibridge, E. M., & Klukken, P. G. (1978) Crisis Intervention Training. Tulsa, OK: Affective House. James, K. J., & Gilliland, B. E. (2001) Crisis Intervention Strategies. Pacific Grove, PA: Brook/Cole.