The chapter outlines the biological, psychological, social and cultural factors that influence health and illness. The potential stressors that increase the risk of illness are stressful experiences or situations that are uncontrollable or chronic lasting for at least six months. Some of them include work related problems, noise, bereavement and loss, poverty, powerlessness and low status.
According to health researchers, there are three factors due to which these chronic stressors do not affect everyone in the same way .They are (1).Individual physiological differences in the cardiovascular, endocrine, immune and other bodily systems (2) psychological factors such as attitudes, emotions, perceptions of events (3) people’s behaviour under stress.
The Physiology of Stress
Research in the area of stress began in the year, 1956, when Canadian physician, Hans Selya (1907-1982) published “The stress of life”. He described about general adaptation syndrome which is a series of physiological responses to stressors that occur in three phases namely alarm, resistance and exhaustion.
Selya believed that some stress is positive and productive while some negative stress that is unavoidable may overwhelm body’s ability to cope.
Stress and Body
The modern research on stress focused on the hypothalamus which sends messages to endocrine glands that activate the sympathetic division of the autonomic nervous system releasing epinephrine and norepineprine. Further to this, it is now evident that when body is under stress the activity along the hypothalamus-pituitary-adrenal cortex called as HPA axis is initiated.
The chemical messages from hypothalamus communicate with pituitary which in turn sends messages to outer part of the adrenal glands that secrete cortisol. If cortisol and stress hormones stay for too long they can be harmful contributing for hypertension, immune disorders, other physical ailments and possible emotional problems.
The Mind-Body link
To understand further on stressors and variations in people’s reaction to stress, an interdisciplinary specialty with focus on psychological processes, nervous, endocrine and immune systems called as psychoneuroimmunology or PNI has emerged. Research shows that chronic stress can weaken or suppress the white blood cells of the immune system.
Not all people are affected in the same way by chronic stressors and environmental condition. The reason behind the differential responsiveness to stress could be attributed more to the perception about the stressor. This simply means that human beings show signs of stress when they feel crowded than when the place is crowed. Therefore psychological factors play a major role.
The Psychology of Stress
Emotions and Illness- The effects of negative attitudes and emotions can affect the course of the illness and of recovery. Research shows that feeling anxious, depressed and helpless for example can delay the healing of wounds after surgery, whereas feeling hopeful can significantly speed healing .Efforts to link emotions and illness occurred with research on Type A personality in 1970s.
The main ingredient in Type A personality turned out to be antagonistic hostility which is related to heart disease. Chronic depression also is a risk factor that is linked to heart disease.
Positive Emotions are helpful in that they are associated with better health and longevity. Psychologists are trying to find out what it is about feeling happy, cheerful and hopeful that could protect a person from getting sick. Perhaps, people with positive emotions have an easy going temperament and also have better social support.
Managing Negative Emotions- As negative emotions are risky, trying to suppress those means processing the thought more frequently. One way to get rid of negative emotions comes from research on benefits of confession and forgiveness.It promotes empathy, the ability to see the situation from another person perspective.
Optimism and Pessimism- Research indicates that optimism helps in promoting health and well-being than pessimism. The feeling of optimism is related to having a sense of control.
According to Rotter, 1990, locus of control refers to general expectation about whether the results of your actions are under your own control (internal locus) or beyond your control (external locus).The greatest threat to health and well-being occurs when people feel caught in a situation they cannot escape.
Two ways of controlling feelings can be through primary or secondary control that can help to reduce or even eliminate the relationship between stressors and health. An effort to modify reality by changing other people, the situation, or events is called as primary control while secondary control is an effort to accept reality by changing attitudes, goals or emotions.
Coping with Stress
Coping involves active efforts to manage demands that feel stressful. Different forms of coping with stress include using physical strategies, problem oriented strategies, cognitive strategies or social strategies. Some of the physical strategies include handling physiological tension by reducing body’s arousal through meditation, relaxation, and massage.
Studies also show that physically fit people have fewer health problems. Some situations demand problem focused coping skills which depend on the nature of the problem. When there are problems that cannot be changed like losing a job, or chronic illness then using cognitive coping methods will help to change the way we think about the problem.
The three ways for coping includes reappraising the situation, learning from experience and making social comparisons. Apart from these individual mechanisms of coping taking help of social support is another important approach that facilitates coping. Family members, friends, neighbors, and co-workers can lend support and provide help. Studies also show that social support enhances health and bolsters immune system.
Another better way of coping with stress is by helping others .Healing through helping enables people to gain strength by focusing less on their woes which can stimulate optimism and restore feelings of control.
How much control do we have over our health?
The process of coping does not involve elimination of stress but to deal with the stressors effectively. In the course of dealing with stressors, illness and health we have control over some psychological and social factors like negative emotions, pessimism, external locus of control, hostility, depression, and lack of supportive friends etc. Other three predictors of longevity are not smoking, eating a healthful diet and exercising regularly.
Therefore coping with stress means learning to live and deal with the stressors, problems and the pain.