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Stress: A Primer

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Q. What some of the most common causes of stress?

A. Stress can arise for a variety of reasons. Stress can be brought about by a traumatic accident, death, or emergency situation. Stress can also be a side effect of a serious illness or disease. There is also stress associated with daily life, the workplace, and family responsibilities.

Q. What are some early signs of stress?

A. Stress can take on many different forms, and can contribute to symptoms of illness. Common symptoms include headache, sleep disorders, difficulty concentrating, short-temper, upset stomach, job dissatisfaction, low morale, depression, and anxiety.

Q. What is post-traumatic stress disorder (PTSD)?

A. Post-traumatic stress disorder (PTSD) can be an extremely debilitating condition that can occur after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Traumatic events that can trigger PTSD include violent personal assaults such as rape or mugging, natural or human-caused disasters, accidents, or military combat.

Many people with PTSD repeatedly re-experience the ordeal in the form of flashback episodes, memories, nightmares, or frightening thoughts, especially when they are exposed to events or objects that remind them of the trauma. Anniversaries of the event can also trigger symptoms. People with PTSD also experience emotional numbness and sleep disturbances, depression, anxiety, and irritability or outbursts of anger. Feelings of intense guilt are also common, particularly if others did not survive the traumatic event. Most people with PTSD try to avoid any reminders or thoughts of the ordeal. PTSD is diagnosed when these symptoms last more than 1 month.

Q. Is there any way to relieve your stress?

A. There are many stress management programs that can teach you about the nature and sources of stress, the effects of stress on health, and personal skills to reduce the effects of stress. Examples of stress reducing skills include time management and physical exercise.

For more serious stress related disorders, like PTSD, research has demonstrated the effectiveness of cognitive-behavioral therapy, group therapy, and exposure therapy, in which the patient repeatedly relives the frightening experience under controlled conditions to help him or her work through the trauma. Studies have also shown that medications help ease associated symptoms of depression and anxiety and help promote sleep.

Q. Is there a relationship between cancer and stress?

A. The complex relationship between physical and psychological health is not well understood. Although studies have shown that stress factors (such as death of a spouse, social isolation, and medical school examinations) alter the way the immune system (the body s defense against infection and disease, including cancer) functions, they have not provided scientific evidence of a direct cause-and- effect relationship between these immune system changes and the development of cancer. Scientists know that many types of stress activate the body's endocrine (hormone) system, which in turn can cause changes in the immune system. It has not been shown that stress-induced changes in the immune system directly cause cancer.

Several studies have indicated an increased incidence of early death, including cancer death, among people who have experienced the recent loss of a spouse or other loved one. But, most cancers have been developing for many years, and it is unlikely that cancer would be triggered by the recent death of a loved one. However, some studies of women with breast cancer have shown significantly higher rates of this disease among those women who experienced traumatic life events and losses within several years before their diagnosis.

Although the relationship between psychological stress and cancer has not been scientifically proven, stress reduction is of benefit for many other reasons.

Q. Are hormones related to stress in women?

A. Scientists know that many types of stress activate the body's endocrine (hormone) system, which in turn can cause changes in the immune system, the body's defense against infection and disease (including cancer). On the positive side for women, there is some evidence that women who breast-feed their infants produce lower levels of stress response hormones, such as adrenalin, and cortisol, than do women who bottle-feed. It is also known, however, that hormone changes during pregnancy, menopause, and during the menstrual cycle can trigger symptoms of depression and stress.

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