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Lecture 32- Mechanism of Producing Stress Through Physical and Psychological Route — Transcript

by SWAYAM BHU · 2,137 words · 361 segments · language en · Watch on YouTube

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0:16Namaskar friends. This is lecture two of
0:20module 7 of the stress management course
0:23and this module is devoted to understand
0:26the intricacies of our cognition and
0:30health conditions in managing the stress
0:34in chronic health problems successfully.
0:38Till now we have talked about what
0:42chronic stress is and how different
0:45psychological factors can contribute in
0:48its perception.
0:51Drawing back to the models proposed by
0:54health psychology.
0:57In this lecture, we are going to learn
1:00more about the physical and
1:02psychological mechanisms through which
1:05the stress is created, experienced and
1:10regulated by individuals who suffer from
1:14chronic illness. And we will also talk
1:17about the interplay between the physical
1:20and psychological mechanisms
1:23including the consequences of these
1:26interactions.
1:29Let us begin with the discussion of the
1:33physical and psychological root of
1:37producing stress.
1:41Whenever we find ourselves
1:45suffering from some kind of ailment,
1:49it triggers a particular bodily response
1:53of course due to that medical condition
1:57and it also triggers a psychological
2:00response
2:02which is expressed or reflected in two
2:06roots.
2:08First is the HPA axis, the hypothalamic
2:12pituitary adrenal axis. We have learned
2:15a lot about it in earlier modules also.
2:18But because it is apt to mention these
2:21things again in this particular lecture.
2:25Let us discuss about these things
2:29briefly. Again
2:32the HPA axis usually encompasses the
2:36endocrine root through which the body
2:40responds to the experience of a stress.
2:44Our hypothalamus triggers anterior
2:47pituitary which in turn triggers the
2:49adrenal gland for the secretion of
2:52cortisol and uh adrenaline.
2:57When these two hormones are released in
3:00the blood, people experience so many
3:03changes in their physiological state
3:07such as increase in the level of blood
3:10glucose or increase in blood pressure or
3:15negative mood state or extreme fatigue
3:19and things like that.
3:22Similarly,
3:24the anxiety or the stress of the disease
3:28can trigger the sympathetic
3:32adrenal nervous system root also.
3:36So the sympathetic nervous system gets
3:39activated especially when we come to
3:41know about the disease for the first
3:44time and it can remain active for the
3:46first few days unless we actually
3:49mentally accepts the fact that the
3:53disease has already come. We are caught
3:57in it but there are ways to get out of
4:00it or at least to manage it
4:03successfully. Unless this happens, the
4:07moment we get to know that we have
4:10developed a new disease which is chronic
4:12in nature and difficult to manage,
4:16we suddenly find ourself in a state of
4:20extreme stress which is reflected by the
4:24palpitation, the sweating, the anxiety,
4:27the dizziness that you feel in your
4:30head. This feeling can continue for a
4:34few days unless we settle down with the
4:36fact this is this happens because of the
4:40sympathetic nervous system root which
4:43make uh significant alterations in the
4:47physiological
4:49mechanisms of our body.
4:52It again increases our blood pressure.
4:54It again mobilizes energy to a great
4:57extent leaving the body exhausted. So
5:01these two things can add up to the
5:04physical symptoms as well as the
5:06perception of a stress. When these two
5:09things happen and the stress continues
5:12for a long time, another response is
5:16suppression of immune system of the
5:18body. When the immune system of the body
5:22gets suppressed, we become vulnerable
5:26for all kind of infections. May it be
5:29bacterial, viral or fungal or of any
5:32other kind. So what happens along with
5:36the main disease? It increases the risk
5:39of developing several comorbidities that
5:42is the disease states which are somehow
5:45developed due to a main disease
5:47condition. So our stress is not only
5:52impairing us from taking proper
5:55corrective measures for the treatment
5:57and management of the disease but it
6:00also makes us more vulnerable towards
6:05development of other diseases
6:08and also creates several physiological
6:12symptoms like indigestion like
6:15palpitations like sweating like fatigue.
6:18igue, headache and many more as a result
6:23of the activation of HPA axis or SAM
6:27axis. So stress created due to a
6:31particular health condition causes
6:35further physiological disturbances in
6:38the body and all of these things taken
6:41together increases the level of stress
6:45experienced by the person manifolds.
6:49Now when all this happens of course
6:54certain psychological factors, cognitive
6:58factors, emotional factors become very
7:01important in the overall management of
7:05this situation.
7:08What happens that the first factor which
7:11comes into play is our assessment of the
7:14situation.
7:17What kind of assessment I was just
7:20talking about that the SAM axis the
7:23sympathetic adrenal
7:26medula axis can become active the moment
7:29we come to know about the disease and it
7:32can last for a day or two unless the
7:36extra anxiety that we are feeling
7:38because of this new development with our
7:40body subsides.
7:43So why does it happen? Why this inner
7:47stress is generated and why it is
7:49subsided?
7:51This is all because of our cognitive
7:54assessment about the situation.
7:56When we feel that we have developed a
7:59kind of condition which is going to make
8:03significant changes in our body,
8:06significant changes in our physiological
8:10state and it may cause significant
8:14impairment in our capacities. So that we
8:18may not be able to live life such
8:21happily as we used to do or we may not
8:24be able to perform our activities
8:28uh with the excellence that we are
8:31trying to do or we have been doing so
8:34far. This causes extreme anxiety and
8:38stress.
8:40Then what happens? We try to look about
8:44the information of of that disease. Why
8:47this disease happens? How we can manage
8:51this disease? What are the possible
8:54treatments available for this? What are
8:56the pros and cons of those treatments
9:00which are available that can be tried.
9:03So we try to get more and more
9:06information about the disease and the
9:09things related to it.
9:11The moment we get enough information and
9:15we process it effectively
9:18and most of the time we get to know that
9:20this particular disease can be managed
9:23effectively and many many people are
9:26already suffering from it and they are
9:28leading their life happily successfully
9:31performing all their duties nicely. They
9:34are not dependent upon other people.
9:36This is another big worry that now I'm
9:38going to be dependent on other people.
9:40So I'm going to lose my independence. I
9:44have to uh live according to other
9:47people's uh guidance or their
9:50availability, their convenience. So
9:52taken together all these anxieties can
9:55uh settle down a little bit or to a
9:59significant level if we get appropriate
10:03informations regarding the development
10:05and the growth of the disease and the
10:07possible course of corrective measures.
10:10The moment it happens, our reaction or
10:13our perception towards the situation
10:16changes and you can find the result of
10:20this change in perception.
10:24The level of anxiety in the first few
10:26days is certainly not equivalent to the
10:30level of anxiety that we find later on.
10:34So it gradually settles down as we
10:37become uh more and more capable of uh
10:41managing the things or our co cognitive
10:44assessment about our own ability to
10:47manage the situation changes with time.
10:50Then comes the emotional response. How
10:53I'm going to respond to the situation?
10:56What kind of emotions I'm going to feel?
11:01Many people find themselves in an
11:04extremely anxious state. They cry. They
11:08become depressed and they
11:12find as if it is the end of their life.
11:16Others may not become so panic.
11:20They try to use their logics and past
11:24experiences and their experiences with
11:27other people to moderate their emotions
11:31about their illness and can remain in a
11:35better state to manage the disease
11:38conditions.
11:40Similarly,
11:42when we manipulate our cognition, when
11:45we try to change our emotions and we do
11:49it successfully,
11:51our behavioral responses towards illness
11:54and the stress produced by it also
11:56changes.
11:58For example,
12:00uh if the person is very very anxious,
12:05he or me he or she may get indulged in
12:09some sort of counterproductive behavior
12:12like uh smoking, like consuming alcohol
12:16or uh trying to overuse
12:20the uh leisures available in life in
12:24view of the fact that the life is too
12:27short. now or we do not have much time
12:31so let us enjoy it let us do everything.
12:34So this uh thinking in itself is not bad
12:38but if we overdo everything so extreme
12:42of anything excess of anything is bad.
12:45It may cause harm instead of doing
12:48something good to the person. Instead of
12:51that, if we adopt a more reasonable
12:54approach towards it, a more logical
12:57attitude towards our uh health
12:59condition, we may exhibit
13:03productive ways to counter the disease
13:07condition and get our functional level
13:11back to normal.
13:13So our behavioral responses mainly
13:16changes as a function of how we
13:19conceptualize the situation and how much
13:23we are able to regulate our emotions
13:27which are associated with the condition
13:30of disease.
13:33Then it is a birectional relationship.
13:37That is the relationship between the
13:39physical factors and the psychological
13:42factors is a birectional relationship
13:46where the physical changes in the body.
13:50Modifies the psychological assessment of
13:53it. Modifies the level of anxiety and
13:56stress that we feel. increases the or
14:00decreases the worry regarding the
14:04future of the disease and all these
14:07psychological assessments can in turn
14:11affect the physical state of the body.
14:15So the changes or the influences flow
14:18from both directions and if one state
14:23gets worsened it is going to worsen the
14:27other part also. The reverse is also
14:30true. If we can make some positive
14:34changes in psychological part of the
14:37person, this will soon be reflected in
14:40the physical state of the person which
14:43will again send a positive impact to the
14:47psychological factors and improve it
14:50further. So instead of entering into a
14:54vicious cycle where both psychological
14:57and physical elements of an individual
15:01are sending negative waves to each other
15:04and becomes a cause to worsen the
15:09situation. One must try to induce
15:12positive changes in the physical and
15:16psychological aspect of the person so
15:19that a fresh circle or cycle can be set
15:23up which is improvementoriented
15:27which is growth oriented.
15:32Whenever a person gets
15:36uh a physical health problem which is
15:39chronic in nature,
15:42it always increases the risk of
15:44developing co-orbidities.
15:47Means a disease attracts other diseases.
15:52For example, if a person became uh a
15:55person becomes obese, it is going to
15:58attract a cluster of diseases like
16:01diabetes, hypertension, arthritis,
16:04cardiovascular problems and so and so
16:06forth. If a person di gets diabetes
16:11again it is going to serve as a trigger
16:15point for other kind of problems may it
16:18be retinopathy or problems related with
16:21kidneys related with hearts and uh
16:24decreased immuno uh immunal immune
16:27capacities or decreased immune
16:31capacities of the body. So one problem
16:35attracts the other problem resulting in
16:38several co-orbidities.
16:40At the same time the chronic health
16:43problem can induce long-term mental
16:46health problems also such as burnout,
16:49depression and of course anxiety and
16:52worries.
16:55Taken together, these two complications
16:59result in impaired cognitive function
17:02shown by the individual.
17:05Sustained stress level can lead to
17:08detrimental effects on cognitive
17:11functions specifically on attention,
17:15memory and decision making skills.
17:19Sometimes the information processing
17:23behavior also gets affected by prolonged
17:27level of stress which is present over
17:30there. Therefore we find people becoming
17:34more forgetful or inattentive
17:38when they have a lot of suffering in
17:40their lives.
17:43That was all regarding the
17:47interconnection of the physical and
17:49psychological aspects of individuals.
17:53Let us have a quick recap of what we
17:56have learned till now.
17:59Physical mechanisms of stress can affect
18:04the main organ systems of the body. They
18:08can also suppress the
18:11immune system and increase the
18:14inflammations if present. Similarly, the
18:18psychological aspect of the disease is
18:22also capable of influencing the
18:25physiology of the body increasing the
18:29perception of symptoms a lot.
18:33So here is a vicious cycle between the
18:36physical and the psychological element
18:40which is quickly set up in an individual
18:44who suffers from chronic illness.
18:47However, one can induce positive changes
18:51in either or both of these elements that
18:54is physical and psychological
18:56and soon they get reflected in the
19:00overall state of the individual. So it
19:03is better to make interventions at the
19:06level of cognition and emotion thereby
19:10improving the cognitive functions and
19:13also the health condition of an
19:16individual because it will increase the
19:19likelihood of behaviors which are
19:22related with positive health behaviors
19:26which are related to the adherence with
19:28the instruction of the doctors. So it is
19:32important to monitor the psychological
19:35aspect of a person suffering from
19:38chronic illness along with the medical
19:42treatment which is prescribed for
19:45improving the physiological state.
19:50These are the references that you can go
19:52through.
19:56some more references for further
19:58reading.
20:02The list goes on.
20:06Thank you very much for your patient
20:09listening. Thank you.

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