Stress and coping: Nursing

Stress is a normal human response to an internal or external threat to homeostasis, or the body’s stable equilibrium, and can be prompted by stressors. These stressors such as illness, high workload, or economic hardship, can induce the stress response, also known as an allostasis, in an attempt to reestablish homeostasis. In the short term, the body can adapt to the physiological changes to stress; however, when stress becomes chronic, it can have a negative impact on mental and physical health.

Now, not all stress is harmful, in fact, it is essential for daily life. There are two types of stress; eustress and distress. Eustress is positive stress, which is necessary for normal development and motivation and can occur with beneficial life changes like having a baby or getting a new job; whereas distress is negative stress that occurs when a person is unable to adapt or cope effectively to the stressor.

Okay, the body’s response to a stressful event can be explained by the General Adaptation Syndrome, or GAS, which has three stages. First, the alarm reaction stage occurs as the sympathetic nervous system is activated, triggering the fight-or-flight response, which involves the release of hormones and neurotransmitters to support the body’s reaction to stress. The posterior pituitary releases antidiuretic hormone, or ADH, and the adrenal cortex releases aldosterone, both of which increase circulating blood volume. The adrenal cortex also releases cortisol, which increases the body’s supply of glucose, while the adrenal medulla releases epinephrine and norepinephrine, which increases the heart rate, blood pressure, and blood flow to the skeletal muscles. Next, the resistance stage is when the body attempts to stabilize and return to homeostasis. If the stress has been dealt with effectively, the parasympathetic nervous system returns vital signs to normal and begins to repair tissue damage. However, if the stress continues, the sympathetic activation will also continue, and the person moves to the exhaustion stage. This stage is characterized by excessive wear and tear on the body, a suppressed immune system, and depletion of the body’s resources, referred to as allostatic load. When allostatic load is not resolved, it can lead to health problems like depression, diabetes, and autoimmune disorders.

Now, coping is a process by which a person uses cognitive and behavioral strategies to manage stress; and their response to stress will depend on their own appraisal of the stressful event and their perceived ability to respond to the stressor. Now, the use of coping strategies may not always involve healthy behaviors and they may not always be effective in resolving stress. For example, defense mechanisms, coping strategies that are typically unconscious, that can be beneficial or detrimental. Detrimental defense mechanisms include denial, where a person completely ignores distressing aspects of reality, or the use of alcohol or drugs. On the other hand, a beneficial defense mechanism is sublimination, which occurs when unacceptable emotions are channeled into acceptable actions, like exercise.