Reactions to stressful experiences

Abstract

In biological terms, stress literally means a force from the outside world acting upon an individual, and is a phenomenon we have all experienced. The term ‘stress’ was first used in the 1930s by the endocrin­ologist Hans Selye to describe the responses of la­boratory animals to various stimuli. Originally, Selye meant ‘stress’ to be the response of an organism to a perceived threat or ‘stressor’, but the term is now used to mean the stimulus rather than the response in some cases. When presented with a stressor of any type, everyone will produce a reaction to that stress, and this is a normal physiological event. However, if the reac­tion is prolonged, too intense, or atypical in some way, stress can become abnormal and cause problems. Stressful events, even when reacted to normally, are important contributors to the causes of many kinds of psychiatric disorder. In this chapter, we consider those psychiatric disorders that are specific reactions to stressful experiences. These may occur independently or alongside other psychiatric conditions and include: … ● acute stress reactions: short- term disorders after stressful events; ● post- traumatic stress disorder: a disorder following exceptionally severe stress; ● adjustment disorders: conditions occurring after a change in life circumstances; ● grief reactions: the normal and abnormal responses to bereavement; ● reactions to special kinds of acute stress: for example, traffic accidents, war, earthquakes, etc… For all these conditions, an identifiable stressor is a necessary but not always sufficient factor in its aetiology. GPs encounter the vast majority of patients with stress disorders who present to the health services, but all clinicians will see these patients in their clinical specialties. The reasons for this are threefold: … 1 Acute physical illness and its treatment are stressful. 2 Chronic illness or disability can result in substantial changes in life circumstances. 3 Clinicians treat people involved in other kinds of stressful experiences…. Everyone reacts to stress differently, and what consti­tutes a stressful event is therefore highly subjective. However, there are certain situations that are likely to be experienced as stressful by anyone. The Holmes and Rahe Stress Scale is a list of 43 life events which predispose to stress- related illnesses, weighted ac­cording to their respective probability of doing so.