The Basics of Stress, Self Care, and Sleep

Stress

Stress is defined by the WHO as “a state of worry or mental tension caused by a difficult situation.” (World Health Organization n.d.) The situation or cause for the state of worry can be called the “stressor.” Chrousos et al. (2009) explain this stressor as something that threatens one’s homeostasis, and the stress response is how a reaction responds to the stressor in an effort to regain homeostasis. Stressors come in different forms. Something major like a natural disaster or the sudden loss of a loved one are stressors, and things that are relatively minor in the grand scheme of things such as running late can be a stressor. While stressors vary greatly, the systems within our body that respond are the same.

Response to Stress

When we are faced with a stressor, the body responds with what is often referred to as the “fight-or-flight” response (Cleveland Clinic, 2023). When we perceive a stressor, the sympathetic nervous system is activated. This is also the system activated during exercise, and the neurotransmitter norepinephrine (noradrenaline) is released. Additionally, the sympathetic nervous system triggers the endocrine (hormonal) system. The endocrine system releases the hormones epinephrine (adrenaline) and norepinephrine (noradrenaline ) (Cleveland Clinic, 2023) and cortisol (Fahey, 2020). The following are downstream responses to the neural and endocrine response. The initial trigger is from the neurotransmitter norepinephrine, but the hormones tell your systems to continue with the reaction. This continues until the stressor is no longer present (Cleveland Clinic, 2023).

Downstream responses

• Increased heart rate
• Increased blood pressure
• Increased breathing rate
• Airway dilation
• Dilation of Pupils in the eye
• Blood is diverted to muscle and away from the skin (skin may appear pale)
• The liver converts glycogen (stored glucose) into glucose so we can utilize it to yield energy!

(Cleveland Clinic, 2023)

These responses occur regardless of whether the threat is real or perceived.

Types of Stress

Stress can be both short-term and long-term. According to The American Psychological Association (n.d.), we are well equipped to manage small doses of stress, but stress that lasts long-term can have more serious effects on the body. Short-term stress is often referred to as “acute” stress and long-term stress is called “chronic” stress. The above response (found under Responding to Stress) is how we respond to acute stress. Acute stress could come from a vehicle coming toward you, a loud noise, having to speak in public, or an upcoming exam. Chronic stress may include things like living or working in a tumultuous home environment, as well as long-term medical or financial stress. Chronic stress causes a continuous activation of the nervous system that can lead to tension headaches, inflammation of the circulatory system, hypertension, heart attack, stroke, impaired immune system function, changes in appetite, gastrointestinal changes, decreased sexual drive, and fertility issues for both males and females as well as menstrual dysfunction in females (American Psychological Association, n.d.).

Not all stress is bad. Stress can be categorized as distress or eustress. According to the American Psychological Association (n.d.), distress is the result of “being overwhelmed by demands, losses, or perceived threats.” On the other hand, eustress is stress that is a result of “challenging but attainable and enjoyable or worthwhile tasks.” For example, you may feel stress before giving a presentation, but it is likely a good opportunity and something you will likely feel good about when it is over. However, an argument with a friend may leave you in distress.

We are all going to be faced with stressful situations throughout life. It is important that we have tools to deal with it. Below are some methods that may be helpful to deal with stress. With that said, if you are struggling to deal with your stress, it is important to reach out to a professional for help.

Ways you can deal with stress:

• Doing physical activity
• Getting enough sleep
• Meditating
• Making sure you are eating well
• Doing things you enjoy doing
• Talking to someone you trust
• Connecting with other people (family, friends, community or faith connections)
• Taking a break from what is causing you the stress when possible ( for example, don’t watch the news over and over if it causing you stress)

(Center for Disease Control and Prevention, n.d.)

Avoid using alcohol or drugs to deal with stress. Using these substances may make you feel better in the short term, but in the long term they will make your stress worse.

Sleep

When individuals are considering lifestyle changes to improve health, quality of life, and well-being, it is not uncommon to hear ideas regarding nutrition, physical activity, or even quitting habits such as smoking or drinking. One habit that likely doesn’t get mentioned as often as it should, is sleep. According to the U.S. Department of Health and Human Services (n.d.), roughly 33% of adults do not get enough sleep, and an even greater percentage of adolescents are lacking sleep. Long term sleep deprivation as well as sleep disorders (such as chronic insomnia, sleep apnea, and restless leg syndrome) may be linked to an increased risk of hypertension, diabetes, obesity, depression, heart attack, and stroke (Institute of Medicine, 2006) as well as a decrease in productivity, increased healthcare needs, and an increased chance of injury. Additionally, serious disasters have been caused by individuals who were severely sleep deprived. According to the National Highway Traffic Safety Administration (n.d.), in 2021, there were 682 deaths associated with “drowsy-driving.”

Circadian Rhythms

Our drive to sleep is impacted by circadian rhythms and our homeostatic sleep drive. According to the National Institute of General Medical Science (2023) Circadian Rhythms are “ the physical, mental, and behavioral changes an organism experiences over a 24-hour cycle.” Many things can influence our circadian rhythm such as eating and physical activity, but the biggest influence is the light and dark cycle. Our bodies naturally want to wake during the light hours, and sleep during the dark hours. We produce the hormone melatonin when it is dark, which triggers different systems in the body to get ready for sleep (Fahey et al. 2020). Individuals who work overnight, or even those who choose to stay up very late can cause disruption to the circadian rhythm. According to Brum et al. (2022), the sleep changes due the night shift work can cause one to lose connection with the light dark cycle and thus alter their circadian rhythms.

Homeostatic Sleep Drive

As mentioned earlier, in addition to circadian rhythms, homeostatic sleep drive also impacts our sleep. From the time we wake up, to the time we go to sleep, sleep pressure builds up (The National Institute for Occupational Safety and Health , n.d.). This pressure is our homeostatic sleep drive. The longer we are awake, the more pressure there is. After a good night’s sleep, sleep pressure is low and will begin to increase again through the waking hours. The sleep pressure or drive is caused by a buildup of adenosine in the brain (Fahey et al., 2020). The best way to maintain a strong homeostatic sleep drive is to wake at and then stay awake until you are ready for bed. Daytime naps will decrease your sleep pressure and potentially make it hard to go to bed at night. Additionally, consuming caffeine can alter the sleep drive because it blocks the adenosine receptors (Fahey et al., 2020) .

Use the link below to see how much sleep you need based on your age, and learn about sleep debt.

Recommended Amount of Sleep

Self-Care

Self-care is a somewhat vague term, as it can encompass many different things. According to Martinez et al. (2021) the exact explanation of self-care is unclear because of the “difficulty integrating the diverse definitions developed over time across disciplines.” Martinez et al. (2021) reviewed 31 different articles regarding self -care and developed the following definition “the ability to care for oneself through awareness, self-control, and self-reliance in order to achieve, maintain, or promote optimal health and well-being.” At its essence, it relates to taking care of yourself. While some may view a visit to a spa or a lavish trip as self-care, it is not always relaxing, fun and/or extravagant. Self care could be making time to schedule necessary appointments, or go for a walk to reduce stress. Self-care could be getting some tasks completed that have been weighing on your mind, learning time management skills, or getting enough sleep. If you note the definition above incorporates “well-being,” and thus work towards improving any of the areas of wellness. If you recall, in Chapter 1, the dimensions of wellness included emotional wellness, physical wellness, vocational (occupational wellness), social wellness, spiritual wellness, intellectual wellness, environmental wellness, and financial wellness (Stoewen, 2015: 8 Dimensions of well-being).