Chronic stress – long activation of adaptation reactions of an organism under the influence of adverse factors. Leads to development of neurotic frustration and somatic diseases. At the physiological level it is shown by bystry fatigue, sleeplessness or the increased drowsiness, appetite change, disorder of digestion, headaches. The list of psychological violations includes differences of mood, irritability, depression, tearfulness, decrease in active attention and memory. For diagnostics the method of a clinical conversation, psychological testing is used. Treatment is carried out by methods of psychotherapy, medicamentous correction.
The word "stress" in translation from English is meant by "tension, loading". The term is entered into physiology, psychology and medicine by U. Kennon in 1929, was widely adopted thanks to the works of his pupil Mr. Selye published in 1946 and later. Researches of a chronic stress are actively conducted with the end of the 20th century. There are no exact data on its prevalence, but, according to official statistics, the epidemiological indicator exceeds 25%. It is established that residents of the large cities, economically developed countries, workers of harmful productions and persons whose activity is connected with processing of large volumes of information, moving, continuous contacts with new people are more subject to a stress.
Reasons of a chronic stress
Long psychoemotional loading is considered a major factor of chronic stressful reaction. Immediate causes a set, they are always individual – what for one person is normal, for another will be a stress source. Include in the list of the most widespread provocative circumstances:
- Disharmonious relations. Misunderstanding and frequent quarrels with relatives, colleagues support constant tension. Characteristic situations – aggressive rivalry at work, alcoholism of the spouse, an asocial way of life of the close relative.
- Excessive loadings. The people who are actively engaged in intellectual and physical work are subject to a chronic form of a stress. The probability of emergence of symptoms is higher during the student's sessions, when performing work without days off, during night shifts.
- Long illnesses. The physical exhaustion and restrictions caused by feeling sick are the reasons of a stress. The alarm is caused by uncertainty of the future, uncertainty in maintenance, external appeal.
- Material difficulties. Financial and housing problems – one of the most widespread stressful factors. The people who are not taking constant place of work, large families, pensioners treat risk group.
- Unsoluble problems. A source of tension is the situation which does harm to health or social wellbeing, but cannot be complete in the nearest future. Examples: the unpaid credit, accommodation it is close to the combat zone, a serious illness of the family member.
The stress belongs to system of nonspecific adaptation answers of an organism. It develops at influence of physical and psychological irritants and allows to keep constancy of the internal environment – adapts an organism for a difficult situation. The main hormones of a stress are cortisol, , adrenaline and noradrenaline. Thanks to change of their concentration in blood work of immune and digestive systems is oppressed, the mechanisms necessary for flight or fight become more active – the blood pressure, breath frequency, a tone of muscles increases, perception escalates, thought processes accelerate.
In a brain the areas connected with emotion of fear and alarm – an almond-shaped body and a hippocampus become more active. Activity of the prefrontal cortex providing strong-willed regulation of emotions, opposite decreases. Feature of a chronic stress is that long intensive production of hormones and hyper activation of a sympathetic part of the nervous system promote organism exhaustion, an internal injury and systems – immunity decreases, there are pains, somatic pathologies develop.
Symptoms of a chronic stress
The feeling of constant fatigue belongs to physiological manifestations. The dream and rest do not improve a state, people wake up with feeling of weakness, after a breakfast have desire to lie down. If the stressful factor continues to influence, then the days off and a holiday it appears insufficiently for restoration of forces. In the evening and at night sleeplessness, nightmares, a dream faltering and sensitive often torments. In the afternoon drowsiness is noted. Headaches, dizzinesses, sudden attacks of tachycardia, the increased sweating, dispepsichesky symptoms, hypersensitivity to bright light, loud sounds, changes of temperature (a chill, heat inflows) are characteristic. Appetite or considerably decreases up to refusal of food, or becomes uncontrollable, develops into a gluttony. The sexual inclination is oppressed. Weakness of immune system is shown by frequent respiratory infections.
Emotional violations are characterized by instability, inadequacy of intensity of affect to irritant force: viewing of the sad movie causes tears, the careless remark of the friend – rough anger. During the day the mood often changes from raised, cheerful to suppressed or aggressive. By the evening the exhaustion collects, depressive experiences – feeling of loneliness, uselessness, misunderstanding by people around amplify. At sthenic (strong) traits of character and temperament the fatigue is shown by decrease in control of emotions – excitability, hysteria, whims, inability to relax independently.
Social contacts are limited. Patients test uncertainty, decrease in motivation to communication and professional activity. They refuse meetings with friends and family holidays, referring to employment or feeling sick. A considerable part of time is spent at home alone. The steady tendency to avoiding of the household chores and any other affairs demanding the physical tension, maintenance of a conversation, intellectual efforts is formed. In the sphere of cognitive functions decrease in concentration and stability of attention, difficulty in storing of new material is noted. It negatively affects performance of professional duties if activity assumes the solution of intellectual tasks.
At a chronic stress there is intensive production of hormones – adrenaline, cortisol and some other. Endocrine failures lead to erectile dysfunction, decrease in a sexual inclination, violations of a menstrual cycle. Activity of immunity is oppressed, the organism becomes subject to development and an exacerbation of infections, chronic somatic diseases. Inability of patients provokes to relax, have a rest hobby for alcohol and drugs. Depressive symptoms quite often include suicide behavior – thoughts of death, suicide attempts.
Inspection of the patient begins with a conversation during which the psychiatrist finds out the anamnesis and complaints. It is possible to define one or two leading stressful factors – working overloads, the regular conflicts with the spouse, the material problems, somatic diseases interfering daily activity. For more exact diagnostics psychological questionnaires of various directions are used:
- Urgent level of a stress. There is a number of the techniques allowing to define character of an adaptation syndrome (sharp or chronic), the level of psychological tension, uneasiness. The Test of a self-assessment of resistance to stress (S. Koukhen, G. Villianson), the Technique of express diagnostics of level of psychoemotional pressure (O. Kopnina, E. Suslova), the Scale of a psychological stress of PSM-25 of Lemura-Tesye-Filliona, the Scale of a self-assessment of alarm of V. Tsunga, the Scale of situational uneasiness of Ch. D. Spilberger is offered to the patient.
- Stress consequences. The chronic stress exhausts adaptation forces of an organism. The Scale of clinical complaints of SCL (R. Derogatis), the Gissensky questionnaire is applied to assessment of negative changes in the state of health. For the purpose of establishment of a depression and suicide risk the technique "Differential diagnosis of depressions" (V. Zung), a questionnaire "The depression level" is used (A. Beck).
- Forecast, assessment of resources. Tests of this group are directed to definition of predisposition to neurotic frustration, resistance to stress diagnostics, identification of social support, the strategy of a sovladaniye with a stress. Application of a technique "Forecast" (V. Baranov), a questionnaire "Sources of social and psychological support" (V. Ananyev), a questionnaire of "Koping-strategii" (R. Lazarus), a questionnaire of SVF120 "Overcoming Difficult Life Situations" is widespread (V. Janka, G. Erdmann).
Treatment of a chronic stress
Therapy of a chronic form of a stress is long, takes from several months to one year. Most often it is impossible to eliminate a negative factor therefore efforts of doctors and the patient are aimed at improvement of adaptation to current situation. Complex treatment includes various methods:
- Psychotherapy. Technicians of the cognitive and behavioural and existential direction, psychoanalysis, the corporal focused therapy are applied. Work with the destructive beliefs and behavioural patterns supporting tension is carried out, the vital purposes and values are corrected, the skill of self-acceptance and self-checking increases.
- Pharmacotherapy. Depending on the prevailing symptoms the psychiatrist or the psychotherapist the scheme of drug intake is selected. At a depression antidepressants are appointed, at uneasiness, sleeplessness, fears – tranquilizers. In the late period of a stress TsNS stimulators can be shown.
- Relaxation. The psychoemotional pressure which is shown by a muscular hyper tone, change of depth and a rhythm of breath is the cornerstone of a chronic stress. For development of skill of relaxation the respiratory gymnastics, massage, occupations is recommended to patients by the physical exercises bringing pleasure and distracting from daily problems (the yogi, , Pilates).
Forecast and prevention
At complex therapy the chronic stress has a favorable outcome: the importance of negative factors decreases, the patient successfully adapts to a life situation. A basis of prevention is ability to switch attention from problems to positive experiences, continuous alternation of work and rest, tension and relaxation. It is necessary to allocate enough time for a dream, sports activities and a hobby, walks and friendly meetings, to support full-fledged sexual life, to watch a diet, doing it to the most various. During the periods of the increased emotional, intellectual and physical activities it is recommended to carry out daily respiratory gymnastics, to come for walk, to accept the vitamin and mineral complexes and means maintaining activity of immune protection.