Chapter 3 — Meeting Life Challenges

Stress is described as the pattern of responses an organism makes to a stimulus event that disturbs its equilibrium and exceeds its ability to cope. It is not merely a stimulus or a response but an ongoing transactional process between the individual and the environment.

Eustress is the level of stress that is good for a person and is considered one of a person's best assets for achieving peak performance and managing minor crises. It has the potential to turn into distress, which causes the body's wear and tear and produces unpleasant effects.

The three major types are: physical and environmental stress (overexertion, noise, pollution, natural disasters), psychological stress (frustration, conflicts, internal and social pressures), and social stress (death or illness in family, strained relationships, trouble with neighbours).

GAS was proposed by Hans Selye after studying animals and patients subjected to various stressors. It involves three stages: (1) alarm reaction — the adrenal-pituitary-cortex system activates, preparing the body for fight or flight; (2) resistance — the parasympathetic nervous system calls for cautious use of the body's resources; (3) exhaustion — continued stress drains the body's resources and increases susceptibility to stress-related diseases such as high blood pressure.

The four major effects are: (1) emotional — mood swings, anxiety, depression, decreased confidence; (2) physiological — release of epinephrine and norepinephrine, increased heart rate, constriction of blood vessels; (3) cognitive — poor concentration, reduced short-term memory, inability to make sound decisions; (4) behavioural — disrupted sleep, poor nutrition, increased use of caffeine, cigarettes, alcohol, and tranquillisers.

Burnout is the state of physical, emotional, and psychological exhaustion that results when stress due to environmental demands and constraints is too high and little support is available from family and friends. Physical exhaustion appears as chronic fatigue, weakness, and low energy; mental exhaustion appears as irritability, anxiety, helplessness, and hopelessness.

Psychoneuroimmunology is the field that focuses on the links between the mind, the brain, and the immune system. It studies the effects of stress on the immune system, including how stress can affect natural killer cell cytotoxicity, which is important in the body's defence against infections and cancer.

Endler and Parker identified three coping strategies: (1) task-oriented — obtaining information and acting directly to deal with the stressful situation; (2) emotion-oriented — maintaining hope, controlling emotions, or venting feelings of anger and frustration; (3) avoidance-oriented — denying or minimising the seriousness of the situation and suppressing stressful thoughts.

Hardiness is a set of personality traits identified by Kobasa in people who have high stress but low illness. It consists of 'the three Cs': commitment (a sense of personal commitment to what you are doing), control (a sense of purpose and direction in life), and challenge (seeing changes in life as normal and positive rather than as a threat).

Resilience is a dynamic developmental process referring to the maintenance of positive adjustment under challenging life conditions — the capacity to 'bounce back' in the face of stress and adversity. Its three resources are: I HAVE (social and interpersonal strengths, e.g. people who trust and love me), I AM (inner strengths, e.g. self-respect), and I CAN (interpersonal and problem-solving skills, e.g. finding ways to solve problems).

Stress inoculation training is a cognitive behavioural technique developed by Meichenbaum that aims to inoculate people against stress by replacing negative and irrational thoughts with positive and rational ones. It has three phases: assessment (discussing the nature of the problem from the client's viewpoint), stress reduction (learning relaxation and self-instruction techniques), and application and follow-through.

The chapter describes assertiveness (communicating feelings and needs clearly and confidently), time management (spending time on valued goals), rational thinking (challenging distorted thinking and irrational beliefs), improving relationships (listening, expressing, and accepting others' viewpoints), self-care (keeping oneself healthy and relaxed), and overcoming unhelpful habits such as perfectionism, avoidance, and procrastination.

Developed by Singh, Kaur and Kaur for the Indian population, based on Holmes and Rahe's work, it is a self-rating questionnaire with fifty-one life changes each assigned a numerical severity score. Sample scores: death of a close family member (66), appearing for examinations (43), change in eating habits (27). The mean number of stressful life events experienced in a year without producing overt physical or mental illness is approximately two.

Social support is defined as the existence and availability of people who care about, value, and love us. The quality of social support (perceived support) is positively related to health and well-being. It can be tangible (material aid), informational (knowledge about stressful events and coping strategies), or emotional (reassurance of being loved and valued). Research shows that social support effectively reduces psychological distress such as depression and anxiety during times of stress.

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