Stress-related disorders

Five core concepts are used to reduce anxiety or stress.[2]

• Recognition of the causes and sources of the threat or distress; education and consciousness raising.
• Relationships identified for support, help, reassurance
• Removal from (or of) the threat or stressor; managing the stimulus.
• Relaxation through techniques such as meditation, massage, breathing exercises, or imagery.
• Re-engagement through managed re-exposure and desensitization.

The major function of these psychological defenses is to prevent the experiencing of painful emotions. There are several major problems with their use.

• Many of these defenses create new problems that are as bad, or worse, than the emotional problems they mask. Some may be just plain destructive. Example: rejection literally destroys the relationships we care most about.
• These defenses distort person's ability to perceive reality as it is. And this prevents them from dealing with their problems in a constructive way.
• These defenses do not get rid of the painful feelings. In fact, by masking them so that person doesn't feel them, they effectively store them up within themselves. Emotions are discharged through expression, so by denying themselves the chance to feel them, they also deny themselves the ability to get rid of them.
• These defenses do not just screen out painful emotions. They are, in fact, defenses against all emotion. So the more effective person's defenses become in protecting them from painful feelings, the less able they are to experience the joyful and happy feelings that make life worth living.
• These defenses are not perfect. As more and more hurt is stored away, a tension is developed. Person becomes increasingly anxious, nervous, and irritable. They become emotionally unpredictable. And when defenses weaken, as they will from time to time, person may experience emotional explosions.
• These defenses prevent person from knowing what is wrong, but they do not prevent us from feeling bad.

Acute stress disorder occurs in individuals without any other apparent psychiatric disorder, in response to exceptional physical or psychological stress. While severe, such reactions usually subside within hours or days. The stress may be an overwhelming traumatic experience (e.g. accident, battle, physical assault, rape) or unusually sudden change in social circumstances of the individual, such as multiple bereavement. Individual vulnerability and coping capacity play a role in the occurrence and severity of acute stress reactions, as evidenced by the fact that not all people exposed to exceptional stress develop symptoms. However, an acute stress disorder falls under the class of an anxiety disorder.

Symptoms show considerable variation but usually include: An initial state of "DAZE" with some constriction of the field of consciousness and narrowing of attention, inability to comprehend stimuli, disorientation. Followed either by further withdrawal from the surrounding situation to the extent of a dissociative stupor or by agitating and over activity.

The signs are: tachycardia (increased heart rate), sweating, hyperventilation (increased breathing). The symptoms usually appear within minutes of the impact of the stressful stimulus and disappear within 2–3 days.

This arises after response to a stressful event or situation of an exceptionally threatening nature and likely to cause pervasive distress (great pain, anxiety, sorrow, acute physical or mental suffering, affliction, trouble) in almost anyone.

The causes of PTSD are: natural or human disasters, war, serious accident, witness of violent death of others, violent attack, being the survivor of sexual abuse, rape, torture, terrorism or hostage taking.

The predisposing factors are: personality traits and previous history of psychiatric illness.

Flashbacks are the repeated reliving of the trauma in the form of intrusive memories or dreams, intense distress at exposure to events that symbolize or resemble an aspect of the traumatic event, including anniversaries of the trauma, avoidance of activities and situations reminiscent of the trauma, emotional blunting or "numbness", a sense of detachment from other people, autonomic hyperarousal with hypervigilance, an enhanced startle reaction and insomnia, marked anxiety and depression and, occasionally, suicidal ideation.

Psychiatric consultation: exploration of memories of the traumatic event, relief of associated symptoms and counseling.

The course is fluctuating but recovery can be expected in the majority of cases. Few people may show chronic course over many years and a transition to an enduring personality change

Stress ulceration is a single or multiple fundic mucosal ulcers that causes upper gastrointestinal bleeding, and develops during the severe physiologic stress of serious illness. It can also cause mucosal erosions and superficial hemorrhages in patients who are critically ill, or in those who are under extreme physiologic stress, causing blood loss that can require blood transfusion.

Ordinary peptic ulcers are found commonly in the "gastric antrum and the duodenum" whereas stress ulcers are found commonly in "fundic mucosa and can be located anywhere within the stomach and proximal duodenum".