If the stressful situation is very intense or continues over a period of time,
the adrenal cortex becomes increasingly involved in the stress reaction. The
activity of the cortex is largely controlled by blood levels of
adrenocorticotrophic hormone (ACTH, which is released by the anterior pituitary
gland. When information about sustained stress has been "processed" by the
central nervous system, a whole range of new bodily responses occurs, and it is
these longer-term reactions that can adversely affect the quality of life.
In general terms, the psychological reaction to stress takes the
- The initial fight-or-flight reaction is accompanied by emotions such as
anxiety or fear.
- Individual ways of coping are activated as we attempt to find a way of
dealing with the harmful or unpleasant situation.
- If the coping strategies are successful, the fight-or-flight reaction and the
anxiety state subside.
- If the coping strategies fail and the stress situation continues, a range of
psychological reactions, including depression and withdrawal, may occur.
The implication is that the consequences of failing to cope can be serious, and
it is therefore important that we develop our own ways of adapting to and
successfully dealing with stressful situations.
Research about how we cope suggests two broad categories of coping strategies.
The first involves attempts to change our unsatisfactory relationship with the
environment. Examples of this category would be:
The second category of response research involves "palliative"
strategies that attempt to soften the impact of the stress once it has
occurred. Examples of this category include:
- Escaping from the unpleasant situation-not always possible!
- Preparing ourselves for situations that we anticipate will be stressful. This
might involve thinking ahead of time about the situation and its likely impact,
thereby preparing ourselves adequately for the event; or it might involve some
actual work - for example, studying for an exam, instead of just worrying about
- Denial, by which we refuse to acknowledge all or some of the threat in the
- Intellectualization, by which we detach ourselves emotionally from the
Both of these strategies serve to protect us and help us maintain a reasonable
equilibrium through difficult times, but there is always the danger that such
strategies may make it more difficult for us to resolve a problem and may
become established as part of our psychological makeup.
Other coping strategies, including various relaxation techniques, may be
appropriate in some or all cases. However, the use of such strategies may delay
the direct reaction that we need to solve the problem that is causing the
stress. This is also true of another, particularly destructive way of coping:
escaping via the use of alcohol, tranquilizers, or other drugs.
There are some stresses for which no clear solution exists, for example, caring
for the chronically ill - and in such situations softening the impact of stress
may be the only way for us to cope. If stress is long-term or particularly
severe, marked emotional changes may take place. If the coping strategies we
employ don't work, we may regard the situation as one for which there is no
solution and increasingly see ourselves as unable to control the events of our
lives. Hopelessness and helplessness are both likely to give rise to feelings
of depression, and may even lead to suicidal thoughts. Following the stress of
chronic illness, for example, patients may literally give up hope. If this
occurs, they may become not only emotionally disturbed but also more vulnerable
to further physical illness.