The human body reacts to stressors with changes that are expressed through disorders of mental, physical, visceral, hormonal, metabolic and immune functions. This is the result of the reaction created by the psycho-neuro-endocrine-immune axis as a whole.

Keywords:

stress, health, behaviour, feelings, disorders

This axis exists in every human organism and at the same time represents a platform that performs the function of a central control system. Modern science has long established its fundamental role in the integrative model of monitoring and interpreting the phenomena that occur, as well as the processes that take place in the human body, under the influence of stress.

On a psychological level, stress is most often experienced as a state of internal tension, restlessness, unpleasant anticipation, anxiety, various forms of fear, worry, etc. This is often accompanied by mood swings, irritability, impulsivity, lack of motivation, lethargy, depression, sleep disorders, changes in the instinctual sphere (impotence, etc.), eating disorders, as well as muscle tension, body aches, headaches, etc.
Emotional disorders, through certain connections and centers in the brain (limbic system), can cause disorders of hormone functions as well as of other important bodily functions, and thus enable further development of psychosomatic disorders.

Behavioral disorders can manifest in an unsocial, antisocial, or addictive form. At the social level, they are expressed in the form of dysfunction of social roles in the family, productive roles in the professional environment, communicative in socializing, creative in self-expression, etc.

Chronic unregulated stress creates a load and an imbalance of the functions of the vegetative nervous system, which controls the functionality of internal organs and glands with internal secretion. This creates the potential, if there is no timely regulation of accumulated stress, for developing psychosomatic disorders and diseases in humans such as: tachycardia, arrhythmia, atherosclerosis, hypertension, myocardial infarction, stroke, indigestion, gastric and small bowel ulcers, ulcerative colitis, migraines, thyrotoxicosis, diabetes mellitus, bronchial asthma, neurodermatitis, eczema, psoriasis, etc.

Chronic stress can also lead to a weakening and exhaustion of the body’s defenses, the so-called immunity. This further leads to the development of an inclination to infections, autoimmune diseases (arthritis, lupus, multiple sclerosis, etc.), as well as to the development of malignant tumors.

Workplace stress and unregulated chronic stress can lead to the appearance of the “burnout” syndrome. Symptoms of this condition can be physical (headaches, chronic fatigue, decreased resistance to alcohol and drug abuse, illness, etc.), emotional (emotional exhaustion, irritability, repulsion, apathy, feelings of helplessness, etc.) and behavioral (complaints at work, absences, leaving a job or profession, social withdrawal, etc.).

Map of stress reactions and disorders

In a simplified view that follows, I have set a practical map with a spectrum of reactions and disorders related to stress. It enables a quick and efficient way to gain basic insights into the richness of phenomenology and the variety of changes to the systems in the human body that are caused by stress. Of course, one should also know that stress is at the same time an immensely creative basis for the development of an endless series of new associated reactions and disorders, which in practice very often supplement the tabular presentation that follows.

Behavior

  • Abuse of alcohol, nicotine, caffeine, drugs, etc.
  • Loss of appetite or overeating
  • Disturbed sleep – insomnia, prolonged sleep
  • Hostile attitude
  • Impulsivity
  • Aggression
  • Careless driving
  • Propensity for accidents
  • Speech problems, flickering of the voice
  • Poor organization of time
  • Coercive behavior
  • Checking rituals
  • Tics, cramps
  • Nervous coughing
  • Low productivity
  • Withdrawal in relationships
  • Squeezed fists
  • Gritting of teeth
  • Frequent absences
  • Decreased or increased sexual activity
  • Fast eating, walking, speaking
  • Grumpy behavior
  • Frequent crying
  • A neglected look
  • Avoiding eye contact

Emotions

  • Anxiety
  • Irritability
  • Hypersensitivity
  • Instability
  • Anger, rage
  • Guilt
  • Concern
  • Depression
  • Hurt, insulted
  • Excessive jealousy
  • Shame, confusion
  • Lack of self-confidence

Body sensations

  • Tension in the body
  • Headache
  • Palpitations (feeling of pounding in the chest)
  • Accelerated heart rate (tachycardia)
  • Nausea, disgust
  • Shivering, inner trembling
  • Body aches
  • Dizziness, fainting
  • Poor digestion
  • Premature ejaculation, erectile dysfunction
  • Vaginismus, psychogenic dyspareunia
  • Limited sensuality and sexual awareness 
  • Butterflies in the stomach
  • Stomach spasms and cramps
  • Stiffness
  • Dry mouth
  • Cold sweat
  • Cold and wet palms
  • Sensitive waves – currents in the body

Imaginations

  • Helplessness
  • Isolation, loneliness
  • Loss of control
  • Accidents, injuries
  • Failure
  • Humiliation, shame, confusion
  • Own or someone else’s death
  • Physical, sexual abuse
  • Nightmares, disturbing recurring dreams
  • Visual flashbacks (images – scenes repeated in fantasies)
  • Unhappy, miserable images of oneself
  • Fantasizing about suicide

Thoughts

  • Negative thoughts
  • Avoiding ideas
  • Overloaded with thoughts while performing tasks
  • Condemning, blaming oneself and others
  • All or nothing thinking
  • Thoughts like: “Life is unfair”
  • Thoughts like: “I can’t …” 
  • Thoughts like: “I’m powerless”
  • Thoughts like: “I have to control myself”
  • Thoughts like: “I have to achieve what I imagined” 
  • Thoughts like: “I have to enforce my norms and rules”
  • Thoughts like: “Others have to agree with me, to approve …” 
  • Thoughts like: “Everything is awful, scary, horrible, unbearable …”

Interpersonal relations

  • Passivity
  • Aggression
  • Cowardice, insecurity
  • Loneliness
  • No friends
  • Competitive attitude
  • Putting the needs of others before your own
  • Indulgent, condescending behavior
  • Withdrawal
  • Too easy or difficult to make friends
  • Suspicion
  • Mystery
  • Manipulation
  • Gossip

Somatic disorders

  • Diarrhea
  • Constipation
  • Flatulence (gases)
  • Frequent urination
  • Allergies, skin rashes
  • Dry skin
  • Hair loss
  • Psoriasis
  • Eczema
  • Atherosclerosis
  • High blood pressure (hypertension)
  • Coronary heart disease (angina pectoris, heart attack)
  • Gastrointestinal problems (bloating, cramps, bleeding, ulcers, digestion, colitis, etc.)
  • Diabetes
  • Hyperthyroidism / hypothyroidism
  • Hormonal disorders (disturbed menstrual periods, PMS, PMDD, functional sterility)
  • Rheumatoid arthritis
  • Multiple sclerosis
  • Asthma
  • Chronic fatigue, exhaustion, burnout
  • Poor diet, exercise, recreation
  • Weakness of the immune system
  • Flu, viruses, colds
  • Cancer
  • Accelerated aging

Psychiatric disorders

  • Anxious
  • Panic
  • Phobic
  • Obsessive
  • Compulsive
  • Dissociative
  • Traumatic and posttraumatic
  • Depressive
  • Suicidal
  • Alzheimer’s disease

Dečko sedi za stolom i drži se za glavu

The burnout syndrome

The burnout syndrome deserves a special place in the tabular representations of the phenomenology of stress reactions and disorders. This is so due to its current extremely high frequency and ubiquitous devastating destructiveness, which is still not fully recognized by modern man, and unfortunately, not even by the professional public. It was only in July 2019 that the WHO (World Health Organization) published the diagnostic criteria, ordering the obligation to recognize and treat it.

Stages of the burnout syndrome

So far, three phases of the burnout syndrome are commonly mentioned in literature. My thirty-five years of experience in the practice and work with stress disorders directs me to the reality of introducing the fourth – final phase. I hereby believe that I should try to open the eyes “wide closed” of the public to notice and accept the seriousness of this modern and omnipresent problem.

First phase (alarm phase): 

  • Increased tension 
  • Irritability 
  • Decreased concentration 
  • Forgetfulness 
  • Insomnia

Second phase (resistance phase):

  • Feeling tired for no particular reason
  • Resistance towards going to work
  • Sick leave
  • Difficult decision making
  • Avoiding society
  • Cynicism
  • Indifference
  • Loss of motivation and creativity
  • Eating disorders
  • Abuse of coffee, cigarettes, reaching out for narcotics, etc.

Third phase (exhaustion phase):

  • Chronic mental and physical fatigue
  • Chronic grief
  • Indifference
  • Apathy
  • Depression
  • Headaches
  • Body aches
  • Problems with the functions of the stomach, intestines, heart rhythm, sugar level, etc.
  • Isolation
  • Withdrawal
  • Self-destructive thoughts
  • Appearance of psychosomatic diseases (cardiovascular, endocrine, etc.)
  • Appearance of immune disorders (autoimmune diseases, cancers, etc.)

Fourth phase (the end)

  • Death

So far, some stages of this syndrome have mostly been misdiagnosed. Because of that, it was usually treated incorrectly or insufficiently successfully. Signs and symptoms of this syndrome have usually been diagnosed either as neurotic disorders (e.g. anxiety, depression, obsessive-compulsive disorder, etc.), very often as crisis disorders or exclusively as somatic and immune syndromes (e.g. cardiovascular, gastroenterohepatological, endocrine, malignant, autoimmune, degenerative, idiopathic, etc.).

Although in rare cases the stress factor was mentioned in some places, it was only verbally present, but not specifically defined and professionally measured.

Such cases were, even less often, further properly referred to the adequate “cleansing” of the existing and threatening stress accumulation, as well as to the programs of successful regulation of the deeper stress constellation and stressful lifestyle. Unfortunately, such a relationship is still dominant in the medical and public approach to this most widespread and highly mutilating syndrome.