1. Stress and Anxiety: Time for a Change Women’s Health Series September 29, 2009

2. What we’ll cover today: Definitions Agents of Disease:  Biochemical / Physiological root of anxiety  Psychological root of anxiety What Makes Populations Vulnerable:  Social roots of anxiety  Structural roots of anxiety Making a Change!

3. Definition: Stress Stress is our own mental or physical response to external changes and difficulties

4. Definition: Anxiety Persistent stress that is not resolved through coping or adaptation, deemed distress, may lead to anxiety or withdrawal behaviour (depression). Anxiety is a psychological and physiological state characterized by cognitive, somatic, emotional, and behavioural components. These components combine to create an unpleasant feeling that is typically associated with uneasiness, fear, or worry.

5. AGENTS OF DISEASE Biochemical / Physiological Psychological

6. Biochemical / Physiological Fight or Flight Alarm is the first stage. When the threat or stressor is identified or realized, the body's stress response is a state of alarm.

7. Resistance is the second stage. If the stressor persists, it becomes necessary to attempt some means of coping with the stress. Although the body begins to try to adapt to the strains or demands of the environment, the body cannot keep this up indefinitely, so its resources are gradually depleted. Biochemical / Physiological

8. Exhaustion is the third and final stage. At this point, all of the body's resources are eventually depleted and the body is unable to maintain normal function. Ulcers Depression Diabetes Digestive troubles Cardiovascular disease Mental health problems Biochemical / Physiological

10. Psychological Primary Appraisal Secondary Appraisal

11. Cognitive Behavioural Therapy Wrongful thinking / negative thinking “A talent for worrying really well.”

12. “This limited thinking focus can have detrimental effects, for ‘by obscuring the role of external factors, these biases may reinforce women’s often highly developed inward focus and self-critical attitude, and ultimately may amplify rather than diminish depression’”

13. WHAT MAKES POPULATIONS VULNERABLE Social roots of anxiety Structural roots of anxiety

14. Social Roots of Anxiety Class position “Working class kids show prolonged rises in cortisol under any kind of stress while upper class kids showed a quick spike and decline”

15. Change in social context and social location Forced displacement Immigration Social Roots of Anxiety

16. Job security Housing Nutrition Childcare Care-giving Social Roots of Anxiety

17. Structural roots of anxiety “Rich countries have reached a level of development beyond which further rises in material living standards do not help reduce health or social problems” Critical analysis of the “stress effects of social status” and how they “vary according to the nature of the dominance hierarchy and the quality of social relations”

18. Superstructure of Society Conditioning & Social Location Power Ability to exert control

19. Systemic Racism & Patriarchy “High frequency, low intensity insults … where one is constantly forced to make strategic decisions… “Am I walking so slowly that the cop will think I am loitering or am I walking so fast he will think I am running from the scene of a crime?” Commodification of women & constant “social evaluative threats”

20. WHAT CAN WE DO TO MAKE A CHANGE?

21. Incorporate All 4 Perspectives Biochemical / Physiological Psychological Social Structural

22. COLLECTIVE APPROACH Sharing stress reduction techniques “Friendship Networks” Demand adequate access to services Community organization for social change