1. This material is made available through The CAM in UME Digital Resource Repository and is owned and copyrighted by the credited author(s). Materials are provided for educational purposes only. All copied materials must contain clear and proper citation. The CAM in UME Project http://www.caminume.ca The CAM in UME Project does not warrant or assume any legal liability or responsibility for the accuracy, completeness, or usefulness of any information presented herein. COMPLEMENTARY MEDICINE: STRESS, HEALTH, ILLNESS – STRESS RESPONSE Joe A Schnurr, MD University of Saskatchewan Revised January 2005 URL: http://www.caminume.ca/drr/resources/00028.ppt 8 slides

2. © JA Schnurr, 2005 Psychophysiology of Stress, Health, and Illness  All behavioral states and activities are underpinned by variations in physiological activity, and are associated with specific patterns of ANS, neuroendocrine (HPA), and metabolic response.  Psychosocial factors influence etiology and maintenance of disease through disturbances in these physiological functions  Some psychophysiological responses are adaptive and some are maladaptive

3. © JA Schnurr, 2005 Psychobiological Stress Response  Neuroendocrine  Cortisol, ACTH, catecholamines, beta-endorphin, testosterone, insulin  Autonomic/metabolic  Cardiovascular function, respiration, renal function, gastro- intestinal motility, fat metabolism, hemostasis  Immune  Immunoglobulins, white cell counts, lymphocyte, subpopulations, cytokines

4. © JA Schnurr, 2005 Hypothalamic-pituitary-adrenal (HPA) Axis Effects of Stressors  Cortex of brain, limbic system and hippocampus  Hypothalamus (release of CRF)  Pituitary gland (release of ACTH)  Adrenal glands (release of steroid hormones)

5. © JA Schnurr, 2005 Effects of Free Corticosteroids  Stimulation of glucose production by the liver  Release of free fatty acids from adipose tissue  Modification of water balance  Alteration in vascular tone and excretion of sodium by the kidney promotion of anti- inflammatory responses  Immunoregulatory effects

6. © JA Schnurr, 2005 Adverse Effects  Elevation of blood lipid concentration  Deposition of fat in abdominal adipose tissue  Supression of some immune functions  Decalicification of bone  Impaired fertility  Increased BP and cardiac reactivity  Clinical depressive symptoms

7. © JA Schnurr, 2005 Stress Response: The Autonomic Nervous System  Stressor response stimulates release of NE and E (catecholamines)  These catecholamines also stimulate ACTH release from pituitary gland  Glucocorticoids affect biosynthesis of catecholamines in adrenal gland

8. © JA Schnurr, 2005 Effects of Catecholamine Release  Increase HR and BP; can affect cardiac rhythm and coronary blood flow - arrhythmia and ischemia  Stimulate platelet aggregation - thrombi  Increase respiratory rate and bronchoconstriction  Affect GI tract - from increased acid production abd gut motility to decreased bile secretion and gut motility (diarrhea, constipation, abdominal pain, IBS symptoms)  Increase blood lipid levels and influence insulin and glucose metabolism  Alter immune function

9. © JA Schnurr, 2005 Immune Function and Stress Response  CNS, HPA, ANS and immune system engage in a complex interplay with immune responses up- regulated or down-regulated by different behavioral and emotional states  Main organs of the immune system include the bone marrow, thymus gland, spleen and lymph nodes  Important components of the immune system are immunoglobulins, B and T lymphocytes, and cytokines