Lec 4 : Stress, Health, and Non-infectious Diseases

Summary

Highlights

• Stress isn't an illness but a natural response that can lead to medical conditions if chronic. 🌪️
• There's a strong connection between mind and body, challenging Descartes' mind-body dualism view. 🧠🌿
• Psychosomatic elements underscore how stress can lead to physical symptoms without an organic cause. 🌀🩺
• The role of stress in heart diseases is significant, as stress hormones can worsen or cause cardiovascular issues. ❤️🔥
• Behavioral changes under stress, like poor diet and inactivity, can further lead to health problems. 🍔🚫
• Stress affects health via physiological reactions, impacting systems like the sympathetic nervous system and immune system. 📊🛡️

Key Takeaways

• Stress and health are intrinsically linked, with stress influencing both infectious and non-infectious diseases through the mind-body connection. 🌐
• Psychosomatic diseases demonstrate how mental states can manifest as physical symptoms, showing stress's powerful impact. 🧠➡️🩺
• Non-infectious diseases like heart disease and diabetes are major health concerns, often exacerbated by stress. ❤️📊
• Both physiological and behavioral pathways explain how stress can lead to health issues, highlighting the need for stress management. 🤯📉
• Understanding stress responses and their impacts can lead to better health strategies and outcomes. 🕵️‍♂️🔬

Overview

Chapters

• 00:00 - 06:00: Introduction to Stress and Health The introduction sets the stage by exploring the relationship between stress and health. It highlights how stress can impact both physical and mental well-being and sets the groundwork for understanding the biological and environmental factors that influence this relationship.
• 06:00 - 18:00: Recap of Previous Lecture and Introduction to New Concepts This lecture, titled 'Recap of Previous Lecture and Introduction to New Concepts,' is the fourth lecture in the NPTEL MOOC course on Psychology of Stress, Health, and Well-being. It is the first lecture for Module Two. The primary focus of this lecture is on the relationship between stress and health, which will be covered over the course of two lectures.
• 18:00 - 22:00: Historical Perspective on Stress and Health The chapter titled "Historical Perspective on Stress and Health" will be part of a series of lectures focusing on stress and its impact on health. The series is divided into two lectures, one addressing the relationship between stress and non-infectious diseases and the other addressing stress and infectious diseases. The current focus is primarily on stress and non-infectious diseases.
• 22:00 - 27:00: Concept of Psychosomatic Diseases In this chapter titled 'Concept of Psychosomatic Diseases', the lecture recaps the physiological aspects of stress discussed in the previous module. It explores how stress leads to various changes in the body, focusing on the fight or flight response.
• 27:00 - 42:00: Mechanisms Linking Stress and Health The chapter titled "Mechanisms Linking Stress and Health" discusses the body's acute stress response, commonly known as the fight or flight response. It explains that upon experiencing stress, the body's immediate reactions include increased heart rate and perspiration. This chapter explores how the body becomes aroused and gains extra energy to handle threats and dangers in the environment, describing it as a natural physiological response to stress.
• 42:00 - 53:00: Stress and Non-communicable Diseases The chapter discusses the body's response to stress as explained by the general adaptation syndrome. It highlights that individuals experience various stages in response to both short-term and long-term stress. The adaptation process involves multiple phases where the body undergoes specific changes to manage the stress.
• 53:00 - 82:00: Stress and Cardiovascular Diseases The chapter 'Stress and Cardiovascular Diseases' discusses the body's response to stressful situations through three stages: alarm reaction, resistance, and exhaustion. It further explores the connection between stress and physiological reactions in the brain and body, highlighting the role of the amygdala's activation during stress.
• 82:00 - 89:00: Broken Heart Syndrome The chapter titled 'Broken Heart Syndrome' delves into the physiological mechanisms activated by stress, focusing on two key pathways: the sympathetic adrenal medullary (SAM) system and the hypothalamic-pituitary-adrenal (HPA) axis. It explains how the body responds to stressful experiences through these systems, highlighting the activation of the adrenal medulla in the SAM system.
• 89:00 - 103:00: Stress, Cholesterol, and Personality Traits The chapter 'Stress, Cholesterol, and Personality Traits' delves into the body's response to stress, focusing on the role of the adrenal gland and the hypothalamic-pituitary-adrenal (HPA) axis. It explains how the inner part of the adrenal gland secretes hormones like adrenaline and noradrenaline, which have significant effects on the body. Additionally, it describes how the hypothalamus activates the HPA system, prompting the release of cortisone from the adrenal cortex. These hormonal releases occur in response to various stressful experiences, indicating the body's complex physiological processes in managing stress.
• 103:00 - 105:00: Behavioral Pathways and Conclusion This chapter explores the intricate relationship between stress and certain key areas of the brain. It focuses on how stress impacts the hippocampus, which plays a crucial role in learning, memory, and emotions, and the prefrontal cortex, which is integral to higher cognitive functions.

Lec 4 : Stress, Health, and Non-infectious Diseases Transcription

• 00:00 - 00:30 [Music]
• 00:30 - 01:00 i welcome you to the fourth lecture of this nptel mooc course psychology of stress health and well-being ah this is overall fourth lecture but this is the first lecture for module two so in today's lecture we will talk about you know the relationship between stress and health so stress and health will be covered in two lectures
• 01:00 - 01:30 so in one lecture we will talk about the relationship between stress and non-infectious diseases and we'll talk about in the next lecture the relationship between stress and infectious diseases so we will have two lectures under this title so obviously today we will talk about the stress and health particularly in the context of stress and non-infectious diseases so before we talk about today's lecture
• 01:30 - 02:00 let us have a brief recap of last lecture that is lecture 3 of module one so in the last lecture we talked about the physiological aspect of aspects of stress ah basically we try to understand how the experience of stress you know causes various physiological changes in the body so in that context we have discussed uh the fight or flight response which we have this
• 02:00 - 02:30 is also called as acute stress response where we try to find whenever we discussed that you know whenever we experience stress the immediate reaction of the body is fight or flight or the body gets aroused and you know there are you know certain symptoms in terms of increase in heart rate perspiration etc and the body gets extra energy to deal with you know various threats and dangers in the environment so this is a natural response that we
• 02:30 - 03:00 all experience whenever we experience stress or threat in the environment we have also discussed uh general adaptation syndrome so in the general adaptation syndrome we all we discussed how our body responds to both term as well as well as long term stress and we have discussed there are three stages in which the body goes or body kind of experiences you know certain changes
• 03:00 - 03:30 uh when they encounter stressful circumstances so we have discussed alarm reaction stage resistance stage and then you know exhaustion stage then we have discussed you know how stress is connected to the brain and body particularly in in terms of physiological reactions ah in that we have discussed you know particularly you know that whenever we experience stress you know amygdala is activated
• 03:30 - 04:00 and then it it further activates hypothalamus which then activates two pathways ah one is called as you know same pathway and another is called as hpa system or same system so there are two pathways by which you know body kinds of response to stressful experiences in the same system basically which is called a sympathetic adrenal medullary system uh where you know body ah activates the medulla or the
• 04:00 - 04:30 inner part of adrenal gland and which secretes adrenaline non-adrenaline uh hormones which has then further other implications in the body ah similarly hypothalamus also activates hp system which is called hypothalamic pituitary adrenal cortical system which activates co cortex of the adrenal gland and it releases hormones such as cortisone so this hormones are released in the response to various stressful experiences
• 04:30 - 05:00 and they have many consequences in the body then we have also discussed the connection between stress and brain and we have discussed stress particularly you know influences two parts of the brain that is one is called as hippocampus and another is prefrontal cortex hippocampus is mainly responsible for you know learning memory and emotions prefrontal cortex is primarily responsible for you know higher
• 05:00 - 05:30 cognitive functions and or executive functions such as you know regulating thoughts and emotions decision making etc so stress can influence these two parts and adversely impact these functions we have also discussed gender differences in the stress response particularly in the fight and flight response so some research suggests that obviously phyto flight response is kind of universal but females are more likely to show another kind of little bit different response which is called as
• 05:30 - 06:00 you know tend and befriend response where you know in the 10 section basically under stressful circumstances uh the females are more likely to show nurturing activities for protecting offsprings and dependence in order to reduce stress and protect the dependents in the befrienders concept basically the females are more likely to create and maintain a social network for protection and
• 06:00 - 06:30 reducing stress and we have discussed this may have evolutionary reason why it happens that you know because females are more you know likely if they were given the role of protection of offspring throughout the history and fight and flight response may not be very conducive for such functions so tend and be different probably is an evolutionary functions for protection of species so these are some of the major concepts that we have discussed in the last lecture today we will talk
• 06:30 - 07:00 about some of the major concepts such as i will talk about historical background of stress and health research how stress is connected to health and we'll see some of the historical you know antecedents of research particularly how research evolve in terms of finding this relationship then we will also discuss you know various pathways uh linking stress and health what are the mechanism by which stress influences our health particularly
• 07:00 - 07:30 physical health and then we will discuss a stress and non-infectious diseases in particular and we will see some of the examples of it in today's lecture so let's start now the stress in itself is uh is not an illness because it is more like a response of the body so it is a natural response of the body so this itself is not an illness however it is
• 07:30 - 08:00 more an unpleasant experience particularly we experience negative emotions however the various research have shown that you know stressful experiences can lead to various physical and mental illnesses or conditions so in itself it is not a problem but when we experience it too much or especially the chronic stress it may lead to various other both
• 08:00 - 08:30 diseases both physical as well as mental illnesses we have already discussed there are many staggering statistics associated with the adverse impact of stress you know in the context of health also we have such statistics now some survey shows that you know stress is the number one threat for health in the u.s and about 70 to 90 percent of doctors visit are related to stress so
• 08:30 - 09:00 there are so many such statistics so this is not just for the u.s context but it is true for most of the other countries also now this relationship between stress and health you know can be explained primarily from the context of the mind body connection when we talk about mind body connection
• 09:00 - 09:30 you know uh the idea is is is that you know the mind and body are not two separate entities you know they continuously influence each other uh uh if you look at historically you know 17th century french philosopher descartes kind of proposed the idea of mind body dualism so where he proposed that mind and body are two separate entities however you know recent research is
• 09:30 - 10:00 clearly indicates beyond doubt that mind and body are not two separate entities rather they are very closely connected to each other and continuously influence each other so and in that context in the mind body connection there are many you know areas of studies have been established and they are flourishing we have mind body medicine we have health psychology all these are primarily you know psycho
• 10:00 - 10:30 neuro immunology all these areas are based on the foundation of mind body connections you know and you know people are trying to understand uh from the diverse perspective how mind body interacts and what are the consequences of it what kinds of therapies and you know medications can be developed based on these ideas so the modern research it is kind of beyond doubt that there are a strong connection between mind and body and they are not seen as a separate
• 10:30 - 11:00 functioning entities you know but as one functioning unit so mind and emotions are viewed as you know influencing the body and as the body in turn can influence our mind and emotions so this is the basic idea between in in the concept of mind body connections furthermore when we discussed the physiology of stress in the last lecture it was evident you know how mind and body is very
• 11:00 - 11:30 strongly and closely connected to each other ah because we have seen when we experience men stress at the mind at the mental level and how the mental experience of stress you know influence our body in so many ways and leads to the release of various hormones and impact our bodies various organs of the body such as heart and other and endocrine glands directly because of our mental experiences of the
• 11:30 - 12:00 stress so the this was very evident in the uh discussion of in the last lecture particularly when we discussed ah the relationship between uh the biology of the stress now in terms of this mind body connection obviously you know we need to understand uh the concept of psychosomatic diseases now so psychosomatic diseases are
• 12:00 - 12:30 basically physical diseases that are caused or deteriorated by mental factors such as stress anxiety depression etc so this is these are category of disease where the symptoms are in the body but causal reasons could be in the mind so the idea of the basically these are two terms one is called psychosomatic so if you look at it
• 12:30 - 13:00 so psycho is basically you know connected with the mind somatic is connected with the body soma is basically means body so this psychosomatic diseases are basically you know such diseases where no mental factors plays very important role in terms of expression of physical symptoms of diseases
• 13:00 - 13:30 so researches very clearly shows this bi-directional relationship between the body and the mind and the psychosomatic diseases are an expression of that relationship so psychosomatic diseases involve both mind and body and it refers to physical symptoms that arise from or influenced by the mind and emotions rather than specific organic cause such as injury
• 13:30 - 14:00 so there are in such diseases there may not be very specific organic reason in the body such as injury in the body or in the body parts but this may be caused by the mental factors so when we talk about uh psychosomatic diseases you know we need to understand that also there are mental aspects in various physic in the physical diseases for example you know how we react to a disease whenever a
• 14:00 - 14:30 physical disease happens to your body how you react to that disease how you cope with that disease uh can differ from person to person so there are mental factors associated with every physical disease in a general sense apart from this causal reasons in the psychosomatic diseases so for example you know skin diseases or rashes in the body part can influence people particularly you know faces and
• 14:30 - 15:00 other body parts particularly you know it can influence our reactions uh you know very strongly and obviously you know whenever we have mental illnesses it may have physical connections to it in the sense that you know you know certain mental illnesses such a depression people you know stop eating uh they stop taking care of themselves so this may further cause other physical diseases or worsen the existing diseases so this is a clear bi-directional
• 15:00 - 15:30 relationship so so every physical disease has a mental aspects and the mental diseases has some physical aspects to it so psychosomatic diseases we need to understand in that context ah and particularly some of the uh physical diseases are very strongly you know connected with the mental factors you know for example uh skin diseases stomach ulcers high blood pressure
• 15:30 - 16:00 and heart diseases so we look into some of them in more detail so in fact a branch of psychological health psychology has evolved you know primarily to understand the psychosomatic aspects of diseases and it investigates the role of psychological factors such as stress emotion beliefs etc on our physical health and illnesses so we have a whole branch of study on based on the psychosomatic aspects of
• 16:00 - 16:30 diseases and it clearly reflects how important mental factors are in physical diseases particularly you know experience such as stress now if you look at the historical background of psychosomatic diseases you know there are some of the important landmarks we can find uh we can discuss so cloudy bernard in 1878
• 16:30 - 17:00 uh he used the term dynamic equilibrium to understand the diseases so basically he says the dynamic equilibrium is the stability or consistency of the inner environment so at the physiological level whether your body is
• 17:00 - 17:30 stable consistent or at the equilibrium stage so that equilibrium basically shows your healthy state so if that equilibrium state is kind of disturbed such disturbances may adversely affect our body and may cause diseases so this was one of the first concept in terms of understanding you know psychosomatic diseases proposed by bernard then in
• 17:30 - 18:00 walter cannon in 1929 he used another term called homeostasis as an extension of dynamic equilibrium concept of bernard ah by homeostasis he meant almost same thing so basically he is talking about the maintenance of a constant inner condition is homeostasis so maintenance of homeostasis of the body is basically maintaining a constant inner conditions
• 18:00 - 18:30 of the body ah for ex but some experience such as stress which may lead to fight and flight response disturbs this homeostasis and you know can lead to diseases so basically bernard said you know that maintenance of life is basically dependent on this maintaining of homeostasis in our body
• 18:30 - 19:00 so this is very crucial for maintenance of life so he uh hencely use the term to represent this effect that you know stress is a condition that disturbs that homeostasis basically and male it may lead to various diseases
• 19:00 - 19:30 then obviously hence ellie who did lot of research in 60s 70s um on stress he proposed as we have already discussed the concept of general adaptation syndrome where he described a physiological response of the body both short term and long term in terms of stress both
• 19:30 - 20:00 acute stress as well as chronic stress so he discussed alarm stage which is more like you know activation of fight and flight and activation of sympathetic part of autonomic nervous system resistance stage was associated with release of cortisol and very other stress hormones particularly cortisol from the hp axis and the exhaustion stage was basically associated with various
• 20:00 - 20:30 diseases of adaptation which were pretty particularly called as psychosomatic diseases so this exhaustion stage where no people the resistance of the body you know is minimized and sometimes it may collapse and as a result ah body kinds of expresses this you know decrease of resistance in terms of various diseases which are called as psychosomatic diseases or called as diseases of adaptation
• 20:30 - 21:00 so hence elev e kinds of you know then you know further elaborated on this idea of psychosomatic diseases ah recently you know an a whole branch of study evolved which is called as psychoneuroimmunology which is in short called as pni it is a field of study based on this
• 21:00 - 21:30 mind body connection ah which revealed that there is a constant interaction between our central nervous system and immune system and obviously central nervous system is influenced by our mental processes so our mental processes can influence our nervous system which can influence the body's immune system so many studies indicated that psychological factors such as stress can
• 21:30 - 22:00 influence our central nervous system and which in turn can influence our immune system so this area of study is clearly kind of evolving this whole idea of psychosomatic diseases and playing very important role so we will look into this this particular branch of study in more detail in the next lecture
• 22:00 - 22:30 when we will talk about ah stress and infectious diseases where we will specifically look into the connection between stress and immune system now we have kind of tried to understand and give you an historical background about the psychosomatic diseases and how stress can cause as well as
• 22:30 - 23:00 worsen the physical disease or send physical diseases now we will talk about what are the pathways that can link stress and health what is the mechanism by which stressful experiences can influence our physical health so this is a diagrammatic representation of mechanisms so here you can see uh there are two pathways by which stress can influence
• 23:00 - 23:30 physical health or illnesses one is stress particularly the distress part or the negative experiences of the stress can directly influence our physiological reactions of the body or physiological mechanisms include sympathetic nervous system and neuroendocrine system and we have already you know looked into
• 23:30 - 24:00 that part in detail in the last last lecture stress may also influence our immune system ah this will discuss in more detail in the next lecture so by influencing our physiology particularly nervous system endocrine system and immune system stress can cause physical illnesses this is the one pathway the second pathway is stress can
• 24:00 - 24:30 influence our behavioral reactions or responses particularly our react behavior may change under stressful circumstances such as changes in the health practices or lifestyles changes in the adherence to medical advices so we'll look more detail into that part also so many behavioral changes may be associated with the stressful experiences which may further worsen the diseases
• 24:30 - 25:00 so these are two pathways basically you know that you can we can we the at least literature shows that through these two pathways stress influences physical health so basically more simpler form if i show you it could be shown like this
• 25:00 - 25:30 so this is more simpler form by which we
• 25:30 - 26:00 can kind of understand the mechanisms so there are two pathways physiological changes and behavioral changes in response to stress can lead to physical illnesses
• 26:00 - 26:30 now stress can influence or cause both infectious as well as non-infectious diseases so if you look at physical diseases uh broadly we can categorize them into infectious or communicable diseases or and non-infectious or non-communicable diseases so stress can lead to both infectious and non-infectious diseases
• 26:30 - 27:00 infectious diseases occur due to attack from an external agent such as bacteria viruses so primarily it comes from outside and it it can be transmitted from one person to another person because the agents are bacteria and viruses that can transfer from one person to another person so that is why they are also called as communicable diseases non-infectious diseases on the other
• 27:00 - 27:30 hand occur primarily because of internal factors such as wear and tear or malfunctioning in certain organs of the body and these are not transmitted from one person to another person so therefore they are also called as non-communicable diseases so basically these are some malfunctions in the organs of the body so so we have various diseases such as you know heart diseases
• 27:30 - 28:00 diabetes so these are all non-communicable or non-infectious diseases so flu you know is a commun probably it could be a communicable disease because it can beco it is caused by you know germs such as viruses so stress can influence or cause both categories of these diseases the today's lecture will primarily focus on
• 28:00 - 28:30 non-communicable diseases and how stress is connected to that now it was evident that you know physiological response to stress is very complex and we don't know everything about it but what we understand is primarily it is done by two pathways one is same system and one is hpa system and the both the system releases end up releasing
• 28:30 - 29:00 hormones such as you know adrenaline nor adrenaline cortisol etc now the question is this is the physiology primary physiological mechanism now the question is how the secretion of these hormones or stress hormones can lead to both infectious as well as non-infectious diseases so this is the question we will try to understand today we will try to understand
• 29:00 - 29:30 non-infectious diseases part so stress can contribute to the development of diverse non-infectious diseases that were earlier believed pure as purely physiological in origin such as cardiovascular diseases so these diseases were primarily ah earlier people used to think their origin is primarily physiological or in the body but recent researches clearly show
• 29:30 - 30:00 you know it such diseases can be contributed by mental factor in a very large way so they are kind of psychosomatic diseases so there are staggering statistics associated with uh stress and you know the diseases particularly you know non-infectious diseases ah for example you know i will just know read out some of these findings
• 30:00 - 30:30 so stress related non-communicable diseases or ncds such as coronary heart diseases diabetes coronary pulmonary diseases neuropsychiatric diseases etc are the major health crisis in the 21st century you know because they are major reason for deaths related to various physical diseases so they are causing major crises in the 21st century in terms of disease management
• 30:30 - 31:00 according to the centers for disease control and prevention cdc division of global health protection the ncds or non-communicable diseases are responsible for more than 68 percent of deaths worldwide and 75 percent of deaths in low and middle income countries so you can understand the huge in impact such diseases have
• 31:00 - 31:30 on in the lives of people and they are mostly causes by factors such as stress ncds are generally preceded by stress related metabolic problems such as hypertension high cholesterol reduce responsiveness to insulin so all these metabolic changes happens by the stress and they ultimately causes all these non-communicable diseases ah particularly
• 31:30 - 32:00 psychosomatic diseases so reduce responsiveness to insulin leads may lead to diabetes high cholesterol may lead to heart diseases you know high blood pressure lead to high hypertension so all these are metabolic changes are caused by stress related factors and they may further lead to various non-communicable diseases stress related chronic non-communicable diseases continue to
• 32:00 - 32:30 plague primary care practitioners resulting in enormous mortality morbidity and suffering and contributes to the expanding of health care cost so they are huge burden on the primary health care system and overall disease burden of various countries so these are major chunk of diseases that we all experience and interestingly you know they are all influenced by
• 32:30 - 33:00 may be influenced very strongly by stress related factors so let us talk now more about specifically about cardiovascular disease because this is one category of disease where stress seems to play most important role so cardiovascular system basically includes heart blood and blood vessels
• 33:00 - 33:30 and it is primarily regulated by autonomic nervous system so now you can understand the connection because these are regulated by autonomic nervous system and autonomic nervous system can be influenced by stress so cardiovascular diseases are the leading cause of death globally and causing an estimate of 17.9 millions
• 33:30 - 34:00 lives each year this is in statistics given by who in this year only so cardiovascular disease are really a huge category of disease i know that are causing one of the largest death globally so this is related to cardiovascular system primarily include coronary artery diseases coronary heart diseases and hypertension so primarily heart diseases
• 34:00 - 34:30 and hypertension or high blood pressures are included under cardiovascular diseases now coronary heart disease develops ah particularly you know when our heart arteries of the heart or the blood vessels that supply oxygen and blood to the heart so
• 34:30 - 35:00 the vessels that are connected to the heart which are called as arteries when they become narrow due to fatty deposits or deposits of the cholesterol in those arterial wall and as a result blood is not able to freely flow from the heart and to the heart and this is called as atherosclerosis so so the we will also look little bit more
• 35:00 - 35:30 deeper into that also so this is the primary reasons one of the primary reason for heart disease that is the blockage in the artery by the cholesterol or fatty deposits ah hypertensions on the other hand is basically you know high blood pressure ah it is a condition in which you know the force of the blood basically you know against the wall of the artery generally becomes higher than the normal situation
• 35:30 - 36:00 and it can lead to heart diseases strokes kidney diseases etc sometimes death also so and for example the ideal blood pressure is generally considered you know the normal blood pressure is between 90 by 60 mmg basically means millimeter of mercury this is the unit of measuring uh you know blood pressure so 90 by 62 120 by 80
• 36:00 - 36:30 mmhg is the normal range of blood pressure ah anything above that is considered higher particularly no if it is 140 by 90 mm ig or more can be considered as hypertension so basically you know this two counts are one is the top count is basically systolic uh blood pressure and one is called
• 36:30 - 37:00 diastolic blood pressure so systolic blood pressure is basically when ah heart beats you measure the pressure of the blood and diastolic is when heart is not beating so 90 by 60 means one is 96 systolic and 60 is diastolic measure so how stress contributes to cardiovascular diseases particularly
• 37:00 - 37:30 heart disease so all obviously the mechanisms are very complex and it is still not very clear however there are many possible pathways that have been linked with cardiovascular disease and the stress ah one is the experience of stress can cause high levels of physiological arousal leading to erratic and rapid heartbeats which can cause stroke cardiac arrest or even death of the person
• 37:30 - 38:00 especially to individuals with pre-existing heart conditions or diseases so one thing is very clear immediately with the experience of stress the heart beats get faster especially the under the fight and flight response ah heartbeat becomes very erratic and faster and you know and when it is experienced again and again can cause wear and tear in the system particularly
• 38:00 - 38:30 in the muscles of the heart due to repeated fight and flight response and can cause heart related problems so this could be one direct mechanisms where how stress can directly cause you know heart related issues by particularly causing wear and tear in the system due to repeated fight and flight responses
• 38:30 - 39:00 another uh way by which you know stress stress is connected to heart diseases is through stress hormones which are released during uh stressful situations so this cortisol epinephrine norepinephrine so these are stress hormones now research have shown that this stress hormones actually promotes atherosclerosis so we have discussed basically it basically means it blocks the arteries
• 39:00 - 39:30 by increasing you know cholesterol level by increasing the build up of fatty patches or plaques on the arterial wall which cause which leads to the narrowing down of the artery so artery is narrowed down because of buildup of plaques and fatty patch patches in the arterial wall this narrow artery decreases the blood
• 39:30 - 40:00 flow resulting in the increase of the blood pressure this decreases the blood flow causes less oxygen flow to the heart muscles which may result in chest pain which is also called angina and heart attack so stress hormones can promote atherosclerosis which ultimately you know can block the arterial wall and increase the blood pressure by decreasing
• 40:00 - 40:30 the flow of the blood and less oxygen in the heart so arterial wall and how this you know build up can be you know i will just show you how this is basically uh you know so for example
• 40:30 - 41:00 let us say this is a cross section of the artery and this is kind of no the cross section of that arterial one so this is a normal arterial opening of the artery ah but when atherosclerosis happens you know ah this fatty cholesterols or patches kind of
• 41:00 - 41:30 gets build up you know around this artery and as a result the area area of for the flow of the blood decreases which further increases the blood pressure so this is how you know kind of atherosclerosis happens in the arterial wall
• 41:30 - 42:00 there is another symptoms which is also connected to stress and heart disease is called as broken heart syndrome now stress can cause broken heart syndrome and it is more prominent among women following stressful or traumatic events so according to john hopkins medicine's website how they defined this symptom is that you know
• 42:00 - 42:30 the broken heart syndrome is a condition in which intense emotional or physical stress can cause rapid and severe heart muscle weakness so with the increase of the stress you know heart beat so fast or particularly if it is a very traumatic highly stressful event suddenly the heartbeat increases so fast that it weakens the muscles of the heart which is technically called as
• 42:30 - 43:00 cardiomyopathy so with stress cardio or the cardiomyopathy we believe that heart muscle is overwhelmed by a massive amount of adrenaline release of adrenaline that is suddenly produced in response to stress so suddenly there is a high intensity of stress and there is too much of stress hormone and too much of erratic movement in the heart which can overwhelm the heart
• 43:00 - 43:30 functioning of the heart the precise way in which adrenaline affects the heart is unknown but it may cause narrowing of the arteries that supply the heart with blood causing a temporary decrease in the blood flow of the heart so it is possible that you know that kind of shrinks temporarily because of this erratic movements and the effect of adrenaline and as a result you know you experience a kind of symptoms of
• 43:30 - 44:00 heart attack now this broken heart symptom isn't basically a stress induce symptom can happen to a normal and a healthy person so according to the american heart association website women are more likely than men to experience sudden intense chest pain the react which is basically reaction to
• 44:00 - 44:30 a surge of sudden surge of you know stress hormones it could be due to death of a loved ones you know suddenly you hear about such traumatic events or even a divorce breakup or physical separation betrayal or romantic rejection those these are some of the traumatic events for example in response to such events you know broken heart syndrome can happen because these are very traumatic and stressful even
• 44:30 - 45:00 sometimes it could even happen after a good shock lots you know suddenly winning a lottery so it can also overwhelm your physiological response so broken heart syndrome may be misdiagnosed as a heart attack so it is not exactly heart attack because the symptom is very similar to heart attack but in heart attack happens primarily because of blockage of the artery by you know cholesterols and other plaques so generally it happens you know due to blockage of the artery but
• 45:00 - 45:30 you know broken heart symptoms may not be connected with the blockage but it may happen suddenly so it can happen to a healthy person ah in response to a highly traumatic event now ah another important connection between stress and heart diseases is the connection between stress and cholesterol
• 45:30 - 46:00 now stress can increase bad cholesterol so there are two types of cholesterol one is called as bad cholesterol and another is called as good cholesterol so bad cholesterol is basically you know called as ldl or low density lipoproteins and good cholesterols are called as high density lipoproteins or hdl so stress can increase the bad cholesterol level of the body directly or indirectly through
• 46:00 - 46:30 directly by stimulating production in the body or indirectly through unhealthy behaviors such as you know eating unhealthy foods so uh for example uh there are many empirical evidences to that um a study by you know catalina romario and his colleagues in 2013 they collected data from more than 91 000 participants and found
• 46:30 - 47:00 a positive correlation between those who experienced high job stress and bad cholesterol level in their body so those who have experienced higher stress in their life their blood cholesterol is particularly the bad cholesterol level in their blood was much higher than the people who experienced less stress another study by asadi 2017 found that psychological stress can lead to higher
• 47:00 - 47:30 levels of bad cholesterol which are basically low density lipoproteins and decrease good cholesterol so it can functions in both ways by increasing bad cholesterol level and decreasing high good cholesterol level now stress hormones such as adrenaline and cortisol can trigger the production of cholesterol you know
• 47:30 - 48:00 which is basically cholesterol is a kind of waxy and fatty substance produced by the liver and it is produced primarily to give you extra energy during the stressful circumstances however when it is released too much because of excessive stress experiences there may be too much of excess cholesterol on excess energy when it is not used may get accumulated in the body as fats and
• 48:00 - 48:30 excess cholesterol can clog the arteries or block the arteries and basically you know it can cause to atherosclerosis and which ultimately cause may cause heart diseases or heart attacks so this is one basically direct mechanisms and obviously another way stress can induce various behavioral changes particularly eating behaviors and eating
• 48:30 - 49:00 of unhealthy foods such as carbohydrate which may further increase cholesterol levels in the body so through this mechanism stress can influence your cholesterol level in the body which particularly the bad cholesterol which can then further lead to heart diseases another important connection between
• 49:00 - 49:30 stress and heart diseases is through personality trait two researchers or heart doctors named friedman and rosen men in 1974 they suggested that people with certain personality characteristics or traits are more predisposed or more vulnerable to suffer from stress than other people because there are different characteristics of personality
• 49:30 - 50:00 so consequently they are more likely to have heart disease because they are more likely to experience stress in their life so in that context they identify two personality traits one is called as type a people and type b people so type a personality trait type b personality trait so what are they try to find out these two types of people by asking simple questions such as
• 50:00 - 50:30 do you feel guilty if you use spare time to relax do you need to win in order to derive enjoyment from game and sports do you always need to win to derive enjoyment do you generally move walk and eat rapidly do you often try to do more than one thing at a time so these are some of the sample questions obviously you know it had many more questions and they asked such questions and
• 50:30 - 51:00 if your answer is yes to this kind of questions you are more likely to be type a personality what happens what are the characteristics of type a people so they found that type a people they show excessive competitiveness and achievement orientation which lead to extreme self-criticism they also criticize themselves too much they have excessive competitiveness in their mind
• 51:00 - 51:30 and they are highly achievement oriented people they have an exaggerated sense of time urgency which leads to constant struggle against the clock and the compulsion to try to do more than one thing at a time so time urgency excessive competitiveness achievement orientation then the third factor is anger hostility that may or may not be openly expressed
• 51:30 - 52:00 so these are the three important or the prime characteristics of type a people and type b people show opposite characteristics basically you know they are very easy going and much less demanding of self and others and they don't have exaggerated sense of time urgency so type b people are more relaxed kind of people type a people because of this nature and they are more likely to be stressed most of the time in their life
• 52:00 - 52:30 so these are two different types of people you know that there is nothing wrong in being type a or type b ah these are only the different types of people different psychological makeup so this friedman and rosen man conducted a longitudinal study which basically means studying a group of people over a period of time for eight and a half years with a sample of 3524 men and men which were aged between 39 to 59
• 52:30 - 53:00 years and they found that type a individuals were twice as likely to develop coronary heart disease than type b individuals primarily due to higher physiological reactivity of type a people than type b people so the type a characteristics makes these people more vulnerable for heart diseases primarily because of
• 53:00 - 53:30 their psychological makeup they are more likely to experience stress and physiological reactivity which may increase the risk of heart disease but that doesn't mean type a people will automatically experience heart disease but they are more likely to experience heart diseases and because of their the nature in build nature and personality trait they are more likely to experience stress and we know stress can
• 53:30 - 54:00 you know increase the chances of our disease now later research indicated that only some aspects of type a behavior particularly the anger and hostility are more important in terms of understanding heart disease so other aspects may not be that strongly connected to heart disease but anger and hostility are particularly more strongly connected to heart diseases some research also indicated that you know particularly anger which is suppressed some people you know when they are angry
• 54:00 - 54:30 they kind of suppressed it and it kind of gets accumulated in the system in the physiology of the system such suppressed anger is more significantly the risk factor for higher physiological reactivity and coronary heart disease it was also reported that individuals who suppress their anger are twice vulnerable to mortality than the expressed anger so so it may not be all the characteristics of the type a people but some characteristics
• 54:30 - 55:00 particularly the anger and the suppressed anger could be more important in terms of causing heart diseases now the last thing that we will discuss is basically the behavioral pathways so obviously the stress cause non-infectious diseases one is through physiological responses that we have discussed and now there is another way that it can uh cause
• 55:00 - 55:30 non-infectious diseases is through behavioral pathways so stress can adversely affect health by increasing the frequency of unhealthy behaviors so under stressful circumstances people are more likely to behave or involve into unhealthy behaviors and healthy behaviors are likely to decrease or by disrupting prescribed healthy behaviors better so under stressful circumstances all
• 55:30 - 56:00 these things can be disrupted so frequency of unhealthy behavior may increase frequency of healthy behavior may decrease or healthy behaviors patterns may be disrupted by stressful circumstances of life all this may ultimately can cause further complications in the physical diseases so stress may induce many behavioral changes and disruptions in lifestyles and routines some of the common findings are for example changes
• 56:00 - 56:30 include disturbances in sleep which is very strongly connected with the stressful experiences disturbances in food intake unhealthy food overeating excessive smoking or other addictive behaviors may increase physical inactivity also increase under stressful circumstances people may involve into excessive drinking of alcohol drugs etc so all such behaviors
• 56:30 - 57:00 are problematic we all know and especially for people with pre-existing illnesses such as heart diseases can further complicate the physical diseases and worsen they are those symptoms and cause also physical diseases so these are the behavioral pathways through which you know stress can influence our influence non-infectious diseases
• 57:00 - 57:30 so this so we can understand it is very complex and there are many possible mechanisms but at least we try to understand some of the major pathways by which you know stress is connected to non-infectious diseases or non-communicable diseases next lecture we'll talk about how stress is connected to infectious diseases or specifically how it is linked to immune system so with this
• 57:30 - 58:00 i end today's lecture thank you [Music] you