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239 Stress Research Topics & Essay Examples

📝 stress research papers examples, 💡 essay ideas on stress, 👍 good stress essay topics to write about.

• ⭐ Simple & Easy Stress Essay Titles

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🏆 best stress essay titles, 🎓 simple research topics about stress, 📣 stress topics for discussion, ❓ stress research questions.

• Posttraumatic Stress Disorder: Effects of Child Sexual Abuse Psychology essay sample: Child sexual abuse is among the common problems facing children. This paper looks at the causes and effects of child sexual abuse, the posttraumatic stress disorder, and its treatment.
• Occupational Stress and Stress Management Techniques Psychology essay sample: The paper discusses and evaluates the current state of literature about psychological debriefing in organizations and their effectiveness in managing acute occupational stress.
• Military Post-Traumatic Stress Disorder Issues Psychology essay sample: The paper discusses conditions that influence post-traumatic stress disorder, symptoms and treatment of the disorder, adjustment and transitional issues faced by soldiers.
• Children Under Stress and Its Management Psychology essay sample: In the current technological world and societies, people tend to experience various kinds of stress at all levels of their lives whether as children, adolescents or as adults.
• Post Traumatic Stress Disorder in the Military Psychology essay sample: The psychological diagnosis posttraumatic stress disorder appeared in 1980 to hallmark long-term reactive psychological disorders in response to exposure to war environment.
• Post Traumatic Stress Disorder in Combat Veterans Psychology essay sample: War is a major cause of Post Traumatic Stress Disorder. About seventeen percent of a veteran returning from war in places such as Iraq and Afghanistan show signs of PTSD.
• Work-Related Stress Reasons and Prevention Psychology essay sample: The psychological well-being of employees in the workplace is critical to avoid stress and improve employees’ performance. Stress is inevitable in the workplace and the effects of stress are mostly negative.
• Work-Place Stress Problem Analysis Psychology essay sample: Stress is inevitable in the workplace, and the effects of stress are mostly negative, as it has outcomes on the incomes of the organization and the health of the worker.
• Human Factors: Workload and Stress Relationship Psychology essay sample: Federico and Won, in their WIHI podcast, examine the relationship between stress and workload. They refer to human factors and their role in work-related stress in health care.
• Post-Traumatic Stress Disorder: Causes, Symptoms, Treatment Psychology essay sample: Post-traumatic stress disorder (PTSD) is a mental disorder associated with trauma and stress, especially from severe physical harm or and exposure to painful events.
• Post-traumatic Stress Disorder and Bereavement Psychology essay sample: In diagnosing bereavement, the first complication is drawing the line between grieving as the ‘normal' reaction and the traumatic distressed caused by the death of the loved one.
• Perceived Stress and Social Support Received Psychology essay sample: Psychological and biological stress models have been put forward to explain the events that take place when one is under stressful conditions.
• Post Traumatic Stress Disorder in the United States Psychology essay sample: Post Traumatic Stress Disorder (PTSD) is an emotional illness that is characterized by constant anxiety and is often the result of continuing frightening.
• "Introduction to Psychology" by Hawkes Learning Systems Psychology essay sample: The paper is about discussion posts on the Introduction to psychology. The each chapter discuss the human psyche, capabilities and behavior.
• Stress Perception in Students Psychology essay sample: The students from Western countries reported that they face greater stress from their relationships with parents, females’ stress levels were higher than those of males.
• Natural Ways to Manage Stress Psychology essay sample: Researchers have shown that respiration techniques help realign the sympathetic and the parasympathetic systems, simply by tuning the brain waves.
• Stress Management Among University Students Psychology essay sample: This paper presents a brief description of the methodology and results of research on the factors and levels of stress in students.
• How to Manage Stress: Key Tips Psychology essay sample: According to Sarafino, stress is a combination of emotional and physical tension in one’s mind and body. It can appear as a response to any traumatic experience.
• Definition of Stress: Pain or Motivation Psychology essay sample: Stress is often understood as a kind of psychological pain. In some circumstances, it can motivate a person to overcome difficulties and develop new skills.
• Stress Management Techniques Psychology essay sample: In this article, the author shares his knowledge of the different types of stress, and also talks about the methods that he uses to overcome them.
• Signs and Symptoms of Stress Psychology essay sample: Stress is a physical or emotional disorder, which can result from any frustrating experience. The signs of stress can be understood through a review of the theories of its causes.
• How Stress Affects Child Brain Development Psychology essay sample: Stress is an unavoidable and important part of any child’s life. Depending on how significant it is it can have a positive or negative effect on the child’s development.
• The Impact of Stress on Academic Performance Psychology essay sample: Stress had a universal presence in living creatures since the dawn of life, it does not mean that we should not try to avoid it and help reduce it for others.
• Post-Traumatic Stress Disorder and Pregnancy Psychology essay sample: The purpose of this paper is to identify the connection between pregnancy and stress. The most famous stress disorder is the so-called post-traumatic stress disorder or PTSD.
• Family Coping With Stressful Events and Transitions Psychology essay sample: Before analyzing the stages of the crisis and using the Double ABC-X Model, it is necessary to describe a hypothetical stressful family situation.
• Psychology of Social Stress. Stress and Health Psychology essay sample: It is important to justify the relevance of a theoretical understanding of the concept of social stress in psychological science.
• The Application of Key Psychological Concepts Psychology essay sample: This essay discusses the application of key psychological concepts in personal life and future aspirations as an anesthesiologist.
• About Stress Reduction Methods Psychology essay sample: In this article, the author shares her knowledge of stress reduction techniques and talks about how her life changed after she started practicing them.
• The Phenomenon of Post-Traumatic Stress Disorder Psychology essay sample: This research paper aims to discuss the phenomenon of post-traumatic stress disorder and its relationship to evidence-based medicine.
• Reaction to Stress: Anxiety and Yoga Psychology essay sample: The paper discusses stress. It is the reaction of the human nervous system to disbalance with the environment caused by internal or external factors.
• Problem of Stress and Its Impact on Student Performance Psychology essay sample: The problem of stress and its impact on student performance at Khalifa University is relevant, and the results of the research confirm the value of addressing this issue.
• Stress: Curriculum, Curricular Divisions and Writing Strategies Psychology essay sample: There are different actions to be so as to reduce the stresses and strains so as to prevent them from occurring, this includes thorough counseling, doing a lot of exercises.
• The Psychological and the Biological Stress Models: Comparative Analysis Psychology essay sample: Psychological and biological models have been constructed to explain the events that take place when a person is stressed.
• Stress Negatively Affects the Decision-Making Process of Business Leaders Psychology essay sample: The purpose of this article is to determine the extent to which stress affects the key elements of decision-making.
• The Effectiveness of Mindfulness Meditation Intervention in Reducing Stress in Adolescents Psychology essay sample: The research proposed in this work intends to examine adolescent stress when treated via the Mindfulness-Based Stress Reduction Intervention.
• Stress Management: Imagery Psychology essay sample: The paper discusses imagery. It is a very effective way of dealing with stress especially when accompanied by physical relaxation through exercising.
• Differents Forms to Stress, Pandemic of Stress Psychology essay sample: In this paper, stress is a major problem in the world today. Many countries and many individuals and families are victims of stress-related problems.
• The Importance of Assessment of Post-traumatic Stress Disorder Psychology essay sample: The purpose of this article is to consider the mechanisms of occurrence of post-traumatic stress disorder, as well as existing methods of its treatment.
• Post-Traumatic Stress Disorder Psychology essay sample: The purpose of this article is to consider the mechanisms of occurrence of post-traumatic stress disorder, as well as existing methods of its treatment.
• PTSD Treatment and Plan of Care Psychology essay sample: The purpose of this article is to review the causes of post-traumatic stress disorder, as well as its clinical manifestations, treatment and care plan.
• Understanding the Psychology of Stress in Everyday Life Psychology essay sample: The paper explains how does stress impacts the body, the relationship between motivation, emotion, and stress, describes two ways that can change stress symptoms.
• Addressing the Post-Traumatic Stress Disorder Psychology essay sample: The purpose of this article is to review the causes of post-traumatic stress disorder, as well as its symptoms and treatment.
• The Notion of Stress as Both a Biological Process Psychology essay sample: In the following paper, the notion of stress as both a biological process and psychological condition will be evaluated.
• Work-Related Stress and Burnout Psychology essay sample: The purpose of this article is to discuss work-related stress and burnout in terms of causes and effects, as well as interventions.
• The Impact of Stress on the Human Organism Psychology essay sample: Two job-related stresses have been affecting me the most, these are decreasing work efficiency. At this time of the year, people who are in the corporate world, tend to work fast.
• Stress as the Main Cause of Students’ Academic Failure Psychology essay sample: The connection between stress and the academic failure of students is quite explicit, specifically, being unable to cope with the emotional strain leads to poor performance.
• Occupation, Culture, and Stress in Middle Adulthood Psychology essay sample: For people in middle adulthood, the main stress-inducing problems are related to their occupations, their particular workplace situation, as well as to cultural determinants.
• Underappreciated Veterans with Post-Traumatic Stress Disorder Psychology essay sample: Veterans with PTSD are underappreciated and are not given enough help to enhance their well-being. PTSD is a health concern among veterans due to the nature of their work.
• Mental Health: Case Study of S. Psychology essay sample: This paper is devoted to the case of a woman I know personally. S. is a 31-year-old single mother with a family history of anxiety disorders.
• Stress and Its Effect on Health Psychology essay sample: Stress is defined as an individual’s reaction to a situation that destabilizes their mental, physical, psychological, or emotional state.
• Stress and Health: How People React to Stressors Psychology essay sample: In this paper, I support my agreement with the concept that different people react differently to different stressors.
• Stress and Anxiety Sources Amongst Students Psychology essay sample: This paper discusses some of the major sources of physiological, social, and psychological stress and anxiety in students.
• Patient's Concentration: Applied Behavior Analysis Psychology essay sample: This paper explores how memories are created, stored, and recalled. The paper investigates how the perception of stress might have affected the patient’s ability to focus.
• Psychology. Holmes-Rahe Life Stress Inventory Psychology essay sample: There are situations when several psychological tests, which are relatively similar to one another, can yield very different results.
• Exploring the Concepts of Productivity and Stress Levels in the Workplace Psychology essay sample: This article examines the impact of multitasking on employee stress levels, as well as ways to deal with stress.
• Secondary Post-Traumatic Stress Disorder in Military Families Psychology essay sample: Secondary Post-Traumatic Stress Disorder is a psychological condition that is common among military families of victims of primary Post-Traumatic Stress Disorder.
• The Stress Refraining Exercise Psychology essay sample: This study is worth reading because it provides invaluable insight into the ways people can effectively counter their stress-induced anxiety
• Handling Organizational Stress Psychology essay sample: Stress is a psychological effect that can affect any individual at some point in their lives regardless of their job capacity.
• Stress Management and Personal Life Experience Psychology essay sample: People need to learn how to manage stress and turn such a situation to their advantage. Stress management is a whole system of sequential actions.
• Post Traumatic Stress Disorder (PTSD) Psychology essay sample: The current research paper is aimed at underscoring a research proposal that is related to Post Traumatic Stress Disorder (PTSD).
• Mind and Body: Stress is Part of Human Life Psychology essay sample: Stress is part of human life and it influences mental health, behavior, moods, and overall sense of wellbeing.
• Stress and Workplace Production Psychology essay sample: The problem of increased stress and emotional pressure in the workplace is a major constituent in shaping people’s motivation, enthusiasm, and performance rates.
• Stress Management Strategies for Working Students Psychology essay sample: The strategies which might help manage stress for the working students are finding trustful mentors and noting positive events of the day in the diary.
• Social Stress and Its Impact on Memory Psychology essay sample: The paper points out that psychological stressors have shown significant impacts on cognition function. This study is meant to determine how and when memory is strained.
• Perceived Stress Among Undergraduate Students Psychology essay sample: In 2016, Abdollahi published a study on the role of hardiness in relieving stress among undergraduate students, which was published in the Journal of Health Psychology.
• The Impacts of Stress on Human Memory Psychology essay sample: Human memory performance can be impacted by several factors, encompassing non-cognitive elements such as the emotional condition of the test-taker.
• Habits, Stress, and Health Psychology essay sample: Personal habits, stress, and health interact in disparate ways. Everyday activities can exacerbate stress levels that an individual might not realize.
• Stress Identification and Management Psychology essay sample: Stress can be defined as any type of change in the human body that can cause physiological, emotional, and physical strain.
• Stress and Meditation as a Form of Treatment Psychology essay sample: Modern medicine eradicated many diseases that once posed a significant threat to humanity, but a new and relatively invisible issue, which came to be nowadays is stress.
• Workplace Stress and Managerial Counterstrategies Psychology essay sample: Workplace stress leads to significant losses and additional costs for enterprises. Most often, stress is caused by excessive workload and too long working hours.
• When the Body Says No by Dr. Gabor Mate: The Cost of Hidden Stress Psychology essay sample: When the Body Says No by Dr. Gabor Mate is a book written by Dr. Gabor Mate. It explores the link between the mind and the body.
• Stress Management (Abnormal Psychology) Psychology essay sample: Stress has devastating effects on one’s life. Coping with stress demands one to have an idea of what gives rise to the stressed condition.
• Psychology: Impact of Stressors Psychology essay sample: The concept of mind, body, and soul connection can help to effectively deal with physical manifestations of stress or use them to recognize and manage it.
• Stress at Work. Steps to Reduce Psychology essay sample: Stress is tension that occurs in the life of a person. There is a way in which an individual manages to control stress in the workplace.
• Effects of Secondary Ptsd in Military Families Psychology essay sample: Veterans with PTSD fail to address their mental health concerns, instead, transferring their trauma to their family members and creating an intergenerational trauma.
• Cognitive Techniques for Preventing Unhealthy Stress Psychology essay sample: As prolonged stress may lead to various physical and mental problems, it is essential to use cognitive techniques for preventing it.
• Intact and Non-Intact Dual Earners: Stress Levels Psychology essay sample: Stress levels occur in both intact and non-intact dual earners. How to deal with the stress levels depends on the individuals and the people around them.
• Stress Among Ethnic Minority Adolescents and Mindfulness Intervention Psychology essay sample: The purpose of the proposed research is to investigate the effect of a school-based mindfulness-based intervention on stress among ethnic minority adolescents.
• Mindfulness-Based Stress Reduction for Adults Psychology essay sample: The study explores the implementation of an adapted mindfulness program for adults, having traumatic brain injuries and substance use problems.
• Developing PTSD: Trauma at a Younger Age Psychology essay sample: Some people are more prone to developing PTSD than others because of trauma at a younger age, like physical assault or major accidents.
• Aspects of Stress Management Psychology essay sample: There are various causes of stress, and they include troubles and challenges, which require significant efforts to cope with them.
• A Qualitative Study of Mindfulness among Veterans With Posttraumatic Stress Psychology essay sample: The study examines post-traumatic stress disorder with a focus on deployment trauma among military veterans, outlining the most effective mindful intervention strategies.
• Psychological Harm in Stressful Environment Psychology essay sample: The issue of a stressful working environment is exceptionally widespread today, with stress-related illnesses and disorders earned by employees even being brought to court.
• "How to Make Stress Your Friend" TED Talk by McGonigal Psychology essay sample: In her TED talk, McGonigal reveals crucial information regarding the effects of stress on the human body. It is beneficial for people to recognize the positive impact of stress.
• The Role Stress Plays in People’s Personal Lives Psychology essay sample: This paper involves a set of psychological reactions that affect people’s behaviors and can have diverse outcomes, both positive and negative.
• The Risk and Protective Factors Linked to Post-Traumatic Growth in Women Psychology essay sample: The paper aims to explore the risk and protective factors linked to post-traumatic growth in women who have experienced sexual violence.
• Early-Life Stress and Behavioral Outcomes Psychology essay sample: The study aims to understand the mechanisms behind the long-lasting consequences of early-life stress exposure. It is accomplished by comparing the results of tests.

⭐ Simple & Easy Stress Essay Titles

• Maintaining Mental Health for Teenagers in the Pandemic Psychology essay sample: The paper states that the pandemic harmed students' lives, who more often began to experience stress and missed communicating with their classmates.
• Deviant Behavior Related to Stress and Strain Psychology essay sample: With the knowledge of new alternatives to self-destructing actions, people could adopt new behavior patterns and activate feelings of excitement and joy.
• Stress Coping Theory in Radiology Career Pathway Psychology essay sample: This paper will discuss possible stressors in a radiologist's job and the application of stress and coping theory to alleviate them.
• Stress Management and Weight Control Psychology essay sample: Effective stress management requires natural body relaxation responses induced by practicing regular meditation and muscle relaxation activities.
• Psychology: Overview and Understanding Psychology essay sample: Like many sciences, psychology has evolved from philosophy and inherited questions and concepts which philosophy had been developing.
• Managing Stress: Techniques for Relaxation Psychology essay sample: Diaphragmatic breathing, meditation as well as imagery, and visualization are discussed as effective techniques for relaxation.
• A Study of Causes of Stress and Stress Management Among Youth Psychology essay sample: “A Study of Causes of Stress and Stress Management Among Youth” strives to expound on the probable causes of stress among students and help counselors give appropriate advice.
• Parental Stresses and Child’s Emotional Development Psychology essay sample: Raising a child as a head of a single-parent family is associated with various challenges. Firstly, a single-parent family may be struggling to afford even the basic needs.
• The Stress Coping Mechanisms Analysis Psychology essay sample: The stress coping mechanisms are based on various aspects and are classified into: problem-based, appraisal-based, emotion-based and occupation-based.
• Coping With School Stress on Support Group Session Psychology essay sample: This paper aims to give a reflection on a support group presentation on the coping mechanism with school stress.
• A Stress-Management Program for College Students Psychology essay sample: A stress-management program for this academic period involves training learners on how to effectively eliminate or at the very least reduce their anxiety levels.
• College Students' Stress Management Psychology essay sample: There is a significant need to evaluate if physical exercise may be employed as a stress management method to boost academic performance among college students.
• Applying Concepts of Psychology Psychology essay sample: The paper explores how the concepts of psychology learned have affected development. They are learning, stress, memory, consciousness, and motivation.
• Critical Incident Stress Management in Emergency Preparedness Psychology essay sample: CISM is a crisis intervention that is vital to a stress management program as part of emergency preparedness.
• Counselors’ Stress: “Meeting Someone at the Edge” Psychology essay sample: “Meeting someone at the edge” focuses on occupational stress in a specific profession; the major exclusion criterion is the lack of professional experience in counseling.
• Trauma and Abuse: Psychoanalysis vs. Person-Centered Approach Psychology essay sample: In terms of the present paper, person-centered and psychoanalytic approaches were closely examined on the matter of their essence and interaction with trauma.
• Deception in Social Psychological Research Psychology essay sample: Current professional codes of ethics are designed to prevent psychological experiments using deception where they are likely to cause psychological harm to research participants.
• Parental and Psychotherapeutic Role in Development of Children With Autism Psychology essay sample: Parents have a significant role in developing and preparing an autistic child for future life, and in such cases, the work of a psychotherapist with the whole family is important.
• Symptoms of Stress and Its Treatment Psychology essay sample: Many people consider stress a normal part of their life and avoid addressing the problem, yet it may have considerable symptoms negatively affecting individuals' health.
• PTSD Among African American Vietnam Veterans Psychology essay sample: Post-traumatic stress disorder is unfortunately common among veterans, and it is especially prevalent among African American Vietnam veterans.
• PTSD Treatment for Earthquake Survivors Psychology essay sample: Post-Traumatic Stress Disorder is a mental illness that occurs in individuals who have experienced severe traumatizing events and have difficulties.
• Symptoms of Posttraumatic Stress Disorder Psychology essay sample: The paper states that African American veterans would report more symptoms of posttraumatic stress disorder as compared to Caucasian Americans.
• Becoming a More Productive Student Psychology essay sample: The paper discusses how to become a more productive student. Sporting events and physical activity are the keys to overall health, immunity, body, mind, and soul.
• Mental Disorders in the "Finding Nemo" Film Psychology essay sample: In Search of Nemo is a 2003 American computer-animated adventure film. According to the plot, a curious Nemo fish went to look for mysterious coral reefs one day.
• Community Counseling: Outreach to Distressed and Marginalized Clients Psychology essay sample: A significant issue in community counseling is community recovery, an effort to rehabilitate the social and physical environment damaged by a disastrous event.
• Prolonged Stress: Negative Effects and Management Psychology essay sample: A person affected by prolonged stress is more likely to develop a shorter memory span, anxious behaviors, secretory changes in the amygdala, and poor sleep.
• Coping with Stress in Athletes Psychology essay sample: Given the specific principles of training, scholastic athletes tend to demonstrate more successful strategies for coping with stress in everyday life and in the academic environment.
• Immigrants' Mental Health and Time Spent in the US Psychology essay sample: The hypothesis of this article is that the prolonged presence of immigrants in the United States for various reasons increases their stress levels.
• Stress Reduction Methods at the Workplace Psychology essay sample: Stress reduction methods may be divided into two categories: those that prevent stress sources and those reducing its consequences.
• Post-Traumatic Stress Disorder After Car Accident Psychology essay sample: This case study assignment will examine and provide a detailed analysis of the case study about Jane, a 54-year-old Black female who became a victim of a terrifying car accident.
• Psychological Disorders: Definitions and Treatments Psychology essay sample: This paper examines such psychological disorders as Social phobia, Generalized anxiety disorder, Post-traumatic stress disorder, and Panic disorder.
• Traumatic Stress in the Justice System Psychology essay sample: The analysis of the article supported by the book shows that experiences of traumatic events in law enforcement affect police officers' mental health.
• Foundational Psychological Processes Psychology essay sample: The basic foundation of psychology is traced back to lifespan development, stressing or emphasizing wellness and overall psychological health.
• The Gendering of Stress and Burn-Out in Modern Policing Psychology essay sample: The psychological strain of executing an aggressive arrest raises the risk of burnout in male officers, and this is the only job variable that is noteworthy.
• Post-Traumatic Stress Disorder in Children Psychology essay sample: Post-traumatic stress disorder in children violates mental activity that develops after an external psychologically traumatic event.
• Aspects of Habit Hacking Mission Psychology essay sample: A good start in hacking any habit is observing and studying their habit routine. Habits are all about behaviors, and these are all about psychology.
• Islamic Psychology and Its Contributors Psychology essay sample: The current paper states that Islamic psychology is a complex topic as there are numerous contributors that created a broad legacy of teachings.
• The COVID-19 Pandemic and Social Well-Being Psychology essay sample: This paper aims to discuss the relationship between the COVID-19 pandemic and the social well-being of people.
• “Psychological Distress: Concept Analysis”: Key Findings Psychology essay sample: "Psychological Distress: Concept Analysis" defines psychological stress as a state that is unique, discomforting, and emotional and appears in response to specific stressors.
• Benefits of Meditations Psychology essay sample: Meditation has many health benefits for humans. It can be exercised at any time, depending on someone’s schedule and comfortable place.
• Post-Traumatic Growth Among Police Officers Psychology essay sample: Effective implementation of Christian counseling has the potential to introduce post-traumatic growth among police officers that are followers of the Christian worldview.
• Secondary Post Traumatic Stress Disorder in Children Psychology essay sample: Understanding child PTSD is fundamental in determining or predicting the future tendencies and outcomes of future life in terms of health, behavior, and social well-being.
• Work-Related Stress and Meditation & Mindfulness Psychology essay sample: An explanation of the two coping strategies, which are meditation and mindfulness and massage therapy, will be provided to reveal how they would be applied to work-related stress.
• How to Increase Happiness Across All Three Types of Subjective Well-Being Psychology essay sample: Some essential benefits of happiness include reduced stress, boosted immune system, a healthy lifestyle, and the maintenance of healthy relationships.
• Childhood Trauma: Causes, Effects, and Preventive Measures Psychology essay sample: It is salient to understand the causative factors and the effects of childhood trauma while also highlighting applicable preventive measures.
• Trauma-Focused Therapy: Effectiveness on Patients Experiencing PTSD Psychology essay sample: The COVID-19 pandemic and its implications ranked first among the predisposing factors for the unprecedented annual statistics.
• Impact of Toxic Stress on Child Refugees Psychology essay sample: More early childhood educators should recognize the complexity of working with child refugees and reduce the amount of stress they tend to experience.
• Sleep Health and Self-Determination Psychology essay sample: Poor sleep is the problem that affects human motivation and performance chosen for this assessment. Poor sleep has become a ubiquitous issue in modern high-paced society.
• The Impact of Stress on Learning Psychology essay sample: The paper states that the level of stress has a long-term impact on many aspects of a person's nervous, physical, and mental development.
• Post-Traumatic Stress Disorder and Animal-Assisted Therapy Psychology essay sample: Dogs are attractive animals to study the relationship between the oxytocinergic system and social connections.
• The Psychological Sources of Stress Psychology essay sample: The psychological sources of stress are numerous, but they can be summarized as the failure of an individual to address their particular needs.
• Student Mental Health: Dealing With Stress Psychology essay sample: The paper discusses the probability of positive outcomes of mindfulness practices on students’ mental health. The solution can help reduce depression symptoms.
• The Stress Outcomes Resistance Psychology essay sample: There are many methods of stress correction, and the task is to choose those that would correspond to individual characteristics and real conditions.
• Perceived Academic Stress and Continuing and Returning Students Psychology essay sample: This paper investigates the relationship between perceived academic stress, continuing, and returning students variables. It adopted a descriptive study design.
• Discussion: Abuse, Work, and Burnout Psychology essay sample: The growth of mental and emotional pressure, as well as the adverse effects of the environment, lead to an increase in the stress level, which causes burnout.
• Positive Psychology in Educational Settings Psychology essay sample: When students are subjected to high levels of stress, their capacity to learn, memorize, and perform effectively can be affected.
• Psychotherapy and Medications for Post-traumatic Stress Disorder
• Yoga and Music Therapy as Effective Methods of Stress Management
• Anxiety, Fear, Phobias and Stress Behavioral Therapy
• Cognitive Behavioral Therapy and Post Traumatic Stress Disorder in Children
• Cognitive Behavioral Therapy Used in the Treatment of Post Traumatic Stress Disorder
• Cognitive Behavioural Therapy Based Stress Management Interventions: An Evaluation of Methodology
• Integrated Trauma-Focused Cognitive-Behavioural Therapy for Post-traumatic Stress and Psychotic Symptoms: A Case-Series Study Using Imaginal Reprocessing Strategies
• Managing Stress Through Progressive Relaxation Therapy
• Massage Therapy and Stress Relief
• Metacognitive Therapy for Posttraumatic Stress Disorder in Youth: A Feasibility Study
• Workplace Stress and Resilience in Australian Nursing Workforce The primary purpose of this systematic analysis was to identify and integrate evidence on job stress and resilience using an example of the Australian nursing staff.
• Moderated Online Social Therapy: A Model for Reducing Stress in Carers of Young People Diagnosed With Mental Health Disorders
• Music Therapy for Post Traumatic Stress Disorder
• Music Therapy Interventions for Stress Reduction in Adults With Mild Intellectual Disabilities: Perspectives From Clinical Practice
• Person-Centered Therapy and Cognitive Behavioral Therapy for Post Traumatic Stress Disorder
• Post-traumatic Stress Disorder: Lucid Dreaming Therapy and Rational Emotive Behavioral Therapy
• Post Traumatic Stress Disorder, Group Therapy, and Recreation Therapy
• Nightmares as a Coping Mechanism for Stress This paper regards the article “Nightmares as a Coping Mechanism for Stress” examining the nightmare and stress correlation and whether nightmare is a coping mechanism for stress.
• Prolonged Exposure Therapy for Post Traumatic Stress
• Trauma-Focused Cognitive Behavioural Therapy on Children and Adolescents With Post Traumatic Stress Disorder
• Treating Posttraumatic Stress Disorder in Female Victims of Trafficking Using Narrative Exposure Therapy
• Treating Post-traumatic Stress Disorder in Patients With Multiple Sclerosis
• Abnormal Psychology: Post Traumatic Stress Disorder
• Altruism, Positive Psychology, Stress, and Lifespan
• Stress in the Educational Environment
• Psychology: Stress, Motivation and Drug Addiction
• Psychology: Coping Mechanism for Stress Management
• Critical Health Psychology View of Stress
• Decision-Making Skills and Stress Management Psychology
• Dependent Variables in Psychology: Depression, Anxiety, and Stress
• Economic Stress and Psychological Well-Being: An Economic Psychology Framework
• Cultural Factors Contributing to Student Stress
• Occupational Health Psychology and Structural Stress
• Psychological Disorders: Stress Coping and Well Being
• Health Psychology: Stress, Substance Abuse, Addictive Behavior, Obesity, and Health Promotion
• Occupational Health Psychology and Work-Related Stress
• Psychology at Work: Organizational Stress and Job Satisfaction
• “Perceived Stress Among Students in Virtual Classrooms…” by AlAteeq
• Post Traumatic Stress Disorder and Effect of Memory
• Positive Psychology and Post Traumatic Stress Disorder
• Psychology and Clinical Response of Stress
• Psychology: Stress and Its Impact on Health
• Relationship Between Job Stress and Job Performance
• Stress: Personality Psychology and Stress Management Activities
• Editorial: How Plants Deal With Stress: Exploration Through Proteome Investigation
• The Physiology of Stress: Understanding the Body’s Response Mechanisms
• Chronic Stress: Causes, Effects, and Coping Strategies
• Stress Management Techniques for a Healthy Lifestyle
• Occupational Stress: Identifying, Preventing, and Managing Workplace Stress
• The Impact of Stress on Mental Health: Anxiety and Depression
• Work-Life Balance and Stress Management
• Stress in College Students: Academic Pressure and Coping Mechanisms
• How to Reduce Your Stress Levels
• Stress and Physical Health: The Connection to Chronic Diseases
• Navigating the Inevitability of Stress in Daily Life
• Coping With Financial Stress: Strategies for Budgeting and Financial Wellness
• The New Sources of Stress in Modern Society
• Stress Management: What Is Stress and How to Overcome It
• The Stress-Immunity Connection: How Stress Affects the Immune System
• Causes and Effects of Stress in Daily Life
• Parenting and Stress: Balancing Responsibilities and Self-Care
• Comparing the Stress Rates Among Children and Adults
• Gender Differences in Stress Responses and Coping Mechanisms
• How Constant Stress Can Trigger Acute Coronary Events
• Mindfulness-Based Stress Reduction: Techniques for Stress Management
• Physical and Emotional Effects of Stress
• Stress and Substance Abuse: The Cycle of Addiction and Recovery
• The Effects of Stress on Cognitive Functioning and Decision-Making
• Social Determinants of Stress: The Impact of Socioeconomic Factors
• The Role of Stress in Obesity and Weight Management
• Analyzing the Negative Impact of Stress on an Individual’s Health
• The Issue of Stress in the Nursing Profession
• Stress and Mental Resilience: Building Emotional Strength
• The Impact of Stress on Academic Success in College Students
• Influence of Yogic Techniques on Stress Management
• Can Music Therapy Improve Stress Anxiety?
• How to Use Cognitive Behavioural Therapy for Post-Traumatic Stress?
• Why Group Therapy Improves Symptoms of Posttraumatic Stress?
• How Cognitive-Behavioral Group Therapy Reduces Stress and Improves the Quality of Life in Patients With Parkinson’s Disease?
• How Does Cognitive Behavioral Therapy Deal With Post Traumatic Stress?
• Does Music Therapy Reduce Stress?
• Can Psychology Help With Stress Reduction?
• How Stress Affects the Human Mind?
• How Can Social Environment Influence Behaviors and Stress Levels?
• Does Stress Affect Students’ Academic Performance?
• Can Stress Cause Illness?
• How Stress Affects Immune Responses?
• How Can You Reduce the Adverse Effects of Stress?
• How Fear and Stress Shape the Mind?
• How Does Chronic Stress Affect the Body?
• How Stress Affects Our Health, Personality, and Relationship With People?
• How Does Stress Affect Child Development?
• How Does Job Stress Affect Your Health?
• How Stress Affects Memory in Adults?
• How Stress Affects Our Bodies, Minds, and Well Being?

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The impact of stress on body function: A review

Habib yaribeygi, yunes panahi, hedayat sahraei, thomas p johnston, amirhossein sahebkar.

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*To whom correspondence should be addressed: Yunes Panahi, Clinical Pharmacy Department, Faculty of Pharmacy, Baqiyatallah University of Medical Sciences, Tehran, Iran; Tel/Fax: +982188211524, E-mail: [email protected]

Received 2017 May 20; Accepted 2017 Jul 18; Collection date 2017.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Licence ( http://creativecommons.org/licenses/by/4.0/ ) You are free to copy, distribute and transmit the work, provided the original author and source are credited.

Any intrinsic or extrinsic stimulus that evokes a biological response is known as stress. The compensatory responses to these stresses are known as stress responses. Based on the type, timing and severity of the applied stimulus, stress can exert various actions on the body ranging from alterations in homeostasis to life-threatening effects and death. In many cases, the pathophysiological complications of disease arise from stress and the subjects exposed to stress, e.g. those that work or live in stressful environments, have a higher likelihood of many disorders. Stress can be either a triggering or aggravating factor for many diseases and pathological conditions. In this study, we have reviewed some of the major effects of stress on the primary physiological systems of humans.

Keywords: stress, physiology, homeostasis

Abbreviations

ACTH: Adrenocorticotropic hormone

CNS: Central nervous system

CRH: Corticotropin releasing hormone

GI: Gastrointestinal

LTP: Long-term potentiation

NMDA : N-methyl-D-aspartate

VTA: Ventral tegmental area

Stress and the Brain Function Complications

For a long time, researchers suggested that hormones have receptors just in the peripheral tissues and do not gain access to the central nervous system (CNS) (Lupien and Lepage, 2001[ 63 ]). However, observations have demonstrated the effect of anti-inflammatory drugs (which are considered synthetic hormones) on behavioral and cognitive disorders and the phenomenon called “Steroid psychosis” (Clark et al., 1952[ 16 ]). In the early sixties, neuropeptides were recognized as compounds devoid of effects on the peripheral endocrine system. However, it was determined that hormones are able to elicit biological effects on different parts of the CNS and play an important role in behavior and cognition (De Kloet, 2000[ 22 ]). In 1968, McEven suggested for the first time that the brain of rodents is capable of responding to glucocorticoid (as one of the operators in the stress cascade). This hypothesis that stress can cause functional changes in the CNS was then accepted (McEwen et al., 1968[ 74 ]). From that time on, two types of corticotropic receptors (glucocorticosteroids and mineralocorticoids) were recognized (de Kloet et al., 1999[ 23 ]). It was determined that the affinity of glucocorticosteroid receptors to cortisol and corticosterone was about one tenth of that of mineralocorticoids (de Kloet et al., 1999[ 23 ]). The hippocampus area has both types of receptors, while other points of the brain have only glucocorticosteroid receptors (de Kloet et al., 1999[ 23 ]).

The effects of stress on the nervous system have been investigated for 50 years (Thierry et al., 1968[ 115 ]). Some studies have shown that stress has many effects on the human nervous system and can cause structural changes in different parts of the brain (Lupien et al., 2009[ 65 ]). Chronic stress can lead to atrophy of the brain mass and decrease its weight (Sarahian et al., 2014[ 100 ]). These structural changes bring about differences in the response to stress, cognition and memory (Lupien et al., 2009[ 65 ]). Of course, the amount and intensity of the changes are different according to the stress level and the duration of stress (Lupien et al., 2009[ 65 ]). However, it is now obvious that stress can cause structural changes in the brain with long-term effects on the nervous system (Reznikov et al., 2007[ 89 ]). Thus, it is highly essential to investigate the effects of stress on different aspects of the nervous system (Table 1 (Tab. 1) ; References in Table 1: Lupien et al., 2001[ 63 ]; Woolley et al., 1990[ 122 ]; Sapolsky et al., 1990[ 99 ]; Gould et al., 1998[ 35 ]; Bremner, 1999[ 10 ]; Seeman et al., 1997[ 108 ]; Luine et al., 1994[ 62 ]; Li et al., 2008[ 60 ]; Scholey et al., 2014[ 101 ]; Borcel et al., 2008[ 9 ]; Lupien et al., 2002[ 66 ]).

Table 1. Destructive effects of stress of CNS function.

Stress and Memory

Memory is one of the important functional aspects of the CNS and it is categorized as sensory, short term, and long-term. Short term memory is dependent on the function of the frontal and parietal lobes, while long-term memory depends on the function of large areas of the brain (Wood et al., 2000[ 121 ]). However, total function of memory and the conversion of short term memory to long-term memory are dependent on the hippocampus; an area of the brain that has the highest density of glucocorticosteroid receptors and also represents the highest level of response to stress (Scoville and Milner, 1957[ 107 ]; Asalgoo et al., 2015[ 1 ]). Therefore, during the past several decades, the relationship between the hippocampus and stress have been hotly debated (Asalgoo et al., 2015[ 1 ]; Lupien and Lepage, 2001[ 63 ]). In 1968, it was proven that there were cortisol receptors in the hippocampus of rats (McEwen et al., 1968[ 74 ]). Later, in 1982, by using specific agonists of glucocorticosteroid and mineralocorticoid receptors, the existence of these two receptors in the brain and hippocampus area of rats was proven (Veldhuis et al., 1982[ 119 ]). It should also be noted that the amygdala is very important to assessing the emotional experiences of memory (Roozendaal et al., 2009[ 91 ]).

The results of past studies have demonstrated the effect of stress on the process of memory (Ghodrat et al., 2014[ 32 ]). Various studies have shown that stress can cause functional and structural changes in the hippocampus section of the brain (McEwen, 1999[ 72 ]). These structural changes include atrophy and neurogenesis disorders (Lupien and Lepage, 2001[ 63 ]). Also, chronic stress and, consequently, an increase in plasma cortisol, leads to a reduction in the number of dendritic branches (Woolley et al., 1990[ 122 ]) and the number of neurons (Sapolsky et al., 1990[ 99 ]), as well as structural changes in synaptic terminals (Sapolsky et al., 1990[ 99 ]) and decreased neurogenesis in the hippocampus tissue (Gould et al., 1998[ 35 ]). Glucocorticosteroids can induce these changes by either effecting the cellular metabolism of neurons (Lawrence and Sapolsky, 1994[ 58 ]), or increasing the sensitivity of hippocampus cells to stimulatory amino acids (Sapolsky and Pulsinelli, 1985[ 98 ]) and/or increasing the level of extracellular glutamate (Sapolsky and Pulsinelli, 1985[ 98 ]).

High concentrations of stress hormones can cause declarative memory disorders (Lupien and Lepage, 2001[ 63 ]). Animal studies have shown that stress can cause a reversible reduction in spatial memory as a result of atrophy of the hippocampus (Luine et al., 1994[ 62 ]). In fact, high plasma concentrations of glucocorticosteroids for extended periods of time can cause atrophy of the hippocampus leading to memory disorders (Issa et al., 1990[ 45 ]). Additionally, people with either Cushing's syndrome (with an increased secretion of glucocorticosteroids), or people who receive high dosages of exogenous synthetic anti-inflammatory drugs, are observed to have atrophy of the hippocampus and associated memory disorders (Ling et al., 1981[ 61 ]). MRI images taken from the brains of people with post-traumatic stress disorder (PTSD) have demonstrated a reduction in the volume of the hippocampus along with neurophysiologic effects such as a weak verbal memory (Bremner, 1999[ 10 ]). Several human studies have suggested that even common therapeutic doses of glucocorticosteroids and dexamethasone can cause problems with explicit memory (Keenan et al., 1995[ 49 ]; Kirschbaum et al., 1996[ 53 ]). Thus, there is an inverse relationship between the level of cortisol and memory (Ling et al., 1981[ 61 ]), such that increasing levels of plasma cortisol following prolonged stress leads to a reduction in memory (Kirschbaum et al., 1996[ 53 ]), which improves when the level of plasma cortisol decreases (Seeman et al., 1997[ 108 ]).

Stress also has negative effects on learning. Results from hippocampus-dependent loading data demonstrate that subjects are not as familiar with a new environment after having been exposed to a new environment (Bremner, 1999[ 10 ]). Moreover, adrenal steroids lead to alteration in long-term potentiation (LTP), which is an important process in memory formation (Bliss and Lømo, 1973[ 7 ]).

Two factors are involved in the memory process during stress. The first is noradrenaline, which creates emotional aspects of memories in the basolateral amygdala area (Joëls et al., 2011[ 47 ]). Secondly, this process is facilitated by corticosteroids. However, if the release of corticosteroids occurs a few hours earlier, it causes inhibition of the amygdala and corresponding behaviors (Joëls et al., 2011[ 47 ]). Thus, there is a mutual balance between these two hormones for creating a response in the memory process (Joëls et al., 2011[ 47 ]).

Stress does not always affect memory. Sometimes, under special conditions, stress can actually improve memory (McEwen and Lupien, 2002[ 71 ]). These conditions include non-familiarity, non-predictability, and life-threatening aspects of imposed stimulation. Under these specific conditions, stress can temporarily improve the function of the brain and, therefore, memory. In fact, it has been suggested that stress can sharpen memory in some situations (Schwabe et al., 2010[ 105 ]). For example, it has been shown that having to take a written examination can improve memory for a short period of time in examination participants. Interestingly, this condition is associated with a decrease in the level of cortisol in the saliva (Vedhara et al., 2000[ 118 ]). Other studies have shown that impending stress before learning occurs can also lead to either an increase in the power of memory (Domes et al., 2002[ 27 ]; Schwabe et al., 2008[ 102 ]), or decrease in the capacity for memory (Diamond et al., 2006[ 26 ]; Kirschbaum et al., 1996[ 53 ]). This paradox results from the type of imposed stress and either the degree of emotional connection to the stressful event (Payne et al., 2007[ 83 ]; Diamond et al., 2007[ 25 ]), or the period of time between the imposing stress and the process of learning (Diamond et al., 2007[ 25 ]).

The process of strengthening memory is usually reinforced after stress (Schwabe et al., 2012[ 103 ]). Various studies on animal and human models have shown that administration of either glucocorticosteroids, or stress shortly after learning has occurred facilitates memory (Schwabe et al., 2012[ 103 ]). Also, it has been shown that glucocorticosteroids (not mineralocorticoids) are necessary to improve learning and memory (Lupien et al., 2002[ 66 ]). However, the retrieval of events in memory after exposure to stress will be decreased (Schwabe et al., 2012[ 103 ]), which may result from the competition of updated data for storage in memory in a stressful state (de Kloet et al., 1999[ 23 ]). Some investigations have shown that either exposure to stress, or injection of glucocorticosteroids before a test to assess retention, decreases the power of memory in humans and rodents (Schwabe and Wolf, 2009[ 104 ]).

In summary, it has been concluded that the effect of stress on memory is highly dependent on the time of exposure to the stressful stimulus and, in terms of the timing of the imposed stress, memory can be either better or worse (Schwabe et al., 2012[ 103 ]). Moreover, recent studies have shown that using a specific-timed schedule of exposure to stress not only affects hippocampus-dependent memory, but also striatum-dependent memory, which highlights the role of timing of the imposed stressful stimulus (Schwabe et al., 2010[ 105 ]).

Stress, Cognition and Learning

Cognition is another important feature of brain function. Cognition means reception and perception of perceived stimuli and its interpretation, which includes learning, decision making, attention, and judgment (Sandi, 2013[ 95 ]). Stress has many effects on cognition that depend on its intensity, duration, origin, and magnitude (Sandi, 2013[ 95 ]). Similar to memory, cognition is mainly formed in the hippocampus, amygdala, and temporal lobe (McEwen and Sapolsky, 1995[ 73 ]). The net effect of stress on cognition is a reduction in cognition and thus, it is said that any behavioral steps undertaken to reduce stress leads to increase in cognition (Scholey et al., 2014[ 101 ]). In fact, stress activates some physiological systems, such as the autonomic nervous system, central neurotransmitter and neuropeptide system, and the hypothalamus-pituitary-adrenal axis, which have direct effects on neural circuits in the brain involved with data processing (Sandi, 2013[ 95 ]). Activation of stress results in the production and release of glucocorticosteroids. Because of the lipophilic properties of glucocorticosteroids, they can diffuse through the blood-brain barrier and exert long-term effects on processing and cognition (Sandi, 2013[ 95 ]).

It appears that being exposed to stress can cause pathophysiologic changes in the brain, and these changes can be manifested as behavioral, cognitive, and mood disorders (Li et al., 2008[ 60 ]). In fact, studies have shown that chronic stress can cause complications such as increased IL-6 and plasma cortisol, but decreased amounts of cAMP responsive element binding protein and brain-derived neurotrophic factor (BDNF), which is very similar to what is observed in people with depression and mood disorders that exhibit a wide range of cognitive problems (Song et al., 2006[ 114 ]). Additionally, the increased concentrations of inflammatory factors, like interleukins and TNF-α (which play an important role in creating cognitive disorders), proves a physiologic relationship between stress and mood-based cognitive disorders (Solerte et al., 2000[ 113 ]; Marsland et al., 2006[ 68 ]; Li et al., 2008[ 60 ]). Studies on animals suggest that cognitive disorders resulting from stress are created due to neuroendocrine and neuroamine factors and neurodegenerative processes (Li et al., 2008[ 60 ]). However, it should be noted that depression may not always be due to the over activation of the physiological-based stress response (Osanloo et al., 2016[ 81 ]).

Cognitive disorders following exposure to stress have been reported in past studies (Lupien and McEwen, 1997[ 64 ]). Stress has effects on cognition both acutely (through catecholamines) and chronically (through glucocorticosteroids) (McEwen and Sapolsky, 1995[ 73 ]). Acute effects are mainly caused by beta-adrenergic effects, while chronic effects are induced in a long-term manner by changes in gene expression mediated by steroids (McEwen and Sapolsky, 1995[ 73 ]). In general, many mechanisms modulate the effects of stress on cognition (McEwen and Sapolsky, 1995[ 73 ]; Mendl, 1999[ 75 ]). For instance, adrenal steroids affect the function of the hippocampus during cognition and memory retrieval in a biphasic manner (McEwen and Sapolsky, 1995[ 73 ]). In chronic stress, these steroids can destroy neurons with other stimulatory neurotransmitters (Sandi, 2013[ 95 ]). Exposure to stress can also cause disorders in hippocampus-related cognition; specifically, spatial memory (Borcel et al., 2008[ 9 ]; Sandi et al., 2003[ 96 ]). Additionally, stress can halt or decrease the genesis of neurons in the dentate gyrus area of the hippocampus (this area is one of the limited brain areas in which neurogenesis occurs in adults) (Gould and Tanapat, 1999[ 34 ]; Köhler et al., 2010[ 54 ]). Although age is a factor known to affect cognition, studies on animals have demonstrated that young rats exposed to high doses of adrenal steroids show the same level of decline in their cognition as older adult animals with normal plasma concentrations of glucocorticoids (Landfield et al., 1978[ 57 ]). Also, a decrease in the secretion of glucocorticosteroids causes preservation of spatial memory in adults and has also been shown to have neuroprotective effects (Montaron et al., 2006[ 78 ]). Other studies have shown that stress (or the injection of adrenal steroids) results in varied effects on cognition. For instance, injection of hydrocortisone at the time of its maximum plasma concentration (in the afternoon) leads to a decrease in reaction time and improves cognition and memory (Lupien et al., 2002[ 66 ]).

In summary, the adverse effects of stress on cognition are diverse and depend on the type, timing, intensity, and duration (Sandi, 2013[ 95 ]). Generally, it is believed that mild stress facilitates an improvement in cognitive function, especially in the case of virtual or verbal memory. However, if the intensity of stress passes beyond a predetermined threshold (which is different in each individual), it causes cognitive disorders, especially in memory and judgment. The disruption to memory and judgment is due to the effects of stress on the hippocampus and prefrontal cortex (Sandi, 2013[ 95 ]). Of course, it must be realized that factors like age and gender may also play a role in some cognitive disorders (Sandi, 2013[ 95 ]). Importantly, it should be emphasized that different people may exhibit varied responses in cognition when exposed to the very same stressful stimulus (Hatef et al., 2015[ 39 ]).

Stress and Immune System Functions

The relationship between stress and the immune system has been considered for decades (Khansari et al., 1990[ 50 ]; Dantzer and Kelley, 1989[ 21 ]). The prevailing attitude between the association of stress and immune system response has been that people under stress are more likely to have an impaired immune system and, as a result, suffer from more frequent illness (Khansari et al., 1990[ 50 ]). Also, old anecdotes describing resistance of some people to severe disease using the power of the mind and their thought processes, has promoted this attitude (Khansari et al., 1990[ 50 ]). In about 200 AC, Aelius Galenus (Galen of Pergamon) declared that melancholic women (who have high levels of stress and, thus, impaired immune function) are more likely to have cancer than women who were more positive and exposed to less stress (Reiche et al., 2004[ 88 ]). This may be the first recorded case about the relationship between the immune system and stress. In an old study in the early 1920's, researchers found that the activity of phagocytes in tuberculosis decreased when emotional stress was induced. In fact, it was also suggested that living with stress increases the risk of tuberculosis by suppressing the immune system (Ishigami, 1919[ 44 ]). Following this study, other researchers suggested that the probability of disease appearance increases following a sudden, major, and extremely stressful life style change (Holmes and Rahe, 1967[ 41 ]; Calabrese et al., 1987[ 12 ]).

Over the past several decades, there have been many studies investigating the role of stress on immune system function (Dantzer and Kelley, 1989[ 21 ]; Segerstrom and Miller, 2004[ 109 ]). These studies have shown that stress mediators can pass through the blood-brain barrier and exert their effects on the immune system (Khansari et al., 1990[ 50 ]). Thus, the effect of stress on the immune system is now an accepted relationship or association.

Stress can affect the function of the immune system by modulating processes in the CNS and neuroendocrine system (Khansari et al., 1990[ 50 ]; Kiecolt-Glaser and Glaser, 1991[ 51 ]). Following stress, some neuroendocrine and neural responses result in the release of corticotropin-releasing hormone (CRH), adrenocorticotropic hormone (ACTH), and other stress mediators (Carrasco and Van de Kar, 2003[ 13 ]). However, evidence suggests that the lymphatic system, which is a part of the immune system, also plays a role in releasing these mediators (Khansari et al., 1990[ 50 ]). For instance, thymus peptides, such as thymopentine, thymopoietin, and thymosin fraction-5, cause an increase in ACTH production (Goya et al., 1993[ 36 ]). Additionally, the existence of CRH in thymus has been proven (Redei, 1992[ 87 ]). It has also been proven that interleukin-1 released from phagocytes has a role in ACTH secretion (Berkenbosch et al., 1987[ 4 ]). On the other hand, natural or synthetic glucocorticosteroids (which are the final stress operators) are known as anti-inflammatory drugs and immune suppressants and their role in the inhibition of lymphocytes and macrophages has been demonstrated as well (Elenkov et al., 1999[ 28 ]; Reiche et al., 2004[ 88 ]). Moreover, their role in inhibiting the production of cytokines and other immune mediators and decreasing their effect on target cells during exposure to stress has also been determined (Reiche et al., 2004[ 88 ]).

In addition to adrenal steroids, other hormones are affected during stress. For example, the secretion of growth hormone will be halted during severe stress. A study showed that long-term administration of CRH into the brain ventricles leads to a cessation in the release of growth hormone (Rivier and Vale, 1985[ 90 ]). Stress also causes the release of opioid peptides to be changed during the time period over which the person is exposed to stress (McCarthy et al., 2001[ 70 ]). In fact, stress modifies the secretion of hormones that play a critical role in the function of the immune system (Khansari et al., 1990[ 50 ]). To date, it has been shown that various receptors for a variety of hormones involved in immune system function are adversely affected by stress. For example, ACTH, vasoactive intestinal peptide (VIP), substance P, growth hormone, prolactin, and steroids all have receptors in various tissues of the immune system and can modulate its function (De la Fuente et al., 1996[ 24 ]; Gala, 1991[ 30 ]; Mantyh, 1991[ 67 ]). In addition, active immune cells are also able to secrete several hormones; thus, some researchers believe that these hormones, as mediators of immune system, play a significant role in balancing its function (Blalock et al., 1985[ 6 ]).

Severe stress can lead to malignancy by suppressing the immune system (Reiche et al., 2004[ 88 ]). In fact, stress can decrease the activity of cytotoxic T lymphocytes and natural killer cells and lead to growth of malignant cells, genetic instability, and tumor expansion (Reiche et al., 2004[ 88 ]). Studies have shown that the plasma concentration of norepinephrine, which increases after the induction stress, has an inverse relationship with the immune function of phagocytes and lymphocytes (Reiche et al., 2004[ 88 ]). Lastly, catecholamines and opioids that are released following stress have immune-suppressing properties (Reiche et al., 2004[ 88 ]).

Stress and the Function of the Cardiovascular System

The existence of a positive association between stress and cardiovascular disease has been verified (Rozanski et al., 1999[ 93 ]). Stress, whether acute or chronic, has a deleterious effect on the function of the cardiovascular system (Rozanski et al., 1999[ 93 ]; Kario et al., 2003[ 48 ]; Herd, 1991[ 40 ]). The effects of stress on the cardiovascular system are not only stimulatory, but also inhibitory in nature (Engler and Engler, 1995[ 29 ]). It can be postulated that stress causes autonomic nervous system activation and indirectly affects the function of the cardiovascular system (Lazarus et al., 1963[ 59 ]; Vrijkotte et al., 2000[ 120 ]). If these effects occur upon activation of the sympathetic nervous system, then it mainly results in an increase in heart rate, strength of contraction, vasodilation in the arteries of skeletal muscles, a narrowing of the veins, contraction of the arteries in the spleen and kidneys, and decreased sodium excretion by the kidneys (Herd, 1991[ 40 ]). Sometimes, stress activates the parasympathetic nervous system (Pagani et al., 1991[ 82 ]). Specifically, if it leads to stimulation of the limbic system, it results in a decrease, or even a total stopping of the heart-beat, decreased contractility, reduction in the guidance of impulses by the heart stimulus-transmission network, peripheral vasodilatation, and a decline in blood pressure (Cohen et al., 2000[ 17 ]). Finally, stress can modulate vascular endothelial cell function and increase the risk of thrombosis and ischemia, as well as increase platelet aggregation (Rozanski et al., 1999[ 93 ]).

The initial effect of stress on heart function is usually on the heart rate (Vrijkotte et al., 2000[ 120 ]). Depending upon the direction of the shift in the sympatho-vagal response, the heart beat will either increase or decrease (Hall et al., 2004[ 38 ]). The next significant effect of stress on cardiovascular function is blood pressure (Laitinen et al., 1999[ 56 ]). Stress can stimulate the autonomic sympathetic nervous system to increase vasoconstriction, which can mediate an increase in blood pressure, an increase in blood lipids, disorders in blood clotting, vascular changes, atherogenesis; all, of which, can cause cardiac arrhythmias and subsequent myocardial infarction (Rozanski et al., 1999[ 93 ]; Vrijkotte et al., 2000[ 120 ]; Sgoifo et al., 1998[ 111 ]). These effects from stress are observed clinically with atherosclerosis and leads to an increase in coronary vasoconstriction (Rozanski et al., 1999[ 93 ]). Of course, there are individual differences in terms of the level of autonomic-based responses due to stress, which depends on the personal characteristics of a given individual (Rozanski et al., 1999[ 93 ]). Thus, training programs for stress management are aimed at reducing the consequences of stress and death resulting from heart disease (Engler and Engler, 1995[ 29 ]). In addition, there are gender-dependent differences in the cardiovascular response to stress and, accordingly, it has been estimated that women begin to exhibit heart disease ten years later that men, which has been attributed to the protective effects of the estrogen hormone (Rozanski et al., 1999[ 93 ]).

Studies have shown that psychological stress can cause alpha-adrenergic stimulation and, consequently, increase heart rate and oxygen demand (Rozanski et al., 1998[ 92 ], 1999[ 93 ]; Jiang et al., 1996[ 46 ]). As a result, coronary vasoconstriction is enhanced, which may increase the risk of myocardial infarction (Yeung et al., 1991[ 124 ]; Boltwood et al., 1993[ 8 ]; Dakak et al., 1995[ 20 ]). Several studies have demonstrated that psychological stress decreases the microcirculation in the coronary arteries by an endothelium-dependent mechanism and increases the risk of myocardial infarction (Dakak et al., 1995[ 20 ]). On the other hand, mental stress indirectly leads to potential engagement in risky behaviors for the heart, such as smoking, and directly leads to stimulation of the neuroendocrine system as part of the autonomic nervous system (Hornstein, 2004[ 43 ]). It has been suggested that severe mental stress can result in sudden death (Pignalberi et al., 2002[ 84 ]). Generally, stress-mediated risky behaviors that impact cardiovascular health can be summarized into five categories: an increase in the stimulation of the sympathetic nervous system, initiation and progression of myocardial ischemia, development of cardiac arrhythmias, stimulation of platelet aggregation, and endothelial dysfunction (Wu, 2001[ 123 ]).

Stress and Gastrointestinal Complications

The effects of stress on nutrition and the gastrointestinal (GI) system can be summarized with two aspects of GI function.

First, stress can affect appetite (Bagheri Nikoo et al., 2014[ 2 ]; Halataei et al., 2011[ 37 ]; Ranjbaran et al., 2013[ 86 ]). This effect is related to involvement of either the ventral tegmental area (VTA), or the amygdala via N-methyl-D-aspartate (NMDA) glutamate receptors (Nasihatkon et al., 2014[ 80 ]; Sadeghi et al., 2015[ 94 ]). However, it should also be noted that nutrition patterns have effects on the response to stress (Ghanbari et al., 2015[ 31 ]), and this suggests a bilateral interaction between nutrition and stress.

Second, stress adversely affects the normal function of GI tract. There are many studies concerning the effect of stress on the function of the GI system (Söderholm and Perdue, 2001[ 112 ]; Collins, 2001[ 18 ]). For instance, studies have shown that stress affects the absorption process, intestinal permeability, mucus and stomach acid secretion, function of ion channels, and GI inflammation (Collins, 2001[ 18 ]; Nabavizadeh et al., 2011[ 79 ]). Stress also increases the response of the GI system to inflammation and may reactivate previous inflammation and accelerate the inflammation process by secretion of mediators such as substance P (Collins, 2001[ 18 ]). As a result, there is an increase in the permeability of cells and recruitment of T lymphocytes. Lymphocyte aggregation leads to the production of inflammatory markers, activates key pathways in the hypothalamus, and results in negative feedback due to CRH secretion, which ultimately results in the appearance of GI inflammatory diseases (Collins, 2001[ 18 ]). This process can reactivate previous silent colitis (Million et al., 1999[ 76 ]; Qiu et al., 1999[ 85 ]). Mast cells play a crucial role in stress-induced effects on the GI system, because they cause neurotransmitters and other chemical factors to be released that affect the function of the GI system (Konturek et al., 2011[ 55 ]).

Stress can also alter the functional physiology of the intestine (Kiliaan et al., 1998[ 52 ]). Many inflammatory diseases, such as Crohn's disease and other ulcerative-based diseases of the GI tract, are associated with stress (Hommes et al., 2002[ 42 ]). It has been suggested that even childhood stress can lead to these diseases in adulthood (Schwartz and Schwartz, 1983[ 106 ]). Irritable bowel syndrome, which is a disease with an inflammatory origin, is highly related to stress (Gonsalkorale et al., 2003[ 33 ]). Studies on various animals suggest the existence of inflammatory GI diseases following induction of severe stress (Qiu et al., 1999[ 85 ]; Collins et al., 1996[ 19 ]). Additionally, pharmacological interventions, in an attempt to decrease the response of CRH to stress, have been shown to result in an increase in GI diseases in rats (Million et al., 1999[ 76 ]).

Altering the permeability of the mucosal membrane by perturbing the functions of mucosal mast cells may be another way that stress causes its effects on the GI system, since this is a normal process by which harmful and toxic substances are removed from the intestinal lumen (Söderholm and Perdue, 2001[ 112 ]). Also, stress can both decrease the removal of water from the lumen, as well as induce sodium and chloride secretion into the lumen. This most likely occurs by increasing the activity of the parasympathetic nervous system (Barclay and Turnberg, 1987[ 3 ]). Moreover, physical stress, such as trauma or surgery, can increase luminal permeability (Söderholm and Perdue, 2001[ 112 ]) (Table 2 (Tab. 2) ; References in Table 2: Halataei et al., 2011[ 37 ]; Ranjbaran et al., 2013[ 86 ]; Mönnikes et al., 2001[ 77 ]; Collins, 2001[ 18 ]; Nabavizadeh et al., 2011[ 79 ]; Barclay and Turnberg, 1987[ 3 ]; Million et al., 1999[ 76 ]; Gonsalkorale et al., 2003[ 33 ]).

Table 2. Stress has various effects on the function of GI system.

Stress also affects movement of the GI tract. In this way, it prevents stomach emptying and accelerates colonic motility (Mönnikes et al., 2001[ 77 ]). In the case of irritable bowel syndrome, stress increases the movement (contractility and motility) of the large intestine (Mönnikes et al., 2001[ 77 ]). Previous studies have revealed that CRH increases movement in the terminal sections of the GI tract and decreases the movements in the proximal sections of the GI tract (Mönnikes et al., 2001[ 77 ]). A delay in stomach emptying is likely accomplished through CRH-2 receptors, while type 1 receptors affect the colon (Mönnikes et al., 2001[ 77 ]). The effects produced by CRH are so prominent that CRH is now considered an ideal candidate for the treatment of irritable bowel syndrome (Martinez and Taché, 2006[ 69 ]). When serotonin is released in response to stress (Chaouloff, 2000[ 14 ]), it leads to an increase in the motility of the colon by stimulating 5HT-3 receptors (Mönnikes et al., 2001[ 77 ]). Moreover, it has also been suggested that stress, especially mental and emotional types of stress, increase visceral sensitivity and activate mucosal mast cells (Mönnikes et al., 2001[ 77 ]). Stimulation of the CNS by stress has a direct effect on GI-specific nervous system ( i.e. , the myenteric system or plexus) and causes the above mentioned changes in the movements of the GI tract (Bhatia and Tandon, 2005[ 5 ]). In fact, stress has a direct effect on the brain-bowel axis (Konturek et al., 2011[ 55 ]). Various clinical studies have suggested a direct effect of stress on irritable bowel syndrome, intestinal inflammation, and peptic ulcers (Konturek et al., 2011[ 55 ]).

In conclusion, the effects of stress on the GI system can be classified into six different actions: GI tract movement disorders, increased visceral irritability, altered rate and extent of various GI secretions, modified permeability of the intestinal barrier, negative effects on blood flow to the GI tract, and increased intestinal bacteria counts (Konturek et al., 2011[ 55 ]).

Stress and the Endocrine System

There is a broad and mutual relationship between stress and the endocrine system. On one hand, stress has many subtle and complex effects on the activity of the endocrine system (Sapolsky, 2002[ 97 ]; Charmandari et al., 2005[ 15 ]), while on the other hand, the endocrine system has many effects on the response to stress (Ulrich-Lai and Herman, 2009[ 117 ]; Selye, 1956[ 110 ]). Stress can either activate, or change the activity of, many endocrine processes associated with the hypothalamus, pituitary and adrenal glands, the adrenergic system, gonads, thyroid, and the pancreas (Tilbrook et al., 2000[ 116 ]; Brown-Grant et al., 1954[ 11 ]; Thierry et al., 1968[ 115 ]; Lupien and McEwen, 1997[ 64 ]). In fact, it has been suggested that it is impossible to separate the response to stress from the functions of the endocrine system. This premise has been advanced due to the fact that even a minimal amount of stress can activate the hypothalamic-pituitary-adrenal axis, which itself is intricately involved with the activation of several different hormone secreting systems (Sapolsky, 2002[ 97 ]). In different locations throughout this article, we have already discussed the effects of stress on hormones and various endocrine factors and, thus, they will not be further addressed.

Altogether, stress may induce both beneficial and harmful effects. The beneficial effects of stress involve preserving homeostasis of cells/species, which leads to continued survival. However, in many cases, the harmful effects of stress may receive more attention or recognition by an individual due to their role in various pathological conditions and diseases. As has been discussed in this review, various factors, for example, hormones, neuroendocrine mediators, peptides, and neurotransmitters are involved in the body's response to stress. Many disorders originate from stress, especially if the stress is severe and prolonged. The medical community needs to have a greater appreciation for the significant role that stress may play in various diseases and then treat the patient accordingly using both pharmacological (medications and/or nutraceuticals) and non-pharmacological (change in lifestyle, daily exercise, healthy nutrition, and stress reduction programs) therapeutic interventions. Important for the physician providing treatment for stress is the fact that all individuals vary in their response to stress, so a particular treatment strategy or intervention appropriate for one patient may not be suitable or optimal for a different patient.

Yunes Panahi and Amirhossein Sahebkar (Department of Medical Biotechnology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran, P.O. Box: 91779-48564, Iran; Tel: 985118002288, Fax: 985118002287, E-mail: [email protected], [email protected]) contributed equally as corresponding authors.

Conflict of interest

The authors declare that have no conflict of interest in this study.

Acknowledgement

The authors would like to thank the "Neurosciences Research Center of Baqiyatallah University of Medical Sciences" and the “Clinical Research Development Center of Baqiyatallah (a.s.) Hospital” for providing technical supports.

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