1. Diet for Stress Management Slideshow
2. Take the Stress Quiz!
3. Tips for Exercise, Diet and Stress Reduction

Medical Author:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Medical Editor:

Jay W. Marks, MD

Jay W. Marks, MD

Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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Medical Editor:

Roxanne Dryden-Edwards, MD

Roxanne Dryden-Edwards, MD

Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.

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In this Article

• What is stress?
• A brief history of stress
• What are the signs and symptoms of poorly managed stress?
• Who is most vulnerable to stress?
• Teen stress
• What is the healthy response to stress?
• How does the response to stress work?
• What is the role of the hypothalamus-pituitary-adrenal (HPA) axis (grouping) in stress?
• What is the role of the locus coeruleus in stress?
• How do the connections in the brain work in stress?
• What do we know about using (activating) and overusing our internal systems that respond to stress?
• What are the effects of stress on medical and psychological conditions?
• Conclusions about the effects of stress
• How can we manage stress?
• What's in the future for stress?
• Stress At A Glance
• Diet for Stress Management Slideshow
• Take the Stress Quiz!
• Tips for Exercise, Diet and Stress Reduction Slideshow
• Stress FAQs
• Patient Comments: Stress - Physical Symptoms
• Patient Comments: Stress - Management
• Find a local Psychiatrist in your town
• Stress Index

A key to the understanding of the negative aspects of stress is the concept of milieu interieur (the internal environment of the body), which was first advanced by the French physiologist Claude Bernard. In this concept, he described the principles of dynamic equilibrium. In dynamic equilibrium, constancy, a steady state (situation) in the internal bodily environment, is essential to survival. Therefore, external changes in the environment or external forces that change the internal balance must be reacted to and compensated for if the organism is to survive. Examples of such external forces include temperature, oxygen concentration in the air, the expenditure of energy, and the presence of predators. In addition, diseases were also stressors that threatened the constancy of the milieu interieur.

The neurologist Walter Cannon coined the term homeostasis to further define the dynamic equilibrium that Bernard had described. He also was the first credited with recognizing that stressors could be emotional as well as physical. Through his experiments, he demonstrated the "fight or flight" response that man and other animals share when threatened. Further, Cannon traced these reactions to the release of powerful neurotransmitters from a part of the adrenal gland, the medulla. (Neurotransmitters are the body's chemicals that carry messages to and from the nerves.) The adrenal medulla secretes two neurotransmitters, epinephrine (also called adrenaline) and norepinephrine (noradrenaline), in the response to stress. The release of these neurotransmitters leads to the physiologic effects seen in the fight or flight response, for example, a rapid heart rate, increased alertness, etc.

Hans Selye, another early scientist who is known to have studied stress, extended Cannon's observations. He included, as part of the body's stress response system, the pituitary gland, a small gland at the base of the brain. He described the control by this gland of the secretion of hormones (for example, cortisol) that are important in the physiological response to stress by the other part of the adrenal gland known as the cortex. Additionally, Selye actually introduced the term stress from physics and engineering and defined it as "mutual actions of forces that take place across any section of the body, physical or psychological."

In his experiments, Selye induced stress in rats in a variety of ways. He found typical and constant psychological and physical responses to the adverse situations that were imposed on the rats. In rats exposed to constant stress, he observed enlargement of the adrenal glands, gastrointestinal ulcers, and a wasting away (atrophy) of the immune (defense) system. He called these responses to stress the general adaptation (adjustment) or stress syndrome. He discovered that these processes, which were adaptive (healthy, appropriate adjustment) and normal for the organism in warding off stress, could become much like illnesses. That is, the adaptive processes, if they were excessive, could damage the body. This observation, then, was the beginning of an understanding of why stress, really overstress, can be harmful, and why the word stress has earned such a bad name.