A Study of the Relationship Between Stress and Psychosomatic

Disorders

Bahman Tofighi
Department of Consulting, Bushehr Branch, Islamic azad University, Bushehr, Iran

Abstract.These days the subject of stress among the people, the specialists, hygienic specialists and other
people responsible for the welfare of people has turned out to be a very important subject. Man lives in a
place where he is exposed to many harmful deceases in his environment, and it has endangered his health. In
reaction to these threats, an extensive number of adaptabilities are formed in body in order to defend it
against these maladies. In this article an attempt is made to establish a relationship between stress and
psychosomatic disorders, and trace the deceases associated with stress.
Key words: Psychosomatic disorders, Stress, Physiological, Biological, Psychological, Vulnerability

1. Introduction
For many years the specialists have realized that special behavioral patterns can threaten man’s life.
Stress is considered one of such patterns which was first considered as a means of explaining the way body
might react against deceases, harms and other problems, but later was turned into a threatening agent for
body. Besides physiological reactions, stress is accompanied by such agitations like anger and sadness. It
should be remembered that there are some weak symptoms of stress to the extent that they are not felt, but on
the other hand, there are some apparent symptoms like the sweating of hands, lack of appetite, breathing
problems or fast heart beating. The important thing about stress is that it has harmful effects on the lives of
individuals. Stress has turned into a focus of attention by many specialists, in that, they consider stress quite
effective in the formation of deceases and disorders.

2. Discussion
During the last few years, Stress has been associated with such symptoms like high blood pressure,
increase in cholesterol, anger and finally loss of hair. These are the physical symptoms and indicate that body
is under pressure. As time passes, these bodily symptoms turn into further unpleasant consequences, the most
critical of which is heart decease. However, there are other deceases like gastric ulcer and diabetics caused
by stress. It is also believed that almost all of the human deceases are connected with stress. These deceases
are not only mental but also physical, such as cancer and Tuberculosis. It is estimated that 50 to 80% of
deceases are caused by stress. This result has been obtained from the tests done by scientists on animals; they
introduced stress on animals and in this way the latter were inflicted with different kinds of bodily deceases.
It should also be remembered that the progress and increase in the rate of heart deceases has had a direct
proportion to the increase in stress.
The broadest definitions of stress include the entire complex sequence of events: (1) the event that
requires some change (external or mental; real or imaginary), (2) internal processes (perception,
interpretation of the event, learning, adaptation, or coping mechanisms), (3) emotional reactions (our feelings)
and (4) other behavioral-bodily reactions (nervousness, sweating, stumbling over words, high blood pressure,
and all the medical conditions mentioned below). In a more limited usage, stress is the upsetting situation
and strain is the mental and physical reactions. However, most of us use the term stress loosely for both the
threatening situation and the anxious reaction. (Schaffer, 85)
Psychosomatic disorders refers to bodily ailment or symptom, caused by mental or emotional
disturbance, in which psychological stresses adversely affect physiological (somatic) functioning to the point
of distress. Psychosomatic disorders may include hypertension, respiratory ailments, gastrointestinal
disturbances, migraine and tension headaches, sexual dysfunctions, and dermatitis. Many patients with
psychosomatic conditions respond to a combination of drug therapy and psychotherapy. They are
characterized by physiological changes that originate, at least in part, from emotional factors. The classical
psychosomatic symptoms and their theorized causes are shown in the table.Psychological states influence
body organs through a combination of three interrelated mechanisms: neural, hormonal, and immunologic.

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Voluntary movements (for example, clenching the teeth) are mediated through the motor neurons by the
conscious command of the brain. In stress, clenching of the teeth, mediated by the same motor neurons, may
also occur, but the act may not be voluntary and conscious. Stress usually causes an activation of the
sympathetic nervous system and the hypothalamo-pituitary-adrenal axis followed by a decrease in immune
competence. Immune mechanisms may be suppressed in part through corticosteroid activation, but a
decrease in T-lymphocyte activity in stress may not be mediated by hormones. Individual specific, but
inadvertent, conditioning of specific conflict or stress to specific bodily malfunction may be an important
psychosomatic mechanism.The studies show that the stressors can be excitatory, biological, physical,
chemical, social, evolutionary, educational, cultural and psychic. It should also be added that the more
individuals are exposed to stress, the more is the probability that they exposed to psychological and physical
deceases. The exposure of individual to different intensive situations at a particular time, will impose heavy
pressure on the defensive system of the individual, which depends upon the intensity of stimulation, period
of stimulation and the control reception. Although the immunity system protects the body from the
pathogenic microscopic creature, it is confirmed that stress and excitation can reduce the resistance of
immunity system against decease. It seems that the exposure to stressful situations in life, like loneliness,
will decrease the immunity system of body.
Hans Selye believed that body reacts against stress through a series of uncertain processes, which he
called general adaptation syndrome, or, GAS. These processes, consists of four stages: the first reaction takes
place against a stressful factor in the form of a short time shock which leads to a decrease in the defensive
process of body. This stage takes place quickly, followed by anti shock where the defensive mechanisms of
body turns active through such changes in body, including an increase in heart beat, dilation of eye ball, a
decrease in body temperature, sweating And the flow of glucose in blood. In case stress persists again due to
the presence of stressful factors, the next stage of “General Adaptation Syndrome”, i.e. resistance, appears.
Under this condition, the defensive mechanisms replace the previous stage. If the stressful factors are
psychological, the lonely individual might turn sad. If the stressful is not removed in the resistance stage, or,
if it returns, the ability of body for resistance against it decreases. It consequently leads to the beginning of
the fourth stage, i.e. the Exhaustion satge. This stage begins when the individual surrenders.
Individuals trying to fit in a certain position/job that doesn't fit their personality or capabilities have a
higher chance to develop cardiovascular diseases. Chronic coronary disease is more typical for proactive
goal-oriented, ambitious and less tolerant individuals. Individuals suffering from stomach ulcers are typically
very anxious and irritable. They are very conscientious, but usually have a low self-esteem, are vulnerable,
shy, sensitive and hypochondriac. These individuals always try to do more than they are capable of. They
tend to overcome difficulties having very high level of anxiety. The level of stress-related pathological
changes in the body is usually linked with personal assessment of the situation, which in turn depends on
feelings of personal responsibility. The signs of emotional tension appearing in stressful situations tend to
intensify when there is a lack of physical activity. (Goldberg, Anxiety p. 95)
Stress leads to different kinds of disorders. The same type of disease could have a stress origin or could
be caused by something else. Many different factors may be combined with the stress in a person's life that
has a negative influence on the body function. The combination of negative factors is particularly dangerous
because it creates more chances to develop certain diseases. Among the many stress-related disorders the
main ones are neuroses - mental imbalance caused by prolonged psycho-emotional experience, mental and
physical strain, lack of rest or sleep, long-lasting internal struggling, inhibited feelings of grief, anger or
suffering. Some somatic diseases may also cause neurosis as well.
Neurosis may appear due to having a lack of options to resolve a serious problem. It could happen when
a person tries to resolve a problem, but is unable to do it. This leads to increased sensitivity or irritability to
the problem making an individual more emotional. This then causes the person to experience various pains in
response to the effect of stressors.
Opeli and Trambal (1967) have done experiments on the vulnerability level and have concluded that
mature individuals, who can adopt themselves, when under stress, can do better than those who cannot adopt
themselves. The reaction to stress, usually, takes place in three forms: emotional, behavioral and
physiological. Most of these forms appear together. The emotional reaction: can appear in the form of
annoyance, anger, melancholy, sadness, anxiety, fear and horror.
Behavioral reaction: it depends upon the personality of people and the nature of stressful factors. Some
people show reaction to stress by aggression. There are also people who turn to alcohol in order to reduce
stress; in this way they are able to get rid of their problems.

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 Physiological reaction: The elements participating in this process are central nervous system,
hypothalamus, sympathetic nervous system, feont and retral, medulla and upper renal cortex. The
physiological parts and their excretions (Hormones) are responsible for the response of nuroandokrine to
stressors. It should also be remembered that not all the parts take part in the reaction to stress. Stressors,
those which are received in the central nervous system, or, those which are received in baroreceptors and
comoreceptors are transferred to bulb and play the role of afferents. Finally, this information move to
hypothalamus in order to create suitable response. Hypothalamus makes the nervous system and feont and
retral grand active. When sympathicus is stimulated, Adrenal medulla, which is a part of the nervous system,
becomes active. Hypothalamus stimulates feont grand by releasing hormones such as CRH emancipator,
CHRH and, finally, PRH. Some of these hormones in feont grand are released, so that hypothalamus reduces
the excretion of its controlling hormones.
Aderno Cortico Theropin (ACTH) which is released from feont grand cause the release of cortisol from
cortex adrenal. Cortex adrenal exudes Aldestron in response to the excretion of (ACTH). Retral hypophysis
gland is the last Endocrine gland. When the retral hypophysis gland is stimulated, it exudes antidyortic
hormone (ADH), or, vasopressin. The stimulating effects of sympathicus foent and retral hypophisis glands,
adrenal medulla and adrenal cortex are caused by catholamines (the neurotransmitters and special chemical
materials) and the hormones released from the nervous systems. Catecholamines, epinephrine and
neuronephrine are stimulated by a special receptor. These receptors are available in different body cells.
According to the researches done by Hans Selyeh on the impact of different kinds of stresses on body
physiology, some specialists consider psychic-bodily disorders as adjustment disorders, that is, producing
disorder in an individual due to the lack of ability in adoptability caused by stress. There are two fast
growing fields concerning the role of the psychological factors in the health of individuals: Behavioral
Medicine and Health psychology.
Some psychologists have different opinions regarding the nature of the causes of disorders. Some believe
that the each psychic-physical reaction is an indicative of a kind of special psychic decease in individuals.
This decease is caused under special conditions and occurs with reference to the past and personality of the
individual. For example, they believe that hypertension is related to an anger an individual has been unable
to overcome in the past, due to the strong authority of his or her parents. This individual has unable to project
his anger, and instead has introjected it; this has created problem for blood circulation. Gastric ulcer is also
seen among those individuals who are ambitious. (Cooper, 208)
On the other hand, some of the psychologists approve of the general theory pertaining to the cause of
suffering of psychic-physical deceases. The research done by Buck and Hobs indicate that there are more
than one psychic-physical reactions in individuals. Therefore the cause of these kinds of deceases can be
general not particular.
There is another reason for the persistence of general cause for the psychic-physical reaction, that is,
there might be a particular psychic state in a particular decease, but it does not necessarily mean that this
state is limited to that particular decease. For example, repression, anger, melancholy, ambition, and anxiety
are found in all of the psychic-physical deceases like gastric ulcer, asthma, hypertension, migren, and so on.
Another important theory pertaining to reaction to psychic-physical deceases is the theory of somatic
vulnerability. According to this theory, a person who has an unbalanced nervous system is prone to
vulnerability against stress. this vulnerability and weak resistance, occurs in the weakest parts of body. For
example, a person who suffers gastric ulcer is not different from a person who suffers asthma concerning the
personal characteristics and motivations; the only difference is that the stomach of the former is weaker than
the latter’s aspiratory system.
A major problem is telling the difference between realistic, helpful tensions, fears, or worries and
unrealistic, unhealthy nervousness. This is because we all could start fretting about some possibly stressful
event at almost any time. Risks are all around us. Thus, unrealistic worries are over-reactions to a tolerable
situation or a prolonged over-reaction to a threatening situation that cannot be avoided. But how can you be
sure a situation won't cause trouble? You can't. How can you be sure you won't handle the problem any
better if you worried about it a lot more? You can't be. However, we can learn to recognize extreme over-
reactions, e.g. being terrified while flying or obsessing for hours about an insoluble problem. But a little
worry about crashing while flying is realistic and some thought is necessary to know that you can't do much
about a problem. So, how much time should you devote to a particular problem? There isn't an exact answer;
that's why some of us let anxiety overwhelm us. Today, most of the specialists who study psychological
processes, reject the simplistic theories regarding body and pay attention to bodily symptoms. The weakness
in the body might lead to the emergence of psychological problems, and vice versa. When the psychological

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factors participate in a decease, they play an indirect role. For example, the personal characteristics cannot be
the only factors in the emergence of Asthma. (Greenberg, 143)
A satisfactory level of emotional gain makes a person perform better. However prolonged emotional
strain eventually leads to a drop in performance. The more complex the activity is, the quicker the person
becomes distressed, causing feelings of fatigue, apathy, loss of concentration, distraction and memory
difficulties. Some people may react to stress in a very active manner while the others would give up quickly.
The emotional climate at work and home plays a major role in maintaining mental and physical health.
Everybody's mood depends a lot on the mood of the people who surround him/her, and it shows up in their
words, mimics and behavior. When communicating with other people, one tends to take on their optimism or
depression. Thus mutual sympathies become typical signs of good atmosphere in the group of co-workers or
family members.
In the recent years, there has an emphasis on interaction between the psychological states and biological
and social variants. According to the biological, psychological and social pattern, a person can be considered
as a system united with the secondary biological, psychological and social systems. The biological,
psychological and social problems are produced when the lives of individuals are affected by changes in the
environmental problems. A reference to the history of those people affected by psychological – physical
deceases, shows that the early periods of life has been disturbing and full of turbulences.
In the early lives of these patients, there are such factors like anxiety, worry, love of father and mother,
excessive protection, intensive limitations, lack of love and affection and other conventions effective in
childhood. There is another theory in this regard, and that is, most of the individuals affected by
psychological – physical deceases have not enjoyed emotional and social relationship with other children and
people of their own age.

3. Conclusion
Stress has played important and critical roles in the emergence of certain physical deceases. It is not
limited to mental problem, but it has its own physical malady. Ever since man has entered the industrial era
in the modern societies, there has been an increase in relationship between stress and its effect.
In general, the history of the growth of the individual affected by psycho-physiologic reactions shows
this fact that these people have been hard working in their education, and it has been important for them to
compete with others in education; quick progress in society has been important and strong motivations for
them. The longer the period of the aforementioned state, the higher the probability of an increase in
weakness and physical disorders. Therefore the study of personality characteristics, and other aspects of life
accompanied by intensive and continuous stress, might turn out to be meaningful. It may destroy the
individual psychologically and physically. Each one of the psychological, social and biological factors is
important and there are many reasons that the importance of their common effects seems equal with the
effects of each one of them.

4. References
[1] Cooper, K.L. Stress. (trans.) Gherachedaghi, Mehdi. Tehran: Roshd publication, 1995.
[2] Goldberg, Richard. Anxiety. (trans.) Poorafkari, Nosrat. Tabriz: Tabesh Publication, 1991.
[3] Greenberg, S. Jerald. How to Control Stress. (trans.) Dehghani, Mohsen. Tehran: Roshd Publications, 2009.
[4] Long, FF. Stress and the Way to Control it. (trans.) Namavar, Hamid. Tehran: Chehr Publications, 19
[5] Martin, Schaffer. Stress. (trans.) Parveen Blourchi. Tehran: Pajang publication, 1992.
[6] Ross, Ellen, o. Personality Psychology, (Theories and processes). (trans.) Syavosh Jamalfar. Tehran: Besat
Publication, 1995.

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