Stress, Anxiety & PTSD

Psych 36 - Biopsychology

Stress
Can be thought of in two ways:
External - a stressor
environmental condition(s) that makes

unusual demands on the organism, such

as a dangerous or threatening situation,
failure, or bereavement

Internal - the stress response

your psychological and physiological
response to a stressor

The Stress
Response

Historically, stressors
were few and far
between

Modern stressors are

more frequent, tend
to last longer,
chronically activating
the stress response

The Stress
Response

When faced with a

stressor:

Amygdala alerts the

hypothalamus

Hypothalamus
activates the
sympathetic nervous
system (SNS)

SNS releases
epinephrine &
norepinephrine

Autonomic Nervous System

Responses

The Hypothalamic-PituitaryAdrenal Axis (HPA Axis)

The hypothalamus also sends

Corticotropin Releasing
Hormone (CRH) to the pituitary
gland

In response, the pituitary

releases Adrenocorticotropin
Hormone (ACTH) which
travels (via the bloodstream)
to the adrenal cortex which
releases glucocorticoids
(like cortisol)

The hypothalamus also

releases other stress
hormones, including
vasopressin, oxytocin &
prolactin.

(releases CRH)

(releases ACTH)

(releases Cortisol)

Glucocorticoids
(Cortisol)

Steroid hormones

Also help to release body

stores of energy

Increase amount of calcium

entering neurons - increases
neurotransmitters

Control and
Regulation of the HPA
Axis

The HPA Axis is

influenced by

Amygdala
Hippocampus
The ANS

The Modern Stress

Response

Chronic activation of stress

response can have a negative
impact on health

Increased blood pressure damages

vessels, increasing heart disease
risk

depletes energy and causes mood

disruptions; compromises the
immune system.

Brain damage: neuron death;

shrinkage of the hippocampus

Memory & learning suffers

Greater risk for Alzheimers

The Impact of Stress on

Health

Vietnam veterans &

torture victims
hippocampal volume

Gray matter found to be

reduced in the brains of
people who had been in
the vicinity of the 9/11
terrorist attacks in New
York City

Hippocampal Damage in a Stressed Monkey

Compare the number of cells between the

arrows in the control monkey (left) and a
monkey that died of apparent stress (right).

The Impact of Stress on

Health
The effects of stress vary
among individuals

Early developmental events

(such as greater nurturing or

abuse) may create
epigenetic changes in the
brain

Beliefs about stress can

reduce or enhance the

negative effects of stress

Oxytocin - death rates lower

among people with social
support.

Anxiety & Anxiety

Disorders

Fear & anxiety are

generally adaptive

All anxiety disorders share

the core element of
anxiety

~30% of Americans will

experience at least one
anxiety disorder

The NIMH estimates

anxiety disorders affect
40 million Americans each
year

Anxiety Disorders
Many different anxiety disorders
Most common in the U.S.:
Generalized anxiety disorder (GAD)
Obsessive-compulsive disorder
(OCD)

Panic disorder
Social anxiety disorder
Post-traumatic stress disorder
(PTSD)

Anxiety Disorders

Strong genetic
predisposition for
developing anxiety
disorders in general

Higher prevalence in
women than men for
nearly all anxiety
disorders

How Does Anxiety

Happen?

Dental Anxiety?

Fear vs. Anxiety

Anxiety disorders
include cognitive
distortion

SNS activation is
associated with a
situation or objector
person

Nearly all anxiety is

learned

What Causes Anxiety

Disorders?

And why is anxiety manageable for some but not

others?

GABA receptors
Low serotonin
Too much glutamate
Chronic stress
Stress-related glutamate release

Anxiety Disorders:
PTSD

Unpleasant memories
repeatedly plague the
victim - also:

Memory changes, such

as amnesia

Flashbacks, dreams

Deficits in short-term
memory, concentration

Hyper-vigilance and
hyperarousal of the SNS

PTSD in the Brain

PTSD victims have

decreased volume in the
right hippocampusmay
be a risk factor rather than
a consequence

Fear conditioning is
learning in which fear is
associated with a
previously neutral stimulus

How Does PTSD Develop?

HPA Axis is activated in the stress
response to the trauma

SNS releases epinephrine and

norepinephrine

Glucocorticoids released from

adrenal glands

A fear memory forms when the

event is consolidated in the

hippocampus with information from
the amygdala about the emotional
significance of the event

binding of glucocorticoids to

receptors in the hippocampus after

a extremely traumatic event impairs
memory consolidation - result: PTSD

PTSD: Hypermnesia?
(Kaouane et al 2012)
Impairment in memory consolidation
Many things are remembered to be associated

with and have the same emotional significance

as the traumatic event itself

Infusion of glucocorticoids
Results in the inability to identify the correct
source of the threat

Extreme emotional fear is invoked by

irrelevant cues