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Physiology of Stress

2.0 Contact Hours
Target Audience: Nurses, healthcare professionals, and interested individuals
Purpose/Goal: The outcome of this course is for the learner to provide an overview of the physiology of stress, the body’s responses to stress, and how stress affects the central nervous, endocrine, and immune systems.
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Stress is at epidemic levels in the world today. Currently, as many as 90% of all visits to health-care providers in the United States are considered to be stress-related. Stress affects every aspect of the body, mind, and spirit, resulting in a wide range of symptoms from headaches or stomach ailments to heart disease or death. Stress is difficult to define because it varies from individual to individual. What one person finds stressful might not bother another person at all. There are many types of stress, and each can result in many different physiological effects on the body.

Upon completion of the course, you will be able to do the following:

  • Compare the different definitions of stress.
  • Describe the origins and concepts of stress.
  • Identify the stages of the general adaptation syndrome (GAS).
  • Explain the fight-or-flight response.
  • Describe the three levels and two forms of stress.
  • Discuss the body's responses to stress.
  • Describe the effects of stress on the nervous system.
  • Describe the effects of stress on the endocrine system.
  • Describe the effects of stress on the immune system.
  • Describe the relationship between stress and the cardiovascular system.
  • Explain the relationship between stress and the gastrointestinal system.

Since the dawn of time, all living organisms have been subjected to evolutionary pressure from the environment (stress). Their ability to respond effectively to threats from the environment, predation, or other stressors ultimately determined their ability to survive and reproduce (Segerstrom & Miller, 2004).

Stress remains an integral part of life for every individual. While it may not be the same types of stressors as in earlier times, everyone has stressors in their lives as they try to juggle the demands of work, family, personal responsibilities, and environmental stressors (such as natural disasters or political upheavals). However, what may be stressful to one individual is not necessarily perceived as stressful to another individual, and that is what makes stress so difficult to define. For example, when riding a roller coaster, some people are hunched down in the back seats with their eyes shut and jaws clenched, stomach tense, skin pale, and grabbing onto the retaining bar with such fear that their knuckles are literally white. Other individuals choose to sit right up front, yelling and screaming and relishing every steep plunge and high-speed twist and turn of their wild ride. These wide-eyed thrill seekers find the ride exhilarating, and they find the “adrenaline rush” and physical sensations so enjoyable they may even choose to go on the ride again. So was the roller coaster ride a stressful event (American Institute of Stress, 2013)? It depends on which of the riders you ask.

Stress research has surged in the last 50 years as interest in the topic has increased. Today the word stress has many different definitions and connotations. According to Seaward (2012), in Eastern philosophies, stress is considered to be the absence of inner peace; in Western culture, it is considered the loss of control. Serge Kahili King, a noted healer, describes stress as any change experienced by the individual. Researcher Richard Lazarus calls stress a state of anxiety produced when events and responsibilities exceed one’s ability to cope with them. Hans Selye added to this definition, stating “stress is the nonspecific response of the body to any demand placed upon it to adapt, whether that demand produces pleasure or pain” (Seaward, 2012, p. 6).

Seaward (2012) states that a more current definition of stress is “the inability to cope with a perceived (real or imagined) threat to one’s mental, physical, emotional, and spiritual well-being, which results in a series of physiological responses and adaptations” (p. 4).

According to Trivieri & Anderson (2002), stress is a reaction to any stimulus or challenge that upsets the body’s normal function and disturbs mental or physical health. Stress can be brought on by internal circumstances (such as illness, pain, or emotional upset) or by external circumstances (such as death, family or financial problems, or job challenges). Attitudes, beliefs, and emotional states ranging from love to anger can trigger chain reactions that affect blood chemistry, heart rate, and the activity of every cell and organ in the body (Seaward, 2012).

A situation, circumstance, or any stimulus that is perceived to be a threat is referred to as a stressor, or that which causes or promotes stress (Seaward, 2012). While the definitions of stress vary, most experts agree that stress is not what happens to someone—those outside forces are the stressors. What matters is how a person reacts to the stressor.

Complete the course post exam (CE Test) with a score of 80% or greater. Complete all fields of the course evaluation form. Certificate of Completion is provided once the course post exam is passed per criteria above.

  • American Board of Managed Care Nursing
  • ANCC - American Nurses Credentialing Center
  • AOTA - American Occupational Therapy Association
  • ASWB - Association of Social Work Boards
  • California Board of Behavioral Sciences
  • California Board of Registered Nursing
  • California Department of Health, Aid, and Technician Certification Section
  • District of Columbia Board of Nursing
  • Florida Board of Nursing
  • Florida Board of Nursing - Certified Nursing Assistants
  • Florida Board of Respiratory Care
  • Florida Council of Dietetics and Nutrition
  • Florida Council of Licensed Midwifery
  • NAADAC - The National Association of Alcohol and Drug Abuse Counselors
  • NCBTMB -National Certification Board for Therapeutic Massage & Bodywork
  • Florida Board of Massage Therapists


Practice Level:


Content Focus:

Domain of OT

Course Expires:

October 05, 2019

  • Cyndie Koopsen, RN, BSN, MBA, HNB-BC, RN-BC, HWNC-BC
  • Caroline Young, MPH
Jurisdictional Requirements:

Continuing education (CE) licensing requirements vary by jurisdiction, are not well defined, and may change. These CE requirements may vary in terms of the number of hours required to the types of courses that must be taken. ALLEGRA Learning Solutions, LLC recommends you contact your licensing board or accrediting organization for the latest continuing education requirements of your state or territory. Compliance with CE requirements is the responsibility of the individual health care provider. Health care providers must understand the CE requirements in their jurisdictions, and be sure they are up-to-date on any rule changes that affect their license. For further information, please see our Accreditation Information.

Accommodations for Disabilities:

Every effort will be made to accommodate your special needs. To request accommodations, please contact us.

Conflicts of Interest and Relevant Financial Relationships:

The authors/planning committee members have no conflicts of interests or relevant financial relationships to declare relevant to this activity.

Commercial Support:

No commercial support has been received for this activity.

Non-endorsement of products:

Accreditation refers to recognition of continuing nursing education only and does not imply ALLEGRA Learning Solutions, LLC approval or endorsement of any commercial product.

Off-label Use of Products:

None of the authors intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.