70 Chapter 4: Stress Management and Sleep The second level of the stress response, called the resistance stage, occurs when stress is prolonged. If a stressful event or situation is prolonged, heart rate, blood pressure and other physiological responses associated with the alarm stage begin to decline, yet still remain above normal, resting levels. These levels remain elevated due to the higher than normal amount of cortisol in the blood, which can increase the risk for heart disease. In some cases, these physiological responses can remain elevated for years. However, due to physiological differences between individuals, the actual amount of time a person can remain in the resistance stage is unpredictable. Unless the stressful situation or event is eliminated, or the person is able to change their perception of the situation or event (i.e., eustress versus distress), then the third stage, or the exhaustion stage, of the stress response occurs. In this final stage, the body has depleted all of its energy resources by continually trying, but failing, to recover from the initial alarm stage. Research shows that prolonged periods of stress can contribute to numerous emotional and physiological disorders including depression, anxiety, heart disease, stroke, hypertension and immune system disturbances that increase susceptibility to infections (American Psychological Association, n.d.). Signs of the exhaustion stage include: Physiological Signs and Symptoms: Psychological Signs and Symptoms: • Hypertension • Elevated cholesterol • Atherosclerosis • Heart disease • Stroke • Irritability • Depression • Anxiety • Paranoia Male vs. Female Response to Stress Males tend to respond to stress differently, and more aggressively, than females do. Interestingly, the difference in the stress response between genders may be a result of a particular gene that males have but females do not: the sex-determining region Y (SRY) gene. The SRY gene is located on the Y chromosome, which directs male development, may promote aggression and the fightor-flight response to stress. Additionally, since females do not have the SRY gene, their responses to stresses are different and generally less aggressive. (Lee & Harley, 2012). According to Taylor et al. (2000), hormonal differences between males and females also contribute to variations in the response to stress. For example, oxytocin (a hormone secreted by the pituitary gland as part of the stress response), promotes nurturing and social contact and is enhanced by the hormone estrogen. The interaction between oxytocin and estrogen may contribute to the tend-and-befriend stress response in females while simultaneously inhibiting the fight-or-flight response. Conversely, the hormone testosterone inhibits the release of oxytocin. The inhibition of oxytocin by testosterone may in turn contribute to the fight-or-flight response, while simultaneously preventing the tend-and befriend response, in males (Taylor et al., 2000).
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