1/109
Looks like no tags are added yet.
Name | Mastery | Learn | Test | Matching | Spaced | Call with Kai |
|---|
No analytics yet
Send a link to your students to track their progress
Yerkes Dodson Law of 1982
Where your equilibrium is for your stress and performance is is important
You need a certain amount of stress, good stress = eustress
When surpassed it will impact their daily life
Heart disease, cancer, ulcers
Also impacts the people around you
“Stress is a concept which suffers from the mixed blessing of being too well known and too little understood” - Hans Seyle
The former is an environmental stimuli like job stressor in the work place
The latter is the individual response that can be seen physically, psychologically, and behaviorally
stressors cause…
stress is the…
strain, outcome
the three ways to classify stress
iv, dv, interactionist
stress as the dv
the response
Sir william osler said that this approach could be used for human behavior and that disease results from stress and strain
This condition was found among Jewish people
Researchers focus on stress as a response to stimuli such as environment or situation
Fight or flight (Cannon 1935) is rooted in stress
General adaptation syndrome
GAS
term used to say there are stress related illness
Three phases - stage 1 is the alarm reaction (hr increases, bp increases, sweating, etc), stage 2 is resistance via fighting it off, if successful you go back to normal stage but if not then you go to stage 3 where you will get ill or die
Hans Seyle 1946
stress as the iv
the stimulus AND STATIC
This definition links health and disease to certain conditions in the external environment
Taken from physical sciences and engineering
External environment provided the conditions and characteristics of health and disease
does not take the individual into account
stress is the disruptive agent
stress as the intervening variable
interactive model
Incorporates the sources of stress and the individual perception/personality and the resulting response
“lack of fit” between the individual and the environment
supported by Cooper 2979 and later Co as well
Not static but complex process with differing behavior that is impacted by environment
interactionist perspective by cooper
said that individuals try to keep their thoughts, emotions, and relationships in a “steady state” and that each factor of a persons emotions and physical state has a “range of stability” that the person will feel comfortable in. when forces disrupt one factor beyond the range of stability the individual must act or cope to store a feeling of comfort
an individuals behavior aimed at maintaining a steady state makes up their adjustment process or coping strategies
Cooper quote about stress 1986
“A stress is any force that puts a psychological or physical factor beyond its range of stability, producing a strain within the individual. Knowledge that a stress is likely to occur constitutes a threat to the individual. A threat can cause a strain because of what it signifies to the person”
stimulus based model of stress (Cox 1978)
says that the environment has stress as a stimulus that leads to a strain on the person as the response
professors definition of stress
four concepts: 1. You need a causal external/internal agent 2. An evaluation (done by mind or body) that will distinguish danger or not 3. A coping process by mind or body to deal with the stressful demands 4. A stress reaction which is the effect on mind or body
biggest stressors - life stress
LCU - life change units first studied by Holmes and Rahe 1967
Category 1: life events - vulnerability. How vulnerable we are to change
#1 is health and death
Death of a family member goes highest
The change DOES NOT have to be negative. It can be positive
New partner or apartment
Stress levels go up if more things change in a short biological time frame
How we perceive the change - Interactionist model by Sir Carry Cooper
biggest stressors - life stress
Category 2: daily hassles studied by lazarus
The accumulation of little things - how many daily hassles has this person been exposed to
The cumulative effects and the regular irritants, minor irritations, and they are completely different from major catastrophic events
Cohen 1980 - children were not doing well in their tests in school because they lived near the airport and had their sleep interrupted by the sound of the large jets coming in and out of the airport at night
Brought in a legal on jets not being allowed to land or take off during the hours of 1am-5am
hypothalamus in stress
activates two stress reactivity pathways
stressor → cortex → thalamus → here
posterior hypothalamus or anterior hypothalamus
autonomic nervous system: controls basic body processes
endocrine system: Consists of hormones that regulate physiological functions
PTSD
•Condition that develops in people who:
–Have experienced or witnessed an extreme psychological or physical event that is interpreted as distressing
•Symptoms may include flashbacks, nightmares, severe anxiety, and uncontrollable thoughts about the event
Categorized by: reliving the event, avoidance, and arousal
treatment for ptsd
talk therapy, medication, and exposure therapy
cortisol
provides energy for action, determine whether we fight/flight, and gives fuel
walter canon 1935: fight/flight snydrome, converting amino acids to glycogen in the liver when it produces too much = decrease in lymphosytes (cancer)
pituitary gland hormones
•Adrenocorticotropic hormone (ACTH): activates the autonomic nervous system
•Vasopressin (ADH): instructs the kidneys to retain water
Oxytocin: contracts the walls of the blood vessels
adrenal glands: cortex hormones
•Glucocorticoids (primarily cortisol): increases blood glucose for energy, prepares the body for flight or fight
•Mineralocorticoids (primarily aldosterone): increases blood pressure by increasing sodium retention and decreasing urine production
adrenal gland: medulla hormones
•Epinephrine (adrenaline): increases heart rate, muscle tension, and how hard the heart pumps blood
•Norepinephrine (noradrenaline): increases heart rate and constricts blood vessels, thereby increasing blood pressure
PTSD
•Condition that develops in people who:
–Have experienced or witnessed an extreme psychological or physical event that is interpreted as distressing
•Symptoms may include flashbacks, nightmares, severe anxiety, and uncontrollable thoughts about the event
Cerebral cortex
Upper part of the brain responsible for thinking functions
has grey matter
frontal lobe, parietal lobe, occipital lobe, temporal lobe
sub cortex
Lower part of the brain responsible for various physiological processes necessary to stay alive
cerebellum, medulla oblongata, pons, diencephalon, thalamus, hypothalamus
reticular activating system RAS
•Network of nerves that connects the mind and the body
•Excessive arousal of the cortex results in stressful responses
•An under-aroused cortex results in difficulty in learning, poor memory, and little self-control
blood pressure in stress response
Systolic: refers to the amount of pressure on the walls of your heart when the blood is being pumped away from your heart
For a young adult it should be 120+
Above 140 is hypertension
Diastolic: refers to the pressure of your blood on the walls of your heart when your heart is relaxed
Should be around 80
90 or above is harmful
For regular people its 120/80 considered healthy and for very fit people it can be between 90/60 to 110/70
ANS in stress response
brain, spinal cord, peripheral nerves
Sympathetic: responsible for expending energy
When constantly stressed: people brace (causes sore muscles), people grind their teeth, TMJ,
Parasympathetic: responsible for conserving energy
The brakes
hippocampus
•Part of the brain that signals the presence of stress
•Adrenal glands release glucocorticoids during stress
glucocorticoids: regulate metabolism of glucose and are detected by hippocampal cells - stress damages those cels
the endocrine system
•Includes glands that secrete hormones which travel via the circulatory system
•Changes the function of other bodily tissues
•Four pathways: adrenal cortex, adrenal medulla, thyroid gland, pituitary gland
adrenal cortex - endocrine
•Influenced by the hypothalamus and pituitary gland
secretes glucocorticoids and mineralocorticoids
main glucocorticoid is cortisol which provides energy for action
main mineralocorticoid is aldosterone which increases bp to prep for action
adrenal medulla - endocrine
Activated through a direct nerve connection from the posterior portion of the hypothalamus
secretes two catecholamines - epinephrine/adrenaline and norepinephrine/noradrenaline
changes caused by catecholamines
•Increase in heart rate
•Increase in stroke force
•Dilation of coronary arteries
•Dilation of bronchial tubes
•Increase in basal metabolic rate
•Constriction of the blood vessels in the muscles and skin of arms and legs
•Increase in oxygen consumption
hypertension
Excessive pressure of blood against the walls of the arteries
can lead to cerebral hemorrhage (blood vessel rupture in brain) or myocardial infarction (Artery ruptures and a part of the heart dies because of lack of oxygen)
normal blood pressire is 120/80 mmHg
thyroid gland
•Secretes thyroxin due to the influence of the hypothalamus and the pituitary gland
important to metabolism
gastro system - in the stress response
Responsible for digestion
GI Tract - brain and body connect
Reduces saliva production and increases hydrochloric acid production due to stress
Results in ulcers
Can break the barrier of your stomach walls and will lead to a bleeding ulcer which you cannot stop
Stress alters peristalsis, the rhythmic movement of food
Leads to bowel distress and disease
Stomach and bowel cancer increases and in career women ovarian cancer is increasing
muscles - in the stress response
Stress results in bracing or tensing
Bracing leads to: development in muscle pains and aches and contractions of smooth muscles that control the contraction of internal organs
Persistent stress in the cardiac muscles: leads to the death of cardiac muscle cells and a loss of contractility of the heart
skin - in the stress response
Temperature and electrical conduction abilities of the skin are affected by stress
Stress causes increased perspiration and vasoconstriction
Changes color of the skin
Galvanic skin response: Electrical conductance of the skin used in a lie detector test
walter canon
First to describe the body’s reaction to stress
Fight or flight: body’s stress reaction that includes an increase in:
Heart rate
Respiration
blood pressure
Serum cholesterol
Brain waves
Effects are based on duration and degree of one’s physiological reaction
hans selye
the physiological responses to stress
Proposed the general adaptation syndrome
Includes the three stages of stress reaction: alarm, resistance, exhaustion
other influential researchers in stress
•Simeons - Related evolution to psychosomatic disease
•Wolff, LeShan, and Engel - Studied illness, disease, and stress
•Friedman and Rosenman - Identified the relationship between stress and coronary heart disease
•Simonton - Applied the visualization technique to cancer therapy
relaxation techniques
Relaxation response: Series of bodily changes that are the opposite of the stress reaction
Autogenic training: Involves a sensation of heaviness, warmth, and tingling in the limbs
Progressive relaxation: Involves contracting and relaxing muscle groups throughout the body
Called neuromuscular relaxation
stress theories - life events theory
Stress occurs when a situation requires more resources than are available
Daily hassles are more stressful than major events
Allostatic load: Cumulative biological wear and tear that results from:
Responses to stress that seek to maintain body equilibrium
hardiness theory - stress theories
Focuses on one’s attitude toward stressful events
Hardiness - Buffering between stress and the development of illness and disease
social support theory - stress theories
Stress occurs when there is not enough social support available to respond to the event effectively
stressors
Stimulus with the potential for triggering the fight-or-flight response
Types - Environmental, psychological, sociological, and philosophical
The human body has evolved to respond to stressors with an immediate action
Alters the physiology for greater speed and strength
stress reactivity
Term for fight-or-flight response
Includes:
Increased muscle tension, heart rate, blood pressure, and perspiration
Change in respiratory rate and brain waves
Effects are based on duration and degree of one’s physiological reaction
stress
Combination of a stressor, stress reactivity, and strain
Ways in which the term is used
Stimulus
Response
Whole spectrum of interacting factors
Stimulus-response interaction
Psychosomatic disease
conditions that has both mind and body components
Referred to as psycho physiological
Can be diagnosed
Manifested physically
Psychogenic
Somatogenic
Psychogenic - psychosomatic disease
Physical disease caused by emotional stress without a microorganism involved
Ulcers and asthma
Somatogenic - psychosomatic disease
Results from the mind increasing the body’s susceptibility to disease causing microbes of natural degenerative processes
Autoimmune diseases, rheumatoid arthritis, cancer
Psychosomatic illness
not all in the mind. Stress in the mind manifesting in the body
Stress and serum cholesterol
without any organic basis we can have high serum cholesterol - going up at highly stressful points in life
Friedman - certain times of the year with certain occupational groups
Accountants when taxes are due
Career women’s stress goes up with children at home after work
Takes 2 hours with young children for women’s stress to go back down but 20 minutes for men
Stroke/apoplexy
is the of oxygen to the brain resulting from a blockage or rupture of a blood vessel
Signs and symptoms: Impaired motor function and speech, paralysis, blurred vision, and headache
Has link to high blood pressure, diet, and stress
Ulcers
fissures or cuts in the walls of the stomach, duodenum, or goner parts of the intestines
During stress, norepinephrine causes capillaries in the stomach to constrict, thereby reducing mucosal productions
Stress results in an increase in hydrochloric acid in the intestinal tract and the stomach
H pylori, a bacteria, inflamed the gastrointestinal lining and stimulates acid production, or both
Caused by the ingestion of aspirin and other nonsteroidal anti inflammatory drugs
Antibiotics rather than histamine blockers are prescribed for ulcers
Migraines
results from the constriction and dilation of the carotid articles of one side of the head
Prodrome: constriction phase of a migraine headache - the pre attack
When the dilation of the carotid arteries occurs, chemicals stimulate adjacent nerve endings causing pain
Involves one side of the head and usually lasts about 6 hours
Caused due to emotional stress and tension
Relaxation techniques include biofeedback, meditation, and autogenic training
Most likely on a Monday morning
Chocolate, cheese, red wine
stress in college life
One of the biggest stressors is having to deal with stress as a student against a societal perception that college years are relaxation and fun years
College is rated one of the most stressful periods of the human life
They are years of uncertainty
Dont know who they will be or what they will do
Lack of autonomy
Expectations from society
stressors for younger
lifestyle changes
grades
course overload
finances
friendships
love relationships
Pressure to be sexually active
Fear of HIV/AIDS
Shyness
Eating disorders
stressors and stress for older college students
people who were in armed forces or were engaged in other activities that postponed their education. May have a family or career.
Experience same stressors as younger college students as well additional stressors such as:
Blending career with college - which is the priority?
Guilt if they have a family - time constraint and how do they spend their time
Money
Study skills
Self doubt
Support
advice regarding stress in college
Do not overload courses
Improve communication with those around you and get involved with other people
Coordinate family and college responsibilities - schedule them
Time management - use time wisely
Make timetable near exam times and leave room for revision and breaks
Write a schedule for responsibilities
Use your resources - professors, advisors, student affairs etc
burnout
Adverse stress reaction to work with psychological, psychophysiological, and behavioral components
includes: emotional exhaustion, depersonalization, and lack of personal accomplishment
symptoms of burnout
•Diminished sense of humor
•Skipping rest and meals
•Increased overtime and physical complaints
•Social withdrawal
•Changed job performance
•Self-medication
•Internal changes
stages of burnout
•Stage 1 - Honeymoon → Worker is satisfied with the job
•Stage 2 - Fuel shortage → Fatigue sets in at work
•Stage 3 - Chronic symptom → Work leads to constant exhaustion
•Stage 4 - Crisis → Worker stops attending work due to illness
•Stage 5 - Hitting the wall → Physical and psychological problems cause life-threatening illnesses
spillover theory - explains work-family balance issues
Change in one domain affects other domains
compensation theory - explains work-family balance issues
When one domain is troubled, resources go to the other domain
wbc - stress and the immunological system
•Phagocytes
–Macrophages: surround and engulf invading substances and summon helper T cells
stress decreases this quantity
lymphocytes
–T cells: identify the invading substance and destroy it
–Helper T cells: stimulate the production of killer T cells and B cells
–Killer T cells: puncture membrane of invaded body cells; kill cells and the invader
–B cells: produce antibodies that neutralize the invading substance or tag it for attack by other cells
–Suppressor T cells: halt the immune response when the invasion becomes contained
–Memory T and Memory B cells: remain in the bloodstream and lymphatic system to respond quickly to future attacks by the invading substance
hot reactors
•People who react to stress with an all-out physiological reaction:
–Suffer from chronic anger or anxiety
–Have high blood pressure
–Are susceptible to heart attacks
resource drain theory - explains work-family balance issues
–Resources devoted to one domain become unavailable in the other domains
nutrition and stress - pseudo stressors
food substances that produce a stress response
known as sympathommetic - stimulate the sympathetic nervous system
lifestyle changes - stressors for young college students
Acute stress
Moving away from stability
Generally has an effect on the immune system
Behavioral manifestation of lower motivation
grades - stressors for young college students
Martinez
Maintenance of gpa for scholarship - chronological stress
Correlated with poorer physical health - when obsession picks up students will over study and sacrifice their physical wellbeing
Flight or flight - flight to social isolation
friendship - stressors for young college students
Change in friends goes along with changing institutions
Element of self doubt - want to know how much you can disclose to the person next to you. How willing are you to share
Friendship requires a testing period. You don't know who your friends are going to be
Trust
Delicate
We need social support
Jealousy
Making new friends is ego threatening - because it is a risk and it takes time
Definition: fear of losing property - here it is the fear of losing that person
Has feeling that your pride has been threatened
Feeling your property rights have been violated - your friendship has been violated
love relationships - stressors for young college students
Erotic: passionate
Ludic: flirtation type without commitment
Storgic: calm and compassionate type of love
Manic: combination of passionate and filtration love characterized by jealousy
eating disorders - stressors for young college students
it is a process of trying to achieve what people see as a perfect body. It is about control
Anorexia: cannot see they are thin. Fear of gaining weight. Unwillingness to maintain a normal or healthy weight
Treated by restoring healthy weight and treating the issues related to the eating disorder. Reducing or eliminating behaviors or thoughts that lead to disordered eating and preventing relapse.
Psychotherapy (individual, group, and family based)
Bulimia: recurrent and frequent episodes of eating unusually large amounts of food and then follow this with purging behavior. Associated with feelings of shame and lack of control over the eating
Treating bulimia: can be treated with nutritional counseling, psychotherapy (CBT), and antidepressants like fluoxetine (Prozac)
occupational stress - sources of stress
Intrinsic to job - factors
Role in organization
Career development
Relationships at work
Organizational structure and climate
Extraorganizational sources of stress
sources of stress - intrinsic to the job
job factors - researched by Cooper and Marshall
Poor physical working conditions
Work overload (qualitative or quantitative) OR too little work
Time pressures and deadlines
Physical danger
Mistakes
Too many decisions
Shiftwork
Poor physical working conditions as an iv source of stress at work interactional
1965 Kornhauser - unpleasant working conditions and having to work fast to produce a lot is correlated with poor mental illness
1984 - Meese - temperature is correlated with productivity
There is a gender divide in this - women want it 2 degrees warmer for equilibrium and job performance than men
Tafalla - uncontrollable noise makes it more difficult to do mental tasks because it impacts your neuroendocrine system
shiftwork as a work stressor intrinsic to the job
Fotinatos - shiftwork among medical profession in the UK and found that with midwives
Chernobyl - occupational hazards of shiftwork
Variable and high workloads along with shift work
Disturbs biological rhythms - 25 hours circadian
Affects blood temperature, blood sugar level, metabolism
This is when accidents occur because your body is not programmed to work in shifts
What kind of work it is is very important
Different shifts will produce different stress
If you only do late shifts your body will adjust but
Rotating shifts do not let your body adjust
“If I have a late shift I have trouble getting to sleep because my mind is so active with things that have been going on in the ward”
“If the shifts could be arranged so that someone could do just mornings, afternoons, or just late but not rotating you could have a better social life”
“I think you would perform better if you only did one shift”
role in organization as cause of work stress - iv
Role ambiguity - Margolist and Quinn
Caplan and Jones
Role conflict - different type of conflict
One person has conflicting roles to do
Cooper and Karr - Dentists have a job that has high anxiety associated with it due to: having multiple roles, having to cope with difficult patients, being seen as someone that inflicts pain on others, and has lots of spillover to family life
Responsibility for people and things
Lack of managerial support
Too little responsibility
Conflicts reorganizational boundaries (internal and external, etc)
Train crashes - role ambiguity leading to accidents - two people on post and one left
career development as a source of occupational stress - iv
considered invalid by professor and today
Overpromotion
Underpromotion
Lack of job security - decreased post COVID. There are no “more jobs for life”
Thwarted ambition
Fear of redundancy or early retirement - retirement age will go up
Many people go into retirement because of mental or physical issues
Mental, musculoskeletal, cancer, circulation
People post COVID now are not as unhappy about not having as much career development, they are just happy to have a job
relationships at work as a source of occupational stress - iv
key correlating variables with burnout
Poor relations with boss, subordinates, or colleagues
W colleagues: French and Caplan - nurses in England had 10x more stress interacting with them than patients
Affects cortisol levels, blood pressure, and glucose level
Leads to lots of absent days - bullying/harassment, physical violence in and out of the workplace, and threats of physical violence
Difficulties in delegating responsibilities, etc
Personality conflicts
In student population: Seltzer UK study students were studying for their MBA and the number one reason for dropping out when their supervisor showed a lack of consideration
Organizational structure and climate as a source of occupational stress - iv
difficult scale to structure and scientifically interpret due to cultural differences and vagueness
Little or no participation in decision making
Restriction on behavior (Budget, etc)
Office politics
Lack of effective consultation or communication
Uncertainty
Loss of identity
APA discussion - hybrid work and working from home will have consequences because you cannot benchmark it to health and wellbeing
Extraorganizational sources of stress as a source of occupational stress - iv
Family problems
Life crises
Financial difficulties
stats about employement stress
Employee satisfaction: high in Austria and Switzerland but low in the UK
Highest percentage of respondents cited this reason for causing long term absences across the board: stress - highest in public and in non profit
In the UK they lost 8.4 billion UK pounds to absenteeism every year - total they lost almost 26 billion from absenteeism, presenteeism (not fit for the job or not feeling well) and turnover
Stress is the highest health problem affecting employees in parts of the UK
Women work more noncontractual hours than men
symptoms of stress - dv - the individual
Level of anxiety
Level of neuroticism
Tolerance for ambiguity
Type a behavioral pattern
Depressive mood
Excessive drinking
Irritability
Chest pains
High blood pressure - diastolic
Smoking
Escapist drinking
Job dissatisfaction
Reduced aspiration
Heart rated
Greece facts
Not a smooth transition in relation to stress (researched in 2015 by her)
Led to upheavals in the country, in jobs, and in stress
Greece relies on a few industries such as tourism and shipping to generate income which makes its economy vulnerable
These factors along with the global economic crisis, refugee crisis, and COVID crisis makes Greece a forerunner of misfortune in European Economic issues
High vulnerability and causes major disruption with market fragility
Results: intensity and severity of of organizational stress with its manifestations of strain and poor wellbeing became evident
Greece is not considered a collectivist country but “in transit” toward a highly individualistic country
This has lead to a mixture of societal and organizational problems that require assessment and evaluation
Data from the European Foundation for the Improvement of Living and Working Conditions work levels vary across countries and ages
Cyprus had high levels of stress related problems
Czech Republic showed work related stress increases with age
Germany showed that people between 30-39 were most affected by stress and said work stress was the main source
For greece stress levels fall after age 54 - which can be related to cultural and contextual factors
OSHA report: stress report was highest in Greece (55%)
Can be attributed to the economic crisis
Restructuring of organizations and its effects on the wellbeing of workers:
Greece must restructure the economy and organizational
Includes private and public companies as well as blue and white collar occupational groups
Trying to help the Kallikratis reform in 2010 cut down public spending but that in one year cut down so many jobs and thus higher level of work intensity which increased levels of stress
Increased emotional exhaustion related to job demand, job insecurity, and unfair treatment during the change
intervention
activities to prevent a stressor from resulting in negative consequences such as psychological discomfort, anxiety, illness, and disease
coping with stress
engaging in a behavior or thought to respond to a demand
will vary because of perceived differently - leads to different appraisals because of cognitive processes and then emotional responses will vary
categories of appraisal
Primary: judging how much of a threat is involved and how important is the outcome
Secondary: determining whether resources needed to meet the demands are available
Reappraisal: evaluating whether the response made to a demand/threat was effective
5 phases of the stress model
Life situation
Perceived as stressful
Emotional arousal
Physiological arousal
Consequences
road blocks and model of stress with eustress
Road map with road blocks to stop or minimize the stressor
No one filter or road block will stop the stressor - you want as many as possible
Cognitive restructuring or medication
Relaxation techniques keep emotional reactions from leading to prolonged physiological arousal
Physical activity can effectively block toe continuation of stress after physiological arousal has occurred
“Eustress is good in the right moments - like right before and exam
Yerkes and Dodson
In appraisal stages: you should say to yourself
“I am in much more control than I ever realized”
taking control of stress
Managing stress means exercising control not giving it up
Individuals can decide to control or not control the stress responses
Practicing specific techniques - means of taking control and assuming responsibility
Employing stress management techniques in a stressful way is dysfunction
Goal is not to eliminate all stress but to limit harmful effects and use stress to motivate oneself
healthy diets are low in:
saturated fat or trans fat
We want monounsaturated oils not poly or trans fats
cholesterol
sodium
sugar - we should keep amount eaten in a short period of time limited
We believe an unhealthy diet is related to risks of cancer
Low fiber diets and high in trans fat
food to limit
Foods high in fat or added sugar
Processed and fried foods
High fat milk products
Baked products and snack foods
Drinks with high fructose corn syrup
Foods that create a stress response - which we want to avoid
Coffee
Tea - theobromine
Chocolate
American Cancer Society recommendations for diet:
Five or more servings of a variety of vegetables and fruits a day
Choosing whole grains over processed grains
Limiting the intake of processed and red meats
Carrying a limited amount of body fat
Cortisol uses these two vitamins
vitamins B12 and C
leads to: stress turning into anxiety, depression, insomnia, muscular weakness, and stomach upset
also takes calcium