Not all stress is bad stress. In fact, a little bit of short-term stress keeps you motivated. Acute stressors such as public speaking, taking an exam, or parachuting from a perfectly good airplane usually cause an immediate and intense stress response. Occasional acute stress actually has a positive effect on immune function. A single episode of acute stress doesn't usually cause a problem for the healthy adult.

Consider the chronic stress of being a family caregiver to an Alzheimer's patient. Betty has been caring for Fred since he was diagnosed. She is not sleeping well because more than once she has awakened during the night to find that Fred has turned on the stove. Also, finances are tight because of the cost of care and resources Fred needs. Fred is increasingly more angry and confused. This chronic, relentless stress has cumulative

effects on Betty's immune function. Her ability to cope is stretched, and her own health issues, seemingly minor compared to Fred's, are ignored. There are few opportunities for Betty to rest and return to a calm baseline. As a result, she becomes ill.

Distant stress, another type of stress that stems from previous trauma, can be unrelenting and influence immune function for years. For example, the long years of posttraumatic stress disorder's (PTSD) wearing effects on the immune system does cumulative damage to health.

For this Discussion, review this week's Learning Resources. Review the concepts of acute, chronic, and distant stress. Also, re-examine the "Pathways of Stress" graphic from Week 1. Then consider the characteristic and physiological differences of these three types of stress, how each impacts the immune system, and the populations most at risk or least susceptible to these types of stress and why. Finally, reflect on how stress management approaches might be different for specific examples of acute, chronic, and distant stress.