Stress and Health: The Silent Threat in Your Body

Stress and Health: The Silent Threat in Your Body

Introduction to Stress and Health

Stress acts as an unavoidable part of life, standing firmly within both personal and professional spheres. Understanding the intrinsic link between stress and health becomes paramount in a fast-paced world where pressures abound. Stress, defined medically, is the body’s response to any demand for change. It manifests in various forms, whether acute or chronic, physical or psychological.

Factors contributing to stress include:

  • Workplace demands: High workload, tight deadlines, and interpersonal conflicts.
  • Personal challenges: Financial issues, relationship problems, and family responsibilities.
  • Environmental factors: Noise, pollution, and major life changes like moving or loss.

Physiologically, stress triggers a cascade of hormonal responses, most notably involving cortisol and adrenaline. These hormones prepare the body for a ‘fight or flight’ response. Short-term stress can be beneficial, enhancing focus and energy. However, chronic stress portends adverse health implications.

The impact of chronic stress on health is multifaceted:

  1. Cardiovascular health: Increased heart rate and blood pressure, heightened risk of heart disease and stroke.
  2. Mental health: Anxiety, depression, and cognitive decline through sustained neural strain.
  3. Immune function: Compromised immunity, making the body more susceptible to infections.
  4. Digestive system: Issues such as irritable bowel syndrome (IBS) and stomach ulcers.
  5. Muscular system: Tension leading to headaches, back pain, and general muscular discomfort.

Implementing stress management techniques is essential. Strategies include:

  • Mindfulness and relaxation: Practices like meditation, deep breathing exercises, and yoga.
  • Physical activity: Regular exercise to bolster physical resilience and mental well-being.
  • Healthy lifestyle choices: Proper nutrition, adequate sleep, and avoidance of harmful habits like smoking and excessive alcohol consumption.
  • Social support system: Connecting with friends, family, or support groups to share concerns and seek advice.
  • Professional help: Consulting healthcare providers when stress becomes unmanageable.

Recognising stressors and understanding their mechanisms aids in mitigating health risks, fostering a balanced and healthier lifestyle. Through proactive management and awareness, individuals can navigate the complexities of modern stressors more effectively.

The Biology of Stress

Stress triggers a complex biological response within the body. When an individual perceives a threat, the hypothalamus activates the pituitary gland, which in turn stimulates the adrenal glands to release stress hormones such as cortisol, adrenaline, and norepinephrine. These hormones prompt several physiological changes.

Increases in Heart Rate and Blood Pressure

  1. Adrenaline Release: Adrenaline increases the heart rate, enhancing oxygen and nutrient delivery to essential organs.
  2. Blood Vessel Constriction: Norepinephrine causes blood vessels to constrict, raising blood pressure to ensure optimal blood flow to muscles.

Suppression of Non-Essential Functions

  1. Immune System Suppression: Cortisol dampens immune system responses, conserving energy for critical functions.
  2. Digestive System Slowdown: The body diverts energy away from the digestive system, leading to slowed digestion.

Alteration of Brain Function

  • Memory and Focus: Cortisol affects areas of the brain responsible for memory formation and learning, potentially impacting an individual’s ability to concentrate.
  • Mood Changes: High levels of stress hormones can affect neurotransmitter balance, leading to mood swings and irritability.

Long-term Effects of Chronic Stress

  1. Chronic Inflammation: Prolonged exposure to stress hormones can lead to chronic inflammation, contributing to diseases such as arthritis, cardiovascular disease, and diabetes.
  2. Mental Health Disorders: Persistent stress is linked to mental health issues, including anxiety, depression, and post-traumatic stress disorder (PTSD).

Regulation Mechanisms

  • Negative Feedback Loop: The hypothalamus senses when cortisol levels are high and signals the adrenal glands to reduce hormone production, maintaining homeostasis.
  • Neuroplasticity: The brain’s ability to reorganise and form new neural connections can help mitigate stress effects when managed effectively.

Understanding the intricate biology of stress is essential for developing effective strategies to combat its health impacts. Proper stress management techniques can aid in reducing the physiological and psychological burden of stress on the body and mind.

How Stress Impacts Physical Health

Stress triggers a cascade of physiological responses, affecting various bodily systems. Chronic stress can lead to persistent health issues, undermining physical well-being.

Cardiovascular System

Stress prompts the release of adrenaline and cortisol. These hormones increase heart rate and elevate blood pressure. Chronic exposure to high levels of these hormones can result in:

  • Hypertension (high blood pressure)
  • Increased risk of heart attack
  • Higher susceptibility to stroke

Respiratory System

Stress can exacerbate respiratory conditions. It can trigger:

  • Asthma attacks
  • Hyperventilation
  • Shortness of breath

Those with pre-existing respiratory disorders may experience worsened symptoms due to stress.

Musculoskeletal System

Stress leads to muscle tension, particularly in the neck, shoulders, and back. Persistent tension can cause:

  • Chronic back and shoulder pain
  • Muscle spasms
  • Tension headaches and migraines

Gastrointestinal System

The digestive system is highly sensitive to stress. Common stress-induced digestive issues include:

  • Acid reflux and heartburn
  • Irritable bowel syndrome (IBS)
  • Ulcers

Prolonged stress can impair nutrient absorption, leading to deficiencies and weakened immune function.

Endocrine System

Stress influences hormone production, impacting various functions. Excessive cortisol can:

  • Suppress thyroid function
  • Decrease insulin sensitivity, increasing diabetes risk
  • Lead to weight gain, particularly around the abdomen

Immune System

Chronic stress weakens the immune response. This can result in:

  • Increased susceptibility to infections
  • Slower wound healing
  • Elevated risk of autoimmune diseases

A compromised immune system leaves the body vulnerable to numerous health conditions.

Sleep Disruption

Stress-induced insomnia and sleep disturbances can have debilitating effects. Poor sleep quality contributes to:

  • Chronic fatigue
  • Impaired cognitive function
  • Mood disorders, such as anxiety and depression

Reproductive System

In both men and women, stress can disrupt reproductive health. Effects include:

  • Irregular menstrual cycles
  • Decreased libido
  • Erectile dysfunction

Long-term reproductive health issues can stem from unmanaged chronic stress.

Understanding the multifaceted impact of stress on physical health underscores the necessity for effective stress management strategies. Identifying stressors and utilising coping mechanisms can mitigate the adverse health effects and improve overall well-being.

Stress and Mental Health

Stress profoundly influences mental health, often acting as a catalyst for various psychological disorders. When exposed to continuous stress, the brain undergoes structural changes influencing cerebrum function.

Impacts on Cognitive Function

  • Impaired Memory and Concentration: Persistent stress results in the release of cortisol, which, in high levels, negatively impacts the hippocampus — the brain’s critical area for memory and learning.
  • Reduced Cognitive Flexibility: Chronic stress hampers the ability to adapt to new situations and think creatively, leading to decreased problem-solving capabilities.

Emotional Consequences

  1. Anxiety Disorders: Long-term stress can lead to generalized anxiety, panic attacks, and social anxiety disorders. This results from heightened activation of the body’s fight-or-flight response.
  2. Depressive Disorders: Chronic stress significantly increases the risk of developing depression. Excessive cortisol production interferes with brain chemicals like serotonin and dopamine, crucial to mood regulation.
  3. Mood Swings: Individuals experiencing high-stress levels often report erratic emotional states. This stems from dysregulations in neurotransmitters caused by prolonged exposure to stress hormones.

Behavioural Manifestations

  • Social Withdrawal: Continuous stress can lead to avoidance behaviours, reducing social interaction and support networks essential for emotional well-being.
  • Substance Abuse: Coping mechanisms often include increased consumption of alcohol, drugs, or other harmful substances, exacerbating mental health issues.
  • Eating Disorders: Stress may provoke unhealthy eating habits, leading to disorders like binge eating, anorexia, or bulimia, due to the brain’s altered perception of hunger and satiety.

Physiological Responses

  • Sleep Disturbances: Stress can lead to insomnia or hypersomnia, disrupting natural sleep cycles critical for mental restoration.
  • Psychosomatic Symptoms: Experiences of recurrent headaches, muscle tension, and gastrointestinal issues can arise from chronic stress, manifesting physically but originating from psychological strain.

Impact on Self-Esteem and Perception

“Chronic stress reconfigures self-perception, causing feelings of helplessness, low self-esteem, and pervasive negativity.”

These disruptions in mental health necessitate proactive and comprehensive approaches to stress management for sustaining cognitive and emotional stability.

Chronic Stress: An Ongoing Battle

Chronic stress, unlike acute stress, persists over long periods and often arises from ongoing pressures related to work, relationships, or financial difficulties. This constant state of heightened alert can wreak havoc on an individual’s mental and physical health. Several key factors contribute to the detrimental impact of chronic stress:

  • Physiological Effects: Prolonged stress leads to the continuous release of stress hormones, such as cortisol and adrenaline. These hormones, when present in elevated levels for an extended duration, can suppress the immune system, increasing vulnerability to illnesses.
  • Mental Health: Chronic stress is closely linked to mental health disorders, including depression and anxiety. The constant activation of the stress response can lead to an imbalance in neurotransmitters, exacerbating symptoms of these conditions.
  • Cardiovascular Health: Ongoing stress significantly impacts cardiovascular health. Elevated stress levels contribute to high blood pressure, leading to an increased risk of heart disease, stroke, and other cardiovascular conditions.
  • Cognitive Function: Persistent stress impairs cognitive functions, including memory, attention, and decision-making abilities. Research indicates that chronic stress affects the hippocampus, a brain region critical for learning and memory.
  • Digestive Issues: Chronic stress can disturb the digestive system, resulting in symptoms such as stomach cramps, bloating, and irritable bowel syndrome (IBS). The gut-brain axis highlights the connection between mental stress and gastrointestinal health.
  • Sleep Disturbances: Long-term stress can severely disrupt sleep patterns, making it challenging to achieve restful, restorative sleep. Insomnia and other sleep disorders are common among individuals experiencing chronic stress.
  • Behavioural Changes: Ongoing stress can lead to significant behavioural changes, including unhealthy coping mechanisms such as over-eating, smoking, or alcohol consumption. These behaviours further exacerbate health problems.

Addressing chronic stress involves a multi-faceted approach, incorporating lifestyle changes, stress management techniques, and professional support. Recognising the signs and sources of chronic stress is crucial in reversing its harmful effects and fostering overall well-being.

Stress-Induced Conditions and Diseases

Stress affects the body in multifaceted ways, often manifesting in various physical and psychological conditions. Chronic stress can lead to several serious ailments, some of which include:

Cardiovascular Diseases

Stress elevates blood pressure and heart rate, contributing to an increased risk of hypertension, stroke, and heart attacks. The body’s fight-or-flight response releases hormones like adrenaline and cortisol, putting extra strain on the cardiovascular system.

Gastrointestinal Disorders

Stress can exacerbate or trigger gastrointestinal problems such as irritable bowel syndrome (IBS), gastroesophageal reflux disease (GERD), ulcers, and inflammatory bowel diseases (IBD). Stress-induced changes in digestion can also lead to bloating, cramping, and discomfort.

Mental Health Issues

Stress is a significant factor in the development of mental health disorders, including anxiety, depression, and panic attacks. Prolonged exposure to stress hormones can alter brain function and structure, increasing vulnerability to mental illnesses.

Skin Conditions

Skin problems such as acne, eczema, and psoriasis can be aggravated by stress. The release of stress hormones can increase oil production in the skin, trigger inflammation, and weaken the skin’s natural barrier.

Metabolic Disorders

Chronic stress can lead to metabolic syndrome, a cluster of conditions including obesity, insulin resistance, and type 2 diabetes. Stress-induced changes in appetite hormones can also result in overeating or unhealthy dietary choices.

Immune System Suppression

Long-term stress can weaken the immune system, reducing the body’s ability to fight off infections and illnesses. Increased levels of cortisol can imbalance immune cell function, making individuals more susceptible to viral and bacterial infections.

Sleep Disturbances

Stress often disrupts sleep patterns, causing insomnia, restless sleep, and difficulties in maintaining a regular sleep schedule. Poor sleep quality can exacerbate stress, creating a vicious cycle that impacts overall health.

Reproductive Health Issues

In women, stress can affect menstrual cycles, leading to irregular periods or exacerbating premenstrual syndrome (PMS) symptoms. In men, stress can impact testosterone levels and sperm production, potentially leading to reproductive challenges.

The multitude of stress-induced conditions underscores the importance of addressing stress proactively to maintain overall health and well-being. Reducing stress can help mitigate these risks and improve quality of life.

Identifying Stress Symptoms

Recognising stress symptoms is crucial for managing and mitigating the impact of stress on one’s health. These symptoms can manifest in various forms, affecting physical, emotional, and behavioral aspects of an individual’s life.

Physical Symptoms

  • Headaches: Frequent headaches can occur due to muscle tension and increased blood pressure.
  • Fatigue: Persistent tiredness might be indicative of chronic stress.
  • Digestive Issues: Stress can lead to stomach aches, ulcers, and irritable bowel syndrome.
  • Muscle Tension: Muscles may become tense, leading to pain and discomfort in various body parts.
  • Sleep Disturbances: Insomnia or trouble staying asleep can be a clear sign of stress.

Emotional Symptoms

  • Anxiety: Feelings of constant worry and unease often signify stress.
  • Depression: Persistent sadness, lack of interest in activities, and feelings of hopelessness are potential indicators.
  • Irritability: Increased irritability and mood swings can be linked to stress.
  • Restlessness: The inability to relax or stay calm might point towards underlying stress.
  • Overwhelming Feelings: Sensations of being overwhelmed and unable to cope are common in stressful situations.

Behavioral Symptoms

  • Changes in Appetite: Stress can either increase or decrease appetite, leading to weight fluctuations.
  • Substance Abuse: An increase in alcohol or drug consumption can be a coping mechanism for stress.
  • Social Withdrawal: Avoiding social interactions and activities may occur due to stress.
  • Procrastination: Delaying tasks and responsibilities can be a sign of being overwhelmed by stress.
  • Nervous Habits: Engaging in habits such as nail-biting or pacing may indicate stress.

Cognitive Symptoms

  • Memory Problems: Difficulty remembering information can be a result of stress.
  • Poor Concentration: Trouble focusing on tasks can be a cognitive symptom of stress.
  • Negative Thinking: Pervasive negative thoughts about oneself or situations can arise from stress.
  • Indecisiveness: Struggling to make decisions promptly is often associated with stress.
  • Confusion: Experiencing confusion or a ‘foggy’ mind state can be linked to ongoing stress.

Understanding these symptoms is imperative for taking the necessary steps to address and alleviate stress effectively. Noticing these signs can lead to early intervention, thereby preventing more severe health issues.

The Role of Lifestyle in Managing Stress

Lifestyle plays a critical role in moderating the effects of stress on health. Several factors contribute to either exacerbating or alleviating stress, and understanding these can guide effective management strategies.

1. Physical Activity: Regular exercise has proven benefits for mental well-being. Activities such as aerobics, yoga, and even walking can release endorphins, which act as natural stress relievers.

2. Diet and Nutrition: Nutritional choices significantly impact stress levels. A balanced diet that includes whole grains, lean proteins, and plenty of fruits and vegetables can help stabilise mood. Conversely, excessive intake of caffeine, sugar, and alcohol can heighten stress responses.

3. Sleep Hygiene: Quality sleep is essential. Practicing good sleep hygiene, such as maintaining a regular sleep schedule, creating a restful environment, and avoiding stimulants before bedtime, can significantly reduce stress.

4. Time Management: Efficient management of time reduces stress by preventing the feeling of being overwhelmed. Utilising tools such as planners, to-do lists, and setting realistic goals can help in managing commitments effectively.

5. Social Support: Maintaining strong social connections can act as a buffer against stress. Engaging in social activities, seeking support from friends and family, or joining support groups provides emotional relief and practical advice.

6. Mindfulness and Meditation: Practices like mindfulness and meditation have been shown to decrease stress. These techniques enhance self-awareness and promote relaxation, aiding in emotional regulation.

7. Hobbies and Leisure Activities: Engaging in leisure activities and hobbies provides a constructive outlet for stress. Whether it is painting, playing a musical instrument, or gardening, recreational activities allow for emotional and mental decompression.

8. Avoidance of Stress Triggers: Identifying and avoiding unnecessary stressors is crucial. This may involve setting healthy boundaries, learning to say no, or avoiding toxic environments.

9. Professional Help: When lifestyle changes are insufficient, seeking help from professionals can be beneficial. Psychologists, counsellors, and stress management workshops can provide coping strategies tailored to individual needs.

By incorporating these lifestyle modifications, individuals can foster resilience and better manage stress’s impact on their physical and mental health.

Effective Stress Management Techniques

Daily stress can negatively affect overall health, but proper management techniques help mitigate these effects. Implementing effective stress management practices is essential.

Regular Exercise

  • Improves Mood: Physical activity increases endorphin levels, promoting a sense of well-being.
  • Reduces Anxiety: Exercise helps lower cortisol levels, reducing stress.
  • Enhances Sleep Quality: Regular physical activity can promote better sleep, crucial for stress recovery.

Mindfulness and Meditation

  • Promotes Relaxation: Mindfulness practices help focus on the present moment, reducing anxiety.
  • Enhances Emotional Health: Meditation helps improve self-awareness and overall emotional well-being.
  • Reduces Negative Emotions: Regular meditation decreases rumination, often linked with stress.

Healthy Diet

  • Reduces Stress Levels: Consuming balanced meals helps stabilise blood sugar levels, mitigating mood swings.
  • Provides Essential Nutrients: Diet rich in vitamins and minerals aids brain function and mood regulation.
  • Limits Alcohol and Caffeine: Reducing intake of these substances prevents further exacerbation of stress symptoms.

Adequate Sleep

  • Improves Cognitive Function: Quality sleep is crucial for optimal brain performance and stress management.
  • Increases Resilience: Adequate rest helps the body recover from daily stressors.
  • Enhances Mood: Regular sleep patterns promote emotional stability and well-being.

Social Support

  • Fosters Connections: Interacting with friends and family helps reduce feelings of isolation.
  • Provides Emotional Support: Sharing experiences can provide different perspectives and solutions.
  • Encourages Healthy Habits: Positive social networks influence better lifestyle choices that reduce stress.

Organisational Skills

  • Improves Time Management: Effective planning and prioritisation reduce last-minute pressures.
  • Enhances Productivity: Organised environments promote focus and efficiency.
  • Reduces Overwhelm: Clear goals and tasks mitigate feelings of being overburdened.

Professional Help

  • Counseling: Professional support can provide strategies tailored to individual stressors.
  • Therapeutic Techniques: Cognitive-behavioural therapy (CBT) and other methods can effectively manage stress.
  • Medical Intervention: In some cases, medication may be needed to manage severe stress symptoms.

Adopting these strategies can significantly diminish the adverse effects of stress and enhance overall health.

When to Seek Professional Help

Recognising when to seek professional help is crucial for managing the adverse effects of stress on health. Stress can manifest differently in individuals, and it’s essential to pay close attention to specific signs that indicate a need for expert intervention.

Emotional Symptoms

  • Persistent Anxiety: Continuous feelings of worry or fear that do not subside can significantly impact daily functioning.
  • Depression: Prolonged sadness or a lack of interest in activities that once brought joy can signal severe stress.
  • Irritability: Increased irritability or anger outbursts, especially if these are disproportionate to the situation.

Physical Symptoms

  • Chronic Fatigue: Unrelenting tiredness or exhaustion, despite adequate rest, can be a red flag.
  • Headaches: Frequent, intense headaches that are not alleviated by usual remedies may require professional attention.
  • Digestive Issues: Persistent stomach pains, diarrhoea, or constipation might be stress-related if other causes have been ruled out.

Behavioural Signs

  • Substance Abuse: Increased reliance on alcohol, drugs, or other substances as coping mechanisms can indicate a severe issue.
  • Changes in Appetite: Significant weight loss or gain due to changes in eating habits may suggest heightened stress levels.
  • Social Withdrawal: Avoiding social interactions or losing interest in connecting with family and friends can be cause for concern.

Cognitive Symptoms

  • Memory Issues: Trouble remembering important tasks, events, or details might be stress-related.
  • Difficulty Concentrating: Inability to focus on tasks, making it challenging to complete work or personal projects.
  • Indecisiveness: Increased difficulty in making decisions, often second-guessing oneself.

Professional Resources

  • Therapists and Counsellors: Seeking therapy or counselling can provide coping strategies and support.
  • Medical Professionals: Consulting a general practitioner for a physical evaluation can rule out other potential causes of symptoms.
  • Support Groups: Engaging in support groups offers a community of individuals facing similar challenges.

When Symptoms Persist

Behavioural, emotional, physical, or cognitive symptoms that persist despite attempts to manage stress independently should prompt seeking professional assistance. Early intervention by professionals can help mitigate long-term impacts on health and improve overall well-being.

Preventative Measures for Reducing Stress

Implementing effective strategies to manage and reduce stress is crucial for maintaining optimal health. Several preventative measures can help individuals mitigate the impact of stress on their lives.

Physical Activity

Regular physical activity serves as a potent stress reliever. It enhances the production of endorphins, which are natural mood lifters. Recommendations include:

  • Exercise Routine: Engage in at least 150 minutes of moderate aerobic activity or 75 minutes of vigorous activity per week.
  • Variety: Incorporate a mix of cardiovascular exercise, strength training, and flexibility exercises.
  • Consistency: Follow a consistent schedule, aiming for daily movement.

Healthy Diet

A balanced diet is essential for stress reduction. Nutrient-rich foods can improve mood and energy levels.

  • Whole Foods: Include fruits, vegetables, whole grains, and lean proteins.
  • Hydration: Maintain adequate hydration to support cognitive and physical performance.
  • Limit Stimulants: Reduce intake of caffeine, sugar, and alcohol.

Mindfulness and Relaxation Techniques

Practicing mindfulness and relaxation can significantly decrease stress levels.

  • Meditation: Dedicate a few minutes daily to meditation to clear the mind and foster relaxation.
  • Breathing Exercises: Practice deep breathing techniques to lower stress and tension.
  • Yoga: Engage in yoga, which combines physical postures, breathing exercises, and meditation.

Adequate Sleep

Quality sleep is fundamental in managing stress.

  • Sleep Schedule: Establish a regular sleep routine by going to bed and waking up at the same time each day.
  • Sleep Environment: Optimise the sleep environment by ensuring a dark, cool, and quiet room.
  • Limit Screen Time: Avoid screens an hour before bedtime to enhance sleep quality.

Social Support

Strong social connections can buffer against stress.

  • Relationships: Nurture relationships with family and friends to foster a support network.
  • Communication: Openly discuss feelings and challenges with trusted individuals.
  • Community Engagement: Participate in community or group activities for shared support.

Time Management

Efficient time management reduces stress by providing a sense of control and accomplishment.

  • Prioritisation: Identify and focus on essential tasks, placing less urgent items on hold.
  • Breaks: Schedule regular breaks to avoid burnout.
  • Planning: Use planning tools such as calendars and to-do lists.

Implementing these preventative measures can significantly reduce the adverse effects of stress, promoting overall well-being and resilience.

Conclusion: Embracing a Healthier, Stress-Free Life

A healthier, stress-free life is paramount for maintaining both physical and mental well-being. Managing stress begins with recognising its sources and how they impact daily living. Numerous strategies can be employed:

  1. Physical Activity: Engaging in regular exercise, such as walking, running, or yoga, helps reduce stress hormones and releases endorphins, the body’s natural painkillers and mood elevators.
  2. Balanced Diet: A diet rich in fruits, vegetables, whole grains, and lean proteins can help stabilise mood and energy levels.
  3. Sleep Hygiene: Ensuring adequate sleep is crucial. Practices include maintaining a consistent sleep schedule, creating a restful environment, and limiting exposure to screens before bedtime.
  4. Time Management: Prioritising tasks, setting realistic deadlines, and taking regular breaks can prevent burnout. Utilising tools like planners and to-do lists can also enhance productivity and reduce anxiety.
  5. Mindfulness and Relaxation Techniques: Practices such as meditation, deep breathing exercises, and mindfulness can ease tension. Techniques like progressive muscle relaxation and guided imagery are also beneficial.
  6. Social Connections: Building and nurturing relationships with friends, family, and colleagues provides a support system that can help alleviate stress. Engaging in social activities and seeking support when needed are essential.
  7. Professional Help: Consulting mental health professionals, such as psychologists or counsellors, is effective for managing chronic stress. Therapies include Cognitive Behavioural Therapy (CBT), stress management programmes, and other therapeutic interventions.

Adopting these methods leads to a profound improvement in quality of life. Integrating stress management into one’s routine fosters resilience and promotes overall health. Employers and organisations also play a crucial role, offering employee assistance programmes, wellness initiatives, and flexible working arrangements to support well-being. Engaging in continuous self-care and seeking appropriate help when necessary ensures a balanced, fulfilling life.

Doctors of the Relevant Department:

Spec. Dr. Mustafa SOYDAN

Psk. Elif CİHAN

Spec. Dr. Seher BAKIRTAŞ

Spec. Dr. Cem GÖNLÜŞEN

Spec. Dr. Beyza ÇİÇEK

Spec. Dr. Fatma İŞ

Spec. Dr. Bülent TOY

Spec. Dr. Raşit Mahir GÖKMEN