Hiding in plain sight…. How Chronic Stress Can Make You Sick
One of the gravest foundational misunderstandings of modern medicine is the assumption that mind and body are separate: in disease and health. Within that context, the profound impact of emotional stress upon our physiology has only begun to be appreciated within the traditional medical practice; despite thousands of years of writing and insights supporting this crucial balance.
It was not until the 1990s when the physical manifestations of severe emotional trauma on the heart could be seen in imaging studies; Takotsubo cardiomyopathy, also known as Broken Heart Syndrome, that this concept took some traction in mainstream medicine.
Broken Heart Syndrome presents primarily in women, ages 59-75. Symptoms are “chest pain and shortness of breath after a severe emotional or physical stress.” “An electrocardiogram shows abnormalities that mimic those of a heart attack but there is no evidence of coronary obstruction.” In addition, there are movement abnormalities and ballooning in the left ventricle. Most recover within the month, although rare, there have been deaths associated with this diagnosis, primarily from cardiogenic shock. Clinicians may recommend diuretics, beta-blockers, and/or ACE inhibitors. Some examples of the emotional stressors associated with Takotsubo cardiomyopathy include the death of a loved one, caring for an ill loved one, domestic violence, learning of a diagnosis of a serious illness, a serious accident, and a natural disaster. It is believed that “surging stress hormones” such as adrenaline, trigger “changes in the heart muscle cells and /or coronary blood vessels that prevent the left ventricle from contracting effectively.” Harvard Health Publishing, Harvard Medical School, May 19,2022, “Takotsubo cardiomyopathy (broken-heart syndrome.)
The field of psycho-neuro immunology has grown based on the observation that our stress levels have a significant impact on our immune system: our ability to fight infections. Coupled with this, chronic stress seems to affect our body’s ability to fend off the development of some cancers. There is sound scientific data supporting the conclusion that chronic stress will weaken our immune system and cancer defense mechanisms making us prone to infections and cancers. According to Anil K. Sood, M.D., Professor of Gynecologic Oncology and Reproductive Medicine, at The University of Texas, MD Anderson Cancer Center, Chronic stress can weaken your immune system leaving you prone to cancer and can “help cancer grow and spread in a number of ways.” He added “Stress hormones can inhibit a process called anoikis, which kills diseased cells and prevents them from spreading. Chronic stress also increases the production of certain growth factors that increase blood supply to tumors. This can speed the development of cancerous tumors.” (December 2014: How stress Affects Cancer Risk, by Markham Heid, The University of Texas MD Anderson Cancer Center)
Chronic stress can make it difficult to fight illness due to the weakened immune system. It can also contribute to, worsen, or increase the risk of diabetes, asthma, irritable bowel syndrome, chronic tension headaches, heart issues, Alzheimer’s disease, obesity, depression, anxiety, colds, back and neck issues, and sleep issues, to name a few. (10 health problems related to stress that you can fix, by R.Morgan Griffin, WebMD)
Research drawing from clinical psychology, health psychology, and psychoneuroimmunology (PNI) has identified relationships between negative emotions such as anxiety and sadness with inflammation. When these emotions are not regulated properly, negative emotions can create stress on the body that increase risk for morbidity and mortality. This review helps understand how that emotional factors alter inflammation and contribute to accelerated biological aging and disease risk. (A review and novel theoretical model of how negative emotions influence inflammation: The critical role of emotional regulation. Megan E. Renna 1 Affiliations expand PMCID:PMC8649080 DOI: 10.1016/j.bbih.2021.100397 Free PMC article Abstract.)
It is believed that dysregulated inflammation (too much in one area and too little in another) may contribute to many chronic diseases. In autoimmune disorders, a dysregulated immune system begins to attack itself. This same dysregulated immune system can be overreacted such as environmental and food allergies or underactive in the case of chronic infections. In addition, many other diseases can be linked to inflammatory and immune dysregulation all caused by chronic stress. Examples include migraine headaches, psoriasis, IBS, and rheumatoid arthritis. It can be a multisystem problem caused by dysregulation of immunity, inflammation, and the ability to overcome infection. Although this imbalance can cause profound illness it is often difficult to test by traditional testing. Blood tests may be negative or non-specific.
When a person is experiencing stress, their body responds as if they are being threatened and these events may happen; blood vessels constrict, blood pressure rises, pulse increases, breathing faster and bloodstream is flooded with cortisol and adrenaline. When this response is chronic, health problems can occur. The human body’s acute response to stress is adaptive and allows us to assess and avoid danger at a heightened level and generally positive helping to escape dangerous situations. These are stressful moments; such as the mother who lifts a car off their child or a man who outruns a lion. Chronic stress however can produce the opposite effect and be damaging to many systems in our body as mentioned above. It can be a viscous cycle where sleep and diet can be affected by stress, and the more sleep and diet are negatively affected the more negative impact stress can have.
Recognizing this connection between the emotional and physical symptoms can prevent multiple trips to multiple doctors with each one focusing on a single system without an appreciation of the whole. Finding a doctor that can look at the patient as a whole would be helpful. Integrated medicine, that combines western medicine (MD, DO, PA and NP) with complementary medicine (like yoga, meditation, acupuncture, massage, etc.) may be beneficial for chronic ailments.
We may not recognize chronic stress in our lives, because our adaptations become our normal. Hiding in plain sight. Incorporating stress management may help reduce or eliminate health risks that are associated with chronic stress.
In R. Morgan Griffen’s article, 10 health problems related to stress that you can fix, in WebMD, she suggests four tips to reduce stress.
1. Breathing deeply for a few minutes can calm the physiologic stress response. She suggests that when you breathe out you relax a specific muscle throughout your body until you feel tranquil.
2. Focus on the moment instead of the past or future. Be in the present. If you are eating focus on the sensation and taste of the food for example.
3. Reframe the situation. Instead of seeing yourself stuck in traffic and late, see yourself having private time listening to the radio.
Other ways to reduce stress
Laughing: When I watch something that makes me laugh, I can feel my body relax.
Exercise: I believe exercise has saved my life. Not only because I have met friends and feel supported, but because it increases my endorphins, which is a “feel good” neurotransmitter.
Pet therapy: When I am with my puppies, I can feel the stress leave my body.
Psychotherapy talking about what is causing your stress, having support, and figuring out a plan for stress management is helpful as well.
Sleep: It is important to get enough sleep but I understand if you are under stress, it may be difficult to sleep. Being rested helps you cope better. Insufficient sleep can increase stress levels. Stress can cause lighter sleep, or more frequent awaking or less sleep causing daytime fatigue. Sleep restrictions may cause a significant reduction in cortisol levels. Insufficient sleep may cause its own health issues as well.
Touch: So important. Appropriate touch makes my body relax.
Meditation: One of its goals of meditation is to join body and mind by increasing breath and body awareness.
Journal: So helpful.
Friends: Support from friends are key.
Dance: My stress reliever. What is yours?
Massage: Touch is so important.
Mindfulness stress reduction techniques that use mindfulness is meditation and MBCT which is mindfulness cognitive behavioral therapy
Acupuncture mind and body connection
Yoga: One of its goals of yoga is to join body and mind by increasing breath and body awareness.
Eat healthy.
Take Time to unwind.
Medication prescribed by doctor.
What makes you happy? Do it. Think about it. Spend time in nature, travel, travel in your mind, think happy thoughts, do what makes you happy.
Self-care which means tending to your own wellbeing and happiness.
Create boundaries and learn to say no.
Ideal is to remove yourself from the stressor as soon as possible.
Calm mind brings inner strength and self-confidence,
so that is very important for good health.
Dalai Lama
Next week’s blog will be about chronic stress in relationships.
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