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How Does Stress Cause Disease, Why, and What Can Be Done?

Updated: Feb 15, 2022

Inflammation of the body
Stress and chronic inflammation

We have all heard about the importance of stress management and for decades we've known that seriously stressed out people are at risk for maladies like stroke and heart attack. But what's really going on in our bodies when psychological stress is manifesting itself as a physical ailment? How widespread in our bodies is the damage of psychological stress? What can we really do to avoid the impacts of stress?

What is Stress?

When we feel threatened the limbic system of our brain comes to the rescue. The limbic system is the survivalist part of your brain. It is active in memory processing, emotional responses, fight-or-flight responses, aggression and sexual response. This part of your brain includes areas like the amygdala, hippocampus, parahippocampal gyrus, cingulate gyrus, subcallosal gyri and associated structures. Let's focus in one one of these structure, the amygdala.

The amygdala is the main processing center for threat and fear. It not only activates at the detection of threat, it then initiates the physiological responses to the threat. For example, imagine that there was a coil of rope on your back porch. One morning, before coffee and in a bit of a slumber stupor, you open the back door and see what appears to be a coiled snake. We've all done this before - the heart rate shoots up in a split second and our head feels like its going to pop. What is really going on?

The amygdala and hypothalamus - stress response
Harvard Health Publishing

The activation of the amygdala signals the hypothalamus to pull the fire alarm - the sympathetic nervous system. This results in the release of the hormones adrenaline, norepinephrine, and cortisol. These hormones then initiate responses in various organs and tissues throughout the body such as increased heart rate, increased skin temperature, blood pressure increases, increased breathing, release of blood sugar and fats. Basically the machinery of your body is getting ready for some intense action.

Another response comes from our immune system, potentially preparing the body for injury or infection during “fight or flight”. Stress increases blood levels of pro-inflammatory cytokines. This immune response to stress, though not fully understood, may be central to why repeated stress responses throughout the day, referred to as chronic stress, may be killing us in ways that we don't even realize.

The stress chain of events
A chain of events that leads to the stress reaction starting with a stimulus and our analysis that it is a threat.

Why does this harm us?

The big difference is whether this stress response is acute, lasting for minutes, or chronic, lasting for weeks, months, or even years. Chronic stress is a constant cycle of threat perception and response. That cascade of hormones has health consequences if it occurs on a regular basis. Cortisol increases appetite, so that people will want to eat more to obtain extra energy for whatever stress may be occurring. This explains why we reach for 'comfort foods' during stressful events. Unfortunately cortisol also increases storage of unused nutrients as fat. Persistent adrenaline and norepinephrine surges can damage blood vessels and arteries, increasing blood pressure and raising risk of heart attacks or strokes.

Perhaps the most insidious outcome from the threat response is that chronic stress leads to chronic inflammation through the immune response. Immune cells have receptors for the stress hormones. This allows the preparation of the body to mount an immune response if the perceived threat results in physical wounds and injuries that could become infected.

The stress response becomes more complex in chronic stress. For example, cortisol is ordinarily anti-inflammatory and suppresses some immune response in order to preserve energy for the immediate action at hand. But chronic elevations can lead to the immune system becoming resistant to this cortisol effect and increased production of inflammatory cytokines that further compromise the immune response.

Chronic stress increases the risk for auto immune disease development. Consider what an auto immune disease is - the immune system attacking bodily tissue instead of invader molecules. When chronic stress induces immune activation, the outcomes of that chronic inflammatory condition resemble those seen in auto immune diseases such as rheumatoid arthritis. In irritable bowel syndrome, another auto immune disease, sustained cortisol activity during stress is associated with an increase in gastrointestinal symptoms. High levels of proinflammatory cytokines resulting from stress have recently been implicated as one of the causes of schizophrenia-related brain alterations. Chronic stress has been shown to worsen the symptoms of multiple sclerosis (MS), an auto immune disease where the immune system attacks nerve cells in the brain and spinal cord.

Why does our body respond this way?

Homo Sapiens have been around for about 300,000 years but the stress response is older than that. This response is shared across many other vertebrates including amphibians, reptiles, birds, fish, and mammals. This response is clearly advantageous in a world of predatory threat. But when was the last time that you were chased by a bear? Today we rarely engage in actual physical threats. More common are the social media posts that may threaten our point of view, the aggressive driver in front of us, the argument with our spouse that feels threatening to our marriage, or the drama with a co-worker that we may interpret as a threat to our ability to support ourselves and loved ones.

This seems to be the common theme of health challenges but I'll say it again, our bodies were not designed for modern living. 99% of the incidents that induce stress do not warrant the physiological response that they induce. Fortunately we are not purely reactionary organisms. While the amygdala and limbic system may be more reactionary portions of our brain we also have higher order interpretational centers of our brain like the posterior parietal cortex and the prefrontal cortex. Unfortunately chronic stress reduces capabilities in some of these higher order cortex regions of the brain. If we cannot break the cycle of chronic stress, biology seems to doom us to reactionary behavior and more stress. Simply put - we must train our brains!

What can be done?

The good news is that there is a whole lot of things that we can do to manage and decrease stress. We can train our brain to interpret stimuli in a different way. We can challenge the concept that a 'threat' is unfolding and see the situation from a different perspective.

Make no mistake, brain training takes practice. Developing the ability to stay calm in an argument with your spouse can be like developing the ability to deadlift twice your body weight. You have to build your ability with consistent training and gradual progression. Don't start with a 300 lb deadlift, otherwise you may be disappointed and think that the task is impossible. We have to start with a small load and develop the technique. Training the brain is like training muscles. For success we need to:

- learn technique

- practice consistently

- practice with lighter loads

- be patient

- learn how to positively reinforce small successes

- be patient when you fail at heavier lifts

- continually recall your motivation for this training

There is a lot to this and there have been thousands of books written on it. In fact, brain training may be the common thread of the self-help genre. In the next article I will lay out a method to brain training from the perspective of a personal trainer.

This is where I make my pitch to help you. I started Flow Dojo fitness and training because I love empowering people to feel healthy and happy. Let's work together to achieve your wellness goals. I'm a certified behavior change specialist as well as a personal trainer and instructor of martial arts, pilates, yoga, and meditation. Let me help you find your Flow.

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