Stress is a part of our daily lives. In northern New Jersey, where I have my medical practice, we are so busy, we may not even be aware of how we respond to stress every day.
Too much stress can adversely affect your health. It is estimated that between 75 and 90% of primary care visits are in some way attributed to stress.
We all know that having a stress free life is impossible. In fact a strong reaction to stress also known as the fight or flight response is a physiologic response that is designed to increase survival.
Understanding your stress is the first step to having more power over it.
When you are faced with a threat whether real or perceived, your autonomic nervous system sets off a series of chemical reactions involving the hypothalamus, pituitary and adrenal glands. Also known as the HPAaxis. This results in the release of epinephrine (adrenaline) and glucocorticoids (cortisol) from the adrenal glands. This triggers physiological changes that help you survive immediate danger.
Adrenaline increases your heart rate, dilates your pupils, increases alertness and decreases blood flow to the skin, and your digestive system. Blood is redirected to your muscles for increased strength. Cortisol increases glucose, which is the main form of energy used by both your brain and body. Cortisol increases your blood sugar by breaking down muscle (protein) and increasing fatty acids to supply energy to the muscles. This increased energy supply gives the body the necessary power to respond to a physically and emotionally demanding situation. It allows you to fight harder or run faster, thus increasing your odds of surviving.
What is cortisol’s role is causing chronic disease? When you are in a stressful situation, large amounts of the hormone cortisol are released into the bloodstream. Over time, prolonged elevations of cortisol can have negative health consequences.
Here is what can happen when stress becomes chronic. Initially you have the alarm phase – the immediate reaction to a stress. Heart rate increases, breathing becomes rapid, digestive enzyme production decreases, and blood sugar levels increase.
The alarm phase is usually short, and self limited, hormone levels go back to normal until activated by another threat. No long-term negative health consequences occur. Unfortunately in today’s world many people have chronically elevated levels of these hormones due to stress. Our lifestyles and the world around us are full of potential stressful situations. You may feel continuing stress related to the economy, fear of terrorists, relationships, natural disasters, traffic, your job, etc.
We have become a nation of chronically stressed individuals
Whether perceived or real, stressful situations arise multiple times throughout the day. The stress response was helpful to our ancestors that had to fight or run from a wild bear. Unfortunately in our daily lives, we all have perceived threats through out the day. This stress has contributed to many chronic health problems.
If stress continues the adaptation phase kicks in, allowing the body to continue the fight or flight response. This is where cortisol comes in, converting protein stores to blood sugar to continue to supply energy to muscles. Sodium is retained to keep body fluid levels up and blood pressure elevated. This is why continued stress can lead to diabetes, heart disease, and hypertension.
We can all relate to catching a cold or coming down with a virus when we are under stress. That’s because cortisol redirects immune cells, which lowers your immunity, causing increased risk of infections. Cortisol can also lead to depressed cartilage and bone formations, increasing risks of osteoporosis. In addition it can also cause damage to the part of the brain the hippocampus responsible for short-term memory, and it alters nerve cell functions in the brain leading to anxiety and depression.
If the stress response continues, the body starts slowing down, as it is unable to continue producing high levels of stress hormones. Eventually, many body functions can become exhausted. Exhaustion due to prolonged stress weakens the heart, blood vessels, adrenal glands, and immune system – partially due to the chronic elevations of cortisol.
Recent research also shows that chronically high levels of cortisol can result in weight gain and changes in body composition too. Cortisol promotes increases in blood sugar, which is converted from protein stores (muscle). This results in the loss of muscle (lean body mass) and in increase in body fat, especially around the mid-section.
One study showed an increased tendency in snacking during times of high cortisol levels in the blood. People who have trouble coping with stress often turn to food for comfort. In addition cortisol causes physiologic changes that increase food intake. Cortisol affects our hunger hormones leptin and ghrelin. Cortisol decreases leptin the hormone responsible for telling us we are full. It also increases ghrelin the hormone that tells us we are hungry. Both these hormonal changes cause one to increase their food intake.
In addition cortisol also increases insulin and neuropeptide Y, again both cause you to consume more food, particularly high fat or sugar comfort food. Therefore, chronic stress can lead to weight gain. Weight gain around the middle, known as “central adiposity,” is associated with the metabolic imbalances of “metabolic syndrome”, insulin resistance, and increased risk of heart disease.
So clearly chronic stress has a negative impact on our health causing or exacerbating heart disease, diabetes, hypertension, anxiety depression, osteoporosis, impaired immunity, dementia, and possibly cancer.
The good news is, your can decide to take care of yourself. You can decide to better manage your stress. A highly effective, but often overlooked therapy is acupuncture. Very briefly, acupuncture enables the body to boost the immune response, and lessen the bad effects of stress on many fronts. More about how acupuncture reduces stress and helps restore healthier conditions in the body is the topic of the next article.