Stress releases hormones that upset every system of the body — musculoskeletal, respiratory, cardiovascular, endocrine, gastrointestinal, nervous and reproductive. What exactly does stress do to you and how can you reduce the damage? Read on …
By Dona Suri
Of all the gratuitous sermons, one of the most frequently repeated exhortations is the one that urges you to de-stress. It comes complete with advice on ways to de-stress: yoga classes, afternoon naps, turning your phone off, etc.
You hear it, nod your head and think to yourself
Yeah, sure. Like I’ve got time for that.
Yeah, sure. If I wasn’t stressing, nothing would get done around here.
But you also have a little voice that acknowledges the truth of the de-stress message. Sooner or later, your morning-to-night, schedule, your multiple commitments, responsibilities, targets, objectives, missions – they’re going to take their toll. Like an electrical system with too much stuff plugged in, your wiring is going to melt and you’re going to short out.
In day to day terms, you understand stress perfectly: the cancelled flight, the dog-chewed shoes, finding out the deadline was yesterday, etc. What you may not know is the physiological mechanics of stress. In other words, what goes on in your body when you are stressed.
When the brain perceives stress (eg sudden appearance of very large spider) nerve cells in hypothalamus produce/release corticotropin-releasing factor (CRF). Within the hypothalamus, CRF stimulates the release of β-endorphin hormone (produces morphine-like effect) and CRF travels to the anterior pituitary gland where it stimulates production of POMC (proopiomelanocortin protein). From POMC, the pituitary makes ACTH (adrenocorticotropic hormone). ACTH travels to adrenal glands commanding production/release of cortisol hormone. Cortisol commands increase in heart rate, rise in blood pressure, surge-release of blood sugar and fatty acids from the liver and alerts immune system. Energy is pumped up, all systems are in top gear. When cortisol in the blood reaches a certain level, the hypothalamus gets the message and switches off production/release of CRF and ACTH.
Cortisol in the bloodstream affects all systems of the body: musculoskeletal, respiratory, cardiovascular, endocrine, gastrointestinal, nervous, and reproductive systems.
Cortisol is normally produced in varying levels throughout the day, typically increasing in concentration from the time you wake up, then slowly declining throughout the day. This is your daily energy cycle.
The body is designed to benefit from this influence but it is not designed to flourish when the cortisol level remains high over a long period. The stressful situation should pass and the body systems should return to default setting.
Long-term, chronic stress (meaning cortisol levels that do not recede) does a lot of damage.
Here are the effects, system by system.
Musculoskeletal system
With sudden onset stress, the muscles tense up all at once, and then release their tension when the stress passes. Chronic stress causes the muscles in the body to remain taut and tense for long periods of time.
Tension-type headache and migraine headache are associated with chronic muscle tension in the shoulders, neck and head. Musculoskeletal pain in the low back and upper extremities is stress-related.
Often, but not always, there may be an injury that sets off the chronic painful state. What determines whether or not an injured person goes on to suffer from chronic pain is how they respond to the injury. Individuals who are fearful of pain and re-injury, and who seek only a physical cause and cure for the injury, generally have a worse recovery than individuals who maintain a certain level of moderate, physician-supervised activity.
Muscle tension, and eventually, muscle atrophy due to disuse of the body, all promote chronic, stress-related musculoskeletal conditions.
Relaxation techniques and other stress-relieving activities and therapies effectively reduce muscle tension, thereby decreasing stress-related disorders (e.g. headache, backache).
Respiratory system
A surge of cortisol produces rapid shallow breathing. The trachea and bronchial tubes constrict. For people with healthy lungs, this is generally not a problem as the body can manage the additional work to breathe comfortably. People with pre-existing respiratory diseases such as asthma and chronic obstructive pulmonary disease (COPD; emphysema and chronic bronchitis, are in for a hard time.
Acute fear (eg fear caused by sensation of suffocation) or emotional stress can trigger attacks. In addition, the rapid breathing—or hyperventilation—caused by stress can bring on a panic attack in someone prone to them.
Working with a psychologist to develop relaxation, breathing, and other cognitive behavioral strategies can help.
Cardiovascular system
The heart and blood vessels work together to provide nourishment and oxygen to the organs of the body. Acute stress (stress that is momentary or short-term, eg meeting deadlines, being stuck in traffic or suddenly slamming on the brakes to avoid an accident) causes an increase in heart rate and strong contractions of the heart muscle, with the stress hormones—adrenaline, noradrenaline, and cortisol—acting as messengers for these effects. Blood vessels dilate, thereby increasing the amount of blood pumped through the body and elevating blood pressure. Once the acute stress episode has passed, the body returns to its normal state.
Prolonged stress produces an unrelenting increase in heart rate which inevitably puts strain on the blood vessels. The name for this condition is hypertension, and it leads to heart attack or stroke.
Repeated acute stress and persistent chronic stress can produce a general inflammation in the circulatory system, particularly in the coronary arteries. This is where stress is tied to heart attack. How a person responds to stress also affects cholesterol levels.
The risk for heart disease associated with stress appears to differ for women, depending on whether the woman is premenopausal or postmenopausal. Levels of estrogen in premenopausal women appears to help blood vessels respond better during stress, thereby helping their bodies to better handle stress and protecting them against heart disease. Postmenopausal women lose this level of protection due to loss of estrogen, therefore putting them at greater risk.
Endocrine system
A challenging, threatening, or uncontrollable situation, triggers a cascade of events involving the hypothalamic-pituitary-adrenal (HPA) axis. While this is valuable during stressful or threatening situations where injury might result in increased immune system activation, chronic stress can result in impaired communication between the immune system and the HPA axis. This impaired communication has been linked to development of numerous physical and mental health conditions, including chronic fatigue, metabolic disorders (e.g., diabetes, obesity), depression, and immune disorders.
Gastrointestinal system
The gut is a highly complicated system.
Millions of independently functioning neurons line your gut and they are in constant communication with the brain. Stress affects brain-gut communication (eg “butterflies” in the stomach).
Millions of bacteria inhabit the gut and influence its functioning and the brain’s health. Gut bacteria do not like a persistent high level of cortisol and their discomfort shows up in mood, emotion and rationality.
The word dyspeptic means two things: having indigestion and irritable bad temper. There is a very good reason that word carries both meanings. Particularly in the first years of life, stress can change the development of the nervous system as well as how the body reacts to stress. These changes can increase the risk for later gut diseases.
Esophagus
Stress influences diet: it causes some people may eat too much, others not eat enough. People turn to alcohol and tobacco to “relax”. Actually, nicotine stimulation is associated acutely with elevated cortisol levels and consumption of alcohol over an extended period of time raises cortisol levels. All this can result in heartburn or acid reflux at the very least.
Stress increases the severity of regularly occurring heartburn pain. A rare case of spasms in the esophagus can be set off by intense stress and can be easily mistaken for a heart attack.
In highly emotional situations, many people experience a “lump in the throat”. They literally “choke up”. The medical term is globus hystericus; there is no physical cause; it is entirely stress-induced.
Stress may increase the amount of air that is swallowed while eating, which increases burping, gassiness, and bloating.
Stomach
Stress makes some people “sick to their stomach” – it makes them physically nauseous to the point of vomiting.
Chronic stress, leading to excess cortisol, can affect levels of both ghrelin and leptin
Ghrelin (hormone produced in the stomach); it’s message is “eat more”.
Leptin (a hormone produced in fat cells); it’s message is “eat less”.
Typically, cortisol stimulates production of ghrelin and reduces the sensitivity of the hypothalamus to leptin. Sometimes, this backfires. Extreme stress inhibits hunger or, if people do eat, then they are unable to keep their food down.
Contrary to popular belief, stress does not increase acid production in the stomach.; (Stomach ulcers are caused by bacterial infection.) But, stress makes ulcers hurt more.
Bowels
The level of cortisol in the body affects movement of food through the intestines – speeding it up (diarrhea) or slowing it down (constipation). It can trigger painful spasms in the bowel. Gas and bloating are also related to stress.
A chronic high level of cortisol weakens the intestinal barrier, allowing gut bacteria into the bloodstream. Most of these bacteria are easily taken care of by the immune system but overtaxing the immune system all the time leads to chronic inflammation.
Nervous system
One aspect of stress and the nervous system was discussed at the very outset of this post. Remember the very large spider?
If someone has to deal with very large spiders all the time, either they overcome fear of suddenly appearing spiders, in which case, the experience ceases to be stressful, or the stress remains which means that the autonomic nervous system continues to trigger physical reactions. Stress doesn’t hit just one system, it hits all the systems.
Everybody has experienced stressful situations, brief or prolonged, at some time or another, so it is not difficult to imagine the physical results of a never-ending stressful situation. People affected by Post Traumatic Stress Disorder suffer mental symptoms but they may also have physical symptoms such increased blood pressure and heart rate, fatigue, muscle tension, nausea, joint pain, headaches, back pain or other types of pain.
Both the Sympathetic Nervous System and the Parasympathetic Nervous System have powerful interactions with the immune system. A chronically stressed person has lower immunity.
Reproductive System – Male
Chronic ongoing high cortisol level reduces
* Testosterone production resulting in decline in sex drive, erectile dysfunction and impotence
* Sperm production, sperm motility and lows the percentage of sperm of normal size and shape.
Reproductive System – Female
Menstruation
Absent or irregular menstrual cycles, painful periods, and changes in the length of cycles are associated with high levels of cortisol.
Sexual desire
Society expects a lot from women. It is not unusual for a woman to be caring for children, ailing or elderly family members, coping with job demands and on top of everything else trying to make a success out of her marriage. Stress piles on really fast, along with fatigue, and both together can torpedo sexual desire.
Pregnancy
Stress can negatively impact a woman’s ability to conceive, the health of her pregnancy, and her postpartum adjustment. Depression is the leading complication of pregnancy and postpartum adjustment and it chiefly arises from stress. Maternal stress negatively impacts fetal and ongoing childhood development and disrupt bonding with the baby in the weeks and months following delivery.
Premenstrual syndrome
Stress makes premenstrual symptoms (cramping, fluid retention/bloating, irritability and mood swings) worse or more difficult to cope with.
Menopause
Menopause can be a stressor in and of itself. Some of the physical changes associated with menopause can be difficult to cope with. Rapidly fluctuating hormone levels are linked to anxiety, mood swings, and feelings of distress. High levels of cortisol can only make menopause worse.
The old phrase “worry yourself sick” is not just a figure of speech. The ill effects of stress on health have been observed for centuries. Now we’ve got the hard medical facts to back up that observation. Stress is not just something in your mind; stress means way more cortisol than the body should ever have to deal with.
Is it possible to de-stress? Yes.
Is it possible to de-stress and still live among all the appurtenances of the 21st century. More difficult but … Yes.
Some suggestions:
If you still find it difficult to calm down, there’s this
