Stress: What it Does (more than you think!) & How to Manage It

Contents

• What is stress

• Good stress and bad stress

• Illnesses associated with a faulty stress response: overactive stress response & underactive stress response

• Factors influencing response to stress

• What you can do

• How osteopathic manipulative treatment can help

What is stress

Stress is defined as how we interact with real or perceived demands(1). When used correctly our body’s response to stress (stress response) releases hormones and stimulates nerves that gives us energy and stops aches and pains. It gives us that ‘get up and go’ to overcome life’s obstacles. However when our body’s response to stress is too little or too much psychological and physical disease follows.

Unless the stress is extreme your body gets used to the same forms of stress and responds in an appropriate calm manner(2). When exposed repeatedly to different types of stress your body can’t get used to it. Your stress response remains high every time you’re exposed to the stress and your body may even amplify this stress response far more than it has to(2).

Good stress and bad stress

In the short term when used correctly our stress response is beneficial as it enables us to cope and adapt to daily changes and gives us energy. By overcoming stressful experiences we learn valuable lessons to cope with life’s obstacles so they don’t wear us down. This enables us to deal with stress and lead a healthy happy lifestyle.

An incorrect stress response or repeated stress promotes wear-and-tear on the body and brain. It affects our behaviour, alters how we understand things and has a deteriorating affect on our body. It visibly ages both our brain and body. As a side effect it commonly leads to other negative lifestyle changes such as poor diet, lack of exercise, increase alcohol consumption, etc. This all has a negative effect on our health.

Illnesses associated by a faulty stress response: overactive & underactive stress response

The correct amount of stress dealt in the correct way is fine. However too much stress, along with other genetic and lifestyle factors affects your chances of developing illness. So stress can cause high blood pressure but this is more likely in someone sedentary than physically fit. Some authors(3) have questioned the validity of the stress response in psychiatric disorders.

Overactive stress response

With an overactive stress response our body is constantly anxious and primed. The increased stress hormones lowers our immune response so we get more prone to infections and affects the health of the nerves in the brain. Illnesses from an overactive stress response include:

• Cardiovascular disease: High blood pressure which can cause high cholesetrol, strokes and heart problems(1).

• Digestion: By affecting the structure of the gut, how the gut moves and the bacteria in the gut stress can give heart burn, stomach ulcers, irritable bowel syndrome and possible food allergies(4).

• Metabolic disorders: Abdominal obesity (fat tummy)(1). High blood sugar and high insulin levels(5). This in itself predisposes to cardiovascular disease.

• Immune response: Stress hormones stop our immune cells from fighting infection(6). When we get stressed we get more prone to infections.

• Learning and memory: An increase in stress hormones decreases our ability to learn and remember especially in the elderly(2). Prolonged exposure to stress hormones have been linked with dementia by killing off nerve cells in the brain(2).

• Bones: Weakens the bones(5).

• Psychiatric: Major depressive disorder(11).

• Ageing: Stress visibly ages the brain(1) and the body(7). There has also been a possible link to this and facilitating cancer growth(7).

Underactive stress response

If we had no stress hormones in our body we’d be permanently tired, have no energy and our body would be constantly inflamed and painful. The illnesses associated with an underactive stress response are:

• Post traumatic stress disorder(2)

• Chronic fatigue syndrome(1)

• Fibromyalgia(1)

• Conduct disorder(3)

• Immune cells (cytokines): When the body senses these immune cells fighting infection and causing inflammation – which is what we need them to do - it releases a stress hormone to calm down and moderate this response. When this doesn’t occur we get an overactive immune response where immune cells attack our own body giving inflammation and pain(6). Therefore a lack of a stress response can make rheumatoid arthritis and lupus symptoms worse(8). These immune cells have been linked with mood, anxiety, depression and learnt helplessness(8). Therefore if we don't have enough stress hormones they can't protect us against this.

 Factors influencing response to stress

• Sex: Oestrogen can fight against the effects of stress hormone(5). Oestrogen can fight against the good effects of stress hormone e.g. by making inflammation and pain worse(8) as well as the bad effects of stress hormones e.g. by protecting nerve cells that get damaged by stress hormones(5).

• Age: As we get older our stress hormones naturally rise. These higher stress hormones are associated with a mental decline in the elderly(1). Stress visibly ages the body as well which is possibly associated with facilitating the growth of cancer cells(7).

• Genetics: Aspects of the stress response can be passed down.

• Cumulative stress exposure: Intense or too frequent stress responses ‘wears out’ your stress coping mechanisms. This means they have to work harder to cope with stress which intern wears them out quicker.

• Childhood experiences: Appropriate stress in childhood teaches a healthy and appropriate stress response to situations when older(1). If you’ve had inappropriate stress, or response to stress, when younger it teaches you to activate these same physical reactions, feelings and thoughts later on in life. These responses maybe out of context to the current day situation and promote a faulty stress response and ill health(9)

• Babies: Babies who had treatment in Neonatal Intensive Care Units (NICU) experience an immediate(10) and long-term impact on their stress and anxiety responses as well as response to pain. This is due to the effects of the stress hormones they release and the inflammation from any procedures(8). Although there are minor changes that can occur to the nervous system during Neonatal procedures no medical procedure should be turned down as a healthy lifestyle over the years will alter any minor changes that can occur to the nervous system.

What you can do

Don’t get stressed about trying to lower your stress response else it won’t work! There’s always something you can do just relax and try not to take it too seriously and make some simple lifestyle changes. Here’s just a few ideas:

• Retrain your stress response: A stress response can be amplified by emotional associations. We may dread a particular scenario due to anticipated anxiety, associations to previous traumatic episodes, feeling a likelihood of risk than what actually exists, etc. Retraining our stress response entails breaking down a situation on paper in terms of risks and likelihood of risk and comparing it to other situations where we don’t feel as anxious. When we can look at a situation in an emotionally detached way it allows us to pragmatically appraise a situation for what it is rather than what we emotionally perceive it to be. This lowers our stress response and helps retrain it for future situations.

• Aerobic exercise e.g. brisk regular walking: not only does this increase the size of the brain to help manage the stress response. It also helps with memory and learning(1).

• Social interaction and support: People who experience loneliness and deficient or broken social relationships have a compromised stress response. Social relationships have been shown to affect longevity and health(1).

• Pharmaceuticals: Your GP can prescribe antidepressants and anti-anxiety medication.

• Cognitive behavioral therapy (CBT): Not only can successful CBT help manage the stress response but in chronic fatigue syndrome it can change the structure of the brain in the same way as physical activity(1).

• Breathing: Our previous blog gave advice on breathing for pain, anxiety and digestive problems.

How osteopathic manipulative treatment can help

Osteopathic manipulative treatment aims to reduce the chronic stress held in your body by reducing pain and inflammation. By releasing areas of tension that people tend to ‘hold’ when they get stressed for example holding your shoulders tight when you're anxious can help make you more comfortable and lower levels of chronic stress.

References

(1) Central role of the brain in stress and adaptation: Links to socioeconomic status, health, and disease (2010). McEwan B & Gianaros P

(2) Regulation of the hypothalamic-pituitary-adrenocortical stress response (2016). Herman J et al.

(3) Associations between DSM-IV diagnosis, psychiatric symptoms and morning cortisol levels in a community sample of adolescents (2012). Robert Young, Helen Sweeting, and Patrick West.

(4) Stress and the gut: pathophysiology, clinical consequences, diagnostic approach and treatment options (2011). PC Kontureki, T Brzozowski, SJ Kontureki

(5) Actions and interactions of estradiol and glucocorticoids in cognition and the brain: Implications for aging women (2015). Alexandra Ycaza Herrera and Mara Mather

(6) Immune Modulation of the Hypothalamic-Pituitary-Adrenal (HPA) Axis during Viral Infection (2005). MARNI N. SILVERMAN, BRAD D. PEARCE, CHRISTINE A. BIRON, and ANDREW H. MILLER

(7) Cellular stress response pathways and ageing: intricate molecular relationships (2011). Nikos Kourtis and Nektarios Tavernarakis

(8) Neuroimmune mechanisms of stress: sex differences, developmental plasticity, and implications for pharmacotherapy of stress-related disease (2015). Deak T et al

(9) TA today. A new introduction to transactional analysis (2009). Stewart I & Joines V. p 111

(10) Pain-related stress in the Neonatal Intensive Care Unit and salivary cortisol reactivity to socio-emotional stress in 3-month-old very preterm infants (2016). Provenzi L et al

(11) The Hypothalamic-Pituitary-Adrenal Axis in Major Depressive Disorder: A Brief Primer for Primary Care Physicians (2001). Varghese F & Brown E .