Stress

Stress: Overview

A hereditary vulnerability and concerns such as economic or political uncertainties, a decreasing quality of life, looming unemployment, and fear of old age or abandonment has led to a general increase in persons who report stress.  Other contributing factors include insufficient regular leisure or physical activity, poor diet, an inadequate family structure and lack of a support network.  These personal, social, economical and dietary factors interact with biological factors to make stress a leading cause of ailments, from a simple heartburn to a decrease in immune responsiveness, and from this to cancer and other diseases.

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In the past few decades a large body of research has confirmed a connection between stress and disease, and between stress management and a reduced risk of, or reduced morbidity and mortality from, certain diseases.

One of the pioneers of modern stress research, the physician/physiologist Hans Selye, was the first to invoke the concept of a physiological response to a wide variety of stressors, both psychological and physical.  He coined the term 'general adaptation syndrome' (GAS) to describe the physiological process by which the organism responds to stressors and attempts to re-establish homeostasis.  The syndrome consists of three phases: alarm, resistance and exhaustion.

During the alarm stage the organism detects a stressor and responds with activation of the sympathetic nervous system and adrenal medulla, the so-called 'fight or flight reaction' during which the body's defenses are mobilized.  The second stage, resistance, recruits the pituitary-adrenocortical axis to permit the organism to achieve optimal adaptation and maintain homeostasis.  Exhaustion results when the organism depletes its adaptive resources and may give rise to disease or even death.

Selye identified 'diseases of adaptation' which include, amongst others, hypertension, cardiovascular disease, kidney disease, peptic ulcer, hyperthyroidism and asthma.

Treatment and Prevention

When organic disease is already installed as a result of stress – be it a simple gastritis, a cardiac or lung disease, asthma, allergies, or any suspected stress-related condition – it is important to seek medical help as soon as possible.  Specific treatment may be required for these ailments.  Simple changes such as more exercise, improving nutrient status, making more free time, or changes in life habits may be enough to resolve the problem.

Treatment should involve taking time enough from your schedule to evaluate your life and priorities.  Take time to reflect about your choices, your social and family life, work, study and even financial conditions.  A stressed-out person should rethink their life, mostly by identifying the sources of stress and make efforts to resolve them.  Wise counseling can be very helpful.

Complications

When you are under stress, cortisol may literally be eating away at your muscle-building potential.  An excess of cortisol can lead to a progressive loss of protein, muscle weakness, atrophy, and loss of bone mass through increased calcium excretion and lower calcium absorption.

Signs, symptoms & indicators of Stress:

Lab Values - Cells

Lab Values - Common

Symptoms - Bowel Movements

Symptoms - Cardiovascular

Symptoms - Food - General

Symptoms - Food - Preferences

Symptoms - Gas-Int - General

(Excessive/severe) flatulence

Gas can be caused by stress and the nervous habit of frequent swallowing.

Symptoms - General

Symptoms - Hair

(Recent) oily hair

Stress can cause hair to lose its shine and become greasy and sticky.

Symptoms - Head - Mouth/Oral

Symptoms - Metabolic

Symptoms - Mind - Emotional

Symptoms - Mind - General

Paying great/paying poor attention to detail

Not only can poor attention to detail be a sign of stress, but so can its exact opposite, being a perfectionist.

Symptoms - Muscular

(Slight/severe) eyelid twitch

These twitches are a spasm of the motor nerves that control the eyelids.  They are harmless and quite common, and have no medical significance.  Although their cause is not fully certain, it is widely believed that stress is a significant contributing factor.  Eyelid twitches usually go away without treatment after a short period of time, but to speed this process you should try to reduce stress.

Symptoms - Reproductive - Female Cycle

Symptoms - Reproductive - General

Symptoms - Skeletal

(Slight) stiff neck

Stress can cause the neck muscles to tighten and become stiff.

Symptoms - Sleep

Occasional/regular/frequent bizarre dreams

It is believed that when a person is stressed, the brain has difficulty processing all the information that it picks up during the day.  It continues to process during the night, which in turn can lead to weird dreams.

Conditions that suggest Stress:

Allergy

Autoimmune

Ulcerative Colitis

Long term stress increases the risk of Ulcerative Colitis flare-ups, according to a study by Susan Levenstein, MD, at the Nuovo Regina Margherita Hospital in Rome.  [American Journal of Gastroenterology, May 2000]

Circulation

Atherosclerosis

Circulation, the journal of the American Heart Association, reports on a study that has correlated the degree of carotid arterial atherosclerosis with exaggerated response to mental stress in men under the age of 55.  Patients whose blood pressure responses to stressful situations were the strongest were found to have significantly more advanced atherosclerosis in the carotid arteries than those whose blood pressure responses were less salient.

Although researchers are careful not to say that stress causes atherosclerosis, the evidence clearly points to cardiovascular reactivity to stress as an atherosclerotic risk factor of the same magnitude as smoking, hypertension, insulin resistance, and elevated cholesterol levels.  The hypothesis is that, "Frequent and prolonged periods of elevated blood pressure during mental stress may promote mechanical injury to the endothelial lining or cause release of hormones that can promote the build up of plaque." [Circulation Vol. 96, No. 11: pp. 3842-3848]

Moscow scientists stated in October, 2000 that they have shown atherosclerotic plaques in blood vessels are formed because of adrenaline, a hormone that releases during stress.

Coronary Disease / Heart Attack

Stress may increase magnesium excretion and the resulting temporary magnesium depletion may make the heart more sensitive to electrical abnormalities and vascular spasm that could lead to cardiac ischemia.

Poor/Slow Wound Healing

Studies have shown that stressed individuals often exhibit significantly delayed wound healing.

Dental

Bruxism (Clenching/Grinding Teeth)

Teeth-grinding is often stress-related.

Periodontal Disease - Gingivitis

Research demonstrates that stress can make it more difficult for the body to fight off infection, including periodontal disease.  [Journal of Periodontology July 1999]

Digestion

Gastric/Peptic/Duodenal Ulcers

In general the duodenum isn't as well protected with mucus as is the stomach and is more prone to ulcers.  A deficiency of pancreatic juices to neutralize the acid chyme from the stomach, or stress causing sympathetic inhibition of enzyme secretion can lead to duodenal ulcer formation.

Constipation

In a study of 34 women with chronic constipation, investigators led by Dr. Anton Emmanuel and colleagues at St.  Mark's Hospital in Middlesex linked emotional distress with changes in the nerve pathway that helps control gut function.  They say the findings suggest a specific path through which psychological factors directly influence the digestive system.

The researchers compared the patients, who had suffered bouts of constipation for an average of 21 years, with a group of women with no history of gastrointestinal illness.  All took standard tests that measure psychological symptoms such as anxiety and depression, self-image, social functioning and ability to form intimate relationships.

Women with chronic constipation were more likely than healthy women to report anxiety, depression and feeling less "feminine".  They also found it harder to form close relationships.  [Gut Aug 2001;49: pp.209-213]

General

Hormones

Night Eating Syndrome

Nighttime eaters have elevated levels of the stress hormone cortisol during almost all hours of the day, suggesting that they suffer from the effects of chronic stress in their daily lives.

Low DHEA Level

Stress accelerates the loss of DHEA.

Progesterone Low or Estrogen Dominance

Stress increases cortisol production; cortisol blockades (competes for) progesterone receptors.  Additional progesterone is required to overcome this blockade.

Low Melatonin Level

Chronic stress causes the production of too much cortisol, which in turn lowers melatonin.

Immunity

Weakened Immune System

Studies show that stress and depression affect the body physically and can weaken the immune system.  Suppressor-T cells, also known as CD8 cells, are part of the immune system.  Studies by Manuck et al in 1991 showed that psychological stressors induced cell division among CD8 cells, thereby increasing the number of CD8 cells and suppressing immune function.  However, this response was only seen in those subjects who also showed high heart rate change and catecholamine change during the stressors i.e. those people who are significantly affected by stress.

Infections

Lab Values

Elevated Cortisol Levels

People under stress produce high levels of the hormone cortisol, which wreaks havoc on the body.

Laboratory Test Needed

Elevated Insulin Levels

One of cortisol's undesirable effects is that it contributes to insulin resistance by decreasing the rate of glucose uptake, probably by blocking the insulin receptor.  [J Clin endocrinol Metab 54 (1982): pp.131-8]

Mental

Metabolic

Problems Caused By Being Overweight

Some people respond to stress by eating.  "Stress Eaters" use food as a drug to deal with external stressors such as work, deadlines or finances.  Carbohydrates are often the craved foods because they increase levels of serotonin in the brain, which has a calming effect and helps induce sleep.  Stress Eaters often use candy, cookies, pretzels, etc.  on the job to relieve stress and are unaware of the reason behind it.  A habit of eating in response to stress may lead to obesity.

Tinnitus

Many people say their tinnitus is worse when they are tired or stressed.

Musculo-Skeletal

Muscle Cramps / Twitching

Small muscle twitching, usually called "tics", are often triggered by stress and anxiety.

Nervous System

Nutrients

Zinc Requirement

Levels of zinc and other trace minerals were determined in 66 men before and after a five-day period of sustained physical and psychological stress.  Zinc levels decreased by 33% on average.

Magnesium Requirement

Stress may increase magnesium excretion.

Respiratory

Skin-Hair-Nails

Symptoms - Female

Cysts in breasts

Suppressed, emotional stress is linked to breast cysts.

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Risk factors for Stress:

Childhood

(Severe) sexual abuse during childhood

One study showed that an average adult female is 6 times more sensitive to stress if she was sexually molested as a child.

Lifestyle

Mental

Personal Background

Symptoms - Female

History of cysts in breasts

Suppressed, emotional stress is linked to breast cysts.

Symptoms - Food - Intake

Symptoms - Mind - Emotional

Counter-indicators

Symptoms - Skeletal

Stress can lead to:

Habits

Hormones

Low Melatonin Level

Chronic stress causes the production of too much cortisol, which in turn lowers melatonin.

Night Eating Syndrome

Nighttime eaters have elevated levels of the stress hormone cortisol during almost all hours of the day, suggesting that they suffer from the effects of chronic stress in their daily lives.

Laboratory Test Needed

Elevated Insulin Levels

One of cortisol's undesirable effects is that it contributes to insulin resistance by decreasing the rate of glucose uptake, probably by blocking the insulin receptor.  [J Clin endocrinol Metab 54 (1982): pp.131-8]

Metabolic

Tinnitus

Many people say their tinnitus is worse when they are tired or stressed.

Problems Caused By Being Overweight

Some people respond to stress by eating.  "Stress Eaters" use food as a drug to deal with external stressors such as work, deadlines or finances.  Carbohydrates are often the craved foods because they increase levels of serotonin in the brain, which has a calming effect and helps induce sleep.  Stress Eaters often use candy, cookies, pretzels, etc.  on the job to relieve stress and are unaware of the reason behind it.  A habit of eating in response to stress may lead to obesity.

Recommendations for Stress:

Botanical

Habits

Aerobic Exercise

Regular exercise can help reduce elevated levels of hormones (such as cortisol) that are associated with chronic stress.

Hormone

Melatonin

Melatonin can protect against stress by controlling overproduction of the stress hormone cortisol.

Lab Tests/Rule-Outs

Test Zinc Levels

Zinc has been shown to counteract some of the adverse effects of stress.

Mineral

Nutrient

DHA (docosahexaenoic acid)

A study performed on Japanese students during the high stress period of final exams showed that students supplemented with DHA were significantly less aggressive than students who were not supplemented with DHA.  Aggression is one of many manifestations of stress along with others such as irritability, defensiveness, being critical, irrationality, overreaction and reacting emotionally.

Another small study found that the effects of DHA may be applied to people under long-lasting psychological stress to prevent stress-related diseases.  [Journal of Nutritional Science and Vitaminology 45(5): pp.655-65.  Oct 1999]

Physical Medicine

Calming / Stretching Exercises

Many people who practice yoga say they experience a "freeing of the mind from mental disturbances", a "calming of the spirit", or a "steadying of the mind" with associated reduction of nervousness, irritability and confusion, depression and mental fatigue.

Reflexology

Reflexology assessment takes place as stress cues are evaluated.  Stress cues are parts of the foot or hand that shows adaptation to stress.  Adaptation is shown by visual signs such as callusing, knobby toes or bunion.  Indications of stress are also seen as sensitivity to technique application or touch signs perceived by the reflexologist as technique is applied.  The assessment of such stress cues allows the reflexologist to target areas of stress and to design a session of pressure technique application appropriate to provide relaxation specific to the individual.

Psychological

Vitamins

Vitamin B-Complex

There is evidence that high doses of B-complex vitamins in humans can reduce the immune-suppressing effects of stress.  [Ann NY Acad Sci 1990;585: pp.513-5]

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