STRESS

The Physical Manifestations of Stress

The Physical Manifestations of Stress
Stress is often thought of as a mental condition, because it leads to many physical ailments. For most of us, after a difficult day at work, we sometimes have a hard time trying to sleep. However, the physical effects of stress go far beyond sleep deprivation. In fact, it is estimated that as much as 50-80% of physical disorders are stress-related. Some diseases and symptoms associated with stress include irritable bowel syndrome, ulcers, indigestion, depression, insomnia, infertility, memory loss, decreased immune function, inflammatory conditions such as musculoskeletal pain, heart disease, and weight gain.

This article will discuss some of the physical consequences that can result from being in an agitated emotional state and the natural strategies that can be used to help our bodies cope with stress.

Symptoms associated with Stress

  • Irritable bowel syndrome

  • Ulcers

  • Indigestion

  • Depression

  • Insomnia

  • Infertility

  • Memory loss

  • Decreased immune function

  • Inflammation conditions such as musculoskeletal pain, heart disease, and weight gain

The Physiology of Stress
Stress causes activation of specific physiological pathways. The hypothalamus-pituitary-adrenal (HPA) axis is stimulated as well as the sympathetic and autonomic nervous system. Activation of the sympathetic nervous system increases the secretion of epinephrine and norepinephrine (NE) from the adrenal medulla. HPA axis activation includes release of corticotropin-releasing hormone (CRH) and arginine vasopressin (AVP) from the hypothalamus causing the release of adrenocorticotrophic hormone (ACTH) from the anterior pituitary gland. ACTH stimulates the adrenal cortex to secrete cortisol, the primary glucocorticoid responsible for much of the physical manifestations of stress.

Sleep
HPA axis dysfunction causes various types of sleep disturbance. Hyperactivity of this pathway inhibits sleep and increases awakenings during the night. This may be due to increased nocturnal CRH and NE levels. Increased nocturnal cortisol levels are also found in insomniacs. In addition, fragmented sleep increases HPA axis activity, thus creating a vicious cycle.

Melatonin is the hormone produced nocturnally by the pineal gland and acts as a circadian rhythm and sleep-anticipating signal in humans. In a study of insomniacs age 55 and older, those using melatonin supplementation found improvements in sleep quality, morning alertness, sleep onset latency and reported quality of life. Also, research has shown that in patients with insomnia currently taking benzodiazepines for treatment, concurrent supplementation with melatonin decreased or stopped the need for benzodiazepine treatment.

Recommendations

Mood and Well-Being
Depression is also associated with the malfunction of the HPA axis that occurs during stress. This stress-depression link is confirmed by studies showing that late-in-life depression is associated with both below and above normal levels of cortisol, suggesting sensitivity to any variation in the HPA axis. In addition to depression, stress, by virtue of dysregulation of the HPA axis, is linked to anxiety and panic disorders. Cognitive function is another surprising factor impacted by stress as studies indicate that higher levels of cortisol are associated with decreased cognitive performance including processing speed, eye-hand coordination, executive functioning, verbal memory and learning, and visual memory.

B-complex is necessary to support brain chemistry and stress response, and individuals under stress often need extra B vitamins. B vitamins including pyridoxine (B6), thiamine (B1), and cobalamin (B12) have been shown to modulate the stress response and improve stress-related disease. In addition, thiamine deficiency is associated with memory and learning deficits.

L-theanine, a component of green tea, is one of the best supplements to help promote relaxation. It has been shown to increase alpha-waves in the brain and also supports GABA levels that help balance the excitatory neurotransmitters. L-theanine can work within as little as 30 minutes.

Recommendations

Digestive System
Elevated stress is associated with several digestive complaints such as irritable bowel syndrome (IBS), stomach ulcers, and changes in appetite. Studies indicate that individuals with IBS have elevated cortisol as well as increased pro-inflammatory markers. These patients show an exaggerated cortisol and ACTH response to CRH. This exaggerated ACTH response means that in individuals with IBS, the adrenal cortex is secreting excessive amounts of cortisol. Individuals with IBS also exhibit increased urinary norepinephrine and epinephrine levels.

Lactobacillus, a probiotic in the intestines that has been found to be important for metabolizing food, absorption of nutrients, and preventing colonization by pathogenic bacteria, can help safeguard the digestive tract from the negative effects of stress. One study showed that supplementation with lactobacillus in children with IBS decreased pain after 4 weeks. In an additional study, individuals with IBS were given a probiotic supplement and evaluated over 6 months. In the treatment group, symptoms including pain, flatulence, distension, and rumbling decreased by 42 percent. Furthermore, supplementations with digestive enzymes which are important in the proper breakdown and absorption of nutrients in food, have been shown to decrease digestive complaints such as abdominal pain and pressure, nausea, and flatulence.
Physical and psychological stress can also induce stomach and duodenal ulcers. Research has demonstrated that individuals with duodenal ulcers have sympathetic-adrenal systems that exhibit elevated sensitivity to environmental stressors.

Recommendations

Musculoskeletal System
Musculoskeletal pain - aches that occur in the bones, joints and muscles - and inflammation may also be stress-induced. Studies have shown increased work-related stressors are related to musculoskeletal pain. Additional studies have shown a correlation between increased depressive symptoms and reported stress with neck/shoulder pain and low back pain in adolescents. Other researchers have demonstrated that perceived stress is correlated closely with the complaint of musculoskeletal symptoms such as shoulder and low back pain.

Glucosamine sulfate and chondroitin sulfate are commonly used to moderate the symptoms associated with osteoarthritis such as joint pain. Numerous studies have reported symptomatic relief in osteoarthritic symptoms when subjects were supplemented with glucosamine sulfate and chondroitin sulfate. Additionally, Methylsulfonylmethane (MSM) has been shown to modulate pain and physical impairment in individuals, particularly those with osteoarthritis. When bone, joint and muscle pain is the result of stress, anti-inflammatory nutrients can offer an additional means of support.

Recommendations

Ways of Managing Stress

  • Make an effort to avoid negative thoughts and avoid people who stress you out or people who influence you negatively. Go out more often with supportive friends and family and have fun!

  • Take a mini retreat every now and then to unwind yourself and engage in favourite hobbies or interest.

  • Say No. Do not overload yourself with more than you can handle. Be it with work or personal life, know your limits and say no.

  • Avoid topics or environmental triggers that stress you.

  • Exercise. Find a buddy to exercise with to make exercise more fun! This will encourage you to keep motivated and enjoy the exercise.

  • Learn relaxation techniques such as meditation or simple breathing exercises. Or simply listening to music!

  • Time management. Learn to create a balanced schedule, do not over-commit and try to delegate responsibility to others.

  • Laugh at yourself. Keep the sense of humor and the ability to laugh at yourself. Laughing is a good way to relax.

  • Adopt a healthy diet. Reduce caffeine and sugar as the temporary ‘high’ provided will soon crash with a dip in energy and mood.

  • Avoid drugs, alcohol and cigarettes. Alcohol or drugs may provide an easy escape from stress, but the relief is only temporary. Do not avoid problems, instead face them head on and deal with them with a clear mind.

  • Sleep. Inadequate sleep and feeling tired will increase your stress and may cause you to think irrationally. Sufficient sleep fuels your mind, as well as your body.

References

  • Randolfi EA. Developing A Stress Management And Relaxation Center For The Worksite. Worksite Health. 1997 Summer; Vol.4, No. 3, 40-44.

  •  Buckley TM, Schatzberg AF. On the interactions of the hypothalamic-pituitary-adrenal (HPA) axis and sleep: normal HPA axis activity and circadian rhythm, exemplary sleep disorders. J Clin Endocrinol Metab. 2005 May;90(5):3106-14.

  • Wade AG, Ford I, Crawford G, McMahon AD, Nir T, Laudon M, Zisapel N. Efficacy of prolonged release melatonin in insomnia patients aged 55-80 years: quality of sleep and next-day alertness outcomes. Curr Med Res Opin. 2007 Sep 14; [Epub ahead of print].

  •  Gluck ME, Geliebter A, Lorence M. Cortisol stress response is positively correlated with central obesity in obese women with binge eating disorder (BED) before and after cognitive-behavioral treatment. Ann N Y Acad Sci. 2004 Dec;1032:202-7.

  •  Gluck ME, Geliebter A, Hung J, Yahav E. Cortisol, hunger, and desire to binge eat following a cold stress test in obese women with binge eating disorder. Psychosom Med. 2004 Nov-Dec;66(6):876-81