Conditions Made Worse by Stress
Published January 2020
From Heart Ailments to Gastrointestinal Issues
Stress is a natural response triggered by your body’s survival instinct. When you experience stress, your body’s resources are engaged to initiate a fight or flight response in order to survive external threats. While not all stress is bad, says Northwestern Medicine Internal Medicine Physician Catherine C. Cheng, MD, FACP, the fight or flight response can have serious implications when prolonged. Here Dr. Cheng explains how chronic stress can impact your health and what you can do about it.
Types of Stress
In general, there are three types of stress:
- Fight or flight stress. This is a survival instinct meant to occur in seconds to minutes, not days, weeks or even decades. The response includes elevated blood pressure, increased coritsol production and narrowed mental focus, and it’s all about survival.
- Challenge stress. Dr. Cheng likens this type of stress to what athletes feel before competition. While the heart rate might go up, mental focus is alert and agile.
- Tend-and-befriend response. This is a positive, biobehavioral stress response. When faced with adversity, this response drives you to connect with people with whom you have a relationship, like family or friends.
It’s common to experience all kinds of stress, and each one impacts the body differently. Dr. Cheng suggests creating a pie chart to help you reflect on the type of stress dominating your life. This can help you better identify and manage stress.
How Stress Impacts Health
Not all sources of stress are evident. Some sources are unconscious, like emotional threats. Conscious or unconscious, a prolonged stress response can take its toll. For example, chronic stress can cause you to lose sleep, which can alter your glucose metabolism or make you more irritable, which each have their own cascade of negative effects. “It’s so complex and simple at the same time. It’s all intertwined,” explains Dr. Cheng.
Below are common ways stress can impact health.
It’s so complex and simple at the same time. It’s all intertwined.— Catherine C. Cheng, MD, FACP
1. Heart health.
When your body releases adrenaline in response to stress, it causes your breathing and heart rate to speed up. This can increase what’s known as systemic vascular resistance.
“Your heart is a pump, connected to pipes that are flexible. The flow through the pipes can be wide open or constricted. Threat stress makes your heart beat faster and harder, but can constrict vessels, which contributes to blood pressure rising,” Dr. Cheng explains.
Under chronic threat stress, your heart begins to adapt to the increased demands. It becomes hypermuscular and stiff. The chambers where blood enters become constricted. When this occurs, your heart’s efficiency goes down with every pump.
Threat stress also has hormonal and metabolic consequences. Some people under stress tend to eat more, and their overall glucose may increase. One possible downstream effect of this is the thickening of the artery walls, known as atherosclerosis. Elevated glucose also correlates with other serious conditions, such as obesity and diabetes. All of these conditions increase your risk for cardiac complications.
2. Mental health.
For some, chronic stress also increases the risk for developing depression and anxiety.
“If you are a person who is easily agitated and tends towards anxiety, then you may be more likely to be affected by adversity as opposed to a person who is happy-go-lucky,” explains Dr. Cheng. “There’s a saying in neurology and psychology: Neurons that fire together wire together.”
In other words, if you’re doing similar actions, you’re reinforcing neurologic information. For example, if you’ve had negative experiences with a dog in the past, you may also be more likely to associate that with negative experiences moving forward.
On the other hand, external factors, such as poverty, violence, and financial or food insecurity, may also complicate the stress response, triggering anxiety, depression and feelings of hopelessness, says Dr. Cheng.
3. Gastrointestinal health.
Conditions like heartburn or irritable bowel syndrome (IBS) are widely understood to interact with your sense of health and well-being. Chronic stress can trigger acid reflux, gastritis and peptic ulcer disease.
On the other hand, IBS is thought to be a functional condition, not caused by a specific mechanism. This means the mainstay of treatment is mind and body. Dr. Cheng suggests stress management, mindfulness and cognitive behavioral therapy can help improve symptoms.
“In the case of IBS, I think of it as nonphysical phenomena manifesting in a physical way that can be extremely disruptive,” says Dr. Cheng. “It’s something patients live with that impairs quality of life, and often it’s very much correlated with threat stress.”4. Tension headaches and migraines.
Mental and emotional threat stress can often result in musculoskeletal symptoms, like neck and shoulder tension and pain. Individuals may grind their teeth or clench their jaw. This type of stress also often correlates with tension headaches, which are usually in the back of the head, or come around above the ears and across the temples to the forehead.
“This tightness or pressure can trigger a migraine headache for those susceptible,” says Dr. Cheng. “This can cause debilitating chronic pain, as well as sensitivity to light, noise, nausea and vomiting.”
What to Do
If you experience chronic stress, Dr. Cheng suggests focusing on your resilience practices. “This helps you identify your strengths,” she explains. “And when you are aware and mindful, you can protect the time for those practices.” Some examples may include exercising, spending time with friends or, for those who are more introverted, spending time alone. Then, find out how you can incorporate more of those activities into your routine.
Find other ways to stress less. Your heart, mind and body will thank you.