HEALING FROM STRESS
Stress disrupts inflammation balance and triggers both protective and damaging responses by the immune system. By Monica Aggarwal, MD, and Jyothi Rao, MD
WE NOW KNOW that imbalance in our bodies can cause illness. Now, let’s understand which factors create imbalance in the first place. Imbalance is prompted by stress and can be brought on by an injury, anxiety, toxins we ingest, lack of activity, and many more triggers.
The powerful effect of stress on your body is the most important concept that we will relay to you, because if you recognize how stress works, you can then start the healing process. The term stress was coined in the 1950s by Hans Selye, MD, a pioneer in the field of endocrinology. Some consider him the first researcher to examine the biological impacts of stress and the connections between the mind and body. He defined stress as a body’s response to a demand for change. Stress can be emotional, mental, physical, chemical or environmental. It can be a physical reality or created in our minds, but in either case it sets off a fixed reaction in our bodies. Dr. Selye broke down stress into eustress and distress.
Eustress is good stress driven by positive anticipation, such as when we are expecting a child, starting a new job, or planning a vacation. It refers more to the way our body reacts to stress. It gives us good coping skills and makes our senses hyperacute. Distress, on the other hand, is negative stress and triggers inflammation and oxidative stress. Distress occurs when we suffer the loss of a child or spouse, termination of a job, or divorce. Both situations demand that the body change.
Dr. Selye was a pioneer because he saw the connection the mind has over the body. He formed our current thinking around general adaptation syndrome, the ways in which our bodies cope with stress. During times of changing environment or a perceived threat, our acute stress response is adaptive and allows us to cope and respond appropriately to survive the stress. An acute stress response in healthy individuals is a good thing. It is a normal process, and it is protective.
In acute stress response, we see activation of the nervous system and the cardiovascular, endocrine, and immune systems. The goal of the stress response is to release resources for the body to make energy for immediate use. The body also starts to allocate these resources to specific organs and shuts down resources to other organs to help conserve energy.
When our senses perceive a threat, the autonomic nervous system is triggered. The two major components of the autonomic nervous system are referred to as the sympathetic and the parasympathetic nervous systems. These systems are regulated by neurotransmitters, or chemical signals, which communicate to the nervous system to set off a chain of responses. They work in balance to affect many systems of the body, such as the heart, eyes, stomach, and genitals. The sympathetic nervous system (SNS) is also called our fight-or-flight system. The SNS triggers the release of neurotransmitters, such as epinephrine and norepinephrine, which then signal the cardiovascular system to increase blood pressure and heart rate. The heart pumps faster and gets blood to all essential organs more quickly, so the body is ready for whatever comes its way. It also suppresses gut motility and the urge to urinate. Simultaneously, the parasympathetic nervous system (PNS), our rest and digestive system, is suppressed. This system is responsible for lowering blood pressure, lowering heart rate, and improving gut motility. When there is an acute stressor, activities not essential for immediate survival, such as digestion, growth and reproduction are suspended.
Another major pathway that becomes activated when stress is perceived comes when a signal in our brain triggers the release of cortisol (from the adrenal gland, the stress response center). Cortisol has two main jobs. The first is to help make energy. It is responsible for breaking down fat (lipolysis) and making sugar from storage sources (glycogenolysis). It also mobilizes fat from the periphery to the center to prepare it for use. Its second job is to regulate the immune system. Without overwhelming ourselves here with how immunology works, the role of cortisol is to balance inflammation with anti-inflammation. Our acute stress response allows for an increase in white cells– the infection fighters (macrophages and natural killer cells) that go into tissues, such as our skin or other organs, and act as protection against those cells most likely to suffer damage during an insult. Our immune system recruits chemicals in our blood to help fight against new trauma, infection, or injury.
One of the benefits of cortisol in acute stress is that it suppresses our pain response. When we are being chased, we cannot worry about the pain in our muscles or minor injuries. This is a protective benefit. It allows us to run despite injury. Cortisol is also known to be a catabolic hormone, which means it breaks down parts of our body, such as our muscle and bone, to provide nutrients to help us weather a stressful time. Again, when we are running from a tiger, we need all of the energy we can muster to save our lives. Cortisol is responsible for keeping us moving in times of stress.
People often ask whether cortisol is good or bad. Cortisol levels are a measure of stress. They are cyclic in the body. When we first wake up in the morning, our cortisol levels are at their highest. It is believed that those high amounts are needed then to mobilize our bodies for the day. A way to think about cortisol is that it gives us our “get-up-and-go” and allows us to be prepared for whatever the day holds. In a healthy state, these levels gradually decrease during the day. However, in times of external stress, cortisol levels shift, and they become elevated at times when they would normally decline. This is necessary to activate our fight-or-flight response, to mobilize energy, and allow us to meet the demands of a stressful day. Imagine a mother watching her child in a park and she witnesses him falling from the monkey bars. She sees her child on the ground, crying in pain and unable to walk. Her alarm phase kicks in, and she is mobilized to her child help. We can see then that the stress response is extremely important.