Stress adds up, the body keeps score

How the physical body holds the consequences of lifestyle factors

Introduction

There are several health determinants that drive both our overall well-being and vulnerability to injury and disease. Our ability to adapt not only to our physical training, but to lifestyle stressors is driven by a variety of behavioral, biological, socioeconomic and environmental aspects. Several of these factors are outside of our control. But our reaction to them is ours to decide, and can impact how susceptible we are.

Physiology Basics

The body’s response to stress is an attempt to re-establish cell homeostasis. Stress hormones trigger a response that is carried out by several different pathways in the body. In the short term, there is the activation of the sympathetic nervous system and the behavioral fight or flight response. In the long term, stress is regulated by the hypothalamic-pituitary-adrenal (HPA) system. The main player in the stress battle is cortisol. “Cortisol is one of the glucocorticoid hormones, which are steroid hormones synthesized from cholesterol. The inactive form, cortisone, is catalyzed to its active form, cortisol, by 11 beta-hydroxysteroid dehydrogenase 1. The HPA axis controls the release of glucocorticoids into the bloodstream.”1 These systems are balancing out the hormones that got shifted out of its natural state. Stress decreases function in every system of the body. Systematically, inflammation is a protective factor against stress, and sure comes in handy when we sprain an ankle and we need the body to protect the injury! But overtime this chronic inflammation is an entirely different beast.

Physical Consequences

When stress continues and becomes chronic, the body attempts to adapt but can’t keep up with the stress, trapped in a consistently active sympathetic nervous system causing several issues physically. Because stress causes a fight or flight response, the functions that can only occur in the parasympathetic nervous system (a state of rest and digest), somatic (physical) symptoms will be different for everyone depending on how your body reacts. Stress will increase blood pressure, heart rate, and glucose levels, putting you at a greater risk of a heart attack, atherosclerosis, and stroke, as well as obesity and diabetes. It is very common to experience tight muscles, body aches, and tension headaches. Digestion will be less efficient because it’s not a priority in a fight or flight response, so there could be stomach aches and nausea. Chronic stress can, impair fertility, menstruation, and sex hormones, making it difficult to have a normal cycle or conceive. The immune system is also significantly decreased making the body more susceptible to infections and much harder to recover from sickness and physical activity.

Mental Consequences

Psychological stress does more damage than previously thought, you can’t just suck it up and move on. We have to find ways to decrease stress and heal. Chronic and even mild inflammation creates a fast track to stress-related disease (obesity, heart disease, Alzheimer’s, diabetes, depression, etc.).

Depression is deeply connected to the physiological responses to stress. Typical sickness behavior like social withdrawal, decreased physical activity, fatigue, somnolence, mood and cognitive changes are too often perceived as a choice rather than a biological response. These symptoms are caused by the proinflammatory cytokines trying to force the body to prioritize the immediate needs over the long-term body processes. “In the case of chronic inflammation that may set in with prolonged stress, persisting cytokine signaling in the brain prevents the resolution of sickness behavior that consequently can degenerate into depression. The biochemical mechanisms underlying cytokine-induced depression are not well defined, but they may involve alterations of serotonin and glutamatergic transmission, and induction of GC resistance”2 Diagnosed depression is not a lazy choice. It is a physiological response to trauma, abuse, neglect, grief and loss, excess stress, chemical imbalances, etc.

Anxiety is another unfortunately common condition that stress causes. Short term anxiety is normal and healthy, like when we are nervous before a job interview or anxious right before a competition. But prolonged stress and trauma can cause extreme anxiety and the inability for the body to cope. This can lead to panic attacks, obsessive-compulsive disorder, and post traumatic stress disorder.

Physiotherapy

Life throws us many things that are out of control, but your ability to recognize the specific effects and manage them is something you can learn and improve. The first step is raising awareness, so using a symptoms, diet, and exercise journal may be useful to target possible sources of stress. When you experience an undesirable symptom, compare the timing with your notes on what you were doing during and before that time that could be the culprit. Once you target certain correlations, you can decide how to decrease the stress.

Methods are physical and psychological and should be explored because you will benefit differently from different activities. Explore different methods and remember you will most likely need a different approach for different triggers of stress.

Stress Management Techniques:

• Deep Breathing

• Meditation

• Yoga

• Take a Nap (restorative sleep for 7-8 hours/night)

• Exercise-especially walking if stressed (30min/day)

• Self Care (Massage, Salt Bath, etc.)

• Get in Nature (sun exposure for at least 20min/day)

• Positive Relationships (talk to a friend)

• Limit Screen Time (unhealthy distraction)

• Time Productivity (organize and plan)

Summary

Stress in life is inevitable. Recognizing when you are stressed and why isn’t always easy, but taking the time to discover the source is vital. Learning the science and why the body is reacting to stress the way it does is even more helpful because you can then manage the process with more understanding and control. Start by recognizing your stress and its source, then explore different stress management techniques to find what you like, then learn the stress response physiology to help you gain more control.

References:

1. Chu B, Marwaha K, Ayers D. Physiology, Stress Reaction. [Updated 2020 Aug 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK541120/

2. Mariotti A. The effects of chronic stress on health: new insights into the molecular mechanisms of brain-body communication. Future Sci OA. 2015;1(3):FSO23. Published 2015 Nov 1. doi:10.4155/fso.15.21