Stress: How it really affects our physical & mental health
Recently, the effects of stress on individuals appears to have made significant progress into mainstream media coverage. It certainly formed a significant chunk to my Psychology MSc. I personally think this signifies a slow shift in attitudes toward understanding health at a deeper level, one that suggests there is more at play than physical factors alone. We casually hear, watch or read how Cortisol is bad for you and how (let’s not think I’ve gone too hipster here) relaxation techniques such as mindfulness and meditation are good for us. But why? Before you reach for your CBD oil, Calm app or any one of the often unproven or contradictory applications to reach Zen or total inner peace, maybe you should first of all understand why stress is bad [1, 2]?
Well, the truth is there are two kinds of stress, “Eustress” and “Distress”. Whilst Eustress is a positive kind of stress e.g. a work promotion, Distress is detrimental and has associations not only with physical health such as hypertension but also affective and altered cognitive states such as depression and anxiety .
The Biology bit…
To understand this better we first have to go to the Autonomic Nervous System (ANS) and the Hypothalamic-Pituitary-Adrenal (HPA) axis, where in ordinary and normal situations, the parasympathetic nervous system runs all resting bodily functions e.g. digestion and resting heart rate. Only when experiencing stress does the sympathetic nervous system take over, setting off a catalogue of hormone inducing reactions that lead to the quick release of adrenaline (epinephrine) to deal with the threat. This causes increased heart rate, breathing and glucose levels leading to the classic adrenaline rush of fight or flight; facing the danger head on or fleeing from it. To deal with the unexpected threat, resting bodily functions are suppressed in favour of those that increase physical activity. In response to these acute psychological stressors, Cortisol is released, and contrary to its adrenaline counterpart takes 20-40 minutes to reach peak levels. Normal levels of cortisol are regained roughly 40-60 minutes following the end of the stressful encounter and the parasympathetic nervous system takes over . It all seems to make sense. However, it is the continual fluctuation of excess cortisol that creates an immunological imbalance and health nightmare.
Research has clearly demonstrated a link between the ANS and Immune System functioning. Therefore, healthy immune cells are negatively affected if subjected to extended Cortisol release over time. The powerful effects of Cortisol to immune system functioning occur partly because of its role in inflammatory responses and the time taken for it to return to normal levels. Too much cortisol inhibits cytokines (cells involved in mediating the correct chemical responses of immune cells), creating a maladaptive immune system that fights an imaginary disease (through high temperatures/muscle aches). Therefore, when we really do get sick, our immune system fails to respond appropriately as it has effectively burnt itself out through fighting imaginary diseases.
The Psychology bit…
Research has shown how certain cytokines negatively affect the central nervous system leading to behavioural change and cognitive ability e.g. mood disorders, PTSD (Post-Traumatic Stress Disorder), anxiety, depression, anorexia, inability to experience pleasure and sleep disruption [5, 6]. This highlights how poor health is not limited to physical factors alone.
Allostasis is the term psychologists use to describe when our immune system functions correctly and is working in tandem with an equally healthy mind. Allostatic load therefore refers to how health is affected via prolonged HPA activation and increased Cortisol due to environmental stressors experienced by the individual [7, 8]. So, in understanding how Cortisol works and covering the basics of what excess amounts does to us physically as well as mentally, psychological detachment is crucial to reduce this risk.
Strategies to reduce Cortisol and increase health…
Psychological research has significantly demonstrated that identifying “perceived control” reduces stressors and limits HPA activation. Therefore, distinguishing between what is really happening as opposed to what “could be”, “might be” or “ought to be” happening will help to reduce maladaptive thoughts. This is obviously easier said than done, take it from me, however Cognitive Behavioural Therapy (CBT) redresses this illogical thinking and has definitely been proven as a beneficial treatment modality [9, 10]. Exercise is also a huge player in releasing happy hormones, just don’t overtrain and make something enjoyable a chore, otherwise it will lead to the exact outcome you’re trying to avoid. Mindfulness/Meditation really comes into its own here because by solely focusing on your breath and maintaining focus with no distracting thoughts can you completely detach and allow yourself to relax. This has been proven time and again and has been around for thousands of years [11, 12].
More interestingly, recent research has shown that social cognitions such as perceived social status/image have also been significantly linked with increased HPA responses. That doesn’t surprise me in a time where people seem to equate success, self-worth and happiness to the material or self-image. This is not helped by what we are fed through (social) media, film and TV. Everybody needs to be rich and beautiful to be successful…yeah right. Research has shown that subordinate individuals that are exposed to dominant power hierarchies or fear-based leadership in the workplace also score higher HPA and lower immune responses . This in turn leads to subordinate power cliques that eventually undermine social status and ostracise peers, leading to reduced self-esteem and self-efficacy.
As if you didn’t need more excuses to turn your back on people like this the answer is simple. Turn towards the few people you have in life that genuinely have your back, love unconditionally, you can talk to, are honest, approachable and non-judgemental. More than anything, be mindful of your thoughts and emotional responses to stressors as these have more power over your health and well-being than you think [4, 14, 15]!
- Hazekamp, A., The Trouble with CBD Oil. Medical Cannabis and Cannabinoids, 2018. 1(1): p. 65-72.
- Mani, M., et al., Review and Evaluation of Mindfulness-Based iPhone Apps. JMIR mHealth uHealth, 2015. 3(3): p. e82.
- Kring, A.M., et al., Abnormal Psychology. 2014: Wiley.
- Kemeny, M.E., The psychobiology of stress. Current Directions in Psychological Science, 2003. 12(4): p. 124.
- Dayan, J. and B. Olliac, From hysteria and shell shock to posttraumatic stress disorder: Comments on psychoanalytic and neuropsychological approaches. Journal of Physiology-Paris, 2010. 104(6): p. 296-302.
- Bennett, J.L., et al., Addressing Posttraumatic Stress Among Iraq and Afghanistan Veterans and Significant Others: An Intervention Utilizing Sport and Recreation. Therapeutic Recreation Journal, 2014. 48(1): p. 74-93.
- McEwen, B.S., Stressed or stressed out: What is the difference? Journal of Psychiatry and Neuroscience, 2005. 30(5): p. 315-318.
- McEwen, B.S., Protective and damaging effects of stress mediators: central role of the brain. Dialogues in Clinical Neuroscience, 2006. 8(4): p. 367-381.
- Dryman, M.T., et al., Evaluation of an open-access CBT-based Internet program for social anxiety: Patterns of use, retention, and outcomes. J Consult Clin Psychol, 2017. 85(10): p. 988-999.
- Hofmann, S., et al., The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses. Cognitive Therapy & Research, 2012. 36(5): p. 427-440.
- DeViva, J.C., et al., Group cognitive-behavioral therapy for insomnia delivered to veterans with posttraumatic stress disorder receiving residential treatment is associated with improvements in sleep independent of changes in posttraumatic stress disorder. Traumatology, 2018.
- Rees, C.S., et al., Understanding individual resilience in the workplace: the international collaboration of workforce resilience model. Frontiers in Psychology, 2015. 6(73).
- Mathieu, C., et al., A dark side of leadership: Corporate psychopathy and its influence on employee well-being and job satisfaction. Personality and Individual Differences, 2014. 59: p. 83-88.
- Dickerson, S.S., T.L. Gruenewald, and M.E. Kemeny, When the Social Self Is Threatened: Shame, Physiology, and Health. Journal of Personality, 2004. 72(6): p. 1191-1216.
- Bower, J.E., J.T. Moskowitz, and E. Epel, Is benefit finding good for your health? Pathways linking positive life changes after stress and physical health outcomes. Current Directions in Psychological Science, 2009. 18(6): p. 337-341.