Chronic stress is a hot topic right now, we've all heard of it, we've probably all experienced it and we all know that it can have serious psychological effects, but how much do you know about the physiological effects of chronic stress on the body?
Some of the common factors leading to chronic stress include uncertainty, loss of control, lack of information and conflict. Any of these sound familiar?? In today's society, these stressors can be found anywhere and everywhere, so it's no surprise that chronic stress is on the rise!
Chronic stress vs acute stress
What is the difference between chronic stress and acute stress?
Well acute stress is an entirely natural and healthy physiological response to a potential threat in our environment.
When we experience a situation that poses a potential threat to us, such as a big grizzly bear heading in our direction! Sensory information from our sensory organs is sent to the brain's amygdala. The amygdala is part of our limbic system which, among other things, is involved in emotional processing. The amygdala interprets the information and if it detects danger, it sends an SOS to the hypothalamus.
The hypothalamus acts as the command centre, communicating with the body through the autonomic nervous system. The autonomic nervous system has 2 main branches, the sympathetic and the parasympathetic nervous systems. When the hypothalamus receives the distress signal from the amygdala, it activates the sympathetic nervous system which is responsible for our fight-or-flight response. The adrenal glands are signalled to start releasing epinephrine (adrenaline) into the bloodstream, which gets us ready to fight, flee or freeze! Heart rate and blood pressure increase, breathing becomes more rapid, our brain goes into high alert and our senses become sharper, our muscles tense and stored energy supplies of glucose and fats are released into the bloodstream.
Once this initial phase of the stress response declines, if the brain continues to perceive a threat, the HPA axis is activated, this leads to a cascade of events involving the hypothalamus, pituitary gland and adrenal glands, which results in the release of the stress hormone cortisol from the adrenal glands, keeping the body in a state of high alert.
This is a healthy acute stress response, we need this to allow us to respond to danger and stay alive! It can also be really useful in situations where we need high cognitive functioning, such as giving a presentation at work.
Once the threat has passed the activity of the HPA axis reduces and the parasympathetic nervous system takes over, providing the 'rest and digest' response that our body needs to recover.
But what happens when our brain is constantly registering threat?
It is unlikely that we're going to come across many grizzly bears, but what about all of the other stressors that we may experience multiple times in a day? Financial worries, parenting issues, health problems, relationships, work deadlines, watching the news, forgetting about fancy dress day at school...
All of these stressors keep our HPA axis switched on and prevent the parasympathetic nervous system from doing it's job of allowing our bodies to recover.
When this continues over a period of time, we enter the world of Chronic Stress!
Long-term effects of chronic stress on the body
The extensive impact of chronic stress on our physiological wellbeing and how it influences all of the systems of our body is still not yet fully understood, but in recent years we have become more aware of the fact that chronic stress can affect everything from our cardiovascular health, to our gut health.
Here are just some of the body systems impacted by chronic stress:
Immune system
One of the key findings is the relationship between chronic stress and the immune system. Immune cells have high levels of receptors for the neuropeptides and hormones produced in a stress response. When immune cells detect these molecules in the bloodstream, the acute inflammatory response of the immune system, often associated with tissue damage and infections may be activated. Sustained activation of this neuro-endocrine-immune response can lead to imbalances and chronic low-grade inflammation, it is this inflammation that has been linked with the development of many common health conditions such as:
Cardiovascular disease
Diabetes
Autoimmune disease
Cancer
Irritable bowel syndrome
Inflammatory conditions
Depression and anxiety
Cardiovascular system
As well the risks of chronic inflammation to the cardiovascular system, continuous low-level stress can lead to elevated heart rate, high blood pressure and damaged blood vessels which increase the risk of cardiovascular conditions, heart attack and stroke.
Digestive system
Communication between the gut and the brain is complex and an imbalance in one can have a strong effect on the other, this bi-directional connection is know as the gut-brain axis. The gut has a rich nerve innervation and is therefore very sensitive to the alterations in the functioning of the nervous system which can be caused by chronic stress.
When we are in a state of fight-or-flight, the sympathetic nervous system puts digestion on hold or slows it down to allow energy resources to be sent to the areas necessary to keep our bodies in a state of high alert, when this state is maintained in periods of chronic stress, this can lead to digestive symptoms such as bloating, constipation, indigestion and diarrhoea.
Chronic stress can also effect the gut microbiome and alter the levels and formations of some of the bacteria in the gut, not only can this impact on gut health, but it can also impact our brain health, influencing factors such as our cognitive functioning and mood.
Musculoskeletal system
We have all experienced the muscular tension that comes with stress; the tight shoulders, stiff neck, sore lower back and tension headaches. When we are stressed our muscles automatically tense to protect us from threat and ready us to fight or run from danger, when stress continues, our muscles remain in this constant state of guardedness which can lead to chronic tension, pain and dysfunction.
Chronic stress has strong links with chronic pain, again this is very complex, but may be due to held muscular tension, sensitization of the central and peripheral nervous systems and a dialled-up pain output by the brain due to the perception of threat in times of stress.
If all of this talk of the effects of chronic stress has left you feeling even more stressed... fear not! There are many, many things that you can do to manage your stress levels and get yourself out of constant fight-or-flight mode!
The best news is that a lot of these things are free, easily accessible and don't have to take up a lot of your time.
So if significantly reducing the amount of stress in your life doesn't seem achievable right now, there are still lots of options that you can explore to give your body and mind time to recover.
I have listed a few suggestions below, but this is not an exhaustive list and not everything will work for everybody. It really is about experimenting and finding what's right for you.
Breathwork - by slowing the breath we bring down our stress response of rapid breathing and increased heart rate, which in turn can lower blood pressure. Slow exhales stimulate the parasympathetic nervous system and bring the body into a restful state. Focusing on the breath is also a form of mindfulness and is used in meditation to calm the mind and body.
A breathing exercise that I find particularly helpful is a box breath:
Inhale deeply and slowly for a count of 4. Place a hand on your tummy and breathe through your nose, deep into your abdomen, you should feel your tummy rise.
Hold your breath for a count of 4
Exhale slowly and fully through lightly pursed lips for a count of 4.
Pause for a count of 4 before beginning the process again.
Progressive muscle relaxation - This technique can be particularly useful if you are experiencing muscular tension and helps you to reconnect with your body, allowing you to notice and release muscular tension before it begins to cause you any problems.
Sit or lie down in a quiet and comfortable place.
Begin at the feet, point your toes upwards and push your heels downwards, notice the tension in your feet and hold for a count of 10. Release the tension in your feet and let them relax, noticing the sensation of warmth and relaxation in the muscles.
Point your toes downwards and lift your heels upwards, noticing the tension in your calf muscles and hold for a count of 10. Release the tension in your calves and let them relax, noticing the sensation of warmth and relaxation in the muscles.
Work your way up the body and repeat this process, tensing and releasing the muscles of the thighs, abdomen, shoulders, biceps, forearms and face.
Finish with a full body scan, starting at the top of your head and working down to the tips of your toes, noticing the flow of relaxation throughout your body.
Mindfulness - both of the above suggestions are a form of mindfulness. Mindfulness can be particularly beneficial in reducing chronic stress as it brings us back to the present moment instead of ruminating on the past or worrying about the future, allowing us to experience things as they are at the time without judgement or trying to fight against thoughts, sensations and emotions. Mindfulness can be practiced in many different ways, but the central idea is to bring our attention to the present moment and if our mind wanders, which it will always do (do not get frustrated with yourself when this happens), simply notice that you have lost your focus and bring your attention back to the present. The five senses mindfulness exercise can be a great tool for beginners:
Take a few slow, deep breaths.
Notice without judgement: 5 things that you can see around you in that moment.
4 things that you can hear.
3 things that you can feel.
2 things that you can smell.
1 thing that you can taste.
If you are concerned about chronic stress and the impact that it may be having on your health, it is important to speak to your GP or a mental health professional who can guide you through your recovery.
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