Stress related disease

Introduction

When we start talking about stress, we realise that stress is a very personal and unique emotion. No two individuals will react exactly the same way to a similar stress stimulus and no two individuals will be stressed in the same way by the same or similar stimulus. The bodies reaction to prolonged stress however will show the same pattern of disease and we find similar reactions on a physical, emotional and psychological level in a broad spectrum of individuals.

It is imperative to note that stress is not always negative or pathological Stress can be a major motivational factor to achieve, succeed and excel irrespective of what line of work and activity you pursue. Stress becomes a problem when we can’t cope with the specific stimulus  which in turn leads to altered structure and function.

In practise we find that stress related disease is increasing at an alarming rate. We live in such a hectically driven stress producing society that it has become imperative to find and embrace mechanisms to deal with and reduce the impact of stress on our lives. With this article I will try to explain exactly what prolonged stress can do to your body and how it does it. I will also give you ideas on how to attack and manage stress in your life.

Before we start getting serious, I would like to make three statements that I want you to keep in the back of your mind as you continue to read this document.

The body was not designed to be perfect, the body was designed to survive. In nature the primary survival instincts are:  food, reproduction and energy conservation in no specific order. What this means is that our bodies are inherently lazy. Your body will tend to follow the path of the least resistance to conserve as much energy as possible!

You are never too old to learn!
You are never too old to change!

People often use no 2 and 3 as excuses to validate their non-compliance to suggestions to manage stress in their lives. I also find that even the conscious decision to try to manage stress more effectively can cause more stress. We are often so used to being dis-eased, that we find it stressful to break the stress-anxiety circle.

The anatomy of stress

What is stress ?

Stress can be defined as the body’s response to any external stimulus that causes a detectable physical, psychological and or emotional response leading to altered function.

What are the most common signs and symptoms of stress?

  • Neck and back pain.
  • Neck and back stiffness.
  • Headaches. Most commonly the headache will start at the base of the skull and then move upwards and forwards covering the temples and ending in  and above the eyes.
  • Dizziness and vertigo.
  • Balance problems.
  • Abnormal bowel movements. Eg. Constipation.
  • Insomnia. Difficulty to fall asleep as well as interrupted sleep.
  • Excessive sweating.
  • Visual disturbances.
  • High blood pressure and increased pulse rate.
  • Irritability and explosive anger outbursts.
  • Chronic fatigue and listlessness.
  • Muscle cramps.
  • Lack of concentration.

These are but a few of the reported and noted reactions to chronic stressful stimuli exposure. If you recognise any of these, you may be suffering from stress related dis-ease. 

What are the major causes  of stress?

  • Trauma.
  • Toxicity.
  • Thoughts.

It is almost impossible to isolate a single causative mechanism behind stress signs and symptoms. The three T’s all contribute to a greater or lesser extend and must be visualised as three intersecting circles where the common denominator will be abnormal timing leading to stress-anxiety disorder. 

Trauma can be broadly divided into external and internal trauma.

Internal trauma : Refers to mechanisms or stimuli that we subject ourselves to on a conscious or subconscious level.

This boils down to choices, habits and routines that can become harmful stimuli. eg:

  • How and what we eat
  • How and how regular we exercise.
  • How we rest and relax.
  • How we communicate and interact with the environment.
  • How we communicate and interact with ourselves.

Internal trauma cause chronic repetitive stress and strain injuries on muscles, joints, viscera and systems that over time can lead to abnormal function and structure, leading to physical and emotional stress!

External trauma: Refers to mechanisms or stimuli that we do not have control over but happens on a regular basis with all of us. Eg:

  • Motor vehicle accidents.
  • Sport injuries.
  • Fall’s
  • Run of the mill accidents.

External trauma cause rapid and acute stress and strain injuries with remarkable macro and or microscopic damage. External trauma, whether treated or untreated can eventually participate and contribute to stress inducing stimuli.

Toxicity: Toxicity refer to ingestion regardless of portal of entry. Eg

  • What we eat and drink.
  • What we breathe.
  • Drugs.
  • Smoking.

Toxicity is a possible stimulus affected by conscious choices and unknown exposure that influences health and well-being constantly.

Thoughts: Refer to the emotional component of stress stimuli and interlink very closely with trauma.

The primary emotion responsible for stress as per definition is, anxiety!

Anxiety is a primitive emotion. Unlike hunger and  thirst that build up and dissipate in the immediate present, anxiety seems to be able to creep up on us at any time at any place.

Anxiety as part of the body’s survival instinct, was designed to stop us from feeling to comfortable and to relaxed. Anxiety keeps us on the edge, keeps us alert, keeps us on a platform of constant readiness to react or to defend. Because we live in a anxiety ridden society that constantly reinforces this primitive instinct, you should be able to comprehend the possible emotional and physical abuse our body’s are exposed to if we do not find a way to manage and control stress and anxiety.

In the past decade we have learned that whatever the factors that trigger stress and anxiety are, it grows out of a response that is hardwired into our brains.

We also know that stress has a very definite genetic component to it. Some people seem to be born worriers. Brain scans can reveal differences in brain activity when people suffering from stress-anxiety disorders are exposed to stressful stimuli. Possibly the most interesting fact that research has shown, is that due to the shortcut in our brain’s information processing system, we can respond to a treat before we are consciously aware of one. The root of all stress-anxiety disorders may therefore not lie with the stimulus that triggers the stress, bur rather with the mechanism that must prevent the anxiety disorder from careering out of control. This concept will make sense to you when you understand the anatomy of the stress response.

Before I can discuss the anatomy of stress I would like to describe all the individual components  involved in the response pathway.

Auditory and visual stimuli:  Sights and sounds are processed first by the Thalamus and then routed to the Amygdala or the appropriate part of the Cortex.

Olfactory and tactile stimuli: Smell and touch sensations bypass the Thalamus in totality and takes a shortcut directly to the amygdala. Smells will therefore evoke stronger memories or feelings than do sights or sounds.

Thalamus: The Thalamus is the sensory integrative centre of the body. Compare the thalamus to a railway shunting station. The thalamus breaks down incoming visual cues into shapes, colour and size and auditory cues into volume and dissonance and then routes the altered info to the cortex.

Cortex: Gives meaning to all the incoming information enabling the brain to become conscious of what it is seeing and hearing. One part of the pre-frontal cortex is responsible for the de-activation of the stress-anxiety response once the initial threat has passed.

Amygdala: The emotional core of the brain with the primary responsibility of triggering the stress response. Information that passes through the amygdala is tagged with emotional significance.

The Bed Nucleus of the Stria Terminalis(BNST) : The BNST takes the information that it gets from the amygdala and magnifies it exponentially. It therefore perpetuates the cycle and prolongs the stress-anxiety state.

Locus ceruleus: Receives the emergency signal via the amygdala/BNST pathway and initiates the emergency response.

Once activated the Hypothalamus and Pituitary glands will stimulate the adrenal glands to release large amount of cortisol and adrenaline into the bloodstream. The stress hormones are broken down and absorbed extremely fast resulting in almost instantaneous reaction from the target organs.

As a result of this pathway, the “fight, fright or flight “ status is reached. The FFF status will be discussed shortly.

How does it work?

When we are exposed to a severely stressful stimulus or a combination of the three TTT’s  over time or suddenly, depending on the magnitude of the impulse, the body will initiate two pathways as a defence mechanism with the ultimate goal of survival.  

Shortcut : The brain automatically engages an emergency hotline to it’s fear centre the amygdala. The amygdala sends an all-points bulletin to all the structures in the emergency protocol pathway. The BNST further amplifies the emergency signal and sends it to the Locus Ceruleus. The LC activates the FFF via the stress hormones released by the renal glands.

  • Once the Fight, Fright or Flight status has been achieved, the body experiences a condition known as sympathetic excess. In other words, the sympathetic nervous system has taken over control. The body will show the following changes.
  • Increased heart rate and breathing.
  • Senses become hyper alert.
  • Increased blood supply to skeletal muscle preparing the muscle to react.
  • Digestion shutdown. The body could initially empty the digestive tract through vomiting, urination and defecation, or the peristaltic movement can totally decrease leading to constipation.
  • Blood pressure will rise, lungs will hyper inflate.
  • Increased sweating.
  • Peripheral nerves will tingle into action creating goose bumps.

The High road : Only after the fear response has been triggered does the conscious mind kick into gear. Some sensory information will take the longer route and go to the Thalamus first. The thalamus will organise the info and route the info to the appropriate part of the cortex. The cortex will now analyse all the raw data and decide whether the fear response was necessary or not. If the cortex feels that the response is validated, it will order the fear centre (amygdala) to continue with the emergency response. If not, the cortex will order the amygdala to stand down and to de-activate.

I think the reader at this stage should be able to comprehend what the possible effect would be should the cortex not be able to shut the emergency condition down. Indeed, research has shown that stress-anxiety disorders are caused by either an overactive amygdala or a under active cortex. It therefore seems to be harder to deactivate the emergency pathway than to activate it. This does seem logical if you refer back to the opening statement where I said that the body was made to survive and not to be perfect. 

Once the body has been in a state of alert or in a state of sympathetic excess for a period of time, signs and symptoms of stress as previously discussed, will start to show. We can almost call it a total systems overloud to failure. A further disastrous finding indicate that due to the emotional link in the amygdala, remember  I indicated that stimuli will be loaded with emotional significance, the amygdala seems to have the capacity to learn. What this means is that the amygdala has the ability to recognise stimuli if it has experienced it before. The emergency pathway towards that stimulus would have been hyper sensitised. Irrespective of the magnitude or severity of the stimulus, the body will react in exactly the same way.

For example: A patient experienced severe stress-anxiety symptoms manifesting in headaches and muscle cramps due to prolonged exposure to an abusive spouse. Even without the presence of the primary stimulus, which in this example will be the spouse, any stimulus reminding the patient of the spouse like smell of aftershave or deodorant, will have the ability to elicit the exact same response.

 

How stress affects us

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