Stressed? No, Diseased.

Let us talk about this word you use on a day to day basis. Stress. Nowadays, you will hear it more often than “I am hungry” or “I am so happy today”. So what is stress? Before I go into the biological definition of it, I like to define stress as the “unnecessary thoughts originated in the mind, regarding an event before the actual event has taken place or after the event is over.”

Stress of any kind, emotional or physical is dangerous. 95% of the stress is not real, its percieved. We must learn to stay calm in all situations and take care of our bodies. We all are pretty familiar with what happens to a person visually when he or she is stressed. You might observe these common signs including dark circles, fine lines and wrinkles, drooping eyes, basically the ” I am so tired” look. All of this is on the outside. Read this to understand what happens in the body when it is encountered with stress.

Diving deep into the understood mechanisms of stress, we will talk abut the short term and long term effects of stress.

There is a model that talks about the various stages of stress. This is called the General Adaptation Syndrome (GAS). GAS is the 3-stages process that describes the physiological changes the body goes through when under stress.

Alarm stage : At this stage there will be presentation of initial symptoms the body experiences under stress, “fight-or-flight” response and the natural reaction prepares you to either flee or protect yourself against dangerous situations. This happens through what we call ” Adrenaline rush”. Adrenal gland releases catecholamines ( the hormones of the gland including adrenaline and non-adrenaline) through stimulation of the sympathetic nervous system which in turn increases energy output. The sympathetic nervous system directs an involuntary body response in dangerous situations. The catch here is, our body will perceive stress as a dangerous situation and the response will be similar to you standing right in front of a Lion. Overall, this increases metabolism and cardiovascular functions and reducing the digestive activity and urinary output. This is because you will need a faster beating heart to run away (the body does not know that you are not facing the lion).

The sympathetic nervous system is activated when adrenaline, binds to the beta 1,2,3 receptors which are G protein coupled receptors. This elevates the SNS activity.  Beta 1 receptor carries out lipolysis (fat breakdown) and myocardial contraction. Beta 2 receptor performs hepatic glycogenolysis (breakdown of glycogen to glucose) and gluconeogenesis (formation of new glucose) and also increases glucagon secretion and smooth muscle relaxation (bronchi and skeletal muscles). All of these responses prepare the body for the fight or flight response.

There will also be stimulation of the alpha 1 and 2 adrenergic receptors contributing to the response.

Resistance stage – This Stage begins when the stressful event is prolonged for weeks, your “fight-or-flight” response lowers and the body begin to repair itself. This leads to long term metabolic adjustments. There will be release of growth hormone and cortisol which cause metabolisation of energy reserves for most tissues and glucose conservation for the brain. Glucagon from the pancreas and cortisol will cause elevated blood glucose levels.

Adrenal cortex also releases mineralocorticoids or aldosterone which will conserve salt and water. This causes increased sodium and water retention along with increased potassium and H+ excretion in the urine. The main culprit here is the hormone of the adrenal gland called cortisol. This stays elevated throughout the resistance phase.

Cortisol will cause increased proteolysis (breakdown of proteins) and lipolysis for the production of glucose for ATP production. When there is increased protein breakdown it causes increased amino acid levels which are harmful for the body as proteins cannot be stored in the body and will have to be excreted via the kidney increasing the kidney load. It raises the blood pressure by vasoconstriction (reducing the diameter of the blood vessels) and reduces anti-inflammatory effects (By depressing the phagocytes (immune cells that engulf pathogens) and reducing the release of histamine from mast cells).

Elevated cortisol levels can cause Cushing’s disease, Type 2 diabetes, oedema, hirsutism and many more such disorders. These will not occur until the end of the resistance phase. The patients suffering from stress will not even notice these as their body will eventually return to homeostasis normalising their heart rate and blood pressure. The resistance stage gives the body a false impression that it can handle the stress well. So during this stage the people do not fall sick easily as their immune system is constantly stimulated and can stay up for long hours making up for the sleep deprivation.

Exhaustion stage: When the stress is still persistent, it will give rise to the third stage, the exhaustion phase where all the body’s energy stores are depleted. Exhaustion phase is when the diseases set in. Exhaustion stage is the result of prolonged or chronic stress. Your body is drained physically, emotionally and mentally making it disease prone.

Signs of this stage include fatigue, burnout, depression, anxiety, decreased stress tolerance, weakened immunity. The body falls apart after years of constant stress and during the exhaustion stage, all kinds of diseases set in because the immune system has now broken down. Overall, there is decreased function of neurons and muscle fibre.

So is there anything doctors can do about this? Well yes, Cognitive behavioural stress management (CBSM) is a short-term therapeutic approach that focuses on how people’s thoughts affect their emotions and behaviours. It attempts to influence a client’s irrational thoughts while focusing directly on identifying and changing behaviors and thought patterns. CBSM protocols provide opportunities for psychologists to provide information, build a client’s emotional and interpersonal skills, and support patients through the process. During CBSM therapy, a client learns recovery skills that are useful throughout their lifetime. Techniques and skills that are acquired during CBSM therapy help facilitate adherence to medication protocols and have been shown to decrease isolation and depressive symptoms while improving immune function. Such interventions decrease perceived stress and negative mood (e.g., depression), improve perceived social support, facilitate problem-focused coping, and change cognitive appraisals, as well as decrease SNS arousal and the release of cortisol from the adrenal cortex.

Prevention is always better than cure. After reading this, I am sure you would not want your body to face any of the three stages of the GAS model. While we cannot eliminate stress completely from our lives because of the lifestyle, some stress is healthy. It keeps us going and helps us face challenges. Do not let the stress dominate you when you know you have the power to control it.