Aug
21
2021

When Stress Becomes Abnormal

Recently CNN published an article that dealt about when stress becomes abnormal.

We all have experienced stress. It makes our heart beat faster and our breathing speeds up as well. But when the stressful situation is over, stress usually subsides also. Some people though have so much stress in their lives that they never completely recover from any stressful situation. They develop chronic stress, which can lead to physical illnesses or mental disease. I have previously written about “stress drives our lives”. In the following I am reprinting the next 5 paragraphs.

Heart attacks and strokes when stress becomes abnormal

In a 2015 Lancet study 603,838 men and women who worked long hours were followed for an average time of about 8 years with respect to heart disease or strokes. All of the subjects were free of heart attacks and strokes when they entered into the study. There was a total of 13% more heart attacks in those who worked extra hours in comparison to those who worked 40 hours per week or less. With respect to strokes there were 33% more strokes in those who worked long hours. Researchers noted a dose-response curve for strokes in groups with various workloads. Compared to standard working hours there were 10% additional strokes for 41-48 working hours, 27% for 49-54 working hours and 33% for 55 or more working hours per week.

Stress drives some of us to substance abuse

In order to cope with stress many of us “treat” daily stress with alcohol. It makes you feel good subjectively, but it can raise your blood pressure causing heart attacks and strokes down the road. A low dose of alcohol may be healthy, but medium and high doses are detrimental to your health.

Next, many people still smoke, although scientists have proven long time ago that it is bad for your health. It can cause heart attacks, various cancers and circulatory problems leading to leg amputations.

Overeating is another common problem. Comfort food relieves stress, but it causes us to put on extra pounds. As you know it is easier to put weight on than to take it off. Being overweight or being obese has its own problems: arthritis in the hips and knees makes walking more difficult. The metabolic syndrome sets in, which is a characteristic metabolic change causing diabetes, high blood pressure, heart attacks, strokes and certain cancers. The more weight you carry, the less likely you are to exercise. This can lead to further deterioration of your health.

Diabetes can occur when stress becomes abnormal

Stress causes too much cortisol secretion from the adrenal glands. This raises blood sugar, and when chronic can cause diabetes. In addition, unhealthy eating habits in an attempt to cope with stress can cause weight gain. Insulin resistance causes high blood sugars and diabetes.

Korean immigrant study

In a 2012 California study 148 adult Korean immigrants were examined. They all had elevated blood sugars confirming the diagnosis of type 2 diabetes. They had an elevated waist/hip ratio.

A high percentage of the study subjects had risk factors for type 2 diabetes. This included being overweight or obese and having high blood glucose readings. 66% of them said that they were feeling stressed, 51% reported feeling anxious, 38% said they were feeling restless, 30% felt nervous and 3% said they were feeling hopeless. It is easy to see the connection between stress and disease!

Australian study showed that anxiety can cause diabetes

An Australian long-term follow-up study computed risk factors for developing type 2 diabetes. Stress was a major contributor to diabetes.

A 30-day episode of any anxiety disorder had a 1.53-fold risk to cause diabetes. A depressive disorder had a 1.37-fold risk to cause diabetes and posttraumatic stress disorder had a risk of 1.42-fold to cause diabetes.

Infertility may develop when stress becomes abnormal

Stress changes hormones in women causing ovulation problems and infertility. 1 in 8 couples in America have problems getting pregnant. Physicians identified stress as at least one of  the contributing factors. But in men stress can also reduce sperm count and semen quality as this study describes.

Alzheimer’s disease and stress

2010 study from Gothenburg University, Sweden examined 1462 woman aged 38-60 and followed them for 35 years.

Psychologists assessed the stress score in 1968,1974 and 1980. 161 females developed dementia (105 Alzheimer’s disease, 40 vascular dementia and 16 other dementias). The risk of dementia was higher in those women who had frequent/constant stress in the past. Women who had stress on one, two or three examinations suffered from higher dementia rates later in life. Researchers compared this to a group of women who did not have any significant stress. Specifically, dementia rates were 10% higher after one stressful episode, 73% higher after two stressful episodes and 151% higher after three stressful episodes.

Hormone system affected by stress

I have written an article before about how stress affects our hormone system.

I am reprinting excerpts from this here (the next 4 paragraphs).

Dr. Andrew Heyman gave a talk about how stress affects our hormone system. He presented his talk at the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas that I attended. It was entitled “Understanding the Stress, Thyroid, Hormone Connections & Prioritizing Systems”.

Dr. Heyman emphasized in particular that there is a triad of hormonal connections that is important to remember: the thyroid hormones, the stress hormones (adrenal glands) and the pancreas (insulin production). It seems like we need a balance of these hormones for optimal energy production and circulation. Under stress our sugar metabolism can markedly derail, we develop obesity and fatigue. But when balanced, we experience vitality and wellbeing.

Metabolic activation pathways

Dr. Heyman projected a slide that showed the metabolic activation pathways. Likewise, he stated that a number of different factors could influence the hormone system:

  • Diet: trans fats, sugar, too many carbs, food allergies.
  • Drugs: drug-induced nutrient depletion (over-the-counter drugs, prescription drugs).
  • Physical exercise: frequency and type matters.
  • Environmental exposure: chemicals, pesticides, herbicides, heavy metals, plastics, molds, and pollens.
  • Stress: physical stress, psychogenic stress.
  • Genetics: methylene-tetra-hydro-folate reductase enzyme deficiency (MTHFR mutation), APOE genes, lack of vitamin D
  • Disease: past or present conditions, active disease or syndromes.

Target areas within your system

The target areas in your system are the

  • Pancreas, where blood sugar can rise because of insulin resistance. In particular, too much insulin production causes inflammation, hormone disbalances, kidney damage, and hardening of the arteries through plaque formation.
  • Thyroid gland, which depends on TSH (thyroid stimulating hormone) for activation. Autoantibodies can also affect it negatively.
  • Brain: decrease in serotonin resulting in anxiety, depression and food cravings; decreased melatonin causing sleep disturbances; increased ghrelin and decreased leptin secretion leading to overeating and obesity.

Other target areas of stress

  • Liver/kidneys: both of these organs are important for detoxification; the liver produces thyroid binding globulin, which when increased can lower the free thyroid hormones.
  • Immune system (gut, lymph glands): the Peyer’s patches in the gut mucosa produce a large portion of the immune cells; lymph glands, the bone marrow and the spleen supply the rest. A leaky gut syndrome can affect the whole body, in addition causing inflammation and autoimmune reactions.
  • Hypothalamus/pituitary/adrenal glands: this is the main axis of the stress reaction. A brain under stress activates the hypothalamus. It sends a cascade of activating hormones via the pituitary gland and likewise activates the adrenal glands. Finally, this leads to cortisol overproduction, and release of epinephrine and norepinephrine from the center of the adrenal glands. High blood pressure, anxiety, heart palpitations, arrhythmias and more can finally develop from this.

Treatment suggestions to cope with stress

There are thyroid supplements that can support the function of the thyroid gland. Similarly, there are several supplements to support the adrenal glands.
Chromium, vitamin D, magnesium, alpha-lipoic acid, fish oil and others are useful to support the pancreas. Relaxation methods like self-hypnosis, meditation, yoga, Tai-Chi and others are very useful to counter stress. If you can change your job to evade stress, take the opportunity and find another job with less stress. See a health professional and discuss what you can do to become more stress-resistant. If you are overweight or obese, see a dietitian to help you lose weight. Aerobic exercises like running for 30 minutes on a treadmill can help reduce stress. Various relaxation methods mentioned earlier also can counter stress. They help you to block out worrying about the past and the future, but instead focus on what is positive in the present.

When Stress Becomes Abnormal

When Stress Becomes Abnormal

Conclusion

I have described what stress can do to your body. It can give you heart attacks and strokes. Stress in some people can lead to substance abuse. It can cause diabetes, infertility and even Alzheimer’s disease. I described how thyroid hormones, insulin and brain hormones are interconnected and suffer with stress. Other factors can make the effects of stress worse or better as I discussed in detail. Treatment of stress-induced conditions requires a combination of preventative steps and medical therapies. Ignoring stress is not an option as this could lead to premature death. Managing stress, as mentioned before, and keeping it to a minimum is the answer.

Nov
12
2016

Stress Drives Our Lives

Every year the American Psychological Association (APA) monitors the American public how stress drives our lives. This yearly report has been compiled since 2007. About 75% of the people questioned reported that they have experienced moderate to high stress over the past month.

Symptoms when stress drives our lives

What kind of symptoms can stress cause? It can cause sleep deprivation, anxiety, headaches and depression. But there can be more symptoms from any disease that stress may cause. The “Stress in America” report from February 2016 shows on page 5 that unhealthy life habits are used by low-income Americans to cope with stress. A bar graph shows that watching television or movies for more than 2 hours per day is common. Another way of coping is to surf the Internet more often, take more naps or sleep longer. Eating more, drinking alcoholic beverages and smoking more are other unhealthy ways to cope with stress.

As the stressed person gains extra weight and eventually becomes obese, there is a higher rate of diabetes that can develop with all of its complications.

Causes of stress in our lives

The “Stress in America” survey was based on 3,068 adults in the US who completed the survey during August 2015. 72% were stressed out about financial issues. 22% of these said that they were extremely stressed in the past month as a result of money concerns. Other common concerns were work, the economy, family responsibilities and concerns about personal health. Average stress levels among Americans decreased when compared to 2007. On a 10-point stress score respondents rated their stress at 4.9 in 2016 compared to 6.2 in 2007. But according to the American Psychological Association this is much higher than a stress rating of 3.7 considered to be a healthy level.

Stress affects people from all walks of life, workers, women, young adults, students and those with lower incomes.

“Stress is caused by the loss or threat of loss of the personal, social and material resources that are primary to us” Stevan Hobfoll, PhD, a clinical psychologist from Rush University Medical Center said. “So, threat to self, threat to self-esteem, threat to income, threat to employment and threat to our family or our health…” is what causes stress.

Stress drives our lives causing disease

When stress is too much for our system, we are starting to see pathology develop. “Stress is seldom the root cause of disease, but rather interacts with our genetics and our state of our bodies in ways that accelerate disease” professor Hobfoll says. The following are common diseases that can result from chronic stress.

Heart attacks and strokes

In a 2015 Lancet study 603,838 men and women who worked long hours were followed for a mean of about 8 years with respect to heart disease or strokes. All of the subjects were free of heart attacks and strokes when they entered into the study. There were a total of 13% more heart attacks in those who worked extra hours in comparison to those who worked 40 hours per week or less. With respect to strokes there were 33% more strokes in those who worked long hours. Researchers noted a dose-response curve for strokes in groups with various workloads. Compared to standard working hours there were 10% additional strokes for 41-48 working hours, 27% for 49-54 working hours and 33% for 55 or more working hours per week.

Stress drives our lives and causes substance abuse

In order to cope with stress many of us treat daily stress with alcohol. It makes you feel good subjectively, but it can raise your blood pressure causing heart attacks and strokes down the road. A low dose of alcohol may be healthy, but medium and high doses are detrimental to your health.

Next many people still smoke, although scientists have proven long time ago that it is bad for your health. It can cause heart attacks, various cancers and circulatory problems leading to leg amputations.

Overeating is another common problem. Comfort food relieves stress, but it puts on extra pounds. As you know it is easier to put weight on than get it off. Being overweight or being obese has its own problems: arthritis in the hips and knees makes walking more difficult. The metabolic syndrome sets in, which is a characteristic metabolic change causing diabetes, high blood pressure, heart attacks, strokes and certain cancers. The more weight you carry, the less likely you are to exercise. This deteriorates your health outlook.

Diabetes

Stress causes too much cortisol secretion from the adrenal glands. This raises blood sugar, and when chronic can cause diabetes. In addition unhealthy eating habits associated with stress can cause weight gain and high blood sugars leading to diabetes.

In a 2012 California study 148 adult Korean immigrants were examined. They all had elevated blood sugars confirming the diagnosis of type 2 diabetes. They had a  elevated waist/hip ratio.

A high percentage of the study subjects had risk factors for type 2 diabetes. This included being overweight or obese and having high blood glucose readings. 66% of them said that they were feeling stressed, 51% reported feeling anxious, 38% said they were feeling restless, 30% felt nervous and 3% said they were feeling hopeless.

An Australian long-term follow-up study computed risk factors for developing type 2 diabetes. Stress was a major contributor to diabetes.

A 30-day episode of any anxiety disorder had a 1.53-fold risk to cause diabetes. A depressive disorder had a 1.37-fold risk to cause diabetes and posttraumatic stress disorder had a risk of 1.42-fold to cause diabetes.

Infertility

Stress changes hormones in women causing ovulation problems and infertility. 1 in 8 couples in America have problems getting pregnant. Physicians identified stress as at least a contributing factor. But in men stress can also reduce sperm count and semen quality as this study describes.

Alzheimer’s disease

A 2010 study from Gothenburg University, Sweden examined 1462 woman aged 38-60 and followed them for 35 years.

Psychologists assessed the stress score in 1968,1974 and 1980. 161 females developed dementia (105 Alzheimer’s disease, 40 vascular dementia and 16 other dementias). The risk of dementia was higher in those women who had frequent/constant stress in the past. Women who had stress on one, two or three examinations suffered from higher dementia rates later in life. Researchers compared this to women did not have any significant stress. Specifically, dementia rates were 10% higher after one stressful episode, 73% higher after two stressful episodes and 151% higher after three stressful episodes.

Remedies for stress

Before you can attempt to remedy stress, you must first detect that you are under stress. You can recognize this when you have problems sleeping, you suffer from fatigue, when overeating or undereating is a problem, and if you feel depressed. Others may feel angry or are irritable. Some bad lifestyle habits may also make you aware that you are under stress. You may smoke or drink more in an attempt to manage stress. Some people abuse drugs.

Here are some suggestions how to remedy stress:

  1. Seek support from family, friends or religious organizations. If you engage in drugs or alcohol overuse or you feel suicidal, it is best to seek the advice from a psychiatrist or psychologist.
  2. Engage in regular exercise. This produces endorphins, the natural “feel-good” brain hormone. This reduces symptoms of depression and improves sleep quality.
  3. Do something that increases pleasure, such as having a meal with friends, starting a hobby or watching a good movie.
  4. Positive self-talk: avoid negative thoughts like “I can’t do this”. Instead say to yourself “I will do the best I can”. Psychologists have developed a technique where they teach patients how to turn negatives into positives. Psychologists call this therapy “cognitive therapy”. You may want to seek the advice of a psychologist to have a few cognitive therapy sessions.
  5. Daily relaxation: you may want to use self-hypnosis, tai-chi exercises or meditation to reduce your stress levels.
Stress Drives Our Lives

Stress Drives Our Lives

Conclusion

Stress is very common. Diverse diseases like heart attacks, strokes, diabetes and Alzheimer’s disease can all be caused by stress. It is important to minimize the impact of stress by seeking family support and support from friends. Engaging in regular exercise will release endorphins and make you feel better. Relaxation exercises and seeking counselling can all help you to manage stress. You cannot ignore or simply tolerate this force in your life. Stress is indeed there, but we can make a difference by managing it to avoid that stress manages us.

Oct
12
2013

Music More Powerful Than Anti-Anxiety Drugs

When was the last time you saw your physicians for anxiety and you were given a prescription that said: “for anxiety listen to your favorite music!” instead of receiving a prescription for an anti-anxiety drug (anxiolytic). This is exactly what a recent study suggests that showed prior to surgery you can control your anxiety either with anti-anxiety drugs or by listening to your favorite music. Listening to your favorite music will do you no harm, while many drugs do have harmful side effects.

How singing can change the brain chemistry

Other studies have investigated how singing can change your brain functioning in terms of brain chemistry. The researchers found that singing will release dopamine in your brain, which is responsible for feeling pleasure; it will stimulate your immune system by elevating immunoglobulin A and decreasing cortisol (the stress hormone). This in turn will preserve your immune cells (lymphocytes). Oxytocin levels of your brain are increased, which promotes social affiliation. It also calms down the autonomic nervous system resulting in a better airway opening, calming of your heart rate and soothing the wave-like muscle contractions in your gut, medically called peristalsis. You would refer to that as “butterflies in your stomach”. Music therapy reduces pain and anxiety by 50% and is important for children and adults alike.

Pain and anxiety reduced

A study in Germany showed that pain and anxiety were significantly reduced with music therapy. A Taiwanese study of women in labor found that music therapy significantly reduced pain and anxiety of women during labor. Ref. 1 explains that music therapy is useful as an adjunct to treating cancer pain, and reducing anxiety associated with colposcopy procedures. It also can help when treating patients who had heart attacks in the setting of a cardiac care unit.

Music More Powerful Than Anti-Anxiety Drugs

Music More Powerful Than Anti-Anxiety Drugs

Hypnosis and guided imagery

Music has been successfully combined with clinical hypnosis and guided imagery where words are carefully chosen to help the patient experience pleasant feelings, which counteract the experience of pain, anxiety or fear of dying. A simple relaxation CD or tape with soothing background music will facilitate this type of therapy. This is useful for patients in a palliative care unit where they prepare themselves to accepting the inevitable death from an incurable disease. But chemotherapy patients undergoing these procedures for cancer treatments also have benefitted from a significant reduction in nausea, vomiting (side effects of chemotherapy) and pain.

Autism and music therapy

A Cochrane study showed that autistic children did better in terms of communication skills when music therapy was incorporated into the treatment protocol. One of the core deficits in autistic children is in the area of communication and social skills. This is where music therapy was most effective. Behavioral problems (stereotypic behavior) in autistic children did not respond to music therapy. A comprehensive treatment program for autistic children should therefore incorporate music therapy. Here is a blog that describes what difference music therapy can make in the lives of autistic children written by a member of the American Music Therapy Association.

Substance abuse and music therapy

An area where you may not expect music therapy to have a role is in the area of drug and substance abuse rehabilitation , which is discussed in more detail in this site. The beauty about music therapy is that it is not a drug, yet the natural endorphins that are released by the brain help the affected person getting through withdrawal easier. Music therapy helps building up self-esteem, participating in group activities, promoting self awareness and expressing feelings.

Mood disorders in adolescents

One important area where music therapy has been employed is with anxiety and depression in adolescents. Adolescents spend an average of 4 hours per day listening to music. So they are already programmed to listen to music. With the help of a music therapist they can be directed to listening to the type of music that will help them get motivated, relax more, make them feel accepted and be part of their peer groups. In this study the authors suggested to combine music therapy with dance and art therapy. In this way the whole person gets involved in the treatment and this can be integrated with conventional antidepressant treatments at reduced doses (with less side-effects) or with cognitive therapy.

General objectives of music therapy

Music therapy is best incorporated into a treatment protocol as an adjunct. It can help reduce the use of drugs for psychiatric patients, for people with anxiety and for patients with pain conditions. The Cleveland clinic has a useful summary about music therapy, which describes the uses of it for reducing anxiety, for helping with coping skills, mood improvement and distraction from pain. There are registered music therapists you can ask for help. The website of the American Music Therapy Association may have other useful links for you.

Conclusion

Music therapy is a treatment modality with no side effects, but providing effective treatment for quite an impressive range of clinical conditions as discussed. Music therapists are widely available in the US and many other countries. This treatment can be integrated with conventional or complementary treatments. It helps people to heal the body as a whole unit (mind and body).

More information on anxiety disorders: http://nethealthbook.com/mental-illness-mental-disorders/anxiety-disorders-panic-disorders-phobias-ocd-ptsd-anxiety-others/

References

1. Rakel: Integrative Medicine, 3rd ed.© 2012 Saunders. Chapter on Integrative Therapy; subchapter of Mind-Body Therapy.

Last edited Nov. 7, 2014