The Effects of Stress on Your Body

Stress is the body's reaction to any change that requires an adjustment or response. The
body reacts to these changes with physical, mental, and emotional responses.

Stress is a normal part of life. Many events that happen to you and around you -- and
many things that you do yourself -- put stress on your body. You can experience stress
from your environment, your body, and your thoughts.

How does stress affect health?

The human body is designed to experience stress and react to it. Stress can be positive,
keeping us alert and ready to avoid danger. Stress becomes negative when a person faces
continuous challenges without relief or relaxation between challenges. As a result, the
person becomes overworked, and stress-related tension builds.

Stress that continues without relief can lead to a condition called distress -- a negative
stress reaction. Distress can disturb the body's internal balance or equilibrium -- leading
to physical symptoms including headaches, upset stomach, elevated blood pressure, chest
pain, and problems sleeping. Research suggests that stress also can bring on or worsen
certain symptoms or diseases.

Stress also becomes harmful when people use alcohol, tobacco, or drugs to try to relieve
their stress. Unfortunately, instead of relieving the stress and returning the body to a
relaxed state, these substances tend to keep the body in a stressed state and cause more
problems. Consider the following facts:

• Forty-three percent of all adults suffer adverse health effects from stress.
• Seventy-five to 90% of all doctor's office visits are for stress-related ailments and
complaints.
• Stress is linked to six of the leading causes of death: heart disease, cancer, lung
ailments, accidents, cirrhosis of the liver, and suicide.
• The Occupational Safety and Health Administration (OSHA) declared stress a
hazard of the workplace. In terms of lost hours due to absenteeism, reduced
productivity and workers' compensation benefits, stress costs American industry
more than $300 billion annually.
• The lifetime prevalence of an emotional disorder is more than 50%, often due to
chronic, untreated stress reactions.

Causes of Stress
Stress can result from a string of specific events, the general conditions in your life, life
cycle transitions and developmental stages, or conflict with your belief system.

• A number of specific irritating events throughout a time period may include:

o Minor frustrations like traffic jams or arguments.
o Arguments with a boss or customer.
o Getting divorced or separated or getting married.
o A major illness or injury to yourself or a family member.
o Losing a job.
• The general conditions in your life can lead to long-term (chronic) stress. These
conditions are stressful by themselves, but they also make it harder to handle
other demands in your life. Conditions that may lead to stress include:
o Your physical health, if you lead an inactive lifestyle or you have a chronic health
problem like heart disease or diabetes. Smoking and abusing alcohol or drugs
may be an unhealthy way of coping with stress.
o Your emotional state, if you are dealing with emotional concerns such as
unexpressed or uncontrolled anger, depression, grief, guilt, or low self-
esteem.
o Your relationships, if you lack someone you can share your feelings with,
are having difficulty in a relationship, or feel that you have no friends.
o Your surroundings, if you live in a dangerous or uncomfortable area where
overcrowding, crime, pollution, or noise is a problem.
o Your job, if you lack a sense of control in it. Do you wonder whether you are good
at your job, feel insecure in it, or lack a strong commitment to your work? (See
stress on the job.)
o Your social situation, such as poverty, loneliness, or discrimination based
on race, gender, or age.
• Life cycle transitions and developmental stages can lead to stress, including:
o Reaching puberty.
o Leaving home.
o Getting married.
• Conflicts with your belief system—your perceptions and beliefs about the world, life, and
yourself—may lead to stress. For instance, if you place a high value on family life but
don't have the family life you want, you may feel stress

How you react to stress may affect how your clothes fit.

Hand me the candy jar -- it's been that kind of day. When feeling frazzled, we likely reach for
some soothing chocolate. Now, new research confirms those urges: Stress makes you eat more
-- especially more sweets -- because it increases levels of a hormone called cortisol. That's bad
news, because fat created by cortisol is the "deep-belly" kind, which, one expert says, is known to
increase health risks.

"We found that women who had high levels of cortisol after a stressful event tend to eat more
calories, especially more sweets," says the study's lead author, Elissa Epel, PhD, a health
psychology researcher at the University of California at San Francisco.
In her study, Epel and colleagues selected a group of 59 women with an average age of 36 -- all
without any signs of depression or eating disorder -- and tested them in a stressful situation. To
rule out the effects of premenstrual syndrome and sex hormones, "we made sure each was in the
same time in their cycle," Epel tells WebMD.

To create a stressful environment, Epel asked each woman to do the same challenging task -- but
didn't give any enough time to complete the task.

After both sessions, each woman went to a quiet room where they sat alone, reading or listening
to music. They also had a basket of snacks in front of them. "We didn't pressure them, merely
invited them to eat," says Epel. "None of the women was aware that their choices of snack foods
were being studied."

The snacks to choose from: sweet and salty snacks, and high-fat and low-fat snacks. The higher-
fat sweet snacks were chocolate granola bars and potato chips, and two low-fat sweet and salty
snacks were flavored sweetened rice cakes and salty pretzels. Each woman was told she could
request additional servings, but very few did, Epel says.

After each woman left the "snack room," the amount eaten was assessed -- including the amount
of serving and nutrient content, and total calories of all snacks eaten. Researchers assessed the
women's mood and they also measured cortisol levels.

They found that those who reacted most to the stressful event through mood and higher cortisol
levels also ate more, and especially more of the sweet snacks. On average, "high reactors" ate a
total of about two sweet servings, whereas "low reactors" ate about 1.4 sweet servings.

When they compared the stressful day with a nonstressful day, no increases in cortisol or eating
were seen.

Previous studies have not made this link between cortisol and increased eating after stress, Epel
tells WebMD. "Animal studies have shown that cortisol increases hunger. ... That's indeed what
we found [in humans] -- that women who reacted to stress the most also ate the most.

"Cortisol and negative mood may reflect greater vulnerability to stress," Epel says. "It may also be
that cortisol is directly affecting appetite. Cortisol can increase insulin, which stimulates appetite."

The bottom line: "If you're an emotional eater, you will likely have trouble keeping weight off," she
tells WebMD.

"Epel has provided several pieces to the puzzle," says Pamela Peeke, MD, MPH, assistant
professor of medicine at the University of Maryland School of Medicine and author of Fight Fat
After Forty.

What Peeke calls "toxic stress" is "defined as any stress that is long term and associated with a
perception of helplessness, hopelessness, and a sense of defeat," she says. "It's having a
micromanaging boss, rotten marriage for 10 years, kid who is a juvenile delinquent -- and you're
trying real hard to be resilient about it."

The result: Stress causes cortisol levels to be elevated all the time, and that tends to facilitate the
deposit of fat deep in the belly, Peeke says. That kind of fat is the most dangerous to health, she
says. "It's what I call "toxic fat" -- that deeply deposited intra-abdominal fat that occurs in thin
people. It's the people who have thin legs, thin arms, and the little bowling-ball belly.
"She found that you don't have to be fat to have that toxic weight. You can be of average weight,"
Peeke tells WebMD. And "it can happen as early as age 30 in women. That deep-belly fat is
caused by toxic stress. It's what I've said before, that it's not just what you weigh, it's where you
weigh it. It's those extra 5, 6, 7 pounds deep in your belly [that] is part of the "metabolic
syndrome" -- the constellation of toxic weight, heart disease, high blood pressure, stroke,
diabetes, and cancer," she says.

Now that you know it's bad, how do you prevent it?

• Mind control: Start thinking in a more stress-resilient way, Peeke says. "Get a
grip. Get a better job. Or just get realistic. "Realize your boss is unhappy and has
no life and his major joy in life is to make yours miserable. It's all in the head.
You have to learn the fine art of regrouping."
• Mouth control: Avoid the temptation to eat, Peeke says. Avoid white sugars and
white starches like bread, rice, potatoes, pasta -- all of which increase insulin
levels, thereby increasing the drive to binge eat.
• Put muscles to work: Through even small bits of aerobic activity -- just walking around for
five minutes at a time -- it's possible to neutralize the stress response, Peeke says. "It
absolutely makes a huge difference. Every hour take five minutes and do something."

Stress Causes Lasting Brain Changes

Study Findings Help Explain Posttraumatic Stress Disorder
By Liza Jane Maltin Reviewed By Charlotte Grayson, MD
WebMD Medical News

Jan. 17, 2002 -- We all know what it's like to be under stress. And we know it can take a
toll on our health -- from headaches to insomnia to serious illness. Even "good" stress --
the birth of a child, a promotion at work -- can cause problems if we don't learn to
manage it effectively. Now there's evidence that even short-term stress can cause lasting
physical changes in the brain -- findings that help explain the devastating symptoms of
posttraumatic stress disorder.

The research team, led by Eran Meshorer from The Hebrew University in Jerusalem,
looked at what happened to mouse brain cells and to live mice following brief exposure
to different types of stress. Their findings appear in the Jan. 18 issue of Science.

They found that within minutes of exposure, brain nerve cells, or neurons, became
hypersensitive. And the change lasted for several weeks -- long after the stress was gone.
This is in keeping with victims of posttraumatic stress, who despite time and distance
from the original trauma remain physically, mentally, and emotionally agitated.

The researchers saw that a specific brain molecule had changed in a subtle but important
way. This molecule normally produces a protein that removes a certain neurotransmitter
from the spaces between neurons. Neurotransmitters are the "chemical messengers" that
help relay information from neuron to neuron.

In this case, when the molecule in question changed in response to stress, the protein it
produced was also changed -- in such a way that it no longer removed its target
neurotransmitter. And this led to communication problems in the brain -- problems that
looked very similar to the behavior and memory symptoms of posttraumatic stress
disorder.

Understanding these mechanisms could be an important first step to finding better, more
effective treatments for the millions of people who suffer from posttraumatic stress
disorder.

Too Much Stress Hinders Immune System

Chronic Stress Makes Body Less Able to Control Inflammation
By Jennifer Warner Reviewed By Brunilda Nazario, MD
WebMD Medical News on Monday, November 04, 2002

Nov. 4, 2002 -- Being stressed out may not only increase your chances of getting sick, but
it could also hinder your immune system's ability to fight off infection and disease. New
research shows that chronic stress can affect how well the immune system is able to
respond to its own signals.

The study shows that constant stress impairs the immune system's capacity to respond to
the normal hormonal cues that signal the end of an inflammatory attack after an infection
or injury. Those hormones, known as glucocorticoids, are responsible for turning off the
production of compounds from the immune system that trigger inflammation.

Researchers say the findings suggest that this interference could increase the risks
associated with a variety of conditions, such as heart, allergic, and immune diseases.
Their study appears in the November issue of Health Psychology.

Although psychological stress has been linked to a variety of health problems,

researchers say it's not clear exactly how stress affects the immune system. In addition,
the effect of chronic stress is difficult to quantify due to the variety of stressors people
experience.

But in this study, researchers attempted to examine what happens to people's immune
systems during an ongoing stressful experience. They compared blood samples from 25
healthy parents who had a child undergoing treatment for cancer with samples taken from
25 healthy parents with healthy children. Investigators also measured the parent's mental
health, levels of social support, and levels of stress hormones obtained from saliva
samples.

They found that the parents of cancer patients had more psychological stress than the
other parents. They also found that blood samples from these parents had less of a
decrease of inflammatory compounds after treatment with glucocorticoids than the blood
samples of parents without stress. Stress, the researchers say, lowered the parents'
sensitivity to glucocorticoids. This lowered sensitivity means that inflammation may go
unchecked, leading to an increased risk for stress-related ailments.
But social support also seemed to play an important role in countering these negative
effects of stress. Study author Gregory Miller, PhD, of Washington University, and
colleagues found less immune impairment among parents of cancer patients that reported
having a strong support network.

Yet Another Reason to Avoid Stress: Sudden Death

By Jane Schwanke
WebMD Medical News

Jan. 17, 2000 (Minneapolis) -- In one of the first studies to show a link between mental
stress and death, researchers at Yale University School of Medicine have found that stress
may actually lead to sudden death. The findings are particularly important in people with
a history of certain irregular heart rhythms that may already predispose them to sudden
death.

Scientists have known for some time that sudden death, usually caused by heart attacks
associated with a lethal heart rhythm, are more prevalent in populations that suffer
earthquake or war. And studies in the laboratory have shown that the primitive fight-or-
flight response to stress alters heart rhythms in animals, while anger, anxiety, and
performance stress alter heart rates in humans. Now researchers are beginning to learn
why.

The patients in the study had a history of a potentially fatal heart rhythm, and all had been
implanted with a cardiac defibrillator. An implantable cardiac defibrillator is about the
size of a pack of cards and is implanted in the chest. The device is programmed to shock
the heart if it detects an abnormal rhythm.

Researchers performed mental stress tests in the patients. These patients were grilled with
rapid-fire arithmetic questions and harshly reprimanded for incorrect responses. Patients
were then asked to discuss an annoying event, as the interviewer pressed for further
details and asked irritating questions.

The study shows that mental stress not only makes abnormal heart rhythm more difficult
to control, but the same condition is quicker and more difficult to terminate when patients
with irregular heart rhythms are under no sedation. "In patients with a [rapid heartbeat
greater than 100 beats per minute], mental arousal [can upset the] circuit, creating a
potentially more dangerous [heart rate]," the authors write.

"Patients should be aware that stress really can alter arrhythmias or make heart rhythms
dangerous," Lampert tells WebMD. Through their research, Lampert says, researchers
will be better able to design preventive strategies in the future.

"This study suggests that treatment of [irregular heart rhythms] should include integrated
medical care, which include not only conventional drug and device therapy, but also a
complementary medicine component focusing on emotional status and living and
working environments," Ruey J. Sung, MD, tells WebMD. "A mutual understanding of
the concept of integrated medical care between the physician and patient is key to better
control [of irregular heart rhythms]." Sung is director of cardiac electrophysiology and
arrhythmia service at University of California-San Francisco Stanford Health Care in
Stanford, Calif.

Only one woman was enrolled in the study. Whether the effects of mental stress on
arrhythmia differ in women requires further evaluation.

Vital Information:

• A new study shows that mental stress changes the heart rate and the rhythm of the
heart, even in patients without evidence of heart disease.
• Researchers suggest that mental stress, particularly in patients who already have
arrhythmias, can lead to sudden death.
• Treatment of cardiac arrhythmias should include integrated medical care, including a
focus on emotional well-being, in addition to treatment with drugs and devices.