Abstract
Stress can be extremely detrimental to our health and could be the causation of many health detriments we experience today. Though i
t isn’t just stress that is the issue, but rather the chronic, unresolved stress that is killing our body. Chronic stress releases a regular stream of Cortisol into a stressed out person that induces inflammation across all spheres of the systems, increases insulin resistance, increases heart disease, obesity, and even mental health issues. (Agnvall, n.d.) The regular release of Cortisol due to chronic stress also causes our body’s c
ells to not regenerate and replenish the dead tissue. It also reduces our immune response which increases our chances of catching any type of infection
or viral illness. Processed foods and sugars actually increase Cortisol levels which in turn increases inflammation and stress. According to the World Health Organization (2019), burnout from work related str
ess is now a disease. This paper hopes to show that more significance needs to be placed upon managing chronic stress as a disease and not merely a risk factor for other diseases. Management of stress can be done by simple breathing techniques, exercise, and eating right. But first, the information as to this topic’s importance needs to be spread.
Key words: Stress, chronic stress, burnout, disease, chronic disease, stress management, World Health Organization, cortisol,
What is Stress
There is a hidden facet to health that lies undetected to most as a silent killer to most bodily systems. Cardiovascular disease, behavioral health issues, insulin resistance, cellular death, are just a few of the known “side effects” of this silent killer. Also known as chronic stress, it is merely dubbed as a common everyday occurrence that doesn’t need to be dealt with. Typically, the stress response is a good reaction to a difficult time, increasing a person’s heart rate and blood pressure, triggered by hormones, opening the fight-or flight response to push a person past that threatening or hard time. However, the issue with stress that we need to speak on revolves around the long-term impacts of cortisol released during those stressful times, creating a poison that reduces a person’s immune response, increases inflammation, and even atrophies the brain. Though, chronic stress should be classified as a disease and not merely a risk factor due to the detrimental impact that chronic, elevated Cortisol levels have upon the body.
Heart Disease, Cellular Death, and Immune Response
“Research shows that almost every system in the body can be influenced by chronic stress.” (Salleh, 2008) Whenever a person becomes stressed with zero release of that stress, excess cortisol remains in the blood stream for days, weeks, or months at a time. During this period, inflammation is rampant, and the body increases plaque and white blood cell buildup in response. However, these hormones actually change the way the white blood cells form, causing the white blood cells to attach to the vein wall. Due to this buildup called atherosclerosis, a clot may form quickly initiating a cardiac event. (Agnvall, n.d.) This is the reason why many people have had heart attacks following the death of a loved one. If stress can cause heart attacks, what other damage may it do?
Every human cell has genetic caps called telomeres. These telomeres allow us to use our genetic code and the length of these telomeres show the age of a cell and how quickly it may replenish with newer cells. Long telomeres mean youth, while short telomeres mean aged cells. This is why older people have gray hair and wrinkly skin because their telomeres are much shorter than younger people. But have you ever seen someone who looks to be 30 years older than they are? Typically, if you speak to them for a short time, you would find that they have been extremely stressed for much of their life without release. Chronic stress shortens a person’s telomeres by inhibiting the production of telomerase, an enzyme that lengthens and protects telomeres. (Kiecolt-Glaser, J. K., & Glaser, R., 2010) Essentially, chronic stress keeps our cells from replenishing and refreshing with new ones, allowing cellular death to run rampant. However, this isn’t the only way stress hurts our bodies.
Our immune system is affected by many things and is controlled by the thymus which regulates and controls the cells responsible for fighting off different antigens as well as accepting certain others. According to the National Institute of Health:
“Several studies have shown that chronic stress exerts a general immunosuppressive effect that suppresses or withholds the body’s ability to initiate a prompt, efficient immune reaction. This has been attributed to the abundance of corticosteroids produced during chronic stress, which produces an imbalance in corticosteroid levels and weakens immunocompetence.” (Salleh, 2008)
Essentially, Cortisol chronically shifts how the thymus creates, distributes, and regulates the T-cells and B-cells responsible for how our body fights off pathogens. Without the correct balance of these specific lymphocytes, our body cannot accurately fight off foreign invaders.
Mental Health
Of all the systems of the human body, chronic stress affects our mental health the most. The link between having a healthy mind leading to a healthy body is diverse and strong. “Exposure to intense and chronic stressors during the developmental years has long-lasting neurobiological effects and puts one at increased risk for anxiety and mood disorders, aggressive dyscontrol problems, hypo-immune dysfunction, medical morbidity, structural changes in the CNS, and early death.” (Schneiderman, 2005) During times of chronic stress, the abundance of Cortisol directly impacts the hippocampus, amygdala, and parts of the prefrontal cortex, which are all areas that regulate emotions like fear and anxiety. (Baycrest Center, 2020) By this literal shrinking of the brain, mental health diseases like depression, anxiety, and even schizophrenia are results of chronic stress as either the root or predisposition of chronic cortisol levels. One study published in 2002 refers to stress as the fired shot in the loaded gun of schizophrenia, finally releasing what has always been there but exacerbating it with stress. (Corcoran, 2002)
Definition of Disease and the Role of Pharmaceuticals
Stress is the causation of heart attacks, cellular death, immune suppression, depression, anxiety, exacerbates schizophrenia, and this is just scratching the surface. If this “silent killer” is so detrimental to a person’s health, why is it not a disease? Could it be because it isn’t a foreign invader? Maybe the research involving the effects of chronic stress are just recently being noticed. According to Meriam Webster’s Dictionary, the definition of disease is, “A condition of the living animal or plant body or of one of its parts that impairs normal functioning and is typically manifested by distinguishing signs and symptoms.” (Merriam Webster, n.d.) Another definition of disease found is, “A disordered or incorrectly functioning organ, part, structure, or system of the body resulting from the effect of genetic or developmental errors, infection, poisons, nutritional deficiency or imbalance, toxicity, or unfavorable environmental factors; illness; sickness; ailment.” (Dictionary.com, n.d.) And still another definition found on the American Heritage Medical Dictionary, “An abnormal condition of a part, organ, or system of an organism resulting from various causes, such as infection, inflammation, environmental factors, or genetic defect, and characterized by an identifiable group of signs, symptoms, or both.” When we look at each facet of these definitions of what a disease actually is, chronic stress meets every one of them. Inside the medical realm, defined by the American Heritage Medical Dictionary, we see that the list is easily met. Stress can cause us to be more susceptible to infection, causes inflammation, and environmental factors like socioeconomic status and family or relational stressors are a strong root of this. (Rejineveld, 1998). As we keep going, chronic stress plays a massive genetic role by affecting telomerase production and length of telomeres. Lastly, the signs and symptoms of stress are broad and intense. Irritability and lashing out, unable to think clearly, brain fog, anxiety, poor appetite and immunity, as well as headaches and stomach problems are all signs of being stressed. (Rana, 2019) We must ask the “Why” question as to the reasons behind stress not being a disease. Could it be our approach in western medicine is heavily focused on taking a pill for the signs and symptoms to be relieved rather than attempting to find the source? Today, large pharmaceutical companies control large swaths of the medical industry by researching and developing a pill for every sign and symptom a person could develop. If this is the case, then finding the source is not what the medical establishment wants, for it is not profitable. Let us a take a look at Pfizer, a large and well known Pharmaceutical company. For example, they created a drug to aid in smoking cessation. This drug is called Chantix. The side effects from Chantix found on drugs.com (2019) include anger, depression, anxiety, mood swings, insomnia, restlessness, seeing or hearing things that aren’t there, suicidal ideations, behavior changes, feelings of panic, and feelings of discouragement. This list is only the mood side effects, not including the physical side effects. But for every major side effect, they have another drug to fix it. For anxiety, Pfizer has roughly 177 medicines. For mood swings like bipolarism, 80 drugs. For depression, 217 drugs. The list goes one. For every side effect of Chantix there is another drug within the same company to “fix it”. Could this be considered a conflict of interest. What if we started managing stress in a massive way, reducing the need for many medicines? How would that affect the pharmaceutical industry?
Solutions
So, what now? If chronic stress is a disease, what do we do? Is there a medicine to take to fix these issues? To answer this question, we must first solve what the root cause is. As we have understood it in the previous pages of this paper, cortisol release is the main hormone that causes these issues chronically. And it is important to note that cortisol is a necessary and beneficial hormone for managing stress in short spurts and durations. It is the long term cortisol release that I have been referencing during the entirety of this paper. With that being said, managing cortisol chronically would be our solution and it is much easier than one might think. First, we must increase endorphin production as it regulates the hormones cortisol and adrenaline, among other things. (TG, 2018) It also has a similar effect on the brain as morphine and codeine, giving a pain relief “high” through dopamine and oxytocin production, even binding to many of the same receptors as the opiate class of drugs. (Palkhivala, 2019) We increase endorphin production by exercising and during this process it releases these endorphins to decrease pain, regulate cortisol, and decrease inflammation.
Another way to manage chronic cortisol levels is through specific breathing techniques. One such technique is called the Wim Hof Method. Simply put, a person needs to do 30, large inhales with relaxed exhales. At the end of the set, they would hold their breath after exhaling all carbon dioxide in their lungs, timing how long they can hold it. This would repeat two more times for a total of three sets and 90 breaths. Within the Krebs cycle, more adenosine triphosphate (energy) is produced due the abundance of oxygen, allowing our body to not retain lactic acid buildup within the body. According to the National Academy of Science:
Both the autonomic nervous system and innate immune system were regarded as systems that cannot be voluntarily influenced. The present study demonstrates that, through practicing techniques learned in a short-term training program, the sympathetic nervous system and immune system can indeed be voluntarily influenced. (Kox, 2014)
This technique couples cold exposure with breathing techniques to regulate cortisol within the human body. Today, biology books are being rewritten due to the idea that the humanity’s autonomic system, i.e. cortisol release, temperature regulation, heart rate, blood pressure, can be voluntarily influenced. Breathing is one way, but cold exposure is the other way. By purposefully surrounding oneself in a cold environment like a cold shower or ice bath, cortisol is regulated to a healthy level again. (Tiina Pääkkönen, 2002) Simply put, stressors cause inflammation through the release of cortisol, and cold exposure downregulates cortisol. This is a big reason why we use icepacks for a swollen ankle.
Nutrition
Not only do we need to find ways to regulate cortisol by breathing techniques, exercising and cold exposure, but what we eat plays a huge role in how stressed we are. For instance, increased and prolonged stressful events causes increased and prolonged levels of cortisol inside a person’s body. This is something we’ve already talked extensively about. Chronic cortisol causes the human body to become resistant to insulin over the long term. Whenever a person becomes insulin resistant, the body’s cells are unable to use sugars. The response to that is a craving for more sugars and carbohydrates resulting in a greatly elevated sugar level in the bloodstream. However, the body doesn’t need more sugars and carbohydrates, it needs the ability to use what it has. In turn, that excess is stored as fat which increases chances for obesity. This is a huge causation of type 2 diabetes, obesity, and metabolic syndrome. (Geer, 2014) Due to the elevated blood sugar over time, diabetic ketoacidosis can alter the electrolytes within the cells and cause a multitude of lifelong issues, eventually resulting in death. Certain processed foods actually inhibit a person’s cells from replenishing the dead ones by inhibiting the telomerase enzyme from ever forming. (Karimi, 2018)
Chronic stress, due to how it affects the human brain, should be classified as a disease, not a risk factor, already meeting all the definitions of what a disease currently is. Increased Cortisol levels, over a long period of time, atrophies the brain and literally kills our cell’s ability to renew and replenish itself. Atherosclerosis and arteriosclerosis are created due to the plaque buildup from stress causing heart attacks and strokes. Insulin resistance, immune suppression, mental health disease, are all results from the neglect of our medical system to classify the increased cortisol levels due to chronic stress as a disease and not a mere risk factor. Mental health is in a steady decline within our society, showing the need for a change of direction by taking a stronger and much needed approach to chronic stress as the causation to many different mental health diseases. By showing the rampant conflicts of interest within the pharmaceutical industries like Pfizer, we can see how there may be other solutions to an ever growing problem. Incorporating stress management techniques like exercise, deep breathing, and smart eating will increase longevity, helps a cell’s ability to regenerate by increasing the telomere length, and also increases telomerase productivity by reducing Cortisol levels within the human body.
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