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April is Stress Awareness Month


According to the Healthgrades Health Observation Calendar, April is Stress Awareness Month. If you woke up this morning, you have stress. We are all aware of things that cause us stress, or our stressors. We’ve got bills to pay, kids or parents to take care of, homework to do /deadlines to meet and relationships to maintain. Some of us have even dealt with traumatic experiences from which we’ve not fully recovered.


But do we really understand how stress affects our emotional and physical health? How about what we can do to help our mind and bodies cope with stress and decrease the longterm effects?


What is stress?

Stress is described as a mood state. “Conventionally, stress is defined as a transactional process arising from real or perceived environmental demands that can be appraised as threatening or benign, depending on the availability of adaptive coping resources to an individual” (McEwen, & Gianaros, 2010, p. 190). In other words, stress is something that causes you to feel vulnerable

resulting in either positive problem solving or a negative coping response. The response to stress can depend on the ability to cope or the number of perceived stresses. Let’s also define the types of stress: good, bad and tolerable. Listen here to Dr. McEwen of Rockefeller University describe these different states of stress. The physiological mechanisms that are affected by stress are started in the brain.


What’s the normal response to stress?


The brain works together with the endocrine system


(this system controls and regulates hormone

production and function) and induces a response

known as the stress cascade.

Once a stressor is identified, the cascade ensues like

this:

• The release of corticotropin-releasing hormone

(CRH) from the hypothalamus, a part of the brain.

• Then the release of adrenocorticotropin hormone

(ACTH) into general circulation from the pituitary

gland, part of the endocrine system attached to the

base of the brain.

• That results in a counter release of cortisol from

the adrenal glands, part of the endocrine system, to

maintain stability.

https://premierneurologycenter.com/blog/6-ways-stress-affects-your-brain/


The inability of the body to maintain balanced cortisol levels leads to adverse health

consequences and chronic disease.


What are the experts learning?

One study showed that chronic social stress can alter the blood brain barrier (this mechanism regulates what can be absorbed into brain tissue from the blood) and allows improper passage of molecules that promote inflammation and lead to depressive behaviors and affects the proper stress response. Not good. Consider this analogy, imagine a sewer pipe that has gotten old and begins to leak and contaminate the surrounding environment like a basement or back

yard. “Clinical studies report higher prevalence of major depressive disorder in patients suffering from inflammatory conditions such as cardiovascular diseases or stroke” (Dudek, et. al, 2020, p. 3326).

In short, stress can lead to chronic disease and chronic disease can lead to stress.

Another study used functional MRI images that suggested that stress affects cerebral (brain) blood blow and adjusts it according to the metabolic need – supply and demand. The study also linked the brain’s response to the change in blood flow to the cortisol response relating it to a risk of stress related disorders (Elbau, et al., 2018, p. 10206).Consistently high stress leads to cortisol dysfunction...then chronic pain and depression.


A large-scale study of stress, emotions and blood pressure linked maladaptive, or

nonproductive, stress responses to chronic hypertension and cardiovascular disease. During times of highly stressful stimulation, the blood pressure and heart rate were elevated and alternately low stimulation resulted in lower blood pressure and heart rate. Didn’t we already know this? This study was different because it used a large number of participants (20,000) and it studied blood pressure and heart rate response to natural everyday stressors (not lab induced). It also utilized an FDA approved and reliable app to track data.


What helps our brains and bodies respond better to stress?

You guessed it, exercise. Both aerobic, like running, jumping rope or burpees AND weight training like the devil’s press, goblet squats, bicep curls and push-ups.


In 2007, the Exercise is Medicine (EIM) initiative was founded by the American College of Sports Medicine. The evidence to support physical activity to treat and prevent chronic conditions is so overwhelming that in the 2018 Physical Activity Guidelines for Americans were established. The guidelines cited that studies regularly show that physical activity has health benefits at any age and is critical for longtime management and prevention of chronic diseases, including stress

disorders.


The EIM recommends that healthcare providers refer patients to appropriate community health and fitness centers just like they prescribe a pill or a therapy.

See the guidelines below:





https://journals.sagepub.com/doi/epdf/10.1177/1559827620912192


These recommendations may seem daunting at first. But which seem worse, a shorter lifespan

combined with dealing with chronic illness and unmanaged stress? Or a 30 minute, fun and challenging workout with 15 or so other people trying to do their best?

Check out the CrossFit workout of the day at NewCov. There’s also a modified version for those of us who are not into barbells. Check out Em's FitCamp.


References


Dudek, K. A., Dion-Albert, L., Lebel, M., LeClair, K., Labrecque, S., Tuck, E., Perez, C. F., Golden, S. A., Turecki, G. T. C., Mechawar,

N., Russo, S. J., & Menard, C. (2020). Molecular adaptations of the blood–brain barrier promote stress resilience vs.

depression. Proceedings of the National Academy of Sciences of the United States of America, 117(6), 3326–3336.


Elbau, I. G., Brucklmeier, B., Uhr, M., Arloth, J., Czmara, D., Spoormaker, V. I., Czisch, M., Stephan, K. E., Bincer, E. B., & Samann,

P. G. (2018). The brain’s hemodynamic response function rapidly changes under acute psychosocial stress in

association with genetic and endocrine stress response markers. Proceedings of the National , 115(43), E10201–

E10215.


Ewen, B. S., & Gianaros, P. J. (2010). Central role of the brain in stress and adaptation: Linksto socioeconomic status, health, and

disease. ANNALS OF THE NEW YORK ACADEMY OF SCIENCES, 1186, 190–222.


Gordon, A. M., & Mendes, W. B. (2021). A large-scale study of stress, emotions, and blood pressure in daily life using a digital

platform. Proceedings of the National Academy of Sciences of the United States of America, 118(31), 1–7.


Lieberman, D. E., Kistner, T. M., Richard, D., Lee, I.-M., & Baggish, A. L. (2021). The active grandparent hypothesis: Physical

activity and the evolution of extended human healthspans and lifespans. Proceedings of the National Academy of

Sciences of the United States of America, 118(50), 1–12.


Miller, D. B., & O’Callaghan, J. P. (2002). Neuroendocrine aspects of the response to stress. Metabolism Clinical and

Experimental, 51(6), 5–10.


NCCIH [@NIH_NCCIH]. (2018, August 9). Stress and your body | Dr. Bruce McEwen. Youtube.

https://www.youtube.com/watch?v=0TUDwXPq67k

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