So you can see that, while short-term stress can be useful and necessary, long-term, prolonged, or unrelenting stress is not a good thing. What begins as a nervous stomach or feelings of nausea during a short-term stressful situation can develop into irritable bowel syndrome, ulcers, and other serious physical ailments in cases in which stress is constant and severe.
The American Academy of Pediatrics has already warned that more and more teens are exhibiting physical symptoms linked to stress, including headaches, chest pain, sleep disorders, and belly pain. That’s worrisome news, since those sorts of problems have the potential to become more serious and result in conditions such as digestive disorders, sleeping disorders, migraines, heart disease, and perhaps even contribute to some types of cancer. Doctors are urging their patients to be aware of the warning signs of stress-related physical problems and to take measures to address them.
In this post we’ll have a look at situations that can result in long-term stress, how long-term stress can affect you physically, what physical symptoms you might experience, and how you can recognize potential problems. Long-term stress also can have significant psychological effects, and you’ll learn more about those in the next post. To begin, let’s look at some common and not-so-common situations that can result in continual or frequent stress.
As you know from previous post, How Stress Affects You Emotionally, some people are more susceptible to stress than others, and some are better able to deal with it when it occurs. Some situations, however, are pretty much universally stressful, as noted on the Holmes and Rahe stress scale. Among those universal stressors are the deaths of a spouse or child, divorce or separation, serving time in jail, death of a family member, illness, marriage, pregnancy, a child leaving home, changing schools, and having a mortgage. (It’s interesting that even occasions or events that we consider to be happy ones—such as getting married or preparing to welcome a new baby into the family—come to us with a good measure of stress).
Fortunately, most of these big stressors occur only on an occasional basis and are not ongoing. Some situations, though, are ongoing and can result in ongoing or constant stress.
Certainly, ongoing physical, sexual, or emotional abuse is reason for extreme levels of stress. So is living in a violent environment, such as a war zone or even a very dangerous urban neighborhood. These sorts of situations, even if they stop, have long-lasting results, including both physical and psychological problems.
While it’s impossible to ignore terribly traumatic experiences like physical, sexual, or emotional abuse or other forms of violence, there are other stressors that might be so constant in your life that you don’t even recognize them. It’s a worrisome fact that you can get accustomed to living with stressful situations to the point where you barely think about them—they’re just the way it is. These situations might include constant worrying about succeeding in school, getting accepted into college, finding the money to go to college or rent an apartment, getting invited to the prom this year, your girlfriend or boyfriend breaking up with you—these sorts of low-level stressors that often remain under the radar. They might not be at the forefront of your mind’s agenda, but they’re always a little below the surface, nagging at you like a mosquito bite that won’t stop itching.
If you’re exposed to ongoing or long-term stress, you might notice over time that your neck and shoulders feel cramped and tight, making it difficult some days to even turn your head without neck pain. You might notice that your stomach is frequently churning, and you wonder if it’s safe to eat or whether you should skip lunch and just have a soda. You don’t understand why you have headaches so often until your dentist says she can tell that you’ve been grinding your teeth as you sleep, a habit that often results in headaches. To top
it off, your asthma, which you thought you’d outgrown by sixth or seventh grade, has returned, making it difficult for you to play on the baseball team.
You feel like your body is falling apart and you’re only 18 years old! What will it be like when you’re 40 or 50 or 60? If you feel that you’re stressed out and already experiencing some physical problems as a result, the best thing you can do is to address the situation now. If you don’t learn how to handle stressful situations now can mean that you’ll lack the skills you need to cope with them as you get older, and it’s likely that physical problems would only become more severe. Let’s take a look at some of the serious physical conditions that are associated with stress, and the problems they can cause.
Also known as hypertension, high blood pressure causes the heart to work harder to pump blood to the body and contributes to cardiovascular disease, stroke, eye problems, and kidney disease. While experts are still trying to determine whether long-term stress actually causes high blood pressure, evidence strongly points to a connection between the two. The School of Public Health at Johns Hopkins University in Baltimore reported on a study which revealed that ongoing stress among teens can lead to elevated blood pressure, more than doubling the risk that those teens would experience chronic high blood pressure as adults.
Increasing numbers of teens also are experiencing elevated blood pressure levels due to factors such as obesity, inactivity, and poor eating habits. Other factors that contribute to high blood pressure include genetics and aging. High blood pressure has been called “the silent killer,” because there usually are no symptoms. This makes the condition particularly dangerous.
A doctor or nurse can measure your blood pressure with a device called a sphygmomanometer, which consists of a stethoscope, arm cuff, dial, pump, and valve. You can also get your blood pressure taken at health fairs, at special machines in some drug or grocery stores, or with home blood pressure monitors. High blood pressure can be treated with lifestyle changes and medications, if necessary. People who are susceptible to hypertension should be careful to monitor their blood pressure so it can be kept at an acceptable level. If you’ve never had your blood pressure taken, or haven’t had it taken for a long time, it’s a good idea to do so in order to establish a baseline reading. If you have your blood pressure taken several times with similar results, you’ll be able to keep an eye on it to see if remains about the same.
Keep in mind, though, that blood pressure is susceptible to your reactions to what’s going on around you and can vary significantly within a short period of time. If you’re on your way to a health fair to have your blood pressure checked and you’re nearly run over by a bus on your way, for instance, chances are your blood pressure will be quite high when you arrive! A good thing to do would be to wait for an hour or two and have it taken again to see if it’s come down.
Blood pressure for some people tends to elevate just at the thought of having it checked, resulting in a sort of false reading. Some people with high blood pressure do well to purchase a machine they can use at home to keep track of daily readings. If there’s a history of high blood pressure in your family—that is, if your mom, dad, or any of your grandparents have or had the condition—you should get yours checked occasionally and keep track of the results.
As with high blood pressure, it’s not yet clear whether stress is an independent factor or a primary cause of heart disease, but evidence strongly points to a link. It’s sort of like a chain, where one link leads to another. People who are under a lot of stress for a prolonged period might end up feeling isolated or angry, traits which have been linked to increased risk of heart disease. Or, stress causes some people to react with unhealthy behaviors, such as smoking, excessive drinking, physical inactivity, or overeating, all of which also can contribute to heart disease. Experts suspect that high stress levels can further elevate blood pressure and levels of cholesterol, which is a soft, waxy substance found in your body’s bloodstream and cells. Everyone needs cholesterol, but when too much of it builds up it can block the flow of blood to the heart and result in health problems, including heart attack. Some studies suggest that stress changes the way the blood clots, and that could be a factor for heart disease. If stress actually is a primary factor in heart disease, it could be due to frequent and excessive exposure to stress-related hormones such as cortisol and adrenaline.
Regardless of whether stress is a cause or a contributor to heart disease, the evidence certainly points to a link between the two.
The term heart disease actually refers to a number of conditions that affect the heart, including coronary heart disease and heart attack, congestive heart failure, and congenital heart disease. Together, those conditions cause more than 652,000 deaths in the United States every year, according to the Centers for Disease Control and Prevention—more than any other disease. The most common type of heart disease is coronary heart disease, which is when the arteries that allow blood to flow to and from the heart get narrowed and hardened due to buildup of plaque.
Some people don’t have any symptoms of coronary heart disease until they have a heart attack, also known as a myocardial infarction. This happens when the heart can’t get enough blood and the cells of the heart muscle don’t receive enough oxygen and begin to die. The more time that passes between the beginning of a heart attack and the start of treatment to restore blood flow, the more damage will occur to the heart muscle. If the heart sustains a great deal of damage, cardiac arrest could result; this is when the heartbeat stops, and it can lead to death.
Other people get a warning that coronary heart disease is present in the form of angina, which is a pain or feeling of pressure in the chest, and sometimes in the shoulders, arms, and back. This occurs when the heart muscle isn’t receiving enough oxygen.
Tests to determine whether or not a patient suffers from coronary heart disease include:
> Electrocardiogram (EKG), which measures the electrical rhythms, rate, and regularity of the heartbeat
> Echocardiogram, which provides an image of the heart
> Exercise stress test, which measures how effectively the heart pumps when it’s working harder than usual, requiring more oxygen for the heart muscle
> Chest X-ray, which provides an image of the inside of the chest, including the heart
> Cardiac catheterization, in which a thin tube is inserted into an artery in the groin or arm and threaded up to reach the coronary arteries. This allows a doctor to check the insides of coronary arteries to determine blockage and other factors affecting the arteries and your heart.
> Coronary angiography, which is when a dye is injected through the catheter used in a cardiac catheterization, allowing a doctor a better look at the flow of blood and whether blockages are present
Treatment for coronary heart disease usually involves making lifestyle changes, and it often includes medicines and medical treatments. Sometimes, but not always, surgery is required to open arteries and improve blood flow.
Congestive heart failure, sometimes called chronic heart failure, occurs when the heart can’t pump enough blood and oxygen to keep other body organs healthy and functioning properly. This can result in a number of serious problems, including kidney failure and other conditions. There is no cure for congestive heart failure, but in many cases it can be managed through lifestyle and with medicines and other treatments.
Congenital heart disease is the most common type of major birth defect; it can be caused by genetic factors, or, sometimes, because a developing fetus is exposed to something that damages the heart. Congenital heart defects include abnormal valves and holes in the walls that divide the chambers of the heart.
Simply being exposed to high levels of stress does not cause any of these conditions. In people who have other risk factors or existing problems, however, stress is suspected as a contributing factor to heart disease.
Strokes are sometimes called “brain attacks” because, as during a heart attack, blood flow is restricted. With a stroke, however, the blood flow to the brain is cut off, meaning that the brain doesn’t get the oxygen and glucose that it needs to survive, and brain cells begin to die. If a stroke is not treated early, it can cause permanent brain damage.
There are two kinds of stroke: ischemic and hemorrhagic. Ischemic stroke, which accounts for about 80 percent of all strokes, occurs because either a blood clot or too much plaque clogs blood vessels and blocks the flow of blood to the brain. A hemorrhagic stroke occurs when a blood vessel in the brain breaks or ruptures and blood seeps into brain tissue, damaging brain cells.
Although stress does not directly cause strokes to occur, people with high blood pressure are four to six times as likely to have a stroke as those who don’t have high blood pressure, and stress also has been connected to other risk factors for stroke, including irregular heart rhythm, smoking, excessive use of alcohol, being overweight, and coronary artery disease.
The immune system is an amazing collection of cells, proteins, tissues, and organs that continually work together to fight off substances that threaten to harm the human body. The immune system employs a series of steps, known collectively as the immune response, to seek out and destroy organisms and substances that, if left alone, could cause disease or infection. When the immune system is functioning properly, it is incredibly effective in protecting you. It can kill bacteria, viruses, and infected cells; assure immunity from diseases; and generally help keep you healthy.
When the immune system is compromised, or not working properly, however, it is not always able to protect the body as it should. Basically, there are four things that go wrong with the immune system: immunodeficiency disorder, autoimmune disorder, allergic disorder, and cancers of the immune system.
Immunodeficiency disorder occurs when parts of the immune system are not working the way they should—or don’t even exist. Some people are born with deficient immune systems, while the immune systems of others are damaged by infections or drugs. There are different levels of immunodeficiency disorder, ranging from mild to severe. People with mild immunodeficiency disorders might suffer from allergies and tend to get more colds and other respiratory infections than others, while someone with very severe immunodeficiency disorder may be almost completely helpless in fighting infection. You may have heard of “the bubble boy disease,” a condition called severe combined immunodeficiency. Its more informal name comes from the case of a boy from Texas who lived in a plastic bubble that had to be kept entirely free of germs because his damaged immune system did not allow him to fight off any sort of infection. That, of course, is an extreme form of immunodeficiency disorder.
Sometimes immunodeficiency disorder occurs when the immune system is damaged by a disease or certain types of drugs. AIDS (acquired immunodeficiency syndrome) is a disease that, over time, destroys the immune system by making it unable to fight off what would normally be harmless organisms. Some medicines, including chemotherapy and immunosuppressant medicines given to people who have had organ transplants, also can cause immunodeficiency disorder.
Autoimmune disorders occur when something in the immune system goes haywire, causing it to attack a part of the body as if it were an invader looking to cause harm. Autoimmune disorders include lupus, which causes pain in the joints and muscles and can involve the kidneys and other organs; juvenile rheumatoid arthritis, in which the immune system attacks joints of the hands, feet, or knees; and scleroderma, which leads to inflammation of the skin, internal organs and joints. These disorders can be life altering and debilitating.
Sometimes the immune system overreacts to certain substances within the body, causing an allergic disorder. This can cause symptoms ranging from sneezing and watery eyes to a dangerous condition called anaphylaxis. Examples of allergic disorders include asthma; eczema; drug allergies; seasonal allergies; food allergies; animal allergies; allergies to toxins, such as bee stings; and environmental allergies, such as allergies to dust mites or mold.
Cancers can occur in the immune system, as in other parts of the body, when cells grow in an uncontrolled manner. This damages the immune system and makes it unable to do its work. The two most common types of cancers affecting kids and teenagers are leukemia and lymphoma. Thankfully, most cases of these cancers are curable.
Researchers and doctors have discovered a link between stress and disorders of the immune system. Studies have shown that long-term stress, particularly when those experiencing it can not see any ending to it or have no hope of escaping it, weakens almost all aspects of the immune system, making those affected more susceptible to a variety of problems. Some researchers believe this is due to the presence of cortisol, a stress-related hormone that may affect the cells within the immune system and limit their ability to fight off diseases.
Continued research is occurring as scientists and doctors learn more about the ways in which stress affects the immune system. It has been observed, however, that people exposed to long-term stress are more susceptible to a variety of problems, ranging from colds to cancer. Addressing overall health is extremely important when considering the immune system and how to keep it at peak functioning levels. Proper nutrition, sufficient exercise, and keeping stress under control are all factors that affect how efficiently your immune system works.
There is no proof that stress, by itself, causes cancer. Studies conducted over the past three decades, however, have suggested a relationship between psychological factors, including stress, and cancer risk, according to the National Cancer Institutes, a branch of the National Institutes of Health.
While some studies have indicated that stress might actually increase the risk of developing cancer, others have suggested that high stress levels may lead to faster progression of the disease once it occurs. Still other studies have linked stress to certain types of virus-related tumors that occur when the immune system is compromised.
This is a complicated topic, because, as with high blood pressure and heart disease, it’s not known whether stress is a factor in the development of cancer, or if it contributes to the effects of other cancer factors, such as obesity, smoking, and alcohol abuse. Someone with a strong family history of cancer may experience a great deal of stress worrying that she too will get cancer, raising the question of whether the stress may contribute to the likelihood of the cancer occurring. And, researchers wonder, once cancer has been diagnosed, could the stress that accompanies such a diagnoses contribute to the progression of the disease?
Most scientists believe that cancer is caused by a combination of factors, including genetics and environmental and behavioral factors. As more research is conducted, we should get a better understanding of a possible link between stress and cancer. We do know, however, that stress can negatively affect the immune system, and the immune system is an important tool in fending off cancer.
A common stress response for many people is to eat. And, generally, when you’re feeling stressed out and looking for relief, a celery stalk is not the first food you reach for. Most people who seek stress relief through food gravitate toward foods high in fat, sugar, and salt—pizza, fried chicken, and donuts, rather than fruits, vegetables, and whole grains.
Many people eat when they are bored, happy, sad, angry, or frustrated—not just because they are hungry. Researcher Brian Wansink claims that the average person makes about 200 decisions pertaining to food every day, most of which are made with little thought or awareness, and most of which have hardly anything to do with hunger. Eating habits, Wansink asserts, depend largely on who we’re with, where we are, and how we’re feeling at the time we decide to eat. So, if you and friend always take a different route home from school on Fridays because you stop at the café for a water ice or gelato, you’re likely to indulge, even if you’re not particularly hungry. If you’re feeling stressed or upset, you might indulge even more than you normally would.
There’s a lot of truth to jokey mottoes such as “When all else goes wrong, reach for chocolate,” because that’s exactly what many people do. Some people use food for escape, just as others might use alcohol or drugs.
A recently released study of more than 1,000 low-income adolescents in Boston, San Antonio, and Chicago revealed that kids who reported high levels of stress based on five factors experienced an obesity rate almost 10 percent higher than their peers who did not feel overly stressed. The five factors considered were: academic problems, drug or alcohol use, depression or poor mental health, aggressive behavior, and lack of future orientation.
The increased obesity in the highly stressed kids could be caused by behaviors adopted in response to stress, such as overeating and not exercising, researchers said. Or, obesity itself may be a stressor, leading to a vicious cycle.
In addition to stress-affected eating habits, scientists recently discovered another connection between stress and weight gain. A study led by Georgetown University Medical Center revealed that a molecule called neuropeptide Y (NPY), which helps in new tissue growth, is released from certain nerve cells during times of stress. The NPY molecule has been linked to appetite and obesity, leading researchers to suspect a link between stress and fat growth. The body of a person who experiences stressful situations on a regular basis could be releasing this molecule often, promoting the production of fat.
Diabetes is another disease which, although not caused by stress, may be affected by it. And, stress may be a contributing factor in the presence of the disease. When someone has diabetes, his or her body doesn’t produce insulin (type 1 diabetes), or doesn’t use insulin properly (type 2 diabetes). Insulin is a hormone necessary to convert sugar, starches, and other foods into energy. Nearly 8 percent of the American population has diabetes, and the incidence of the disease is rising. Both genetics and environmental factors, including obesity, play a role in the development of this disease.
Ninety to 95 percent of people suffering from diabetes have type 2, in which their bodies don’t use insulin properly. Traditionally, type 2 was known as “adult diabetes,” because it usually didn’t occur until well into adulthood. Today, however, children as young as seven have been found to exhibit early signs of type 2 diabetes, and, alarmingly, the number of children being diagnosed with this type of the disease is increasingly rapidly. Overall, the incidence of diabetes in the United States increased by 13.5 percent between 2005 and 2007, according to the American Diabetes Association.
Experiencing frequent stress poses particular problems for someone with diabetes. When the fight-or-flight response kicks in, so do stress hormones. The hormones allow stored up energy in the body to be released into the cells to get the body into shape for fleeing or fighting. A person who has diabetes may not have insulin to help that stored-up energy get into the cells—the glucose and fat that makes up the energy gets stacked up in the blood. For such a person, stress occurring on a regular or constant basis, can result in long periods of high levels of glucose in the blood.
Also, people who have diabetes and find themselves under stress may not take care of themselves as well as they should, which can have a negative effect on their health.
As you have read, long-term stress plays a role in a number of very serious diseases, as well as causing less serious problems such as headaches, digestive problems, neck and shoulder pain, sleeping problems, and skin rashes. If you are already experiencing any of the physical problems associated with stress, you should make an appointment to see your doctor. If you haven’t had a physical examination for two years or more, it’s advisable to try to schedule one. If you don’t have a family doctor or can’t afford to see a doctor, there may be alternatives available to you. You’ll read more about that in this post, Paying for Care – Health care coverage for Stress.
> While short-term stress can be useful, long-term stress can cause a variety of problems, including serious physical conditions.
> Many people become accustomed to living with ongoing stress and no longer recognize that the stressful situation exists.
> If you’re already experiencing physical symptoms of stress, you should address the situation now so it doesn’t continue to worsen as you get older.
> Stress is believed to play a role in high blood pressure, heart disease, stroke, problems of the immune system, cancer, obesity, and diabetes.
> While stress doesn’t cause these serious diseases and conditions, it might contribute to their presence or make them worse once they are diagnosed.
> If you believe you may be experiencing stress-related physical problems, you should consult with a doctor or other health professional.
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