Tag Archives: worry

Chronic Stress: The Cascade Effect (Part 2 Of The Biology of Stress)

Today’s second post in this series about the biology of stress comes to us from the Causey Law Firm in Washington. We encourage anyone who suffers from stress, whether it is acute or chronic, to seek professional assistance to manage the symptoms and, if possible, develop strategies to alleviate the underlying causes.

Stress is how the body reacts to a real or imagined stressor — a stimulus that causes stress. Acute stressors affect a bodily organ in the short term; chronic stressors over the longer term. Chronic stress is the state of prolonged tension from internal or external stressors which may cause various physical manifestations such as asthma, back pain, arrhythmias, fatigue, headaches, irritable bowel syndrome, ulcers, and suppression of the immune system. Chronic stress takes a more significant toll on the body than acute stress. It can raise blood pressure, increase the risk of heart attack and stroke, and induce symptoms of anxiety and depression.

The Three Stages of Stress – From Acute to Chronic

  • Alarm: In this first stage, when the threat or stressor is first identified or realized, the body’s stress response is in a state of alarm. During this stage, adrenaline is produced in order to bring about the flight-or-fight response, causing sweating, raised heart rate, etc. The body’s resistance to the stressor drops temporarily below the normal range and some level of shock may be experienced. There is also some activation of the HPA Axis, producing cortisol, as discussed in our last post.
  • Resistance: If the stressor persists, the body must find some means of coping with the stress. Although it begins to try to adapt to the strains or demands of the environment, the body cannot keep this up indefinitely, so its resources are gradually depleted.  As it attempts to cope with the condition that is causing the stress, the mind may try to focus on the problem, which can actually exaggerate the awareness of the problem and make it seem difficult to overcome.
  • Exhaustion: third stage. At this point, all of the body’s resources are eventually depleted and the body is unable to maintain normal function. The initial symptoms may reappear (sweating, raised heart rate, etc.). Long-term damage may result, as the body’s immune system becomes exhausted, and bodily functions become impaired. The result can manifest itself in obvious illnesses such as ulcers, depression, diabetes, digestive system problems or cardiovascular problems.  It can also manifest as a chronic pain syndrome, guarding/avoidance behavior, and/or sleep disturbance.  Hopelessness can set in.

Chronic Stress and Cortisol

When the body’s HPA-axis cannot overcome a challenge and/or is chronically exposed to a threat, this system becomes overtaxed and can be harmful to the body and brain. An increased level of cortisol is one of the most dangerous outcomes of chronic stress.

Cortisol is an important hormone in the body, secreted by the adrenal glands and involved in some of the following functions: proper glucose metabolism, regulation of blood pressure, insulin release for blood sugar maintenance, immune function and inflammatory response. Normally, cortisol is present in the body at higher levels in the morning and is at its lowest level at night. Although stress is not the only reason that cortisol is secreted into the bloodstream, it has been termed “the stress hormone” because it’s also secreted in higher levels during the body’s ‘fight or flight’ response to stress, and is responsible for several stress-related changes in the body. Small increases of cortisol have some positive effects: a quick burst of energy for survival reasons, heightened memory functions, a burst of increased immunity, lower sensitivity to pain, and helping to maintain homeostasis in the body.

People are biologically ‘wired’ to react differently to stress.

While cortisol is an important part of the body’s response to stress, it is important that the body’s relaxation response be activated so the body’s functions can return to normal following a stressful event. Unfortunately, in our current high-stress culture, the body’s stress response is activated so often that the body doesn’t always have a chance to return to normal, resulting in a state of chronic stress, thus producing high chronic cortisol levels.

Higher and more prolonged levels of cortisol in the bloodstream like those in chronic stress have been shown to have negative effects, such as:

  • Impaired cognitive performance (loss or poor concentration, inability to complete tasks or heightened confusion in mildly stressful situations
  • Suppressed thyroid function
  • Blood sugar imbalances such as hyperglycemia
  • Decreased bone density
  • Decrease in muscle tissue
  • Higher blood pressure
  • Lowered immunity and inflammatory responses in the body, slowed wound healing, and other health consequences
  • Increased abdominal fat, which is associated with a greater amount of health problems than fat deposited in other areas of the body

When people feel stressed, stress hormones can be over-secreted, dramatically affecting the brain. Cortisol also plays a large part in post-traumatic stress disorder (PTSD) and memory. In a 2002 article in Biological Psychiatry regarding cortisol, PTSD and memory1, cortisol was noted to work with epinephrine (adrenaline) to create memories of short-term emotional events.  This effect may serve as a means to help a person remember what situations to avoid in the future. However, long-term exposure to cortisol damages cells in the hippocampus and can create impaired learning ability. It has been shown that cortisol inhibits memory retrieval of already stored information.

Cortisol secretion varies among individuals. People are biologically ‘wired’ to react differently to stress. One person may secrete higher levels of cortisol than another in the same situation. Studies have shown that people who secrete higher levels of cortisol in response to stress also tend to eat more food, and food that is higher in carbohydrates, than people who secrete less cortisol.

1“Depression. What happens in the brain?” Biological Psychiatry, 2002

Prior results do not guarantee outcomes.

The Biology of Stress (Part 1)

Today’s post comes from the Causey Law Firm in Washington.

Today’s post is the first in a multi-part series about stress, covering first the biology of stress and the effects of chronic stress on the body.

Stress is a term that is commonly used to explain — or explain away — much in our world. We live in a time of multifactorial stress: the economy; keeping, losing or getting jobs; housing, food, medical and dental care; personal and familial safety; fear or anger over political or governmental decisions; injuries and/or disabilities. At times, stress can be overwhelming when it seems we are losing control over our lives and our futures.

The following is an overview of the biology of stress to help better understand how stress can control such a large part of our health. There are many types of stress and those will be investigated after first laying out a basic understanding of what stress is and the physiologic mechanisms of stress.

The term stress is derived from the Latin word stringere, “to draw tight.”

The term stress is derived from the Latin word stringere, “to draw tight.” It had been used almost solely in the field of physics to define the internal distribution of a force exerted on a material body, resulting in strain — or stress — such as a rubber band pulled tautly. In the 1920s, stress started to be used in both biology and psychology, referring to a mental strain or a harmful external agent that could cause illness. Interestingly, in an early example, researcher Walter Cannon used the term strain/stress in 1926 to refer to external factors that disrupted homeostasis.1

The idea of stress and homoeostasis is intriguing for it is widely known that the incredible human system strives to maintain homeostasis, or equilibrium. So, it makes great sense that maintaining equilibrium is central to the idea of stress. This is true with all biological and most biochemical processes. The body always attempts to maintain this steady state of being; however, environmental factors, internal or external, continually challenge and disrupt this equilibrium (homeostasis) causing the body to constantly strive for balance. Environmental factors causing the body continued strife are generally called stress. Stress can be simply moments or events from which the body returns to equilibrium or it can turn into chronic stress where the body is constantly trying to reach homeostasis against resistance.

The balance of our body systems can be disrupted (stressed) by events from such disparate sources as a life-threatening situation or a simple insult, resulting in disequilibrium. Stress can bring on a cascade of biological reactions Continue reading

Prior results do not guarantee outcomes.

How To Manage Worry Without Medication

Today’s post comes from guest author Kit Case from Causey Law Firm. It is part 3 of 3 in a series about the dangers of psychological stress and how to cope with it.

For the last few weeks we’ve been talking about the very real medical dangers of worry. For injured or disabled workers, worry can add an additional and very significant burden on the body. In this post, we’ll talk about some of the ways that worry can be treated or even avoided.

Much of the time treatments are simply medications that increase GABA. Cognitive therapy is prescribed depending upon insurance coverage. Addressing the physical and mental effects of excessive worry can aid in recovery from an injury or disability and can increase levels of success in vocational retraining efforts. In rare cases, worry and anxiety can become permanent fixtures in a person’s life, and the effects of this condition can result in ratable permanent impairment. But, the greater part of lay and scientific literature lists non-medicine tips to reduce worry, fear and anxiety to a more modulated level, thereby providing some relief from this constant invader that often creates unproductive and hurtful periods in life.

Here, summarized, are six tips cited in the literature to help manage worry without medication:

  • Separate out toxic worry from good worry: Good worry amounts to planning. Toxic worry is unnecessary, repetitive, unproductive, paralyzing, frightening, and in general, life-defeating.
  • Get the facts rather than letting your imagination run away. Analyze the problem and take corrective action.
  • Develop connectedness in as many ways as you can: family, social, information and ideas, organizations and institutions. Never worry alone.
  • Touch and be touched: in addition to massage therapy, seek out hugs and laughter – being around children or family can help.
  • Be good to yourself. Exercise, eat well, get enough sleep, meditate, do yoga and be aware of over consumption of substances detrimental to your health, such as alcohol.
  • Sing, read, cry, do what you love, look for what’s good in life and don’t sweat the small stuff.

Prior results do not guarantee outcomes.

The Very Real Dangers Of Worry (Part 2)

Today’s post comes from guest author Kit Case from Causey Law Firm. It is part 2 of 3 in a series of posts about the dangers of worry.

Previously we posted on how worry can affect the lives of injured or disabled workers. In today’s post, we’ll talk about some of the specific effects of worry on the body.

The physical reactions to excessive fear and anxiety (worry) initiate a chain or cascade of pathological events by stimulating the amygdala area of the brain (fight/flight response), releasing neurotransmitters to the cortex. There, the fear or anxiety, whether real or imagined, is analyzed in detail and the analysis is returned to the amygdala where, in normal situations, the fear response is shut off by amino-butyric acid (GABA). GAD worriers may not have high enough GABA levels to shut off this pathway. Consequently, there are constant marked secretions of glucocortocoids and catecholamines that increase blood sugar levels. Marked levels of epinephrine and norepinephrine dilate blood vessels in skeletal muscles and other adrenergic (adrenal) stimulations that in turn create modifications in breathing, increased temperatures, sweating, decreased mobility of the stomach, bowels, and intestines, constrictions of the sphincters in the stomach and intestines.

Simply said, constant fear and anxiety result in debilitating amounts of stress hormones like cortisol (from the adrenal glands) and hormones that cause blood sugar levels and triglycerides (blood fats) to rise significantly. This process, if not shut off or modulated, can cause premature coronary artery disease, short-term memory loss, digestive problems, and suppression of the natural immune system. The scientific literature is now implicating constant stress, such as constant work stress or toxic fear and anxiety, in causing large weight gains in the midriff area which can greatly exacerbate orthopedic injuries, particularly of the spine or knees, and can lead to increased incidences of diabetes and cancer.

Worry causes increased mortality and morbidity. It is that simple.

For information on how to treat and avoid worry, check in with us later this week for the next installment in this 3-part series.

Prior results do not guarantee outcomes.

The Very Real Dangers Of Worry (Part 1)

Today’s post comes from guest author Kit Case from Causey Law Firm. It is part 1 of a 3-part series about managing psychological stress.

Worry is increasingly pervasive in our society as insecurity about the economy and safety, nationally and personally, grows daily. Worry is compounded in the daily lives of those who are injured or disabled, as they struggle with the added burdens of medical costs and loss of income, all of which engenders a bleak outlook on their future.

“At its worst, [toxic] worry is a relentless scavenger roaming the corners of your mind, feeding on anything, never leaving you alone.” This was the description of “worry” by Edward M. Hallowell, MD, in Worry, 1997, with a 2002 introduction. (This study is still considered the “bible” in lay literature and often quoted in scientific research.) Long ago, Dr. Charles Mayo said, “Worry affects circulation, the glands, the whole nervous system and profoundly affects the heart.” Indeed, worry appears to be, at worst, of genetic origins, and to a lesser degree a learned or environmental response.

Hallowell defines worry as two types: toxic worry and good worry. He likens toxic worry to a virus, insidiously and invisibly attacking you and robbing you of your ability to work, your peace of mind and happiness, your love and play. On the other hand, good worry, or adaptive worry, is necessary to avoid real danger and life-threatening situations.

Worry is categorized as part of Generalized Anxiety Disorder (GAD) in most lay and scientific literature. The National Institute of Mental Illness (NIMH) defines GAD as people who go through the day filled with exaggerated worry and tension, even though there is little to provoke it. NIMH literature states that people with GAD anticipate disaster and are overly concerned about health issues, money, family problems or difficulties at work. GAD is diagnosed when a person worries excessively about everyday problems for at least six months. Worry, as part of GAD, is commonly treated with medication and cognitive therapy.

The everyday worry of the disabled or injured worker is direct, with anxiety and fear over money, physical abilities, medical care, vocational options, housing, food, and family disintegration. It does prey upon so many, compounding their physical health problems and environmental lives.

For more on the very real physiological implications of worry, check in next week for the next installment in this series.

Prior results do not guarantee outcomes.