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

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James Zadroga 9/11 Health and Compensation Act Now Covers Many Types Of Cancer

Today as we reflect on the tragic events which took place 11 years ago, we are relieved to learn of the news that the Federal Government is finally  acknowledging what we, as representatives of many of these injured workers have suspected for many years-  that exposure to the toxins around Ground Zero can cause cancer.  We pray for all those who are sick and have died and for those who will continue to become ill as a result of this horrible attack.

The following article from NBC New York written by Brynn Gingras and Greg Cergol details the new coverage that those suffering from cancer are entitled to receive: 

The federal government will now officially add dozens of cancers to the list of illnesses linked to the Sept. 11 attacks, making those who lived or worked near ground zero and later became sick eligible for financial payments, authorities said Monday.

Fourteen categories of cancers, a total of 50, will be added to the illnesses covered in the James Zadroga 9/11 Health and Compensation Act, the National Institute for Occupational Safety and Health announced.

The Zadroga Act — named after NYPD Detective James Zadroga, who died at 34 after working at ground zero — passed into law two years ago. Despite the hundreds of sick responders, the act did not cover cancer because of a supposed lack of scientific evidence linking cancer to ground zero toxins.

“We have urged from the very beginning that the decision whether or not to include cancer be based on science,” said Mayor Bloomberg in a statement, adding that the decision “will continue to ensure that those who have become ill due to the heinous attacks on 9/11 get the medical care they need and deserve.”

Eighteen-year FDNY veteran Jeff Stroehlein spent several weeks working at ground zero, and is certain the brain cancer he has been fighting for a year is linked to his work there. The father of three welcomes the financial help the federal government will now be offering first responders with cancer, but says it should have arrived much earlier.

“The fact is, the government has turned their back for 11 years now,” he said. “I saw no politicians digging on the pile. If you saw a politician that was sick or on the pile, or their kid was sick or on the pile, this would have been solved months ago.”

Two more scientific studies are expected to be released shortly, which will determine whether more cancers should be added to the list, Senators Charles Schumer and Kirsten Gillibrand said in a statement.

“Today’s announcement is a huge step forward that will provide justice and support to so many who are now suffering from cancer and other illnesses,” they said.

About 400 residents and rescue workers have died from cancer since 9/11, according to the New York Post.

With cancer included in the program more victims are likely to seek compensation, which could cause individual awards to be reduced as officials divide up the $2.77 billion fund.

“They’re going to add cancers, but are they going to add more money to the fund?” Thomas “T.J.” Gilmartin, who suffers from lung disease and sleep apnea, said to the Post. “It’s crazy. Every time, we gotta fight. It’s two years since Obama signed that bill, and nobody’s got 10 cents.”

Stroehlein is now cancer-free and feeling well. But at 48, after being forced to give up a job he loved and facing an uncertain future, he’s focusing on speaking to lawmakers for his lost comrades, many of whom lost their life savings in their fight to survive after 9/11.

He’s also troubled by the uncertainty future first responders may face.

“Do you want to give up your life for a government that turned around and didn’t support you?”

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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 →

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NFL Players Suing For Workers’ Compensation – Head Injuries At All Levels Are Cause For Concern

In light of the lasting damage caused by head injuries, NFL players are catching on that they can get workers’ comp benefits. We hope the NFL takes all necessary steps to protect its players, and we are glad that the workers’ comp system protects all injured workers.

A recent ESPN article highlighted this recent phenomenon:

“Playing professional football is inherently dangerous, but the known risks do not prevent players — and former players — from filing workers’ compensation claims against teams, courts have ruled. And while an individual compensation award might cost a team just $20,000, the changing types of claims being filed could end up costing teams millions of dollars a year.”

The article also points out that teams might be liable for millions in yearly claim payments and that at least one insurance broker who has worked with an NFL team thinks that workers’ compensation costs could force significant changes to how the game is played on the field. It saddens us that cost, not player safety, could be the cause of this much-needed change, but we welcome anything that will keep our workers — and players — safe.

We recommend that you read the whole article to get a better understanding of how football injuries can have serious and long-lasting effects. This is important, not just from a fan’s pespective, but also because young children and adolescents have suffered irreperable harm from injuries incurred while playing amateur football.

For this recent ESPN report highlights a case where a young player was paralyzed after an on-the-field play went wrong:

 

Check out this video for an entertaining debate between Malcolm Gladwell, Buzz Bissinger, TIm Green and Jason Whitlock about the place of football in America’s colleges:

BAN COLLEGE FOOTBALL – On WNET from Intelligence Squared U.S. on Vimeo.

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Loss of Health Insurance Access: The Personal Toll on the Unexpected Uninsured.

We wanted to take some time out on Labor Day to bring you this post by our colleague Charlie Domer from the Domer Law Firm in Wisconsin. We hope each of you have a safe and happy holiday.

Access to health insurance is under attack. President’s Obama’s comprehensive health care reform law, intended to increase health care coverage for millions of Americans, faced extreme scrutiny by the U.S. Supreme Court last week. Congressman Paul Ryan’s federal budget plan is a cynical and careless proposal that would slash Medicaid programs, while providing tax cuts for the wealthy. In Wisconsin, Governor Walker and his fellow Republicans also propose gutting funds to the state’s vital Medicaid program. The ultimate goal is hard to deny: certain politicians and interest groups actually want a country with more uninsured citizens. The personal toll on the uninsured is devastating, especially for those dealing with work injuries.

Access to health insurance alters this equation. If the worker had adequate access to health insurance, especially Medicaid, he could obtain the medical care that could allow a return to work, regardless of whether the worker’s compensation insurer accepted or denied the claim.

As a worker’s compensation attorney, the following scenario plays out on a daily basis: A hard-working individual—who is lucky enough to have health insurance through the employer—is injured at work through no fault of his own. The injury is severe enough Continue reading →

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Suicide – Recognize the Signs Before It’s Too Late

Today’s post comes from guest author Leonard Jernigan from The Jernigan Law Firm.

Several years ago I had declined to represent an injured truck driver until his wife called me and said she found a suicide note and asked me to reconsider. I did and was able to help him. I believe there is a connection between suicide and workers’ compensation. Clearly the pain of an injury, coupled with the stress of not being able to return to work can cause tremendous psychological strain.

One Texas doctor actually testified at a legislative hearing that prolonged decisions on workers’ compensation coverage in the state had lead to an increase in work’ comp’ related suicides in recent years. “The incidence of those reports has been astonishingly high compared to five years ago,” he told the legislators, “when they were, to my knowledge, nonexistent.”

Below are some signs that you or somebody you know may be at risk. This list of warning signals comes from the website of the American Psychological Association. If you see any of these signs, seek help from a doctor or therapist, or call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255). Continue reading →

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The 6 Things You Need To Do If You Are Exposed To Mercury

 

Irving J. Selikoff Center for Occupational & Environmental Medicine at Mount Sinai School of Medicine has released a guide to treatment for elemental mercury (the pure form of the metal, when it is not combined with other chemicals) exposure. There are other forms of mercury, such as compounds found in contaminated fish, known as organic mercury and those are not covered by the guide.

Workers who experience a one-time sudden exposure to any chemical substance at work, should:

  1. Gather as much information as you can about the type and amount of exposure, including labels, Material Safety Data Sheets (MSDS), and the medical emergency phone number on the MSDS.
  2. If you are feeling ill, seek medical attention at an emergency department (ED) immediately. It is best if a medical toxicologist is consulted as part of your visit to the ED. They can be reached for advice about treatment by having the healthcare professional contact the Poison Control Center at 1-800-222-1222.
  3. You can call the PCC independently for recommendations as well.
  4. Once the urgent situation has been taken care of, you may contact the nearest occupational health clinic in New York State or in the country for recommendations and follow-up.
  5. This fact sheet is not a substitute for medical care. The purpose is to direct the exposed worker to the proper medical provider.
  6. Report any exposure to your employer immediately. Complete an incident or exposure form. If none is available, write a memo informing them of the exposure incident (date, time, location, what you were doing in the area, and for how long). Keep copies and insist that documents are placed in your personnel files.

You can download a copy of the fact sheet by clicking here. It contains more information about the following topics: Continue reading →

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Zoloft, Prozac, Paxil, Lexapro, Celexa and Sarafem Can Cause Birth Defects

 

Antidepressants are one of the most prescribed drugs in the United States, with selective serotonin reuptake inhibitors (SSRIs) being the most common antidepressants prescribed. SSRI drugs include Zoloft® (sertraline), Paxil® (paroxetine), Lexapro® (escitalopram), Celexa® (citalopram), Prozac® and Sarafem® (fluoxetine).

Studies have shown that women who take SSRI antidepressants while pregnant, or who become pregnant while taking the drug, are at risk of having babies with SSRI related birth defects. Pharmaceutical companies may not have adequately warned of SSRI birth defect risks. Depending upon the trimester of SSRI exposure in the womb, babies can suffer:

  • Congenital heart defects such as ventricular and atrial septal defects (VSDs and ASDs)
  • Persistent Pulmonary Hypertension (PPHN) in which the arteries of the lungs remain narrowed or constricted, inhibiting blood flow to the lungs and reducing the amount of oxygen in the bloodstream that can result in brain damage or death
  • A condition called Omphalocele in which the baby is born with intestines or other organs outside the body
  • Spina Bifida and other neural tube defects affecting the spinal cord
  • Craniosynostos, a malformation of the head caused by premature fusing of cranial sutures of the skull
  • Facial deformations such as Cleft Lip and Cleft Palate
  • Club foot, a deformation of the lower leg and foot
  • Blockage of the anus called Anal Atresia
  • Genital deformities
  • Birth complications
  • Infant death

Parents of children exposed to SSRI medications in the womb that have developed these conditions or complications should contact our attorneys for a free SSRI birth defects lawsuit consultation. They may be entitled to compensation for their child’s injury and suffering.

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