Stress and adrenal hormones, specifically cortisol, have long term impacts on the body. We talk about stress, we feel it, and we use the terms interchangeably, but what is stress and what does it do in our bodies? What are long term impacts of chronic stress? 

Stress is “any type of change that causes physical, emotional, or psychological strain” (Scott, 2020). Stressors can be “good” or “bad” such as physical or emotional trauma; loss; or a promotion; getting engaged; building your dream home to name a few. Our bodies are programmed to release chemical messengers (called hormones) to help us adapt to these changes. Hormones can be helpful in the short-term, but can cause chronic disease in the long-term.

What are the symptoms of stress?

Stress symptoms come in various shapes and sizes, and differ from person to person as a way to react to trauma and stressors. Some of the most common symptoms include: 

• Psychological signs: difficulty concentrating, worrying, memory problems, anxiety

• Emotional signs: Irritability, frustration, anger

• Physical signs: high blood pressure, weight changes, frequent illness, menstrual changes, changes in sex drive

• Behavioral signs: poor self care, lack of enjoyment in activities, using drugs or alcohol. 

The science behind symptoms 

Regardless of the type of symptom, it’s important to be aware of why these happen. A complex system in your brain that involves pathways and feedback loops keep your body in balance through a variety of functions and multiple hormones. The loops send messages back and forth between the hormone secreting glands in your brain and your adrenal glands that are on top of your kidneys. The adrenal glands help control secretion of the many hormones but perhaps the most known hormone secreted by the adrenal glands is cortisol.

Each of these hormones control physiological processes, immune function, metabolism, and the autonomic nervous system; cortisol in particular is known for its role during stress to help your body get an energy boost and handle an emergency situation. Cortisol does this and releases other chemicals such as dopamine, epinephrine, and norepinephrine which can increase blood sugar levels, contract blood vessels, and cause your heart to beat faster. These adaptations are great in the short-term, as they work to keep us alive in a dangerous situation. However, when you experience chronic stressors, resulting in the body continually releasing cortisol and other stress hormones to keep up, this process can lead to chronic health problems. 

The increase in blood sugar that was good for the body for a short term energy burst can become diabetes if the body is chronically exposed. Chronic cortisol release contributes to high blood sugar, decreased insulin sensitivity, and increased storage of fat by the body. Decreased insulin sensitivity prevents the body from removing sugar from the bloodstream and giving it to the cells that need it. Sugar is damaging if it remains in your bloodstream; it can cause visual changes including blindness, kidney damage, open skin sores that do not heal, and loss of toes/lower legs. Long term cortisol and other stress hormone exposure increases heart rate and blood pressure, which can cause changes in heart rate or rhythm, high blood pressure, and heart attack.

Additionally, both animal and human studies have shown that babies born to parents living with chronic stress are also affected by elevated cortisol levels. Offspring of females who have had higher levels of cortisol during pregnancy have been found to have increased hormone secretion, altered immune function, increased systolic blood pressure, and altered metabolic function as adults. The altered metabolic function led to an increased risk of diabetes. 

Chronic stress can affect the gut microbiome.

Studies have shown gut health to be important to our overall health. A healthy gut microbiome, with high levels of good bacteria, decreases your risk of chronic disease such as diabetes, depression, heart disease, and high blood pressure. Stress exposure has been linked to reduction of beneficial bacteria in the gut and irritable bowel syndrome (IBS). Experimental replacement of gut bacteria with stress-exposed gut bacteria increased the stress response of an organism and induced anxiety as well as other behavioral/mood disorders. These responses were reduced by giving probiotics of particular bacterial strains. 

Elevated cortisol also affects the brain.

In a study of patients who had Post Traumatic Stress Disorder (PTSD) from childhood trauma and abuse, researchers found cortisol levels to be 60% higher than normal and 122% higher than normal when another stressor was introduced. It is hypothesized that long term exposure to higher levels of cortisol reduces memory function because of its effects on the hippocampus (major component of the brain which assists with learning and memory). Anxiety and depression are prevalent conditions especially during uncertain times such as during the recent pandemic, and were commonly thought to arise in the brain. It is now understood that cortisol release occurs due to stress. Cortisol elevations over the long term due to chronic stress actually cause anxiety, depression, and other mood disorders. 

Stress hormones, including cortisol, have a profound impact on our health.

The process by which it affects our bodies demonstrates how important mental health is for our overall well being. We see that stress, which is generally regarded as an aspect of mental health, can cause long term mental and physical effects. Thus, it is beneficial to take care of the mind as well as the body. 

Seek mental health services, nurture your spirit, eat well, and exercise!

Deep breathing, yoga, and meditation decreases stress response through reducing stress hormone production - anyone can stretch and deep breath comfortably in his/her own home as well as at work! It can be as simple as sitting back, closing your eyes, and taking a couple of deep breaths for one minute.

Read the rest of the series:

This is part two of our Mental Health Awareness Month series. Read parts one and three below:

• Part 1: What Is Trauma and How Does It Impact Your Brain?

• Part 3: How Does Trauma Affect Personal Relationships?

References:

1. Dombeck, M. (N.D). Chronic cortisol exposure causes mood disorders. Mental Help. Retrieved April 15, 2022 from: https://www.mentalhelp.net/blogs/chronic-cortisol-exposure-causes-mood-disorders/

2. Elzinga, B., Schmahl, C., Vermetten, E. et al. Higher Cortisol Levels Following Exposure to Traumatic Reminders in Abuse-Related PTSD. Neuropsychopharmacol 28, 1656–1665 (2003). https://doi.org/10.1038/sj.npp.1300226. Retrieved April 15, 2022 from: https://www.nature.com/articles/1300226#citeas

3.  Foster, J. A., Rinaman, L., & Cryan, J. F. (2017). Stress & the gut-brain axis: Regulation by the microbiome. Neurobiology of stress, 7, 124–136. https://doi.org/10.1016/j.ynstr.2017.03.001. Retrieved April 19, 2022 from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5736941/

4. Scott, Elizabeth (2020). What is stress? Very well mind retrieved April 13, 2022 from: https://www.verywellmind.com/stress-and-health-3145086  

5. Sheng JA, Bales NJ, Myers SA, Bautista AI, Roueinfar M, Hale TM and Handa RJ (2021) The Hypothalamic-Pituitary-Adrenal Axis: Development, Programming Actions of Hormones, and Maternal-Fetal Interactions. Front. Behav. Neurosci. 14:601939. doi: 10.3389/fnbeh.2020.601939. Retrieved April 15, 2022 from: https://www.frontiersin.org/articles/10.3389/fnbeh.2020.601939/full

6. Torpy JM, Lynm C, Glass RM. Chronic Stress and the Heart. JAMA. 2007;298(14):1722. doi:10.1001/jama.298.14.1722.Retrieved April 13, 2022 from: https://jamanetwork.com/journals/jama/fullarticle/209139