We all know that stress can drastically impact your mental health. From feelings of sadness and anxiety to isolation and substance abuse, stress has the potential to completely derail your emotional wellbeing. That’s not all. Stress can also have negative effects on your physical health, all the way down to the immune system.
Stress is more than a cognitive or emotional state, it’s a complete physical process. During periods of chronic stress, levels of the hormone cortisol are dysregulated. Over time, this impacts the immune system: overactivation of cortisol levels increases risk for infection while repression of cortisol increases risk for autoimmune diseases (Buford & Willoughby, 2008).
On a cellular level, the mechanism that affects immune system function is oxidative stress, which is a phenomenon that occurs when cells are not able to detox themselves. Damaged-induced apoptosis (DIA) is a natural response to oxidative stress that occurs throughout the lifespan and is needed to remove damaged immune cells in the body (Kokoszka et al., 2001). Increased cortisol inhibits the DIA process leading to decreased immune function and immunosenescence – the decline of the immune system with aging (Buford & Willoughby, 2008). As with most things in life, balance on an emotional, hormonal and cellular level is key to health and longevity.
It’s imperative to note that cortisol itself is not bad, rather a critical part of maintaining homeostasis and allostasis. During the acute stress response, cortisol functions to inhibit inflammatory cytokines while promoting anti-inflammatory cytokines, which is pretty important if you’re in a fight or flight situation (McEwen, 2019). It’s only once this system becomes dysregulated from chronic stress that we see detrimental effects on the immune system.
Human behavior is largely influenced by stress. Our natural human instincts respond to stress to protect us – this is our fight or flight response. It makes sense, then, that our brains continue to respond in this way to more complex stressors like work, relationships, or trauma. Imagine yourself at work or school when you find out about an urgent project that must be completed today. Do you feel panicked? Tense? What would you do next?
This stress can be helpful, allowing you to focus your attention and productivity on the task at hand before the deadline. It could also cause you to freeze and panic, making it feel impossible to complete the task or any others. Your natural response to stress guides your behavior in all situations, including those related to your health that may help you cope with stress.
Researchers have demonstrated that health behaviors such as exercising and stress management have positive effects on the immune system (Filaire & Lac, 2000; Riechman et al., 2004; O’Donnell et al, 2006). In particular, these health behaviors support normal cell functioning through regulation of cortisol and DHEA levels (Buford & Willoughby, 2008). These health behaviors attenuate the effects of immunosenescence and chronic stress, therefore boosting immunity and longevity (Kohut & Senchina, 2004). Health behaviors can also improve mental health by relieving anxiety and depression, the latter which is strongly related to dysregulated cortisol (Joseph & Golder, 2016).
It’s clear that engaging in healthy behaviors is the ideal way to live our lives, but why does it feel so hard? While these behaviors can reduce stress, stress can also make it more difficult to engage in these behaviors (Park & Iacocca, 2014). If you are someone who tends to “freeze” in stressful situations, it may feel impossible to move your body, cook a nutritious meal, or carve out time to rest and recharge at times. This creates a loop where we cannot engage in healthy behaviors to reduce stress, so it continues to build making it even more difficult to cope. Prioritizing prevention can be extremely beneficial in this case (Recabarren et al, 2019).
By preventing and protecting yourself from stress in the first place, situations like the work deadline example are less likely to impact your stress levels, and in turn your health (Recabarren et al, 2019). The more protective barriers you have around you, the more true this becomes. Some ways to prevent stress include scheduling self-care or rest time each day or week, setting healthy boundaries with work, friends, and family, and getting enough sleep each night (Mayo Foundation for Medical Education and Research, 2021). Starting slow by adding just one of these changes into your daily routine can have a major impact on your overall health and wellbeing.
References
Buford TW, Willoughby DS. Impact of DHEA(S) and cortisol on immune function in aging: a brief review. Appl Physiol Nutr Metab. 2008 Jun;33(3):429-33. doi: 10.1139/H08-013. PMID: 18461094.
Kokoszka JE, Coskun P, Esposito LA, Wallace DC. Increased mitochondrial oxidative stress in the Sod2 (+/-) mouse results in the age-related decline of mitochondrial function culminating in increased apoptosis. Proc Natl Acad Sci U S A. 2001 Feb 27;98(5):2278-83. doi: 10.1073/pnas.051627098. Epub 2001 Feb 13. PMID: 11226230; PMCID: PMC30129.
McEwen BS. What Is the Confusion With Cortisol? Chronic Stress (Thousand Oaks). 2019 Jan-Dec;3:2470547019833647. doi: 10.1177/2470547019833647. Epub 2019 Feb 27. PMID: 31608312; PMCID: PMC6788742.
Filaire E, Lac G. Dehydroepiandrosterone (DHEA) rather than testosterone shows saliva androgen responses to exercise in elite female handball players. Int J Sports Med. 2000 Jan;21(1):17-20. doi: 10.1055/s-2000-8851. PMID: 10683093.
Riechman SE, Fabian TJ, Kroboth PD, Ferrell RE. Steroid sulfatase gene variation and DHEA responsiveness to resistance exercise in MERET. Physiol Genomics. 2004 May 19;17(3):300-6. doi: 10.1152/physiolgenomics.00097.2003. PMID: 15152080.
O’Donnell AB, Travison TG, Harris SS, Tenover JL, MicKinlay JB. Testosterone, dehydroepiandrosterone, and physical performance in older men: results from the Massachusetts Male Aging Study. Journal of Clinical Endocrinology & Metabolism. 2006 Feb 1;91(2):425-31. Doi: 10.1210/jc.2005-1227.
Kohut ML, Martin AE, Senchina DS, Lee W. Glucocorticoids produced during exercise may be necessary for optimal virus-induced IL-2 and cell proliferation whereas both catecholamines and glucocorticoids may be required for adequate immune defense to viral infection. Brain Behav Immun. 2005 Sep;19(5):423-35. doi: 10.1016/j.bbi.2005.04.006. PMID: 15935613.
Joseph JJ, Golden SH. Cortisol dysregulation: the bidirectional link between stress, depression, and type 2 diabetes mellitus. Ann N Y Acad Sci. 2017 Mar;1391(1):20-34. doi: 10.1111/nyas.13217. Epub 2016 Oct 17. PMID: 27750377; PMCID: PMC5334212.
Park CL, Iacocca MO. A stress and coping perspective on health behaviors: theoretical and methodological considerations. Anxiety Stress Coping. 2014;27(2):123-37. doi: 10.1080/10615806.2013.860969. Epub 2013 Dec 10. PMID: 24192138.
Recabarren RE, Gaillard C, Guillod M, Martin-Soelch C. Short-term effects of a multidimensional stress prevention program on quality of life, well-being and psychological resources. A randomized controlled trial. 2019;10. Doi: 10.3389/fpsyt.2019.00088. Epub 2019 Mar 12.
Mayo Foundation for Medical Education and Research. How stress affects your body and behavior [Internet]. Mayo Clinic; 2021 March. Available from: https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress-symptoms/art-20050987.