Stress, the good and the evil - Podcast

Before detailing the stress response, let’s talk about homeostasis first. This term refers to the ability of an organism to maintain its balance. This implies to maintain constant all our body parameters (temperature, blood glucose, blood pressure or heart rate). These parameters will be strongly disturbed during stress response.

But what is stress?
It is a defense mechanism of our organism to fight aggression and face new situations. This allows us to cope with a sudden change in our environment to maintain our integrity and restore our homeostasis. Since the dawn of mankind, stress has allowed humans, as well as animals, to save themselves from danger, whether through combat or flight.

The stress reaction
As this is a question of survival, stress therefore solicits many systems of our body such as the nervous, cardiovascular or muscular systems. The goal is to mobilize our strengths and abilities to survive. Everything is controlled by our brain, which perceives the stressful element and will activate these systems by the production of particular hormones. This instant response will last from minutes to hours, the time it takes to manage or avoid the situation.

3 phases are distinguished:

1 – The alarm phase: the nervous system captures the danger (or the stressor) and triggers a first hormonal response through the production of epinephrine. This hormone is produced and released by the central part of the adrenal gland, called the adrenal medulla. It induces several actions: increased heart rate, blood pressure and ventilation, stimulation of the immune system, release of glucose. Its main action is therefore to bring more energy (oxygen and nutrients) to the muscles and the brain. Also, the pupils will dilate to increase our vigilance. In addition, other functions will slow down, such as digestion or reproduction. It will last until the threat is dismissed.

2- The resistance phase
If the stressor persists, the body enters the resistance phase and a second hormone is produced: cortisol (a corticosteroid). This time, the production and release are done by the adrenal cortex, the peripheral part of the adrenal gland. Cortisol mobilizes more energy reserves of the body, including sugar converted from fat. Cortisol is a hormone normally present in our body. It is produced in the morning and its rate gradually decreases during the day. Its rate must be neither too low nor too high. While this hormone is considered as positive, it can be deleterious in many ways if its rate remains too high, too long. In this phase of resistance, a feeling of distress can appear and be manifested by anxiety, fear, fatigue, difficulty of concentration.

3- The return to normal phase
The physiological parameters return to normal constants, but if, on the other hand, the stressor is still present, the body will wear itself out.

We often talk about good and bad stress. Good stress could be defined as a positive energy needed for resource mobilization, motivation, performance and, in general, a taste for life. Stress can therefore have a positive impact. At first, you can survive in immediate danger or perform well (driver’s license, exam, etc.). Indeed, stress can improve our sports performance but also our cognitive and memory skills. In order to do so, do not be overwhelmed by your own emotions!

Chronic stress, the evil of our century

Stressors are classified into different categories. At first, some may be perceived as a physical aggression, such as noise, fatigue imposed by our lifestyle, illness, polluted air, etc. But usually, stressors are often psychological (too much work, mental overload, conflict, permanent mockery, social networks, etc.). Most stressors are personal (they are called subjective). Finally, it is important to know that the most powerful and dangerous stresses are the psychological and psychosocial tensions between members of the same species.

When it is difficult to eliminate stressful recurring elements of our lives, we suffer from chronic stress. Unfortunately, many people are victims of it:
– 24% of employees are in a state of hyperstress and 50% live with stress at work.
– Women are more affected than men (28% in hyperstress against 20%).
– The sectors most affected are those of “human health and social actions”, “arts, entertainment and recreation”, “services” and “financial and insurance activities”.

Finally, the cost of this epidemic to society is high and amounts to 20 billion euros for the EU.

Stressful situations, whether they persist or recur or that several stressors occur in the same period, repeatedly increase our physiological stress response or prevent this reaction when it is no longer necessary. In these cases, the good effects of the stress disappear, the homeostasis is disturbed, and the conditions are thus reunited for the appearance of different diseases.

Glucocorticoids (cortisol) act on energy storages, heart rate, immune system, food intake and also sleep. In fact, cortisol is produced just before waking up and helps activate our appetite. As a result, chronic stress tends to favor snacking, including the one of sweets. In addition, these snacks bring us comfort. Because of this double association, this pathology is often associated with weight gain. Finally, in stressful situations where there is no energy expenditure (traffic jams, overwork), adrenaline and cortisol are still released. But the amount of energy produced to respond to stress will not be used and will therefore be stored as fat.

In general, when glucocorticoids and adrenaline are secreted continuously to respond to psychologically stressful situations, they definitely lose their beneficial effect. On the brain first. The morning peak of cortisol is supposed to wake us up. But because of stress, these rates become chronically too high and delay bedtime. Paradoxically, lack of sleep also causes an increase in glucocorticoids, and the person suffering from stress enters an endless circle, and can become insomniac.
In addition, experiments conducted in rodents, indicated that the state of chronic stress, leads to a decrease in neuronal activity, see the death of certain neurons, at the level of the hippocampus. An essential area for learning, memory and emotion management. Finally, scientists have also shown that stress exposure before or immediately after birth reduces the number of neurons and the size of the brain, with irreversible consequences on the child’s ability to react to stress.

The consequences are also at the cardiovascular level. The combined increase in adrenaline and cortisol can cause hypertension and / or atherosclerosis (thickening of the arteries that limit blood flow), increasing the risk of heart attack.

Finally, the immune system is also sensitive to circulating hormones stress. Although transient secretions associated with acute stress enhance immunity, prolonged exposure to glucocorticoids results in a continuous inhibition of the immune system and a decrease in our defenses against pathogens. Although the scientific community does not report a consensus around this issue, these effects could have an impact on cancer. But, on the other hand, it is not unreasonable to think that a less effective immune system would reduce response against appearing tumor cells. Also, a recently published Chinese study indicated that adrenaline plays a role in cancer growth, namely the ability of tumor cells to generate metastases. However, there is no indication that stress is causing the appearance of these cells. And it is even more difficult to determine that correlation since stress often causes weight gain and can increase the consumption of tobacco and alcohol. All are recognized factors to favor the appearance of certain cancers.

Habits that allow us to reduce stress.

Yes, nibbling, consuming tobacco and alcohol, will certainly mitigate the effects of stress for a very short period of time. But, they are to be avoided and banned given the repercussions on health and the notions of addiction that they entail. On the other hand, social activities, not isolating oneself, discussing with relatives or the practice of sophrology make it possible to better manage stressful situations. Finally, the practice of physical activity reduces stress levels. Indeed, physical activity allows you to escape and produce endorphins, which will exert the opposite effects of adrenaline and cortisol. For example, for the brain, sport stimulates the production of different molecules that promote the production of new neurons, their growth, their functioning and their connections. Finally, if you suffer from chronic stress, do not hesitate to take a vacation or make a trip.

Outstanding Stress – Post Traumatic Stress Disorder (PTSD)

PTSD is a very strong form of anxiety. Anxiety is an emotion that is often felt to be unpleasant and corresponds to the more or less conscious fear or expectation of a future danger or problem. Anxiety is a normal phenomenon, present in all individuals. It can, however, take on an excessive and pathological character in different situations: we then talk about anxiety disorders.

A post-traumatic stress disorder is a form of anxiety and is identified by a strong stress response to a traumatic or shocking event, such as kidnapping, war, assault, rape, accident and of course a terrorist attack. These events are traumatic in the sense that there is a threat of death or significant physical harm; that their happenings are unpredictable and their unfolding uncontrollable; these hit people arbitrarily and generate a very intense stress. These stress reactions can take very special or unusual forms. Indeed, people can remain frozen in a state of cognitive stupefaction (misunderstanding of the event) and emotional stupor (emotional emptiness). These reactions are infrequent during acute stress but their frequency increases sharply during a traumatic event, especially in case of rape.

Reviviscence and avoidance behaviors are strong symptoms of PTSD. People experience strong stress reactions to events that make them think of the traumatic event. Not only will these events cause stress, but daily life is also destabilized.

Also, other symptoms may also occur, I think of emotional anesthesia (which manifests itself as difficulty in feeling tenderness or desire), difficulty concentrating or finding sleep or the feeling of being in a permanent state of alert.

In addition to these very heavy symptoms, affecting daily life in a deep way, the risks of addiction to drugs, alcohol or antidepressants are more important.

Finally, and despite this pretty dark picture, treatment options exist. The treatment concerns PTSD but also the complications often associated. As a first step, patients are offered psychosocial support, including information about their disorder and their rights. Then, as for other anxiety disorders, the patient can be helped by a psychotherapeutic approach, hypnosis or by drug treatments. These approaches have relative efficiencies and obviously depend on the patient and the tragic events he went through.

Another example, the burnout

Dr. Freudenberger introduced the “burnout” in 1974 to describe an intense fatigue, a weakening due to excessive demand for energy, strength or resources. This lack of energy is closely related to permanent and prolonged stress. He has cleverly adopted the term aerospace, which refers to the situation of a rocket which, by the total exhaustion of its fuel, may brutally overheat and explode.

The burnout is the ultimate degree of stress exhaustion and people suffering from it have unfortunately arrived at the end of what they could bear. For Dr. Freudenberger, this notion reflects a candle that, after having illuminated long hours, offers only obsolete flames. He wrote: “As a psychoanalyst and practitioner, I realized that people are sometimes victims of fire, just like buildings. Under the tension produced by life in our complex world, their internal resources come to burn like flames, leaving only an immense void inside, even if the external envelope seems more or less intact.” Thus, thanks to his work, associated with others, he proposed in 1980 a definition of burnout as “a state of chronic fatigue, depression and frustration brought by devotion to a cause, a way of life, or a relationship that fails to produce the expected rewards and ultimately leads to decreased involvement and accomplishment at work.”

Then in 1981, researchers Maslach and Jackson characterized this phenomenon in three dimensions: emotional exhaustion, depersonalization and reduction of personal fulfillment:

– The frequency of feelings of emotional exhaustion translates itself into a lack of energy. The person is nervously emptied, has lost all enthusiasm, and is no longer motivated by his/her work, which becomes a chore.

– Depersonalization refers to the appearance and reinforcement of detached, immoral attitudes and the development of negative feelings towards individuals encountered in the context of work (clients, patients). This characteristic leads to the isolation of the person experiencing the burnout phase.

– The reduction of personal fulfillment. For example, feelings of incompetence, worthlessness, and low self-esteem invade the person. One is then convinced that he/she will not be able to respond to requests or issues in his/her work.

Today, many professional sectors are sensitive to this phenomenon, which affects approximately 10,000 people annually in France. It is therefore necessary to set up training and prevention actions to avoid becoming completely exhausted. Finally, because of its resemblance to depression, those affected, in addition to of course a work stoppage, can be prescribed antidepressants and are encouraged to undergo psychotherapy. Relaxation, meditation or sports activities are also recommended and have shown benefits in people who have experienced a burnout.

References:

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