Written by Lawson R. Ursin
University of Cincinnati
COVID-19 has taught most people that the line between tolerable stress and toxic stress (defined as persistent demands that lead to illness) is very different. However, some people age faster and die younger than others due to harmful stressors.
So how much stress is too much and what can you do about it?
Toxic stress increases the risk of obesity, diabetes, depression, and other diseases. (Photo by Klaus Vedfelt/Digital Vision, via Getty Images, The Conversation)
I am a psychiatrist specializing in psychosomatic medicine, and I research and treat people with physical and mental illnesses. My research focuses on people with psychological and medical illnesses, and people whose health problems are exacerbated by stress.
I have spent my career researching mind-body issues and training physicians to treat mental illnesses in primary care settings. The title of my upcoming book is Toxic Stress: How Stress is Killing Us and What We Can Do About It.
A 2023 study on stress and aging across the lifespan (one of the first studies to support this conventional wisdom) found that all four measures of stress accelerate the pace of biological aging in midlife. They also found that sustained high stress ages people in a manner comparable to the effects of smoking and low socio-economic status, two established risk factors for accelerated aging.
The difference between good stress and harmful stress
Good stress—demands and challenges that can be dealt with immediately—is good for your health. In fact, the rhythm of these daily tasks, such as eating, cleaning up clutter, communicating with each other, and getting work done, can help regulate your stress response system and keep you healthy.
On the other hand, as psychiatrist and trauma expert Bessel van der Kolk explains in his best-selling book, The Body Keeps the Score, toxic stress can debilitate the stress response system. , with long-lasting effects.
The earliest effects of toxic stress are persistent symptoms such as headaches, fatigue, and abdominal pain, which often interfere with overall functioning. After months of initial symptoms, full-blown illnesses can surface with a life of their own, such as migraines, asthma, diabetes, and ulcerative colitis.
When we are healthy, our stress response system is like an orchestra of organs that miraculously coordinate and play in unison without conscious effort. This is a process called self-regulation. But when we get sick, parts of this orchestra struggle to regulate themselves, leading to a series of stress-related dysregulations that lead to other symptoms.
For example, in diabetes, your hormonal system has a hard time regulating sugar. Obesity makes it difficult for the metabolic system to regulate energy intake and expenditure. Depression causes an imbalance in central nervous system circuits and neurotransmitters, making it difficult to regulate mood, thinking, and behavior.
“Treat” stress
Stress neuroscience in recent years has provided researchers like me with new ways to measure and understand stress, but in a doctor's office, stress management is not typically part of the treatment plan. You may have noticed.
Most physicians do not assess the contribution of stress to common chronic diseases in their patients, such as diabetes, heart disease, and obesity. This is partly because stress is complex to measure and difficult to treat. Doctors generally don't treat what they can't measure.
Stress neuroscience and epidemiology have recently shown that when people are exposed to traumatic and adverse events, especially during vulnerable years such as childhood, they are more likely to develop serious mental and physical illnesses in midlife. Researchers are learning that this can dramatically increase.
The alarming increase in diabetes, obesity, depression, PTSD, suicide, and addiction in the United States over the past 40 years points to one common factor in these various diseases: toxic stress.
Toxic stress increases the risk of onset, progression, complications, or early death from these diseases.
suffering from toxic stress
It's difficult to know how many people suffer from stress because the definition of harmful stress varies from person to person. One of the starting points is the fact that approximately 16% of adults report that in childhood he was exposed to four or more adverse events. This is the threshold at which a person is at increased risk of developing the disease in adulthood.
Studies dating back to before the COVID-19 pandemic also show that about 19% of U.S. adults have four or more chronic conditions. If you have at least one chronic illness, you can imagine how stressful having all four of them can be.
And about 12% of the U.S. population lives in poverty, which is typical of a life where demands outstrip resources every day. For example, if you don't know how to get to work every day, fix a leaky water pipe, or resolve a conflict with your partner, your stress response system will never rest. One or a combination of threats can cause a company to go on high alert or shut down, unable to respond at all.
These overlapping groups are all joined by people in harassing relationships, homelessness, incarceration, severe loneliness, living in high-crime areas, and working in or around noise and air pollution. It seems conservative to estimate that approximately 20% of people in the United States live with the effects of harmful stress.
Recognize and manage stress and related conditions
The first step to managing stress is recognizing it and talking to your doctor about it. Clinicians may conduct assessments that include self-report measures of stress.
The next step is treatment. Research shows that it is possible to retrain a dysregulated stress response system. This approach, called “lifestyle medicine,” focuses on improving your health by changing high-risk health behaviors and incorporating daily habits that help your stress response system self-regulate.
Adopting these lifestyle changes isn't quick or easy, but they can be effective.
For example, the National Diabetes Prevention Program, the Dutch “UnDo” heart disease program, and the U.S. Department of Veterans Affairs' PTSD program all use stress-related treatments through weekly support groups and guided daily practices from 6 to 6 days. It has been realized that the progression of chronic diseases can be slowed or reversed. 9 Months. These programs help teach people how to implement personal stress management, diet, and exercise habits in a way that builds and maintains new habits.
There is now strong evidence that it is possible to treat harmful stress in ways that improve the health outcomes of people with stress-related diseases. Next steps include finding ways to expand awareness of harmful stress and expand access to these new and effective treatment approaches for those affected.
Lawson R. Ursin is a professor of psychiatry and family medicine at the University of Cincinnati. This article is republished from his The Conversation under a Creative Commons license. Read the original article.
