Amina Altai has always prided herself on her drive and tenacity. When she started feeling foggy and fatigued, the 39-year-old figured it was simply because of long hours at her marketing job. So she started writing down reminders to stay on track. But then she started losing her hair, gaining and losing weight rapidly, and having gastrointestinal problems.
Altai was convinced something was wrong, but she says the six doctors she first saw didn’t take her seriously. Some told her she had lots of hair and that a little loss was fine. Some told her she looked healthy and dismissed her symptoms as just stress. It wasn’t until another doctor ordered blood tests that Altai was diagnosed with Hashimoto’s and celiac disease, two autoimmune disorders that can damage the thyroid and small intestine.
“They called me and said, ‘Don’t go to work, go to the hospital, you’re just a few days away from multiple organ failure,'” Altai recalled. The two chronic illnesses had impaired her ability to regulate hormones and absorb important vitamins and nutrients.
Scientists now know that stress is closely linked to many chronic diseases. Stress can trigger immune changes and inflammation in the body, exacerbating the symptoms of asthma, heart disease, arthritis, lupus, inflammatory bowel disease, and more. Meanwhile, many problems caused by stress (headaches, heartburn, blood pressure problems, mood changes) can also be symptoms of chronic diseases.
For doctors and patients, this overlap can be confusing: Is stress the only cause of symptoms, or is something more serious at play?
“It’s really hard to tease out,” says Scott Russo, director of the Brain-Body Research Center at the Icahn School of Medicine at Mount Sinai.
How stress causes chronic disease
Stress naturally triggers something called the fight-or-flight response. When we encounter a threat, our blood pressure “Your heart rate increases, your muscles tense up, and your body concentrates your blood sugar so you can respond quickly,” says Dr. Charles Hattemer, a cardiovascular specialist at the University of Cincinnati.
Stress over a period of weeks or months can overwhelm your body, causing problems like forgetfulness, fatigue, and sleep problems. Stress hormones like adrenaline and cortisol can increase your blood pressure chronically and Increases plaque depositionOver time, that could cause damage to the heart, Dr. Hattemer said.
There are also indications that stress may contribute to overactivation of the immune system, leading to inflammation. In a study of 186 patients, Italian researchers found that 67% of adults Celiac diseasehad experienced a stressful event prior to receiving their diagnosis.
Recently, Dr. Russo and his colleagues found that stressed mice High neutrophil levelsThe virus multiplies, causing inflammation, and there are fewer T and B cells in the bloodstream that can produce antibodies and kill virus-infected cells.
He and his colleagues also Major depressive disorder Compared to healthy controls, the immune cell imbalance was similar, and the researchers believe the body may be changing the composition of immune cells circulating in the blood as a way to reduce damage from infection or acute stress, Dr. Russo said.
But when faced with chronic stress, the body may not be able to “shut down the immune system,” Dr. Russo said.
For people who are already at risk for chronic disease due to genetic predisposition, exposure to chemicals, air pollution or viral infections, prolonged stress can put them at greater risk of falling ill.
Lynn DeGitz, 56, had been battling bad infections on and off for several years. At one point, she thought she had mononucleosis. At another, she was sure she had bronchitis. Neither she nor her doctors suspected it might be a chronic condition.
She then took a new, stressful job that left her with fevers, swollen joints and fatigue almost every day. “It was interesting and challenging, so I just stuck with it,” DeGitz says. “I used short-term disability benefits to help me recover and took time off when I needed.”
After more than two years of repeated doctor visits and ultimately ineffective treatments, DeGitz was diagnosed with a form of arthritis called Still’s disease. Doctors don’t know exactly what causes it, but the study Evidence is beginning to suggest that the condition is likely caused by a combination of factors, including an abnormal response to infection or stress.
“We all have physical ailments and weaknesses,” Dr. Russo says, “and stress only makes them worse.”
Symptoms that cause stress
For those with chronic illnesses, the same stressors that may have triggered symptoms can also make it harder to control their condition.
They also said doctors don’t always understand how hard it can be to manage stress, especially when you’re feeling unwell. When Theresa Rose was first diagnosed with rheumatoid arthritis decades ago, her doctor encouraged her to reduce stress and exercise more to strengthen the joints that had been damaged by the disease.
But “the symptoms themselves were stressful,” says Rose, now 66. “When you’re really tired, it’s really hard to exercise.” After other stressors in her life subsided — her children were grown and she got out of a difficult marriage — Rose was finally able to get enough rest and finally start exercising again.
Many doctors aren’t trained to ask about stressors or to counsel patients about their effects, says Alice Bedell, a clinical researcher at the University of Chicago Medicine who specializes in the effects of stress on digestive health. A 2015 survey of physician visits involving more than 30,000 patients found that primary care physicians advise patients about stress management in only 10 to 20 minutes a day. 3 percent Number of visits.
When Stephanie Torres’ 12-year-old son, Nico, was diagnosed with Crohn’s disease, she was surprised to hear his gastroenterologist think it was the family’s responsibility to manage the apparent cause of the symptoms: stress. “Her response was basically, ‘This is your problem. You solve it.'”
Patients say that rather than simply recommending that they eliminate sources of stress, their doctors work with them to identify small ways to manage stress every day. After Altai was diagnosed and began taking medication for both illnesses, she felt well enough to make the dietary changes necessary to address the nutritional deficiencies caused by her illnesses. She went for regular walks and began meditating in the mornings.
Altai eventually quit her job in marketing to become an executive coach and take control of her own schedule, a change she says she realized was necessary after being hospitalized and diagnosed with two chronic illnesses.
“I call this my ‘pause moment’ because it literally stopped me in my tracks,” she told Business Insider. “I had to really reevaluate my relationship with work, success, and stress.”
