American Medical Association Family Medical Guide - American Medical Association [49]
One person may overreact to a relatively minor source of stress (such as missing a bus), activating a cascade of stress hormones that elevates his or her blood pressure and heart rate, while another person might shrug off the situation. Genes, personality, and reactions learned during childhood explain the differences between people’s responses to stress. A person may have inherited an overly sensitive stress response or may have learned to respond in this way from one or both parents. The answer probably lies somewhere between the two—an interaction of genetic makeup and experiences.
How Stress Can Make You Sick
The human body is not able to handle the constant release of powerful hormones triggered by chronic stress. The brain can easily become overloaded with the constant release of the stress hormone cortisol, which can kill brain cells directly, impairing a person’s ability to remember and learn. The constant release of cortisol makes us feel fatigued but we can’t sleep; then we get anxious and depressed.
Most people are aware of the psychological effects of stress, such as an inability to think clearly, make sound judgments, and remember. But stress also can produce angry outbursts, hostility, impatience, and reduced self-esteem, and can lead to depression and a wide range of physical problems, including headaches, indigestion, stomachaches (especially in children), and backaches. Stress can also cause dizziness, a rapid heartbeat, ringing in the ears, and muscle tightness.
Even more serious, stress can contribute to the development of heart disease by damaging the arteries. The increase in blood pressure that occurs during a stress response exerts so much force on the linings of the arteries that it injures them, triggering an immune system response and making the artery walls susceptible to the buildup of plaque—deposits of fat, cholesterol, calcium, and other substances. As these deposits build up, they make the arteries narrower and less able to carry blood to the heart.
The constant release of cortisol during chronic stress also causes high blood sugar (glucose) levels, triggering the release of the hormone insulin, which regulates the body’s use of glucose for energy. The excessive, long-term release of insulin can eventually make the body resistant to the effects of the hormone, a condition that causes glucose to build up in the blood. This buildup of glucose in the blood can lead to type 2 diabetes (see page 894).
Are You Under Too Much Stress?
If you are trying to cope with a stressful situation, you may be at increased risk of stress-related illness. Keep in mind that positive changes (such as getting married or having a baby) can produce stress just as easily as negative changes. Here are some examples of common stressful situations:
• Someone close to you died.
• You recently were divorced or separated.
• You or a family member has been hospitalized recently.
• You got married recently.
• You lost your job or retired.
• You are having sex problems.
• You just had a baby.
• Your finances recently became a lot better or worse.
• You changed jobs.
• A child has left home recently or come back home.
• You got a promotion at work.
• You moved, or are remodeling your house.
• Your job is at risk.
• You have taken on substantial debt, such as a mortgage.
Take steps to manage your stress before it overwhelms you or makes you sick. See the next page for the best ways to handle the stress in your life.
Stress and Sleep
Doctors have known for many years that lack of sleep can cause foggy thinking and poor concentration. But lack of sleep also can lead to potentially serious health problems. For example, chronic lack of sleep can place you at risk of developing type 2 diabetes (see page 894). Cortisol, a stress hormone that regulates the blood sugar glucose, seems to be to blame. Prolonged sleeplessness causes the body to continuously release