Stress

Studies on survivors of sexual abuse and those with post-traumatic stress disorder suggest they have elevated levels of stress hormones, as do students at exam time. In these groups of people and others experiencing loneliness, anger, trauma and relationship problems, infections last longer and wounds take longer to heal. However, having fun with friends and family seems to have the opposite effect on our immune systems. Social contact and laughter have a measurable effect for several hours. Relaxation through massage or listening to music also reduces stress hormones.

The reasons for this link remain unclear, but the brain appears to have a direct effect on stress hormones such as adrenaline and cortisol, which have wide-ranging effects on the nervous and immune systems. In the short term, they benefit us with heightened awareness and increased energy, but when prolonged, the effects are less helpful. They lead to a profound change in the immune system, making us more likely to pick up a bug.

Stress also can overactivate the immune system, resulting in an increased risk of autoimmune diseases such as arthritis and multiple sclerosis. Skin conditions such as psoriasis, eczema, hives and acne also may worsen, and stress can trigger asthma attacks.

The mechanisms behind this are complex and still only partially understood, but what we do know is that our reactions to life events can have far-reaching effects on our health. This can work to our advantage — feelings of relaxation reduce cortisol, together with other beneficial bodily responses. In turn, these changes feed into the immune system, making it function well. This happens spontaneously in our daily lives, but we also can encourage it by choosing to look after ourselves.

Insights from the ‘placebo effect’

A mind-body link also is found in experiments where people with infections are given placebo (inactive) treatments, which they think are the real thing. Even though the treatment has no medicinal effect, these volunteers report milder symptoms than those given no treatment.

The link also can work the other way once we have developed an infection. Volunteers who are given a symptomless infection feel more anxious and depressed for the next few hours than healthy volunteers. The infection also has a detrimental effect on their memory, lasting several hours.

It’s also been found that happier people may be less likely to come down with colds.

Dr. Sheldon Cohen, professor of psychology at Carnegie Mellon University, Pittsburgh, suggests in his research that our susceptibility to infection can easily be altered by our lifestyle choices.

“Don’t smoke, exercise regularly, eat a healthy diet, try to reduce the stress in your life, and strengthen your interpersonal relationships,” he advises.

Being depressed or anxious is linked to catching more infections and experiencing the symptoms more strongly. Of course, it’s possible that happier people might have a tendency to play down how bad they are actually feeling.

Helping Ourselves

While no one knows for sure how our feelings can affect the immune system, most doctors agree that reducing stress is a good idea. Many stresses cannot be avoided altogether, but we can minimise our ‘background’ stress and our reactions to stressful events.

This is easier said than done. The modern world almost is set up to produce anxiety and frustration. But we can manage stress by reducing the demands upon us, increasing our ability to cope with them, or both.

Creative thinking may lead you to ways — such as delegating work or deleting less important items from your to-do lists — to help reduce stress. Then you can look for ways to improve your coping ability, such as learning a new, useful skill or spending more time unwinding each day. If you are anxiety-prone, consider meditation, yoga, or tai chi classes.

Although it takes effort to stand back and assess how things are going, it’s more than worth it for your happiness as well as your health.

References Christakis N. A., Allison P. D. Mortality after the Hospitalization of a Spouse. The New England Journal of Medicine. Vol. 354, Feb. 16, 2006, pp. 719-30.

Vedhara K. et al. Chronic stress in elderly carers of dementia patients and antibody response to influenza vaccination. The Lancet, Vol. 353, June 5, 1999, pp. 1969-70.

Friedman M. J. et al. Thyroid hormone alterations among women with posttraumatic stress disorder due to childhood sexual abuse. Biological Psychiatry, Vol. 57, May 15, 2005, pp. 1186-92.

Al-Ayadhi L. Y. Neurohormonal changes in medical students during academic stress. Annals of Saudi Medicine, Vol. 25, Jan-Feb 2005, pp. 36-40.

MacDonald C. M. A chuckle a day keeps the doctor away: therapeutic humor and laughter. Journal of Psychosocial Nursing and Mental Health Services, Vol. 42, March 2004, pp. 18-25.

Khalfa S. et al. Effects of relaxing music on salivary cortisol level after psychological stress. Annals of the New York Academy of Sciences, Vol. 999, November 2003, pp. 374-76.

Source: Psych Central Copyright © 1992-2007 Psych Central. All rights reserved. (16/05/07)

Abstract

This study was a pilot project to explore the effect of an autogenic training program (AT; a relaxation intervention) on the health-related quality of life (HRQOL) and well-being for people with multiple sclerosis. Participants either met weekly for sessions in AT for 10 weeks (n = 11) or were assigned to the control group (n = 11).

The AT group was also asked to practice the technique daily at home. Scales designed to measure HRQOL and aspects of well-being (mood and depressed affect) were taken preintervention and at week 8 of the 10-week program. ANCOVAs using a measure of social support and pretest scores as covariates revealed that at the post-test review the AT group reported more energy and vigor than the control group and were less limited in their roles due to physical and emotional problems.

Future research should involve studies conducted over an extended period, together with sufficiently sized samples to explore the effect of frequency of practice of relaxation training on HRQOL and well-being for people with multiple sclerosis.

Source: Journal of Behavioural Medicine, Volume 28, No 3, June 2005

Stress may increase multiple sclerosis activity, according to a new study.

For one year, 50 female MS patients filled out weekly life-event checklists. The threat of each event was determined by using the Life Events and Difficulties Schedule, an instrument used to measure life events and stress levels. Neurological or nervous system symptoms were monitored weekly. A neurologist, unaware of the patient's life events, confirmed MS exacerbations.

Forty-two percent of life events were associated with an exacerbation or increase of MS activity.

Ref: Brain, Behavior, and Immunity. June 2003.

Stress, together with an impaired hypothalamus - pituitary axis, has long been discussed as a factor in MS. Now there is hard evidence how acute stress actually affects people with MS.

Medical researchers chose a standardized acute psychological stressor to find out whether MS patients show altered endocrine and immune responses to stress.

This study involved 35 people with relapsing-remitting MS. They were found to have higher than normal baseline levels for catecholamines, prolactin, and IL-6 compared to 15 healthy controls.

All neuroendocrine parameters declined during the stress intervention in all subjects. But only prolactin showed a significantly larger decline in stressed MS patients versus controls.

Ref: Brain Behav Immun 2002 June; 16 (3):282-7 Heesen C, Schulz H, Schmidt M, Gold S, Tessmer W, Schulz KH.

For further information, refer to the original article.

Circulatory problems may result from blood vessels being constricted by the stress hormones adrenaline and noradrenaline.

Muscles surrounding arterial blood vessels have receptors for stress hormones and they constrict the vessel in response to these.

A study at the University of South Florida, Tampa, has demonstrated that Pycnogenol (pine bark extract) enhances the body's own response to overcome blood vessel constriction. Pycnogenol increases production of nitric oxide by the cells lining the inner wall of blood vessels.

Ref: Fitzpatrick DF et al. Endothelium-dependent vascular effects of Pycnogenol. Journal of Cardiovascular Pharmacology 32:509-515

New research from Ohio shows that the state of our relationships actually does affect the state of our physical health.

Couples who argue and who use negative behaviour during conflict, especially criticism, sarcasm and put-downs had a weakened immune response, as measured by the activity of the T lymphocytes. They also had higher levels of the stress hormones adrenalin, noradrenalin, cortisol and adrenocorticotropic hormone (ACTH) - substances that can further reduce immunity.

Ref: Centre for Stress and Wound Healing, Ohio State University

An episode of depression and anxiety - clinically isolated syndrome (CIS), can be an early sign of MS, Italian researchers have discovered.

A team in Rome investigating the relationship between emotional changes, brain lesion burden and development of multiple sclerosis (MS) found a definite link between severity of depressive scores and the lesion load in the right temporal region (P=0.005).

After 33 months of the study entry, patients who had a clinical relapse were more frequently depressed than those who had not had a relapse. Emotional disturbances are frequently observed in CIS patients and show a tendency towards a normalization in relapse-free patients.

The increased rate of depressive symptoms observed in patients who developed MS seems to result from a combination of psychological and organic features.

The lesion load in the right temporal region is confirmed as a key area for developing depressive symptoms, even in the early phase of the disease.

Ref: Multiple Sclerosis, 1 June 2003, vol. 9, no. 3, pp. 302-306(5) Di Legge S.; Piattella M.C.; Pozzilli C.; Pantano P; Caramia F; Pestalozza LF; Paolillo A.; Lenzi G.L. Department of Neurological Sciences, University of Rome 'La Sapienza , Rome, Italy

This article can be found at the Ingenta website.