Everything in Moderation: Stress Included.

There is not a human being on this planet who has not experienced stress at some point in their lives. Stress is all around us, and it is an inescapable part of life that we must all deal with. When considering the various levels of stress in one’s life though, some may find themselves asking the question: “What actually is stress?” Some may think of it as a hormone or a chemical reaction of some kind, whereas others may consider it to be a feeling, an emotion, or possibly even label it to be a disease.

The reality of stress is that in its appropriate amount, stress is actually a good and necessary thing. Whether stress about bills is motivating you to get your finances in order, or the upcoming date of the exam is spurring you to put in the extra study time necessary to excel on it, or the stress of the new responsibilities at work are applying pressure to encourage you to work more efficiently, stress in these scenarios is working to your benefit. From the most primitive of times of the distant past when the stress fight or flight response helped us to be hunters and gatherers, to the way that stress helps us stay active and working to improve ourselves in the modern-day future, stress is actually a very helpful and essential thing in our lives.

Stress that drives us toward continuous improvement should be celebrated and embraced. That being said, it is important to remember that stress, especially in excess, can also be a bad thing. Stress in large part is a balance of sympathetic (prepares the body for strenuous activity) and parasympathetic (calms the body allowing rest and repair) neurologic influence in the body, which further dictates various levels of inflammatory molecules and hormonal messages being relayed to various organs and tissues in the body. Chronic sympathetic activation over time encourages the body to break itself down, which if left unchecked can compromise both one’s physical and mental well-being in the long-term. Thus, it is crucial to keep these stress response systems working in balance as much as possible.

A good example of stress playing a vital role in one’s physical health can be seen in the body’s response to physical injury. Even with things like joint and soft tissue trauma, some level of stress in the body via the inflammatory response is necessary in order to promote healing. Various growth factors and blood vessel formation-promoting chemical messengers are dependent on the inflammatory stress response in order for tissue to grow back even stronger. However, if the stressful inflammatory response goes on indefinitely and is not kept in check, scarring and fibrosis will eventually occur, along with other pathologic inflammatory changes to the body. This can subsequently cause systemic changes over time, including the promotion of elevated blood pressure and the encouragement of weight gain via the increased risk of obesity.

The immune system is another example of this, particularly through how immune cells, like neutrophils, use inflammatory enzymes to fight off pathogens in the body via a controlled inflammatory stress reaction. But if the inflammation goes on to become chronic, the end product is a less effective immune system that is ill-equipped to defend the body from sickness and infection. In this way, maintaining appropriate levels of stress is crucial to one’s ability to maintain a healthy and robust immune response.

Although often overlooked, stress plays a critical role in the psychological coping response that any individual undergoes when something difficult or unexpected happens. In the first few days after a hard or trying event that has occurred, the completely normal and necessary “acute stress response” initiates, which helps the individual to mount a psychological response to better adapt to what is happening in their life from an emotional standpoint. If this acute stress response persists though, beyond just a few days to weeks, it can progress into something called an acute stress disorder, often with troubling dreams and disturbing flashbacks to the traumatic event. If not addressed, acute stress disorder can further continue past the one-month mark, potentially progressing into a post-traumatic stress disorder, a condition that can be truly debilitating and require psychiatric evaluation and medical treatment.

Although these are extreme examples, and unresolved emotional stress following an event more often progresses into something like an adjustment disorder at most, as opposed to an acute stress disorder or PTSD, the fact remains that stress must be managed effectively in order for it to remain in balance. One must pay specific attention to their emotional response to stress in order to avoid possibly developing mental illness over time.

In order to overcome stress, it is of paramount importance to recognize that not all stress is bad, but all stress can become bad if one allows it to fester. Be intentional about researching methods to better manage stress. Make lists, put reminders in your smart phone, look for a group of people with similar goals and interests as you to help you to hold each other accountable. Life can be hard at times, but it is even harder if you try to get through it without ever asking anyone else to walk alongside of you.

Lastly, there is no shame in admitting that you need help. Reinforcements are always available if you are willing to look, and it is never too late to ask for assistance. Your Family Physician would be a tremendous help in this regard. Although stress can so often seem overwhelming, it only has power over you that you give it. Stress is an inevitable part of life, but your attitude and response to it are always exclusively your decision.

Dr. Johnson is a resident physician who sees patients of all ages and provides obstetrical services at Lone Star Family Health Center, a non-profit 501©3 Federally Qualified Health Center operating facilities in Conroe, Spring, Willis, Grangerland, and Huntsville, and serving as home to a fully integrated Family Medicine Residency Program to increase the number of Family Medicine physicians for Texas and our community.