Long-Term Stress -- More Harmful Than You Think,
by Bruce Schaefer, LMT

Unfortunately, stress is an all too familiar concept. For many of us, the demands of work, school, and/or family have made stress an accepted part of our daily lives. By design, when a person is confronted with a situation they perceive as a challenge or threat, their bodies start the process of "stress response." This stress response evolved to increase one's chances of survival in potentially life-threatening circumstances -- of short duration. However, if an individual is continuously living in state of stress, the physiological changes and by-products of the stress response can be very damaging to one's health. Fortunately, there are some very simple actions that can reduce some of the harmful by-products of the stress response.

Stress Defined

The term "stress," as it is most commonly used today, evolved out of the work of Dr. Hans Selye. Selye was a Canadian endocrinologist who's pioneering work found that whether an individual experiences a positive impulse or a negative impulse (i.e., receiving good news or bad news) the response is stressful. Selye described stress as "... the nonspecific response of the body to any demand made upon it." Stress from positive or negative experiences can be equally taxing on one's body. Selye categorized healthy stress (that which comes from exciting, challenging, and/or fulfilling experiences) with the term "eustress." When an individual cannot cope with or adapt to persistent stress (from positive or negative experiences), the individual is in a state of "distress."

Dr. Richard Lazarus, a pioneering psychologist who studied emotion and stress, wrote that stress arises in "... any event in which environmental demands, internal demands, or both tax or exceed the adaptive resources of an individual..."

Other sources describe stress as any psychological force (perception, emotion, anxiety) or physiological force (injury, infection, disease) which disturbs equilibrium.

The Escalation of Stress

A "stressor" is any stimulus which elicits a "stress response." A stressor can be psychological or physical in origin. As individuals, we will often have differing reactions to the same stressor (with different perceptions of whether it is pleasant or unpleasant).

A "stress response" begins if the stimuli are unusual, extreme, or long in duration. When the stress response is initiated, our bodies will experience up to three progressive stages: the fight-or-flight response, the resistance reaction, and exhaustion.

The "fight-or-flight response" is characterized by quickly initiated (but short in duration) changes in the body that prepare us for immediate physical activity. In time, if we still continue to react to the stressor, the stress response progresses into the longer-lasting "resistance reaction" to help our bodies fight the stressor after the effects of the fight-or-flight response start to wane. During the resistance reaction, a number of hormones are released which, for the most part, start processes which make more energy available for the needs of our body.

Hopefully, the psychological or physical stressor (and the resulting stress response) is short in duration and we soon return to our normal, calm, healthy selves. Unfortunately, a person may be exposed to a stressor for long periods of time with the body not being able to continue its resistance stage. At this point, the body has depleted many of its resources and enters into the "exhaustion" stage.

Cortisol -- A Friend

During the resistance stage, the adrenal cortex (located within the adrenal glands at the top our kidneys) is stimulated to release more than usual amounts of the hormone "cortisol." If one goes through a prolonged resistance stage of stress into a state of exhaustion, their body will be exposed to high levels of cortisol for a prolonged period. But is cortisol a bad thing?

In a healthy person, cortisol is released into the body while one eats, exercises, fasts, wakes up, and during the stress response. Cortisol levels in the bloodstream follow a daily rhythm and are highest in the morning, with levels decreasing as the day continues. The main functions of cortisol are regulating energy (by selecting the appropriate source; carbohydrate, fat, or protein) to address our physiological needs as we place differing demands on our bodies and moving energy from one part of our bodies to another part (such as to working muscles). Cortisol also has powerful anti-inflammatory effects.

Cortisol -- A Friend You Don't Want Hanging Around

As mentioned earlier, if we experience ongoing stress (even low-grade stress), our bodies are exposed to elevated amounts of cortisol for extended periods of time. Among the effects of long-term exposure to cortisol are:

systemic weakening of connective tissue; skin, muscles, tendons (which increases the likelihood of injury and ongoing pain and slows down the healing process of connective tissues)
slows down bone formation, increasing the likelihood of osteoporosis
weakening of the immune system
fat stores and excess circulating fat within our bodies are relocated deep in the abdomen, which may develop into or increase obesity
high blood pressure
increase in appetite with cravings for high caloric fatty and sugary foods
hyperglycemia
higher susceptibility to the effects of allergies

Also, there are studies that suggest chronically elevated levels of cortisol may induce clinical depression.

Well, Don't Encourage It!

Again, our bodies have a healthy, daily rhythm of cortisol release with levels being highest in the early morning then tapering off in the afternoon to reach its lowest levels around midnight. When a person experiences partial or complete sleep deprivation, the normal tapering off of cortisol levels is delayed. Therefore, sleep loss will result in the continuation of elevated levels of cortisol (from the morning) when levels would normally be lowering as the day progresses.

A study published last year by Pharmacology Biochemistry & Behavior, found that during mental stress, cortisol levels were increased even further with the addition of caffeine. They also found that caffeine taken before exercise elevated levels of cortisol.

And when do we usually go for that hit of extra coffee? After a poor night of sleep, in the morning when our cortisol levels are normally at their highest (not to mention while we might be experiencing ongoing, low-level stress).

Get Rid of Those "Resistance Stage" Leftovers

A number of studies conducted through the Miami School of Medicine have found that massage therapy significantly decreased cortisol levels (on average by 31%) in a number of different age groups experiencing various types of psychological and physical stressors. The article detailing these studies (published in 2005 by the International Journal of Neuroscience) states, "Although each condition may be affected by massage therapy in some unique ways, some effects generalize across these highly variable conditions. Of these, the stress reduction effects (cortisol reduction) of massage therapy and activation effects (increased serotonin and dopamine) would appear to generalize across conditions." "...cortisol reduction following massage therapy has been noted in conditions ranging from job stress to depression to HIV and breast cancer."

So, What Do I Do Between My Massage Therapy Appointments?

Obviously, the best action would be to address stimuli in a way that diminishes the likelihood they become stressors, which then elicit the stress response (somewhat easy to say -- not always easy to do). So, in that case, just laugh! A study published in 2008 titled "Cortisol and Catecholamine stress hormone decrease is associated with the behavior of perceptual anticipation of mirthful laughter" (that really is the title) found that laughter and experiencing humor can lower cortisol levels.

Music therapy has been found to lower cortisol levels. A study published in 2005 states, "Patients who listened to music during colonoscopy tended to have lower pain scores. Salivary cortisol levels increased significantly less in the group receiving music. Conclusions: Music therapy during colonoscopy markedly reduces fear-related stress, as indicated by changes in salivary cortisol levels." I think the cortisol-lowering effects of the music will still be effective even without the posteriorly-placed camera.

An article in Psychology Today titled "Vitamin C: Stress Buster" noted studies where vitamin C prevented expected increases in cortisol levels in subjects exposed to stress and found those "...that did not receive vitamin C had three times the level of stress hormones."

Conclusion

Long-term stress can have serious implications for our psychological and physical health. The effects of over-exposure to cortisol are only a few of the many consequences we may face.

So, let's all try to lighten up, get a massage, and eat an orange (or lemon) while watching a campy musical.

Long-Term Stress -- More Harmful Than You Think, by Bruce Schaefer, LMT