How Do Stress and Trauma Make Us Sick?

by admin on February 17, 2012

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We spend a lot of time reviewing ANSAR Heart Rate Variability Results here at Life Vessel, and a part of this is explaining the basics of the autonomic nervous system—what it is, how it works—to our clients. The blog gives us a great opportunity to share this information with all of our readers.

We have a veritable mountain of evidence-based medical research at our fingertips that clearly shows the link between stress and illness, and you need only turn on the news on any given night if you’re looking for more examples. Life Vessel clients are always so knowledgeable about this link—they know the “how,” but frequently don’t quite grasp the “why”. Today we’ll try to briefly explain the link between trauma and disease, the ins and outs of your autonomic nervous system (ANS) and its two branches, the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS). We will of course expand on these topics in future posts.

To start, we’ll compare the terms disease and illness—we use them synonymously, but actually they describe two completely different things. Disease is the objective malfunctioning of the organism that can be diagnosed by machines about which experts can form a consensus. Illness, on the other hand, can be described as the subjective feeling of this disease state (Goswami, 2004). For example, your “disease” is diabetes—your hemoglobin A1C test shows a result of 8.9 mg/dl, and there isn’t a medical professional in the world who would disagree with me on that diagnosis. The “illness” is your fatigue, the numbness and tingling you feel in your feet, perhaps frequent urination. Numerous studies have shown that the victims of trauma, particularly of psychological or emotional trauma, frequently experience both phenomena. Let’s look at a few studies so you get what we’re talking about.

Trauma survivors often have significant physical health problems that can linger for many years after the traumatic event has ended and are often above and beyond the effects of direct physical injury (Kendall-Tackett, 2007; Kibler, Joshi, & Hughes, in press). For example, a woman’s whose arm was broken by an abusive boyfriend in her teen years might experience chronic pain, depression, fibromyalgia, even cardiac disease years after this abusive relationship ended. Felitti and colleagues (1998) found that patients who experienced four or more types of adverse childhood events had higher rates of ischemic heart disease, cancer, stroke, chronic bronchitis, emphysema, diabetes, skeletal fractures, and hepatitis. Finally, in the National Comorbidity Study, women who were maltreated as children had a nine fold increase in cardiovascular disease compared with non-maltreated women (Batten, Aslan, Maciejewski, & Mazure, 2004). There is so much data on the link between trauma and disease that we’ve dedicated an entire field to its study, the field of psychoneuroimmunology (PNI).

The negative health effects of trauma and PTSD, at this point, are fairly well established, and a substantial number of research studies have shown that a wide range of traumatic exposures and experiences can lead to poor health (Kendall-Tackett, 2009). Some of this is attributable directly to injury suffered during the trauma—i.e., abusive boyfriend breaks patient’s arm, and subsequently patient suffers from chronic pain at the fracture site. Others result from the effects of the trauma—i.e. patient has a high probability of developing cardiovascular disease later in life after the trauma. This second link is a little more unclear. Our question is, why does this occur?

PNI research asserts that severe or overwhelming stress, and any resultant PTSD, alters and dysregulates the key systems that are part of the stress response. So, how does the stress response work? It’s a pretty complicated neurochemical cascade, and if we were to give you the kind of graphic providers have to learn in school, it would look something like this:

We find Loyd and Johnson’s (2010) explanation to be much more helpful: “Physiologic stress, simply put, is when our nervous system is out of balance. The [autonomic] nervous system can be described using the analogy of a car. If you continually floor the gas pedal, you’ll end up breaking something. Likewise, if you ride the brakes, you will end up breaking something”.

As we mentioned above, the ANS has two divisions—the sympathetic (SNS) and the parasympathetic (PNS) nervous systems. The PNS is responsible for growth, healing and maintenance, and the maintenance of homeostasis, one of my favorite words, used to describe a “stable internal environment.” The SNS is responsible for our “fight or flight” response—that speedy heart rate, fast respiratory rate, and tunnel vision we all experience when we’re in danger, or even just really stressed out about something. Simply put, when man experiences stress, either from within because of illness, or from outside the body because of danger or fear, the SNS serves to mobilize energy to fight or flee from the stressor (Fox et al., 1999). Through the antagonism between the sympathetic and parasympathetic systems, the ANS regulates the activities of the viscera, involuntary smooth muscles, cardiac muscles, and glands to maintain a stable internal environment within the body (homeostasis). The SNS and the PNS have a “push-pull” relationship—one is always responding to the other, and they never act alone.

The stress response functions as a defense mechanism to support physical action. Essentially, your body thinks you have to get ready to run, so your heart gets pumping hard to get lots of oxygen and energy to you cells, and your digestive system shuts down and goes on autopilot so your body can divert more energy to your heart and lungs. The thing is, current stress-provoking events rarely require the intense physical capability that the primordial stress response produces. Thus, a potentially dangerous mismatch occurs between mediators of the stress response and tissue needs (Lusk et al., 2005). Your heart does not technically need to beat faster to keep you ready to run 10 years after you escaped that boyfriend who emotionally and physically abused you, but because the trauma is still fresh in your mind, it does anyway. So, in the case of trauma—the initial trauma likely produced the appropriate SNS response. The ongoing SNS response that occurs year after year is the culprit that leads to disease.

Let’s turn to good old Loyd and Johnson (2010) again for another great way to think about the ANS: “When we go into fight or flight, many things happen. Blood flow completely changes. It’s no longer going to the stomach to digest food. It’s no longer going to the frontal lobes of the brain for creative thought. It’s no longer going to the kidneys and liver. The lion’s share of the blood is now going to the muscles because your body thinks that it is going to have to fight harder or run faster than whatever is threatening your life. So you don’t need to digest that food in the bowel or clear the toxins from the liver, balance the electrolytes in the kidneys, or have creative thought, because if you don’t survive the next few minutes, all of that doesn’t matter.”

Finally, just a brief word on stress and inflammation. When you’re in fight or flight because you’re under a huge deadline at work, your body has no idea that this is the problem, and that you are not in fact in physical danger—it thinks you might need help healing wounds that could result from this attack you’re under. So, the immune system responds to threat by releasing pro-inflammatory cytokines. These cytokines increase inflammation and serve the adaptive purpose of helping the body heal wounds and fight infection (Kendall-Tackett, 2009). The human stress response has a number of checks and balances built in to ensure that various components do not become overactive. Unfortunately, in the case of severe or overwhelming stress, the normal checks and balances fail, causing inflammation levels to be abnormally high. For example, cortisol (which is normally anti-inflammatory and keeps those pro-inflammatory cytokines in check) can actually change function under severe stress and potentiate the actions of inflammatory mediators rather than inhibiting them (Dhabhar & McEwen, 2001). When there are too many proinflammatory cytokines, or other inflammatory factors, humans become vulnerable to disease (McEwen, 2003).

So, how in the world do we put all of this together? Extensive and varied supporting research shows us that, with chronic stress, the inhibitory mechanisms built into our stress response eventually cave in and fail, and are thus unable to maintain homeostasis (that stable internal environment we talked about), and that this precipitates immunosuppression (Fox et al., 1999). Plain language? If you’re always in fight or flight, your immune system gets weak, and you get sick.

Life Vessel therapy works to create a state of deep relaxation in the body in order to take us out of our sympathetic, fight-or-flight state, and allow the parasympathetic nervous system to promote homeostasis allowing our liver, kidneys, and digestive organs to work normally to clear toxins from the body. When we move out of sympathetic dominance our body is also able to stop creating all of this needless inflammation that so frequently leads to disease. You can do your part to help, too—drink lots of water, rest, then rest some more, and try to look at what you can do in your life to address a dysfunctional and hyperactive stress response. We hope to see you soon at Life Vessel of the Rockies!

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