The wilful butchering of Jane Austen’s iconic line apart, many modern men (and women), even if blessed with the good fortune mentioned in the original quotation, will nod their head in mute agreement. Stress has become a shadow that follows most of us, if not all of us, like a curse; stress at the workplace, stress about managing finances, stress of coping with relationship woes, stress about parent management…it seems as if the shadow lengthens or shortens depending on the time of the day. Stress is often compared to a poltergeist – devious, underhand and able to sneak in unobtrusively; before you realise, the damage is done.
Little surprise then, that several ailments and lifestyle diseases that affect us today and make our shoulders sag further are blindly attributed to stress. The internet and the media too are full of stories (this one included) about what stress is, how to combat it and how not to fall prey to it – the information overload indeed stresses you further!
Relax. The best way to lead longer, happier lives is to fine-tune your awareness of your own mind and body and not get sucked into a well of conflicting data.
For this purpose, we decided to tackle head-on 10 common lifestyle diseases that are prevalent today and get experts to demystify the role of stress in each one of them.
1. Polycystic Ovary Syndrome (PCOS)
One of the most common endocrine disorders in women, affecting up to 10 per cent of women of reproductive age worldwide, PCOS is often believed to be caused by erratic lifestyles, heavy workload and poor diet. Patiala-based Dr Sonali Gupta, Consultant Gynaecologist, believes the link between stress and PCOS is rather direct due to a hormone called Pregnenolone. “This hormone is produced when one is stressed for long periods of time to enable the body and mind to cope with the after-effects of such pressure. This causes a chain reaction in the hormone levels; the production of other hormones such as estrogen is lowered as the pathways used by the hormones get overcrowded. This hormonal imbalance plays havoc with the menstrual cycle leading to some of the symptoms of PCOS including ovarian cysts, erratic or no periods and the release of androgens which can cause acne and facial hair.” She also cautions that though stress is a big contributing factor in PCOS, many other genetic and lifestyle aspects are also responsible. Nevertheless, reducing stress levels go a long way in shrinking of the ovarian cysts and triggering a reversal of PCOS.
2. Common headaches
Though headaches are considered to be the most common symptoms of stress, both acute and chronic, it is not true that all headaches are due to stress. Neurosurgeon Dr Arvind Malhotra of Columbia Asia Hospital, Bangalore, says the myth about stress being responsible for all headaches is perpetrated because ‘tension’ headaches are the most common among adults. Stress busting activities like deep breathing, long walks, meditation or simply doing the things one really loves, often makes such headaches vanish in a jiffy. “But it is important to remember that headaches are not just a result of stress, though stress may aggravate the symptoms. Headaches are also caused by poor posture, inadequate rest, depression, hunger and other factors. If headaches persist for more than a week, don’t attribute it to stress and dismiss it,” he warns.
3. Hair fall/Hair problems
It is not without reason that people say stress makes them want to pull out their hair. If information out there is to be believed, that won’t be necessary. Get stressed and hair will fall by itself! But is it really true that stress is a major cause of hair fall and related hair problems such as scalp infections, dandruff, brittle hair and dryness? Doctors clarify that it is not mild stress like the ones experienced with jobs or relationships that leads to hair fall. Usually, it is only high emotional stress or stress triggered by other causes like diabetes, thyroid disorders and certain types of medications that leads to hair fall. Sometimes stress triggered by life events like pregnancy, childbirth and surgery can also have depressing effects on the hair.
The good news though, according to Mysore-based practitioner Dr Rajgopal, is that stress-related hair loss is often reversible. He has a word of warning though. The more you worry about hair loss, the more hair you will lose! So the first advice you should give yourself in this case is really to stop stressing – most likely, the hair will be back.
Diabetes may be a minefield littered with myths but you will not find many disputing the effect of stress on blood sugar levels. Doctors often use the ‘fight or flight’ analogy to explain how stress increases the risk in diabetics. To put it simply, when you are stressed, the blood sugar levels rise. This is because the body releases stress hormones like cortisol and epinephrine because it feels you need more energy to combat with the stress. This is the ‘fight’ response; you cannot fight if your energy is low, so the body is helping you meet the challenge. But you can also use the same hormones for ‘flight’ because they enhance your ability to flee. The assumption is that the balance will be restored, regardless of whether you chose to fight or flee because you will use up those hormones to perform that action. But for people with diabetes, there isn’t enough insulin to take the load of these hormones and hence, blood sugar levels do not come down naturally. The only way to tackle such an increase, according to Internal Medicine consultant Dr Latha Muthanna of Columbia Asia, is to directly reduce the stress-causing hormones like adrenaline and corticosteroids or indirectly combat them with diet and lifestyle changes.
5. Sexual dysfunctions
That stress causes sexual dysfunctions is a well-known fact. But what is often ignored is that stress causes sexual problems not just in men as it is widely believed but also in women. Delhi-based gynaecologist Dr Chetna Jain warns that while stress may be the direct cause of erectile dysfunction in men, in women, the effects of stress on sexual functions is much harder to discern. It may show up in poor arousal, lack of orgasm and sometimes, painfully dry intercourse. "Often, it is also a result of related ailments like diabetes and depression," she adds.
Interestingly, researchers from the University of California, Berkeley recently claimed that they found exactly how stress causes sexual dysfunction and infertility. According to this research, stress increases the levels of a reproductive hormone in the brain and this in turn hinders reproduction by inhibiting another hormone in what the researchers’ term as a 'double whammy' for reproduction.
Dr Arvind has an interesting take on stress and depression, often projected to be a cause-and-effect relation. He says stress could be either good or bad for you and it is "lazy" to blame everything on stress. Stress goes some way in keeping us alert, motivated and primed to respond to danger. "And yet, when that invisible line is crossed, it is this very motivating factor that leads to depression. Remember that even seemingly positive events like marriage, a new job or a child birth can be stressful and lead to an episode of major depression." This, he clarifies, does not mean that stress is the only cause of depression. "About 10 per cent of depression cases are caused without stress triggers -- the reasons could vary vastly."
What has to be remembered is of course stress is different for different people. What is stressful for one person might be simply adrenaline rush for another.
It is often stress that makes you reach out for the second cookie or make you forget that New Year resolution and head to the chocolate section in the supermarket. It is a proven fact that eating habits are the first casualty of stress. As Dr Rajgopal says, it is a vicious cycle. "Stressed out people eat inappropriately. This causes weight gain and that aggravates stress all over again." He also warns that excess consumption of carbohydrates increases the presence of a chemical called serotonin in the body. No doubt this makes one feel good but it again works in circles -- it encourages cravings for sugary and fatty foods, thus contributing to obesity.
Undoubtedly, stress can lead to heart-related ailments as well as hypertension and high stress levels indeed are like a precursor to contracting hypertension. But Delhi-based Internal Medicine specialist Dr Satish Koul clarifies that though being in a stressful situation can temporarily increase one's blood pressure; science has not yet proven that stress is the cause of hypertension. Some scientists have noted a relation between coronary heart disease risk and stress in an individual's life, health patterns and socio-economic status, but again a host of subjective factors such as unhealthy diet habits, lack of physical activity, excess consumption of alcohol, smoking and intake of drugs may have a stronger effect than mere everyday stress.
9. Skin diseases
It would come as a surprise to many that the inexplicable skin breakouts they suffer sometimes could be a direct effect of stress in the mind. Current research makes it pretty clear that stress activates immune cells in the skin, causing such inflammatory skin diseases like psoriasis and atopic dermatitis. But what researchers are yet to figure out is exactly how stress increases the frequency and intensity of these skin diseases. As Dr Koul emphasises, stress can lead to many psychosomatic disorders and can overwhelm you before you can figure out the reasons.
A new study published in The Journal of Clinical Investigation shows that stress hormones may increase the risk of contracting cancer by indirectly weakening the immune system and by encouraging tumour growth and spread. Bangalore-based cancer survivors and wellness practitioner couple Vijay and Nilima Bhat believe that to be the precise view advocated in the science of Psychoneuroimmunology. "Any stress will lead to some physical or psychological ailment because it supresses immunity, thus exposing the person's health to unknown breakdowns. Cancer is no different," says Nilima.
Ultimately, Nilima believes, from a holistic health perspective, the body is self-healing and the immune system, our inner healer, is its most powerful medicine. The biggest enemy of this immune system is stress. Once the stressors are identified and resolved, the immune system quietly goes back to its job. As a cancer survivor, she should know!
Published in the May 2012 issue of Smart Life, a health and lifestyle magazine published by the Malayala Manorama Group. (www.manoramaonline.com)