Amina AlTai has always prided herself on her drive and resilience. When she started experiencing brain fog and fatigue, Ms. AlTai, 39, simply thought it was due to the long hours in her marketing job. So she started writing reminders to stay on track. But then her hair started falling out, she gained and lost a lot of weight, and she started having gastrointestinal issues.
Ms. AlTai was sure something was wrong. But the first six doctors she saw didn’t take her seriously, she said. Some told her that she had so much hair that losing a little shouldn’t be a problem. Several said she appeared healthy and dismissed her symptoms as simple stress. It wasn’t until another doctor ordered blood tests that Ms. AlTai was diagnosed with Hashimoto’s disease and celiac disease, two autoimmune diseases that can damage the thyroid and small intestine.
“They called me and said, ‘Don’t go to work. Go to the hospital instead, because you are a few days away from multi-organ failure,’” recalls Ms. AlTai. Both chronic illnesses had disrupted his ability to regulate his hormones and absorb essential vitamins and nutrients.
Scientists now know that stress is closely linked to many chronic diseases: it can lead to immune changes and inflammation in the body, which can worsen the symptoms of diseases such as asthma, heart disease, arthritis. , lupus and inflammatory bowel diseases. At the same time, many problems caused by stress – headaches, heartburn, blood pressure problems, mood changes – can also be symptoms of chronic illnesses.
For doctors and patients, this overlap can be confusing: Is stress the only cause of a person’s symptoms, or is something more serious at play?
“It’s really hard to unravel,” said Scott Russo, director of the Center for Brain-Body Research at the Icahn School of Medicine at Mount Sinai.
How Stress Can Trigger Chronic Diseases
Stress naturally triggers what is called the fight or flight response. When we face a threat, our blood pressure and heart rate rise, our muscles tense, and our body concentrates blood sugar so it can respond more quickly, said Dr. Charles Hattemer, a cardiovascular health specialist at the University of Texas. Cincinnati.
If people are stressed for weeks or months, their bodies may be unable to keep up with other functions, leading to problems such as forgetfulness, fatigue, and trouble sleeping. Stress hormones like adrenaline and cortisol can chronically elevate blood pressure or increase plaque deposits, which can damage the heart over time, Dr. Hattemer said.
There is also some evidence to suggest that stress can contribute to overactivation of the immune system and lead to inflammation. In a study of 186 patients, Italian researchers found that 67 percent of adults with celiac disease had experienced a stressful event in their lives before their diagnosis.
More recently, Dr. Russo and his colleagues showed in two studies that distressed mice had higher levels of neutrophils, which cause inflammation, and fewer T cells and B cells in the blood, capable of producing antibodies or kill cells infected by viruses. .
He and his colleagues also found that patients with major depressive disorder had similar imbalances in their immune cells compared to healthy controls. Researchers believe the body changes the composition of immune cells circulating in the blood to reduce damage caused by infection or acute stress, Dr. Russo said.
However, when faced with chronic stress, the body “sometimes just can’t turn off the immune system,” Dr. Russo said.
For people who may already be at risk for chronic illnesses, whether due to genetic predisposition, exposure to chemicals, air pollution, or viral infections, a prolonged period of stress can push them towards illness.
Lynne Degitz, 56, spent several years battling what seemed like extreme infections from time to time. Once she thought she had mono. Another time, she was sure it was bronchitis. Neither she nor her doctors thought it was a chronic illness.
Then she started a new, more stressful job and began experiencing fever, joint swelling and fatigue almost every day. “I had an interesting and demanding job, so I continued,” Ms. Degitz said. “I was just using short-term disability to recover or I was using my vacation time to recover when I needed it.”
After more than two years of going back and forth to medical appointments and trying treatments that ultimately didn’t help, Ms. Degitz was diagnosed with a type of arthritis known as arthritis. Still. Doctors aren’t sure what causes it, but research is starting to suggest it’s likely a combination of factors, including abnormal reactions to infections and stress.
“We all have illnesses and physical weaknesses,” Dr. Russo said. “Stress only exploits them and makes them worse.”
When symptoms become a source of stress
For patients with chronic illnesses, the same stressors that might have triggered their symptoms can make it difficult to control their condition.
And some said they don’t always feel like doctors realize how difficult it can be to manage stress, especially when they’re feeling sick. When Teresa Rhodes was first diagnosed with rheumatoid arthritis decades ago, a doctor suggested she exercise more to reduce stress and strengthen joints damaged by the disease.
But “the symptoms of the disease themselves were stressors,” said Ms. Rhodes, now 66. “It’s very difficult to exercise when you’re so tired.” Only once other life stressors subsided – her children grew up and she left a difficult marriage – was she able to get enough rest and eventually start training again.
Many doctors aren’t trained to ask questions about sources of stress or to counsel patients about the impact of stress, said Alyse Bedell, a clinician-scientist specializing in how stress affects digestive health at UChicago Medicine. . A 2015 survey of more than 30,000 patient visits to doctors’ offices found that primary care doctors only counseled their patients on stress management during 3% of visits.
When Stephanie Torres’ 12-year-old son Nico was diagnosed with Crohn’s disease, she was surprised to learn that the gastroenterologist believed that managing the stress that clearly triggered his symptoms was the family’s responsibility . “His response was basically, ‘That’s your problem.’ Go solve it.’
Patients said that rather than simply suggesting eliminating sources of stress, doctors could work with them on small ways to manage their stress in everyday life. Once Ms. AlTai was diagnosed and began taking medication for both of her illnesses, she felt well enough to make the dietary changes needed to address the nutritional deficiencies caused by her illnesses. She began taking regular walks and meditating in the morning.
Ms. AlTai eventually left her marketing job and became an executive coach, which allowed her to set her own schedule, she said. Being hospitalized and diagnosed with two chronic illnesses made her realize that these changes were necessary.
“I call it my downtime, because it literally stopped me in my tracks,” she said. “I had to really re-evaluate my relationship with work, success and stress.”