By Lauren M. Smith, PhD, LP and Erin Kauffman, MS, LPC
It has been more than two years since the global COVID-19 pandemic was declared (can you believe it?), and many of us are now starting to see how this stressor, in addition to all the others in our daily lives, has impacted our functioning.
Stress is an emotional response to an event or challenge that causes a cascade of neuroendocrine and hormonal responses in the body. The body responds to stress through “fight,” “flight,” or “freeze” states. Over time, these responses can affect the body in a multitude of ways—and can even contribute to chronic illness.
Stress has long been known to impact our immune response. Several groundbreaking studies in the 1990s showed that stress increased the likelihood that individuals would catch a cold after being exposed to the cold virus. In fact, individuals who reported that they were chronically stressed were twice as likely to get sick from the common cold. The findings indicated that interpersonal stressors and being unemployed were particularly significant in the development of colds. Stress is also linked to two leading causes of illness: heart disease and cancer.
The effect of multiple stressors over time is additive or “compounding.” Situational stressors can compound stress experienced over a lifetime, and these together can have long-term impacts on the body.
The pandemic, for example, has introduced a level of stress to our lives that we may not have experienced before. A stressor of this magnitude can influence chronic illness symptoms as the body struggles (unsuccessfully) to “turn off” its response to stress. You may have experienced a worsening of your spondyloarthritis (SpA) symptoms at some point during the past two years, which may be attributable to this phenomenon.
The nervous system works as a negative feedback loop, which means that when the stress-regulating hormone cortisol is high enough, the system will shut off and return to baseline. When stress is chronic, the body becomes resistant to signals that turn off the nervous system. This can lead to one of two responses. For some individuals, the nervous system gets stuck in the “on” position, which causes a person to experience anger, anxiety, restlessness, panic, or hyperactivity. For others, the nervous system may get stuck in the “off” position; these individuals experience depression, disconnection, and fatigue.
New research from chronic illness trauma studies shows that stress not only alters the nervous system, but it also alters the genetic functions that regulate how our nervous system and other organ systems work. This means that early childhood experiences—including physical, psychological, and emotional environments—shape the activity of genes involved in the regulation of our internal systems. How we respond to experiences such as trauma and potential perceived threats such as infections and toxins is, in some ways, predetermined by our nervous and organ systems.
Think of chronic illness as a volcano—it is often unpredictable and can disrupt life in many ways if unmanaged. Managing a chronic illness holistically starts with understanding how lifestyle factors help shape long-term health, with the goal of being able to recognize when your volcano is headed toward “eruption.” Eruption of symptoms can look very different from person to person. The chronic pain that is often associated with chronic illness can be related to hyperirritability of the nervous system. This hypersensitivity causes nerve sensitization that can lead to increased pain signals, and tension that causes muscle spasms or reduced blood flow. Finding ways to manage and reduce stress can help decrease the frequency and duration of flares, and reduce the overall impact of chronic illness.
Techniques for reducing stress include:
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