How Chronic Stress Damages Health

Amy Rothenberg, ND, explains the effects of perpetual stress and what you can do to avoid burnout.

Throughout my 35-year career, I have never witnessed as many people experiencing ongoing stress as I have recently. Even before COVID-19 hit our communities, constant access to work, social media, and disconcerting news about the environment and climate change exposed our vulnerabilities, throwing our bodies out of whack. The resulting illnesses and imbalances across the physical, emotional, and cognitive spectrum got me thinking about the role of stress. Chronic stress, especially, has the potential to derail good health. When they should be flourishing at the peak of well-being, patients are feeling joyless, unmotivated, and empty. These emotions are often tied to persistent stress and burnout.

Stress, Body Burnout, and Bounce-Back

During unrelenting stress, we simply can’t adapt as well. “Bouncing back” like we did when we were kids isn’t possible because we never give ourselves a proper chance to heal. With chronic stress, the hypothalamus stimulates the adrenal glands, which in turn generate and release adrenaline and cortisol. These hormones raise our heart rate, blood pressure, respiratory rate, and glucose levels, while simultaneously compromising immune function. All increase the risk for numerous health complications. 

Some people call the fallout from long-term stress “adrenal burnout.” Although it’s not an accepted concept in conventional medicine, there are certainly patients with physical, emotional, and cognitive concerns seemingly tied to chronic stress.¹Cadegiani FA, Kater CE. Adrenal fatigue does not exist: a systematic review. BMC: 10.1186/s12902-016-0128-4. Erratum in: BMC Endocr Disord. 2016 Nov 16;16(1):63. PMID: 27557747; PMCID: PMC4997656. There are a number of tools to consider when seeking help for the physical and physiological damage caused by stress.

The extent to which stress affects an individual also affects their susceptibility, which is shaped by various factors: genetics, coping skills, personality, and access to support systems. Some stress can be positive—stimulating immune function or sharpening focus, but too much has the opposite effect. Studies show chronic stress may also lead to histamine release, contributing to allergy symptoms, asthma, and rashes.²Salleh MR. Life event, stress and illness. Malays J Med Sci. 2008 Oct;15(4):9-18. PMID: 22589633; PMCID: PMC3341916.  

Psychological stress also alters insulin metabolism and sensitivity—a risk factor for diabetes. Stress agitates stomach acids, leading to all manner of digestive complaints. Ongoing stress contributes to arterial plaque buildup, worsened by a sedentary lifestyle and high-saturated fat diet. Research associates the Standard American Diet (SAD) with long-term stress that suppresses natural killer (NK) cells. NK cells have many important functions, not least of which is preventing cancer metastasis.

Beyond physical ailments, we know unmitigated and ongoing stress contributes to and aggravates depression, anxiety, irritability, and insomnia. Every aspect of our well-being is interconnected; that’s why holistic, natural medicine approaches are crucial for healing. They offer a fresh perspective on treating stress and its connection to human health. 

While they may appear more prevalent and intense recently, fluctuating emotions and the experience of stress are natural aspects of life. We are ever more aware that adverse childhood events, socioeconomic status, and racial disparities all contribute. Stress is not meted out evenly across zip codes or populations.²Salleh MR. Life event, stress and illness. Malays J Med Sci. 2008 Oct;15(4):9-18. PMID: 22589633; PMCID: PMC3341916.

You Can Overcome Stress and Burnout

Burnout—The Secret to Unlocking the Stress Cycle³Nagoski, Amelia, Nagoski, Emily (2021) Burnout—The Secret to Unlocking the Stress Cycle. Random House Publishing Group. describes the neurobiology of the stress cycle. Every emotion has a beginning, a middle, and an end. But you must feel your emotions and get through to move on. There are many ways to process emotions: talking about them, having a good cry, practicing deep-breathing exercises, hugging it out, enjoying a deep belly laugh, exercising, writing, drawing, or singing. Connectedness with family and friends also helps.

Spending time outdoors in green spaces like parks or forests is a great way to relieve stress. As research delves deeper into the benefits of outdoor exposure, we increasingly recognize its positive effects on overall wellness.⁴Hartig T, Mitchell R, de Vries S, Frumkin H. Nature and health. Annu Rev Public Health. 2014;35:207-28.

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Nine Natural Necessities to Avoid Burnout and Adrenal Fatigue

1.   Adopting a healing, anti-inflammatory diet while addressing nutritional deficiencies or potential food sensitivities. Work toward balancing blood sugar levels, reducing frequent snacking, and cutting down on or eliminating refined sugars, refined carbohydrates, and alcohol.

2.   Adequate hydration. It’s amazing how being adequately hydrated can help many people feel better. I ask my under-hydrated patients to set out four small juice glasses of water as a starting goal and work their way up. We aim for half a person’s weight in ounces. I recommend herbal teas, diluted fruit juice, and lemon or lime water to make hydrating more exciting.

3.   Sufficient, regular, and restful sleep—an enormous challenge for some. Naturopathic doctors have a broad range of tools to help people sleep better.

4.   Exercise! For most people, more movement is better. Exercise is one of the best ways to blow off steam, clear the mind, sweat out natural toxins, improve sex drive, and get better sleep. Research shows exercise improves quality of life and delays the onset of more than 40 chronic ailments!⁵Ruegsegger GN, Booth FW. Health Benefits of Exercise. Cold Spring Harb Perspect Med. 2018 Jul 2;8(7):a029694

5.   Individualized nutritional supplementation or botanical medicines to address specific or synergistic biochemical issues. These include vitamin C, vitamin B, adaptogenic herbs, licorice root, and curcumin:

• Vitamin C to improve energy and reduce overall inflammation⁶Tardy AL, Pouteau E, Marquez D, Yilmaz C, Scholey A. Vitamins and minerals for energy, fatigue and cognition: a narrative review of the biochemical and clinical evidence. Nutrients. 2020 Jan 16;12(1):228.
• Vitamin B complex to ease stress and boost cognition
• Adaptogenic herbs like Ashwagandha and Rhodiola. Both address mental and physical fatigue.⁷Lopresti AL, Smith SJ, Malvi H, Kodgule R. An investigation into the stress-relieving and pharmacological actions of an ashwagandha (Withania somnifera) extract: A randomized, double-blind, placebo-controlled study. Medicine (Baltimore). 2019 Sep;98(37):e17186.,⁸Edwards D, Heufelder A, Zimmermann A. Therapeutic effects and safety of Rhodiola rosea extract WS® 1375 in subjects with life-stress symptoms—results of an open-label study. Phytother Res. 2012 Aug;26(8):1220-5.
• Licorice root (Glycyrrhiza glabra), a plant-based medicine that supports adrenal function.⁹Yang R, Wang LQ, Yuan BC, Liu Y. The pharmacological activities of licorice. Planta Med. 2015 Dec;81(18):1654-69. Choose deglycyrrhizinated products (often abbreviated DGL), which do not raise blood pressure.
• Curcumin (Curcuma longa), a bioactive compound in turmeric, has so many positive attributes as a culinary and medicinal herb, from its anti-inflammatory properties to its antioxidant impact. Studies show it also improves overall quality of life.¹⁰Hewlings SJ, Kalman DS. Curcumin: a review of its effects on human health. Foods. 2017 Oct 22;6(10):92.

6.   Regularly practice mind–body approaches to normalize an activated stress response. Breathing techniques, mindfulness meditation, Qigong, yoga, and hobbies such as art and music can help you relax.²Salleh MR. Life event, stress and illness. Malays J Med Sci. 2008 Oct;15(4):9-18. PMID: 22589633; PMCID: PMC3341916.

7.    Simplifying your home and work space a la Marie Kondo.

8.    Thinking beyond material possessions—what you are trying to accomplish on any given day? Sometimes we put too much pressure on ourselves to be productive, as if we were human doings instead of human beings! A tremendous amount of stress can be alleviated by doing less. It may seem counterintuitive, but de-prioritizing our to-do lists from time to time has its benefits.

9.   Consider tried-and-true, whole-person homeopathic medicines to address physical and emotional conditions associated with stress and burnout. By definition, constitutional homeopathy is customized to meet a specific patient’s needs. These remedies can mitigate the impact of stress, whether it’s aggravating PMS symptoms,¹¹Danno K, Colas A, Terzan L, Bordet MF. Homeopathic treatment of premenstrual syndrome: a case series. Homeopathy. 2013 Jan;102(1):59-65. insomnia, or anxiety. Some homeopathic remedies can raise your tolerance of stress, reducing your susceptibility to patterned stress reactions.¹²Naudé DF, Stephanie Couchman IM, Maharaj A. Chronic primary insomnia: efficacy of homeopathic simillimum. Homeopathy. 2010 Jan;99(1):63-8.

Acupuncture has proven benefits for overall energy, anxiety, stress, and related pain and discomfort.¹³Schroeder S, Burnis J, Denton A, Krasnow A, Raghu TS, Mathis K. Effectiveness of acupuncture therapy on stress in a large urban college population. J Acupunct Meridian Stud. 2017 Jun;10(3):165-170. https://doi.org/10.1016/j.jams.2017.01.002. Epub 2017 Jan 16. PMID: 28712475.,¹⁴Vickers AJ, Vertosick EA, Lewith G, MacPherson H, Foster NE, Sherman KJ, Irnich D, Witt CM, Linde K; Acupuncture Trialists’ Collaboration. Acupuncture for chronic pain: update of an individual patient data meta-analysis. J Pain. 2018 May;19(5):455-474. Look for an experienced provider when exploring homeopathic remedies or acupuncture.

Talking About Stress and Its Roots

I welcome conversations with patients to identify the most stressful aspects of their lives and help them differentiate stress from the stress response. Think about ways to reduce everyday stress, whether that means letting go of a difficult relative, shifting your schedule at work, or adjusting expectations at home.

Addressing underlying chronic disease and mitigatating or reversing those ailments is just as important. Depression, burnout, and fatigue are common side effects of chronic disease. Conversely, stress and depression put us at greater risk for certain ailments.

For many people grappling with chronic stress and burnout, the road back to tranquility may be a long one. Holistic natural remedies that target underlying causes, activate the body’s innate healing abilities, and seek to counteract the effects of chronic stress can make a difference. Embracing change and reflecting on the present also provide peace of mind and help us manage stress more effectively.

Footnotes

• 1
  Cadegiani FA, Kater CE. Adrenal fatigue does not exist: a systematic review. BMC: 10.1186/s12902-016-0128-4. Erratum in: BMC Endocr Disord. 2016 Nov 16;16(1):63. PMID: 27557747; PMCID: PMC4997656.
• 2
  Salleh MR. Life event, stress and illness. Malays J Med Sci. 2008 Oct;15(4):9-18. PMID: 22589633; PMCID: PMC3341916.
• 3
  Nagoski, Amelia, Nagoski, Emily (2021) Burnout—The Secret to Unlocking the Stress Cycle. Random House Publishing Group.
• 4
  Hartig T, Mitchell R, de Vries S, Frumkin H. Nature and health. Annu Rev Public Health. 2014;35:207-28.
• 5
  Ruegsegger GN, Booth FW. Health Benefits of Exercise. Cold Spring Harb Perspect Med. 2018 Jul 2;8(7):a029694
• 6
  Tardy AL, Pouteau E, Marquez D, Yilmaz C, Scholey A. Vitamins and minerals for energy, fatigue and cognition: a narrative review of the biochemical and clinical evidence. Nutrients. 2020 Jan 16;12(1):228.
• 7
  Lopresti AL, Smith SJ, Malvi H, Kodgule R. An investigation into the stress-relieving and pharmacological actions of an ashwagandha (Withania somnifera) extract: A randomized, double-blind, placebo-controlled study. Medicine (Baltimore). 2019 Sep;98(37):e17186.
• 8
  Edwards D, Heufelder A, Zimmermann A. Therapeutic effects and safety of Rhodiola rosea extract WS® 1375 in subjects with life-stress symptoms—results of an open-label study. Phytother Res. 2012 Aug;26(8):1220-5.
• 9
  Yang R, Wang LQ, Yuan BC, Liu Y. The pharmacological activities of licorice. Planta Med. 2015 Dec;81(18):1654-69.
• 10
  Hewlings SJ, Kalman DS. Curcumin: a review of its effects on human health. Foods. 2017 Oct 22;6(10):92.
• 11
  Danno K, Colas A, Terzan L, Bordet MF. Homeopathic treatment of premenstrual syndrome: a case series. Homeopathy. 2013 Jan;102(1):59-65.
• 12
  Naudé DF, Stephanie Couchman IM, Maharaj A. Chronic primary insomnia: efficacy of homeopathic simillimum. Homeopathy. 2010 Jan;99(1):63-8.
• 13
  Schroeder S, Burnis J, Denton A, Krasnow A, Raghu TS, Mathis K. Effectiveness of acupuncture therapy on stress in a large urban college population. J Acupunct Meridian Stud. 2017 Jun;10(3):165-170. https://doi.org/10.1016/j.jams.2017.01.002. Epub 2017 Jan 16. PMID: 28712475.
• 14
  Vickers AJ, Vertosick EA, Lewith G, MacPherson H, Foster NE, Sherman KJ, Irnich D, Witt CM, Linde K; Acupuncture Trialists’ Collaboration. Acupuncture for chronic pain: update of an individual patient data meta-analysis. J Pain. 2018 May;19(5):455-474.