Chronic stress is a trigger for mental disorders – 04/04/2023 – Mental Health

No one runs away from stress. Every day we experience episodes such as chaotic traffic, a deadline to meet at work or even any scare. Chronic stress, on the other hand, occurs when we face situations that extend over a long period, such as a financial problem that is difficult to solve, the illness of a family member or continuous pressure in the professional environment.

This condition of constant tension generates impacts on our mind and body that can cause disorders such as panic, depression, anxiety, in addition to diseases such as gastritis, irritable bowel syndrome and muscle pain.

When our brain is faced with a stressful or dangerous situation, it activates a system called fight and flight. “At first, the amygdala, which is a brain structure, will be activated and will initiate the activation of the sympathetic system and the release of a series of chemical signals, such as noradrenaline and adrenaline. These substances will put us on alert and prepare our body to face the threat”, explains neuroscientist Andrei Mayer.

“If this dangerous situation continues for a longer time, we will have the release of the famous cortisol, the stress hormone”, says Mayer.

Cortisol participates in the regulation of complex organic functions, such as the decrease in insulin levels, the increase in available energy in the form of glucose and the important anti-inflammatory action during a period of greater demand on the body’s organs. These substances allow, for example, the brain to adjust to challenging situations, keeping the person attentive, motivated and ready to avoid danger.

“The problem occurs when this physiological reaction is maintained for long periods. Some people have genes that are more susceptible to chronic stress, and negative impacts on memory, cognition, anxiety control and mood may occur in these individuals”, highlights psychiatrist Bruno Ax.

The doctor says that clinical conditions such as depression and anxiety disorders are directly related to the prolonged action of the biological mechanisms of stress. “Brain areas such as the cortex, hypothalamus, amygdala and hippocampus normally have cortisol receptors and also participate in controlling the release of this corticosteroid. However, when subjected to the hormone for long periods, these areas of the nervous system are functionally impaired. There are neuroimaging studies that show even demonstrate atrophy of these brain structures.”

As a consequence, says Machado, learning and memory are impaired, in addition to cognitive deterioration, which in turn contributes to the chronification of anticipatory anxiety, leading to a vicious cycle that perpetuates stress itself. In this scenario, there is an increased risk of mental disorders such as depression, panic disorder and generalized anxiety disorder.

“It is very important to emphasize that cortisol is not the cause of stress, it just participates in a broader process. Nor should we use the test that detects the level of cortisol in the blood to diagnose or monitor the treatment of these mental disorders. Such tests are useful in research and have valid methodology only for diagnosing endocrinological diseases, but not accurate for diagnosing stress or anxiety. inadequate. This is a common problem that we see in clinical practice”, observes Machado.

Chronic stress can also lead to tension headaches, gastritis, irritable bowel syndrome and insomnia. However, since systemic mechanisms of the human body are involved, diseases generally unrelated to stress may also be directly and indirectly influenced by this biological process.

“We could cite a correlation with heart disease, dementia such as Alzheimer’s, asthma and also obesity. The search for rewards and the attempt to momentarily relieve anxiety symptoms can also lead to behaviors associated with the development of diseases, such as the use of cigarettes, eating foods with a high sugar content, alcohol use, drug abuse, among others”, he says.

The best way to dribble the effects of stress is to maintain healthy habits, such as regular physical activity, nutritional monitoring for a balanced diet and regular sleep. Starting a therapeutic process with a psychologist and taking medications prescribed by a psychiatrist may also be recommended in some cases.

“Drug treatment is often fundamental, but it is only part of the recovery process. Physical activity, adequate exposure to the sun, sleep hygiene, healthy eating and appropriate psychotherapies are also of great importance”, he says.

The psychiatrist says that, in clinical practice, mindfulness has gained prominence, a practice applied to health that was developed by physician Jon Kabat-Zinn in the 1970s in the United States.

The effectiveness of these techniques in the treatment of anxiety disorders is so great that in November 2022 a study was published in the traditional scientific journal JAMA Psychiatry, comparing a structured mindfulness protocol with the antidepressant escitalopram, one of the drugs with the best results in anxiety disorders. . The mindfulness therapy was as effective as the medicine, but with a lower risk of side effects.

It is important to point out that mindfulness therapy has fundamental differences in relation to meditation, although there are similarities, says the doctor. “The cognitive lines and stress reduction based on mindfulness objectively aim to restore psychic balance through the self-regulation of thoughts and emotions, helping patients to overcome symptoms always in an intelligible way and with the development of skills easily applied to situations It is important that the state of full attention is worked together with organization and pragmatism, helping in the management of anxiogenic situations and in self-care.”

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