In this occasional feature on Psych Congress Network, members of the Psych Congress Steering Committee answer questions asked by audience members at Psych Congress meetings.
QUESTION: How does stress pull the body in? I thought stress was much more a mind thing that doesn't involve the body. Please help me better understand this connection.
ANSWER: This is a very good question and I'm happy to offer you some thoughts. It is true that stress is perceived by the human mind and brain. It behooves us to remember that the human brain is intimately connected to the human body via multiple pathways.
One of the well-known pathways is of course the hypothalamic–pituitary–adrenal (HPA) axis, which has long been thought to provoke a corticosteroid reaction in the human body when we perceive emotional stress. The other pathway of note is the autonomic nervous system (ANS), which includes the sympathetic and the parasympathetic systems. During times of stress, the sympathetic system is overactivated and the parasympathetic system is unable to hold it in check. This therefore ‘exports’ stress to the body.
Finally, the inflammatory pathway connects stress to the body. In fact, a recent study by Tawakol and colleagues, published in The Lancet, revealed that exposure to stress activates the amygdala, and this has a very tight relationship with increased bone marrow activity. That is not a typo—I did indeed say bone marrow activity! What the data show is that human stress, through activation of the bone marrow, is able to increase the production of proinflammatory monocytes that produce inflammatory cytokines. In addition, amygdala hyperactivity also increased arterial inflammation and raised the risk of developing cardiovascular events.
So, the reality is that stress might be emotional in nature, but it is widely exported into the human body, and this has negative consequences. We clinicians should appreciate this connection, educate our patients about it, and create individualized treatment plans that help them deal with stress, in order to diminish its negative impact on a patient’s mind-body (or more accurately, brain-body) functioning.
— Psych Congress cochair Rakesh Jain, MD, MPH, Clinical Professor, Department of Psychiatry, Texas Tech Health Sciences Center School of Medicine, Midland
Yamagata AS, Mansur RB, Rizzo LB, et al. Selfish brain and selfish immune system interplay: a theoretical framework for metabolic comorbidities of mood disorders.Neuroscience & Biobehavioral Reviews. 2017;72:43-49.
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