By Eric Hochman, M.D.
In a 1789 letter describing the recently penned Constitution of the United States, Benjamin Franklin wrote “…nothing can be said to be certain, except death and taxes”. This time of year, we are typically immersed in another certainty…stress. The stress response is the body’s reaction to harmful or very demanding circumstances. Whether “good” stress such as the birth of a child or a long anticipated vacation, or “bad” stress such as the death of a family member, stress is stress.
The human body’s response to stressful situations is quite amazing. Changes occur in every organ system that enable us to adapt and better manage stressful circumstances. Our cells release energy faster, blood is diverted from the gastrointestinal tract to the brain and muscles, and even our hearing increases. These changes, along with many others, help ensure that we are functioning at our best when we need to be.
Unfortunately, although the body’s stress response is very helpful in dealing with acute situations, these adaptive responses also can be responsible for many detrimental effects over the long term. Decreased gastrointestinal blood flow can lead to abdominal pain, nausea, and diarrhea. Cardiovascular modifications to stress include increases in blood flow to the brain, blood pressure, and heart rate. These physiologic adjustments can cause relatively minor maladies, such as headaches, or more severe conditions such as heart attacks and strokes. The body’s ability to form blood clots increases. Although this can help decrease bleeding during a trauma, it can also lead to heart attacks, strokes, and blood clots elsewhere in the body.
What about illness? Why are we more likely to develop fever blisters, colds, and other illnesses during periods of increased stress? The stress response has a profound effect on the immune system. Although the immune response to stress is very complicated and not fully understood, stress is known to increase the body’s cortisol level. Cortisol is the body’s natural steroid, and steroids are potent immune system suppressors. So as one is exposed to chronically high levels of cortisol, there is an increased risk of infection and illness.
Elevated stress levels are not only associated with immune system suppression, but also with an increased risk of autoimmune diseases, conditions created by an overactive and inappropriately active immune system. In an autoimmune disease such as rheumatoid arthritis, lupus, or crohn’s disease, the immune system malfunctions and attacks the very body it is supposed to be protecting. Many studies have found a disproportionately high level of emotional stress prior to the onset of autoimmune diseases. Furthermore, patients with these diseases frequently undergo flares during periods of increased stress levels.
Research has repeatedly demonstrated that the Holiday season is the most stressful time of year. The demand for extra resources in an already busy life can be quite daunting. Deadly heart attacks increase during the Holiday season, sometimes known as the “Merry Christmas Coronary”. The Holiday season pulls together a “perfect storm” of stressors. Time constraints, money, and family are all central themes around the holidays.
What can we do to cope? There are many stress management strategies that can be adopted or intensified around the holidays. Planned meditation or quiet time can go a long way towards relieving stress. Be sure to maintain good habits. Hopefully you have worked all year to maintain your weight, watch what you eat, and exercise regularly. Don’t forget these habits during the month of December. When a person exercises, the body releases endorphins which help produce numerous positive effects on the body. Running, biking, swimming, and walking are all known to help reduce stress.
Additionally, sharing your thoughts with your spouse, family, or close friends can be very helpful in reducing stress. It is always reassuring to realize that you are not alone.
And of course, remember to get the necessary amount of sleep.
The Holidays should be a happy time of time of year. Understanding the body’s reaction to stress, and what strategies you can employ to help cope, will help make your holiday season the best it can be.
Dr. Hochman, President of the Collier County Medical Society, is the founding physician of Gulfshore Concierge Medicine and board certified in Internal Medicine, Pediatrics, and Rheumatology. His expertise includes treating common diseases such as hypertension, hyperlipidemia, and diabetes, as well as diagnosing and treating osteoporosis, musculoskeletal diseases, and solving medical mysteries, often at the request of other physicians to help determine the cause of unique symptoms. He offers patients a personalized four-step approach to optimize health and maximize longevity called the WELLStrides™ Plan.
Dr. Hochman was named a Castle Connolly “Top Doc” by Gulfshore Life magazine from 2011 to 2014, and was a Patients’ Choice Award winner in 2008 to 2015, as well as Most Compassionate Provider and On-Time Physician Award winner. He completed his dual residency program in Internal Medicine and Pediatrics at the Ohio State University, and his Rheumatology training at Washington University in St. Louis.
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