Stress Literally Kills

Inflammation, Morbidity, Mortality, and Firemen.

Photo by Hailey Kean on Unsplash

Think back to the last time you had a cold. Hopefully it wasn’t this truly nasty one making the rounds, but even if it was this still applies. You probably had a lot of symptoms. You may have had a fever, it’s possible you produced more mucous than you usually do, and your throat might have been sore and inflamed. These are all symptoms of the virus your body was fighting. In order to kill the virus or interrupt its replication, your body raised its temperature sometimes globally and sometimes in key locations, produced more white blood cells, created mucous to catch and expel the pathogen assailing you, and redirected nutrients to fight the disease.

With most colds and minor infections you might feel a bit rotten for a short time, but your body eventually prevails against the pathogen, expels its last remnants, and then returns to normal. Your inflammation decreases, your mucous goes clear, your white blood cell count goes down, your appetite returns, and your energy goes back to normal.

Your body has prevailed against the infection and no longer needs to create those annoying symptoms to fight it off.

Now think back to the last time you were driving and narrowly avoided an accident or the last time a deadline for something important at work was dropped on your head or the last time someone got angry in your general direction. You had a physical reaction. Your heart started beating faster, your blood vessels dilated, your rate of breathing increased, and you may have even moved involuntarily and far quicker than you normally can. You dealt with the perceived danger immediately but may have remained in this elevated state for a few seconds, minutes or even hours, after you had resolved the problem. But then, at some point you likely let out that breath you didn’t know you were holding and returned to normal.

Your body put you in a state that better allowed you to prevail against the external threat and having helped you defeat or escape the threat you no longer need to be in that elevated physical state.

I did actually have a choice between this and a pair of leopards, but honestly I’m pretty proud of myself. (Photo by Mevrouw Hatseflats on Unsplash)

This is normal. Everyone deals with this throughout their life and when we talk about “biological stress” this is what we mean. The reason you have symptoms when you get sick and the reason some people get stomach aches and diarrhoea or feel faint while experiencing anxiety is because there is a very real physical response. Stress is NOT just in your head. It is completely normal to have an elevated state when experiencing stress or to have a chemical reaction when you miss a meal or an immune response when you get sick. This is your body helping you to deal with the immediate issue. It’s an emergency response.

Your oven caught on fire so you called emergency services, firefighters came into your house, put out the fire, determined what caused it and isolated that issue, and then they left. They might have been tromping through your house for a bit scaring your cat and tracking in mud, depending on how bad it was they may have even broken a window or busted down a door, but they put out the fire and they ensured there wasn’t anything that would catch in the near future. Your house is messy and possibly in need of repair, but you’re okay and the fire is out.

The problem comes when the firefighters can’t leave or when your system won’t allow you to return to your normal homeostatic state.

Pictured: not a homeostatic state. Also, not a fireman. Not even an Edo period Japanese fireman. Literally, this was one of the photo search results I got for “fireman,” because I was going to make a joke about you maybe not wanting them to leave and somehow I got a Kurosawa samurai. I’m sure there’s a “Fist Full of Dollars” joke in here somewhere but … (Photo by Barthelemy de Mazenod on Unsplash)

If you miss one meal, once narrowly miss a car crash, or get a mild infection it’s physiologically metaphorical to having a stove top fire or having your oven catch. It’s really bad, but you’ll probably be fine.

But if you keep on having to deal with these onslaughts your body has to be in a state of hypervigilance all the time. The metaphorical firefighters can’t leave, because if they do your house will burn down. So you are going to have to feed them.

Additionally, if you do finally get back to a relatively normal state after having been “stressed,” for so long and have another fire you may not want to call the firefighters right away or they may not want to come until it’s clearly a huge problem.

What I’m saying here is for your body to have these elevated adrenaline and immune responses it needs to “call” them with — usually — cortisol. Cortisol is more or less your 911 call. Your body creates it, it’s received by the appropriate receptors and they respond by dilating your blood vessels, raising your temperature, quickening your reflexes, and diverting resources from your normal physiological functions to fighting the infection or getting you ready to fight or flee. Once the cortisol is produced and causes the reaction it stops being produced. This is you hanging up the phone when emergency services arrives at your door.

But, if you’re repeatedly having these little fires throughout your house or you’re repeatedly getting infections, having poor nutrition, or dealing with serious threats you start to be seen as a burden to the system because you’re always calling for firefighters and they’re not going to come unless and until it’s quite serious. When people experience frequent biological stress they need to produce more cortisol in order for the immune or adrenaline response to be triggered. This would be like if you had to call the firefighters multiple times before they agreed to come to your house and put out the fire.

But the effects of cortisol go a bit beyond it being just a 911 call. Cortisol when it activates your immune system as it’s supposed to is fine. But if you live such a biologically stressful life that you are constantly producing it or need higher activation levels then it ends up just floating about in your bloodstream when you don’t actually need it to be there. And like really anything in the wrong quantities, it’s a bit destructive.

I felt like now was the time for the requisite cat/sexy man picture. (Photo from the Australian Firefighters 2020 Calendar.)

Cortisol is often cited by diet gurus as the reason you can’t get rid of weight, and as much as I hate agreeing with diet gurus on this one point they are actually sort of right. Cortisol will cause you to gain weight and retain body fat. This is for your survival. Cortisol doesn’t care if you wanted to be an Instagram model. This can end up contributing to Type II diabetes and has the potential to increase your risk for heart disease and some cancers. One of the weirdest things excess cortisol can do is destroy your joints and lead to osteoarthritis. Cortisol is not great with cartilage and having excess cortisol in your system increases the likelihood that it will get into your cartilage and start messing with it.

When you are perpetually biologically stressed you have two problems. You are unable to allocate enough resources to both deal with the assault and maintain your normal physiological functions, meaning you will weaken over time AND you have excess steroids like cortisol wreaking havoc throughout your body. I can’t really make a cutesy firefighter metaphor there, so just stare at the picture of man and cat until you feel better.

Getting an infection will sort of train your immune system to recognize that pathogen and know what sort of antibodies to produce to deal with it, but at the same time you’re putting your body through stress. You’re allocating resources not to repairing your bone and muscle or creating healthy new cells or proteins but to fighting off an infection. If you’re super healthy and the infection is not that bad you can deal with it yourself. But if we return to the fire metaphor above, you’re going to have to go buy yourself a new fire extinguisher.

Children who are born to stressed parents or who experience nutritional deficiencies, extreme psychological stress, or numerous infections growing up are more likely to develop heart disease, hypertension, Type II diabetes and a myriad of other serious illnesses. In some cases these same children may also miss developmental benchmarks or never reach their full height. Individuals who suffer from high amounts of biological stress are more likely to die from an infection, suffer a heart attack, or even get cancer.

Observe: a speckled and fuzzy belly. (Photo by Daria Shatova on Unsplash)

Women with high levels or histories of stress are more likely to have complications during pregnancy and childbirth. And stress is additive. So you may be more resilient when you’re younger, but it’s not just because you’re young that you’re resilient. It’s all that stress piling up on you as you age.

The best proof for this, and the most depressing part of it is the relative rates of morbidity and mortality for white and Black Americans. Black Americans tend to have considerably higher rates of Type II diabetes, heart disease, hypertension, and pregnancy complications than white Americans. Despite tending to practice better hygiene and wear masks more regularly, Black Americans also are at a greater risk of death from Covid-19.

Racism kills. And yes, racist cops literally kill, assault, and menace innocent Black Americans largely just to show they can. But the very threat of racism and the need to be persistently vigilant has serious health ramifications for non-white Americans. Racism can kill via an actual racist murderer or it can kill through persistent biological stress.

This means you, yes you need to relax. Your immune and endocrine systems exist for a reason and as much as I’ve trash-talked cortisol it’s a really necessary part of your biochemistry. But if you want to have a long healthy life you need to find a way not to always be stressed out. The Mayo clinic has a number of suggestions on reducing your unnecessary cortisol. So you can hopefully implement these in your own life.

But the other thing we need to do in our community and society is start treating all people equally and eliminating threats and danger from one another’s lives. Part of this will come through things like job security, equal pay and non-discriminatory hiring practices, affordable education, affordable housing, judicial reform, immigration reform, tribal autonomy, universal healthcare, as well as clean energy, and regulation of food, water, and environmental safety standards. Those can all be implemented via government policy and oversight.

But another huge part needs to come specifically from white people. I think part of our detox-destress routine needs to be specifically anti-racist. Stress kills everyone which is why it is so important not to impose unnecessary stress on one another. It’s no longer good enough to just not be overtly racist. I want to challenge white people trying to lower their own stress to work towards a world where people of colour are not literally dying of stress. You can do this by supporting candidates of colour particularly women, volunteering with or donating to voter registration drives, supporting charities and healthcare groups and organizations like Planned Parenthood, supporting advocacy groups like the ACLU, NAACP, or ADL, or helping with food and school supply drives or after school programs. You’ll feel great about it and you’ll have provided tangible help to someone who needed it.

Take care of yourself first, and then when you’re ready, go out and help others.

Doctor of Palaeopathology, rage-prone optimist, stealth berserker, opera enthusiast, and insatiable consumer of academic journals.

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