James Comey Jr., former Director of the Federal Bureau of Investigation (FBI), made a “gut wrenching” decision that made him “feel nauseous”. He seemed tense, anxious and probably didn’t get his usual good night’s sleep.
Stress causes physical, mental and emotional unrest. It can upset your stomach making you feeling nauseated and wanting to vomit. It can make your blood pressure spike, provoke chest pain, interfere with sleep and cause headaches. It can make you overeat or refuse to eat.
Stress occurs during good times and bad times. It can come on suddenly or slowly and the latter seems to explode out of nowhere. What is stress?
Stress is our body’s reaction to situations we perceive as being overwhelming. Unmet expectations contribute to stress. Job insecurity, divorce proceedings, cancer, unexpected medical expenses, moving from one residence to another are just a few of the myriad stressors that play havoc with our body and psyche.
Not all stress is harmful or long lasting. Wedding preparations, the precarious first few days in a new job, holiday celebrations can all be stressful. The anxiety of public speaking or passing an exam can be nerve-racking. These short term anxiety uprisings usually pass with no long lasting consequences. And, of course, the “fight or flight” response can be life-saving.
Fight or flight, the reaction to acute stressful situations, has been indispensable for the survival of our ancestors and our own survival. The example of a Zebra zigzagging away from a charging lion is commonly used as an example of acute stress. This terrifying encounter seems to be over in minutes and shortly thereafter the escaped Zebra is grazing and the female lion seems to be taking a nap.
We too avoid stressful situations when we zigzag — drive way from dangerous streets in a crowded city or at other times refuse to get too close to the edge of a cliff or balcony.
Stress becomes chronic when you have repeatedly suffered anxiety and fear due to the travails of day to day living. Such stress can wreak havoc with your health. For example, it can have harmful effects on the psyche, digestive (ulcers) endocrine (diabetes)) and immune system. It influences insulin (sugar metabolism) and brain biochemistry.
If a family is surviving from paycheck to paycheck, you dread opening the mailbox at the end of the month. One month you open the mail and are greeted with a hefty credit card bill. The next month, the rent is due, you get a note that Billy is not doing well in school, Mary needs a new pair of glasses and the car blew a gasket. You’re close to doing the same thing. .
Mom, worried and frustrated, says “I’m stressed out. I don’t remember the last time I had a good night’s sleep. All this stress is messing up my blood pressure and diabetes. I’m not eating right. I can’t take it anymore.”
Stress and Weight Gain
Prolonged stress causes an increase in the production of cortisol. This steroid hormone is produced by the adrenal glands located on top of each kidney. There are many biochemical interactions involving cortisol. Of special interest is that chronic stress causes an elevation of cortisol leading to weight gain and loss of sleep.
One way cortisol causes weight gain is to increase the production and storage of fat. Another way, chronic elevation of cortisol sends hunger signals to the brain, in particular, to the hypothalamus.
The hypothalamus, about the size of an almond, is located in the center of the brain and has many functions. Of note, it is involved in the management of stress, hunger and sleep.
The cortisol circulating in the blood connects with the receptors of the Hypothalamus in the brain like a key fitting into a lock. This interaction sets off a cascade of chemical responses that stimulates the hunger hormone ghrelin (more food please) and depresses leptin (I’ve had enough to eat) the satiety hormone.
Cortisol also activates the Pituitary gland causing the Adrenal glands to produce more cortisol (HPA Axis). The good news is that the interactions of this axis-feedback mechanism work to get the body into balance to reduce stress.
Stress and Sleep Loss
We need sleep the way we need food, water and breathing. We can’t live without it. If we’re chronically stressed, the level of cortisol becomes elevated at the wrong time.
We want cortisol to be elevated in the morning and gradually decrease throughout the day. We want cortisol to jump-start our day, energize us and be at its lowest level in the evening when we are ready to go to sleep.
We want to go to sleep in a relaxed, calm state of mind. When we are habitually stressed, the nighttime levels of cortisol are abnormally elevated and it can trigger problems. Put in another way, we want HPA axis activity to be at its lowest level in the evening for us to enjoy a good night’s sleep.
Not getting enough sleep has also been associated with an increase in ghrelin (the hunger hormone) and a decrease in leptin (the satiety hormone). In many instances, the combination of stress and sleep loss make it likely that you will eat more, gain weight and be emotionally frazzled.
There are no easy solutions to stress, weight gain and loss of sleep. But recognizing the problem is a first step. People have handled stress by taking advantage of the benefits of sleep experts, biofeedback, psychological counseling, exercise, meditation or yoga. If the problems persist, seek expert advice to find out which treatment option might be best for you.
References
Anna-Sophia Wisser et al; Interactions of Gastrointestinal Peptides; International J. of Peptides, vol 2010
Kuoo LE; Neuropeptide Y; Nature Medicine, July 2007
Dhillo, WS et al; Hypothalamic Interactions; J of Neuroendocrinol; 9/14/2002
Epel E, Lapidus R, McEwen B, Brownell K. Stress may add bite to appetite in women: A laboratory study of stress-induced cortisol and eating behavior. Psychoneuroendocrinology. 2001; 26 (1):37-49
Joseph R. Anticaglia, MD; Yin and Yang of Hunger & Satiety; Ghrelin and Leptin; H.C. Smart, 2017
This article is intended solely as a learning experience. Please consult your physician for diagnostic and treatment options.