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 Stress and Diseases

 

The  association between stress or a stressful period with a disease is not a new one. The  affect of mood and thought on disease process has been held true along history throughout the centuries. At the times when true cure for diseases were scarce, the physicians, shamans and bomohs strove to 'comfort always , cure seldom' approach to treatment. Hippocrates, the father of modern medicine established that the reassuring hands of the physicians as a  therapeutic principle. Even now, sensitive clinicians would draw the inner strength from the patient to help fight diseases and to relief symptoms.

'Sudah Jatuh ditimpa tangga'. So goes the Malay proverb telling how one problem is followed by another. It is not an uncommon for a health problem to follow a period of stress. Some simply call it bad luck . The Hindus say ' the time is not right for so and so'. No matter under what name it goes by, such an occurrence is recognized by almost all societies in the world. We can ask ourselves, whether illness that occur with other calamities is just  due to sheer coincidence, or is there other reasons for this to happen, leaving aside bad luck?

 In fact this relationship between stress, mood and diseases has been held to be intuitively valid for ages. But medical science does not take kindly to the use of intuition as a mean of gaining knowledge. Medical researchers are taught to substantiate their beliefs with intangible , visible and repeatable evidence. Current attention is focused on the relationship between stress and disease is channeled towards the interaction between the neuro- endocrine system and the immune system in our body.

The physiological system in the body

 the neuroendocrine system is  scattered throughout the body . The  brain forming the major organ in this system It exerts control over the body though a network of nerves directly linked to it. Beyond this, it also controls the release to hormones to control other organs -either directly or by feedback mechanism on  other organs such as the adrenals near the kidneys and thyroid glands that produce hormones themselves. The brain  is involved directly in the process of  thought, memory and by extension emotion and stress. Many of the hormones are also stress related and controls how the inner function of the whole body reacts to stress

 The policeman of the body is the immune system. The white blood cells and their descendants are the backbone of this system. They are trained in the art of fighting the 'barracks' of the bone marrow, liver and spleen and get further specialized training in the lymph nodes and thymus glands. In fact they are more than just simple policemen and have different units to counter different types of attacks  .They act like the FRU to fight against internal uprisal  of rogue cells( ie cancer cells). They are  the military that defend against the  invaders from the outside- the  bacteria and viruses. They even do the work of the municipality workers to clears of the mess after every fight. There are also cells  specialized  in creating weapons( antibody) to weaken and even kill specific groups of attackers. There is no doubt hence that this system protects us from many diseases that affect mankind

Psychoneuroimmunology

Until as recently as 20 years ago these two systems are thought to act  in parallel but  independently of each other. In the past 2 decades a small but growing group of elegant studies have revealed a set of direct interactions between the neuroendocrine and the immune system. This has given rise to the birth psychoneuroimmunology (PNI) branch of medicine.

 The root of PNI can be traced to the beginning of the twentieth century. During the First World War the effect of fright (fear) response to a stress is noted. An upsurge of hormones ( the cathecolamines ). during this period is shown to suppress the number and activity of T-cells( a subgroup of the white blood cells)  A person under repeated or chronic stress may become sufficiently immune-suppressed to be at risk of an infectious disease.. the 1960s the US navy completed a study correlating a recent history of  serious lifestyle change such as divorce moving or loss of a job with an increased likelihood of a serious illness in the following months. Subsequent studies have found a higher rate of illness and early death in people without a social network.

 In 1977 stress researchers noted that 50 to 70 percent of all diseases and illness are stress related. By 1995 the estimates were even higher , indicating that 70 to 80 percent of health related problems are either precipitated or aggravated by  by stress. The list of such disorders are endless  ranging from common cold to more serous conditions.

In the event of stress , organs that are acted upon by hormones or that receive direct innervations  from the brain increases theirs metabolic activity. Persistent state of increased activity results in dysfunction of the body organ. The personality trait of some individuals makes them more prone to stress and its related condition.  The most widely accepted of such a relationship is coronary artery disease which may manifest as ' heart attack'. Ulcers of the stomach which can be  life threatening is multifactorial in origin but is has a very close relationship with stress. In fact medication for ulcers are started in ill patient to prevent 'stress ulcers'. Similarly migraines , tension headaches and asthma can be aggravated by stress. Irritable bowel syndrome is another stress related medical condition commonly missed as patients come with repeated bouts of abdominal discomfort not relieved with common medications. The list can go on and on, from the commonest flu and mouth ulcers viral infection to the most debilitation life threatening condition . Some even believe though not proven that that psychological stress alone - if sufficiently great-  in the absence of other risk factors can result in a person's death. This is known as psychogenic death. Voodoo deaths and due to 'charms' are said to be extreme examples of this.

Much attention is currently being paid  to the relationship between stress and diseases. As the lifestyles appear to be more stressful , the incidence of several illness that appear to be closely related to stress is also increasing. Recently there were statement by the Malaysian Government to pay more attention to preventive medicine and promotion of healthy lifestyle in the 9th Malaysian Plan. Hopefully we can bring down the incidences of this lifestyle and stress related illness as a preventive measure.

 References

Kaplan H I, Sadock B J, Synopsis of Psychiatry. Behavioral Sciences/ Clinical Psychiatry 8th edition William & Wilkins Publishers 1998

Seaward B L, Managing Stress. Principles and Strategies for Health and Well Being  Jones and Bartlett Publishers 3rd edition 2001

 By The Holistic Doc

 

 

 

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