At the Rocky Mountain MS Center, we endorse a three-part treatment approach aimed at maximizing lifelong brain health and minimizing damage done by MS in the brain. The first component involves the use of disease-modifying therapies to mitigate the damage MS causes in the central nervous system. The second facet encourages regular physical and mental exercise, active social engagement, and active participation in life to enhance brain resilience and build cognitive reserves. And finally, wellness strategies — including maintaining healthy nutrition, getting regular exercise, adequate sleep, and protecting mental health, which includes effectively reducing and managing stress — play a crucial role in preventing the development of secondary medical conditions like heart disease, obesity, and diabetes, which can strain the body and, ultimately, impact brain health.
The Science of Stress
The science of stress involves the body’s complex response to perceived threats or challenges. When we encounter a stressor, such as a demanding situation or a perceived danger, our body initiates a “fight-or-flight” response. The brain’s amygdala, a region responsible for processing emotional reactions, initiates a rapid response. It signals another part of the brain, the hypothalamus, to release stress hormones. These hormones, primarily cortisol and adrenaline, are released by the adrenal glands located on top of the kidneys. Adrenaline provides the body with a rush of available energy so that it has increased resources to deal with whatever the threat. Cortisol helps get that energy to the organs that most need it by turning off all non-essential activities.
Emotional responses such as anxiety, fear, frustration, irritability, or sadness can manifest with stress. And stress can also impact cognitive functions like decision-making, memory, and concentration.
With the release of these hormones, a range of physical changes occur, including an increase in heart rate, blood pressure, and respiration rate – these are all changes aimed at preparing the body for immediate action. The senses become heightened, and energy is redirected toward the muscles and brain.
During the stress response, the body’s digestive and immune systems temporarily shut down as resources are redirected towards the immediate threat. This response can be adaptive and beneficial in the short term, helping individuals react swiftly to challenges and perform better in certain situations. Indeed, the stress response is the body’s way of helping individuals cope or react to a threat or a danger they are facing.
But the problem is that the stress response is also activated by life’s day-to-day stressors including long lines at the store when you’re in a rush, traffic jams, money pressures, dealing with the challenges and demands posed by living with a chronic illness, conflicts with family, work deadlines, and the list goes on. Over time, these accumulating stressors can sometimes add up to chronic stress. And chronic stress, with the persistent release of stress hormones, can have adverse effects on long-term health, potentially leading to issues such as high blood pressure, suppressed immunity, and increased risk of chronic diseases.
The impacts of chronic stress can also lead to other negative health consequences. The prefrontal cortex, the brain’s executive control center, plays a crucial role in regulating and managing stress. It assesses the situation and sends signals to inhibit the stress response initiated by the amygdala. However, chronic stress can impair the prefrontal cortex’s functioning, leading to difficulties in emotional regulation and decision-making. Long-term exposure to stress can also affect the brain’s hippocampus, a region essential for memory and learning. Chronic stress can lead to the atrophy of hippocampal neurons, potentially impairing cognitive function, and memory.
Understanding these physiological and neurological aspects of stress is crucial for managing it effectively in ways that promote brain health and resilience. While stress can be a normal and even beneficial response in the short term, chronic or excessive stress can have negative effects on physical and mental health.
Key Stress Responses
Stress response types refer to the varied ways in which individuals react to stressors, whether they are acute, chronic, or situational. As discussed above, when confronted with a stressor, the body initiates a “fight-or-flight” response. This involves the release of stress hormones like cortisol and adrenaline, leading to changes in heart rate, blood pressure, and other bodily functions to prepare for action.
Emotional responses such as anxiety, fear, frustration, irritability, or sadness can manifest with stress. And stress can also impact cognitive functions like decision-making, memory, and concentration. Sometimes these feelings can produce physical symptoms that make you feel worse including headaches, muscle tension, nausea, indigestion, digestive problems, or shortness of breath.
Stress can also influence behavior, leading to actions like increased alertness, withdrawal, procrastination, or unhealthy coping mechanisms such as overeating or substance abuse. According to the Mental Health Foundation, a person may also be indecisive or inflexible, or have problems getting to sleep or staying asleep.
Types of Stress
Stress is a multifaceted phenomenon, and understanding the various stress types is essential for comprehending the diverse ways it can impact our lives, ranging from short-lived bouts of acute stress to the sometimes-debilitating effects of chronic stress.
Acute Stress: Acute stress is a short-term, intense reaction to a specific event or situation. It is a normal response that helps individuals cope with immediate challenges. Once the stressor is resolved, the stress typically dissipates.
Chronic Stress: Chronic stress results from ongoing, persistent stressors, such as long-term work-related pressure, financial problems, dealing with health conditions, or ongoing relationship difficulties. When left unmanaged, chronic stress can lead to health issues.
Eustress: Eustress is a positive form of stress that arises from challenging but manageable situations, such as starting a new job, getting married, or pursuing personal goals. This type of positive stress can motivate and enhance performance. Even though eustress is a positive form of stress, it is still stress and can contribute to excess or prolonged stress responses.
Distress: Distress is negative stress that arises from overwhelming situations, such as trauma, loss, or chronic health problems. It can lead to mental and physical health problems if not addressed.
Post-Traumatic Stress Disorder (PTSD): PTSD is a specific type of stress reaction that occurs in response to a traumatic event. It involves recurring intrusive memories, nightmares, and severe emotional distress long after the traumatic incident.
Burnout: Burnout is a form of chronic stress typically associated with work-related stressors, long-term health issues over time, and caregiver burnout. It involves physical and emotional exhaustion, reduced performance, and feelings of detachment.
Chronic Stress and Mental Health Impacts
The negative effects of chronic stress can significantly impact mental health. Anxiety and depression can be consequences of prolonged exposure to stressors. It is important to have clarity on the definitions and differences between stress, anxiety, and depression.
Anxiety is a psychological and physiological response to a perceived threat or danger, whether real or imagined. It often involves feelings of apprehension, unease, and worry, and can manifest as physical symptoms like increased heart rate, muscle tension, and restlessness.
While stress and anxiety share common features and can often overlap, the key distinction lies in the fact that stress is a response to external pressures or demands, whereas anxiety is typically a prolonged state of unease or worry often characterized by excessive or irrational fears, even in the absence of an immediate stressor.
Anxiety can be a normal response to stressors, but when it becomes chronic or overwhelming, it may develop into an anxiety disorder, characterized by excessive and irrational fears and avoidance behaviors.
Chronic stress can also contribute to the development and exacerbation of depression. Prolonged exposure to stressors can disrupt the brain’s neurochemical balance and impair its ability to regulate mood. This can lead to persistent feelings of sadness, hopelessness, and a lack of interest or pleasure in daily activities, which are characteristic symptoms of depression.
Additionally, chronic stress can increase the risk of developing clinical depression, particularly in individuals with genetic predispositions or a history of mood disorders. Understanding the link between chronic stress and depression underscores the importance of stress management as a vital component of mental health care and prevention.
Stress and MS
The intersection of stress and MS is a complex and multi-layered relationship. Many individuals living with MS report believing that stress exacerbates the symptoms of their disease.
Coping with the physical and emotional aspects of MS, navigating symptoms that may come and go, managing treatments, and navigating the uncertainties of the disease can all contribute to heightened stress levels.
While research hasn’t proven this direct connection conclusively, it’s very real for those who experience it and certainly strategies to manage and reduce stress are particularly important for those people. Although it hasn’t been widely researched, a small study published in The Journal of Neuroscience Nursing earlier this year showed that some individuals living with MS may struggle more than others to identify and understand emotions they are experiencing. This makes it that much more important to have tools for recognizing and responding to stress.
And at the same time, the challenges of living with a chronic condition like MS can be a significant source of stress for individuals. Coping with the physical and emotional aspects of the disease, navigating symptoms that may come and go, managing treatments, and navigating the uncertainties of MS can all contribute to heightened stress levels. In addition, it can be stressful to deal with the invisibility of some MS symptoms and to feel that those around you don’t understand what you are experiencing. Adjusting and readjusting to changing abilities or needs and financial pressures or concerns about employment can be additional stressors.
With no shortage of stressors to manage, difficulty in recognizing physical signs of stress can also be common when living with MS. Often signs of stress are similar to common MS symptoms like fatigue or muscle tightness. It’s important to take notice of emotional and cognitive signs of stress to help you recognize when you need to take action to reduce or manage your stress in different ways. These signs of stress could include excessive nervousness, feeling overwhelmed, being easily distracted, or having difficulty making everyday decisions.
Recognizing and effectively managing stress is crucial for individuals with MS. Stress reduction techniques, such as mindfulness, relaxation exercises, and support from healthcare professionals or support groups, can help individuals better cope with both the emotional and physical aspects of MS. By addressing stress, individuals with MS can potentially improve their overall quality of life and well-being while also positively impacting the course of their disease.
Looking at Stress from Another Perspective
Stressful situations and events are a fact of life. While we may not be able to change stressful situations and many facets of stress are out of our control, you can take steps to manage how stressors impact you. Managing different types of stress involves employing a range of strategies tailored to the specific stressor and its duration.
Interestingly, new research on stress mindsets from Stanford University published in 2023 indicates that embracing the concept of stress can improve our quality of life. The research showed that “viewing stress as a helpful part of life, rather than harmful, is associated with better health, emotional well-being, and productivity – even during periods of high stress.”
The significance of one’s perspective on stress lies in its influence on how individuals respond to stressors. When stress is perceived as harmful, it often leads to less constructive coping strategies, such as resorting to alcohol as a stress release, procrastinating to evade stress, or fixating on worst-case scenarios. A study has revealed that merely aiming to avoid stress can elevate the long-term risk of adverse outcomes like depression, divorce, and job loss, primarily due to the adoption of detrimental coping mechanisms. In contrast, embracing a more positive view of stress tends to foster coping approaches that promote personal growth, including confronting the stressor head-on, seeking support from others, or discovering meaning within the challenging experience.
Stanford psychologist and author of the book The Upside of Stress, Kelly McGonigal, explains that in her research about stress mindsets, the most helpful and protective beliefs about stress are: “1) to view your body’s stress response as helpful, not debilitating; 2) to view yourself as able to handle, and even learn and grow from, the stress in your life; and 3) to view stress as something everyone deals with, and not something that proves how uniquely screwed up you or your life is.”
This thought-provoking research shows us that changing our mindset on stress is likely to be foundationally important. But that mindset change is usually a longer-term endeavor, and taking small, practical steps to employ stress management strategies in our daily lives is critically important. We explore some of these important strategies in more depth in “Practical Strategies for Managing the Many Types of Stress.”