Anne Gallo, M.S., Sarah Miller, R.N., Diana Zuckerman, Ph.D.
Updated October 2010
Can stress make you sick? The answer is a resounding yes. If you want to know how to avoid that, it helps to know what stress is and exactly how it affects your body.
Anything that an individual perceives as a problem can cause stress. When we perceive a problem and don’t have the resources (or believe we don’t) to cope with it, we will experience stress. Stressors can be physical, such as an illness or injury, or emotional, such as family, job, or financial problems. According to Dr. Esther Sternberg, director of the Integrative Neural Immune Program at the National Institute of Mental Health, our body’s response to stress is natural and adaptive. However, chronic stress may be harmful to our health, resulting in both psychological and biological changes that increase our chances of becoming ill. When under stress for a long time, the body produces too much of two hormones: cortisol and adrenaline.
When faced with stress (for example a physical threat), your body reacts with a “fight or flight reaction” to enable you to fight back or run away from danger. The adrenal glands release the hormone epinephrine (adrenaline) and the neurotransmitter norepinephrine into the blood stream. The adrenal glands also release corticosteroid hormones that release fatty acids for energy, causing digestion to stop, blood sugar levels in rise, and the heart to pump more blood to the muscles. At the same time, the pituitary gland releases a hormone that stimulates the release of cortisol. In the short term, cortisol helps the body maintain the exertion needed to avoid danger.
However, the same hormones that help defend the body in the short-term can help cause illness when stimulated for long periods. The stress response is effective for handling an immediate problem or situation but becomes physically dangerous when it lasts for a long time. Because one action of cortisol is to suppress the immune system, chronic stress contributes to a compromised immune system that can’t respond effectively to viruses and bacteria. Cortisol suppresses the body’s natural inflammatory processes, and the high levels caused by chronic stress will cause wounds to heal more slowly. Chronic stress is also associated with gastrointestinal conditions such as ulcers and irritable bowel syndrome, as well as diseases of the cardiovascular system, including hypertension, stroke and heart disease.
Telomeres are caps that we all have on the end of our DNA. As we age, we slowly lose small bits of our telomeres and they become shorter. Therefore, measuring the length of a telomere can tell us the “real age” of a person’s cells. Several studies have found that people who are under chronic stress tend to lose length on their telomeres more rapidly. For example, one study found that caregivers of people with Alzheimer’s disease not only had poorer immune function, but that their telomeres were shortening more rapidly. In other words, the stress of caring for an Alzheimer’s patient was permanently aging their cells.
Another study found that otherwise mentally and physically healthy adults who had a history of being mistreated as children had shorter telomeres. This suggests that it’s not always possible to “reverse” the damage stress causes to our cells and that stress at a young age may have life-long effects.
Women and Stress
Studies show that women and men cope with stress differently. The friendships and other social support systems that are more common in women than men may help them cope more effectively with stress, enhancing the immune response and resistance to diseases. Studies have shown that women with breast cancer who have strong social supports have significantly longer life spans than women who do not. Interestingly, researchers found that social support provided by women is more effective at lowering blood pressure responses to stress in both males and females than support from men.
On the negative side, scientists find that women are three times more likely to develop depression in reaction to the stress in their lives. Working women are often under considerable stress as they try to balance work, marriage and children. Some experts have found that this can cause the chemical imbalance that can lead to depression. In addition, those who care for sick and elderly family members are usually women. Studies indicate that these caregivers have high cortisol levels, and therefore weakened immune systems.
What To Do
It is unclear how much of the stress response is determined genetically and how much can be controlled by the individual. Genetics play a part in determining someone’s stress response, as does individuals’ experience with stress, and their learned perceptions of specific events or situations as stressful. So, the way we see ourselves as well as others, our method of handling stress, and our genetic makeup all affect the immune system and therefore our health.
Experts indicate that there are many different ways to affect our levels of stress. Different strategies work for different people. You can manage stress levels by meditation, exercise, and doing things that relax you. The most effective stress-reduction measure for many people, however, is exercise. Physical exertion causes physical changes (endorphins), which can make you feel better, as well as boost the immune system. Slow breathing has also been shown to have a calming effect that lowers blood pressure, reduces muscle tension and decreases the heart rate.
Our eating habits can affect our immune systems’ response to stress. A balanced diet emphasizing fresh fruits, vegetables, legumes, raw nuts and seeds and whole grains can help the body respond to stress. Reducing caffeine can also help. People who have a high intake of caffeine experience more stress and produce more stress hormones.
Getting enough sleep is also important. Many Americans get only 7 hours of sleep a night, but research indicates that most adults and children do better with 8-9 hours; in fact, most teens in a sleep lab sleep more than 9 hours each night if given the opportunity. It can be a vicious cycle: lack of sleep can make an individual more susceptible to stress, and stress often interferes with the ability to sleep.
Researchers have also linked the inability to identify and express emotions to a number of health conditions. Expressing emotions to members of a support system, friends and family, or even writing down feelings can help reduce stress.
Not everyone is the best judge of what reduces his or her own level of stress. For example, smokers depend on cigarettes to relax, but the nicotine in cigarettes does exactly the opposite. Watching TV may feel relaxing, but depending on the program and on how TV interferes with sleeping or other responsibilities, it may sometimes increase stress and decrease the ability to cope with stress.
It’s worth making the effort to think through how stress affects your life. If you’re aware of how physical and emotional stress affects your body, it can help you cope with stressful situations, modify the way you react to them, and may make you feel better and live longer. But it is important to remember that often we can’t do it all on our own – in that case, seek help from a professional.
For more information, we recommend Dr. Esther Sternberg’s book, The Balance Within: The Science Connecting Health and Emotions (Holt, Times Imprint).
Also, check out our Survival Guides for Working Moms for more tips and research based information about coping with stress.
 Damjanovic AK, Yang Y, Glaser R, Kiecolt-Glaser JK, Nguyen H, Laskowski B, Zou Y, Beversdorf DQ, Weng NP; Accelerated telomere erosion is associated with a declining immune function of caregivers of Alzheimer’s disease patients; Journal of Immunology, 2007, 179(6), pp. 4249-54.
 Tyrka AR, Price LH, Kao HT, Porton B, Marsella SA, Carpenter LL; Childhood maltreatment and telomere shortening: Preliminary support for an effect of early stress on cellular aging; Biological Psychiatry, 2010, 68(6) pp. 531-4.