Stress, Pain and Immunity
The Stress-Pain Connection
The connection between stress and illness has been known for a long time.
When our minds perceive a threat, this activates certain brain regions, which cause the autonomic nervous system to trigger the fight or-flight response. As a result, the body increases muscle tension, heart rate, and blood pressure and restricts blood flow to the peripheral tissues while suppressing digestion, immunity, and healing. The purpose of these physiological changes is to direct the most energy possible toward saving the person’s life in the moment of danger. These physiological changes, if chronically triggered, can cause changes in nerve-firing patterns and brain-wiring patterns that cause chronic pain and many other disorders.
Another connection between emotional stress and pain is breath—when people are stressed, their breathing is shallower. This deprives the muscles of the oxygen they need for normal functioning and can create or exacerbate pain. Low-back pain, neck pain, jaw pain, and tension headaches can all occur as a result of muscle tension. Functional magnetic resonance imaging (fMRI) studies have shown that when pain patients have negative thoughts, areas of the brain associated with pain perception are activated and pain sensations intensify. Emotional responses increase the activity of a part of the brain called the anterior cingulate cortex (ACC). When the ACC is more active, pain increases. In addition, when the ACC is activated, the dorsolateral prefrontal cortex (DLPFC), which decreases pain signals, is turned off.
Many studies have shown the connection between emotions and physiological responses that cause pain. For example, anger can cause unconscious increases in tension in the back muscles of people in chronic pain. This muscle tension can create severe pain. Also, suppressing anger has been shown to increase pain perception and physiological reactivity. People who have experienced childhood trauma are much more likely to develop chronic pain as adults than those who have not experienced such trauma because their autonomic nervous systems are chronically more activated. Unresolved trauma from childhood—such as illness, hospitalizations, surgeries, birth trauma, attachment trauma, and physical and emotional neglect and abuse—can all get stirred up by a current event, including the onset of pain.
Stress and Suppressed Immunity
As noted above, part of the fight or flight response involves suppression of immune system response, as the mind/body perceives that as a longer-term threat than one posed by, say, a tiger chasing you. During acute stress, the body releases cortisol, which mobilizes glucose reserves for energy and to inhibit pain. Cortisol is anti-inflammatory. When stress is chronic, the body’s capacity to generate cortisol is exhausted, leading to an increase in inflammation and chronic inflammatory diseases such as arthritis, fibromyalgia, lupus and inflammatory bowel disease. In addition, chronic stress decreases the number of lymphocytes, the white blood cells that fight off infection. The less lymphocytes, the more at risk you are to viral and other infections.
What to do about stress
*Deep, slow breathing. When we’re stressed, breathing becomes rapid and shallow. One of the quickest ways to reduce stress and anxiety is to take deep, slow breaths, also known as diaphragmatic breathing. This tends to affect and calm the entire nervous system, not just breathing.
*Meditation, a process of training your mind to focus and redirect your thoughts as a way to reduce stress and heighten self-awareness. There are many types of meditation but they have many similarities, including a focus on something neutral or positive as a way of calming the mind and body.
*Energy Psychology is a set of very helpful techniques for quickly calming emotional disturbance, including from long ago trauma that is still causing distress. It can also be used to focus on and lower pain levels. The techniques involve focusing on a distressing situation while working with your own energy system, often through tapping.
*Cognitive Behavioral Therapy (CBT) is based on the idea that thoughts affect behavior and emotions and that changing maladaptive thoughts can improve mood and functioning. Many chronic pain patients fear the consequences of their pain and worry about their ability to cope with it. They may have unrealistic fears that their resumption of normal activities at home and at work will result in further injury. These thoughts and fears may prolong or prevent recovery. CBT includes replacing unhelpful beliefs with more positive ones. It also includes behavioral experiments, such as gradual exposure to feared situations and activities to reduce reactivity. These mental changes have been shown to be an effective way to achieve better emotional and physical well-being, including pain relief.
*Laughter is a great antidote to stress that relaxes the body, releases endorphins (the body’s natural opioids) and improves immunity.
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