By: Expert No. 323128, M.D.

Despite the wealth of research and clinical information available these days about various health conditions, it still amazes me how often people speak about stress as the basis for many illnesses. That perception forms an accepted premise often utilized in advertising schemes for various vitamins, supplements, and other promoted cures for stress.

Stress is often perceived as an evil force in the universe and sometimes due to the action of others. It commonly gets mentioned in wrongful termination lawsuits among other actions. People perceive that some or all of their medical conditions were either directly caused or aggravated by the stressful experiences that they endured.

Indeed, there is a well understood physiology when it comes to stress. Our bodies release various chemicals and hormones to alert ourselves of impending dangers. Fight or flight behavior is often ascribed to the effects of those hormones, among which include adrenaline, cortisone, and serotonin. The ancestral origins of these likely evolved due to survival needs of humans.

It is normal and healthy to have periodic fluctuations in the release of these hormones. There is the stress of getting up everyday that explains morning surges. Similarly, these same hormones prepare us for the trials and tribulations we experience on a daily basis at work and in our relationships.

The acute effects of stress and the related hormones typically register as physical symptoms. We may notice muscle tension, headaches, chest pain, palpitations, shortness of breath, abdominal cramps, or diarrhea. If stress persists and recurs, it may interfere with the quality and quantity of our sleep and lead to fatigue and muscle soreness. It may affect our appetite and lead to under eating or sometimes binge, overeating. And certainly, there is erectile dysfunction.

Chronic stress is not good for us. Tiredness promotes bad choices with diet and exercise. It may lead to overindulgence with alcohol or even misadventures with addicting drugs. Recent evidence has even associated premature memory loss to damaging effects from stress hormones on the brain.

Yet, stress does not cause the conditions of hypertension, diabetes, reflux esophagitis, or sleep apnea, to name a few. These medical conditions have their own physiology, and evolve completely independent of stress. Apparently, it is easy to confuse the fact that when we become aggravated or stressed, our blood pressures, sugars, and stomach acid levels may temporarily rise. Yet, smoking a cigarette, having a full bladder, or experiencing pain, can also transiently elevate blood pressure. It is not the acute spike that defines those conditions, but rather the chronic patterns that make it a meaningful illness.

Hypertension, or high blood pressure, is a reflection of elevated blood vessel tone. It is common, affecting one of three people in the United States, and, for the most part, it is silent, without symptoms. There is a genetic basis that predisposes individuals to hypertension. Diabetes, particularly the adult form of it, reflects a relative resistance to insulin, due to cellular effects of obesity. Eventually, the pancreas can not make enough insulin to drive glucose or sugar into cells and levels rise. Reflux esophagitis is not the result of too much acid, but rather from acid leaving the protective environment of the stomach and getting into the vulnerable esophagus above. And sleep apnea results from the subtle crowding of the oral airway from obesity that obstructs and actually ceases breathing in the middle of the night on a repetitive basis.

Therefore, in contrast to stress, it is obesity that most often causes or aggravates those conditions. Two of every three people in this country is considered obese when using BMI scores or basal metabolic indexes; a function of one’s height and weight. And the numbers are rising. Remaining diligent to diet, exercise, and sleep habits would be the correct path, as opposed to inappropriate concern about stress.

Finally, it should be noted that much of stress is attitudinal. After golfer Rory Mcllroy’s infamous Masters tournament collapse, he noted, ‘If that’s the worst thing that happens to me in my life, I must have had a pretty good life’.

Expert is board certified in internal medicine and primary care health care. He has practiced medicine for over 25 years and is also an Associated Clinical P rofessor of Medicine at major University. His expertise includes initial diagnostic, therapeutic, and medical management decisions to primary care physicians that often include conditions involving surgical, neurosurgical, vascular surgery, and various medical specialties including cardiology, GI, pulmonary, infectious diseases, endocrinology, and cancer medicine.

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