Chronic stress

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For other kinds of stress see stress.

Chronic stress is the response to emotional pressure suffered for a prolonged period over which an individual perceives he or she has no control. It involves an endocrine system response in which occurs a release of corticosteroids. While the immediate effects of stress hormones are beneficial in a particular situation, long-term exposure to stress creates a high level of these hormones that remains constant. This may lead to high blood pressure (and subsequently heart disease), damage to muscle tissue, inhibition of growth, suppression of the immune system,[1] and damage to mental health.


Animals exposed to distressing events over which they have no control respond by releasing corticosteroids.[2][3] The sympathetic branch of the nervous system is activated, also releasing epinephrine and norepinephrine.[1] These, if prolonged, lead to structural changes in the brain. Changes happen to neurons and their synapses in the hippocampus[4] and medial prefrontal cortex.[5] These produce impairments in working memory[6] and spatial memory,[6] as well as increased aggression.[7]

Linked to impairment of the medial prefrontal cortex are deficits in the part of the striatum with which it is linked.[8] This can bias decision-making strategies, as affected individuals shift from flexible behavior to one dominated by habit.[8] Changes also occur to dopaminergic activity in the prefrontal cortex.[6]

Stress has a role in humans as a method of reacting to difficult and possibly dangerous situations. The "fight or flight" response when one perceives a threat helps the body exert energy to fight or run away to live another day. This response is noticeable when the adrenal glands release epinephrine, causing the blood vessels to constrict and heart rate to increase. In addition, cortisol is another hormone that is released under stress and its purpose is to raise the glucose level in the blood. Glucose is the main energy source for human cells and its increase during time of stress is for the purpose of having energy readily available for over active cells.[9]

The release of these hormones is evolved to be temporary. If someone is under stress for long periods of time they may have adverse health effects later on, such as hypertension and increased risk of cardiovascular disease.[10]

Chronic stress is also known to be associated with an accelerated loss of telomeres.[11]

Different factors may prolong this "fight or flight" reaction in the body. Chronic stress can be rooted in prolonged psychological stressors. For example, some studies have looked at the health effects of social discrimination in African Americans. This demographic has markedly higher hypertension levels that are attributed to higher levels of perceived social discrimination. This phenomenon has been coined John Henryism by sociologist James Sherman.[12]


Different types of stressors, the timing (duration) of the stressors, and personal characteristics all influence the response of the hypothalamic-pituitary adrenal axis, which is implicated in many theories which related chronic stress with health morbidities.[13] Symptoms of chronic stress can vary from anxiety, depression,[14] social isolation, headache, abdominal pain or lack of sleep to back pain and difficulty concentrating. Other symptoms include hypertension,[15] hemorrhoids,[15] varicose veins,[15] panic attacks or a panic disorder[14] and cardiovascular diseases.[14]


There are a variety of methods to control chronic stress, including exercise, healthy diet, stress management, relaxation techniques, adequate rest, relaxing hobbies, psychotherapy, or medication.

See also


  1. 1.0 1.1 Carlson, Neil (2013). Physiology of Behavior. Pearson. pp. 602–606. ISBN 9780205239399.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  2. Sapolsky RM. (1998). Why Zebras Don't Get Ulcers: An Updated Guide To Stress, Stress Related Diseases, and Coping. 2nd Rev Ed, W. H. Freeman ISBN 978-0-7167-3210-5
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  6. 6.0 6.1 6.2 Mizoguchi K, Yuzurihara M, Ishige A, Sasaki H, Chui DH, Tabira T (2000). "Chronic stress induces impairment of spatial working memory because of prefrontal dopaminergic dysfunction". J Neurosci. 20 (4): 1568–74. PMID 10662846.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  7. Mineur YS, Prasol DJ, Belzung C, Crusio WE (September 2003). "Agonistic behavior and unpredictable chronic mild stress in mice" (PDF). Behavior Genetics. 33 (5): 513–519. doi:10.1023/A:1025770616068. PMID 14574128. Retrieved 2009-08-16.CS1 maint: multiple names: authors list (link)<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  8. 8.0 8.1 Dias-Ferreira E, Sousa JC, Melo I, Morgado P, Mesquita AR, Cerqueira JJ, Costa RM, Sousa N (2009). "Chronic Stress Causes Frontostriatal Reorganization and Affects Decision-Making". Science. 325 (5940): 621–625. doi:10.1126/science.1171203. PMID 19644122.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  9. Tsigos C.; Chrousos G.P. (2002). "Hypothalamic-pituitary-adrenal axis, neuroendocrine factors, and stress". Journal of Psychosomatic Research. 53 (4): 865–871. doi:10.1016/s0022-3999(02)00429-4.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  10. Blascovich J.; Spencer S. J.; Quinn D. M.; Steele C. M. (2001). "African Americans and high blood pressure: The role of stereotype threat". Psychological Science. 12 (3): 225–229. doi:10.1111/1467-9280.00340. PMID 11437305.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  11. Notterman DA, Mitchell C (2015). "Epigenetics and Understanding the Impact of Social Determinants of Health". Pediatric Clinics of North America (Review). 62 (5): 1227–40. doi:10.1016/j.pcl.2015.05.012. PMID 26318949.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  12. James S. A.; Hartnett S. A.; Kalsbeek W. D (1983). "John Henryism and blood pressure differences among black men". Journal of Behavioral Medicine. 6 (3): 259–278. doi:10.1007/bf01315113.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  13. Miller, Gregory E.; Chen, Edith; Zhou, Eric S. (January 2007). "If it goes up, must it come down? Chronic stress and the hypothalamic-pituitary-adrenocortical axis in humans". Psychological Bulletin. 133 (1): 25–45. doi:10.1037/0033-2909.133.1.25. PMID 17201569.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  14. 14.0 14.1 14.2 Cohen S, Janicki-Deverts D, Miller GE (2007). "Psychological stress and disease". JAMA. 298 (14): 1685–1687. doi:10.1001/jama.298.14.1685. PMID 17925521.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles> "Stress Contributes To Range Of Chronic Diseases, Review Shows" (Oct. 10, 2007) [1]
  15. 15.0 15.1 15.2 Metcalfe C, Davey Smith G, et al. (March 2003). "Self-reported stress and subsequent hospital admissions as a result of hypertension, varicose veins and haemorrhoids". Journal of Public Health Medicine. 25 (1): 62–68. doi:10.1093/pubmed/fdg013. PMID 12669921.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>