How to Handle a Stress-Related Psychosomatic Illness

In Greek, psyche refers to the mind or soul, and somatic refers to the body. In essence, the term psychosomatic captures the mind-body connection. The World Health Organization defines psychosomatic medicine as “the study of biological, psychological, and social variables in health and disease.”

Psychosomatic illness involves experiencing physical symptoms that are the body's response to stress. In contrast, somatopsychic illness would be the psychological symptoms caused by disease, injury, or infection.

Stress-related illness is very common, but people often mistakenly think that the physical symptoms caused by stress are not serious. In fact, chronic stress can cause physical symptoms that have a grave impact on your health, and without intervention, can lead to diseases such as heart disease, diabetes, and digestive issues that can shorten one's lifespan.

In this article, we will explore the biological mechanisms that link the mind and the body in the disease process and dispel the myth that these illnesses are "all in your mind." You will learn more about current views of psychosomatic illness, common stress-related health symptoms, and the appropriate treatment.

Stress

No one is immune from experiencing stress in life. There are daily hassles, like dealing with traffic, working with a demanding boss, and managing a busy schedule. There are also major stressors such as poverty, maltreatment, relationship problems, job loss, caregiving, and traumatic events.

The burden of chronic stress can take its toll on the human body through the "biological embedding" of a maladaptive stress response, especially in childhood if the brain is developing through a variety of adverse experiences. Without intervention, this maladaptive stress response can carry on through adulthood. Neuroplasticity of the brain, or the ability for neurons to adapt and re-wire, gives hope for recovery from the damaging effects of stress.

The way we perceive and cope with stress will also be a determining factor in the development of psychosomatic issues. There can be an additional layer of damage added to our health caused by negative coping behaviors related to diet, exercise, smoking, alcohol use, drugs, etc. On the other hand, social support, positive coping strategies, and a healthy lifestyle are mediators in the pathway between the mind and the body that can minimize the impact of stress on your health.

Types of Stress-Related Symptoms

When you are under stress that exceeds your ability to cope, you are likely to experience physical symptoms. These can include aches, pains, muscle spasms, and headaches, possibly from unconsciously tensing your muscles for extended periods. Your stomach may be upset from the impact of stress hormones. And you may not be sleeping well, leaving you feeling fatigued and burnt out.

Some common examples of symptoms that a person might experience as a result of stress include:

• Body aches
• Cognitive problems (foggy brain, forgetful)
• Decreased sex drive/erectile dysfunction
• Digestive issues (diarrhea, constipation)
  
• Fatigue
• Grinding teeth
• Hair loss
• Headaches and migraines
• High blood pressure
• Insomnia or hypersomnia
• Muscle tension
• Pain (back pain, stomach pain, etc.)
• Skin rashes
• Weight changes

It is important to note that this does not mean that these symptoms are always caused by stress, and there may be medical causes that need to be identified.

Psychosomatic Illness

Stress can cause a variety of symptoms, as seen above. These symptoms are mediated through the immune system, the nervous system, and the endocrine system. Over time, if left unchecked, this can lead to disruption in the delicate balance of hormones, neurotransmitters, metabolic processes, and the immune response that is required to maintain health. These systemic changes contribute, at least in part, to the development of illness and disease, that oftentimes could be prevented.

Examples of illness and disease influenced by stress:

• Arthritis
• Dementia
• Diabetes
• Gum disease
• Heart disease
• High blood pressure
• Hyperthyroid
• Irritable bowel syndrome
• Metabolic syndrome
• Obesity
• Osteoporosis
• Stomach ulcer
• Stroke
  

The Biological Mechanisms Linking Mind and Body

One of the main culprits in this disease process is the stress hormone known as cortisol. When someone perceives a threat in their environment, the emotional processing center in the brain, the amygdala, sends out an alarm signal. Through neuroendocrine hormones, the signal is picked up by the hypothalamus, which triggers the pituitary gland, and then the adrenal glands where stress hormones like adrenaline and cortisol are produced. This is known as the hypothalamus-pituitary-adrenal (HPA) axis, and is responsible for the "fight or flight" response.

Sympathetic Nervous System: During the fight or flight response, cortisol affects a wide range of body functions through the sympathetic nervous system. Heart rate increases, blood pressure rises, breathing becomes more shallow and rapid, pupils dilate, blood sugar is released into the blood, and blood flow rushes to the large muscle groups and the brain. There is also an immune response in preparation to heal damaged tissue, and digestion is put on hold. Your body systems are being appropriately mobilized to manage the threat.

Metabolism: Cortisol directs the metabolism of sugar and fats and is a helpful anti-inflammatory under normal circumstances. However, excess cortisol can lead to metabolic problems like high cholesterol, increased appetite, weight gain, decreased insulin sensitivity, high blood sugar, adrenal insufficiency, fatigue, sleep issues, and so on. In addition, the gut microbiome is altered as a response to stress, resulting in a release of toxins, metabolites, and neurohormones that in turn affect eating behavior, mood, energy, and immune functioning.

Immune System: A review of the research published in 2015, shows that people who experience chronic stress have signs of a dysregulated immune system with higher levels of pro-inflammatory cytokines in their bloodstream, lower antibody response to viruses, more frequent illness, and even re-activation of latent viruses like Epstein-Barr. People with ongoing stress also experience more auto-immune flare-ups and slower wound healing. All of these immune system responses place an extra burden on the immune system.

Biological Aging: It is worth mentioning, that there are signs of advanced biological aging at the cellular level indicated by shorter telomeres (the protective end cap of the chromosome).

Treatment for Psychosomatic Symptoms

Fortunately, the symptoms that manifest can lead you to see a doctor, who then may rule in or rule out any disease process that might be causing them. Without a diagnosis, you may only get treatment aimed at relieving the symptoms, rather than getting at the root cause.

Psychological treatments and stress management are important, but this does not mean that psychosomatic illnesses do not require medical treatment. Medications may be prescribed to help treat the medical symptoms that you are experiencing.

Psychotherapy

Research suggests that cognitive behavioral therapy (CBT) can be effective in treating stress-related disorders. CBT can minimize stress by correcting faulty thinking habits and negative core beliefs, reducing avoidance behaviors, and building positive coping skills. You can also learn relaxation techniques that activate the parasympathetic nervous system to counteract some of the effects of cortisol.

Medications

Your healthcare provider or therapist may also prescribe medications such as antidepressants or anti-anxiety medications. Mental health conditions such as depression and anxiety can contribute to physical symptoms, so medications such as selective serotonin reuptake inhibitors (SSRIs) and benzodiazepines may be helpful for improving well-being.

Self-Help

Self-help may also be an effective tool for reducing medically unexplained symptoms and improving quality of life. Research suggests that self-guided stress management (such as journaling and meditation techniques) can help manage symptoms of stress. However, this approach may be best utilized as a first step or as part of a more comprehensive treatment program.

Relieving Stress for Health

If you are experiencing health concerns that might be related to stress, your first step should be to talk to your healthcare provider. However, there are also steps you can take to relieve stress and improve your overall health. To stay healthy, learn positive ways to deal with stress and eliminate excessive stress from your life whenever possible.

It may seem overwhelming to even think about, but slow and steady, figure out what works for you and what doesn't, and build a new lifestyle that supports your mental and physical health. Strategies that may be helpful for reducing stress levels include:

• Avoiding smoking and alcohol
• Deep breathing
• Focusing on the things you can control
• Getting regular exercise
• Getting enough sleep each night
• Gratitude journaling
• Meditation
• Mindfulness
• Progressive muscle relaxation
• Social support

There are dozens of stress-relieving tactics available, so it is important to learn what stress relievers work best for you. Create a stress management game plan to examine and change the stress in your life. By maintaining healthy habits, you can minimize the stress in your life and reduce the impact of stress-related psychosomatic illness on your health and well-being.