Bringing It All Together

Throughout this semester we learned a plethora of valuable information regarding stress and health. This class is extremely important, especially to me, because I want to specialize in research that focuses on traumatic stress in particular. In order to become a leading researcher in my field, I knew I would need to understand the basics of our stress response and how this stress response can potentially affect our health in detrimental ways, caused by even the small stressors we face every day.  For this post, I wanted to bring together and refer back to three posts I previously wrote. I feel these posts and the topics discussed in each, were important for me to write about and understand because of the research I am currently conducting and hope to conduct in the future. The three key topics that I want to really highlight in this post are Immunity, Stress, and Disease, Traumatic Stress, and Stress Management – The Bad. Throughout this post, I will be referring to the posts I wrote for each topic and how they come together to make a cohesive story. Links to each post will be provided.

To begin, when first learning of how stress can negatively affect our bodies, we are introduced to how our bodies respond to stress and what exactly happens in the body that could lead to the development of a disease brought on by stress. One of the big take-home messages from this discussion, in particular, was chronic stress can have a detrimental effect on how our immune system functions. This is caused by the decrease in the formation of lymphocytes, which we learned are white blood cells (cells that attack infectious agents) while also inhibiting new antibodies to form, inhibiting the killing of infectious disease agents. Additionally, glucocorticoids have the ability to both shrink thymic tissue and kill lymphocytes themselves. When facing a stressor for a long chronic duration, something we will discuss next, we drive our immune system down to working as much as 40% below our baseline (Sapolsky, 2004). This happens when our immune system mistakes our good healthy cells for bad foreign cells, thus we develop an autoimmune disease. This not only has a detrimental effect during the time of the stressor occurs but can have carry-over effects. You can read my blog post on this subject here: https://sites.tufts.edu/chinoj01/2017/09/29/immunity-stress-and-disease/

Such carry-over effects of experiencing sustained chronic stress can result in the development of psychopathology such as posttraumatic stress disorder (PTSD) which is a debilitating disorder that can be developed after experiencing a traumatic event. Such events could include natural disasters, combat, and assault to name a few examples. We learned from our discussion that week that individuals who develop PTSD are more prone to developing other disorders or diseases than individuals without the disorder. For example, we learned that veterans with the disorder developed heart disease, hypertension, and obesity, more so than individuals without the disorder. This could be caused by the unhealthy eating habits or decrease in exercise (Kibler et al. 2008; Cohen et al. 2009b) we see in this population. This makes sense given the information we gained from our previous discussion on immunity and stress. Additionally, individuals with PTSD will be less likely to exercise because they fear they will extend their hyperarousal symptoms, making it difficult to lose weight. These factors are important given the implications they cause. In order to prevent individuals with PTSD to gain weight or fear working out, more work will have to be done to design workout routines for these men and women that provide the most comfort. You can read my blog post on this subject here: https://sites.tufts.edu/chinoj01/2017/10/07/traumatic-stress/

Lastly, one of the most important topics that was discussed this semester was how some individuals may turn to unhealthy coping mechanisms to deal with stress. For example, about half of the individuals diagnosed with PTSD will also have a comorbid diagnosis of a substance abuse disorder, eating disorder, or depression. Instead of trying to schedule a time to meet with a therapist, many individuals feel that alcohol or other substances are a much faster way of taking care of the PTSD symptoms they suffer from, even if it is short-lived.  Unfortunately, taking drugs to cope with stress causes tolerance to that substance. Our brain will now need more of the substance to deliver the same euphoric effect we received the first time taking the drug. Thus, the unhealthy cycle of drug abuse becomes activated and instead of needing the drug to inhibit the feeling of stress, individuals will now need to take the drug to wake up in the mornings and inhibit the horrible feelings of withdrawal. Additionally, food can become a coping mechanism as well. As discussed above individuals with PTSD are more prone to eating fatty foods instead of a well-balanced meal, making them more prone to becoming obese. More work and research will need to be done in order to prevent this vulnerable population to turn to such unhealthy coping mechanisms. You can read my blog post on this subject here: https://sites.tufts.edu/chinoj01/2017/11/10/stress-management-i-the-bad/

Thus, we can see that stress, both chronic and small everyday stressor can grow to become detrimental to our health. It is extremely disheartening to know that the men and women who suffered through horrible stressful events are still suffering, not only by having PTSD but by also developing eating and/or substance abuse disorder. The readings and discussions in class have really opened my eyes allowing me to understand that the population I’m studying have more problems to deal with than PTSD, but also other detrimental effects of stress. This new knowledge has allowed me to expand the possibilities my research could go. I have learned that I not only could expand my research to help those with these comorbid conditions but in fact should. I can not only study how PTSD affects brain and behavior but how adding drugs to the mix could potentiate symptoms. Furthermore, I also look forward to developing ways I can prevent such psychopathology from developing after experiencing stressful events.

References

Cohen, B.E., Marmar, C., Ren, L., Bertenthal, D., and Seal, K.H. (2009b). Association of cardiovascular risk factors with mental health diagnoses in Iraq and Afghanistan war veterans using VA health care. JAMA, 302, 489-491.

Kibler, J.L., Joshi, K., and Ma, M. (2008). Hypertension in relation to posttraumatic stress disorder and depression in the US National Comorbidity SurBehavioralioral Medicine, 34, 125-131.

Sapolsky, R.M. (2004) Why zebras don’t get ulcers: A guide to stress, stress related diseases, and coping. New York: W.H. Freeman.

2 Comments

  1. Hi Ceci! This is a good review of some of the previous topics that we covered. From the perspective of someone who does PTSD research, do you think that there is the potential for an effective treatment strategy, and if so, do you think this would be a universal treatment or one that we should tailor to each individual and, perhaps, to the circumstance that triggered an individual’s PTSD symptoms? In other words, do you think individual differences in PTSD etiology should be considered when treating individual cases of PTSD? Anyway, it was a great semester, and thank you for being a co-discussion leader with me!

    • Hello Emily! Thank you for a great discussion! While I have not formally worked with a clinical psychologist specializing in treating PTSD, I think what usually happens is just that (in most cases). The gold standard treatment that is currently offered is called Cognitive Behavioral Therapy (CBT). There are different types of CBT, the leading being Prolonged Exposure (PE) therapy, where the clinician and the patient discuss the patient’s specific trauma until they no longer find the memory or anything associated with the trauma to be threatening or evoke emotion. While this works for some people, it definitely does not work for others. It is the clinician’s job to let the patient know their options regarding treatment before starting any treatment and tailor each treatment session to the individual patient. My research is currently using neuroimaging to predict how well patients will respond to PE. Hopefully, clinicians will be able to use neuroimaging in the future to save patient’s time and money!

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