50 shades of stress
It’s not just symptoms like balding and constipation that one seldom associates with stress, a range of disorders have been found to be linked to mental and emotional upheaval
Imagine visiting a doctor for palpitations and hair loss only to realise it has less to do with your physical health and more with your mental state! That was the case with Hyderabad- based doctor Sapna Vadera, who’d noticed she was experiencing hair fall and acne issues, something she’d never had in the past. She recalls having even some palpitation episodes. Blood checks and routine diagnostic tests turned up nothing.
“Everything seemed normal. Then I went to a dermatologist for the hair fall and acne, and she asked me a couple of questions,” narrates Sapna. “That was when I recollected that the hair fall had started when my final exams were approaching and it was that stress which triggered it.” Sapna’s is not an isolated case. Today, more and more medical experts around the world concur that an increasing number of physical ailments are linked to stress, including constipation, vomiting, hair fall, acne, headache, pre- exam jim- jams and even premature ejaculation.
EARLY GREY AND DEADLY IMPACTS
A new study published in the scientific journal Nature has linked stress to greying. The most telling example would be Barack Obama at the beginning of his term in 2009, with a head full of black hair, which slowly turned grey towards the end of his first term. It surely grew many shades greyer towards the end of his second term.
Sport stars also have shown the stress they take on. Team India captain Virat Kohli’s greying beard had become a talking point across the virtual space. Many claimed it to be the stamp of his captaincy, never mind that the man is only close to 32 years!
The aforementioned study found that stress activates nerves part of the fight- orflight response, which, in turn, causes permanent damage to pigment- regenerating stem cells in hair follicles.
Over the years, stress has also been linked to many ailments including depression, heart disease, obesity, digestive problems, auto- immune diseases and early death. Most often, however, when one develops physical symptoms, one goes through a string of tests and suffering for many years before even wondering if the symptoms could be linked to one’s mental health and stress.
Dr Prakriti Poddar, a mental health expert and managing trustee of Poddar Foundation, recalls a patient who suffered aches for many years before she went into therapy. “Doctors informed her that she has nerve damage, and she went through physiotherapy for a long time. When she came to me, we did neuro feedback and counselling. I remember she told me, ‘ It’s like magic. I can’t feel any pain anymore.’ We also realised she got no attention at home, so the pain manifested as a call for attention,” explains Dr Prakriti.
Another example the doctor cites is of a woman who was advised knee surgery. “However, after therapy and counselling, her symptoms improved and she could walk,” says Dr Prakriti, adding that there are many such cases, where physical complaints have been resolved or improved with improvement in one’s mental condition.
As per Dr Prakriti, all noncommunicable diseases are stress- related. Psychosomatic disorders are ailments caused by or worsened by mental factors. Worse, an increasing number of medical professionals believe most lifestyle ailments are psychosomatic in nature.
STRESSED OUT AND STUCK IN ACHES AND PAINS
Stress can trigger the fightorflight response in your body, which is the body’s selfdefence mechanism against physical threat. Dr Vasant R, consultant psychiatrist, Fortis Malar Hospital, even asserts that any form of mental disturbance can present itself in chronic physical symptoms. According to him, stress causes the body to get stuck in the flight- or- fight response, resulting in many health problems. “Stress has a threshold. When that breaches, it manifests in physical symptoms,” he adds.
Akanksha Pandey, a clinical psychologist at Fortis hospital, Bangalore, also points out that chronic stress can knock off one’s immunity. “Patients often get frequent colds, fever, upset stomach, loss of weight or excessive weight gain and many other problems.”
Stress often causes aches and pains, especially manifesting in the form of headaches. A 2000- study published in The Journal of Headache and Pain showed that stress could trigger chronic headaches. Of the 267 patients studied, 45% showed that a stressful event preceded the chronic headaches. Another study focused on stress and headache frequency in a sample of 5,159 participants found an association between stress intensity and headache frequency.
Dr Vasant strongly believes that in the case of aches and pains when all tests show normal results, it’s important to take the patient’s history. “Understand the stressors in his/ her life. There could’ve been a major life event that could’ve been the trigger,” explains the doctor, adding that this is especially so in tensiontype headaches and vague body pain.
In such cases, the doctor advises it as important to treat the mental problem as it is to treat the physical problem. Social and environmental factors can contribute to stress, as do social and financial pressures, he adds.
THAT GUT FEELING
Sadly, stress can even affect the digestive system, causing gastrointestinal symptoms such as constipation and vomiting. A study published in The Journal of Tropical Pediatrics found that the relationship between constipation and stressful life events in 2,699 Sri Lankan children between the ages of 10 and 16 years was higher in those exposed to stressful events ( separation from best friend, failing in exams, severe illness of a family member, a parent’s job loss, frequent punishments and living in separatist war- affected area).
Clinical psychologist Akanksha Pandey recalls a patient who had constant vomiting. “She was to appear for her 12th class exams and was under immense stress of expectations. For many days, she was constantly vomiting, had stopped eating and was losing weight. All her medical tests showed ‘ Normal’. After a few sessions of therapy, she started opening up to what was bothering her. We did a psychological evaluation, counselled her, spoke to her family and asked them to be more supportive. After a month, the vomiting, which we call psychogenic vomiting, stopped.” ( Psychogenic refers to a psychological origin rather than a physical one.)
So, the next time you feel constipated or have pains and aches you aren’t used to, apart from trying remedies for your body try to understand what’s bothering you, too.
Stress can trigger the fight- or- flight response in your body, which is the body’s self- defense mechanism against physical threat. Any form of mental disturbance can present in physical symptoms as well. Stress has a threshold. When that breaches, it manifests in physical symptoms
— Dr Vasant R, consultant psychiatrist