Is stress making you sick?

Stress versus immunity

A case of corporate burnout – Emma’s story

Emma**, a 38-year-old successful business executive who frequently travelled for her work was continually getting sick. She’d barely recover from one head cold before getting hit with the next. Even when she didn’t have a cold she felt tired and fatigued – like she was dragging herself through mud. A sore throat and stuffy nose were regular companions. Her social life was non-existent. She spent the weekend recovering from her week. She couldn’t understand why this was happening as she had a healthy diet, didn’t drink much alcohol and exercised every day.

Recent blood tests showed Emma’s fasting blood glucose and cholesterol markers had been rising over the last four years and were at the high end of normal. Her white blood cell count was low.

 

What was going on?

It was pretty obvious her immune system wasn’t at the top of its game. Her blood test results supported this.

The stress from a busy working life is often the culprit. This “burn out” can emerge in your late 30s or early 40s when the bulletproof covering of your 20s wears thin. If you regularly work more than 50 hours per week you could be at risk.

Chronic low-grade stress reduces the effectiveness of the immune system to combat infections ¹.

 

How stress reduces immunity

Two components regulate the stress response.

1. Sympathetic Adrenal Medullary (SAM) response

The release of adrenaline and noradrenaline and primes the body to fight or get the hell out of there. This is a fast acting response – within seconds.

2. Hypothalamic Pituitary Axis (HPA) response 

The release of glucocorticoids such as cortisol to sustain the stress response. The HPA activates after about 15 minutes and helps to cope with on-going stressors.

 

Signs stress is affecting your immunity

If you’ve always got your SAM and HPA switched on this will decrease the ability of your immune system to do its job.

You may notice:

• Wounds are slow to heal
• You seem to be allergic to things you never were as a kid
• Increases risk of autoimmune conditions
• Your body increases the production of inflammatory molecules. Research shows this may increase susceptibility to depression, cardiovascular disease and diabetes. This may explain the rising cholesterol and blood sugar markers on Emma’s tests.
• You can’t make white blood cells as fast or as strong
• Reactivation of latent viruses such as herpes or Epstein Barr virus – ouch ²!

An evolutionary mismatch

Our stress response evolved as a short-term “fight or flight”. We either ran away from the predator/ threat or became the victor in the fight. Whatever strategy we chose, if successful, the problem resolved.  Fire put out!

Modern stressors tend to be non-life threatening but smoulder away in the background. The HPA stress response is always switched on to some degree. This means our immune system can be sub-optimal.

How you can fix it

The treatment plan for this kind of situation consists of two goals.

1. Reducing the stress load
2. Supporting the body to better cope with stress

In Emma’s case things that were adding to the stress load were:

• Long work hours in a high-pressure job
• Frequent plane travel and being away from home
• Intense exercise longer than 40 minutes in a session which raises cortisol. In a non-stressed person this would not be a problem but if cortisol is already high intense exercise may exacerbate the problem.
• Lack of time spent with her friends

Current habits which were supportive included:

• Healthy eating
• Minimal alcohol consumption
• Good sleep
• Regular exercise

A wonder pill to fix stress?

Sorry, no.

Although it would be nice, it’s unrealistic to wave a magic wand and make all stress disappear. Hello, working two hours per day from your hammock on a tropical island!

The right kind of stress in life is actually beneficial for you – it’s how we get things done. The trick is to be able to dial down the SAM and HPA when it’s not needed to allow our body to recover fully. This means making daily time for relaxation and rest. Do things which restore rather than deplete.

Offload to reduce stress

Ask for help? You’re not a superhero.

They say many hands make light work and sometimes we can get into a mindset where we think we need to do it all.

We don’t. In Emma’s case she was feeling overwhelmed from her work. With meeting overload and frequent travelling she never felt like she had time to work on projects or strategy. Could on-line meetings replace the need to travel as often? (We have the technology – let’s use it!) What things could her team support her with?

In the short term, this might create extra work training staff, and designing and implementing new systems. But, the long-term benefits will be worth it. Emma will get to do more of the project and strategic work she enjoys. Her team will enjoy the challenges of increased responsibility. Win/win.

Make time to relax and recover

Ancient Roman poet Ovid articulated what every successful farmer knows. “Take rest, a field that has rested gives a bountiful crop.”

If we planned and prioritised our rest and recovery half as much as we do our work we’d most likely be pretty chilled out beings. Setting firm boundaries is essential to prevent work seeping into your relaxation time.

Strategies to consider here:

• Create a clear break between your work and your non-work part of the day. This can be particularly useful if you work from home. A simple 10-15 minute walk can help you transition out of work time and into relaxation time. If you commute listen to/read something non-work related on the way home or get off the bus a stop earlier and walk.
• At the end of each working day allocate time to “clean up and close down your day”. I got this from Dan Charnos’s book: Work clean: the life-changing power of mise-en-place. Spend 10-15 minutes tidying up both physical and virtual workspace. This is not a time to answer emails, but you can file and put things away. Create a list of what you need to do tomorrow so you can “mentally not have to think about it when you leave work. I like to shut down my laptop as a strong signal the working day has ended.
• Set clear parameters around email checking. Let people know when they can expect an answer from you and stick to it. A simple message in your email footer will do this.
•  Avoid checking work emails when you’re not at work. Your focus needs to be on relaxation not work.
• The same goes with phone calls and texts. If you’re not on call, it can wait until tomorrow.
• Be mindful in your use of social media and how it makes you feel. Social media is part of our lives, but it is designed to keep you in its thrall. I find it can be a real time suck. All the information about other people’s lives can be overwhelming. Do I need to know the details of someone’s relationship dramas who I haven’t seen since high-school? Probably not.

Make time for real life catch ups.

There’s nothing like a face to face catch ups and some laughs with friends and family to get perspective on the important things.

Get the body moving

Relaxation and recovery doesn’t have to be about lounging around on the couch. If your day job involves sitting at a desk breaking a little bit of sweat could be what you need to help your body unwind.

Intense exercise will release the feel-good endorphins. On the other hand, a gentle walk in nature where you will get exposure to terpenes, a phytochemical released from trees, boosts immunity and your mood.

A herbal prescription for stress

Nature also has more support for our stressed selves. This comes in the form of a special class of herbs known as adaptogens. Adaptogenic plants help you cope better with psychological, physical and environmental stressors. They help the body to maintain equilibrium by balancing both the SAM and HPA part of the stress response.

There are many herbal adaptogens. I chose the following three to support Emma as they also have an action on the immune system.

Ashwagandha – Withania somnifera

A key herb from Ayurvedic tradition, Ashwagandha is a calming adaptogen which balances the immune system, reduces anxiety and promotes refreshing, healing sleep. It also can support thyroid function to improve metabolism.

Siberian Ginseng – Eleutherococcus senticosus

Although not a true ginseng, Eleutherococcus is useful to support people who always seem to be getting over a cold. They often have dark circles under the eyes, a sign of high cortisol. Russian studies showed Eleutherococcus improves both cognitive and athletic performance.

Astragalus – Astragalus membranaceous

Astragalus supports the production of   white blood cells and helps them work better. It reduces fatigue and may mitigate frequent upper respiratory tract infections.

Emma’s story – a relaxed ending

One month review

Emma reported feeling an increase in her energy after three weeks of the treatment. She noticed she was sleeping better and not feeling a large energy dip in the middle of the afternoon. The throat soreness had gone, and her sinuses were less stuffy (She’d also been doing nasal rinses 4-5 times a week). She’d replaced a couple of her more intense running workouts with a gentle nature walks and noticed her other runs felt easier.

Work still felt busy, and a little stressful but that was due to the transition of responsibilities within her team. She felt this would settle down.

Three month review

Energy levels, motivation and concentration levels were all high. Weekends were no longer about catching up on sleep but catching up with friends. The transition with her team was almost complete. She was enjoying having more time to work on the creative and strategic aspects of her job.

She had one cold during this time but recovered much faster with no lingering symptoms.

Blood tests revealed a normal white blood cell count. Her blood glucose and cholesterol markers had returned to the middle of a healthy range.

The final word

Emma’s case is a typical example of how excess stress and lack of recovery can stifle immune function.

It also illustrates the benefits of combining lifestyle changes, prioritising rest and using a tailored herbal medicine prescription to regain energy and joy for work and life.

 

** Name has been changed for privacy

 

 

 

 

References:

1. Padgett DA, Glaser R. How stress influences the immune response. Trends Immunol. 2003;24(8):444-448. doi:10.1016/S1471-4906(03)00173-X.
2. Glaser R, Kiecolt-glaser JK. Stress-indued immune dysfunction: implications for health. Nat Rev Immunol. 2005;5(March):243-251.