Psychological Stress and Physical Recovery

Nearly two years into the Covid-19 pandemic, mental health issues have risen a lot. Stress has been one of the main problems that has seen a notable rise. Studies conducted recently, and previously, have shown that prolonged stress has a negative influence on a person’s physical recovery. Even though stress is a natural physiological response, prolonged stress has displayed adverse effects. This has made it an important factor during the management of physical wounds and trauma.

Psychological stress is a mental or emotional strain, often caused by feelings of anxiety, fear, or being overworked. Stressors such as events posing threat, harm, or challenge, are also stress-inducing and are appraised as situational or psychological [1]. During stressful situations, activation of the hypothalamic-pituitary pathway triggers a combination of nervous and hormonal signals to the adrenal glands release adrenaline and cortisol [2], [3]. This influx allows the body to boost its heart rate and energy output via the sympathetic nervous system [2]. Cortisol allows an increase in sugar for energy as well as tissue repair substances [2]. On the other hand, cortisol also suppresses certain systems that are not immediately needed in order to prioritize functions needed for stress response [2].

These responses prove very beneficial as occasional, short-term solutions with body systems returning to homeostasis levels once the stressor has passed [2]. However, if psychological stress continues for a prolonged period, an imbalance in physiological processes may occur causing disruptions, affecting the wound healing process [2].

An enhanced production of glucocorticoids and catecholamines can directly influence several components of the healing process [3]. Considerable evidence from human and animal studies has shown that physiological stress responses are able to retard the inflammatory phase of wound healing [2]. Study samples who had undergone adrenalectomy to prevent glucocorticoid production displayed reduced adverse effects of stress on wound healing [3].

In an experiment using the blisters wound model, couples had their oxytocin and vasopressin levels monitored during a social experiment [3]. Since oxytocin and vasopressin are two important hypothalamic peptides that modulate physiological stress responses, the study tested whether there would be any changes in wound healing duration [3]. In the study, individuals who had more positive interactions with each other had higher plasma oxytocin levels [3]. Higher levels of oxytocin in circulation were associated with faster healing time of the standard blister wound [3]. Additionally, greater plasma vasopressin levels were related to faster healing but only in women [3].

The effects of psychological stress are not limited to just wound healing though. Its effects on the immune system also include impacting effector and regulatory components [1]. This causes increased susceptibility to various infections, reactivation of the latent virus, and impacting the immunoregulatory circuit [1]. Recent research has confirmed that high levels of stress not only have immune-suppressive functions but have effects that alter immunoregulatory networks causing an increased risk for allergic and autoimmune diseases in both young and older individuals [1]. In other words, individuals who are psychologically stressed will not only be more likely to have a weakened immune system, allowing for higher risk of infection but will also present a slower recuperative duration for injury or disease recovery.

Psychological stress has also been associated with increased acid and decreased oxygen and blood flow in the stomach, upsetting the normal bacterial flora in the intestines and can cause gastrointestinal issues [2]. Cardiovascular disease problems were noted, as well as hypertension disrupted sleeping patterns, and increased pain threshold levels [2].

Psychological stress is also an important factor in dealing with patients recovering from physical trauma or surgery [4], [5].

In order to reduce or prevent psychological stress, walking, exercising, sleeping early, and stopping of smoking and alcohol have been proven to against stress and anxiety [5]. Consuming fresh vegetables, fruits, nuts, green tea, fatty fish, turmeric, pumpkin seeds, and taking in lots of fresh water, air, and exposure to sunshine also has great health benefits that reduce stress and fortify the immune system [5].

Given that times have become more stressful for many during this Covid-19 pandemic, it has become important that, as much as possible, we should partake in positive and beneficial activities that would help keep us stress-free and healthy. As someone once said, ‘healing starts in the mind’.

References

[1]

G. J. M. Marshall, "The Adverse Effects of Psychological Stress on Immunoregulatory Balance: Applications to Human Inflammatory Diseases," Immunology Allergy Clinic of North America, vol. 31, no. 1, pp. 133-140, 2011.

[2]

"How stress can affect recovery after an illness or surgery," Glenview Terrace, 2020 July 15. [Online]. Available: https://www.glenviewterrace.com/blog/how-stress-can-affect-recovery-after-an-illness-or-surgery/#:~:text=Participants%20who%20were%20experiencing%20high,suppression%20of%20the%20immune%20system.. [Accessed 4 April 2021].

[3]

J.-P. Gouin and J. K. Kiecolt-Glaser, "The Impact of Psychological Stress on Wound Healing: Methods and Mechanisms," Immunology Allergy Clinic of North America, vol. 31, no. 1, pp. 81-93, 2012.

[4]

R. Moore, "The Impact of Mental Health on Injury Recovery," Performance Health Academy, 20 September 2019. [Online]. Available: https://www.performancehealthacademy.com/the-impact-of-mental-health-on-injury-recovery.html. [Accessed 31 March 2021].

[5]

G. Griffith, "Stress and Surgery: How Psychological Stress Affects Your Ability to Heal," Medwell, 21 August 2020. [Online]. Available: https://mendwell.com/how-stress-affects-your-recovery/. [Accessed 31 March 2021].