Stress, glucocorticoids and the effects on our brain.

There are still many things we don’t know for certain about COVID 19, but one thing we can say with certainty is how protracted high levels of stress can have an impact on our lives as it relates to health and our immune defense system. And each of us has had to deal with increased demands from added pressures resulting from this global health crisis.

In a recent KFF.org poll nearly half (45%) of responding adults in the United States reported that their mental health has been negatively impacted due to worry and stress over the virus. As the pandemic wears on, it is likely the mental health burden will increase as measures taken to slow the spread of the virus, such as social distancing, business and school closures, and shelter-in-place orders, lead to greater isolation and potential financial distress.

While several of these figures may have changed since this April poll was administered, given phased re-openings of some commerce activities, the effects of what may be dramatic lifestyle changes, economic concerns and more won’t suddenly cease. Nor will the negative impact on brain and mental health just as automatically revert to our current pre-pandemic state.

So what can we do right now to better understand and cope with this “stress isolation” and concurrent loneliness or depression? It’s important to note that loneliness doesn’t just apply to those who live alone – it can occur even if you are surrounded by immediate family in the same home.

Understanding the mechanisms of stress on our system.

A recent journal publication detailed some of the mechanisms in place that occur when we experience stress. In this study,  "Glucocorticoids prime the inflammatory response of human hippocampal cells through up-regulation of inflammatory pathways" (March 2020, Brain Behavior and Immunity), these important points were made:

1.    Increased pro-inflammatory cytokines and an overactive hypothalamic-pituitary-adrenal (HPA) axis have both been implicated in the pathogenesis of depression.
2.    This study showed that glucocorticoids can potentiate inflammatory processes in some circumstances.
3.    The data suggests a mechanism by which stress may prime the immune system for increased inflammation and suggests that stress and inflammation may be synergistic in the pathogenesis of depression.

In response to psychological stress, impulses stemming from the higher cortical areas of the brain are transmitted to the hypothalamus through the limbic system, which is the complex networks in the brain, involving several areas near the edge of the cortex concerned with instinct and mood and that control basic emotions. The subsequent neurotransmitter and hormone release result in the adrenal cortex produces and emits glucocorticoids (GCs, cortisol and corticosterone). This is called the HPA axis and it exists in a critical feedback loop.
Studies have shown that not only does chronic stress affect our mood, but it can also affect the brain with a decrease in hippocampal and prefrontal cortex volumes; these areas are especially critical for memory and cognitive function. With chronic stress, our brain and body become immersed in cortisol and other excitatory neurotransmitters that lead to equally chronic neuro-inflammation. No matter how you look at it, unrelenting and ongoing stress is just bad news for the brain and overall health, particularly if you were already diagnosed with depression.

Reduce stress now and optimize our immune defenses for the future.

We may not be able to control extraneous events that are influencing our lives and affecting so many people – but we can try to control our own responses to it and reduce stressful influences with practical life tenets that are things we can take forward too:

▪ Discover “breathwork,” deep breathing exercises that are like a spa for your brain!
▪ Prioritize meditation and prayer - both are ideal for giving your brain a break from distracting thoughts.
▪ Stay connected even in this time of social distancing. Call, text, use available technology to host online video chats with family and friends who are nearby or afar. Remember that connections are not measured by quantity, rather the quality of your interactions is what offers the most support. Talking to even one person who brings you joy can make a world of difference in your stress response efforts.
▪ Eat real food, not processed, as much as that is possible or available. Get creative with recipe substitutions if necessary and make cooking at home a family affair.
▪ Exercise – take a walk, do yoga or Pilates, find things at home you can use for weights or, health-permitting, try a new activity with one of the many free online classes now.
▪ Take a break from the news and instead, why not take a virtual tour of some of the world’s museums?!
▪ Give back in some way and serve with a full heart and an open mind.
▪ Have a daily gratitude practice.  While it may seem difficult in these times, try to think of just three things for which you are thankful. (And giving back supports your gratitude practice too!)
▪ Try to get seven to eight hours of quality sleep each night and talk to your family physician if you are experiencing ongoing irregular sleep patterns.
▪ Stay focused on being positive. We know it’s not easy, but positivity on some level supports your energy and emotions. If you are having very difficulty coping or managing negative thoughts, reach out to your physician or mental health services in your area for help, much of which is available through telemedicine options right now.
▪ Listen to music that lifts your spirits and soothes your soul!
▪ Body movement and dancing are not only good exercise, they’re mind-freeing and great distractions from negative thoughts.
▪ Make sure to include laughter, self-compassion and self-care in your daily routine.

Finally, I highly recommend you listen to this wonderful podcast with Dr. Vivek Murphy, former U.S. Surgeon General, about the importance of human connection even and especially in this time of physical distancing.
https://www.npr.org/2020/04/20/838757183/a-social-prescription-why-human-connection-is-crucial-to-our-health

Dr. Murphy also wrote a beautiful book “Together: The Healing Power of Human Connection in a Sometimes Lonely World” that you might want to investigate as well for its additional insights and support for your mind and your brain’s wellbeing.

In spite of our circumstances, it really is possible to strengthen our social ties as we also explore solitude, which is very different than being alone. Solitude and looking within ourselves, focusing on what we can do versus what we can’t and accessing the many resources available to change our mindset and reduce stress is not just important – it’s actually quite powerful. And something your brain will appreciate and benefit from today and well into the future.

Zivjjio, to a long and healthy life,  
Dr. Suzanne K. Gazda

Additional resources

Free online workouts:
https://www.shape.com/fitness/trends/free-online-workouts-coronavirus

More about breathwork:
https://www.vogue.co.uk/beauty/article/breathing-exercises-for-stress

https://breathwork-science.org/2019/08/27/what-is-the-4-7-8-breathing-technique/