Dr. Kerr: Chronic stress hard on immune system

Hot weather is here, the economy is staggering, kids are out of school, traffic is worse than ever (How can all these people still afford the gas to be on the roads?) and stress levels are soaring.

Stress has direct effects on our health, and while some of those effects are helpful to our survival, chronic stress is not good for the human body.

When we are presented with a stressful situation, our body has physiologic responses that were designed for short-term benefits. Heart rate increases, blood pressure rises, and stress hormones are released into the bloodstream to activate survival mechanisms. These hormones increase stomach acid, change insulin needs, release histamines, and depress the immune system.

All these changes are appropriate if the stress is short lived; they help us deal with the situation and respond appropriately. We perform much better in competitions, onstage and during tests when we have good levels of stress going for us.

But if the stress is ongoing, these physiologic changes can be harmful. Persistently increased stomach acids exacerbate ulcers. Diabetics have difficulty controlling blood sugars. People with asthma and allergies have more symptoms. We are much more likely to get sick, since our immune systems have been told to slow down. And the effects of a depressed immune system inconveniently appear during rest and recovery periods, which explains why we tend to get sick on weekends or during long awaited vacations.

But why do some people get sick when stressed and others seem to be less affected? In 1993, researchers identified "high" reactors and "low" reactors. High reactors have greater cardiovascular and hormonal reactions to stressors. Low reactors show fewer responses, only minimally increasing their heart rates and blood pressure. The immune system is not significantly depressed in low reactors. So if you are a low reactor you are less likely to get sick with stress.

The good news is that we can use our minds to help treat our bodies. If you are a high reactor (You know who you are!), you can focus on stress management. Support groups, meditation and exercise can counteract the stress hormone levels and help kick your immune system back into action.

Both high and low reactors are at risk of inappropriate stress reactions if denial is the preferred method of coping. If you are a person who attempts to ignore chronic stress, you may not be sleeping well, but you function well and maybe even avoid the latest flu that's going around.

Then, one day, you may have an episode that is terrifying. It occurs when there is no obvious trigger, seemingly out of the blue. Your heart is pounding, you feel lightheaded, and you are shaking. You are sweating, have shortness of breath, chest pain, and maybe some numbness or tingling in your extremities. You fear you are losing control.

You rush to the emergency room, certain you are having a heart attack, and after a complete and expensive workup you are told it was a stress reaction. A panic attack.

The causes of panic attacks are not clearly understood, but stress can be a trigger. Symptoms are the result of a sudden, unpredictable flood of stress hormones. Imagine a dam holding back the physiologic stress reaction suddenly giving way. Your stomach is full of acid, your heart is racing and your blood flow cannot keep up with the demand. You are being inundated with all the symptoms of stress at once with no chance to control the situation.

There are medications to help with panic attacks, and your physician can help you with a prescription. But being proactive and managing stress appropriately is a more healthful option. Avoiding stress-related illness is within your control.

Your goal should be to try to make stress work for you, so don't expect to get rid of stress altogether. Appropriate levels of stress keep us sharp and functioning well. Make stress work to your advantage by acknowledging and managing it before it manages you.

Dr. Stacey Kerr, a longtime Sonoma County family physician, graduated from UC Davis Medical School and is certified in her specialty by the American Board of Family Medicine. Her columns are not intended as a substitute for hands-on medical advice or treatment. Consult your health care provider before adhering to any recommendations in this column. E-mail comments to drkerr@the-doctors-inn.com.