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Maintaining Sanity in Times of Stress: How Stress Affects Mental Health


April 25, 2012 | Published by

depressed woman sitting on floor

It’s not hard to see the physical effects of too much stress; things like muscle tension, fatigue, blood sugar imbalances and rising blood pressure (or dropping blood pressure with adrenal fatigue) are easy to recognize. However, sometimes stress takes an even greater toll on areas which aren’t as visible: your emotional health. Stress can contribute to depression, anxiety, irritability, cynicism, interpersonal problems, emotional exhaustion, and suicide. 1, 10

Chronically stressed people have a harder time responding to additional challenges and take a longer time to recover from them.2 Once you’re juggling the maximum number of balls you can handle, tossing in one more can bring the whole act tumbling to the ground and bring you to tears in the corner. This kind of stress puts a strain on your relationships and affects your ability to function at work. It’s hard to be productive when you can’t concentrate or remember details. A 2007 survey grouped stress, depression and anxiety together as the single largest cause of absences due to work-related illness.5

Stress can affect your mood in many ways. Stress hormones such as cortisol interact and interfere with various neurotransmitters such as serotonin and dopamine7 – brain chemicals involved in regulating mood. There is even evidence that exposure to excessive stress causes damage to brain structure in addition to function. 4

A healthy stress response adapts to a challenge by mobilizing resources and energy, and then when the stress is over, shifting back into balance. Cortisol, secreted by the adrenal glands, is the primary stress hormone in humans and its main function is to help the body deal with all kinds of stress. Chronic pain, low blood sugar, or even giving a speech can induce a rise in your cortisol, which comes to the aid of your stressed body: reducing inflammation, raising blood sugar levels, assisting blood flow, and giving you the “edge” you need to meet the challenge. Once the stress is over, cortisol levels should drop and allow your body to rebalance. However, protracted stress can cause chronic cortisol elevation – and irritability, anxiety and depression.

If the stress continues even longer, your adrenals can fatigue with the result that stress response system may not be able to continue to keep pace with the demand for cortisol. At this point, the stressors will still be there, but your ability to adapt to them and handle them will have diminished. Pain and inflammation can worsen, blood sugar levels may drop even lower – resulting in hypoglycemia and the related irritability, spaciness and fatigue. This makes it even more difficult to focus your thoughts or gather the “oomph” to take on any additional challenge, and depression can tighten its grip.

Dealing with stress, depression and its other emotional manifestations is difficult. However, it is possible to intervene in this downward spiral and improve your stress response and your mood.

Continue to part 2 – Stress Management Tips to Save Your Sanity

Dr. Lise NaugleAbout the Author: Dr. Lise Naugle is an associate of Dr. James L. Wilson. She assists healthcare professionals with clinical assessment and treatment protocols related to adrenal dysfunction and stress, and questions regarding the use of Doctor Wilson’s Original Formulations supplements. With eleven years in private practice and a focus on stress, adrenals, hormonal balance and mind-body connection, she offers both clinical astuteness and a wealth of practical knowledge. Dr. Naugle also maintains updated information about the latest scientific research on the hypothalamic-pituitary-adrenal axis function, endocrine balance and nutritional support for stress and develops educational materials about stress and health for clinicians and their patients.



1. Bhui KS, Dinos S, Stansfeld SA, White PD. A synthesis of the evidence for managing stress at work: a review of the reviews reporting on anxiety, depression, and absenteeism. J Environ Public Health. 2012;2012:515874. Epub 2012 Feb 14.

2. Brosschot JF, Benschop RJ, Godaert GL, Olff M, De Smet M, Heijnen CJ, Ballieux RE. Influence of life stress on immunological reactivity to mild psychological stress. Psychosom Med. 1994 May-Jun;56(3):216-24.

3. Chang EC, Hirsch JK, Sanna LJ, Jeglic EL, Fabian CG. A preliminary study of perfectionism and loneliness as predictors of depressive and anxious symptoms in Latinas: a top-down test of a model. J Couns Psychol. 2011 Jul;58(3):441-8.

4. Frodl T, O’Keane V. How does the brain deal with cumulative stress? A review with focus on developmental stress, HPA axis function and hippocampal structure in humans. Neurobiol Dis. 2012 Mar 9. [Epub ahead of print]

5. HSE. Health and Safety Statistics 2006/2007.

6. Kieviet-Stijnen A, Visser A, Garssen B, Hudig W. Mindfulness-based stress reduction training for oncology patients: patients’ appraisal and changes in well-being. Patient Educ Couns. 2008 Sep;72(3):436-42. Epub 2008 Jul 25.

7. Krugers HJ, Karst H, Joels M. Interactions between noradrenaline and corticosteroids in the brain: from electrical activity to cognitive performance. Front Cell Neurosci. 2012;6:15. Epub 2012 Apr 9.

8. Martinsen, EW. The role of aerobic exercise in the treatment of depression. Stress Medicine 1987; 3(2): 93-100.

9. Mikolajczak M, Quoidbach J, Vanootighem V, Lambert F, Lahaye M, Fillée C, de Timary P. Cortisol awakening response (CAR)’s flexibility leads to larger and more consistent associations with psychological factors than CAR magnitude. Psychoneuroendocrinology. 2010 Jun;35(5):752-7. Epub 2009 Dec 2.

10. Spickard A Jr, Gabbe SG, Christensen JF. Mid-career burnout in generalist and specialist physicians. JAMA. 2002 Sep 25;288(12):1447-50.

11. VanderWeele TJ, Hawkley LC, Thisted RA, Cacioppo JT. A marginal structural model analysis for loneliness: implications for intervention trials and clinical practice. J Consult Clin Psychol. 2011 Apr;79(2):225-35.

12. Weir K.F.; Jose P.E. A comparison of the response styles theory and the hopelessness theory of depression in preadolescents. Journal of Early Adolescence, v28 n3 (2008 08 01): 356-374

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