Ginny Estupinian PhD, ABPP

Stress illustration

HOW CHRONIC STRESS IMPACTS YOUR HEALTH AND LONGEVITY

The following is taken from an in-person interview with Dr. Ginny Estupinian, PhD, ABPP

Clinical psychologist Dr. Ginny Estupinian frequently works with patients grappling with various life stressors. In urban America, these common stressors often include:
• High-pressure work environments and long commutes
• Financial strain, including rising living costs and debt
• Relationship challenges and family responsibilities
• Information overload from constant connectivity
• Environmental factors like noise pollution and overcrowding

Most people accept stress as a normal, unavoidable part of life. However, as this article will explore, this acceptance can harm both short-term well-being and long-term health.

As an experienced clinical psychologist, Dr. Estupinian is well-versed in helping individuals find balance and alleviate stress in their lives. Throughout this article, she will share some of the key ideas and strategies she often discusses with her patients who are dealing with chronic stress.

The Ubiquity of Stress in Modern Life

In today’s fast-paced world, stress has become an almost constant companion for many of us. From work deadlines to family responsibilities, financial pressures, and global uncertainties, stressors seem to lurk around every corner. While most of us are familiar with the immediate effects of stress – the racing heart, sweaty palms, and a surge of adrenaline – fewer people are aware of the long-term impact that chronic stress can have on our bodies and overall health.

Dr. Estupinian notes, “Many of my patients come to me feeling overwhelmed by the constant demands of modern life. They often don’t realize how much these ongoing stressors are affecting their physical and mental health.” This chronic stress can lead to a variety of health issues, from sleep disturbances and digestive problems to more serious conditions like heart disease and depression.

Introducing Allostatic Load: The Hidden Toll of Chronic Stress

Enter the concept of allostatic load – a term that might sound unfamiliar but has profound implications for our health and longevity. Allostatic load represents the cumulative wear and tear on our bodies resulting from repeated or chronic stress. It’s like a silent scorekeeper, tallying up the physiological costs of life’s challenges over time.

“Understanding allostatic load is crucial,” Dr. Estupinian explains, “because it helps explain why chronic stress can be so detrimental to our health, even when we might not feel particularly stressed in our day-to-day lives. The accumulation of stress over time can lead to serious health consequences.”

II. WHAT IS ALLOSTATIC LOAD?

Defining Allostatic Load

Dr. Estupinian elaborates, “Allostatic load is a scientific term that describes the physiological consequences of chronic exposure to stress. It represents the price our bodies pay for adapting to life’s challenges over time.”

To understand this concept better, it’s helpful to first consider the idea of allostasis. Allostasis refers to the body’s ability to maintain stability through change. It’s our body’s way of adapting to stressors and maintaining balance. This process is essential for our survival and involves various systems in our body working together to respond to challenges.

However, when we’re exposed to chronic stress, this adaptive process can become overtaxed. This is where allostatic load comes in. Unlike acute stress, which triggers a short-term “fight or flight” response, allostatic load accumulates gradually as our bodies work overtime to maintain balance in the face of ongoing stressors.

Dr. Estupinian adds, “Think of it like a bank account. Each stressor is a withdrawal. Normally, we can make deposits through rest, relaxation, and self-care to balance things out. But when we’re constantly making withdrawals without enough deposits, we start to run a deficit. That deficit is allostatic load.”

THE BODY’S STRESS RESPONSE SYSTEM

To understand allostatic load, we must first grasp how our bodies respond to stress. Dr. Estupinian outlines the process: “When we encounter a stressor, our body activates several systems:

  1. The nervous system releases adrenaline and noradrenaline. These hormones increase heart rate, elevate blood pressure, and boost energy supplies.
  2. The endocrine system releases cortisol, often called the ‘stress hormone.’ Cortisol increases sugar in the bloodstream, enhances the brain’s use of glucose, and curbs functions that would be nonessential in a fight-or-flight situation.
  3. The immune system ramps up inflammation to protect against potential threats. While acute inflammation is protective, chronic inflammation can damage healthy cells and tissues.”

These responses are beneficial in the short term, helping us deal with immediate challenges. For instance, if you’re in a dangerous situation, these changes help you react quickly and effectively. However, when stress becomes chronic, these systems can remain activated for prolonged periods, leading to wear and tear on our bodies – this is allostatic load.

Dr. Estupinian notes, “It’s like keeping your car engine revving high all the time. It might be necessary for short bursts of speed, but if you do it constantly, you’ll wear out the engine much faster than normal.”

III. THE SCIENCE BEHIND ALLOSTATIC LOAD

How Chronic Stress Affects Different Body Systems

Chronic stress and high allostatic load can impact multiple systems in our body. Dr. Estupinian highlights some key areas:

  1. Cardiovascular system: “Chronic stress keeps your heart working harder than it should for extended periods,” Dr. Estupinian explains. “This can lead to increased blood pressure, a major risk factor for heart disease and stroke. Also, stress hormones can increase cholesterol levels and promote plaque buildup in arteries.”
  2. Immune system: While acute stress can temporarily boost immune function, chronic stress has the opposite effect. “Long-term elevation of stress hormones suppresses the immune system, making you more susceptible to infections and slowing wound healing,” says Dr. Estupinian. “It also promotes chronic inflammation, which is linked to a host of health problems including autoimmune disorders and certain cancers.”
  3. Metabolic system: Stress hormones like cortisol affect how our bodies process and store energy. “Chronic stress can lead to insulin resistance, increasing the risk of type 2 diabetes,” Dr. Estupinian notes. “It can also promote fat storage, particularly around the abdomen, which is associated with numerous health risks.”
  4. Brain: The brain is particularly vulnerable to chronic stress. “Prolonged exposure to stress hormones can actually change the structure and function of the brain,” Dr. Estupinian explains. “This can affect memory, learning, and decision-making. It’s also linked to an increased risk of mental health disorders like depression and anxiety.”
  5. Digestive system: “Many people don’t realize how much stress affects their digestion,” says Dr. Estupinian. “Chronic stress can exacerbate conditions like acid reflux, ulcers, and irritable bowel syndrome. It can also change the gut microbiome, which plays a crucial role in overall health.”

KEY BIOMARKERS OF ALLOSTATIC LOAD

Scientists measure allostatic load using various biomarkers. Dr. Estupinian explains some of the most common ones:
• Cortisol levels: “Cortisol follows a daily rhythm, typically peaking in the morning and declining throughout the day. Chronic stress can disrupt this pattern, leading to either consistently high cortisol or an abnormal daily rhythm.”
• Blood pressure: “Consistently elevated blood pressure is a key indicator of cardiovascular strain.”
• Cholesterol levels: “Both high total cholesterol and an imbalance between ‘good’ (HDL) and ‘bad’ (LDL) cholesterol can indicate allostatic load.”
• Waist-to-hip ratio: “This is a measure of abdominal fat, which is particularly sensitive to stress and associated with various health risks.”
Inflammatory markers: “Substances like C-reactive protein (CRP) in the blood can indicate chronic inflammation.”
• Glycated hemoglobin (HbA1c): “This measures average blood sugar levels over the past few months and can indicate problems with glucose regulation.”

Dr. Estupinian adds, “It’s important to note that no single biomarker tells the whole story. Allostatic load is about the cumulative effect across multiple systems.”

Recent Research Findings

Dr. Estupinian points to recent studies showing strong links between high allostatic load and increased risk of various health problems.

“A 2021 study published in Psychotherapy and Psychosomatics found that higher allostatic load was associated with poorer health outcomes in both general and clinical populations,” she notes. “This included increased risk of cardiovascular disease, diabetes, and even mortality.”

Another significant study, published in the Journal of the American Heart Association in 2020, found that higher allostatic load was associated with an increased risk of cardiovascular events, even in people without traditional cardiovascular risk factors.

“What’s particularly interesting,” Dr. Estupinian adds, “is that we’re seeing these effects across different age groups and populations. It’s not just affecting older adults or those with pre-existing conditions. This underscores the importance of managing stress and reducing allostatic load throughout our lives.”

IV. SIGNS AND SYMPTOMS OF HIGH ALLOSTATIC LOAD

Dr. Estupinian often educates her patients about recognizing the signs of high allostatic load. “It’s important to understand that these symptoms can be subtle and develop gradually,” she explains. “Many people attribute them to ‘just getting older’ or ‘being busy,’ but they can be signs of a deeper issue.”

Physical Indicators

• Frequent headaches or migraines: “Tension headaches are particularly common with chronic stress, but some people may experience more severe migraines,” Dr. Estupinian notes.
• Digestive issues: This can include acid reflux, stomach pain, nausea, diarrhea, or constipation. “The gut-brain connection is powerful, and stress can significantly disrupt digestive function,” she explains.
• Unexplained aches and pains: Chronic muscle tension from stress can lead to pain, particularly in the neck, shoulders, and back.
• Frequent illnesses or infections: “A suppressed immune system from chronic stress can make you more susceptible to colds, flu, and other infections,” Dr. Estupinian says.
• Fatigue: Despite getting enough sleep, many people with high allostatic loads feel constantly tired or lack energy.

Emotional and Mental Signs

• Persistent feelings of anxiety or worry: “This can range from a general sense of unease to more severe anxiety symptoms,” Dr. Estupinian explains.
• Difficulty concentrating or making decisions: “Brain fog” is a common complaint among those with high allostatic load.
• Mood swings or irritability: “People might find themselves overreacting to minor frustrations or experiencing rapid mood changes,” she notes.
• Sleep disturbances: This can include difficulty falling asleep, staying asleep, or waking up feeling unrefreshed.
• Depression or feelings of hopelessness: Chronic stress can contribute to or exacerbate depressive symptoms.

Behavioral Changes

• Changes in appetite: “Some people may overeat for comfort, while others might lose their appetite altogether,” Dr. Estupinian says.
• Increased reliance on caffeine, alcohol, or other substances: “These can be attempts to cope with stress or boost energy, but they often make the problem worse in the long run,” she warns.
• Procrastination or difficulty completing tasks: High allostatic load can affect motivation and follow-through.
• Social withdrawal: “People might find themselves pulling away from social interactions, which can further increase stress,” Dr. Estupinian notes.
• Neglecting self-care: This might include skipping exercise, eating poorly, or not taking time for relaxation.

Dr. Estupinian emphasizes, “It’s important to pay attention to these signs and not dismiss them. They’re your body’s way of telling you that something needs to change. If you’re experiencing several of these symptoms, it might be time to assess your stress levels and consider ways to reduce your allostatic load.”

V. THE IMPACT OF ALLOSTATIC LOAD ON HEALTH AND LONGEVITY

Short-term Effects

In the short term, high allostatic load can lead to:
• Fatigue and low energy: “Many people with high allostatic load feel exhausted, even after a full night’s sleep,” Dr. Estupinian explains. “This is because your body is constantly in a state of high alert, which is energetically demanding.”
• Decreased productivity: “Brain fog, difficulty concentrating, and reduced motivation can significantly impact work and daily tasks,” she notes.
• Weakened immune response: “You might find yourself catching colds more often or taking longer to recover from illnesses,” Dr. Estupinian says. This is due to the suppressive effect of chronic stress on the immune system.
• Mood disturbances: Short-term effects can include irritability, anxiety, and mood swings.
• Sleep problems: “Many people experience difficulty falling asleep, staying asleep, or waking up feeling unrefreshed,” she adds.

Long-term Health Consequences

Over time, chronic high allostatic load has been linked to more serious health issues:
• Cardiovascular diseases: “Chronic stress puts a significant strain on the heart and blood vessels,” Dr. Estupinian explains. “This can lead to hypertension, atherosclerosis, and increased risk of heart attack and stroke.”
• Type 2 diabetes: “Chronic elevation of stress hormones can lead to insulin resistance and problems with blood sugar regulation,” she notes.
• Autoimmune disorders: The dysregulation of the immune system associated with high allostatic load can increase the risk of autoimmune conditions.
• Accelerated aging: “We’re seeing evidence that chronic stress can actually speed up the aging process at a cellular level,” Dr. Estupinian says. This includes effects on telomeres and the protective caps on our chromosomes that are associated with cellular aging.
• Cognitive decline: “Long-term exposure to stress hormones can affect brain structure and function, potentially increasing the risk of cognitive decline and dementia in later life,” she warns.
• Mental health disorders: Chronic high allostatic load is associated with an increased risk of depression, anxiety disorders, and other mental health issues.

Relationship Between Allostatic Load and Chronic Diseases

Dr. Estupinian highlights recent research showing that individuals with higher allostatic loads are at greater risk for developing chronic diseases.

She notes that “a particularly striking study using data from the National Health and Aging Trends Study found that each incremental increase in allostatic load was associated with a 47% increase in comorbidity—that is, having multiple chronic conditions—over a five-year period.”

This study, which followed older adults over time, demonstrated that the effects of allostatic load continue to accumulate even in later life. “It’s never too late to start managing your stress and reducing your allostatic load,” Dr. Estupinian emphasizes.

Another significant finding comes from research published in the journal Psychoneuroendocrinology, which showed that higher allostatic load was associated with a 40% increased mortality risk over a 10-year follow-up period.

“What’s particularly concerning,” Dr. Estupinian adds, “is that we’re seeing these effects even in people who don’t have traditional risk factors for these diseases. This suggests that chronic stress and high allostatic load are independent risk factors for poor health outcomes.”

Dr. Estupinian concludes, “Understanding allostatic load gives us a more comprehensive view of how stress affects our health over time. It’s not just about feeling stressed at the moment – it’s about how our bodies carry that stress and how it accumulates over months and years. By recognizing this, we can take steps to reduce our allostatic load and potentially improve our long-term health and longevity.”

LOOKING AHEAD: WHAT’S COMING IN PART 2

As we’ve explored in this first part, understanding allostatic load is crucial for recognizing the long-term impacts of chronic stress on our health and longevity. But knowledge is just the first step. In Part 2 of our deep dive into the allostatic load, we’ll explore practical strategies and solutions to help you manage your stress and reduce your allostatic load.

In the upcoming article, Dr. Estupinian will guide us through:

  1. Factors Contributing to Allostatic Load: We’ll examine how various aspects of modern life, individual differences, and lifestyle choices can increase or decrease your allostatic load.
  2. Measuring Allostatic Load: Learn about current methods researchers use to measure allostatic load and the potential for future clinical applications.
  3. Strategies to Reduce Allostatic Load: Discover evidence-based techniques for stress management, lifestyle modifications, and social support’s importance in mitigating chronic stress’s effects.
  4. The Future of Allostatic Load Research: Get a glimpse into emerging areas of study and the potential for personalized interventions based on individual stress responses.
  5. Practical Steps for Implementation: We’ll conclude with actionable advice on incorporating stress-reduction strategies into your daily life. These strategies can help you control your allostatic load and improve your overall health and well-being.

Stay tuned for Part 2, where we’ll equip you with the tools and knowledge to manage your stress and potentially add years to your life. Remember, it’s never too late to start managing your allostatic load and investing in your long-term health!