Stress - Conditions with Similar Symptoms

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Eating Disorders. Chronically elevated levels of stress chemicals have been observed in patients with anorexia and bulimia. Some studies, however, have not found any strong link between stress and eating disorders. More research is needed to determine whether changes in stress hormones are a cause or a result of eating disorders.

Diabetes

Stress can exacerbate existing diabetes by impairing the patient's ability to manage the disease effectively.

Pain

Researchers are attempting to find the relationship between pain and emotion, but the area is complicated by many factors, including the effects of different personality types, fear of pain, and stress itself. Evidence suggests that chronic pain may impair the action of neutrophils, thereby weakening the immune response.

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Muscular and Joint Pain. Stress may intensify chronic pain caused by arthritis and other conditions. Psychological distress also plays a significant role in the severity of back pain. Some studies have clearly associated job dissatisfaction and depression to back problems, although it is still unclear whether stress is a direct cause of the back pain.

Headaches. Tension-type headaches are highly associated with stress and stressful events. Sometimes the headache does not start until long after the stressful event has ended. Additionally, stress can contribute to the development of headaches or cause headaches to occur more frequently.

Some research suggests that people who experience tension-type headaches may have some biological predisposition for translating stress into muscle contractions. Among the wide range of possible migraine triggers is emotional stress (although the headaches often erupt after the stress has eased).

Sleep Disturbances

The tensions of unresolved stress frequently cause insomnia, which prevents stressed people from sleeping or causes them to awaken in the middle of the night or early morning. This appears to be due to the fact that stress causes physiological arousal during non-rapid eye movement sleep.

Sexual and Reproductive Dysfunction

Sexual Function. Stress can reduce sexual desire and cause women to be unable to achieve orgasm. The stress response can lead to sexual problems, including erectile dysfunction, in men.

Premenstrual Syndrome. Some studies indicate that the stress response in women with premenstrual syndrome may be more intense than in those without the syndrome.

Fertility. Chronic stress may affect fertility. Stress hormones have an impact on the hypothalamus, which produces reproductive hormones. This effect may lead to changes in a woman's menstrual cycle, as well as a reduction in a man's sperm count. Stress can also reduce sex drive.

Effects on Pregnancy. Old wives' tales about a pregnant woman's emotions affecting her baby may have some credence. Stress may cause physiological alterations, such as increased adrenal hormone levels or resistance in the arteries, which may interfere with normal blood flow to the placenta. Maternal stress during pregnancy has been linked to a higher risk for miscarriage, lower birth weight, and an increased incidence of premature births. Some evidence also suggests that an expectant mother's stress can even influence the way in which her baby's brain and nervous system will react to stressful events. One study found a higher rate of crying and low attention in infants of mothers who had been stressed during pregnancy.

Menopause. A drop in estrogen levels during perimenopause and menopause may be responsible for changes in mood precipitated by stress.

Memory, Concentration, and Learning

Stress affects the brain, particularly memory, but the effects vary widely depending on whether the stress is acute or chronic.

Effect of Acute Stress on Memory and Concentration. Studies indicate that the immediate effect of acute stress impairs short-term memory, particularly verbal memory. On the plus side, high levels of stress hormones during short-term stress have been associated with enhanced memory storage, improved working memory, and greater concentration on immediate events. The difference in effect may be due to how cortisol impacts glucocorticoid receptors in the hippocampus and prefrontal cortex.

Effect of Chronic Stress on Memory. If stress becomes chronic, sufferers often lose concentration at work and home, and they may become inefficient and accident-prone. In children, the physiologic responses to chronic stress can interfere with learning. Studies have connected long-term exposure to excess amounts of the stress hormone, cortisol to a shrinking of the hippocampus, the brain's memory center. It is not yet known whether this shrinking is reversible.

Other Disorders

Skin Disorders. Stress may worsen numerous skin conditions, including hives, psoriasis, acne, and rosacea, and it is one of the most common causes of eczema. Unexplained itching may also be caused by stress. Evidence suggests that experiencing the stress of a traumatic event (parental divorce or separation, or a severe disease in a family member) before age 2 increases the risk of developing eczema.

Unexplained Hair Loss (Alopecia Areata). Alopecia areata is hair loss that occurs in localized (individual) patches. The cause is unknown, but stress is suspected as a player in this condition. For example, hair loss often occurs during periods of intense stress, such as when people are in mourning.

Teeth and Gums. Stress has now been implicated in increasing the risk for periodontal disease, which can cause tooth loss and has been linked to heart disease.

Substance Abuse

People who are under chronic stress often turn to alcohol or tobacco for relief. Stress compounds the damage these self-destructive habits cause under ordinary circumstances. Many people also resort to unhealthy eating habits, smoking, or passive activities, such as watching television when they are stressed.

Alcohol affects receptors in the brain that reduce stress. Lack of nicotine increases stress in smokers, which creates a cycle of dependency on smoking.

The cycle is self-perpetuating: a sedentary routine, an unhealthy diet, alcohol abuse, and smoking all promote heart disease. They also interfere with sleep patterns, and lead to increased rather than reduced tension levels. Drinking four or five cups of coffee, for example, can cause changes in blood pressure and stress hormone levels similar to those produced by chronic stress. Animal fats, simple sugars, and salt are known contributors to health problems.

Review Date: 10/14/2010
Reviewed By: Reviewed by: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).