#28 Stress-Driven Inflammation: How Stress Can Worsen Arthritis (and What to Do About It)

So what exactly is stress? Well, it's the body's ancient alarm system, and some of you may be familiar of the story of, you know, uh, being chased by a tiger and that fight or flight, uh, and also fawn and freeze mechanisms of stress.

It's a biological response.

It's a cascade of chemical and electrical signical- signals designed to keep you alive.

And the feeling of stress is just the surface because underneath it, it's one of the oldest survival systems in the human body.

And when your brain perceives a threat, and it doesn't have to be a real physical threat either, and this can also be different from person to person, so one person's stress may not be another person's stress, so it can also vary from person to person.

But whether it's a physical threat, you know, if somebody is coming at you in a, in a stressful way, [laughs] or it's an emotional threat, you know, maybe a memory of something, a worry about the future, that can kick off what's called the stress response.

And two things, two main systems, I should say, light up.

So the first is the sympathetic nervous system, which gives you that familiar surge of adrenaline, you know, the faster heart rate, the shallower breathing, the tension in the muscles, pupils dilating, digestion grinding to a halt.

And then the second sort of slightly slower system is in the HP ac- HPA axis, which is the hypothalamic pituitary adrenal axis, and this releases cortisol from the adrenal glands.

Well, it sends a signal which then releases the cortisol from the adrenal glands.

And cortisol gets, you know, a bad reputation, [laughs] but in the short term, cortisol is actually anti-inflammatory, and we actually use synthetic versions of cortisol.

They're the steroid injections that we use to calm inflammation and calm inflammatory flares.

So the problem, you know, isn't really cortisol itself, it's the problem that, that we have when cortisol doesn't switch off or never gets the opportunity to switch off because the stress is just constantly-Constantly there.

So acute stress and chronic stress.

And similarly, there's acute inflammation and chronic inflammation as well.

So they're very, they coexist and they're, and they're quite similar.

So, you know, acut- acute stress might be you see a bus coming, so you jump out of the way, and then afterwards your heart rate settles and your body returns back to its baseline, and the whole kind of episode, biological episode of that may just be a few minutes, and, you know, it can even be good for you.

So say, for example, you are really close to a deadline, and you feel stressed about it, but actually that stress in a way can be good.

It sharpens your focus, it boosts memory consult, so, so, it boosts memory consolidation, and it can briefly strengthen our immune system, and it's sometimes called eustress, which is the helpful kind.

And then chronic stress is, or distress, um, that remains chronic, is what happens when the alarm system never really gets that all clear, never really gets the opportunity to switch off because you are in a constant state of stress.