Why stress makes us sick

It has long been known that stress can make people ill. What is less well known is that not only the psyche suffers from negative continuous stress, but also the body. "Chronic stress, especially when experienced in childhood, is a risk factor for the development of frequent neuropsychiatric or cardiovascular diseases later in life," says Isabelle Mansuy, Professor of Neuroepigenetics at the University of Zurich and ETH Zurich.

Isabelle Mansuy, together with Birgit Kleim, psychology professor at the University of Zurich, is leading the new major flagship project of Hochschulmedizin Zürich (HMZ), which bears the simple name "Stress". The project will start on May 1 and is supported with one million Swiss francs, with ETH and the University of Zurich sharing the costs. A five-member steering committee includes professors from UZH and ETH. The project was recently formally launched at the HMZ annual event.

The purpose of the flagship project "Stress" is to understand, diagnose and treat the effects of stress on mental and physical health. Researchers from ETH, the University, the Psychiatric University Hospital and the University Hospital Zurich are participating in the research collaboration. In doing so, they are addressing a socially serious problem, because stress as such has increased dramatically in recent decades and probably reached a peak with the Covid pandemic.

One in four children affected

In general, a distinction is made between healthy eustress and unhealthy disstress. While eustress increases performance in the short term and can be managed well, disstress reduces brain performance, burdens the immune system and makes people ill in the long term.
When we have stress, the body adjusts to an acute dangerous situation. Adrenaline, noradrenaline and corticoids are released, heart rate and blood flow increase, glucose is released and gastrointestinal activity is restricted. It is an involuntary reaction pattern that developed over the course of evolution: In a dangerous situation, the body adjusts to flight or fight. In the process, cortisol attacks important brain cells during continuous stress. In the long term, the stress hormones even lead to physiological and anatomical changes in the brain.

Stress is also common in childhood - caused by physical or sexual abuse, for example. According to WHO estimates, one in four children worldwide is affected by stress - the negative consequences have an impact across the entire lifespan. This is because stress is a risk factor for chronic diseases, including psychiatric diseases, but also cardiovascular diseases, type II diabetes, and neurological diseases such as dementia. Comorbidity, in which several diseases occur simultaneously, is characteristic of people exposed to severe stress.

Spanning disciplinary boundaries

Nevertheless, psychiatric and cardiovascular diseases are rarely considered holistically. This is partly due to the traditional separation of psychiatry and cardiology. This is where HMZ's new flagship project comes in. The Stress Consortium brings together experts in psychiatry/psychology, neuroscience, cellular and molecular biology, cardiology, engineering, and translational bioinformatics to study stress risk and resilience across the life course. "Methodologically, long-term studies are conducted on individuals who have been exposed to stress, and animal models of stress are used for mechanistic studies," explains Isabelle Mansuy.

Recognize and treat alarm signs

For example, a cohort study is planned with over one hundred medical students who complete their internship in a stressful medical setting, such as the emergency department, intensive care unit, internal medicine, or oncology. Six months after the start of the internship, anxiety, depression symptoms, psychosocial functioning, and perceived stress will be recorded as "stress-related psychopathological manifestations." Further interviews over a longer period of time will allow determination and comparison of individual health trajectories within the cohort.

This is a slightly modified version of an article by Marita Fuchs, which first appeared in the "UZH News".