Stress influences both physiological pathways and health behaviors. The frequent health symptoms are headache, tiredness, sleep difficulties, and musculoskeletal pain
Author: Muhammad Mustafa, Tooba Asif
Stress, anxiety, and depression are pre-eminently present in Pakistan. Stress exists as either a subconscious puzzle or a conscious compulsion. It is an emotional or physical reaction of the body towards a challenge or demand. It is a liability in today’s competitive world that also affects the students. Student life is full of stressful situations in their academic career and youthful pursuits. The main stressors for students are academic pressure, obligatory success, the uncertainty of the future, and complications of integration into the system. Social, emotional, financial, and family problems also disturb their learning capability and academic performance. Stress exerts its effects on the physical well-being, health behavior, and cognition of students. Students that cannot cope with the stress lag while others see it as a challenge and work harder. Long-term stress can be challenging in terms of carrying academic duties and seeking remedial action.
Symptoms of Stress:
Stress influences both physiological pathways and health behaviors. The frequent health symptoms are headache, tiredness, sleep difficulties, and musculoskeletal pain. Stress also causes negative health behaviors such as inadequate diet and lack of exercise. The major players of the stress response are hormones such as norepinephrine, epinephrine, adrenocorticotrophin, and cortisol. Every cell of the body has receptors for one or more of these hormones. So the stress hormones can impact all cells and tissues, informing them about a stressor. Stress response starts with adrenocortical secretion and serum glucocorticoid elevation. This, in turn, triggers the sympathetic nervous system, followed by catecholamines release. The limbic system of the brain provides adaption and neuroendocrine responses to stressors. It also assesses the stress signals and compares them with the stored data of past encounters. Hypothalamus is another brain region that regulates sympathetic activity and endocrine secretion, such as Adrenocorticotropic hormone (ACTH) against stressors.
Stress and Immune System:
The altered equilibrium of hormones under stress influences has a significant impact on the immune system. Many students get sick during periods of academic pressure. It is because there is a bi-directional interaction between the immune system and the Central Nervous System (CNS) mediated by the endocrine system. Neurohormones produced by the Hypothalamus-Pituitary-Adrenal (HPA) axis and immune cells both use plasma to reach their target site. Moreover, immune cells also have receptors for many neurohormones. This interaction results in changing cellular activity via secondary messenger activation and affecting the production of cytokines. Stress reduces the immune system’s ability to fight antigens, resulting in an increased risk for infections.
On the other hand, cytokines can feedback to the brain and bring changes in the HPA axis. They also induce sickness, appetite loss, changes in sleep patterns, and depression. Adrenal glands produce a stress hormone called cortisol. It happens to release on waking up, during exercise, and under acute stress. Under normal circumstances, cortisol maintains homeostasis and monitors the energy requirements of the body. If elevated, it can impose adverse effects on body weight, immune response, and create risks for chronic diseases. Cortisol reduces inflammation in the body. However, in chronic inflammation due to distress, the cortisol level keeps rising, suppressing the immune system. It makes the body susceptible to colds and allergies and increases the risks of cancer and autoimmune diseases.
Stress and Weight Gain:
Some students face the problem of weight gain and unnecessary cravings during stressful periods. Cortisol activates the sympathetic nervous system, preparing the body for fight and flight under stress. It provides the body with glucose stored in the liver and increases the blood pressure to deliver the oxygenated blood. However, prolonged stress elevates cortisol levels, increasing the blood glucose level leading to an increased risk of diabetes. Cortisol is also responsible for weight gain as it relocates the stored triglycerides towards the visceral fat cells in the muscles and abdomen. It also develops adipocytes into mature fat cells. Cortisol directly impacts appetite as it binds to the receptors in the hypothalamus. It has an indirect influence on cravings via the modulation of stress responding factors related to appetite stimulation.
Stress and Gastrointestinal Issues:
Gastrointestinal issues are also common among students during the examination period. The parasympathetic nervous system is essential during quiet periods, such as eating, so that the body could utilize the food energy and the hormones and enzymes needed for digestion can work properly. As cortisol activates the sympathetic nervous system, it suppresses the parasympathetic nervous system as both cannot work simultaneously. Food consumed under these conditions causes indigestion. Also, the inflammation of the mucosal lining can occur, thus causing ulcers. Adrenaline is another stress hormone that can cause ulcers.
Hormonal problems are also common these days among youth. Along with cortisol, adrenal glands also produce androgenic sex hormones. Excess production of cortisol may hinder the optimal production of these hormones impacting their role in the body.
Stress and Sleep:
Sleep issues are also becoming normalized among students and they have the deepest effect on their cognition. Sleep loss can be a cause or an effect of stress. Many research studies associate the loss of sleep with amplified anxiety. In a healthy individual, the loss of one night’s sleep triggers a neural pathway. This pathway includes the hyperactivity of the amygdala and dorsal anterior cingulate cortex (dACC). It also relates to the hypoactivity of the medial prefrontal cortex (mPFC) and an impaired coupling between the amygdala and mPFC. Amygdala is the core emotional processing region. These alterations cause an increased reactivity to negative emotions and decreased psychological control, leading to anxiety.
Insomnia is one of the outcomes of stress. Evidence suggests that the wakefulness-promoting area of the brain also affects the neural response towards stress. Moreover, one of the reasons for the changes in the immune response is stress. The changes may include thymus involution, T cells apoptosis, and granulocyte suppression. The neural circuitry involving stress-induced insomnia and an altered immune response consists of HcrtLH and CRHPVN neurons. HcrtLH are the neurons that control the transition from sleep to wakefulness. Data suggests that the connection between the two neurons is responsible for stress-induced insomnia. Also, the activation of CRHPVN leads to stress-induced immunosuppression.
Sleep deprivation is responsible for reduced attention due to limited cortical response to the incoming stimuli. Also, the elevated levels of adenosine, a neuromodulator, inhibit proper neural activity. The loss of one night’s sleep can disturb the process of strengthening the newly learned information. Chronic sleep deprivation is a chronic stressor and has adverse effects on the immune system and nervous system. The negative consequences of sleep loss are more conspicuous on the tasks that require one’s attention. Prefrontal Cortex (PFC) has a central role in behavioral effects due to sleep loss. It is a neocortical region and has a role in top-down processing. Alleviated function in PFC is responsible for impaired attention and cognitive processes. Sleep deprivation can also affect the Hippocampus that functions as the learning and consolidation center for newly learned information. Sleep loss impairs its functions reducing the cognition processes.
These facts illustrate that stress consumes our youth in a way that they cannot express their true abilities. Today’s student is lethargic, de-motivated, and self-involved. This kind of lifestyle can never lead to the success of an individual or a nation as a whole. Students are the brightest minds in any society and have the potential to exploits their hidden talents, but stress and anxiety hinder this ability. One may blame our educational system for that, but it is a much smaller hurdle if one has to achieve greatness. The true struggle is to overcome our anxieties and fear, to face them, and be successful.
Literature suggests that approximately one in ten students need professional help to alleviate stress levels. Encouraging students to see the academic pressure as a challenge to excel in studies is one way of doing it. A healthy and balanced life can also reduce stress levels. Physical exercise reduces the sympathetic nervous tension and cardiovascular response to psychophysical stress. Exercise has a tranquilizing effect as it lowers cortisol levels. A stressed person has a low ability to perform physical work and it may lead to cardiovascular diseases. Physical exercise can be efficacious in reducing the risk of such diseases as well as in promoting psychological health. It is critical to form a habit of getting sleep at night as daytime sleep increases the cortisol level. No matter how many academic deadlines are at hand, a good night’s sleep is always better for cognition rather than staying up with a stressful mind.
A healthy diet can also lower stress levels and inflammations. Coffee has now become a power drink among students, however, it is a significant contributor to inflammation. Sugar-containing items are comfort food as they reduce the cortisol release against a stressful situation, but constant intake of sugars due to cravings keeps cortisol levels afloat. Dark chocolate, black and green tea, prebiotics and probiotics, maintaining hydration can decrease cortisol levels. Literature suggests that mindfulness-based stress reduction is helpful to reduce stress among students. It is one’s strategic self-awareness of stressful thoughts and their acknowledgment and understanding. In simpler terms, one becomes the objective observer rather than the victim of stress. Studies also indicate that this technique alleviates cortisol levels. So understanding the adverse effects of stress on the mind and the body and adapting the simple coping strategies can be the first step for a student to ease up a stressful life.
Forman Christian College University, Lahore Pakistan