Stress related autonomic dysfunction and common diseases

Psychological stress may have negative effects on organ function and psychological well-being. Hans Selye considered “stress” as a”non-specific response of the body to any demand for change“. Selye distinguished acute stress responses from the “General Adaptation Syndrome”, i.e. the responses to long-lasting stressors, with an initial alarm phase attempting to maintain homeostatic balance, a “resistance phase” during which coping strategies are activated, and the exhaustion phase when coping mechanisms fail and the person is at risk of disease. The acute stress response described by Walter Cannon as Fight-or-Flight-Response consists of acute sympathetic activation with noradrenaline and adrenaline release and responses preparing the individual for fighting or fleeing. Acute threats trigger central autonomic responses, particularly in the amygdalae and hypothalamus which activates the pituitary gland that secretes ACTH. Subsequent cortisol and adrenaline release contribute to increases in energy levels, blood glucose, lipolysis, heart rate, blood pressure, respiration, myocardial and pulmonary perfusion, pupillary diameter, muscle perfusion, and sweat output but a decrease in skin perfusion. Acute stress may trigger syncope, arrhythmias, coronary artery constriction, Takotsubo syndrome, or sudden cardiac death. Complications of acute or chronic stress are legion and include metabolic syndrome, diabetes mellitus, arterial hypertension, arterial occlusive disease, kidney failure, stroke, myocardial infarction, chronic pain, irritable bowel syndrome, sexual dysfunction, cancer, depression, fatigue, burn-out syndrome, pseudo-dementia, cognitive dysfunction, etc. Options to reduce daily-life stressors include approaches that reduce sympathetic and increase parasympathetic activity, such as physical exercise, breathing techniques, Yoga, Tai-Chi, meditation, prayer, music, progressive muscle relaxation, or autogenic training.