Stress and the Adrenal Glands
The General Adaptation Syndrome (GAS)
- The GAS has proven useful for many years by providing a model of how stress-induced illness arises and giving clinicians some insight into how to manage stress related conditions in their patients.
- According to Selye, there are three stages of stress response: alarm phase (acute stress); resistance phase (chronic stress); and exhaustion phase (burnout).
- Stress can include not only psychological stress but any insult to the body that may tax the adrenal gland function, including chronic infections, allergies, exposure to chemical toxins, use of stimulants (such as caffeine and nicotine), poor nutrition, physical trauma, steroid use, chronic low blood sugar and drug use, pharmaceutical and otherwise. For example, many people develop adrenal exhaustion after a physical trauma, such as a car accident, after an acute exposure to toxins in the workplace, or after an extended course of steroid treatment.
Alarm Phase (Acute Stress)
The alarm phase of the GAS occurs when a stress is first encountered and an alarm is sounded in the body. This alarm, sometimes called the fight or flight response, is associated with an activation of thesympathetic nervous system.
Hormonally we see an increase in cortisol release from the adrenal cortex, and epinephrine from the adrenal medulla. This response is a normal defense mechanism that occurs when the organism is threatened, and serves a critical function by stimulating the organism to respond to the threat at hand. Once this phase is over, the body goes through a 24 to 48 hour period of recovery, during which one desires primarily to rest.
However, this response can be considered non-adventageous when the hormonal release is not appropriate for the situation (i.e. in states of hyper-vigilance, chronic anxiety syndromes, post-traumatic stress disorder). Animal studies of prolonged alarm reactions associate this stage with weight loss, gastric ulcers, and immunosuppression.
Resistance Phase (Chronic Stress)
Due to the challenges of modern life, for many people the perceived stressors are not short term but chronic. In this second phase of the GAS, the organism is still reacting to the perceived stress, but some of the outwardly observable signs of stress are different.
Levels of cortisol and epinephrine are still elevated. This chronic elevation results in weight gain, although the person may appear to have returned to normal functioning. Immunity and inflammatory responses are still suppressed, and there is an increased susceptibility to infections, tumors, arthritis, allergies, and autoimmune conditions.
In addition, chronically elevated adrenal hormone levels may lead to depression, hyperlipidemia, atherosclerosis, high blood pressure, diabetes, osteoporosis, and other degenerative diseases.
Exhaustion Phase (Burnout)
Chronic stress can eventually lead to the exhaustion phase, characterized by deficient glucocorticoid and mineralocorticoid production, sometimes combined with episodic releases of excess epinephrine. This is commonly known as adrenal exhaustion.
Adrenal exhaustion is associated with decreased resistance to stress, premature aging, and if left uncorrected, even death.
Conditions that are common in this phase of the GAS include allergies, chronic fatigue syndrome, fibromyalgia, hypoglycemia, multiple chemical sensitivities, irritable bowel syndrome, hypotension, insomnia, hypothyroid, lack of motivation, and anxiety disorders.
